What Treatments to Consider for the Winter?

Winter is a great time to reset the skin—especially with treatments like chemical peels, radiofrequency (RF) microneedling, and laser. These procedures are often best done when you can be extra diligent about sun protection, because the skin will be inflamed and can become more UV-sensitive right after treatment. Less intense sun in winter makes it easier to protect your treated skin, reduce the risk of unwanted pigmentation and scar, and ensure the result you want.

In addition to UV rays, heat and sweat are your enemy after these treatments. Your goal immediately after treatment is to minimize inflammation and calm your treated skin. Activities, environments or conditions that lead to heat, flushing, sweating, irritation, itchiness and breakouts are to be avoided before and after these procedures. In the winter, we are less likely to engage in activities or be in environments that would cause these concerns. 

These treatments are commonly recommended for two major categories of skin concerns: tone and texture.

So, what do those terms actually mean, and how do these treatments help?

Skin tone refers your baseline skin shade and hue (warm, cool, neutral or olive). However, in skin care and aesthetic, skin tone is often discussed in the context of how even the skin color appears. For most, the concern with skin tone is the unevenness, hyperpigmentation or even melasma.

Of these treatments, chemical peels effectively even the skin tone. Chemical peels target the superficial layer of the skin, where discoloration occurs. The peels do not remove all of the melanocytes, cells that produce melanin; they lift away the damaged, pigmented top layers of the skin and increase cell turnover for healthy, new skin to rise to the surface. Some formulations include ingredients that disrupt the melanocytes and thus melanin formation. For example, our Intense Brightening Chemical Peel contains ingredients that exfoliate and brighten the skin for more lasting even skin tone.

Now, texture refers to the surface of skin and how smooth. Ideally, the skin is void of flakiness, enlarged pores, acne scars, and fine lines. Significant thinning and fine lines of skin result in “crepey” texture. Chemical peel helps smooth out the dried, flaky skin on the surface. However, for the deeper concerns like pores, scars and lines, treatments that stimulate collagen in the dermis, the deeper layer of the skin, are more effectively.

Microneedling creates micro-channels in the skin and stimulates a controlled healing process. This mechanism involves activating fibroblasts, increasing the production of collagen, elastin and extracellular matrix, and remodeling of collagen. Old collagen gets replaced and re-organized. Collagen, elastin and extracellular matrix are the support structure that give the skin the plumpy, firm, and youthful appearance. Scars and fine lines form when the skin loses collagen. Microneedling results in new collagen filling in the scars and fine lines and thickening the skin. With radiofrequency microneedling, heat is delivered into epidermis and dermis and thus stimulates deeper collagen remodeling, tightens the pores, increases firmness and reduces “crepey,” lax skin. Compared to a chemical peel, RF microneedling targets deeper skin structure to help the surface.

Laser can improve pores, scars, fine lines and crepey skin by also creating controlled micro-injury and triggering collagen remodeling—similar to the microneedling, but by a different mechanism. Laser also resurfaces the epidermis, like chemical peels but usually deeper. In my practice, laser is my go-to for fine lines. It can produce some of the smoothest overall texture of any modality.

With laser, the energy is delivered in a highly consistent pattern and depth. That consistency helps create a bigger and more uniform collagen remodeling response, which fine lines often need. Also, because of the tight pattern of energy delivery, laser can also target fine lines better.

While all three modalities cause micro-trauma and thus collagen production and remodeling, the latter two treat beyond the superficial epidermis. Depending on the concerns, one, two or all three of these modalities may be performed.