Tattoo Ink Risks, MultiFrax Laser, and the Impact of GLP-1 Medications on Skin Health

“PRX is a topical collagen biostimulator that has been out in Europe for a while. It's now come to the United States in the past year. It has a 33% TCA. It has hydrogen peroxide and about a 5% kojic acid. And together, the TCA, because of the hydrogen peroxide, penetrates, but not as much, and so you don't wind up with the hyperpigmentation you might see in a 33% TCA in somebody with my skin tone otherwise,” said Jeanine Downie, MD, FAAD, in an interview with Dermatology Times at the 2025 American Academy of Dermatology (AAD) Annual Meeting in Orlando, Florida.

Downie, a board-certified dermatologist at and founder of Image Dermatology in Montclair, New Jersey, presented “Pearls From the Masters of Dermatologic Surgery” at AAD on March 7.

In her session, Downie discussed critical updates on tattoo ink safety, new dermatologic technologies, biostimulators, and emerging trends in aesthetics and longevity science.

Tattoo Ink Safety

Downie first highlighted the increasing prevalence of tattoos and the dermatologic complications associated with them. With nearly 38% of women and 27% of men in the US having tattoos, dermatologists frequently encounter tattoo-related reactions. She noted that 20% to 30% of tattoo inks are contaminated with microorganisms, while only 10% of ink contents are labeled. Many inks contain suspected carcinogens like polycyclic aromatic hydrocarbons (PAH) and components derived from car paint, printer toner, and carpet dye. These concerns underscore the need for dermatologists to be vigilant about tattoo reactions and patient education.

MultiFrax Laser Technology

Next she introduced the MultiFrax, a handheld fractional laser combining 1550 nm and 1927 nm wavelengths for skin resurfacing and pigmentation treatment. This portable device offers versatility for treating fine lines, wrinkles, acne scars, and surgical scars across all skin types. She praised its convenience for multi-office practices and its efficacy in delivering simultaneous resurfacing and pigment correction.

PRX Topical Collagen Biostimulator

PRX technology, a topical collagen biostimulator, has gained popularity in the US after success in Europe. Composed of 33% trichloroacetic acid (TCA), hydrogen peroxide, and kojic acid, it penetrates the skin without causing hyperpigmentation, making it suitable for all skin types and seasons. Unlike injectable biostimulators such as Sculptra or Radiesse, PRX provides a needle-free, painless option for skin rejuvenation on the face, neck, chest, and body.

Salmon Sperm Polynucleotides

Another emerging technology discussed was the use of salmon sperm polynucleotides for skin regeneration. While further research is needed, these compounds have shown promise in skin rejuvenation and even vascular occlusion management. Downie expressed enthusiasm for their potential dermatologic applications.

Sirtuins and Longevity

Downie also delved into the role of sirtuins (SIRT1 and SIRT3) in longevity, noting their higher levels in individuals who exercise regularly. She highlighted dietary sources such as berries, leafy greens, and red wine that can induce sirtuin activity, promoting cellular health and longevity.

GLP-1 Medications and Aesthetic Concerns

With the widespread use of GLP-1 receptor agonists for weight loss, dermatologists are seeing increasing cases of facial volume loss, skin texture changes, and hair thinning. Downie discussed strategies to manage "Ozempic face" and help patients maintainskin health post-weight loss.

Beyond these clinical pearls, Downie emphasized the importance of the AAD meeting for professional growth, networking, and camaraderie. She finds the conference to be a source of inspiration and remains actively involved in the AAD diversity committee, contributing to the field in meaningful ways.