Tuesday, July 24, 2018

Immediate skin rejuvenation with injectables. Rejuran versus PRP versus Skinboosters: Which one is best for me?


Immediate skin rejuvenation with injectables. Rejuran versus PRP versus Skinboosters: Which one is best for me?

An educational article by Attending Physician Dr Bob John

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As an Aethetic Physician, I commonly get enquiries on how to improve the skin condition instantly. It could be in preparation for a reunion, a wedding or a special event, but these clients would come in for quick fix and a perk me up, so that they can look their best in the shortest amount of time possible.

Energy based devices such as Q-Switched laser (Medlite C6), Copper Bromide laser (Dual Yellow), Picosecond laser (Cutera Pico Genesis), Microneedling Radiofrequency (Sylfirm), Microfocused Ultrasound devices (Ultherapy) usually requires time to exert the effects.

Therefore, the fastest method to see almost instantaneous results is by using injectables. The downtime is minimal, and the results are immediate.

But between the different modalities that can be injected into the skin, amongst them Platelet Rich Plasma, Skinboosters (Hyaluronic acid) and the newest kid on the block Rejuran (Polydeoxyribonucleotide), which one provides the best results?

In this article, I hope to shed some light on the difference between the different injectables and help you to decide which one suits your condition best.


What is Rejuran Healer?

The active ingredient in Rejuran Healer is Polydeoxyribonucleotide (PDRN) which is a type of polynucleotide (PN) derived from trout (salmon). PN are molecules that are present in all living organisms and are basically the building blocks that make up DNA.

PN in Rejuran Healer is derived from Salmon germ cells and subjected to a very rigorous purification process that removes any antigens or proteins that might cause immune reactions.

PN has been extensively researched and demonstrated to be effective in wound healing.

Rejuran improves your skin via the following

1)         Improving microcirculation via process called angiogenesis.
 2)        Anti-inflammatory effects on tissues.
3)         Improves skin texture and elasticity- collagen synthesis is enhanced by fibroblast activation.
4)         Tissue repair and wound healing- PN salvages DNA and RNA fragments from damaged cells to incorporate them into new DNA for normal cell proliferation and recovery.
5)         Protection from UV damage- PN has been shown to enhance DNA repair and clearance of toxic by-products of UV damaged cells.



What is Platelet Rich Plasma (PRP)?

PRP is harvested from a patient’s peripheral blood by a centrifugation process to concentrate platelets and growth factors. Once processed, the PRP has between five to eight folds the concentration of platelets relative to whole blood.

PRP can promote stem cell regeneration as well as soft tissue healing. The growth factors identified in PRP include platelet-derived growth factor, transforming growth factor-β, vascular endothelial growth factor, epidermal growth factor, and insulin-like growth factor.

PRP improves the skin by the following

1)             stimulate multiple cell types including monocytes, fibroblasts, stem cells, endothelial cells, and keratinocytes

2)             Promote new blood vessels (angiogenesis)

3)             Induce new collagen production (neocollagenesis)

4)             Increase vascular permeability


Aesthetic uses include soft tissue augmentation, skin rejuvenation, hair restoration, wound and skin graft healing, and fat graft augmentation.


What is Restylane® Skinbooster (Skinbooster)?

Skinbooster is a hyaluronic acid (HA) product injected superficially for revitalization of the skin are and have a clinically proven effect duration of up to 12 months.

It improves the signs of skin aging through stimulation of the extracellular matrix (ECM). Our skin contains approximately 50-56% of the total body content of hyaluronic acid. HA is a significant stabilizing component of the ECM, can bind large amounts of water and is essential for hydration homeostasis.

Skinboosters improve the skin by the following

1)             HA is an important functional tissue component, because extracellular substance transport as well as the activity of the immune system are associated with the hydration status of the ECM.

2)             HA is pivotal for cellular processes such as proliferation, differentiation and migration.

3)             HA stimulates fibroblast proliferation and activity with an increased biosynthesis of collagen and other components of the ECM

4)             HA has cell protecting properties against external noxious substances.

Restylane® Skinboosters lead to an improvement of skin quality without significant volume changes. The skin is hydrated, its elasticity increased, the skin surface smoothened, and fine lines and wrinkles are reduced.


So which one is the best for me? 

The functions of Rejuran and Platelet Rich Plasma are very similar. They both share the same mechanism of action via promoting tissue healing and repair. Rejuran does so via Polynucleotides, whereas PRP does the same via growth factors.

The main difference would be the source of the product. PRP is harvested from clients own blood, therefore there is no risk of an immune response (allergy) nor risk of blood-borne infection.  This may be more suitable for clients with concerns of anything foreign injected into their skin.
Rejuran on the other hand is derived from Salmon DNA, as it is very similar to human DNA. The salmon cells are subjected to a rigorous purification process to remove any antigens or proteins that may cause biocompatibility or immune reactions. This treatment may be suitable for clients who find the very thought of applying their own blood products on their face (famously known as vampire lift), or who may face difficulty having their blood drawn to harvest PRP (difficult veins).  However, clients with concerns of animal sources (vegans, PETA) may object to the idea that Rejuran is derived from Salmon.

Skinboosters on the other hand differentiates from PRP and Rejuran, because its main mechanism of action is  hydration of the ECM. The main content of Skinbooster is hyaluronic acid, which is extremely hydrophilic and therefore very hydrating. If skin dryness with poor elasticity is the main skin concern that you are addresing, then skinbooster may be the better choice compared to the either PRP or Rejuran.


References

1.              Squadrito, F., Bitto, A., Irrera, N., Pizzino, G., Pallio, G., Minutoli, L. and Altavilla, D., 2017. Pharmacological activity and clinical use of PDRN. Frontiers in pharmacology8, p.224.
2.              Sand, J.P., Nabili, V., Kochhar, A., Rawnsley, J. and Keller, G., 2017. platelet-rich Plasma for the Aesthetic Surgeon. Facial Plastic Surgery33(04), pp.437-443.
3.              Kerscher, M., Eiben-Nielson, C., Kleine-Boerger, L., Haas, H., Sattler, S. and Sattler, G., 2017. Restylane Skinboosters for improved facial skin quality using two treatment sessions.


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