The protein collagen maintains healthy and wrinkle-free skin, but as you age your collagen levels decline. The good news: Collagen can be restored!
By Georgetta Lordi Morque
UPDATED FEB. 12, 2022
What’s the secret behind a youthful complexion? Many MDs and skin care specialists will say “collagen.” This miracle protein is the most abundant in our bodies; it provides our skin with strength and structure and plays a vital role in skin cell renewal.
But alas, the production of collagen declines with aging. By age 30, a woman begins to lose one percent of her collagen levels each year. By pre-menopause and menopause, the reduction is significantly more frequent and, as a result, wrinkles and sagging occur; mature skin may look like it needs a drastic overhaul. The good news is that collagen can be restored through a growing number of treatments that revitalize the skin. What can you realistically expect and how do you determine the best methods for your needs?
“Everyone produces collagen and everyone’s collagen breaks down. The balance changes as we age,” says Hooman Khorasani, MD. Prior to starting his practice, Dr. Khorasani was Chief of Dermatologic and Cosmetic Surgery at Mt. Sinai Hospital for a decade. He adds that smoking and exposure to direct sunlight can also contribute to collagen breakdown.
Fraxel fractional laser technology can be ablative or non-ablative depending on the amount of skin damage. . . . . . . . . . . . .
Cosmetic laser procedures and state-of-the-art technologies have become the collagen-restoring treatments of choice for many who desire a smoother and more youthful appearance. With infrared light or visible light wavelength, laser-based technology heats up the collagen deep beneath the skin’s surface, causing the skin to contract and tighten which in turn, stimulates the regeneration of one’s natural collagen. There are many different types of lasers to rejuvenate the skin and build collagen while also treating more surface area issues, such as acne scars and uneven pigmentation. The more well-known lasers are the Fraxel or fractional laser technology and CO2 laser treatment. Thermage, a popular therapy introduced ten years ago, has also proven effective by using radio frequency energy rather than light to heat the skin.
Dr. Khorasani’s practice offers more than a dozen types of laser-based treatments, each designed to help in different ways to tighten and resurface the skin and to restore collagen. Dr. Khorasani considers these devices options for women seeking a non-surgical facelift. Lasers are considered non-invasive or minimally invasive since there are no incisions or needles and anesthesia isn’t required. At Dr. Khorasani’s practice, sometimes a topical lidocaine cream is used or, in select cases, a small dose of Xanax. Laser procedures have less downtime than traditional facelifts and the costs are much lower. Prices for most cosmetic laser procedures at Dr. Khorasani’s practice range from $600 to $4,500.
Typically, the lower energy lasers, or non-ablative lasers that don’t impact the outer surface of the skin, would require at least two treatments for the best results with little downtime. The higher energy lasers or ablative lasers, which are more invasive and result in more downtime, would require one treatment. Results can last from upwards of a year, depending upon the individual. Women with fair skin show more of an improvement than those with darker skin.
Choosing the type of laser depends on one’s needs. “Some patients have more fine lines, others have wrinkles or tissue laxity,” says Dr. Khorasani, who provides a customized approach for each patient. Identifying the problem will determine how deep a treatment you need and how often you need treatment. How much can lasers help turn back time? Dr. Khorasani has seen a five to ten-year difference. “Generally speaking, the more you age the more you need.”
Other methods to restore collagen production include microneedling, (shown below) a minimally invasive technique of applying needle punctures in the outer surface of the skin to stimulate collagen production, and Sculptra, a cosmetic injectable that restores facial volume and stimulates collagen buildup.
It’s important to be careful in choosing a treatment and a practice. “Every procedure has a risk,” warns Dr. Khorasani, who recommends asking this question to evaluate a facility: If something happens—excessive burning or a medical issue—will you be taken care of? “We’re in an era where everyone wants to be in the cosmetic business. If something sounds like it’s too good to be true, it’s probably not true.”
For best practices at home he suggests exfoliating, which is good for skin cell turnover, electronic brushes and the topical vitamin A derivative, Tretinoin, a prescription treatment known by such brand names as Retin-A, Atralin and Avita, which can be helpful. Sunscreen should also be used daily to prevent further collagen loss.
Advanced skin care procedures including laser therapy are so widespread now that you can find treatments in dermatology practices, plastic surgeons’ offices and medical spas. Technology seems to be advancing quickly and new types of devices are available to do more and more. I had the opportunity to try out The Collagen Bar, a skin lab that opened this past year in Manhattan and Greenwich, Connecticut.
I went to The Collagen Bar in Greenwich operated by Diana Seo, a Korean American biophysics graduate who initially performed facials on her own face to treat her acne. Eventually she became a certified aesthetician and skin care specialist with advanced training from the Atelier Esthétique Institute of Esthetics and worked with plastic surgeon Dr. Charles Thorne. The Collagen Bar uses the FDA-approved Forma, a radio frequency therapy that has been in the U.S. for about four years. Similar technology has been successfully treating women in Asia and Europe for more than five years. The Forma heats the skin to stimulate collagen production and can be used on the face, including upper and lower eyelids, nasolabial folds, jowls, smile lines and neck. It can also be used on upper arms, the abdomen and other areas that need contraction.
During my treatment, Diana used the Forma device, which reminded me of an ultrasound, to massage areas of my face with a gel for around 10 to 15 minutes. I was a bit nervous, but all I felt was heat, however it was not overly hot. The Forma, Diana explained, has built-in temperature controls that measure heat levels automatically, so there are no hot spots. Afterwards I noticed a slight redness. At first my skin was plumper and my wrinkles were less pronounced. But as I had only one session, after a couple of days, my skin looked the same as it did before the treatment.
For more effective results that last up to a year, a series of six to eight treatments scheduled a week or two apart are recommended. However, the fact that I did see initial improvement was very promising. “I’ve gotten results for everybody, from 20% to 90%,” Diana told me. “Results vary since everyone is different.”
The Forma treatment can be followed by The Collagenizer, a proprietary technology that uses the skin’s water-base intercellular channels to facilitate the transdermal delivery of medical grade collagen directly into the skin (see diagram at right). This involves no needles and patients typically feel vibration, but no pain. The device infuses macromolecules of collagen, hyaluronic acid and vitamins using a low reversed polarity current. The Collagenizer provides an additional boost, yet patients often attain their desired results after a series of Forma treatments. “What’s great about the system is that it’s all non-invasive,” says Diana.
Pricing for the Forma treatment starts at $1,300 for six sessions for one area. Better deals are available for two or more areas. The Collagenizer is $200 per session or $960 for six sessions. The results are very positive. A client from the Upper East Side said she is extremely happy with the results. “I haven’t received this many compliments from my friends in years! I look more refreshed and my lines & wrinkles have almost disappeared. It’s already been over a year, but I come in for maintenance every few months. This treatment has been my secret weapon against aging.”