NEW YORK, Nov. 13 To satisfy the public's quest foryounger-looking skin, the marketplace for cosmetic procedures has expandeddramatically over the years, with little signs of slowing down. From newfacial fillers that produce longer-lasting results to at-home treatments thatcan temporarily remove unwanted hair, the average consumer now has manychoices when it comes to improving their appearance. However, this trend alsohas created an influx of unqualified practitioners lacking the training andexpertise of dermatologists who understand the science behind these cosmeticprocedures and their effects on the skin. This can put patient safety at risk.
Speaking today at the American Academy of Dermatology's SKIN academy(Academy), dermatologist Ranella J. Hirsch, MD, FAAD, clinical assistantprofessor of dermatology at Boston University School of Medicine in Boston,discussed how new technology and products entering the growing market ofcosmetic procedures are enhancing dermatologists' ability to fine-tunetreatments and the pros and cons of at-home cosmetic procedures.
Dermatologists Select Safest Solutions
Advances in the use of fillers, lasers and botulinum rejuvenation areallowing dermatologists to better refine treatments based on each patient'sspecific cosmetic needs. Dr. Hirsch credits the influx of new technologies andproducts in these areas as the reason behind the expanded treatment optionsfor patients.
"The biggest news in cosmetic procedures is the number of new products inthe pipeline that allow us to truly customize and refine treatments for theindividual patient," said Dr. Hirsch. "Dermatologists are now in a position tobe able to offer patients very specific solutions to each of their skinconcerns."
For example, the technology behind lasers and other light sources -- whichis the cornerstone of many skin rejuvenation procedures -- is continuallyevolving. Fractional resurfacing is one of the newer laser technologies thatgives dermatologists the option to safely treat patients with more extensiveskin damage. Dr. Hirsch noted that the main benefits of fractional resurfacingare increased collagen production that creates more dramatic results toimprove the appearance of skin texture and reduce the appearance of wrinklesand acne scars, doing so with considerably less downtime than other olderinvasive laser technologies.
In addition, laser technologies used to treat vascular lesions -- such asport-wine stains and other birthmarks -- have greatly improved over the years.This allows more patients to benefit from treatment, especially infants. Forexample, the pulsed dye laser selectively heats abnormal blood vessels withinthe port-wine stain without injuring the surrounding skin.
"It is simply best practice for a dermatologist trained in lasertechnologies to determine if a patient's birthmark is conducive to treatmentand how early and aggressive the intervention should be," added Dr. Hirsch.
A number of new fillers have been introduced in recent years to replacelost volume in the skin and to shape and sculpt areas that show signs ofaging. Where once natural collagen was the only filler available, now theadvent of synthetic collagens, several hyaluronic acids, L-polylactic acid,and calcium hydroxyapatite allow dermatologists to correct signs of aging fromsunken cheeks to fine lines around the eyes and lips. "Fillers represent themost visible area of cosmetic procedures where new products have reallyexpanded the menu of choices available for very specific skin problems," saidDr. Hirsch. "Different kinds of fillers can address specific kinds of faciallines, specific kinds of aging and shaping of the face."
Botulinum toxin, most widely known for its ability to diminish wrinklesand other facial lines, currently is being studied across many medicalspecialties for an array of different conditions. For example, onemanufacturer is seeking FDA approval of using botulinum toxin to treatmigraines. Dr. Hirsch explained that a few new manufacturers have introducedbotulinum toxin formulations in recent years. This helps patients by makingpricing more competitive and, hence, more affordable.
"The important thing to remember with any of these cosmetic procedures isthat you have to be sure that what you're choosing is the real McCoy --authentic and trustworthy," cautioned Dr. Hirsch. "Unless you go to adermatologist specifically trained in cosmetic procedures, you cannot be sureyou are receiving the highest quality care -- and in the case of botulinumrejuvenation, the safe dosage and manufacturer-specific formulation."
For some consumers, the "do-it-yourself" cosmetic treatments that can beperformed at home represent a viable alternative for those looking for aquick, albeit temporary, remedy. Many of the at-home products such asmicrodermabrasion kits and chemical peel solutions that can be purchased atdrug stores can be safe when they have been thoroughly tested for this type ofself-use. To ensure the highest level of safety, the concentration of theactive ingredients in these products is much lower than that used bydermatologists.
However, Dr. Hirsch pointed out that there are drawbacks to at-hometreatments of which consumers should be aware. While most at-home treatmentsdo not produce results as dramatic or long-lasting as the cosmetic proceduresperformed in dermatologists' offices, there are still safety concerns if theseare used improperly or if any of the active ingredients cause an unforeseenskin reaction.
"It is important for consumers considering any at-home cosmetic treatmentsto first discuss these products with their dermatologist," advised Dr. Hirsch."For example, a person using a retinoid could be at risk for an adverse skinreaction from a chemical in these at-home products that should not be usedsimultaneously."
Perhaps the most sought after new at-home cosmetic procedure that has beenintroduced recently is in the realm of laser hair removal devices. Unlike thelaser hair removal procedures performed in dermatologists' offices and whichoffer a long-term solution to unwanted facial and body hair, laser hairremoval performed at home is intentionally temporary. Despite giving consumersonly a temporary remedy for unwanted hair, Dr. Hirsch added that these typesof devices can be expensive -- ranging in price from approximately $800 to$1,000. These devices also can pose a safety concern for people who are tan orhave darker skin.
The concern for people using an at-home laser hair removal device or forthose opting to receive cosmetic treatments outside of a dermatologist'soffice, such as at a spa or mall-based establishment, is that many factorscould adversely affect the outcome of the procedure and pose unforeseen sideeffects.
"Knowing who not to treat is extremely important, and that is whyconsumers should remain highly skeptical of cosmetic procedures offered atlocal malls or venues where packages of treatments are sold," said Dr. Hirsch."In these cases, there is no motivation to turn anyone away, and theconsequences could be very serious. To ensure the highest level of safety andefficacy, see your dermatologist for all your skin care needs."
For more information on aging skin, go to the "AgingSkinNet" section ofhttp://www.skincarephysicians.com, a Web site developed by dermatologists thatprovides patients with up-to-date information on the treatment and managementof disorders of the skin, hair and nails.
Headquartered in Schaumburg, Ill., the American Academy of Dermatology(Academy), founded in 1938, is the largest, most influential, and mostrepresentative of all dermatologic associations. With a membership of morethan 15,000 physicians worldwide, the Academy is committed to: advancing thediagnosis and medical, surgical and cosmetic treatment of the skin, hair andnails; advocating high standards in clinical practice, education, and researchin dermatology; and supporting and enhancing patient care for a lifetime ofhealthier skin, hair and nails. For more information, contact the Academy at1-888-462-DERM (3376) or http://www.aad.org.
SOURCE American Academy of Dermatology