This is the one tweakment I’m scared of, and why

Between Alice and I, there aren’t many tweakments we won’t try – providing we’re suitable candidates, of course.

But then there’s plasma. You may have seen pictures of plasma treatment online – it’s the one where patients have rows of tiny dark dots across their eyelids, or neck. Also referred to as ‘plasma pens’, ‘fibroblast’ and ‘plasma shower’, it’s the one non-surgical treatment we’re both scared of. Why?

1. The technology is broadly referred to, often misunderstood and poorly explained
2. There are loads of unregulated devices on the market that anyone can buy online
3. It’s often performed by non-medics despite the…
4. …horrendous damage people are left with when it goes wrong.

Plasma treatments are so called because they use plasma energy to tighten the skin. The science gets pretty complicated, but plasma is actually the fourth state of matter after solid, liquid and gas – I don’t know why we aren’t taught this at school – and in the context of medical applications, it’s created when energy from a plasma device meets oxygen in the air and ionises it. Think of it as creating a tiny lightning-bolt of energy, directed at the skin. This non-light energy passes through a thin probe touching the skin and vaporises (burns) it, with the intention of leaving the area tighter and smoother.

Is plasma safe?

We most commonly get asked about plasma by TTG readers considering it for a non-invasive alternative to a surgical eyelid lift. Personally, the thought of burning off the skin that shields my eyes doesn’t appeal, and looking at the immediate after effect of plasma treatments makes me feel a bit queasy. The treated skin is left branded with a uniform pattern of tiny burn marks, a bit like it’s been left to sizzle on a barbecue grill. These are microscopic charring marks from where the skin has been deliberately burnt, and they form a brown crust before flaking off  around seven days after treatment, revealing the fresh skin underneath.

At least this is what happens when a plasma treatment goes to plan. Because there are so many dodgy, cheap devices around – you can buy them on Amazon for under £100 – that don’t have anything near to a proven safety profile and no controlled treatment parameters, it’s not uncommon for people to end up quite literally scarred for life. Just last week a story emerged online about a 59-year-old woman from Hampshire who had a £500 ‘fibroblast’ neck lift with a non-medic practitioner she found on Facebook and has been left with white scars where the scabs fell away, but the skin underneath didn’t fully heal.

There was no improvement in the skin laxity she had the treatment for in the first place. All it did is burn the pigment off her skin and leave her with hypopigmentation (where the melanin has been stripped out of her skin), which is basically impossible to reverse. This is just the latest of many nightmare plasma treatments I’ve read about.

Don’t get me wrong – plasma can work successfully and there are reputable medical aesthetic practitioners who perform it safely. But for inexperienced, non-medical practitioners to market the treatment as an easy and affordable skin-tightening solution with little risk and downtime is just wrong. The one device I’d trust with this traditional type of plasma treatment – more on that shortly – is Plexr, because it’s an FDA-cleared, EU-certified and CE-marked Medical Device, and there are multiple published studies that show it to be safe and effective. So, if you’re hellbent on having it done, find someone who uses Plexr specifically, like many of our TTG-registered practitioners – as opposed to just offering generic plasma treatments.

Enter, NeoGen

But plasma’s dubious reputation could be about to change, thanks to a new device called NeoGen Plasma. Manufactured by Welsh company Energist, NeoGen has a crucial point of difference compared to the type of plasma devices we’re already familiar with – it uses nitrogen. The key point here is that nitrogen doesn’t need oxygen to create plasma, and oxygen, as a key component in fire, is what causes the skin to char in traditional plasma treatments, causing those microscopic burns. Instead, with NeoGen, atmospheric oxygen is ’pushed’ out of the way as the nitrogen plume comes out of the device’s tip, so that by the time the energy hits the skin there is no oxygen present. This means that the outer layer of skin remains intact, with no charring, ablation, puncturing or vaporising of the skin.

Making plasma safe again

‘Plasma as a whole gets a bad name because it’s associated with plasma pens and plasma shower – potentially very dangerous devices,’ says Dr Raj Thethi. ‘I’ve had patients come into clinic six months or a year later after being treated with those devices, and the scars still haven’t gone – this is psychologically and physically traumatising.’ Dr Thethi, a TTG-registered practitioner and the first doctor in the UK to use NeoGen in clinic, says that keeping the skin intact is crucial for healing to commence.

Instead, he explains, ‘NeoGen’s plasma thermal energy permeates the skin’s surface, conducting high temperatures via water contained within the patient’s tissue, penetrating to the reticular dermis [the thick bottom layer of the skin]. The heat generated can be very tightly controlled, which translates into predictable, reliable outcomes. I don’t want anything unpredictable in my clinic – I want to make sure that I am tightening, resurfacing and regenerating the skin in a safe framework where it won’t cause my patients any harm.’

Plasma as a whole gets a bad name because it’s associated with plasma pens and plasma shower – potentially very dangerous devices.

Because the energy targets water in the skin tissue, patients need to be well hydrated in the days before treatment, and Dr Thethi applies a hydrating mask to the skin prior to using the device. The NeoGen device allows the practitioner to select the required depth of energy depending on each patient and what they’re trying to achieve, which again means that downtime can be easily predicted depending on the intensity of the treatment – from superficial tightening all the way through to deep skin regeneration comparable to ablative CO2 treatments.

‘The layer of non-viable tissue will then flake off over four to seven days, and the underlying skin gets a massive reboot and comes through as if it were young skin again – tmhose ongoing architectural changes will continue to occur for three to six months after treatment,’ explains Dr Thethi. He describes the result as having ‘taken away the frosted glass – the skin looks fresher, younger, smoother and firmer.’

Before-and-after examples of Dr Raj Thethi’s NeoGen Plasma work. Images courtesy of Dr Raj Thethi

NeoGen Plasma is also FDA approved for Fitzpatrick skin types 1-4, but Dr Thethi says treatments can be performed safely on darker skins. It can be used to treat active acne – nitrogen has anti-microbial properties – acne scars, actinic keratosis, wrinkles, scars, burns, large pores, photodamage, stretch marks, and drooping eyelids and jowls. It sounds pretty promising, so I’ll keep an eye on NeoGen and maybe I won’t write off plasma just yet.