Cosmetic Dermatology

This chapter presents an overview of the most common techniques of cosmetic dermatolgy in current use. Photoaged skin has reduced levels of the fibrillar collagens, a major structural element in healthy dermis, and a disrupted elastic fibre network. Ultraviolet radiation (UVR) generates free radicals in the dermis and epidermis that alter protein structure directly, as well as initiating signal transduction cascades that activate matrix metallopro‐teinase (MMP) enzymes. The techniques used most commonly are the application of emollients and retinoid creams, facial peels, injection of botulinum toxin and dermal fillers, and laser and light sources. Emollients help to ‘unstick’ the corneocytes, and contain two main types of ingredient: occlusives and humectants. Superficial microdermabrasion can improve pigmentary dyschromias, comedonal acne and superficial rhytides while deeper procedures can correct rhinophyma, deep rhytides, acne scarring and textural irregularities associated with surgical and traumatic scars.