Plasma Pen: fibroblast therapy skin rejuvenation

Plasma pens are popular cosmetic devices that have been increasingly marketed online for the past 2 years. The treatment delivered by plasma pens is also called fibroblast therapy due to the effect the device exerts on fibroblast, the cells in the dermis that produce collagen, hyaluronic acid, elastin and other such proteins and molecules that keep the skin plump, smooth and young looking.

plasma pen for skin rejuvenation and tightening in fibroblast therapy
Woman photo created by wavebreakmedia_micro – www.freepik.com

How does the plasma pen work?

The plasma pen is a small handheld battery-operated device with a metal tip; this shape led to the “pen” denomination. The energy released from the tip of the device ionizes the air surrounding it and generates plasma, the fourth state of matter constituted by ionized gas, which forms an arch from the tip of the device to the surface of the skin, which are kept about 1 mm apart, releasing its high energy. The heat damage generated by the plasma on the skin surface stimulates the fibroblasts into producing more proteins and other components of the extracellular matrix, like hyaluronic acid, producing a skin rejuvenating effect.

The principle of action is similar to that of lasers for which the indications are similar, but with a key difference: lasers work following the selective photothermolysis principle; this means that the high energy light beam from the laser device produces thermal damage only on specific targets which absorb the specific wavelength emitted by the laser. This target or chromophore could be the melanin in the hair and in hyperpigmented spots, the water in the skin cells, or the red pigment in blood when treating vascular lesions. The surrounding tissues don’t suffer from the thermal damage since the energy is almost entirely absorbed by the specific target. With plasma the energy is delivered on the skin surface, with no specific target, creating a generalized thermal damage. By increasing the energy generated by the device, the energy is delivered deeper into the skin.

Usually some results can be seen already after the first treatment, but for more apparent changes at least 3 treatments are needed. Each session lasts 15-45 minutes depending on how large the area to be treated is. A local anesthetic gel or cream may be applied before the treatment and sessions are performed 3 to 8 weeks apart.

What are the indications for the plasma pen?

The plasma pen has been marketed and used by cosmetic dermatologist and aesthetic medicine practitioners in the past few years for:

  • treatment of fine lines and wrinkles of the face and in particular the periorbital wrinkles and the lines that form above the upper lip
  • photodamaged skin
  • skin laxity
  • brighten the skin and improving the texture
  • skin rejuvenation in general.

Treatment is generally only advised on Fitzpatrick skin types I, II, and III.

Is the plasma pen FDA approved?

Some brands have been approved by the FDA, but the cosmetic application is an off-label use of such devices. The plasma pens are FDA-approved for the “removal and destruction of skin

lesions and the coagulation of tissue”. The devices are intended for use by a physician, not to be used in SPAs by untrained aestheticians or at home.

There are plenty of “plasma pens” selling online for a limited budget and for home use: such devices should be absolutely avoided! The difference between the approved devices and the ones sold online is the reliability of the instrument and the controlled energy emission. Cheap devices lack control and have inconsistent amounts of energy delivered to the skin; there is no control or consistency in spot size and depth of treatment either. All these factors increase the risk of permanent hyperpigmentation and scarring, and longer recovery.

What are the risks and possible complications of the plasma pen treatment?

Among the risks and possible complications there are: redness, swelling, hyperpigmentation, scarring, infection, dissatisfaction with the treatment, burns and blisters. Some of these complications are mild, temporary and to be expected, but if the treatment is not properly executed there may be permanent damage as well.

For this reason, it is important to be treated by a medical professional trained in the use of this specific device as unproper treatment is more like to lead to unwanted damage and possibly to scarring and permanent hyperpigmentation.

How is the recovery from the plasma pen fibroblast therapy like?

Plasma pen treatment is delivered in tiny spots and essentially burns the skin, leaving brown dots which form small scabs. Spot sized scabs following a grid pattern usually last up to 1 week. There may be some redness and minor swelling for a few days as well. Some creams may help the healing process and their use will be advised by your treating physician. Sun protection will be very important for the first few weeks following treatment to avoid the risk of hyperpigmentation. Make-up is better avoided until the skin has healed completely.

Applying icepacks (15 minutes on, 15 minutes off) a couple of times per day may help with the discomfort, redness and swelling which are common and expected the first 1-2 days. 

How much does the plasma pen treatment cost?

Depending on how big the treated area is, on the chosen clinic and surgeon, and on the geographical location, the price of plasma pen treatment is:

  • 300-1,700 USD in the United States
  • 150-1,200 GBP in the UK
  • 200-2,000 AUD in Australia

Sources
  • Plasma Energy Skin Rejuvenation.
    JD Holcomb – Facial Plastic Surgery Clinics of North America, Feb 2020
  • Nitrogen plasma skin regeneration for the treatment of mild-to-moderate periorbital wrinkles: A prospective, randomized, controlled evaluator-blinded trial.
    N Theppornpitak, M Udompataikul – Journal of Cosmetic Dermatology, Feb 2019
  • Nitrogen plasma skin regeneration and aesthetic facial surgery: multicenter evaluation of concurrent treatment.
    JD Holcomb, KJ Kent – Archives of Facial Plastic Surgery, May 2009
  • Plasma Skin Resurfacing: Personal Experience and Long-Term Results.
    SH Bentkover – Facial Plastic Surgery Clinics of North America, May 2012
  • Evaluation of plasma skin regeneration technology in low-energy full-facial rejuvenation.
    MA Bogle, KA Arndt – Archives of Dermatology, Feb 2007
  • Evaluation of plasma skin regeneration technology for cutaneous remodeling.
    ML Elsaie, JN Kammer – Journal of Cosmetic Dermatology, Dec 2008
  • U.S. Food and Drug Administration (FDA)

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