Skin Maintenance – optimisation of anti-aging results

A holistic approach as outlined below gives the best results, namely, to address your skin’s chronological age from the outside in (skincare, peels, lasers, devices), & the inside out (diet & lifestyle). Read more to understand our services & the ethos behind sensible supplementation & nutrition. 

Anti-aging procedures are designed to turn back time. Depending on the procedure, we can achieve up to 20 years with only one procedure. Skin maintenance treatments are designed to keep you staying young & refreshed. 

Skin maintenance procedures have a much lower downtime & associated costs compared to reversal treatments. 

Though we use many different skin maintenance treatments at Cutis Dermatology, our top 4 are-

• Laser Assisted Retinoid Infusion or LARI. This combines the most powerful ingredient in skincare, namely retinoids with a lower power laser. This treatment is so good that it not only maintains skin quality, but also reverses skin aging. 

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• Clear + Brilliant laser is a mini-Fraxel laser resurfacing treatment & can be used in all skin types. Downtime is only 48 hours. 

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• Picoway Laser Toning is great for darker skin types. This improves skin quality, reduces pigmentation & erases fine lines, wrinkles & pores. Zero downtime procedure that works. 

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• Skin care is an essential part of skin maintenance. Our experts will guide you as to the optimal ingredients for your skin type. 

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Mainstream skin care ingredients are the key to effective maintenance for your skin. This includes- 

• Sunscreen: twice daily protects collagen & reduces pigmentation.
• Antioxidants: including ferulic & ascorbic acid, tocopherol & resveratrol
• Vitamin A: including retinoids, retinol & retinaldehyde
• Vitamin B: including niacinamide or B3 & nicotinamide orally
• Vitamin C: protects the skin from damage, aids in collagen production
• AHAs: are powerful exfoliants to improve dull skin 

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Antioxidants help in two ways, firstly with reduced oxidative stress to your body. Antioxidant rich foods include grapes, nuts, fish, legumes, green leafy vegetables & wine, in moderation.

Antioxidants found in skin care products can reduce UV & environmental stressors to skin, including collagen. They include-

• Vitamin C, or ascorbic acid
• Vitamin E or tocopherol
• Ferulic acid
• Green tea
• Ginseng 
• Niacinamide
• Resveratrol
• Co-enzyme Q10 

Chemical peels are awesome at slowing down the aging process, they can be divided into maintenance peels, including retinoic acid peels, glycolic & lactic acids. Or age reversing peels including Jessner TCA & phenol peels. 

In the context of maintenance peels, downtime is minimal (0 to 3 days), & only costs $120. They should be performed as a series of peels (3-5) over a period of a year.

• For skin types 1-3 (fair to medium skin): the Clear & Brilliant is the best way to maintain your skin’s texture & quality. It cost $460, & you only require 2-3 sessions annually. Downtime ranges between 2 to 3 days. Learn more (link to Clear & brilliant laser in the laser section)For skin types 3+ to 6 (medium to dark skin): the Picoway laser is the best. This provides safe & effective maintenance of collagen & improves the clarity of your skin. Downtime ranges from 6 to 24 hours at most. Cost ranges from $490 to $690+

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LED phototherapy including Healite & Omnilux are awesome at wound healing & treating acne, they do not give quantifiable results in the context of anti-aging. Sure, the theory behind ‘red light’ & “orange light’ stimulation of collagen sounds promising, however in reality the clinical outcomes are not seen. 

At Cutis we employ more effective treatments including Pico Toning, Laser Toning, Vascular Lasers, chemical peels & fractional lasers. They work. 

Microneedling is performed by our dermatologist in the correct context, namely, to improve hair growth, or as a method to increase the delivery of skin care actives into the deeper layers of skin. Can microneedling be used to maintain your skin’s age? Yes, but there are far better methods including lasers, energy devices & clinical peels. 

If you are keen on microneedling, book a consultation with our therapists. We use Derma Pen, SkinPen, rollers & stampers. Tip: DIY microneedle at home with a 0.1 to 0.2 stamper or roller, add some actives. Do it every 2-4 weeks, save some money, & spend it on more effective treatments. 

In correct subjects, threads are a good way to maintain skin turgor & firmness. Contrary to advertisement, PDO threads are not designed to lift. 

Our nurses & dermatologist apply threads very differently compared to other clinics. We apply them en masse in specific vectors. We do not scatter them as you see on social media. Vector lifting is-

• More effective
• Uses less threads, & saves you money
• Supplemented with devices to provide optimal contraction 

Suitable candidates have a thick layer of collagen that has minimal overlying photodamage. Book a free* nurse consultation at our Brisbane clinics to see if this treatment is correct for your skin & concerns. T&C apply.

There is evidence that foods rich in antioxidants can reduce the risk of photodamage & signs of aging. The largest study was conducted in Queensland by QIMR. 

Essentially, eat foods high in antioxidants including grapes, nuts, fish, legumes & leafy green vegetables, & wine in moderation. You can do your research on Pubmed, as this study was done by Prof A. Green, Brisbane, Queensland.

The use of collagen supplements is controversial, here is our take on it. There are two large studies from Japan that have suggested that collagen supplements can reduce aging. The scientific evidence, based upon degradation of collagen in the GI tract to sorter chain peptides, then to amino acids is unlikely to translate into skin benefits, however, we encourage collagen supplements because-

• There is good evidence that they work for joint health, & osteoarthritis
• They are harmless, & cost effective

So, if collagen supplements are your thing, knock yourself out, at least your joints will thank you. 

In the context of slowing down the aging process, there is good evidence that bioequivalent hormone therapy can slow down chronological aging. Take for example age related atrophy of the female genital tract, estrogen creams work!

Mainstream bioequivalent hormone replacement measures hormone levels including estrogen, testosterone & human growth hormone.  These levels do require monitoring. Ideally you should be just to the right of the 50th centile on a bell curve. 

Our dermatologists do not offer this service, as it requires frequent monitoring. You will need to see an anti-aging doctor for this. 

There is good evidence that intermittent fasting has anti-aging effects. There are however no long-term studies that have shown evidence that it extends to skin benefits, however, as skin is the largest organ of the body, it is highly likely that this translates to beneficial effects. 

There are many ways to fast, a sensible & easily attainable method is 8 hours of eating window, followed by 16 hours of fasting. Most of our dermatologists follow this method. 

There is good evidence that sensible use of metformin can help reduce the aging process, including reduction of visceral fat. We know many dermatologists & plastic surgeons who are on low dose (500 to 1000 mg) metformin. 

We do not provide this prescription; you will need to see an anti-aging doctor for this. 

There is good evidence that resveratrol & NMN are powerful anti-aging tools. 

Resveratrol: There is evidence that resveratrol works synergistically with NMN. Resveratrol is needed to activate the sirtuin genes that protect our DNA. 

Benefits of Resveratrol include:

• Promotes youthful gene expression similar to calorie-restricted diets 
• Supports healthy insulin response & mitochondrial function
• Helps maintain already-healthy glucose levels
• Supports a healthy inflammatory response & helps inhibit oxidation
• RDI ranges from 500 to 900 mg daily

NMN & Nicotinamide Riboside (NR) : falls into a category of supplements referred to as NAD boosters.

NAD is required for cellular function to aid in energy production. NAD production declines with age. With supplementation we can boost the cellular level of NAD closer to youthful levels. NMN acts synergistic with resveratrol to activate sirtuin genes. 

Many dermatologists (at least those who have read the latest literature), will encourage supplementation of nicotinamide. Refer to next FAQ. 

Dr Devita Surjana, dermatologist at Cutis Dermatology has contributed to ground-breaking Australian research showing that nicotinamide, a form of Vitamin B3 reduces the risk of non-melanoma skin cancers & solar keratosis. For those with a high risk of skin cancer, supplementation is recommended. B3 can reduce the risk of non-melanoma skin cancer by as much as 23%.

DNA damage from UV radiation from the sun interferes with your cells’ immune system resulting in accelerated growth of skin cancer.

Nicotinamide may help to reduce the risk of skin by replenishing cellular energy, which also enables faster and more efficient DNA repair following exposure to the sun. It is also an effective antioxidant. 

Vitamin B3 appears to be an effective & low risk treatment that works best in people with the highest levels of risk, i.e. those who have had multiple NMSC. The RDI is 500mg twice daily. 

LED masks are marginally effective in the treatment of acne. In the context of providing effective & sustained collagen simulation, the answer is no. Even in clinic low level laser emission devices do not stimulate enough collagen to effectively show any difference. Save your money & get a mini laser or a chemical peel.

Microcurrent devices have a role to play in the correct patient. Ideal candidates are those with a moderate to thick dermal layer with little or no elastosis or sun damage. They are suitable for mild laxity in patients aged in their early 30s to early 50s. The clinical outcome is perceived firmness & not objective skin lifting- contraction. 

Immediate dermal collagen contraction can be expected in ideal candidates. Microcurrent devices are biased to darker skin types such as Asian, Middle Eastern, African American & Islander skin (based upon probability & not possibility).

No. It is a really bad idea. Plasma has a very high chance of scarring due to uncontrolled energy levels. In the best case, it leaves dots of pigment that last between 4 to 18 months. In the worst case, it leaves pucker & divots that last a lifetime. There are far better ways to rejuvenate your skin safely & effectively.