LOOK AND LISTEN
Regardless of a client’s age and their stated concerns, it is always important to take the time to consult with each client prior to creating a treatment plan. What is visible and what the client says may not always be in alignment, but their concerns should always guide the conversation. Before professionally assessing their face, hand them a mirror and have them identify what bothers them first. Then, relay the assessment. Remember to be realistic about the results they can expect to see and use appropriate language to communicate what can be accomplished. Instead of using words like “erase,” “remove,” or “eradicate,” say things like, “We can soften those fine lines” or “We can minimize and smooth the appearance of your wrinkles.”
When treating lines and wrinkles, consider these three approaches: prevent, correct, and preserve.

PREVENT
When it comes to preventing lines and wrinkles, the sooner the better. It is always more difficult to reverse a skin condition or concern than it is to prevent that issue in the first place. For example, many individuals start using neuromodulators in their 20s and 30s – particularly in the glabella area (the area between the eyebrows), forehead, and crow’s feet. These lines are expression lines that move as an individual expresses emotions. They become more permanent wrinkles with age. When assessing a client, ask them to furrow their eyebrow, which usually creates lines. If those lines disappear when they relax their face, then those are expression lines (which are impossible to remove unless the client completely stops moving their face). If the lines remain visible after the client relaxes their face, then those expression lines have become more permanent wrinkles.

There are a number of actions that can help in preventing lines and wrinkles. In the treatment room, bimonthly skin care treatments (like superficial peels) to keep the skin rejuvenated can be performed, as well as quarterly neuromodulator injections (to prevent some facial expression, which can postpone the development of wrinkles) and LED treatments. LED (or low level light therapy) with a polychromatic panel (running multiple wavelengths of blue, red, and near infrared simultaneously) is always a good adjunct treatment for clients considering virtually any service intended to prevent the signs of aging, since it can keep the skin clear, reduce inflammation that can lead to lines and wrinkles, and up-regulate collagen production.

At home, it is essential for clients to incorporate a comprehensive skin care plan that includes daily sun protection, hyaluronic acid, and antioxidants.
Lifestyle can also play an important role. Clients should limit sun exposure, smoking, and alcohol consumption, which can lead to photodamage and premature aging.
If a client’s expression lines remain visible at rest, then it is time to step it up and correct those deeper lines and wrinkles. Keep in mind that these wrinkles are the result of genetics, years of movement, environmental exposure, and the loss of fat, bone, and collagen underneath the surface. So, in order to effect change to a depression on the face, it is important to not only turn over the cells on the surface of the skin to minimize the appearance of those lines, but to also consider ways to rebuild the structure underneath.

CORRECT
To correct lines and wrinkles, follow the steps taken to prevent them, but step it up. In the treatment room, step up resurfacing procedures for clients with more aggressive protocols, increased frequency, or both. Trade superficial peels for mid-depth peels or try a series of three to four microneedling (or microchanneling, depending on state laws) treatments about every four week that puncture the skin with tiny needles, triggering the skin to produce more collagen as it heals those microscopic wounds. These treatments will address the more superficial lines on the surface of the skin, but if the lines are deeper (crevices and folds rather than etched, fine lines), then injecting dermal fillers may be necessary to lift and fill specific areas of volume loss. If social downtime is an issue, integrate a post procedure LED treatment as part of the protocol to minimize redness and bruising or consider twice weekly LED treatments (for four to six weeks) as the primary procedure (using a combination of red light, 620-670 nm and near-infrared, 810- 880 nm wavelengths) to boost epidermal cellular activity and activate fibroblasts with zero downtime.

At home, make sure clients add in growth factors to repair damage, peptides to soften fine lines, and retinols to turn cells over more quickly.

For lifestyle, suggest that the client reduce the amount of inflammatory foods in their diet, drink plenty of water, and get at least seven hours of sleep per night.

PRESERVE
Regardless of the modalities used to prevent and correct lines and wrinkles (including cosmetic surgery), it is imperative to preserve or maintain results. In the same way that the body will revert back to its former fitness level if exercise is stopped, the face will also start to reveal signs of aging if there is not an effort to care for it. Age alone does not predict the number of lines on a face, but ignoring skin will certainly increase that number more quickly. Maintaining optimal skin health with a healthy lifestyle, daily skin care, monthly skin care treatments, injectable treatments when necessary, and a series of LED treatments every year, is highly recommended.

After stopping to look and listen in assessing a client’s aging skin concerns, an approach including prevention, correction, and preservation will lead to the best results.

Reference
1 Calderhead, R. Glen, and David B. Vasily. “Low Level Light Therapy with Light-Emitting Diodes for the Aging Face.” Clinics in Plastic Surgery 43, no. 3 (2016): 548 doi:10.1016/j.cps.2016.03.011.

Gina Thompson has over 20 years of experience in the medical aesthetic industry. Her diverse positions include: aesthetic educator for Celluma Light Therapy, medical skin care specialist, makeup artist, marketing director, business consultant, health coach, researcher, content writer, and public speaker. As a true insider in this industry, Thompson is able to provide unique educational and marketing strategies that are based on her personal experience with skin care, plastic surgery, and dermatology patients. She is passionate about her profession and believes that happy patients lead to financial success.