Wednesday, October 21, 2009

SHOCK THERAPY Can electricity zap away the years? Celebrities are lining up but some doctors are skeptical.

Reprinted from ELLE Canada
November 2009

By Amber Nasrulla

Long before diamond facials, clay masks, and chemical peels were invented, women created their own age-defying concoctions: cucumber slices to soothe eyes, milk baths to soften skin, sugar and salt scrubs to purify and exfoliate skin and lemon juice to remove blemishes.

Now a new anti-aging technology is kicking the simple facial to the curb: radio frequency (RF) technology. In Europe, a handheld device called the TriPollar STOP – which claims to smooth wrinkles using RF energy and micro-electric currents – is generating buzz.

Physicist Dr. Zion Azar, who created the TriPollar STOP, hopes to sell it in North America in 2010. “It turns back time five to 10 years,” he effuses by phone from Tel Aviv, Israel. “It’s actually making the skin younger.” Azar says that the TriPollar STOP stimulates collagen production to provide a “non-surgical facelift”. (Collagen gives the skin elasticity, so more collagen means plumper, firmer skin.) For anyone with wrinkles deep as ravines that Sherpas could fall into, the allure is obvious.

In the United States, the Food and Drug Administration has cleared six handheld cosmetic devices. (Health Canada regulates medical devices but cosmetic technology doesn’t require pre-market approval.) Suzanne Somers, the duchess of late-night infomercials, sells the FaceMaster ($250), calling it “a lunch-time facelift”. NuFace, a $350 device from California, promises an “instant youthful appearance within minutes.” Creator Carol Cole says NuFace’s micro-current “is like Pilates for the face. It strengthens the core muscles.”

Micro-current facials and RF are a fixture in salons in Beverly Hills, New York City, Miami, Vancouver, and Toronto. As with headlight-bright teeth and customized spray-on tans, Hollywood A-listers are poster children. Oscar-winner Kate Winslet frequents the Tracie Martyn Salon in Manhattan and is reportedly devoted to the Resculpting Facial that offers micro-dermabrasion, micro-currents, and calming creams. In a note to Martyn scribbled on a cover of InStyle magazine, Winslet gushes, “It’s only because of you that I look good enough to be on this cover.” (Winslet doesn’t mention the phalanx of chefs, personal trainers, make-up artists and stylists, who ensure she looks heavenly.) Susan Sarandon, Madonna and Liv Tyler are also rumoured to be fans of the $360 treatment.

For years, physicians and physiotherapists have used micro-current technology (also called TENS, or transcutaneous electrical neuromuscular stimulation) to help heal soft tissue injuries and alleviate neck and back pain. Dermatologists have Thermage, which uses patented RF technology to generate heat that penetrates deep into skin. Clinical studies show that Thermage stimulates the body’s natural production of collagen, which tightens skin and gives it a smoother appearance. Doctors can contour or remodel the face with Thermage says Dr. Vince Bertucci, a consultant dermatologist a Women’s College Hospital in Toronto and medical director at Bertucci MedSpa in Woodbridge, Ont. “It’s not a facelift but the results can be significant,” he says.

Micro-current technologies and RF have been tweaked for non-medical use in dermatologists’ offices. But salon devices (and handheld ones) are weaker and don’t penetrate skin as deeply. Some use two or three electrodes while others use patches. Some claim to stimulate muscles while others report that they increase collagen. After short training sessions, aestheticians can do treatments without a physician supervising. (Session fees run from $200 to $400.)

But some dermatologists are skeptical. The marketers’ scientific language sounds authoritative, but there’s often little evidence behind the claims. “It’s getting harder to separate the blue-ribbon science from the bluff,” says Dr. Douglas Hamilton, an assistant professor of dermatology at the University of California at Los Angeles and chair of the New Technologies Committee of the American Society for Dermatologic Surgery. Hamilton has a dermatology practice in Beverly Hills with numerous celebrity clients. “There’s no consumer czar to help people make a decision,” he says. “It’s buyer beware.”

Although physicians use TENS devices, the results can’t be extrapolated for cosmetics facial rejuvenation. “There’s not a lot of great published science behind it,” cautions medical and cosmetic dermatologist, Dr. Benjamin Barankin, of The Dermatology Centre in Toronto.

The gold standard in medicine is double-blind placebo controlled trials. Clinical trials evaluate thousands of participants over several years and the results are published in peer-review and scientific journals. To date, none of the doctors consulted for this story has seen clinical studies on cosmetic RF or micro-current devices.

One manufacturer talked about its 30-day-study of five people that found a 67% reduction in wrinkles. Another manufacturer sent ELLE Canada its study of 23 women over six weeks, and reported an 86% improvement in eye wrinkles and 76% of mouth lines. The manufacturer also tested a single sample of human skin and found collagen increased by 40%. “Medical journals publish high-quality research with lots of patients in the studies so we can generalize the results to the population,” notes Barankin. “A study with one patient – the inventor’s wife I’m sure – counts for nothing.”

The results “stretch credibility,” agrees Hamilton, because of few participants and short duration of the tests. “There’s a huge disconnect in skin care. Many things work beautifully in a test tube but do not work at all on complex, living, human skin.”

How do these devices come to market? The FDA and Health Canada “approve” the treatments for medical use. The FDA classifies machines for cosmetic differently and “clears” them, meaning they’re safe but not necessarily effective. Neither the FDA nor HC conduct their own, independent, clinical studies; instead, they rely on the information provided by the company applying for approval. (They also don’t specify the number of people required.) In his book Beverly Hills Beauty Secrets, Hamilton spells it out: “This potentially corrupts the integrity process and, at the least, reduces its efficiency.”

So what’s the secret to Winslet’s radiant skin? RF and micro-currents can irritate the skin so it swells and facial lines disappear, says Barankin. The effect is likely temporary. Manufacturers recommend treatment three or four times a week because “you have to keep initiating the inflammation and swelling.”

Dermatologists also question manufacturers’ claims that micro-currents strengthen facial muscles. True, the body sags less when muscles are stronger. But over time the muscles could grow bigger. “Those muscles will contract more and make deeper furrows, grooves, and wrinkles,” says Barankin.

When manufacturers trumpet their contraptions bump up collagen production, Hamilton responds: “To stimulate collagen is no great trick.” Shaving and micro-dermabrasion do it too. “It’s all a matter of degree.” So, is it likely the devices induce enough collagen formation to reverse wrinkles? “No.”

His conclusion? “This could be one trend when it’s best not to be at the front of the line.”

For the complete feature, pick up the November 2009 issue of ELLE Canada.

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