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Facial Concerns

A concern-based knowledge hub to support structured, physician-guided treatment planning.

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Recommended Topics: Facial Concerns

Acne Scars

Acne Scars

This Acne Scars category at Drema Clinic includes doctor-guided knowledge on assessment, treatment planning, expected outcomes, and aftercare for individualized decision-making.

Dark Circles

Dark Circles

This Dark Circles category at Drema Clinic includes doctor-guided knowledge on assessment, treatment planning, expected outcomes, and aftercare for individualized decision-making.

Deep Nasolabial Folds

Deep Nasolabial Folds

This Deep Nasolabial Folds category at Drema Clinic includes doctor-guided knowledge on assessment, treatment planning, expected outcomes, and aftercare for individualized decision-making.

Dull Skin

Articles about dull or yellow-looking skin, its causes, and practical ways to restore a brighter complexion.

Hollow Temples

Hollow Temples

This Hollow Temples category at Drema Clinic includes doctor-guided knowledge on assessment, treatment planning, expected outcomes, and aftercare for individualized decision-making.

Loose Facial Skin

Loose Facial Skin

This Loose Facial Skin category at Drema Clinic includes doctor-guided knowledge on assessment, treatment planning, expected outcomes, and aftercare for individualized decision-making.

Sagging Skin

Sagging Skin

This Sagging Skin category at Drema Clinic includes doctor-guided knowledge on assessment, treatment planning, expected outcomes, and aftercare for individualized decision-making.

Sunken Cheeks

Sunken Cheeks

This Sunken Cheeks category at Drema Clinic includes doctor-guided knowledge on assessment, treatment planning, expected outcomes, and aftercare for individualized decision-making.

Wrinkles

Wrinkles

This Wrinkles category at Drema Clinic includes doctor-guided knowledge on assessment, treatment planning, expected outcomes, and aftercare for individualized decision-making.

All Articles

14 articles in this category

Facial Concerns

How Can Sagging, Crepey Skin Be Improved? Understanding How to Restore and Regenerate Skin Health

Skin regeneration differs fundamentally from filling: filling addresses surface-level problems with immediate results, while regeneration targets root causes at the cellular and ECM level, requiring deep understanding and patience since results aren't immediate. Combination treatment is justified but requires clearly distinguishing each method's role rather than stacking treatments without a plan.

Acne Scars

What Are Acne Scars and How Are They Treated?

Acne scars result from disrupted wound healing (elevated MMP, reduced TIMP, abnormal TGF-β1 signaling), classified into ice pick, boxcar, and rolling scars that respond differently to treatment. The standard approach is morphology-driven treatment — classify first, then select technique: subcision, fractional laser, RF microneedling, TCA CROSS, and biostimulators/fillers as appropriate, with PN as an adjunct only.

Facial Concerns

What Causes Skin Aging at 40? Unlocking the Science of NAD+, Mitochondria, and Skin Longevity

Skin longevity for those 40+ rests on six mechanisms: NAD+ as the cell's declining battery, mitochondria as the weakening power plant, epigenetic aging showing biological age differs from chronological age, glycation stiffening collagen via sugar, oxidative stress as the central damage accelerator, and the skin barrier as the foundation that matters more than whitening. Core principles: barrier-first, combination approach, personalized skin longevity.

Facial Concerns

How Does Skin Aging Happen? Understanding Cellular Aging Before Choosing the Right Skin Restoration Approach

Wrinkles are a result, not the cause, of skin aging. Aging results from multiple systems declining together: slowing fibroblasts, deteriorating collagen and elastin, declining HA, a weakening ECM, cellular senescence, accumulating oxidative stress, and weakening mitochondria. Effective restoration addresses root causes through four levels: lifestyle, skincare, regenerative medicine, and energy-based devices — not surface-level fixes alone.

Facial Concerns

Mitochondria and Skin Aging: How Cellular Energy Affects Skin Health

Mitochondria help power the processes that keep skin functioning, but they are one part of a complex biological system. As we age, changes in cellular energy, oxidative stress, and mitochondrial quality control may contribute to slower repair and visible skin aging. The most evidence-aligned strategy is not to chase a single “mitochondrial” treatment. It is to protect skin from UV exposure, support overall health, manage inflammation, and select treatments based on a dermatologist’s assessment of the actual skin concern.

Facial Concerns

There Are 3 Main Types of Acne Scars

Acne scars come in different types, and no single treatment works for all of them. This article summarizes the main scar types in simple terms, explains why a physician's assessment before treatment matters, and why acne scar treatment requires multiple repeated sessions to see real results.

Facial Concerns

The Starting Point: Why Patients Get Confused About Which Technology to Choose

In acne scar treatment, patients may have heard of several technologies, including the SylfirmX program, the PicoSure program, and collagen booster injections. However, each technology has a different mechanism of action and a different area of strength — they are not always interchangeable. In this article, Dr. Punyanun explains the mechanism behind each technology, which scar types each is best suited for, and how combining them can lead to more comprehensive results.

Facial Concerns

Correcting Marionette Lines at the Right Point

Building on the previous article, which explained that jowl results from combined changes across multiple facial layers, this article dives into treatment approaches for three key structural layers: the bone layer, which sags with age and requires filler to compensate for lost volume; the fat layer, which migrates downward and requires skin-tightening devices or thread lifting to reposition it; and the Platysma neck muscle layer, which pulls tissue downward and can be addressed with Botox to reduce this pulling force. This article also covers an important caution about thread-lift fat repositioning done only partially, which can create an unnatural tethering effect.

Facial Concerns

Skin, Hair, and Changes After Age 40

----------------------------------------------------- As women reach age 40 and beyond, many begin noticing drier skin, more visible wrinkles, facial sagging, thinning hair, or increased facial hair. These changes aren't caused by age alone — they're also linked to estrogen fluctuations during perimenopause and menopause. This article is based on a medical review published in Climacteric in 2022, which explains that skin is an organ that directly responds to hormones. As estrogen declines, skin collagen may drop by as much as 30% within the first 5 years after menopause, continuing to decline by roughly 2% per year afterward — leading to seven common changes, ranging from dry skin and thinning skin to sagging, slower wound healing, thinning hair, and adult acne. The key message of this article is that these changes don't mean skin decline has to go unaddressed, since each person's concerns typically stem from multiple factors and layers at once. A thorough individual assessment by a physician is the essential starting point for targeted, safe care planning.

Facial Concerns

The Future of Skin Rejuvenation

This review article from a research team at the University of the Ryukyus, Japan, compiles current knowledge on regenerative medicine for skin care and anti-aging — an approach distinct from conventional treatments like fillers or Botulinum toxin, which produce temporary results and cannot truly repair skin structure. Regenerative medicine is divided into two main categories: cell-based therapy, which uses cells directly, such as Mesenchymal Stem Cells (MSCs) from various sources, fibroblasts, and PRP; and cell-free therapy, which uses substances secreted by cells instead of the cells themselves, such as exosomes. Adipose-derived MSC (ADMSC) has the most supporting research, thanks to its ease of collection, abundance, and mechanisms that boost collagen, elastin, and new blood vessel formation. Exosomes are gaining increasing attention because they can produce results similar to direct cell use, but with fewer risks and regulatory constraints. However, the authors conclude that while regenerative medicine holds high potential, long-term clinical evidence and clearer manufacturing standards are still needed before widespread adoption.

Key Benefits of Facial Concerns

  • Starts with the patient’s core concern before selecting treatment tools.
  • Distinguishes look-alike issues that require different treatment approaches.
  • Improves consultation clarity and supports better treatment decisions.

Comparison

ItemBest forType
Skin laxityLifting and tightening goalsUltrasound / Thread lift
Pigment concernsUneven tone and dark spotsPico / Laser
Acne scars and textureTexture and scar depth concernsRF microneedling

Frequently Asked Questions

How should I choose where to start?

Start with physician assessment of your primary concern, urgency, and acceptable downtime to define the right sequence.

Can multiple treatments be combined?

Yes, in many cases, when sequencing and intervals are planned properly for safety and balanced outcomes.

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