Expert Opinions

Aesthetic Surgery

Aesthetic Guide - July/August, 2009

As technology in the aesthetic industry continues to evolve, so does topical skin-care. New, anti-aging skincare products are introducing unique ingredients ranging from skin lighteners - such as alpha arbutin - to a ceramic material bioactive glass, in order to fight the aging process. Furthermore, adding intense pulsed light (IPL) or a neurotoxin to skincare regimens is also demonstrating enhanced results.

Hydrating Complex and TNS Essential Serum are two of the newest anti-aging products from SkinMedica, Inc. (Carlsbad, Calif.) Hydrating Complex contains a micronized form of hyaluronic acid (HA) for penetrating and holding moisture both in the stratum corneum and dermis. “The particle size is 0.01 of a large HA molecule, which allows it to penetrate better and stays in the skin longer It won’t wash out,” said Richard Fitzpatrick, M.D., founder of SkinMedica and director of cosmetic dermatology at La Jolla Cosmetic Surgery Centre, in La Jolla, Calif. Moisture is stimulated for about three days after application. The inclusion of a hyaluronidase inhibitor prevents the breakdown of HA in order to prolong moisture, as well as the breakdown of elastin. “In total, our Hydrating Complex has four different mechanisms to stimulate moisture in the skin.”

TNS Essential Serum, on the other hand, is a dual-chamber serum comprised of TNS Recovery Complex in one chamber and APS Corrective Complex in the other TNS Recovery Complex contains 11 0 naturally occurring growth factors, whereas APS Corrective Complex is a potent mixture of three novel peptides and seven antioxidants. Specialty ingredients of APS Corrective Complex include alpha arbutin, HA spheres (for filling fine lines on the surface of the skin) and gamma aminobutyric acid (GABA), a topical skin tightening agent that relaxes muscles.

The Condition and Enhance System from Obagi Medical Products, Inc. (Long Beach, Calif.) consists of a plethora of skincare products in four stages of application: prepare, which includes their Gentle Cleanser or Foaming Gel and NuDerm Toner; repair, featuring Clear (hydroq uinone 4%), Exfoderm or Exfoderm Forte; stimulate and maintain, featuring Blender (hydroquinone 4%) and/or tretinoin (as prescribed), and protect, which includes Healthy Skin Protection SPF 35 and/or Physical UV Block SPF 32.

A multicenter study determined that adding two sessions of IPL to the Condition and Enhance System augmented results, according to Mitchel Goldman, M.D., study investigator and medical dire ctor at Dermatology/Cosmetic Laser Associates of La Jolla, Inc. and La Jolla SpaMD, in La Jolla, Calif "Combining these two modalities helps to build trust and credibility with my patients." The Obagi system plus IPL achieved a 75% overall improvement in facial appearance versus only a 19% improvement when using IPL with placebo. Statistically significant benefits were seen in hyperpigmentation and skin laxity as well.

A separate study by Dr. Goldman found that combining ELASTIderm topical eye treatment (also from Obagi) with BOTOX from Allergan (Irvine, Calif.) improved the results of BOTOX alone.

Visible Youth Healing Complex from Enhance Skin Products, Inc. (Toronto, Ontario, Canada) provides a synergistic effect by combining a specific fraction of HA with bioactive glass know as Vitryxx, which is a ceramic material that promotes healing. "This ceramic material was originally developed in the late 1960s to enhance bone growth after nonunion fractures," explained Sam Asculai, Ph.D., president and CEO of the comp any. "Then it was discovered that it disp layed activity in the personal care area. It was very gentle on skin. This ceramic is an antioxidant, anti-inflammatory and anti-microbial, with a smoothing and re-mineralization effect.”

There are two versions of Visible Youth Healing Complex: one for use by the physician's office immediately following skin resurfacing, which contains 3% lidocaine; and the other for home-use, without lidocaine, which is applied every three to four hours during the first 48 to 72 hours post treatment. According to Dr Asculai, "The healing of the skin is accelerated." He also believes that Visible Youth Healing Complex reduces downtime to less than one week versus the two weeks that is typical after some laser and chemical treatments.