Aesthetics

Dermatologists and their patients have numerous cosmeceutical productsfrom which to choose. Doctors who categorize the agents can better helptheir patients understand how the novel therapies fit into skincare regimens.According to Zoe Diana Draelos, M.D., clinical associate professor ofdermatology, Wake Forest University School of Medicine, Winston Salem, N.C.,key cosmeceutical categories include: barrier-enhancing vitamins, receptor-mediatedvitamins, regulators of collagen breakdown, anti-inflammatories, exfoliates,and botanicals.

February 10 - Intradermal botulinum toxin has a durable effect in thetreatment of primary axillary hyperhidrosis, with nearly half of treatmentresponders requiring only one injection over a 52-week period, said DeeAnna Glaser, M.D., associate professor, department of dermatology, St. LouisUniversity.

Zein Obagi, M.D., a pioneer in the anti-aging movement, checked in withDermatology Times yesterday at the 62nd annual meeting of the American Academyof Dermatology. The Obagi Nu-Derm System of skin health remains a top-sellerfor those wishing to stem the aging process and retain young, vibrant features.

As dermatologists accumulate knowledge about the injection of botulinumtoxin Type A, the safer the procedure is becoming, according to AlastairCarruthers, M.D.With reports of rare side effects, such as extreme fatigue and headaches,surfacing from sources across the United States, dermatologists might bequestioning the safety of a drug that continues to grow in popularity anddemand. But these concerns should be eased with sound evidence supportingthe contrary.

Experts in the art of facial rejuvenation are now able to restore orenhance the "pillars" of the face - chins, cheekbones, and jawlines - for many patients who have lost the strength of these characteristicsat midlife. As a result, more and more patients are enjoying the permanentyet reversible changes that can be made to the face using a variety of volumetricimplants.

Who can deny the progression of cosmetic dermatology? Most sources saythat an impressive amount of dermatologists now call aesthetics an importantof their practice despite it being a topic debated among clinical dermatologists.

When it comes to photoprotection, people expect too much from sunscreens.In a perfect world - if people would put on enough to get full protection,reapply it as often as necessary, use a high enough SPF and a sunscreenwith the best protective ingredients, and start early enough in life protectingtheir skin from the sun - sunscreens might offer powerful protection againstmalignant melanoma and other skin conditions related to the sun. However,ours is not a perfect world and dermatologists should arm patients withthe reality that sunscreens alone are not the end-all solution in sun protection.

When it comes to complications from laser resurfacing, prevention isthe best medicine. For patients, this means picking the most qualified doctoravailable. For doctors, it's sometimes a matter of knowing your limitations.

Washington - Botulinum toxin, the wildly popular dewrinkling treatment,is not just for women anymore. Men are favoring the easy defurrowing injectionsmore and more, according to dermatologist Christopher B. Zachary, M.D.,clinical professor of dermatology, University of California, San Francisco.He discussed how men are turning to botulinum rejuvenation in order to diminishwrinkles around their eyebrows, forehead region, and mouth, he said yesterdayat the AAD annual meeting.

Despite the growing popularity of new modalities, the CO2 laser remainsthe gold standard for tissue tightening and contraction of the skin, saidSue Ellen Cox, M.D. However, the choice of therapy largely depends on theage and mindset of the patient, she added.

Laser and light therapies, while still controversial, are dramatically changing acne treatment. Rosacea patients also benefit from the more patient-friendly nondrug options. And drug therapies, including hormonal options, provide a strong hope that patients will have alternatives in treatment aimed at tackling severe acne in the future.

Many of the modern therapies that evolved during the last 25 years are new, more patient-friendly twists on old therapies. Harsh treatments with unpleasant odors that fail to diminish the most severe forms of acne and rosacea are no longer the main tools in the dermatologists' arsenal.

National report - Cosmetic dermatology is relatively new, and while no one can be expected to predict the future with certainty, it is destined to continue to grow based on consumer demand, ongoing research, and advances in science, techniques, and technology.

National report - Cosmetic treatments and modalities to prevent and reverse skin aging are relatively new realms in the field of dermatology. Looking back 25 years ago, there was much less concern among the populace about the appearance of aging skin, and limited attention was being directed by dermatologists in practice or in research to elucidate its pathophysiology or modalities for treatment and prevention.

David McDaniel grew up with a family full of role models - parents and aunts and uncles who set an example by never limiting themselves because of what other people said they could or could not do.

Washington D.C. - Experts in the art of facial rejuvenation are now able to restore or enhance the "pillars" of the face - chins, cheekbones, and jaw lines - for many patients who have lost the strength of these characteristics at midlife. As a result, more patients are enjoying the permanent, yet reversible changes that can be made to the face using a variety of volumetric implants.

New York - Comparing the pros and cons of facial rejuvenation techniques such as dermal fillers, Botox, and nonablative lasers is like comparing the pros and cons of peanut butter and jelly. They are completely different products that aren't nearly as effective alone as they are together. That's what oculoplastic surgeons Stephen Bosniak, M.D., New York, and Marian Zilkha, M.D., Brazil, found in their study of FDA-approved Restylane and Perlane (pending approval).

Philadelphia - Practitioners can avoid the complications of typical mid-face rejuvenation and improve the most important area of the nasojugal crease to rebuild the cheek with autologous fat transplantation of the mid-face region, according to Suzan Obagi, M.D.

Washington - Dermatologists and their patients have numerous cosmeceutical products from which to choose. Those doctors who categorize the agents can better help their patients understand how the novel therapies fit into skincare regimens.

Waikoloa, Hawaii- Since the advent of botulinum toxin type A (Botox) for cosmetic purposes, its use has been guided by two primary sources: clinical study and practice.

National Report - With an ever-increasing array of products and technologies available to treat scars, it might be tempting to overlook the basics. However, that's the worst thing you could do for your patients and your practice.

Washington - Choosing patients with the appropriate weight and exercise history is critical to the long-term success of the liposuction procedure, according to Naomi Lawrence, M.D. "Liposuction is an excellent and efficacious procedure, when you pick the right candidate - someone with a stable weight," she said.

Washington - When it comes to sun protection methods, there are some new options on the horizon. While many have yet to be approved for use in the U.S., they are showing promise as future preventive methods, according to Darrell S. Rigel, M.D., a dermatologist, clinical professor of dermatology at New York University, and a past president of the American Academy of Dermatology.

Las Vegas - Whether patients seek treatment of problem veins and vascular lesions for cosmetic or medical reasons, dermatologists have many tools at their disposal that offer alternatives to hospital-based procedures, said Margaret Weiss, M.D., who is in private practice at the Maryland Laser, Skin & Vein Institute and Dermatology Associates, Hunt Valley, Md. Dr. Weiss, a specialist in the treatment of unwanted veins, provided an overview of office-based treatment of veins and vascular lesions at the Fall Clinical Dermatology Conference here. She is assistant professor of dermatology, Johns Hopkins University School of Medicine.

The arena of cosmeceuticals, cosmetics, and skincare has undergone dramatic changes in the past 25 years. Why, 25 years ago there were no cosmeceuticals, in fact the word had not yet been coined by Dr. Albert Kligman, and the most sophisticated product in the over-the-counter skincare market was a petrolatum, mineral oil, and glycerin moisturizer. Exciting changes have occurred on many fronts, including the development of new ingredients, new classes of products, and new biologic actives.

British Columbia - While dermatologists tend to think of Botox as a primary therapy, some are looking at it as an adjunctive therapy, offering benefits from longer- lasting results to better wound healing and less scarring.

Washington - Recent regulatory decisions about hyaluronic acids and hyaluronic gels have brought facial wrinkle fillers even further into the fold of the impulse purchase.

Waikoloa, Hawaii - Many modalities are available for minimizing patient discomfort during laser and radiofrequency procedures, but for optimal benefit, method selection should be tailored to the patient's needs as well as the type of procedure, said Suzanne L. Kilmer, M.D., at the annual Hawaii Dermatology Seminar in January.

Amsterdam -- Combined use of an artificial skin substitute and stem cells may promote healing of difficult wounds, according to Sadanori Akita, M.D., Ph.D., senior assistant professor in the division of plastic and reconstructive surgery at Nagasaki University, Japan. "When dealing with serious wounds, such as extensive burn wounds, acceleration of wound healing is critical for survival," Dr. Akita said. "There is an unmet surgical need for better treatments for difficult wounds, especially in cases requiring resurfacing of large skin defects, and in contaminated or poorly vascularized wounds caused by irradiation or systemic diseases such as diabetics."

Rome - Transplantation of autologous cultured epidermal grafts after erbium: YAG laser removal of achromic epidermis offers a rapid, safe, and effective technique for treating large, stable vitiliginous lesions, according to Liliana Guerra, M.D.