IPL was found to improve the skin’s quality210 and increase collagen synthesis after only four sessions211. When IPL was compared to CO2 laser, it was found that although skin elasticity was improved in both groups, clinical wrinkle reduction was much more evident in the CO2-treated group. However, the CO2-treated group suffered from erythema, dyspigmentation and milia, while the IPL had no observable side effects212. On the contrary, in another independent study IPL was found to have more side-effects than the Nd:YAG laser213.

Radiofrequency (RF) by electromagnetic energy generates heat through the dermis, causing collagen to contract and thus improving skin’s laxity and reducing wrinkles. Minimal side-effects have been reported, with erythema usually resolving after 1–2 hours214, 215. In a randomised, blinded split-face study, no significant results were observed in wrinkle reduction and laxity for both the unipolar and bipolar RF, but it only showed a trend towards improvement214. New machines have been developed which give a combination of RF and non-ablative lasers, but unfortunately there is lack of long-term studies of efficacy.

Conclusions

Age brings characteristic changes to the skin. In addition, UV exposure and other environmental factors accelerate the natural ageing process. There are a number of treatment options available, but recent discoveries in dermal skin ageing mechanisms are giving rise to new treatments to prevent and delay skin ageing.

Currently, the appropriate dose and application frequency of most topical antioxidants, retinoids, hormones, growth factors and cytokines still needs to be determined. Future research should also focus more on the ideal diet and caloric intake needed to minimise skin ageing. Another area of research that has a lot of potential is stem cell technology. Adipose-derived stem cells have shown to have an anti-wrinkle effect on human skin owing to their antioxidant properties216. A 2% cream applied twice daily for 4 weeks, made up from apple cultivar stem cells, was found to significantly reduce wrinkles in the crow’s feet217. Whatever the approach to preventing and treating skin ageing, the trend is towards finding treatments which are less invasive and with minimal side-effects.