The anti-ageing world moves in leaps and bounds, with new products or non-surgical treatments being introduced as fast as you can say Botox. Market research group Mintel said sales of anti-ageing skincare products in the US rose to more than US$1.6 billion in 2008. For the first time, anti-ageing sales surpassed sales of facial cleansers, which garnered nearly US$570 million in 2008. Mintel said it expected the market to remain robust over the next five years, growing some 20 per cent through 2013. The global market for anti-ageing products is projected to reach US$115.5 billion this year, according to Global Industry Analysts, another market research group. Euromonitor International said in a 2006 report that the anti-ageing skincare product market in Hong Kong would see average annual growth of 6.4 per cent to the end of this year. Dermatologists say those seeking the elixir of youth will be pleased to hear that this year, there are new and improved, fast and effective solutions emerging that will keep them reaching for their credit cards - until the next one comes along. Included is medical-grade Botox applied via the much less painful option of a topical cream and the concept of 'masstige' skincare products - a lower priced option for the masses, but with a luxury image. Central-based dermatologist Henry Chan Hin-lee says he also expects to be using something called Ulthera. 'Ulthera is a focused ultrasound that induces collagen damage at 2mm to 4mm [under the skin] and received [US] Food and Drug Administration approval for the non-invasive eyebrow lift last September,' Chan says. 'It is another option for skin tightening. The procedure involves the use of ultrasound, inducing thermal damage. In doing so, the subsequent healing process leads to new collagen formation. The procedure is slightly uncomfortable but well tolerated. Patients can have mild redness that resolves within the next 12 hours, so [there is] minimal downtime.' Got cellulite? Zeltiq is a procedure that involves heat extraction, he says, to cause the triglyceride within fat cells to solidify. As the freezing temperature of triglyceride differs from water, the water content in other cells is not affected. To explain, he gives the example of butter in a fridge, which is in solid state, but a glass of water is still a glass of cold water, not ice. 'When the device is removed from the site after an hour, the triglyceride is warmed up by body temperature and changed back to liquid state. Such changes [from liquid to solid and then back to liquid] will cause the cell to go into apoptosis [premature cell death]. Not immediately, but gradually over three months.' The applicator requires suction to suck the fat into it. After a single treatment, Chan says, a patient can achieve a 20 per cent fat reduction over two months and 25 per cent over six months. 'Side effects are transient and include bruises that occur as a result of the suction. Some patients complain of numbness or discomfort that lasts several weeks. The procedure is Europe- and Canada-approved for the treatment of localised fat reduction and US FDA-approved for the treatment of cellulite.' Perhaps the best new thing will be that Botox - while set to remain popular - may have a competitor, in the form of a cream. Chan says it is undergoing phase-three clinical trials. 'This Botox cream literally contains Botox and is a drug rather than skincare. It is being tested for treatment of periorbital [crow's feet] wrinkles.' Another Central-based dermatologist says we can expect to see more prescription retinoids, as 'they remain the most scientifically based treatment for anti-ageing'. When it comes to product ingredients, simple protective measures will still hold sway. 'Antioxidants such as vitamin C, vitamin E and coffee berry provide protection against future free-radical damage that contributes to ageing,' he says. For lunchtime procedures, 'innovations in the use of ultrasound energy for skin tightening are maturing. By using intensely focused ultrasound energy to cause microscopic thermal injury selectively at different levels under the skin, collagen regrowth and skin lifting can be produced to rejuvenate the skin with minimal downtime'. Botox and fillers, he predicts, are still likely to dominate the non-surgical arena. These are often supplemented by skin-tightening treatments such as fractional carbon dioxide laser, radiofrequency and focused ultrasound treatments. Medical-grade, higher-tech products are in store for us, according to a December report from Mintel on global beauty trends for the coming year. 'In 2010, products will increasingly include medical or pharmaceutical-grade actives and next generation nano-technology,' the report says. 'In addition, clinical testing to substantiate claims and results will move from prestige to 'masstige' - that is, affordable for general consumers but positioned as luxury.' Such pharmaceutical-grade actives is what the Ultraceuticals range of products - also sold in Hong Kong - is focusing on. Cosmetic surgeon Geoffrey Heber, based in Australia and the founder of the brand, says an ingredient buzzword for the year is 'peptides'. 'In some cases [peptides] have an undoubted biological effect,' Heber says. 'We have been surprised by the effect on crow's feet. We have seen in a trial of an eye cream containing acetyl hexapeptide-6 applied to one side of the face compared to the same cream without the peptide applied to the other side of the face in 20 people. The effect on wrinkles was dramatic.' He says the anti-ageing world will also see an increasing focus on stabilisation and delivery systems. 'The formulation expert Dr Johann Wiechers has estimated that 99 per cent of ingredients in cosmetics never penetrate the skin. As the demand for effective cosmetics increases, companies will increasingly become aware of the need for ingredients they put into their cosmetics to penetrate into the skin, as basic as this might seem.' For those seeking more than a cream or lotion, the lunchtime process of volumetric filling of hollow cheeks can take years off the appearance when used appropriately. 'We have seen dramatic improvement of skin ageing with the use of sonophoresis of active ingredients into skin,' Heber says. He says it's difficult to see Botox being used less as a treatment. 'It is so easy and the effects so dramatic. However, Botox does not address lower face ageing with significant results.' That is because with Botox, the results are dramatic only for the upper face wrinkles. In the lower face, loss of skin elasticity and structural volume meet gravity to create sagginess. 'Volumetric replacement with fillers and skin tightening technologies are improving to address this,' Heber says. 'Non-surgical treatments are usurping surgical treatments to a major extent.' In 2010, filling up at lunch time seems to have taken on a whole new meaning.