Dr Griffiths explained that changes in the skin commonly attributed to an older appearance are actually due to cumulative sun (UV) exposure.

Intrinsic ageing, due to the passage of time and genetics, results in thinning of the outer and middle layers of skin, reduction in the production of natural skin oils and increased water loss from the skin; the subsequent visual impact of fine lines and wrinkles is actually quite subtle, she noted. 

Dr Griffiths stated however that photoageing or photodamage results in the degeneration of collagen and elastin in the skin with the formation of deep, coarse wrinkles, leathery texture and the loss of skin elasticity. Loss of support around blood vessels leads to purpura (a red, flushed appearance) and telangiectasia (thread or spider vein) formation, lentigenes (also known as freckles, age or liver spots) develop due to abnormality in skin pigment.

Dr Griffiths commented that consumers are bombarded with information on anti-ageing creams which claim to prevent or reverse skin changes associated with photodamage, however noted that much of it is misinformation.

She explained that when it comes to photodamage, only the following is true:

Dr Griffiths also highlighted that growth of the multi-million pound cosmeceutical industry demonstrates the public’s insatiable appetite for youth and beauty.

She demonstrated that the numerous topical products available vary in their efficacy for photoprotection and rejuvenation. Effective skin hydration (moisturisation) from such products results in temporary improvement of appearance, but must be differentiated from those agents which successfully repair damaged collagen and other aspects of skin photoageing. Some of them may have potential, she noted, but robust evidence in the form of controlled trials is often lacking.

Dr Segall reminded us that mesotherapy is defined as:

“the practice of using microinjections of conventional or homeopathic medicines, vitamins, minerals and amino acids intradermally (into the skin) to deliver a therapeutic or corrective treatment to a specific area of the body.”

Although originally applied solely to alleviate pain, following the publication of three works by Dr. Michel Pistor in 1952, its use has expanded into every field of general medicine and surgery and in 1987 it was recognised as a speciality in its own right by the French National Academy of Medicine.

1. Little
2. Infrequently
3. In the right place.

Dr Segall highlighted that mesotherapy has been successfully incorporated into aesthetic medicine, both as a “stand alone” and “complementary” treatment, to prevent and alleviate the signs of ageing due the age related loss of collagen, elastin, and hyaluronic acid. Cosmetic Mesotherapy, also known and marketed as Mesolifting or Mesoglow, is the technique of infusing the skin with polyvitamins, amino acids, anti-oxidants and Hyaluronic Acid to stimulate energy and new cell activity and replace their age-related loss.

In order to explain this, Dr Segall detailed that healthy skin depends on: 

• A healthy microcirculation, both to constantly replenish the supply of nutrients and to remove the waste products, especially the damaging free radicals.
• Hyaluronic Acid to both capture and retain water molecules and provide the optimum environment for collagen production.

With increasing age, our skin loses natural hyaluronic acid and its microcirculation becomes sluggish. This decreases the amount of oxygen in the cells and allows the build up of damaging free radicals which further accelerate the ageing process. Fibroblast (cell that produces collagen) activity decreases with consequent loss of collagen and elastin. Clinically this results in skin thinning, a duller, drier complexion and the appearance of fine lines and wrinkles to due to increasing skin laxity.

Based on this, Dr Segall stated that Cosmetic Mesotherapy acts specifically to stimulate production of new cells within the skin and replace the age related loss of hyaluronic acid. This stimulus is the key to the rejuvenation process. In order to do this the products are infused directly into the skin using the multiple microinjection technique.

Dr Segall highlighted the main details of the treatment as follows:

• Injections can be performed manually using a standard syringe and 4mm mesotherapy needle or by using a mesotherapy gun.
• Side effects are rare and usually attributable to poor technique.
• Injection pain is mild and usually well tolerated.
• The number of treatment sessions will depend on the condition of the skin. On average, 2 treatments are given monthly for the first 2 months, followed by monthly treatments for 2 - 3 months. Maintenance is on average 3 - 4 sessions per year once skin quality has been restored.

In summary, she emphasised that by acting directly on skin quality Cosmetic Mesotherapy both prevents and corrects the effects of skin ageing.

Skin care by skin type – Dr Leslie Baumann

Dr Baumann explained that in the 1930s, 4 basis skin types were described by Helena Rubinstein: Dry, Oily, Combination and Sensitive. However the Baumann Skin Typing Systems uses 4 main parameters to establish 16 different skin types. These parameters are Oily or Dry, Sensitive or Resistant, Pigmented or Non-Pigmented, and Wrinkled or “Tight”. Dr Baumann highlighted some misconceptions about these parameters by explaining that “pigmented” does not refer to whether a person is of black or white skin colour, but whether a person is prone to pigment changes such as melasma or freckles. Also, the “wrinkled” or “tight” parameter is not denoted by your age and whether you currently have wrinkles but by your skin’s tendency to wrinkle and thus acquire them or more of them as you age.

The New York Times bestselling book The Skin Type Solution will be published in the UK in July 2006.  It contains a list of products on the UK market specific for each skin type.  Dr. Baumann does not have her own skin care range; instead the book discusses hundreds of readily available brands and over 200 products currently on the UK market.

Dr Katz introduced us to Laser Lipolysis (brand name LASERLIPOLISI® using the Smartlipo® device), a minimally invasive advanced technique for removing localised collections of fat in the areas that are normally resistant to dieting and physical exercise; basically a laser-assisted liposculpture treatment with a totally revolutionary concept.

It is an innovative liposuction technique using a pulsed Nd:YAG laser system. The light energy emitted by the laser source is conveyed in a thin fibre optic protected by a 1-mm stainless steel cannula so that it does not affect the tissue along its length.

The interaction between the laser energy and the fat cells causes the breakdown of their membranes, resulting in a leakage of their contents which is then dispersed in the spaces in the surrounding tissue. He explained that this is not the only effect of the laser light because there is also a reduction of bleeding and it promotes collagen retraction and skin shrinkage, producing skin tightening. Dr Katz also noted that this method is more precise and less traumatic than conventional liposuction with so many important advantages to be considered as the new frontier in lipo-sculpture.

Dr Katz went on to outline his own treatment protocols for this new device. He stated that when carrying out Laser Lipolysis, the anaesthesia used may be local, epidural, or general; however he prefers to use this technique only with local anaesthesia for sessions limited at one to one and a half hours. A small incision of 2 mm is made, where the cannula is introduced. The surgeon then controls the motion of the cannula by a handpiece; speed must be relatively slow, as compared with conventional liposuction, in order to allow the necessary time for the laser–tissue interaction. After the laser lipolysis, the liquid fat can be removed using suction or a standard syringe.

According to Dr Katz, the results give rise to a harmonious body shape in a short time, without the secondary effects of more aggressive procedures, such as conventional liposuction.

In summary, Dr Katz outlined the advantages of the SmartLipo® device: