Aesthetics

National report - California pharmaceutical manufacturer Allergan is taking steps to reassure doctors and patients about the safety of Botox after four people became critically ill after they were treated with an unapproved raw botulinum toxin.

Santa Barbara, Calif. - The U.S. Food and Drug Administration has approved Inamed Corp.'s Captique, a non-animal-based hyaluronic acid gel to combat facial wrinkles. It is the newest dermal filler to enter the U.S. market.

Stanley A. Klatsky, M.D., believed in cosmetic surgery when few of his plastic surgery peers would even discuss its existence.

Many reliable sources will be providing physicians and staff input regarding all the changes set forth by the American Medical Association (AMA) and the Center for Medicare & Medicaid Services (CMS) for fiscal year 2005. Based on the display copy of the Nov. 2, 2004 Federal Register, the 2005 AMA CPT book, and the ICD-9-CM Book for 2005 published by the World Health Organization, pertinent changes for dermatology practices are summarized below:

Philadelphia - The advent of tumescent infiltration in the late 1980’s and its widespread adoption in the 1990’s was a revolutionary event in the history of liposuction, says Gerald H. Pitman, M.D. Since then, theory and technique have been moving forward in graduated steps.

Philadelphia, Pa. - Calling a new laser from Reliant Technologies "one-stop shopping for aging skin," Lawrence Bass, M.D., presented his take on the Fraxel laser as well as a number of intense pulsed light systems as part of a discussion of advances in cosmetic laser surgery at the American Society of Plastic Surgeons here.

A San Francisco-based plastic surgeon says Botox (Allergan), used prior to browlift surgery, actually leads to an improved permanent outcome in that procedure.

Philadelphia - Excising and lifting can give the face a less old, but not necessarily young, appearance. The way to truly rejuvenate is to let go of the idea that gravity drives aging and rediscover the role of atrophy, says Sydney R. Coleman, M.D.

San Diego - Results from a U.S. Food and Drug Administration pivotal trial demonstrate that the injectable wrinkle filler Artecoll, composed of polymethylmethacralate (PMMA) microspheres (20 percent) suspended in an ultra-purified collagen carrier (80 percent) is an equally safe, but longer-lasting, alternative to bovine collagen for the cosmetic correction of a variety of facial contour defects, Steven R. Cohen, M.D., tells Dermatology Times.

National report - Some physicians swear by it. Others call it "bogus." Still, mesotherapy glitters with a bit of the star power that lights up one of its better-known advocates, singer Roberta Flack. Hundreds of U.S. physicians now offer mesotherapy treatments - injections of homeopathic remedies, supplements, drugs or other substances into the mesoderm - starting at $200 to $300 per session.

National report - As the baby boom generation ages, its members will want what they have always wanted from dermatologists - to look younger longer. At the same time, they'll encounter more age-related medical problems, while the supply of dermatologists who can meet these needs continues to dwindle.

Are general, medical derms considering newer, less invasive cosmetic procedures?

New York - A recent study suggests Propionobacterium acnes plays a role in the development of rosacea.

Acne phototherapy has a very favorable safety profile.

New York - A global group of acne experts says doctors should use treatments combining a topical retinoid and an antibiotic as a first-line measure for patients with mild-to-moderate acne rather than relying on antibiotics alone.

Philadelphia - Experts in the field of acne management gathered here in June to discuss the implications of recent data on the use of antibiotics in relation to the treatment of acne.

For mild-to-moderate comedonal acne, he says, he usually begins with topical retinoids.

National report - Patient demographics play a small but important role in diagnosing psoriasis and, more importantly, in providing a path to open discussion about treatment.

Incision and drainage services are commonly performed dermatologic services; although, they are frequently billed incorrectly causing unnecessary denials and reviews.

Topical application increases skin thickness. However, absorption is problematic because peptides are hydrophilic and ionically charged, preventing passage through the stratum corneum.

Only Hylaform was available until the U.S. Food and Drug Administration recently approved Hylaform Plus for treatment of moderate to severe facial wrinkles and folds.

National report - Many dermatologists' attitudes toward antibiotic resistance can be summarized as: "I don't see it in my practice, so it's not my problem."But a growing number of practitioners are recognizing the potential significance of the problem, particularly when it comes to treating common conditions, including acne.

National report - The U.S. Food and Drug Administration (FDA) has approved Hylaform Plus (Hylan-B gel), a large-particle-size hyaluronic acid-based dermal filler indicated for the correction of moderate to severe facial wrinkles and folds.

National report - Despite a long history of ambitious goals and promises of over-the-counter rejuvenation, the field of antiaging topicals remains young. Still, the science is improving, although many dermatologists contend that many claims are short on evidence.

Boston - Stimulating the body to regenerate itself and repair the damage of aging is the latest goal of anti-aging medicine. One of the founding members of the American Academy of Anti-Aging Medicine and the first president of the American Board of Anti-Aging Medicine, Vincent C. Giampapa, M.D., F.A.C.S., says research shows that, if given the right conditions, stem cells in the subcutaneous layer of the skin can develop into healthier tissue and inhibit the aging process.

Stanford, Calif. - By nearly all accounts, nothing beats Botox in the upper face for quickly, consistently and noninvasively offering patients the most bang for their rejuvenation buck. Yet, physicians are now finding new indications farther down the face - particularly in the perioral area, which has proven resistant to surgical treatment.

Zurich - Sunscreens containing ultraviolet B (UVB) filters protect against sunburn, but not against ultraviolet A (UVA) rays, which are deemed responsible for skin cancer. So far, there have been only a limited number of products offering UVA protection in the United States. Possibly the most effective ingredient available for UVA protection is Parsol 1789 (avobenzone), but its photo-instability makes it a less than optimum product in trying to achieve broad spectrum UV protection.

Dallas - Dermatologists who are using either intense pulsed light laser or pulsed dye laser therapy to treat photodamaged skin should use it concurrently with a topical retinoid according to a randomized study performed by Emil A. Tanghetti, M.D., of the Center for Dermatology and Laser Surgery, in Sacramento, Calif.

San Diego - Psoriasis patients find a plethora of treatment options today, beyond methotrexate and cyclosporine and their potential to cause side effects.

Cigarette smoking is the most preventable cause of morbidity and mortality in North America, and is a significant public health concern.