Dermatology’s 2017 Game Changers

We asked dermatologists what they predict will be the specialty’s game-changers in 2017. This is what they had to say:

Atopic dermatitis treatment

Harper N. Price, M.D.Harper N. Price, M.D., pediatric dermatology division chief, Phoenix Children’s Hospital, tells Dermatology Times that she’s looking forward to new and exciting treatments for pediatric atopic dermatitis (AD).

“A new topical formulation (a phosphodiesterase-4 inhibitor) for pediatric AD is slated to be on the market in early 2017,” Dr. Price says. “Clinical trials for biologic therapies for severe pediatric AD will also be underway. There is currently little evidence-based literature supporting treatments for severe AD in childhood and adolescence. These new trials will be a welcomed addition, hopefully bringing better treatment options to the table.” (No conflicts)

It is an exciting time in dermatology, as there continues to be a shift in the understanding of the pathophysiology of many disease states, bringing new therapies for difficult to treat conditions, according to medical, cosmetic and surgical dermatologist Jennifer Salsberg, M.D., of Women's College Hospital, Toronto, Ontario.

“I am looking forward to the new treatments on the horizon for atopic dermatitis, both topical and systemic, especially new biologic agents targeting specific inflammatory mediators implicated in atopic dermatitis,” Dr. Salsberg says. “We will soon have exciting new options to help patients with this chronic and sometimes debilitating condition."

No conflicts

Drug dispensing in the office

Jessie Cheung, M.D.Jessie Cheung, M.D., director of the Dermatology & Laser Center in Willowbrook, Ill., says there’s a movement towards dispensing prescription medications in the office, and bypassing pharmacies and insurance companies.

“It's frustrating to both me and my patients when my desired treatment plan is denied,” Dr. Cheung says. “Now, my patients can walk out of my office with the correct medications. I do hope that the healthcare dilemma gets sorted out in 2017.”

On another note, Dr. Cheung says her favorite new procedure involves the use of resorbable sutures to suspend and re-orient the skin. She uses Silhouette Instalift (Silhouette Lift Inc.) and Novathreads (Aesthetic Experts Laboratory).

“They are a great complement to filler injections, since they can lift a jowl or melolabial fold without adding heaviness to the skin. These sutures really can be used anywhere in the body, and I've had great success with lifting buttocks and knees, in addition to the face,” Dr. Cheung tells Dermatology Times.

No conflicts

PRP to grow in popularity

Debra Jaliman“I think PRP injections made of platelet rich plasma will be big for 2017,” says Debra Jaliman, assistant clinical professor of dermatology, at the Icahn School of Medicine at Mount Sinai, New York, N.Y. “I use it in my practice for acne scars, anti-aging and hair loss. The treatments are given four to six weeks apart and are well tolerated. The results are impressive, and you don't have to worry about allergic reactions.”

No conflicts

Next: Off-label use, fillers, micro treatments

Off-label technology use, combinations

Arash Akhaven, M.D.Arash Akhavan, M.D., owner of The Dermatology & Laser Group in New York City, says the growing trend of less invasive cosmetic procedures is resulting in physicians’ using these technologies for off-label purposes and combining many of them to produce more impactful results.

“For example, SculpSure [Cynosure] is FDA-cleared for laser lipolysis of fat in the flanks and abdomen, but we commonly use it for body contouring of the thighs, arms and bra-fat areas. We have also found it an invaluable tool for skin tightening needs and have had near surgical results for some patients in this regard after multiple treatments,” Dr. Akhavan says. “For an added boost of skin tightening and lifting we often combine SculpSure with off-label uses of Ultherapy [Merz Aesthetics] (a device originally FDA-cleared for non-surgical face and neck lift) that we have found useful as a skin tightening device anywhere on the body.”

Another more popular combination of treatments in Dr. Akhavan’s office as the practice enters the New Year, involves combining procedures for general beautification of the buttock and thigh area, he says.

“We have been using Cellfina [Ulthera] cellulite treatment to remove cellulite dimples in these areas, but then treating patients after about one to two months with either Ultherapy and/or SculpSure to tighten the skin and improve contour, if needed,” Dr. Akhavan says. “Combining procedures gives patients more of the ‘wow factor’ they expect, as the public becomes more cosmetic savvy.”

No conflicts

New fillers; new filler uses

Robert Anolik, M.D.New York, N.Y. dermatologist Robert Anolik, M.D., says he expects game changers in cosmetic fillers in 2017, both in terms of new products and also how dermatologists use them.

“Just in the past few years, we have gone beyond original hyaluronic acid fillers to others that bring greater specificity and nuance, so that the skilled injector can optimize results,” Dr. Anolik says. “Highlights include stronger lifting materials with Voluma [Allergan] and Restylane Lyft [Galderma]; softer lip enhancers with Volbella [Allergan] and Restylane Silk [Galderma]; and distinct cross-linking strategies to minimize swelling with Vycross. I expect launches of several newer fillers (e.g. such as the expected launch of Galderma's Refyne and Defyne and more) that will bring their novel individual benefits. And I also await new products created for yet to be developed indications such as under-eye troughs, earlobes, temples and more. We are becoming more than artists, but artists with a full palette of paints.”

Dr. Anolik is a consultant for Allergan.

More micro treatments in 2017

Kristel D. Polder, M.D.Kristel D. Polder, M.D., clinical assistant professor of dermatology at UT Southwestern and partner with Dallas Center for Dermatology and Aesthetics, Dallas, Texas, says that in 2017, she is looking forward to the growing adoption of micro treatments, including micro-blading for semi-permanent eyebrow enhancement; and microneedling (SkinPen, Bellus Medical) for improvement in pores, wrinkles, scars and sun damage.

“We predict micro-blading will be a particularly appealing option for women who are experiencing a disappearance of the brow tail and brow head, and are seeking a more natural-looking restorative treatment,” Dr. Polder tells Dermatology Times. “In our practice, we have found microneedling therapy to be a well-tolerated, effective and viable alternative to acne scarring creams or more intense laser therapies, depending on the severity.”

No conflicts

Next: Picosecond lasers, men, acne treatments

Upswing in picosecond laser use

Jeffrey Fromowitz, M.D.Boca Raton, Fla., dermatologist Jeffery Fromowitz, M.D., says he thinks one of the most exciting innovations for 2017 is the introduction of picosecond laser technology and certain wavelengths of energy that have created a new era in skin revitalization.

“Using Cutera’s Enlighten laser, we are able to deliver controlled high energy ultrashort pulses to the skin surface. These pulses selectively target and shatter pigment in a photomechanical fashion. The photomechanical laser shockwaves disrupt and remodel the papillary dermis, stimulating collagen formation, improving skin tone and creating a more youthful appearance,”

Dr. Fromowitz says. “The best part is the treatment is safe on all skin types and has no down time.”

Dr. Fromowitz has lectured for Cutera but not on this laser.

More men in 2017

Janet Prystowsky, M.D.New York City dermatologist Janet Prystowsky, M.D., says dermatologists will be seeing more men coming in for facial rejuvenation in the next year.

“Generally their preferences vary a little from women’s. So this may be a good time to diversify your options in anticipation of this growing demographic,” Dr. Prystowsky says. “Botox [Allergan] is still the number one option going forward. But men do not seem as interested in deep-tissue radiofrequency and volumizing filler treatments as women are. I think this is because men’s faces tend to hold their volume longer than women’s faces do. That being said, men seem more interested in pulsed dye lasers that treat redness and red spots. I also see more interest in silicone fillers around the mouth.”

No conflicts

Growing demand for antibiotic-free acne treatments

Hilary Baldwin, M.D.Hilary Baldwin, M.D., medical director of the Acne Treatment and Research Center in Morristown, N.J., says that she continues to see more and more patients who are looking for options to help manage their condition.

“They are specifically looking for options that do not increase the risk of antibiotic resistance. They are most interested in once daily treatments with little tolerability issues,” Dr. Baldwin says.

The option Dr. Baldwin noted: prescription treatment Epiduo Forte (adapalene and benzoyl peroxide, Galderma) Gel, 0.3%/2.5%, which, she says, contains the highest-available concentration of adapalene combined with benzoyl peroxide.

Dr. Baldwin is an advisor for Galderma, Bayer, Allergan, Sun, Valeant, Encore, BioPharmX and Novan.