ELLE Beauty - Douglas Hamilton MD

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SHOCK
THERAPY
Can electricity zap away the years Celebrities are lining
up, but some doctors are skeptical. TEXT: AMBER NASRULLA
MARC PHILBERT
L
ong before diamond facials, clay masks and chemical
peels were invented, women created their own agedefying 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 actually makes 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.)
In the United States, the Food and Drug Administration
(FDA) has cleared six handheld micro-current cosmetic
devices. (Health Canada regulates medical devices, but
cosmetic technology that makes no therapeutic claims
doesn’t require pre-market approval.) Suzanne Somers, the
duchess of late-night infomercials, sells the FaceMaster
($250), calling it “a lunchtime facelift.” NuFace, a $350
device from California, promises an “instant youthful appearance within minutes.” Creator Carol Cole says that
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, 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, which offers microdermabrasion, micro-currents
and calming creams. In a note to Martyn scribbled on a
cover of InStyle, 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,
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makeup artists and stylists who ensure that 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 (transcutaneous electrical nerve 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 the
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 at 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 the 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 supervising physician. (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 clinical 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 cosmetic facial rejuvenation. “There h
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isn’t a lot of great published science behind it,” cautions
Dr. Benjamin Barankin, a medical and cosmetic dermatologist for The Dermatology Centre in Toronto.
Double-blind placebo-controlled trials are the gold
standard in medicine. 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 high-quality clinical studies on cosmetic RF or
micro-current devices.
One manufacturer talked about a 30-day study that
found a 67-percent reduction in wrinkles. Another
manufacturer conducted a study of 23 women over six
weeks and reported an 86-percent improvement in
wrinkles around the eyes and 76-percent improvement
in lines around the mouth; the manufacturer also tested
a single sample of human skin and found a 40-percent
collagen increase.
“Medical journals publish high-quality research with
lots of patients in their studies so that we can generalize
the results to the greater population,” says Barankin. “A
study conducted with few patients counts for little.” The
results stretch credibility because of the lack of participants and short duration of tests, explains Hamilton.
How do these devices come to market? The FDA and
Health Canada have approved the treatments for medical use. The FDA classifies machines for cosmetic use
differently and clears them, meaning that they’re safe but
not necessarily effective. Neither the FDA nor Health
Canada conducts its own independent clinical studies;
instead, both agencies rely on information provided by
the companies applying for approval.
So, what’s the secret to Winslet’s radiant skin?
Micro-currents and RF can irritate skin so that it swells
and makes facial lines appear to disappear, says
Barankin, but the effects are probably 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 can grow bigger. “While
there may be facial strengthening, those muscles will
contract more and create deeper furrows, grooves and
wrinkles,” says Barankin.
When manufacturers claim that their contraptions
bump up collagen production, Hamilton argues that
stimulating collagen is no great trick. Shaving and
microdermabrasion do it too. “It’s all a matter of degree,” says Hamilton. So, is it likely that the devices
induce enough collagen formation to reverse wrinkles?
“No,” he says. “This could be one trend where it’s best
not to be at the front of the line.”N
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