Collagen Induction vs Collagen Destruction, Where Is the Line?

Featured in Mocha Beauty Year 19, Issue 3.

Every energy-based treatment we perform is, by definition, a controlled injury. The goal is always induction - stimulating the skin to repair, rebuild and strengthen. But the line between collagen induction and collagen destruction is thinner than many therapists realise. And in a market flooded with devices, trends and aggressive protocols, that line is being crossed more often than we’d like to admit.

A detailed 3D render shows the layered structure of healthy human skin, revealing the epidermis and dermis with a dense network of collagen fibres.

It Starts With Understanding the Interaction

Thirteen years ago, when I was running my clinic, I was combining modalities in ways the industry wasn’t even thinking about yet. My wait list was full - not because I was doing more, but because I understood exactly what I was doing and why. I understood the interaction between the device and the skin, and that knowledge allowed me to push boundaries safely and get results that genuinely changed my clients’ skin.

That’s what separates a therapist who truly understands their devices from one who doesn’t. It’s not just about avoiding burns or adverse events - although that matters enormously. It’s about being able to customise, combine and stage treatments in a way that works with the skin rather than against it.

When therapists don’t understand that interaction, that’s when things go wrong. I’ve seen second and third degree burns from IPL where parameters were changed without test patching. I’ve seen skin shredding from microneedling where the applicator was moved too fast at the wrong settings. I’ve seen hyperpigmentation from HIFU that was set too aggressively. And on the flip side, I’ve seen therapists so conservative they never get a result - which is just as problematic, because what’s the point?

A device can be a powerful clinical tool. In the wrong hands, it can also be a weapon.

The 72 Hour Window

Most therapists know inflammation is part of the process. What many don’t realise is that there’s a window - roughly 72 hours - where inflammation is doing exactly what we want. It’s purposeful, controlled and setting the stage for fibroblasts to lay down new collagen and elastin.

When we push beyond that window, the skin shifts from repair into a destructive cycle. Enzymes called matrix metalloproteinases become overactivated, breaking down collagen faster than the skin can rebuild it. The collagen that does get produced tends to be weaker, thinner and disorganised - scar-pattern collagen rather than the strong, well-aligned type I collagen we’re actually trying to stimulate. In older skins especially, that transition from inflammation to repair is already slower. Chronic inflammation isn’t just unhelpful, it’s actively working against the outcome we’re trying to achieve.

Before and After Matter as Much as the Treatment Itself

Skin prepping is non-negotiable. A minimum of four weeks before any collagen induction treatment, clients should be on vitamin A, B and C, hyaluronic acid, a quality moisturiser and SPF. LED sessions and nourishing infusion treatments beforehand allow the skin to communicate better, heal faster and respond more effectively to the device.

Post treatment is equally important. Without giving the skin the tools it needs to recover - the right skincare, the right recovery modalities - are we simply creating trauma and walking away?

Know the What, the How and the Why

More is not always more. Pushing harder, stacking more modalities or increasing settings doesn’t automatically mean more collagen. What it means is more risk if you don’t understand what you’re doing.

Know your device inside out. Know what it’s doing, how it’s doing it, and most importantly, why. Because without the why, what’s the point?

At TADLI, this is exactly what we teach. We sit in a unique space between formal education and manufacturer training - drilling down to what therapists genuinely need to know, in language that makes sense, usually within one to three days. Bespoke, practical and built around your devices, your clients and your clinic.

Because a therapist who truly understands the skin will always outperform one who simply follows a protocol.

Nancy Abdou is the founder of The Australian Dermal & Laser Institute (TADLI), with over 20 years of experience in aesthetic devices and education. She is a two-time ABIA Educator of the Year (Individual), and TADLI is proudly the 2025 ABIA Educator of the Year (Product/Equipment Company).