Aging Skin and The Décolleté

Is youthful skin giving way to cracks and rougher texture?

We give you tons of information below on aging skin, what ingredients to look for in anti-aging skincare products, and Spa and Med Spa interventions. We go into depth on microneedling with or without radiofrequency, the different types of peels and ingredients, and which lasers can be helpful for anti-aging. We finish with Spa services that are effective whilst being refreshing and recharging.

Give yourself the gift of beautiful skin. Call Pulsar Health in West Palm Beach, FL to book an appointment today.

There is aging gracefully, and there is looking old before your time. Early intervention and prevention extend your years of beauty and youthfulness, and even if you have let it go, we can help turn the clock back. Chronological age - how many birthdays the calendar has recorded - and physiological age - your actual health and vitality - can be very different. At Pulsar Health, we are all about keeping your physiological age at a number you are happy with. 

As our slogan is "beauty based on health", anti-aging campaigns start on the inside with wellness. We have a whole arm of Pulsar Health called Eternal Vitality where we work on optimizing weight, active recovery, and even sexual health. Please refer to those sections if you are interested.

Aging skin starts subtly, with a coarser texture, and then a few laughter lines or neck lines that won't go away. Gradually pigmentation problems can start showing up, and the skin loses elasticity. For loss of facial volume, you may want to check out the website sections on Facial Balance: Tox, Filler & Threads as well as Lifting your Face. For specific areas of concerns like the eyelids or jawline, please refer to those sections (Looking at Eyes and Snatched Jawline respectively.) Here we are going to address overall skin texture and elasticity.

Wrinkles, knows as rhytids in medical terminology, can be prevented and treated. That is the good news. To make it look "natural" though, instead of a person "caught in a wind-storm face-lift" look, we are now in the age where technology changes the structure of the skin itself. To add back elasticity and strength to the skin, rather than to just get rid of excess thinned out skin, is the goal.

Hopefully, you don't wait to go to the dentist when you have a toothache, or your teeth fall out. Prevention and maintenance go a long way to keeping your smile your own. The same is true of skincare, the largest organ in the body. Using high quality products to protect and treat your skin right, and regular visits for deeper cleanings and work, will keep you looking physiologically younger longer! So below we talk about skincare and then move on to Spa and Med Spa interventions.

Anti-aging Skincare Products

For homecare products, quality does matter. Medical grade products are more potent and a little goes a long way, versus drug store products that are less effective and you have to use larger amounts. However, don't just get on one skincare regimen and stick with it for life. Your skin changes as your internal and external environment change, so like an exercise regimen, keep adjusting for optimal health. We can coach you in this process. There are times when it's worth being on "big gun" stem cell products, and other times when taking a break to focus on something else is appropriate.

Ingredients that are important in anti-aging products for skincare include:

• Retinoids, Retinols (weaker), Bakuchiol (natural alternative to retinols) - Vitamin A derivatives which are the workhorse of a skincare regimen for cell turnover. They have several benefits including improving epidermis thickness (promotes keratinocyte differentiation), thereby reducing fine lines as well as reducing pigment issues. However, stronger retinoids can cause annoying redness and sensitization, so formulations and what ingredients they are combined with are important.
• Vitamin C - also known as ascorbic acid, Vitamin C is an antioxidant that not only protects skin from UV and environmental damage, but also increases / helps cross-link collagen for improved skin strength and elasticity. Additionally, it reduces pigmentation problems. The formulation again makes a huge difference to the stability and permeability of the Vitamin C, so higher quality products usually turn out to be better value.
• Hyaluronic Acid - this sugar molecule is naturally part of the "matrix" between our cells and draws water to it, functioning as a humectant. Many formulations of hyaluronic exist and getting it into the skin, and not just on top of the skin, can be part of your Spa services (see below). PCA has long been known for their hyaluronic acids as well as peels.
• Ceramides - fatty molecules, ceramides are part of our natural cell membranes, but get depleted with aging. Adding ceramides, like adding back hyaluronic acid, help restore youthful skin. Whilst hyaluronic acids increase the water side of the hydration equation, ceramides work more on the fatty side, keeping the water in, protecting and restoring the skin barrier by improving cell adhesion, reduce free radicals that can damage elastin and collagen, and reduce redness, irritation and skin flakiness. What's not to love?
• Peptides - these wonders of modern technology are precision tools. The word peptide just refers to a chain of amino acids, and peptides are like mini proteins, but their utility lies in that they are often signaling molecules carrying information to trigger some useful process, such as increasing the production of collagen, elastin and glycosaminoglycans like hyaluronic acid - as copper peptides (GHK-Cu) do - or to speed up wound healing as is one of the functions of antimicrobial peptide (AMP). Specialist peptides can assist with improving hyperpigmentation or block neurotransmitters (acetyl hexapeptide-8) to reduce expression lines being solidified into wrinkles.
• Antioxidants - Many naturally occurring vitamins (C, E and some of the B vitamins) have antioxidant functions that protect the skin from damage. Our skin repairs itself but there is a balance between repair and destruction from environmental assaults. Antioxidants tip that balance towards repair and protection.
• Stem cell extracts - at Pulsar Health, we have found this to be the heaviest hitter against aging. Currently, we love the AnteAGE line of products that use mesenchymal bone marrow stem cells from young adult donors (pre Covid-19 pandemic so far), both straight after intense Med Spa treatments or Spa Microneedling (see below), and in at home skincare. It works to restore skin to a younger, plumper version of itself. Core products in their line are the serum and accelerator, and, for pigment control, the brightener. They also have hair growth products including eyelash and eyebrow growth promoters. Stem cells recruit your body's own natural healing molecules to repair damage, create new collagen and elastin, and improve blood flow, overall reducing wrinkles, lines and pigmentation problems.
• Sunblock - broad spectrum sunblocks are critical protection for all skin types, regardless of if you see the sun. Iron oxide (seen as the "tint" in some sunscreens) protects from indoor blue light emitted from cellphones and device screens. Physical sunblocks reflect and scatter light due to the minerals in them - zinc, titanium, iron... Different mineral colors reduced different wavelengths of light. Black iron oxide for example works across the visible light spectrum, but yellow iron oxide is best below 500nm wavelengths, whilst red can manage below 570nm wavelengths. Most physical sunblocks have zinc oxide, as it is also soothing, and these days comes in such a fine layer that it's hard to tell if you have it on (particles made super tiny sized - okay micro or nanoparticles in technical language), and it protects against both UVA and UVB, whilst titanium dioxide is better at blocking UVB rays. Chemical sunblocks work by absorbing the UV rays and converting them to heat, but they do need to be reapplied every couple of hours to remain effective. Sweating, wiping or washing off sunblock requires reapplication for ongoing protection.

At Pulsar Health, we are always on a quest for the most effective products and will share our experience and personalized recommendations for you when you visit.

Spa Services and Med Spa Interventions

For Spa and Med Spa anti-aging treatments to improve skin quality, we typically suggest a combination of micro-needling, peels and lasers. 

Microneedling is a powerful treatment, made even more so if done with the Virtue machine that combines it with radiofrequency. The new technology allows sub-pulsing of the energy to make strong treatment comfortable, and deliver tighter skin over a series of treatments. The SMART tool is great for the face and the DEEP for thicker areas such as heavy chins and body areas. Combining this with stem cell treatments, dermal exosomes, or your own blood's platelet rich plasma (PRP) ensures you look great straight after a Radiofrequency-Microneedling (RF-MN) treatment and get excellent booster signals for deep healing. The final result is at around 3 months, but we layer the treatments every few weeks for faster results. We can also combine it with a Cool Peel (carbon dioxide laser) treatment that smooths out fine lines very effectively, but you can be red for a couple of days with the Cool Peel, and the skin takes a week or two to fully heal. This is Dr. Gill's favorite treatment for helping skin stay or go back to being young and beautiful.

Microneedling by itself is also very effective at improving skin texture, and helps with pigmentation problems (in combination with peels), as well as with skin elasticity and strength. We typically combine it with hyaluronic acid, vitamins, stem cell products or PRP to maximize its results. For five days after microneedling, your skin absorbs a lot more products and you should avoid strong retinoids. A series of treatments is important to get long-lasting gains. We like to use the MDPen for precision depth and speed of microneedling, and sometimes use other forms of microneedling in combination with peels.

Peels usage is an art form. The results of peels depend a lot on your history of skincare, as well as the experience of the provider. At Pulsar Health, we have over 26 different peels in order to customize what work best for you. We use peels solo, in a series, or combine peels with facials, microneedling or neuromodulator (botox / dysport) treatments for a one-stop shop to glowing skin with a more refined texture. Check out our MegaStar peel, created by Sandra our head aesthetician.

The most comfortable of the effective peels are VI Peels, as they have a numbing agent (phenol) built into the signature cocktail of five different acids (retinoic acid, trichloroacetic acid, salicylic acid, phenol, ascorbic acid). This original VI Peel is good for rosacea but the Advanced is best for aging, although you may need to "work up" to it. There are also VI Peels designed for pigment control, oily skin and acne, as well as body peels. There is ongoing adjustment of the peel done at home for a couple days with additional towelettes or creams containing ingredients that add to the peel, or control pigment or inflammation. Peeling is maximal at days 3 to 5. If you have had a lot of prior peels, there may be only flaking, whilst "peel virgins" can have sheets of peeling. The amount of peeling also depends on your skin's condition at the time. Don't forget about treating your decollete when addressing your face and neck!

Correcting aging skin can require stronger peels, where we increase the concentration or duration of the peel and in lighter toned skin, can use deeper penetrating acids such as:

• Trichloroacetic acid - a monocarboxylic acid, trichloroacetic acid (TCA) is a corrosive chemical that functions as a peel by itself or in combination with other acids. TCA is usually referred to as a medium-depth peel but it depends on the concentration used as well as how long it is left on the skin. Like glycolic acid (see section on Clear Skin & Pore Perfecting), it can be used at low strengths, or medium strength such as 30%, to high at 50%, or even 70%. TCA concentration is very variable:

• 6 to 10% TCA, it is a very superficial peel (only going into the layer of dead surface skin cells)
• 10 to 20% TCA is regarded as a superficial peel (stays in the epidermis)
• 30 to 40% TCA is a medium depth peel (goes through the epidermis all the way down to the junction with the dermis or even into the papillary dermis)
• over 40% TCA is a deep peel going all the way to the reticular dermis

It is a useful tool but needs to be carefully administered and managed afterwards. 

• Pyruvic acid - the simplest alpha-keto acid, pyruvic acid is formed naturally in the body during the breakdown of sugar molecules. It is a powerful agent at 50% by itself, or used around 30% with other acids, so at these levels, it is best used in lighter skin tones only. Like other medium-depth peels, it decreases fine lines and improves skin texture and tone, as well as reducing dark spots (pigment) near the skin surface. Glytone makes a nice neck peel with pyruvic acid for this purpose.
• Phenol - this carbolic acid was used by Joseph Lister for disinfection in surgeries, and it continues to be used in medicine. At low strengths, it can be combined into other peels such as VI Peels to help reduce discomfort, but at full strength, it is a deep peel that goes all the way down to the reticular dermis, and should only be administered with cardiac monitoring. We do not do use phenol at full strength at Pulsar Health. Also, if there is a risk of pregnancy, phenol in any product should be avoided as it can harm the growing baby.

Peels are a controlled "burn" to the face, and as such can have effects such as post-inflammatory hyperpigmentation or even scarring with deeper peels. It is important to be very careful after the peel not to expose your skin to the sun, or to rub it. There are risks of pigment issues with darker skin tones, so there may be preparation needed prior to a strong peel, and often times we "work up" to deeper peels but doing more superficial ones first in a series. Also, some peels are simply not suitable for darker skin tones. Many peels require that retinoids (Vitamin A derivatives) are stopped for a week prior to and a week after the peel. 

Follow post-peel directions carefully and you can reap the many benefits of peels whilst minimizing any risks.

Lasers are very effective anti-aging tools. 

For a quick pick-me-up, a photofacial laser treatment minimizes pores and brings out gentle radiance. It also over time improves collagen formation, and is safe on any skin type. 

Deeper treatments though are needed to make an impact on wrinkles and long-term texture issues. One of our favorites is the Cool Peel, a carbon dioxide laser treatment that can be used on any skin type now. In the past, carbon dioxide lasers were too strong to be used on darker skins or the neck area, but the Cool Peel allows us to fine tune the strength and spacing of the laser beams, so that we can give great results in all skin types. At Pulsar Health, we prefer to give a series of lighter treatments than to "go heavy" with a very deep treatment, as lighter treatments have less down-time, less things that can "go wrong", allow more time for skin recovery and restructuring, and with repetition and adjuncts such as stem cells, PRP or exosomes, can get the results of deep treatments. 

Where we do use the stronger carbon dioxide laser (Deka), it is in lighter skin tones and usually specific areas that need stronger therapy such as the lower eyelid lines or lines around the mouth. 

These lasers remove a core of skin - called fractional ablation - and the Deka has stronger effects deep in the skin to further reduce wrinkles and improve collagen formation. As the skin heals, it looks red for a couple of days (longer with Deka) and can feel like sandpaper for a week or two. It has a marvelous effect on reducing lines, including necklace lines, and even reduces some pigment issues as well as mildly tightening the skin. Don't forget to try it on your hands as these can show aging damage too!

Other lasers for control of dark spots or small broken blood vessels that can happen with aging are the Alexandrite and Nd-Yag wavelength lasers. The Elluminate treatment at Pulsar Health can combine treating redness, dark spots, and skin texture by using all three lasers to create a beautiful canvas with your face.

For those who just want a pampering treatment and to look younger, we have you covered too. Hydrafacial and our customized facials make you look and feel great whilst turning around your skin's aging. We cleanse and use specific peels to help lift off blackheads - and can treat whiteheads - before adding in factors that hydrate, encourage collagen formation and / or treat pigmentation changes. We use adjunct technologies, such as the microcurrent in facials, or the Hydrafacial vortex technology, to deeply penetrate serums containing hyaluronic acid, peptides, vitamins and other anti-aging ingredients. We always use the best products on the market, in order to deliver effective ingredients that continue to work on your skin well beyond the time you spend with us.