4 mins
Sabika Says
Dr Sabika Karim considers the evolution of prejuvenation, from ancient rituals to modern aesthetic medicine
DR SABIKA KARIM
Dr Sabika Karim, founder of Skin Medical, is a multi-award-winning international educator who combines her NHS GP background with 19 years of aesthetic medical practice to deliver gold standard treatments to her patients at the clinic whilst raising industry standards by teaching and training her peers.
Conflict of Interest Statement – The views expressed are solely my own and have not been influenced or sponsored by any external parties. For full transparency, I am a key opinion leader (KOL) for Sinclair Pharma, Cellese, Evolus, Dermalux, and Erchonia.
Prejuvenation – a term denoting proactive strategies to maintain youthful skin and delay ageing signs – has gained prominence, particularly among younger demographics. While the concept is contemporary, the practice of preserving youth dates back millennia. This article explores the historical context and current trends in prejuvenation, providing insights for aesthetic medical professionals.
HISTORICAL PERSPECTIVES ON PREJUVENATION
1. Ancient Egypt (c. 3000 BCE – 300 BCE): Egyptians prioritised beauty preservation. Cleopatra’s famed donkey milk baths, rich in lactic acid, served as natural exfoliants to rejuvenate the skin.
2. Ancient India – Ayurveda (c. 1500 BCE – present): Ayurvedic practices emphasised daily self-care (dinacharya) and rejuvenation therapies (rasayana), utilising herbal tonics like amalaki and ashwagandha, facial oils, and yoga to promote vitality.
3. Ancient China (c. 1000 BCE – present): Traditional Chinese Medicine advocated for internal and external youth-preserving methods, including herbal remedies, acupuncture, jade rolling, and qigong. Pearl powder and ginseng were commonly used for skin health and longevity.
4. Classical Greece and Rome (c. 500 BCE – 500 CE): Greek physicians like Hippocrates and Galen recommended skincare using olive oil and rosewater. Roman beauty rituals involved exfoliation with strigils, massages, and oil applications to maintain skin health.
5. Islamic golden age (c. 800 – 1300 CE): Scholars like Avicenna documented preventive care and beauty treatments, emphasising diet, hygiene, and herbal applications to sustain youthful skin.
6. Renaissance and enlightenment Europe (1300s – 1700s): Beauty regimens included milk baths and wine-based tonics. However, the use of lead-based face powders, such as Venetian ceruse, often led to skin damage and health issues.
7. 19th and early 20th century: The era saw the advent of cosmetic procedures and the popularity of cold creams and facial massages. Products like Vaseline were marketed for skin protection.
8. Modern era – Late 20th century to present: The term “prejuvenation” emerged in the 1990s–2000s, describing early aesthetic interventions like botulinum toxin injections, laser treatments, and medical-grade skincare aimed at preventing ageing signs.
CONTEMPORARY PREJUVENATION
TRENDS
1. Skincare and at-home prevention: Younger generations focus on proactive skincare routines to achieve radiant, healthy-looking skin. Popular ingredients include:
• SPF: Daily use of broad-spectrum sunscreen with SPF 30 or higher is crucial for protecting against UV damage and preventing premature ageing.
• Vitamin A derivatives: Tretinoin, retinol, and alternatives like bakuchiol promote cell turnover and collagen production.
• Antioxidants: Vitamin C, vitamin E, and niacinamide combat oxidative stress and enhance skin brightness.
2. Minimally invasive treatments: Procedures such as neuromodulators (e.g. toxin treatments) and conservative dermal fillers offer subtle enhancements, smoothing wrinkles and improving facial contours without surgery.
3. Collagen-stimulating treatments and supplements: As collagen production declines with age, treatments like laser skin rejuvenation, microneedling, and radiofrequency microneedling (RFMN) stimulate collagen synthesis. Supplements supporting collagen production are also gaining popularity.
4. Regenerative medicine and bio-stimulation: Advanced treatments like platelet-rich plasma (PRP) therapy, exosomes, and polynucleotides promote cellular renewal and skin health. Injectable collagen stimulators, including polycaprolactone (PCL) (e.g. Ellansé), calcium hydroxylapatite (CaHA) (e.g. HarmonyCa), and poly-L-lactic acid (PLLA) (e.g., Sculptra, Lanluma), enhance skin texture and provide volume restoration.
5. Longevity, health, wellness, and biohacking: A holistic approach to ageing includes adopting healthy lifestyles, focusing on nutrition, exercise, and stress management. Photobiomodulation therapies, such as LED treatments (e.g. Dermalux Tri-Wave MD) and low-level lasers (e.g. Emerald), are utilised to improve cellular function and promote skin rejuvenation.
IMPLEMENTING PREJUVENATION IN CLINICAL PRACTICE
Prejuvenation emphasises early intervention through skincare and minimally invasive procedures. Aesthetic healthcare practitioners should:
• Assess patient suitability: Evaluate skin type, age, and specific concerns to tailor prejuvenation strategies effectively.
• Educate patients: Provide comprehensive information about the benefits, risks, and realistic outcomes of prejuvenation treatments.
• Monitor progress: Regularly assess treatment responses and adjust protocols to ensure optimal results.
A ROUGH GUIDE TO RECOMMENDED INTERVENTIONS BY AGE GROUP:
• Age 18–25: Focus on protecting the skin and maintaining a healthy barrier with at-home skincare, regular in-clinic peels or facials, and LED treatments.
• Age 25–35: Continue skincare routines and introduce minimally invasive procedures such as radiofrequency microneedling, gentle lasers, exosomes, polynucleotides, and neuromodulators.
• Age 35 and above: Maintain skincare practices alongside more intensive treatments like RFMN, advanced laser therapies, and injectable collagen stimulators.
ETHICAL CONSIDERATIONS AND FUTURE OUTLOOK
While prejuvenation offers benefits, it’s essential to manage patient expectations and ensure informed consent, acknowledging that these interventions can slow ageing but not eliminate it. The trend is expected to grow as individuals across various age groups seek proactive approaches to skincare and ageing, with scientific advancements focusing on regenerative mechanisms at the cellular level.
CONCLUSION
Prejuvenation represents a proactive shift in aesthetic medicine, blending historical practices with modern technology to prevent ageing signs. By understanding its evolution and current applications, practitioners can offer informed, effective strategies to patients aiming to maintain youthful skin..