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From the age of 30 onwards, production plummets. There is more, because not only is the amount the body produces reduced, but also the deposits that are stored in the body begin to be endangered. Yes, we are talking about collagen, one of the proteins responsible for skin firmness, elasticity, radiance and which also plays a key role in skin hydration. This is why collagen inducers are one of the treatments that, according to aesthetic medicine experts, should not be missing from patients’ portfolios.
Collagen stimulators are those substances or elements that allow the body itself to trigger a greater production of collagen,” explains Dr. David Bentué, expert in facial treatments and member of EIMEC’s professional training team. They are used on patients so that collagen levels in the superficial layer of the skin are not only maintained but also increased. With what purpose? Well, to prevent sagging and give structure to the skin“. In other words, the presence of collagen will make the skin struggle less to fight against ageing, become thicker and look more luminous. In addition, they are allied in dermatology to treat acne marks and even wrinkles.
Students applying collagen inducers at CEMEF23.
“There are several substances that stimulate collagen. The most common is calcium hydroxyapatite; then we have polylactic acid, polycaprolactone and polynucleotides,” Bentué says. These substances can be combined with other elements resulting in different products, such as Radiesse, Ellansé, Harmonyca, Lanluma, or what is now called Fillers”. All of them, insists the specialist, who holds a master’s degree in aesthetic medicine from the Complutense University of Madrid, are different products from different laboratories that include collagen stimulators, but always in combination with some other substance. There is no collagen stimulator on the market that is free,” warns Bentué. In the end, collagen stimulators are mixed with other substances”.
What is the history of these products? It is true that hyaluronic acids have always been more widespread in terms of their use,” admits Bentué. Hyaluronic acid has always been safer and easier to use. But collagen stimulators have been used in ascetic medicine for more than 10 years now. In the last two years, new products have come out, and they are increasingly safer, with more indications, with more protocols. And that has favoured their application.
Regarding the reputation of collagen inducers, Bentué does not hesitate to say that it has always been good. However, he warns: “The most widely used until two years ago, which was Radiesse [which combines calcium hydroxyapatite with carboxymethylcellulose], is a product that has always been subject to some complications, sometimes irreversible. What does this mean? When I have a complication with hyaluronic acid, most of the time I have an antidote, which is hyaluronidase, and it solves the problem. Hydroxyapatite has no antidote as such, so there was a time when it was less used for fear of lack of solutions in the case of a complication.
“When applied incorrectly, or where it does not correspond or in the wrong amount due to an incorrect diagnosis, a stimulator such as calcium hydroxylapatite can have a complication -although in a small percentage-, such as nodules,” the expert maintains. And in this sense, he points out the progress in the standardization of protocols. “As in all sectors of aesthetic medicine, we have achieved greater standardization in the last five or six years. Now we no longer prick because we think it will work, we prick because we know it will work. There are protocols for dosage, zone and technique, which has standardized all the procedures, and there are currently very good protocols for collagen stimulators.
As with any treatment, Bentué repeats, collagen stimulators are not exempt from some complication or the result not being as the doctor or the patient expected. “There may be, for example, a low collagen stimulation response. Although it is also true that, recently, the latest stimulators that have come out products with very low rate of side effects. One of them is Harmonyca -which is a hybrid that contains calcium hydroxyapatite mixed with hyaluronan-, or polynucleotides -of great regenerative capacity-. These are very safe products to use, and there have been no complications. The key is to use a good technique and to have a good diagnosis”.
Dr. Bentué in the course of Anatomy Applied to Aesthetic Medicine CAAME.
In short, they are all biodegradable, biocompatible and safe if used properly. They are applied with a cannula or needle and are completely eliminated over time. But keep in mind that it will take at least a month to see results, as this is the approximate time fibroblasts need to produce collagen. “Today we have many ways to stimulate collagen, and it is a type of treatment that has to be within the portfolio recommended to patients -suggests Bentué, and concludes: “It is very important not only to fill faces, not only to fill hollows. One of the benefits of working with collagen stimulation is that it is a long-term treatment. We are talking about durations between 12 and 18 months.”
In summary, Bentué concludes, the best combination in a patient would be the application of neuromodulators (botulinum toxin) in the upper third, collagen stimulators for the middle third and hyaluronic acid in the lower third.
