I'm 48, I smoked for years, I drink alcohol occasionally and I've had a lot of sun exposure throughout my life. I'm starting to notice more wrinkles and a loss of skin quality. I feel a bit lost with so many treatments: polynucleotides, exosomes, skinboosters, biostimulators… Which treatment would you recommend and how many sessions are usually needed?

Hello Elena,

This is a question I hear very often in consultation. Today there are many aesthetic medicine treatments and it's normal to feel confused. However, rather than looking for “the best treatment”, what matters is choosing the treatment best suited to your skin.

From what you describe, you have several factors that accelerate skin ageing: accumulated sun exposure, smoking and the passage of time itself. All of this promotes the loss of collagen, elastin and hydration, as well as the appearance of fine wrinkles, pigment spots and a more irregular texture.

In these cases, my philosophy is not to start by filling wrinkles, but first to restore the health and quality of the skin. When the skin improves from within, the result is much more natural and long-lasting.

I usually plan the treatment in several phases.

The first is a regeneration phase, in which we can combine treatments such as polynucleotides, skinboosters or, in certain cases, collagen biostimulators. Each has a different role and, far from competing with one another, they usually complement each other.

If there is also significant sun damage, pigment spots or a very altered texture, I often add a fractional laser procedure or rejuvenation technologies to stimulate a deeper renewal of the skin.

In most patients, I usually recommend an initial cycle of 2 or 3 sessions, spaced three to four weeks apart, although the number may vary depending on the condition of the skin and each person's goals. Afterwards, once the desired improvement is achieved, it is advisable to have maintenance sessions every few months to preserve the results.

I would like to make a clarification about exosomes, as they generate a lot of interest. Although the early results are promising, the scientific evidence is still evolving and I currently consider them a complementary treatment within an overall skin-regeneration strategy, not a substitute for procedures with stronger scientific support.

My advice is not to choose a treatment because it is fashionable or because you have seen it on social media. What matters most is a complete medical assessment of your skin. Not everyone ages in the same way, and two 48-year-old patients may need completely different treatments.

When the treatment plan is properly personalised, the goal is not to change the face, but to achieve skin that is more luminous, firmer, more even and healthy-looking, always respecting each person's expression and identity.

I hope I have helped guide you. Warm regards.