Why at Doctor Eckstein® we focus on healthy skin physiology instead of the principle of "controlled injury"
For over 75 years, we have not followed fleeting trends but a constant compass: human physiology. When our company was founded in 1949, it was in close exchange with cosmeticians who had a deep understanding of their business. They knew: the skin is a living organ – complex, intelligent, and capable of remarkable self-healing if properly supported. This insight is the foundation of our philosophy. It guides us to preserve the skin's protective barrier, avoid unnecessary inflammation, and strengthen natural cell functions.
Again and again, we are asked today why we do not follow the common trends of cosmetic equipment. Why we do not, or no longer, integrate procedures such as microneedling or high-intensity laser resurfacing into our concept.
In an age characterized by instant self-optimization, gentle, physiological approaches often seem to lose their value. They are increasingly being displaced by complex interventions – fueled by the fallacy that more invasive and expensive is necessarily "better," true to the motto: "more is more." Likewise, our fast-paced society often has the expectation that only something you can directly feel and see has an effect. Our answer to this is deliberately simple and clear: we are committed to the long-term health of the skin, not a short-term, expensively bought "quick effect."
The questionable logic of controlled injury
Procedures such as microneedling or fractional lasers are based on a principle known in technical terms as "controlled injury." By creating countless micro-wounds or thermal damage down to the dermis, an inflammatory cascade is intentionally triggered. This is intended to cause the release of signaling molecules such as interleukin-1 or transforming growth factor-β, which in turn stimulate collagen-producing cells (fibroblasts).
Science confirms this mechanism. For example, Aust and colleagues showed as early as 2008 that microneedling indeed causes dermal injuries that stimulate collagen production via inflammatory mediators. Hantash et al. (2007) demonstrated similar findings for fractional photothermolysis. El-Domyati et al. (2012) also documented the tissue changes associated with these inflammatory processes.
However, what is often overlooked in this consideration is that the immediate result – the feeling of tightness and "plumping" – is primarily an edema from a physiological perspective, meaning swelling of the tissue in response to the trauma – the injury. The skin initially appears plump because it is in an exceptional state of inflammation. What serves as a motto for surgery "vulnerando sanamus – by wounding we heal" becomes a curse for cosmetic dermatology.
Inflammaging: The high price of permanent alert
While inflammation is a powerful repair tool, it is extremely demanding for the organism. In dermatological research, chronic, recurring inflammation is now considered one of the main drivers of skin aging – a concept known as "inflammaging."
Persistently elevated inflammation levels increase the activity of enzymes, such as the so-called matrix metalloproteinases. As Fisher and colleagues (2002) demonstrated, these enzymes are significantly involved in the breakdown of collagen and elastin. While a single, acute inflammation serves for repair, repeated cycles of injury lead to long-term structural degradation of connective tissue.
Even more significant is the way the body repairs these injuries: often not with the original, elastic tissue structure, but through the formation of scar tissue – even deeper and initially invisible. In the long run, this can lead to a hardening of the tissue. While the skin may feel "firm," it loses its natural suppleness and elasticity. So far, we have no long-term studies on the effects of these repeated injuries on the aging process of the skin over the entire lifespan – however, leading dermatologists often warn of accelerated skin aging with the loss of important, valuable skin properties.
The skin barrier: The foundation of youthful radiance
Our conviction is that the skin barrier should be inviolable. Research results, such as those by Proksch et al. (2008), clearly show that a disturbed barrier increases skin moisture loss, promotes oxidative stress, and thus triggers inflammatory signals. Any damage to the barrier – even intentionally induced damage – robs the skin of valuable energy and resources that it needs for regeneration. Our philosophy has never been to challenge the skin to test its resilience. Our goal is to preserve its vitality.
Healthy, youthful-looking skin is characterized by a balanced level of inflammation, an intact barrier function, and a stable microbiome. These properties cannot be achieved through repeated trauma from micro-injuries, but only through consistent, skin-physiological care.
Our path: Strengthening biology, instead of misguided "bio-hacking"
The true key to long-lasting, beautiful skin is not quick correction, but proactive care and prevention. A short-term collagen boost from an injury cannot replace daily sun protection. It does not undo years of oxidative stress.
We align ourselves with a science that relies on proven methods. This primarily includes consistent sun protection, because UV radiation is and remains the main factor for premature skin aging. By combining natural antioxidants for protection with valuable, partly skin-identical lipids to strengthen the barrier and active ingredients for moisture retention, we achieve natural, long-lasting skin function – completely without tissue damage.
Conclusion
The most beautiful skin at seventy is not the skin that was repeatedly injured at thirty-five in the pursuit of perfection. It is the skin that has been protected, nourished, and respected for decades. Repeated, inflammation-inducing procedures may temporarily feign a better appearance of the skin through swelling or scarring changes, but in the long run, they harm it.
Therefore, we remain true to what over 75 years of experience have taught us: we strengthen the natural skin barrier and avoid unnecessary injuries and inflammations of our largest and most valuable organ. Because beautiful, youthful-looking skin is not created in a single afternoon in a treatment room. It is preserved over an entire lifetime.
Your Verena Eckstein
Literature:
Aust, M. C., Fernandes, D., Kolokythas, P., Kaplan, H. M., & Vogt, P. M. (2008). Percutaneous collagen induction therapy: An alternative treatment for scars, wrinkles, and skin laxity. Plastic and Reconstructive Surgery, 121(4), 1421–1429.
El-Domyati, M., Barakat, M., Awad, S., Medhat, W., El-Fakahany, H., & Farag, H. (2012). Multiple microneedling sessions for minimally invasive facial rejuvenation: An objective assessment. Journal of Cosmetic Dermatology, 11(4), 261–268.
Fisher, G. J., Kang, S., Varani, J., Bata-Csorgo, Z., Wan, Y., Datta, S., & Voorhees, J. J. (2002). Mechanisms of photoaging and chronological skin aging. Archives of Dermatology, 138(11), 1462–1470.
Hantash, B. M., Bedi, V. P., Kapadia, B., Rahman, Z., Jiang, K., Tanner, H., Chan, K. F., & Zachary, C. B. (2007). In vivo histological evaluation of a novel ablative fractional resurfacing device. Lasers in Surgery and Medicine, 39(2), 96–107.
Krutmann, J., Bouloc, A., Sore, G., Bernard, B. A., & Passeron, T. (2017). The skin aging exposome. Journal of Dermatological Science, 85(3), 152–161.
Proksch, E., Brandner, J. M., & Jensen, J. M. (2008). The skin: an indispensable barrier. Experimental Dermatology, 17(12), 1063–1072.