Reference Lab

DEZ 6, 2021

Genetics, aging, skin disorders, lifestyle, and sun exposure can result in skin damage and textural irregularities on the face and body. Additionally, conditions like acne, scarring, freckles, and pigmentation may worsen with age, causing many to seek aesthetic remedies. If you choose to seek ways to address the signs of aging, modern technology, skincare, and medicine offer a variety of choices.[1]

When judging different options, it’s helpful to decide whether you’re willing to explore invasive anti-aging treatment options and accept the potential associated risks, or whether you would like to avoid the risks and stick with non-invasive skincare.

Although the term “invasive” is an ambiguous label, the most commonly accepted definition of an invasive procedure is one that necessitates a trained professional to penetrate the skin with an incision. Generally, invasive procedures require time for recuperation and are accompanied by significant risks.

For people looking for a dramatic change, invasive procedures can seem appealing. Take, for instance, one of the most popular invasive skincare treatments: the facelift. Also referred to as “rhytidectomy” by plastic surgeons, facelifts are an effective way to tighten sagging skin and eliminate wrinkles quickly. This surgical procedure lifts the skin on one or both sides of the neck or face, tightening facial muscles and readjusting how skin falls over the face. A facelift physically changes an individual's facial appearance, often in a dramatic way.[2]

Other procedures, like a thread lift, are considered only a “minimally” invasive procedure by the American Society of Plastic Surgeons. More commonly referred to as a “lunchtime lift,” a thread lift places absorbable barbed sutures under the skin to create tautness in the face and neck. Thread lifts are ideal for small, contained areas like the eyebrows, neck, or temples.[3]

From a purely logistical standpoint, the downtime that more invasive procedures require can often be a deterrent for people with busy schedules. The recovery period for invasive procedures may take days or even weeks and commonly include pain, swelling, and bruising. For the most part, while invasive skin procedures offer immediately noticeable results, the greatest drawback is that they come with significant health risks. So, although a facelift delivers smoother, firmer facial skin almost immediately, the possible adverse effects are worth considering.

As an example, the following are a few (rare) risks that may come with invasive procedures, like facelifts.

• Nerve injury can result in temporary weakness or numbness in the skin. In some cases, nerve changes may occur permanently.[4]
• Invasive surgical procedures often require local or general anesthesia, which carries its own risk of infection or adverse reaction.[4]
• Significant hematomas —more commonly known as bruises — are blood that collects under the skin and can result in prolonged discoloration.[5]
• People who have pre-existing conditions, like diabetes, or who are chronic smokers may experience a longer healing process than usual.[4]
• Scarring can differ from person to person. Individuals who tend to develop keloid scars may require further treatments to manage scarring. Keloid scars are raised and much more noticeable than typical scars, and can result in itching.[5]
• Temporary or permanent hair loss may occur at the sites of the incision. Hair transplantation can regrow hair in areas where hair loss is permanent.[6]

Going “under the knife” comes with a monumental commitment. Results are usually permanent unless corrected by more surgery. Not to mention, invasive skin tightening procedures are often accompanied by a hefty price tag. For example, the average cost of a facelift, excluding anesthesia and recovery, is about $8,000.[7]

According to the American Society of Dermatological Surgery, non-invasive skin tightening treatments utilize non-surgical measures to stimulate collagen and elastin production within the deeper skin layers. Age and lifestyle can slow the production of proteins that keep the skin plump and firm — collagen and elastin—causing the skin to sag, appear leathery, and “crepey.” For people who want to improve skin texture and elasticity, non-invasive aesthetic procedures and skin tightening treatments offer viable options with effective results. With consistent use, non-invasive anti-aging treatments shrink tissue, help stimulate the production of collagen and elastin, and recover lost elasticity over time.[8]

Non-invasive skin procedures are ideal for people whose schedules can’t accommodate the downtime that more invasive treatments require, for those who are looking for more natural visual benefits, and/or for those who would like to avoid the significant health risks of an invasive procedure. Many non-invasive aesthetic treatments are available for at-home use. Even in-office treatments typically take less than an hour, and the results — though less dramatic than a facelift — can last for up to a year or more. What’s more, non-invasive aesthetic treatments come with minimal risks. And, when adverse effects occur, they’re often temporary.[9]

Additionally, unlike most invasive surgical procedures, it’s possible to apply non-invasive skin tightening treatments to most areas of the body, including legs and arms. This is encouraging, because although the skin on the face tends to receive the most attention, many people also have concerns regarding the skin on their body. The skin on the hands, for example, may age before the skin on the face, as hands are consistently exposed to environmental elements and subsequent damage. Invasive procedures typically don’t offer viable options for the skin on the hands, but non-invasive skin treatments might work well in this area.[9]

While non-invasive treatments tend to be gentler, procedures that must be performed in an office can often be expensive and still carry some risk of infections. Additionally, at-home non-invasive devices tend to range in their quality and effectiveness and lack in supporting scientific data, making it difficult to evaluate what options are worth the time and money.

As a general guide, consumers who choose to stick with non-invasive treatments and want to avoid health risks should look for products that can be used at home, have data-validated claims to support their effectiveness, and that focus on improving skin health rather than simply treating the symptoms of aging.

As people seek additional approaches for improving skin appearance, the growing anti-aging market is offering new and effective treatments to meet the demand.[10] The following non-invasive aesthetic procedures have gained momentum in the last decade.

Ablative laser treatments, also called laser resurfacing, for skin tightening removes the outer layers of damaged skin, encouraging the development of newer skin cells. The ablative laser uses layers of intense light wavelengths, slightly wounding the skin and stimulating collagen formation. As the damaged skin sloughs away, smoother and tighter skin takes its place. JAMA Dermatology recognizes ablative laser treatments as an effective form of scar treatment because of their effectiveness at treating marred skin.[11]

One downside of ablative non-invasive aesthetic treatments is the pre-treatment and post-treatment attention they require. A physician may prescribe an antiviral medication before and after the procedure as an infection precaution. In addition, some cases may require sedation, depending on the type of ablation and the area. Ablative non-invasive aesthetic treatments can cause discomfort, and unprotected sun exposure is not advised in the months leading up to and after treatment.[12]

Unlike standard ablative laser treatment, non-ablative laser treatments for skin tightening do not wound the skin but still stimulate collagen production, helping to enhance skin texture. Because this non-invasive skin resurfacing procedure is gentler on the skin, the recovery time for non-ablative treatments is shorter than ablative laser treatments — and much less painful. The results for non-ablative skin tightening skin treatments may not offer the same level of results that ablative laser procedures do, but over time they can result in smoother skin and a more even skin tone.

People are most familiar with ultrasound's use in medical diagnostics and obstetrics, but ultrasound energy is also beneficial for keeping skin firm and smooth. Ultrasound targets the lower layers of skin below the epidermis. Using a handheld device, ultrasound is transmitted through the skin and heats skin at depths of up to 5mm. The gentle heat stimulates collagen production (neocollagenesis), making skin firmer. Targeting specific areas, ultrasound non-invasive skin tightening rejuvenation treatments can improve elasticity in places where it’s often needed the most — the middle and lower face. When used on aging or sagging skin, ultrasound treatments can offer an alternative to a mini-facelift.[13]

In fact, a 2018 study published in the journal Plastic and Reconstructive Surgery evaluated the effectiveness of focused ultrasound on 50 adults with lower and mid-face sagging. After six months, the participants were assessed by third-party evaluators and also by a self-assessment questionnaire. The evaluators saw improvements in 93% of the participants. About 85% of participants themselves saw positive changes in their skin, according to the self-assessment questionnaires.[14]

The side effects of ultrasound treatments for skin tightening are often temporary. While the procedure is being delivered, clients may experience some discomfort. Afterwards, redness, numbness, and slight bruising may occur for a short period.[15]

As a similar approach to ultrasound treatments, radiofrequency (RF) energy can also be used to heat the skin in order to boost collagen production. RF energy for skin tightening concentrates heat onto the upper layers of skin, the epidermis. Effective for both younger and older individuals, RF energy reduces wrinkling and alleviates minor sagging. A 2018 study published in the Annals of Dermatology found that RF energy, when used for three treatments performed over six weeks [16] on older adults, demonstrated significant wrinkle reduction. Another small study focused on the use of RF energy for facial contouring. Of the 11 participants in the study, 73% saw improvements in the contours of their face when RF was combined with electromagnetic treatments.[17]

Radiofrequency treatments are available for use on the face, neck, and body and are performed in-office with professionals. Treatments can also be combined with other non-invasive aesthetic procedures, like microneedling and ultrasound to target multiple layers of skin. Because RF energy heats skin layers, there’s always a potential for burns and pain.[18]

The sun’s ultraviolet lights are dangerous for unprotected skin, but not all light is harmful. Light contains other frequencies that have properties that can heal the skin. Red, blue, and near-infrared light don’t include any damaging ultraviolet rays. LED light therapy for skin tightening harnesses these lights to renew and firm-up damaged skin. LED light therapy not only stimulates collagen but also kills bacteria, reducing the appearance of acne.

Interestingly, NASA initially used LED light therapy aboard space shuttle missions to promote wound healing, a consequence of which was making skin smoother.[19] The procedure was also adopted for some time by the United States military, as it was used by Navy SEALs to facilitate wound healing. In fact, a published study indicated that LED light therapy promoted skin healing in 40% of its participants.[20] This method was later picked up by the anti-aging skincare industry and has received much attention recently as at-home LED devices have become popular, especially given the recent skincare craze during the pandemic.

Chemical peels, also called chemexfoliation or derma-peeling, utilize a variety of chemical mixes to penetrate the skin and kill skin cells on the mid to outer layers of skin, encouraging new cell development and the synthesis of collagen. Typically done in-office, chemical peels can be painful and may require numbing medication and recovery time.[21]

Chemical peels used as non-invasive skin tightening treatment consist of three categories:[22]

• Superficial peels that use mild acids to penetrate the outermost layers of skin gently.
• Medium peels use glycolic acid or trichloroacetic to remove the outer layers of skin and those right beneath the top layer.
• Deep peels reach the middle layer of skin, using phenol or trichloroacetic acid to remove damaged cells.

Although chemical peels are effective at encouraging new cell and collagen production, they can be painful and often require recovery days and significant downtime following the procedure. Most chemical peels increase skin sensitivity and irritation, while deep chemical peels can cause swelling, burning, and redness, with significant post-procedural pain. Post-procedure instructions typically include pain management.[21],[22]

Botox is a derivative of the same toxin that causes botulism, a condition brought on by exposure to Clostridium botulinum bacteria which causes paralysis. Botox treatments paralyze specific facial muscles in order to reduce movement of skin, which would otherwise cause wrinkles.[23] Despite the source, Botox itself is thought to be generally safe and effective for in-office cosmetic use as a non-invasive skin tightening procedure. Delivered through an injection, Botox is considered a noninvasive aesthetic treatment because no surgical incisions are necessary. It’s important to note that Botox does not come without its risks. Individuals may experience rare anaphylactic reactions. More often, however, side effects include bruising, bleeding, or pain in the treatment area.[24],[25] Additionally, the long-term side effects of botox are not fully known, as the product wasn’t approved for cosmetic use until 2002.

According to the American Board of Cosmetic Surgery, more than one million adults opt for injectable dermal fillers as a non-invasive anti aging procedure every year. Injectable dermal fillers tighten skin by literally filling facial areas that have lost their volume, like the cheekbones or lips. By filling sunken and sagging areas with a gel-like substance, users can regain lost volume, filling in fine lines and wrinkles. Dermal fillers are typically made from a number of substances, including fat injections, Poly-L-lactic Acid, and synthetic products. How long the effects of dermal fillers last depends on the make-up of the filler, the area filled, the patient’s metabolism, and how deep the fillers were injected. More natural fillers are typically absorbed by the body, and last from 6 to 18 months. Synthetic fillers, on the other hand, last much longer. The Food and Drug Administration cautions against the overuse of injectable dermal fillers, and does not advise the use of fillers on large areas of the body. Side effects range from bruising, infection, allergic reactions, and discoloration.[26],[27]

One of the best perks of non-invasive skin tightening procedures is that many of them can be done at home. At-home devices can deliver in-office-like results from the comfort of a person’s own home.

At-home LED light therapy for skin tightening comes in various forms, from handheld wands to masks that fit over the entire face. They differ in the kind of light they use (red, blue, near-infrared) and what type of skin conditions they target. Wands typically work well for targeting specific areas, like scar tissue, or for targeting different areas of the body. For full facial treatments or facial acne, an LED mask works well. Instructions vary according to the manufacturer and device, but most devices require consistent use for the best results. Also, the quality of the devices can differ significantly, making it difficult to gauge the safety and effectiveness of the device. What’s more, special eyewear is recommended to protect the user’s eyesight.[28]

The thought of at-home microneedling may give some people pause. Luckily, the devices for at-home treatments are gentler than those meant for in-office use—an at-home microneedling device for skin-tightening looks akin to a miniature paint roller. The roller portion of the device contains tiny, delicate needles that gently penetrate the skin. A study into micro needling indicates that a 1.5mm needle works best, but this optimal size is typically reserved for in-office visits. For comfort, safety, and effectiveness at home, a 0.15mm is recommended.[29] When it comes to microneedling, a larger needle doesn’t necessarily produce better results.

As with most at-home cosmetic devices, quality can vary greatly between devices and manufacturers. Some needles, for example, are too short and barely penetrate past the first layer of skin. Additionally, most devices roll across the face, the motion of which may cause excessive injury compared to in-office microneedling in which the needles are inserted and removed from the skin head-on. Microneedling may cause bleeding, bruising, and — though rare — can cause infection, swollen lymph nodes, and hyperpigmentation.[30]

At-home topical products for skin tightening typically target cell regeneration and hydration. Connective tissue cells called fibroblasts produce skin tightening proteins, like collagen and elastin, which give skin its flexibility and recoil, allowing skin to spring back to its original shape when repeatedly stretched and folded. Fibroblasts also produce glycosaminoglycans (GAGs) such as hyaluronates, like hyaluronic acid, which maintain moisture within the skin, reinforcing skin’s flexibility and elasticity.[31],[32]

Over time, however, fibroblasts slowly decrease their production of collagen, elastin, and hyaluronates. As production slows, skin becomes dry and brittle, losing its resilience and elasticity. Additionally, skin loses its ability to repair itself, making the skin more susceptible to sun damage, like dark spots and inflammation. With less collagen and hyaluronates, skin begins to wrinkle and sag, bringing about all the aesthetic signs of aging skin.[33]

In fact, after the age of 30, we lose approximately 1% of our natural collagen each year, resulting in sagging skin and wrinkles. Most at-home topical products for skin tightening aim to add or boost the production of these beneficial skin cell proteins in the hope of returning elasticity to the skin.[34]

Retinol, also known as vitamin A, is widely known for its wrinkle-reducing effects. Retinoid, the name of retinol’s broader chemical class, effectively reduces fine lines by boosting the skin’s natural collagen production, which can smooth out rough spots, plump up wrinkled areas, and tighten skin. Retinol also helps to synthesize new blood vessels and encourages cell turnover, which reveals newer cells and rids the skin of damaged cells.[35] For all the good that it does, however, retinol has adverse effects which some individuals may find difficult to tolerate. Certain retinol products are dangerous to use for women who are pregnant or breastfeeding. Retinol can also result in severe skin dryness, significant irritation, and cause increased sensitivity, especially to sun exposure. Furthermore, prolonged retinol use will cause thinning of skin, doing more harm in the long run due to its inevitable damage to the skin barrier.[35]

Creams and moisturizers for skin tightening can seem like the easiest choice. Non-invasive, cost-effective, easy to use, and convenient, creams and moisturizers are typically available over-the-counter. However, most fall short on their skin-tightening claims. A vast majority of creams and moisturizers on the market only hydrate the uppermost layers of skin, causing temporary hydration and wrinkle reduction. Unfortunately, they fail to penetrate the deeper layers of skin, which provide structural support for upper skin layers. Without reaching lower layers, skin remains loose and continues to sag. Moreover, the formulations that compose most creams and moisturizers are simply different iterations of each other, with no new proprietary compounds or ingredients.

Unlike other creams and moisturizers, OS-01 Topical Supplement contains a proprietary peptide, which penetrates to the deepest layers of the skin and extends the health of skin cells at the molecular level. Additionally, when compared to retinol, OS-01 is able to increase collagen and hyaluronic acid production at similar levels, while reducing inflammation and aging mechanisms in the skin which have been shown to increase with exposure to retinol. OS-01 has also been shown to improve barrier function, while retinol degrades the skin barrier and causes flaking, skin sensitivity, and irritation.

Unlike aggressive or invasive skin tightening procedures, OS-1 Topical Supplement requires no downtime or recovery period to use. In fact, OS-01’s benefits are cumulative, so consistent use of OS-01 over time results in continuous improvements in skin’s health. That’s because OS-01 reduces the accumulation of damaged and aged cells in the skin, which would otherwise accelerate the aging process. Rather than just treating the symptoms of aging, like invasive procedures do, OS-01 targets the biological root cause of aging, allowing it to deliver long-term skin tightening results that soothe skin and promote skin health. Additionally, there are no risks for infection since skin incisions are not required.

OS-01 offers measurable visible results, similar to many invasive and non-invasive skin tightening procedures, without any of the side effects. In a 12 week clinical study, OS-01 improved skin elasticity in 90% of participants. Even better, OS-01 was shown to improve firmness -- otherwise known as skin tightening -- by 95.5%.

• Skin loses its elasticity over time due to environmental influences and aging, causing sagging and wrinkles.
• Invasive treatments for skin tightening — like facelifts — offer dramatic results, but the procedure comes with major risks, like nerve injury and infection.
• Creams and lotions can moisturize the skin, but most formulas don’t reach deeper skin layers for prolonged skin tightening effects.
• OS-01 is gentle on skin, safe, and uses a proprietary peptide to tighten skin and renew skin’s elasticity.
• OS-01 offers many of the same benefits of non-invasive in-office treatments and invasive in-office treatments, but with no downtime or recovery time. Additionally, there are no risks for infection or any need for surgical incisions or anesthesia.

References

• [1] https://www.asds.net/skin-experts/skin-treatments
• [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678000/
• [3] https://www.plasticsurgery.org/cosmetic-procedures/thread-lift
• [4] https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/facelift
• [5] https://www.mayoclinic.org/tests-procedures/face-lift/about/pac-20394059
• [6] https://www.mayoclinic.org/tests-procedures/face-lift/about/pac-20394059
• [7] https://www.plasticsurgery.org/cosmetic-procedures/facelift/cost
• [8] https://www.asds.net/skin-experts/skin-treatments/non-invasive-skin-tightening-treatments
• [9] https://www.americanboardcosmeticsurgery.org/procedure-learning-center/non-surgical-procedures/skin-tightening/
• [10] https://www.sciencedirect.com/topics/materials-science/cosmetics
• [11] https://jamanetwork.com/journals/jamadermatology/article-abstract/1787836
• [12] https://www.mayoclinic.org/tests-procedures/laser-resurfacing/about/pac-20385114
• [13] https://pubmed.ncbi.nlm.nih.gov/24267423/
• [14] https://journals.lww.com/prsgo/fulltext/2019/12000/use_of_micro_focused_ultrasound_for_skin.1.aspx
• [15] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4695420/
• [16] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5929946/
• [17] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360959/
• [18] https://www.americanboardcosmeticsurgery.org/are-radiofrequency-treatments-really-safe/
• [19] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4148276/
• [20] https://pubmed.ncbi.nlm.nih.gov/11776448/
• [21] https://www.aad.org/public/cosmetic/younger-looking/chemical-peels-overview
• [22] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122508/
• [23] https://www.cdc.gov/botulism/general.html
• [24] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874868/
• [25] https://www.americanboardcosmeticsurgery.org/procedure-learning-center/non-surgical/guide-botox-type-injectables/
• [26] https://www.americanboardcosmeticsurgery.org/procedure-learning-center/non-surgical/guide-botox-type-injectables/
• [27] https://www.fda.gov/consumers/consumer-updates/filling-wrinkles-safely
• [28] https://www.health.harvard.edu/staying-healthy/led-lights-are-they-a-cure-for-your-skin-woes
• [29] https://www.ncbi.nlm.nih.gov/pubmed/22256622
• [30] https://www.fda.gov/medical-devices/aesthetic-cosmetic-devices/microneedling-devices#risks
• [31] https://www.genome.gov/genetics-glossary/Fibroblast
• [32] https://www.genome.gov/genetics-glossary/Fibroblast
• [33] https://www.sciencedirect.com/science/article/pii/S0022202X15
• [34] https://parjournal.net/article/view/3863
• [35] https://www.health.harvard.edu/staying-healthy/do-retinoids-really-reduce-wrinkles