What are the best treatments to stimulate collagen production in the face?

Question

I have lost almost a stone in weight over the last year through exercise, eating less sugar and greatly reducing alcohol intake to only an occasional drink. While my body is like a 20 year old again I have lost volume in my face especially around the sides of my chin which now have wrinkles! I have 48 and have chronic atopic ezcema which unfortunately most often affects my face Can you recommend any laser treatments or LED therapies for my skin type? I am not keen on getting fillers thanks

Jason Emer, MD · Answer

"I suggest reaching out to an expert for a formal consultation. I like to recommend my patients start a combination of facial rejuvenation treatments.

1) Skincare with products and microneedling/PRP
2) PDT Light Therapy a few times per month with growth factors
3) Laser treatments like Clear + Brilliant regularly and others (Fraxel, Moxi, Viva, CO2, Erbium, Halo) a few times per year
4) Sculptra injections a few times per year for collagen production with fillers like Juvederm, Restylane, Belotero, Radiesse, and/or Bellafill
5) Thermage/Ultherapy for yearly skin tightening with or without PDO or cone-based Instalift threads for lifting
6) Botox every 2 to 3 months to stop movement lines and prevent lines at rest

Best, Dr. Emer."

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

William Groff, DO · Answer

One of the best ways to stimulate the production of new collagen and elastin is through skin resurfacing with Fraxel lasers. You can either choose Fraxel Re:Pair or Re:Store. Re:Pair is a CO2 ablative laser that has about one week of social downtime. You only need one treatment to get a significant improvement. If you want to reduce the downtime that comes with Fraxel Repair, then choose Fraxel Re:Store, which is nonablative and has minimaldowntime. You will need more than one treatment with this laser to get the same results as you would with Re:Pair. Be sure to consult a board-certified dermatologist who has experience resurfacing the face with Fraxel to get the most benefits.

Adam Scheiner, MD · Answer

Dear Ash,Skin wrinkles are primarily due to past sun damage. To improve past sun damage requires procedures that cause the skin to renew its-self.I've had success using lasers to help sun damage and improve wrinkles.I'll include some links below.I hope this was helpful.

Bruce E. Katz, MD · Answer

Thank you for your question. Treatments such as Microneedling and PRP can help stimulate collagen. Please make sure you get a in person consultation from a board-certified dermatologist.

Charles M. Boyd, MD · Answer

Hello Ash, thank you for your question. In our practice, we generally recommend the CO2 fraxel laser for skin resurfacing, improvement of pigment, pores, and fines lines, and overall skin tightening. The treatment is done in the office and only has a few days of downtime. I would recommend setting up a consultation with a board certified plastic surgeon to determine what treatment is best for you. Best of luck.

Narin (Joe) Apisarnthanarax, MD · Answer

Hello Ash and thank you for your question. As we age or go through weight loss, we lose volume and fat in various parts of the face. Congratulations on your weight loss! I recommend a Consultation with an expert who can asses the areas where you are experiencing volume loss for best treatment options. Treatments that help create collagen are lasers such as, Microneedling, Fraxel, Clear & Brilliant, IPL Photo facial.. etc. Radio-frequency treatments such as, Ultherapy and Exilis. Finally, Filler works great for achieving volume. Sculptra is collagen stimulating injection that rebuilds areas where there is volume or bone loss. Best of Luck!

Jake Wardwell, DO · Answer

Aside from fat grafting to the face, which in even the most skilled hands relies on the ability of the graft to stay where it is injected and not break down, there are a few other options. 
Lasers can stimulate collagen and increase the tone of the skin. I would use Halo (2-3 ideally) to achieve this goal.
 Looking at the underlying cause of your eczema and the fat malabsorption that often times comes with it can help your body restore its own volume naturally. I have restored volume to patient’s faces by addressing digestive issues causing fat breakdown that leads to a gaunt appearance in the face countless times. If you are not absorbing fats and have an imbalance of the microbiome (which is the case with eczema the majority of the time) causing the body to release excess amounts of cortisol then facial wasting will continue whether you inject more fat into the face or not. 
Another mechanism for increasing fat volume in the face is to inject stem cells or PRP into the native fat in the face, which stimulates pre-adipocytes (baby fat cells) to mature into new native fat. This mechanism of restoring fat was only recently discovered in the last 10 years or so and is the preferred method for many plastic surgeons who used to do fat grafting. This creates a much more natural appearance and avoids the possible complications of facial fat grafting, which can be disfiguring. 
Facial fat grafting can turn out amazing and is an option but there are other less invasive options that may replace the need for fillers or fat grafts and in some cases are the more definitive solution.

Mary C. DuPont, MD, FPMRS, FACS · Answer

Collagen loss begins in your 20's and amounts to amount 1-2% per year.  This loss of collagen results in less skin elasticity and firmness.  When you lose weight, you lose facial volume as well and that results in greater prominence of wrinkles.  To replace volume loss you need to use a filler.  This filler can be your own fat that can be transferred to areas of volume loss or other types of fillers that are synthetic (eg., Bellafill stimulates collagen growth and is the only filler that is FDA approved to last 5 years) or composed of hyaluronic acid (last one to two years) and/or collagen (breaks down early).  Each type has pluses and minuses. Atopic eczema can benefit from treatment options such as laser phototherapy.  It would be best to speak to your physician to make the best decision for your situation.
Best,
Dr. DuPont

Leonard Grossman, MD · Answer

You haven't lost collagen in your face, what you have lost is volume by losing the ever so important facial fat. In this day and age when so many people have eating disorders and eventually learn how to eat properly and thereby lose weight, they see the same symptoms as you-a deflated face. My solution for the last 25 years has been to use the patient's own fat which can be grafted strategically to the face and bring the face to the appearance that the patient had some 20 years prior to weight loss. Find yourself a plastic surgeon who is extremely comfortable and good with autologous fat grafting. In the process of fat grafting you can also improve an area where fat is undesirable. You can go to our website and look at photographs of similar patients in facial Rejuvenation with fat. Good luck from New York City

What are the best treatments to stimulate collagen production in the face?

Answers (10)

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