Treating Sun Damage
With increasing knowledge, the environmental and medical fields have teamed up to educate the public about the dangers of the sun’s ultraviolet radiation (UV rays). The two types of rays, UVA or long wave and UVB or short wave, cause dangerous alterations of skin cells, leading to both medical and cosmetic harm. Tan skin forms when UVA rays trigger melanin, or skin pigment cell production as a protective mechanism. When the skin darkens through this natural form of sunscreen, the sun’s rays are not as readily absorbed by the skin. While wrinkles and skin damage are thought to be caused by UVA rays, sunburn of the uppermost layers of skin is caused by UVB rays, which have higher energy. Both types of radiation are suspected to contribute to skin cancer. While daily broadband SPF use and other measures are recommended, many people already exhibit signs of aging due to a lack of proper sun education and protection. Dr. Rubinstein, a facial plastic surgeon of Laser & Cosmetic Surgery Specialists, PC in Newburgh, NY performs a number of procedures to combat sun damage, including chemical peels & HydraFacials, various laser therapies, non-surgical skin tightening including Thermage, and cosmeceuticals.
While the name and procedure resemble the popular spa treatment, the facial, HydraFacial is innovative in its multifaceted care of the skin. Dr. Rubinstein’s HydraFacial patients will experience the next generation in skin exfoliation, combining this essential step with deep cleansing, extraction, and hydration of the skin. HydraFacial can be fully customized with different add-on steps to create a treatment plan that focuses on the patient’s specific needs.
HydraFacial can best be described as a coupling of microdermabrasion and chemical peel (read more about these individual treatments in the sections below). The procedure begins with a manual cleansing of the skin, followed by a special vortex exfoliation process that utilizes water to break up deposits in the skin, like natural oil and cosmetics. The skin may then undergo a light steaming to prepare it for the topical acid application. Patients may choose from various acid solutions, including GlySal™, which is an acid peel that combines glycolic acid and salicylic acid to loosen skin debris for the extraction phase. Next, extractions of whiteheads, blackheads, and other accumulated imperfections rid the skin of biomaterial and environmental components, smoothing its texture of and unclogging the pores. A single handheld device with different head placements performs each of these steps during HydraFacial, though manual techniques can be added as well. Additional topical solutions that can be added to HydraFacial are:
- Brightalive – a brightening serum that lessens skin discoloration
- DermaBuild – an antiaging serum to improve lines and wrinkles, tone, and texture
- Growth factors – lessens the appearance of lines and wrinkles and improves overall skin health
- Britenol – targets sun-damage and dark spots
The same wand that administers all the other functions during HydraFacial also provides an intense moisturizing session with hydration contain antioxidants, peptides, and most importantly, hyaluronic acid. This is ideal for parched, UV-affected skin. HydraFacial is non-ablative and non-invasive, but effectively targets skin problems to provides more youthful skin of the face, neck, and chest. HydraFacial is a soothing, pain-free experience that can be repeated on a monthly basis.
Microdermabrasion for Sun Damage Concerns
Mechanical exfoliation of the skin is a procedure commonly performed by a medical professional at a facial plastic surgeon or dermatologist’s office, or by a licensed aesthetician within a medical spa setting. Microdermabrasion is similar to using a facial scrub, only the procedure and results are amplified. Those with sun-damaged skin can benefit from its polishing effects, and a more youthful-looking face.
During the non-invasive treatment session, the skin is thoroughly cleansed of oil, bacteria, and cosmetics as well as any environmental pollutants. A handheld device that sprays tiny crystals or sometimes diamonds from its exfoliation tip is used to buff the skin by making repeated passes across its surface, which is held taught by the device’s operator. Most microdermabrasion wands also have a light suctioning action to collect the dead skin cells the device sloughs off. Through this abrading process, a fresh layer of cells becomes the outermost epidermis, and the remaining micro injuries encourage collagen and elastin to form in the area, which firms up the skin. Microdermabrasion is designed to combat the following cosmetic side effects of UV damage:
- Smooth fine lines and wrinkles
- Fade brown spots and hyperpigmentation
- Reduce the appearance of enlarged pores
While microdermabrasion provides exfoliation through the high-quality grit of crystals or diamonds, chemical exfoliation creates a fresh layer of uppermost skin through a controlled acid treatment of sun-damaged skin. During the in-office procedure, patients will be treated with a solution that effectively eliminates the layers of skin containing the most UV-induced changes.
Chemical peels are available through Dr. Rubinstein’s med spa in different strengths, targeting different layers of the skin with different benefits. Glycolic acid is the most potent of the alpha hydroxyl acid group, and is the best solution for the epidermis, our outer layer of skin. Glycolic facial peel addresses conditions varied conditions of the skin, from acne to dryness. It can even treat texture and tone by smoothing fine lines and creating more even pigmentation of the face, chest, or hands. There is no recovery period necessary for this light peel. The medium-strength chemical solution, TCA peel (for trichloroacetic acid), is intended for issues that affect deeper layers of skin. TCA chemical peels are best suited for skin with blemishes and acne scars, and will also improve the look of wrinkles and age spots. Like glycolic facial peels, TCA facial peels can also even out skin discoloration. Due to further penetration of the stronger acid solution, TCA recovery may last between three and five days.
Photodynamic Therapy to Treat Aging from the Sun
Photodynamic therapy (PDT) is literally light action, just as the name implies, working at the skin’s cellular level to combat unwanted changes often produced by sun exposure. Also called blue light therapy, this treatment works in conjunction with a solution called Levulan. The scientific description of this chemical is abbreviated as ALA for amino levulenic acid. Levulan, a photo sensitizing molecule, is applied topically for an hour. It gets absorbed preferentially by pre-cancerous and sun damaged skin cells. A laser or blue light is used to activate the Levulan killing the precancerous and sun damaged cells leaving the normal cells intact. The benefits of this treatment are beneficial for both the look and health of the skin. Laser facial with Levulan is used off-label to reverse sun damage like fine lines, wrinkles, and enlarged pores. This in-house system can also minimize the effects of inflammatory rosacea, acne and acne scars. Its most important contribution, however, is to the medical field as it can eliminate certain types of cancerous and pre-cancerous cells from the skin. Actinic keratosis and other forms of the disease that are found closer to the surface of the skin are targeted with precision, without invasive techniques. The procedure can be repeated as many times and Dr. Rubinstein recommends for the treatment site. The result is healthier & more youthful looking skin.
The intense pulsed light treatment, which is also referred to as photofacial, is a broad-spectrum light treatment with an output between 400-1200nm. Dr. Rubinstein uses the ICON Palomar, the gold standard in IPL to treat various skin concerns that occur as the result of unprotected sun exposure, such as melasma and broken capillaries. Discoloration and vascular irregularities often appear in the red to brown color ranges, pigments that IPL targets in the skin. The light beams are absorbed by areas containing these issues and over time, the body rids the affected sites of darkened skin cells and visible blood vessels. Though not technically a laser therapy, this light treatment can provide similar results in certain cases. Patients who also want some skin tightening along with sun damage reduction, are offered Laser Genesis.
Fraxel Dual 1927/1550
This innovative 2-in-1 device operates on an output of two wavelengths (1927nm and 1550nm) that target different depths of the skin. The dual laser treats both superficial issues of sun damage, like pigmentation concerns, enlarged pores, and deeper damage, like creases. The laser promotes the formation of collagen, and improves the skin from the inside out by strengthening deeper structures of the skin. In addition to the cosmetic benefits provided by Fraxel Dual, the laser removes pre-cancerous cells and strengthens the skin, improving its overall health. Patients who have more advanced sun damage would opt for this procedure over IPL as it also treats wrinkles and firms the skin. Dr. Rubinstein also offers Clear & Brilliant, a “mini Fraxel” for patients who have early sun damage and are not quite ready for the more intense Fraxel Dual.
Skin Tightening for Skin Aged by Sun Exposure
While much of anti-aging medicine focuses on smoothing the texture of the skin, Thermage is also performed to tighten areas of loose, lax skin. The sun’s rays can cause and exacerbate the breakdown of collagen in the skin that contributes to an aging appearance. They penetrate through deeper layers and affect the skin from the inside out. Thermage counteracts the changes by providing a radiofrequency heat energy treatment to the skin that initiates collagen growth for firmer, smoother skin.
While face lift, neck lift, and eyelid surgeries produce instant results, they are more invasive than Thermage. Because this skin-heating treatment produces changes to three layers of skin, contouring results will be more apparent over time. The aesthetic effects of Thermage are long-lasting and appear very natural. Patients can undergo a full face treatment to target each area of the face, tightening the skin around the forehead and eyes to the folds around the nose and mouth, all the way to the jawline. Other popular areas to be tightened include crepe skin on the arms, knees, inner thighs and abdomen. One main difference between the capabilities of Thermage and laser treatments is that Thermage is safe to be used on all skin types. Thermage can be performed as a standalone procedure, or in conjunction with dermal fillers or facial plastic surgery.
Laser Lift Precision TX
When sun penetrates the various layers of skin, it damages underlying collagen and can impact future production of this connective tissue, causing skin laxity. When affected by ultraviolet radiation, patients can develop features like nasolabial folds and jowls. Sometimes a double chin or “turkey waddle” appears as a result of damaged or diminished collagen. A minimal amount of fat is present in the face, and can become displaced over time with the shift in skin placement.
Although Dr. Rubinstein performs many neck lifts and facelifts, he finds that many patients are not ready go under the knife. In the past, facelift or lower facelift surgery was the only way to address each of these concerns. Dr. Rubinstein was the first to offer his patients the Laser Lift Precision Tx in the Hudson Valley, utilizing a minimally invasive 1440 nm ND:YAG laser for minimal down time skin tightening. Laser energy is delivered below the skin, directly where cosmetic issues occur. A small cannula is guided through a small skin opening the size of a pencil tip where it heats up fatty deposits while also emitting thermal energy below the skin to jumpstart collagen remodeling. Laser Lift Precision TX has been clinically proven to provide cosmetic results following treatment that will be visible in the following months, improving a patient’s aesthetics over time. Skin tightening and the elimination of excess fat restores youthful contours to the lower face. Results can last 3 to 5 years.
Topical Cosmeceuticals for Sun-Damaged Skin
Dr. Rubinstein operates a successful plastic surgery practice and medical spa, and has worked to develop his own line of skin care products called RubinsteinMD Skin Science. Patients seeking treatment can also benefit from the application of medical-grad skin care to supplement their in-office treatment with an at-home regimen. Dr. Rubinstein recommends the following items to improve skin that has been damaged over time through sun exposure:
A form of vitamin A, retinols are a powerful group of products that effectively reverse the effects of premature aging that results from sun damage. Typically, retinols, an active ingredient, are prescribed for nighttime use as sunlight can cause the various formulas to become inactive. Retinods are formulated to promote skill cell turnover, so fresh, new cells are present in the skins upper layers rather than older cells that cause lines and wrinkles to form. Dark spots are also improved through topical retinol treatments.
The best known antioxidant is vitamin C, which naturally occurs in our skin as well as many foods we eat. Antioxidants work to correct free radical damage that is caused by the sun. Some antioxidants like vitamin C also have brightening properties, and can fade dark spots of the skin. Ingesting vitamin C can improve a person’s aesthetics as well.
Growth factors are present in a patient’s own platelet-rich plasma (PRP), which can be extracted from a treated blood sample. Often times, PRP is combined with a minimally invasive treatment like microneedling, so the reparative molecules can gain access to the deeper layers of skin. Growth factors are also available in cosmeceuticals, like SkinMedica TNS Essential Serum, which also contains antioxidants and proteins. This serum smooths the texture of the skin while working to decreases the depth of lines and wrinkles. It can even soften the look of enlarged pores.
Hyaluronic acid, which is found in the human body, has the amazing ability to attract and absorb water molecules at up to 1,000 times its weight. Hylauronic acid is a main component of many injectable fillers, like Juvéderm and Restylane products. These injections plump areas of skin that can benefit from extra volume. As far as topical hyaluronic acid (HA) products, HA-5 by SkinMedica combines 5 different forms of the ingredient in a line of products that include the Rejuvenating Hydrator, Lip System Smooth, and Lip System Plump. Dr. Rubinstein also has his own product line called Refining peptide gel. Through optimal hydration of the skin, the hyaluronic acid products help the skin restore its own supply of this essential hydration booster.
Candidates for Sun Damage Treatments
Patients who are best suited for treatments to reverse the physical side effects of aging have obvious changes to the skin that can be improved by procedures offered by Dr. Rubinstein or a skilled member of his aesthetic staff. Patients with cancerous skin lesions may require treatment to address their skin health, and a thorough assessment to ensure patient safety. By setting up a consultation at Laser & Cosmetic Surgery Specialists, PC, patients will have the opportunity to discuss ways to improve their looks and the health of their skin.
Sun Damage Treatment FAQs
Can more than one non-surgical treatment be performed to aging skin?
Yes, and it is often the case that Dr. Rubinstein’s patients undergo one or more cosmetic treatments to improve the skin of the face. In cases where a patients request a laser facial and liquid facelift, he may suggest undergoing the laser session and after a one or two week healing period, the facial fillers can be administered. The spacing between the popular combinations ensures that each treatment is maximally effective.
Are treatments for sun damage painful?
Aesthetic medicine is continually offering improvements to existing procedures or newer procedures that are more comfortable to undergo. Many elective treatments do not offer health benefits, so patients make the choice to see the doctor for enhancements. To provide the best possible experience, these visits are as pain-free as possible. During Thermage, a cooling tip counteracts the heat emitted from the hand piece, while a topical numbing solution can treat the skin prior to a microdermabrasion or microneedling procedure.
Does Dr. Rubinstein’s offer additional surgical and non-surgical solutions to aging and sun-damaged skin?
Dr. Rubinstein specializes in facial plastics and skin care, and has numerous solutions to combat existing UV damage. His treatment options range from plastic surgery, to in-office treatments, and even at-home regimens for patients to follow. During a consultation with the doctor and his staff at Laser & Cosmetic Surgery Specialists, PC, people have the opportunity to explain their concerns while the doctor will provide different plans that best suit their needs. Each treatment is customized entirely for total patient satisfaction.
Ran Y. Rubinstein, MD
Ran Y. Rubinstein, MD, a top-rated facial plastic surgeon in New York, is recognized for his innovative treatment options, surgical expertise, and extensive knowledge of laser resurfacing techniques. Dr. Rubinstein is a physician educator on the latest injectable treatments including Botox and dermal fillers. His practice is also designated a laser training site by Cynosure- Laser Lift Precision Tx, a National Luminary Site for Cutera, -Laser Genesis, Secret (RF microneedling), Juliet (vaginal rejuvenation laser). Rather than focusing solely on ways to improve one’s looks, the doctor is skilled in various aesthetic options than also improve skin health for long term benefit. The dual board-certified doctor is accepting new patients seeking to enhance their looks after too much time spent in the sun.
New patients can fill out a Patient Contact Form or call the office at 845-863-1772.