It may seem as if new developments to combat aging skin are being introduced faster than the speed of light. At the forefront of the research, dermatologists are underpinning these advancements, refining the basic understanding of how the skin ages in order to develop more effective non-invasive cosmetic procedures and products. Now, as an alternative to laser light -- used successfully for years to make skin appear younger -- dermatologists are investigating electricity.
"Electrical devices are integral to medicine, as physicians use low-level electricity to stimulate bone growth, reduce chronic pain, pace the heart and even improve hearing," said dermatologist Patricia K. Farris, MD, FAAD, clinical assistant professor, Tulane University, New Orleans. "As dermatologists, we use electrical devices daily in our practices when removing unwanted growths and stopping bleeding after surgery. Based on these proven medical capabilities, electricity has been studied in the cosmetic arena to further improve aging skin."
Electric Devices: The Good, the Bad, and the Future
Dr. Farris explained that the first attempts to use electricity in cosmetic procedures were aimed at stimulating facial muscles. Low-level electrical stimulation has been shown to increase muscle mass and muscle tone, and it was thought that electrical stimulation of facial muscles might be useful to build up the supporting structure of the skin, elevate soft tissue and improve facial contour. While many of these early electrical devices were designed to use at home to improve signs of aging and were sold directly to consumers, Dr. Farris noted that the results from these devices (known as galvanic skincare devices), were less than stellar.
"Although the majority of these devices have not been tested, they are generally believed to be ineffective by the scientific community," said Dr. Farris. "In one study where patients using two different at-home electrical stimulation devices were evaluated by blinded reviewers after four months of use, the reviewers examined before and after photos and were unable to detect any differences in the appearance of aging skin in patients who used these devices. Unfortunately, many of these at-home electrical devices are still being sold today via the Internet -- with no scientific basis for their claims of improving aging skin."
A more effective electrical technique for non-surgical skin lifting is in-office radiofrequency (RF) treatments. RF devices deliver electrical energy deeply into the skin, changing electricity into heat. Dr. Farris explained that studies show it is the tissues' inherent resistance to the electrical current that generates the heat, which causes contraction of thin membranes running through the fat in the deep layers of the skin, resulting in an immediate tissue tightening.
"RF devices have not replaced traditional surgical face lifting, but significant improvement in neck sagging, jowl and cheek contour, and eyelid and brow drooping have been documented," said Dr. Farris. "The latest generation of RF devices delivers energy using the fractionated technology adapted from lasers, and studies show that fractionated radiofrequency (FRF) may be more effective than traditional radiofrequency at skin lifting because it induces both collagen and elastin formation."
Another new technique using electricity to improve aging skin that is currently being evaluated is electoporation (EP). With this technique, electricity is used to physically enhance skin penetration through high voltage, short duration pulses applied to the skin.
"While research is preliminary, electoporation has been shown to effectively enhance skin penetration of molecules and water-based compounds.
It is possible EP will enable us to deliver compounds such as skin nutrients and growth factors to the skin far more effectively in the future and ultimately help reduce the signs of aging," said Dr. Farris.
Cosmeceuticals Get a Charge of Electricity to Improve Aging Skin
Most cosmeceuticals marketed for aging skin use chemicals to improve the appearance of the skin, but Dr. Farris noted that now the principles of electricity are beginning to be used in these products to create "bioelectricity" to alter cellular activity of the skin. For example, a cream with a metal in it is placed on the skin, followed by another cream containing a different metal. The metals applied to the skin have opposite charges, which act like a battery -- similar to electric stimulation techniques to reduce muscle or nerve pain.
"Much of what we know about bioelectricity comes from our study of wounds, which appear to generate a low level of electricity that starts the healing process," said Dr. Farris. "Interestingly, it also has been shown that aging skin has lower levels of bioelectricity, resulting in poor wound healing, and reduced collagen and elastin formation. This is an exciting area of research, and more studies on these electrically based cosmeceuticals will help us further understand their capabilities and the duration of aesthetic improvements that can be expected."
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