Men's skincare in the clinic

A man in his forties sits down in the chair and says: “I look tired, even though I have slept well”. Or he shows a photo from five years ago and asks what has happened to his hairline.

There are more and more such conversations in my clinic. The largest group of my patients are men between 40 and 50 years of age. The scale of the phenomenon is also visible in the statistics — for years the American Society of Plastic Surgeons has recorded a rising number of aesthetic procedures in men in its annual reports.

Men's skin follows its own rules. It is thicker, has more sebaceous glands and ages differently from women's. That means different problems — and a different approach to solving them.

Hair: a process that cannot be stopped, but can be slowed down

Premature hair loss is one of my patients' greatest worries. There is no point in beating about the bush: it is a process that is very hard to stop. There are, however, methods that allow it to be slowed down considerably.

The basis is diagnosis. In men we most often deal with androgenetic alopecia — genetically determined and progressing gradually, though relentlessly.

The hair weakens and falls out first in the so-called androgen-dependent areas: above the forehead, where the receding hairline forms, and at the crown of the head.

The basis of treatment for androgenetic alopecia is two drugs with the best documented efficacy: minoxidil applied topically to the scalp and finasteride taken orally. Both work for as long as they are used, and it is the doctor who decides about starting them and about contraindications — finasteride is a prescription drug intended for men. The treatments described below supplement such therapy; they do not replace it.

Platelet-rich plasma, the so-called vampire lift

This is usually the first method I propose.

The material for the procedure comes from the patient's own blood — we draw it and spin it in a centrifuge. Thanks to this there is no risk of a reaction to foreign material and the procedure can also be carried out in sensitive people and in those with allergies. As with any injection, you have to reckon with soreness, swelling and bruising at the puncture sites.

The platelets are the key. They are a natural reserve of growth factors, essential for the regeneration of cells. The plasma is administered by injection straight into the scalp.

The effect: stimulated tissue regeneration and increased regrowth. The hair becomes thicker and stronger, shedding slows down, regrowth speeds up.

For optimal results we carry out a series of 3–6 treatments at intervals of 2–4 weeks.

Peptide mesotherapy

The second method is for men who want to thicken and densify their hair and stop it falling out.

As in mesotherapy, the preparation is administered straight into the scalp. This time, instead of platelets, we inject a mixture of seven selected peptides and hyaluronic acid. The preparation stimulates circulation and nourishes the hair follicles.

The very first treatment slows the shedding. The following ones stimulate the regrowth of new hair, make it denser and thicker.

A single treatment takes about 30 minutes and consists of a series of microinjections — fewer than in classic mesotherapy. A small amount of concentrated preparation is enough, because thanks to prolonged-release technology it remains in the skin for another two weeks after the treatment.

Most often I carry out a series of 4 treatments at two-week intervals. The results are noticeable after two months. After six months we usually do a booster treatment, and the whole therapy can be repeated after a year.

Needle mesotherapy

If you want to strengthen your hair but do not want to give blood, there is a third way: a series of needle mesotherapy treatments with preparations dedicated to the scalp.

The treatments are carried out in a series, but often the first one already brings the effect of strengthening the hair follicles.

Wrinkles in men: later, but deeper

Thicker skin has its advantage — wrinkles appear in men later than in women.

The catch is that once they do appear, they are deeper and more pronounced straight away, they cover the face with a denser network and are harder to smooth out. It does not help that most men approach wrinkle prevention rather casually.

When the wrinkles are already visible, home care is not enough.

Nd:YAG laser — for those who have no time for recovery

The non-ablative Nd:YAG laser is a treatment for men with a full diary.

It counters the signs of ageing: it softens fine wrinkles and improves the density of the skin. The result is firming and improved density and texture of the skin. Carried out in autumn, the treatment also helps to remove sun-induced pigmentation and reduces the visibility of pores.

The most important thing from a practical point of view: it requires no recovery time. You walk out of the clinic and go back to what you were doing.

Botulinum toxin

An anti-wrinkle treatment that works on an entirely different principle — an injection of botulinum toxin.

Botulinum toxin blocks the conduction of nerve impulses to the muscles. Deprived of the stimulus, the muscles stop contracting. The process is reversible — everything returns to its original state after roughly 3–5 months.

The preparation is administered with a thin needle into the muscles lying just under the skin. The treatment is not very painful, but at the patient's request the skin can be numbed beforehand with a cream.

In men I most often work on the mimic wrinkles of the forehead, crow's feet and the frown line between the eyebrows. The face then looks smoother and more rested.

A more masculine face — it can be designed

How does a man's face differ from a woman's? Above all in geometry. A man's is angular, it has sharp edges. A woman's has flowing, rounded cheeks and chin, without pronounced angles.

That is of course a canon, not a rule — not every one of us fits into it. If a man would like a more masculine face, there is a way: masculinisation.

During facial volumetry I administer hyaluronic acid so as to sharpen the jawline, the cheeks and the chin.

Skin after the holidays

Patients coming back from holiday are in great spirits. Their skin — less so. It can be greyish, dull, often sunburnt.

What works well then is GeneO® — a treatment for the face, neck and décolletage that gives an immediate improvement in tone and hydration. Pigmentation fades, wrinkles are reduced, the face regains a radiant look.

How does it work? First I apply to the skin a gel rich in care ingredients. Then a capsule which, on contact with the skin, releases carbon dioxide. Bubbles form on the skin and, as they burst, they cause better blood supply. As a result of the Bohr effect, more oxygen is released in the skin.

The treatment gives three things at once:

• exfoliation of the outer layer of the epidermis,
• better absorption of revitalising substances (azelaic, kojic and hyaluronic acid),
• natural oxygenation of the skin.

Right after the treatment the skin is smoothed, cleansed and radiant. The effect lasts up to 3 months.

Acne after thirty is not a mistake

Men's skin is thicker and stronger than women's — this is due to the androgen-dependent density of collagen in the dermis. It also has more sebaceous glands and more pronounced seborrhoea. But the same feature has another side.

It is men who often suffer from adult acne — and usually do not know what to do about it.

Sometimes it is persistent acne: acne that was not fully treated in adolescence and that returns from time to time with varying severity. But it may just as well be an entirely new condition, unrelated to teenage breakouts. The scale changes with age: acne affects about 40% of men before thirty, about 20% between 30 and 40, and about 12% after forty.

Breakouts, nodules and inflammatory lesions can be a source of real frustration. And acne can be treated — depending on the severity, topical treatment, oral treatment or both at once are used.

When the condition of the skin improves, selected dermocosmetics and chemical peels come into play. For acne-prone, oily skin with enlarged pores I use a medical peel based on pyruvic acid. It soothes the lesions, reduces comedones and seborrhoea, and at the same time does not cause heavy peeling.

The male flush that will not go away

Hard to hide facial erythema. Dilated vessels (telangiectasia). At an advanced stage — papular lesions.

These are symptoms of rosacea, a common complaint in men with vascular skin that is sensitive to external factors and easily irritated.

At first the redness may be transient. Over time it becomes fixed and the face is covered by an ever denser network of red “spider veins”. The sooner you start treatment, the greater the chance of halting the condition.

In rosacea in remission and in chronic redness of vascular skin, what helps is a medical peel based on mandelic, salicylic and lactic acids and retinol, in precisely selected concentrations. Rosacea is not, however, a bacterial infection — the peel works here by exfoliating and reducing inflammation, not by disinfecting. In very reactive skin retinol can be an irritant, which is why I select the concentrations carefully and start with the lowest.

If you care about a faster effect, it is worth considering laser treatment of pigmentation and erythema. The results are visible after just a few days, although the treatment is usually carried out in a series of 3 sessions about 4 weeks apart.

Body treatments

The fashion for a healthy lifestyle has meant that men appreciate the process more than the result alone. They like to work up a sweat at the gym and treat healthy eating as a pleasure. They do not want to take shortcuts.

It happens, however, that exercise, diet and supplements are not enough — and there remain places from which the fatty tissue does not want to disappear.

For local reduction of stubborn fat we use Coolshaping cryolipolysis — non-invasive reduction with controlled cold — injection lipolysis, and LPG Alliance® endermologie together with shockwave therapy when skin firmness also matters.

Laser hair removal

Once the body is well looked after, the final touches remain.

For many men it is not baldness but excessive hair that is the greatest nuisance. Hence the growing popularity of hair removal from the chest, back and armpits, and not infrequently also the buttocks and intimate areas.

Men look for methods that are effective and give a long-lasting result — which is why the best solution is diode laser hair removal.

The mechanism is thermolysis: the laser energy is absorbed by the melanin contained in the structure of the hair and thermally damages the follicle. The principle is simple — the darker the hair, the more effective the treatment.

The laser is equipped with a reader of the melanin level in the skin. On the basis of the measurement, personalised parameters of the treatment are selected, which makes it possible to use higher energy and increase effectiveness without the risk of a burn.

Important: during the treatment only hairs in the growth phase (anagen) are destroyed. That is why it has to be repeated:

• Intimate areas, armpits — 4–6 weeks.
• Back, calves, thighs — 8–10 weeks.

Two things worth knowing before the first appointment. The laser recognises the hair by its melanin, so it will not work on grey, white or very fair hair. Rarely — more often in men and more often on the back, shoulders and upper arms — the opposite reaction occurs: in the area next to the treated one the hair starts to grow more densely. This is reversible and responds to further treatment, but it is better to hear about it before the procedure than after.

Finally

The truth is that most treatments in aesthetic medicine and cosmetology are also carried out in men. The offer is broad and there is nothing in it reserved for one sex.

If I were to advise one thing: do not start by choosing a treatment. Start with a consultation and a diagnosis. With hair, the basis of good treatment is the diagnosis of the alopecia, and with facial lesions — recognising what kind of acne we are dealing with. That is what determines whether a treatment will work at all.

You will find the full range of treatments for men — from skincare to aesthetic medicine — on the page Dr Kuschill MEDESTETIS clinics' offer for men.

This article was prepared by Joanna Kuschill-Dziurda MD PhD — specialist in allergology and internal medicine, physician in aesthetic medicine.