Abstract
Involutional skin changes are the result of complex disturbances in extracellular matrix homeostasis, cellular senescence, cytokine imbalance, and microbiome disorganization, which has led to growing interest in regenerative technologies in dermatology. The study aims to systematize modern regenerative treatment protocols for involutive skin changes and to summarize the clinical, microbiological, and biochemical indicators of their effectiveness. It also aims to develop an author’s approach to the treatment of involutive skin changes, taking into account the possibilities of its implementation in Ukrainian clinical practice. An analytical review of current publications selected from international databases was conducted, focusing on randomized clinical trials and molecular biology studies that evaluated changes in dermal parameters under the influence of various regenerative interventions. The article showed that plasmatherapy ensures rapid normalization of coagulation homeostasis by increasing the synthesis of collagen types I and III and reducing the activity of matrix metalloproteinases. It has also been established that polynucleotides have a pronounced antioxidant and cytokine-modulating effect and contribute to a stable increase in dermis thickness. Meanwhile, peptide complexes demonstrate a restructuring effect on the matrix with inhibition of matrix metalloproteinase-1 and stimulation of neocollagenesis. Hyaluronic acid preparations (especially in combination with amino acids) improve skin hydration and mechanical properties, while hardware techniques (microneedle RF lifting, fractional lasers) provide deep controlled remodeling of the dermis. The highest clinical and morphological efficacy has been demonstrated with combined protocols that simultaneously affect the structural, inflammatory, and oxidative links in the pathogenesis of aging. The authors presented their approaches to the treatment of involutive skin changes. These are “Deep Biostimulation of the Dermis”, which is aimed at correcting the loss of density associated with the degradation of collagen fibers, and “Matrix Boost” for working with pronounced involutive changes. Regenerative techniques play a leading role in the treatment of involutive skin changes, and their use should be based on an understanding of ECM- and cytokine-dependent mechanisms of action. The conclusions justify the standardization of combined treatment protocols for involutive skin changes and the development of national clinical guidelines in the field of regenerative dermatology in Ukraine.
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