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Wrinkle fillers-Collagen injections

 

Collagen, the key structural protein of the skin, would seem a perfect choice as a wrinkle filler. To a large degree, a wrinkle is a localized loss of collgen. So it would seem natural to try to restore the lost collagen by injecting it back. Indeed, collagen has been injected into wrinkles for decades. However, the merits of collagen injections, or lack thereof, is another matter. While a standard collagen injection can temporarily plump up a wrinkle, the effects rarely last beyond 3-6 months and, for some types of collagen, there is a significant risk of allergic reaction. In recent years, other types of wrinkle fillers have stolen some spotlight and market share from injectable collages. On the other hand, new approaches to delivering collagen into a wrinkle have been evolving too. Below we discuss various types of collagen injections.

Bovine collagen


Bovine injectable collagen (Zyderm, Zyplast, etc.) has been around the longest and is the least expensive. Unfortunately, around 3-7 percent (estimats wary widely) of people develop an allergy due to small but important structural differences between human and bovine collagen. As a result, every patient considering bovine collagen treatment requires a skin test to determine sensitivity. Only if no reaction is observed at the injection site after four weeks, the treatment may proceed.

Importantly, people with connective tissue diseases such as rheumatoid arthritis, systemic lupus erythematosus, scleroderma and dermatomyositis appear more likely to develop an allergic reaction to bovine collagen. It is prudent to avoid bovine colagen injections in people with such conditions. There have also been reports of connective tissue disease arising for the first time after bovine collagen injections. However, a causative link between the injections and connective tissue disease has not been established.

Injectable bovine collagen is used mainly for wrinkles of varying depth and depressed scars. The existing range of brands allows to select a product optimal for the size of target wrinkles or scars.

Since collagen is gradually degraded by the body's enzymes, the effects tend to dissapear after 3-6 month and the treatment must be repeated to maintain results.


Human collagen


Human injectable collagen (Dermalogen, Autologen, etc.) is similar to bovine collagen in terms of its uses, durability and other properties but has one important advantage: lower risk or allergic and other immune reactions. It does not require allergy testing. However, human collagen tends to be more expensive. The sources vary depending on the brand and include human tissue culture, cadaver tissue obtained at the time of death, and patient's own excess skin removed during cosmetic procedures.

Fibroblast Injections


One of the main drawbacks of collagen injections is that injected collagen is gradually broken up by the proteolytic enzimes and can only be replenished by more injections. An interesting new approach is to inject collgen-producing cells (fibroblasts) instead of collagen itself. If the injected fibroblasts take hold in your skin, they can keep producing collagen for a long time. However, the use of fibroblasts from donor skin is difficult because of tissue rejection problems. (You wouldn't want to take immunosupressive drugs just to soften your wrinkles, would you?). One currently available aletrnative (patented under the brand name Isolagen) is to harvest the patient's own fibroblasts (from a small skin sample), grow them in tissues culture and then inject into wrinkles and scars. In theory, such approach should provide lasting results without the need to repeat the treatament. On the other hand, this process is far more expensive than conventional collagen injections. The use of fibroblast injections for skin rejuvenation is still relatively new, more research is needed to better quantify the benefits.

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