Effectively combine aesthetic treatments

combining aesthetic treatments - skintherapy.uk

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a) Combining aesthetic treatments

Demand for non-invasive aesthetic treatments is soaring across the globe and there is no sign of the trend decelerating. Highly sought treatments span from injectable products such as fillers, toxins, skin rejuvenation such as chemical peels, energy-based devices such as radiofrequency, ultrasound and lasers and active cosmetics known as cosmeceuticals that include skincare, eye care, skin lightening and scar care products. 

Any and all aesthetic concerns faced by clients today can be addressed with overlapping or complementary strategies, and it is rare that a client has only one specific goal. More often than not, clients seek to revitalise their face and body, and address issues of photoaging, pigmentation, loss of tone, wrinkles, laxity, localised fat and cellulite.

In short, we seek to reverse the signs of ageing together with setting goals of personalised cosmetic tweaking that they feel will lead to the best aesthetic version of ourselves. 

The current trend in the clinical arena is that of a multimodal approach, that exploits several different procedures to treat multiple issues that are involved in the manifestation of various skin concerns. 

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b) Five step combination approach for facial rejuvenation

1) Chemical PeelSkin prep - PHA
2) MesotherapyProduct implantation
3) Micro-needlingCollagen induction
4) MaskNourishment – soothing
5) LEDStimulation – calming

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c) Step one – Chemical peel – Skin preparation

Chemical peeling is the controlled removal of the stratum corneum, epidermis, and/or superficial dermis to improve skin texture and pigmentation. Superficial chemical peeling with hydrophilic glycolic acid or lipophilic salicylic acid is intended to produce mild exfoliation of the top layer of the skin.

The action of a chemical peel exfoliates dead skin cells and unclogs pores allowing for improved penetration of mesotherapy actives.

PHAs and bionics provide clinically proven in vivo anti-ageing and skin-smoothing effects that are comparable to AHAs, while offering several therapeutic advantages. They are less irritating to the skin compared to AHAs, and cause less stinging and burning. Accordingly, PHAs are compatible with clinically sensitive skin types including patients diagnosed with atopic dermatitis and rosacea. 

PHAs also enhance the skin barrier, an important benefit for people with compromised skin conditions. In addition, these molecules function as humectants and moisturisers, as well as provide antioxidant chelation effects due to their polyhydroxy structure.

PHAs provide free radical scavenging effects and do not increase the skin’s sensitivity to sunlight. The bionics have the additional benefit of inhibiting matrix metalloproteinase (MMP) enzymes, providing preventive anti-ageing effects. 

Multiple skin benefits have been proven for the PHAs and bionics, making them ideal ingredients for use in dermatology either alone or in combination with other complementary cosmeceutical agents and/or cosmetic procedures.

Ingredients such as gluconolactone and lactobionic acid are types of polyhydroxy acid.

Gluconolactone lipophilic and hydrophilic

Gluconolactone is composed of multiple water-attracting hydroxyl groups, which hydrate the skin. According to a study featured in the Dermatologic Surgery journal, Gluconolactone is capable of cheating metals and may also function by scavenging free radicals, thereby protecting skin from some of the damaging effects of UV radiation.

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d) Step two – Mesotherapy – Product implantation

Whether administered manually or with a mesotherapy gun, the choice of injection technique is important as it determines the quality of the results obtained. Depending on the injection site, the condition treated, the structure of the dermis and the products injected the results will vary considerably according to the technique.

A distinction is made between 3 techniques.

  • Papule: 1 to 2mm depth
  • Nappage: 2 to 4mm depth
  • Point by point: deep injection, 4 to 12mm depth

Peels and Mesotherapy

A concentrated boost of radiance, hydration and volumising effects. Mesotherapy enables subcutaneous injection of a cocktail of vitamins and hyaluronic acid using very fine needles. The results are a gradual reduction of fine lines and firmer, brighter skin. Associated with a peel, Mesotherapy boosts skin radiance and ensures optimal hydration.

The peel will be carried out first to eliminate dead skin cells and optimise penetration of the Mesotherapy product into the skin. The peel is recommended to prevent the mesotherapy product from escaping via enlarged pores for certain skin types.

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e) Step three – Microneedling – Collagen induction

Proposed depth per skin area

1. Forehead0.25-0.5mm
2. Chin & jawline0.25-0.5mm
3. Cheeks0.5-0.75mm
4. Peri-orbital0.25mm
5. Nose0.25mm
6. Peri-oral0.25mm
manual vs mechanical micro-needling device - skintherapy.uk

The Dermapen® is an automated micro-needling device with a disposable tip cartridge that is made up of 12 micro-needles, which uses proprietary technology to penetrate vertically into the skin.

The stamping action of the Dermapen’s vertical tip creates invisible micro-injuries to the skin while stimulating the skin’s natural ability to heal itself and increase the production of new collagen. In doing so, these micro-injuries encourage and harness the body’s innate ability to regrow and repair the skin through normal physiological processes and the skin becomes rejuvenated and refreshed.”

Mesotherapy can repair acne, acne scarring, scarring from laser treatments, hyperpigmentation and PIH, dehydrated skin, compromised barrier, toxicity, tissue loss, wrinkles, muscle loss, unwanted fat deposits, cellulite, enlarged pores, shave bumps and just about any concern a client may be hoping to correct.

Mesotherapy is more effective with dermal rolling such as the Dermapen for its ability to facilitate deep product penetration into the skin’s layers.

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f) Step four – Mask – Nourishment & skin soothing

A hydrating mask can produce an immediate cooling effect that soothes the skin and stimulates cellular renewal by accelerating the skin’s natural defences. It can provide remedial benefits post-care for skin procedures such as chemical peels, needling as well as irritated skin.

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g) Step five – LED – Stimulation & calming

Contradictory opinions exist with the use of LED in conjunction with needling. Whilst the goal of needling is to instigate a controlled wound and in doing so stimulate the production of collagen and elastin, LED therapy has been proven effective for a wide range of healing and rejuvenation.

The argument is each treatment cancels the other out. By healing the skin through light therapy we disallow a ‘natural healing’ giving our skin time to regrow. This practice is said to render needling useless.

In other opinions, LED and needling are welcomed together. LED light therapy following a needling treatment further aids the anti-ageing process.

LED light is clinically proven to stimulate cellular activity, therefore encouraging collagen production. LED light therapy will further reduce fine lines and wrinkles, improve scarring, clear blemishes, improve skin tone, and repair sun damage.

Perhaps the true answer lies within device selection, method and mode. The goal of our 5-step combined treatment plan is to stimulate and calm. 

LED light therapy started as NASA technology, but it’s now being used as a cosmetic treatment for acne and wrinkles. With the help of infrared light, red, and blue light penetrate into the tissue to stimulate basic energy processes in a cell’s mitochondria. This speeds up the rate of cell reproduction.

Red light stimulates collagen, and blue light kills the acne-causing bacteria, Propionibacterium acnes. There’s growing evidence to suggest other colours may play a role.

Peels and LED light therapy

Combining a peel with LED therapy intensifies the action of light therapy. The LED technique uses the light’s vibrations to provide a gentle skin regeneration effect. The light triggers photochemical reactions in the cells to stimulate renewal. Depending on the indication to be treated, the practitioner will select the right light combination.

LED stimulates the activity of collagen and elastin fibres, protects the free radicals and is appreciated for its anti-inflammatory benefits.

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h) Combined aesthetic treatment conclusion

combined aesthetic treatment plan - skintherapy.uk


Combination aesthetic treatments are integral to achieving successful whole body rejuvenation. Treatments can be done the same day but also staged at regular intervals, especially when performing treatments that are anticipated to result in swelling and erythema.

Combining energy-based devices with each other are most successful when they don’t overlap in the mechanism of action i.e. thermal with non-thermal, and when they don’t target the same tissue layers i.e. epidermis versus subcutaneous fat.

Together with topical cosmeceuticals, always in the context of a healthy lifestyle in terms of activity and nutrition, these treatment plans are anticipated to simplify over time and become an indispensable part of the clients’ well-being.

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