New modalities, old standbys help skin fight advancing years

Age management

"A lot of us prefer to call it 'age management,' which is a concept that's a lot more than injecting Botox (Allergan Medical) - it's about the patient's overall health."

Dr. Werschler divides age management into two categories - intrinsic and extrinsic. The former would include human growth hormone (HGH) therapy, nutraceuticals, anti-oxidant therapy - an overall focus on wellness, nutrition and exercise, he says - while extrinsic age management "is the general field of cosmetic dermatology and plastic surgery."

In that general field, several trends have emerged in recent years and others are on the horizon. Among the current trends are combination therapies.

"Hardly anyone comes in for a single treatment anymore," says Tina S. Alster, M.D., director of the Washington Institute of Dermatologic Laser Surgery and clinical professor of dermatology at Georgetown University Medical Center, Washington, D.C.

"Combining treatments has become the norm, such as Botox with fillers and lasers with topical prescriptions," she says.

"I've been using combined modalities, such as fractionated resurfacing for photoaged skin, nonablative techniques for skin toning, a noninvasive skin tightening approach to tighten jowls and neck, and LED technology to photomodulate cells," says David J. Goldberg, M.D., director of Mohs Surgery and Laser Research at Mount Sinai School of Medicine in New York City.

Cosmeceutical evolution

"As for other trends, some cosmeceuticals are beginning to show evidence of efficacy. As this trend continues, dermatologists will increasingly use them," Dr. Goldberg tells Dermatology Times.

Dr. Werschler and Dr. Alster agree.

"Cosmeceuticals get better every year," Dr. Werschler says.

"They're a safe and easy, albeit expensive, way to attempt to reverse the sins of our youth."