Updated: Oct 21
Human skin ageing is a complicated process, which has left many scientists struggling for answers.
It is the result of two biologically independent processes.
The first is intrinsic or genetic aging, an unpreventable process, which affects the skin in the same pattern as it affects all internal organs.
The second is extrinsic ageing, which is the result of exposure to external factors, mainly ultraviolet (UV) irradiation, that is also referred to as photoaging. Other factors being smoking, pollution, unhealthy lifestyle etc.
Intrinsic skin ageing is influenced by hormonal changes that occur with age, such as the gradual decreased production of sex hormones from the mid-twenties and the diminution of estrogens and progesterone associated with menopause.
It is well established that the deficiency in estrogens and androgens results in collagen degradation, dryness, loss of elasticity, epidermal atrophy and wrinkling of the skin. Elevated levels of degraded collagen and reduced collagen synthesis are pathologies occurring in intrinsically aged as well as photo-aged skin.
Daily external injury, in addition to the normal process of ageing, causes loss of moisture. The key molecule involved in skin moisture is hyaluronic acid (HA) that has unique capacity in retaining water. Skin ageing is also associated with loss of skin moisture. The key molecule involved in skin moisture is hyaluronic acid. Youthful skin retains its turgor, resilience and pliability, among others, due to its high content of water.
WHAT IS HYALURONIC ACID?
HA is a naturally occurring sugar found in our body, which soaks up 1000 times its weight in water like a sponge!
Functions of HA include the following: hydration, lubrication of joints, a space filling capacity, and the framework through which cells migrate.
The synthesis of HA increases during tissue injury and wound healing and HA regulates several aspects of tissue repair.
HA also provides the framework for blood vessel formation and fibroblast migration. Fibroblasts are cells that make collagen.
HYALURONIC ACID IN SKIN
HA accounts for most of 50% of total body HA.
The HA content of the dermis (second layer of skin) is significantly higher than that of the epidermis.
The HA of the dermis is in continuity with the lymphatic and vascular systems. HA in the dermis regulates water balance, osmotic pressure and ion flow and functions as a sieve, excluding certain molecules, enhancing the extracellular domain of cell surfaces and stabilizes skin structures by electrostatic interactions.
HYALURONIC ACID AND SKIN AGEING
The most dramatic histochemical change observed in ageing skin is the marked disappearance of epidermal HA.
All of the above age-related phenomena contribute to the apparent dehydration, atrophy and loss of elasticity that characterizes aged skin.
Premature aging of skin is the result of repeated and extended exposure to UV radiation.
Approximately 80% of facial skin aging is attributed to UV-exposure.
The physiological reduction of HA activities in the aged skin contributes to dermal thinning and the formation of folds and wrinkles.
Photographs of the treated area before the treatment and 1 month after the second treatment (T2).
WHAT IS PROFHILO?
The procedure of HA injections in the dermis, defined “viscosupplementation,” restores the skin tone, fullness, and elasticity, although native HA remains stable in the dermis only for few days due to the quick degradation by hyaluronidase.
For this reason, chemically stabilized cross-linked HA filler has been developed to prolong dermal stability. Profhilo is a novel high- and low-molecular-weight HA hybrid complexes, injected into the skin.
Although the majority of dermal fillers are made from hyaluronic acid, Profhilo is not a traditional dermal filler.
The molecule chains of both high and low molecular weight non-animal hyaluronic acid are heat stabilised and fused together creating a unique patented hybrid complex, to form a gel which spreads and becomes integrated into the skin.
Profhilo is injected into the skin in a specific pattern depending on the area to be treated. Two treatments are required, 4 weeks apart. The first to stimulate, the second to ‘boost’ and ensure longevity. In some cases, and depending on your initial skin quality, you may benefit from a third treatment, typically 8 weeks from your second treatment.
Profhilo is used to treat skin laxity and improve skin quality. It can be used to treat skin laxity and skin quality, almost anywhere, common indications include;
o The face
o Inner arms.
Generally, patients report an overall improvement in skin hydration, brightness, smoothness and firmness.
Treatment with hyaluronic acid is safe, but not risk free, the clinician will discuss all the risks and benefits with you at consultation and again prior to treatment.
Anaesthetic cannot be used and is not necessary for this treatment. The injections sting briefly, but patients generally report only a mild discomfort. After the treatment, you may experience some tenderness for the first 24- 72 hours.
Longevity does vary between individuals, but results are expected to be gained over a period of 4-6 weeks and last for approximately 6 months. If you choose not to maintain the results with further treatment, your skin will return to its pre-treatment state over time.
Most people can continue with normal activities. Some will have some redness, pin prick marks. Bruising is possible.
The product is injected in small ‘deposits’, you may be able to see them initially, but they settle usually within hours. It may be possible to feel the product where it has been injected under the skin. It will settle, there is no need to massage.
o Make-up should not be worn for 12 hours
o You are advised to avoid alcohol and vigorous exercise for 48 hours
o Avoid sun bathing, and extremes of heat or cold for 14 days post treatment. Any bruising may take a few days to appear, arnica can be helpful in clearing bruising. It is advisable to avoid aspirin and alcohol for 12-48 hours after treatment.
o Tenderness should settle as swelling and bruising goes down.
Profhilo is without doubt the number one cosmetic intervention at my London practice. My largest patient cohort is made of elegant women who want to age well! They want to look the best for their age but not appear ‘done’.
Due to the pure nature and superior hydrating abilities of Profhilo, it has been magical for patients who suffer post-menopausal dryness and other drying skin disorders.
Coupled with the Morpheus 8, this has been a game changer at my Cosderm UK London Clinic. It is simple, available at a reasonable cost of £300, minimal downtime and delivers amazing results.
There is no going back once you have experienced the magic of Profhilo!
Dr Surbhi Virmani