Healing Without Harm: The Rise of Holistic Medical Aesthetics 

The skin care industry has always sought after real repair of aging skin but generating dermal collagen has proven to be elusive. While it is true that lasers and other heat devices, including medium-depth chemical peels, result in new collagen by ways of burning existing collagen, there has never been any evidence that these modalities add to the collagen layers. I would argue that the research simply takes a snapshot of the replacement efforts of skin and calls the uptick in collagen manufacturing a “rejuvenating event.” Unless scar tissue miraculously tightens things up for a time, there is most likely no improvement in aging skin from this trauma after the initial healing phase. In fact, heat damage of any kind can create long-term DNA damage and collagen losses as the research has always identified.  

Where does that leave skin? Is there any hope in restoring youthful collagen density? The key is to not inflict new damage if the goal is for skin to work on old damage. This is called holistic medical aesthetics. Collagen is produced within the dermis, yet the skin is remarkably effective at preventing most topical ingredients from penetrating that deeply. While certain ingredients, like many widely promoted peptides, can stimulate the skin’s immune response in a petri dish, actually reaching the fibroblasts in living skin is an entirely different challenge. Retinols and alpha hydroxy acids can trigger exfoliation that leads to modest collagen gains, but this collagen is directed to the epidermis to keep up with the forced shedding.  

An effective delivery system that does not wound skin is needed. Phosphatidylcholine liposomes are the most proven strategy – even the pharmaceutical companies use it. Very few companies spend the money on this ingredient, and it is to their detriment. When effectively delivered, ingredients like chlorella, retinaldehyde, niacinamide, hydroxy amino acids, beta glucan, human growth factors (especially when paired with exosomes), asiaticoside, and R-lipoic acid have shown potential as collagen stimulators. While some of these also offer antioxidant benefits, it is worth noting that antioxidants alone are unlikely to visibly reverse signs of aging unless they also support collagen production.