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Highlights (for you) from the 2017 Annual Dermatology Meeting

Highlights (for you) from the 2017 Annual Dermatology Meeting

I want to share some of the highlights presented at the American Academy of Dermatology meeting this year. The AAD (as we call it) is THE annual educational meeting in dermatology. It attracts about 18,000 dermatologists from all over the world. I go every year, except I missed it this year. The AAD was in Orlando, and I opted for my writing sabbatical (and summer) to be in Australia. I know I made the right choice, and yet I miss my yearly 'tank-up' of what’s new and big in dermatology. I’m playing catch up now by reading the highlights published in Dermatology Times, our professional ‘newspaper’. I want to share the topics I think you’ll be interested in. First, it looks like the interesting news is all about beauty! Common skin problems like rosacea, acne, psoriasis, and eczema (my bread and butter) did not appear to garner any truly new revelations for you, as a patient. I filter this by info allowing you to function on your own without professional assistance. This includes information on lifestyle or skin care advice, not surgery or prescription drugs. Each condition has new pharmaceuticals that were being promoted by speakers, but you need your physician to guide you with these. They are always expensive, laden with side effects, and will require a trip into your dermatologist to individually weigh the risk, benefit, and cost to you. There is often some exciting new development to help patients control or understand their skin problem without pharmaceutical intervention. Apparently not this year and I’m disappointed. I’ll keep my eyes on the dermatology journals, and hopefully advances will be presented there in 2017. For patients, the ‘news’ was in beauty and rejuvenation of skin-aging and sun damaged skin. Here is what I’m reading:

Do the Hot and New Beauty Products Work?

At the cosmeceutical session (cosmeceuticals are non-prescription skin care products with ingredients known to effect skin changes), which I always attend, Dr. Zoe Diana Draelos, professor at Duke and consultant, summarizes products I know you’ve been hearing about:

Korean Paper Masks:

Dr. Draelos describes these as paper masks that are pre-soaked in treatment products. The masks claim to brighten skin, tighten pores, minimize wrinkles, and more. She says the masks work largely because the paper provides an occlusive barrier to reduce transepidermal water loss (TEWL). The skin becomes overhydrated, and fine lines are temporarily reduced. “But the effect is not permanent,” she cautions. “TEWL resumes when you remove the mask, and the lines will slowly return to view.”

Skin Rolling (micro-needling):

This is a consumer tool to induce skin injury by rolling short needles across the skin. The goal is to trigger controlled collagen production during wound healing. Rollers are also promoted as a tool to help active ingredients penetrate into the skin such as hyaluronic acid, peptides, and more. Dr. Draelos says, “Skin rollers can work, but they can be problematic if consumers use them aggressively,”

Applied Polymer Technology

This is the use of polymer patches applied to different facial areas to reduce wrinkles. Like paper masks, the patches occlude the skin, and the effects reverse when the patches are removed, according to Dr. Draelos.

Silicone Line Improvers

These promise to hide facial lines and soften skin. The thick silicone film can mask shallow lines temporarily, and leave the sensation of softer, smoother skin.

Botanical bioreactors (think 'stem cells' in products)

These products use bioreactors to grow plant stem cells for cosmetic products. Once grown out, the stem cells are filtered, centrifuged, and freeze-dried into a powder that can be added to cosmetic creams. It is important to understand there are no living stem cells in the powder or the cosmetic. Dr. Draelos says, although the powdered ingredients may be of high purity, the real benefit is the high-quality moisturizer vehicle.

Neck Creams

Dr. Draelos' opinion is the active component in these products is the moisturizing base. In summary, Dr. Draelos recommended (as I have for years!),
Ignore the front label and go directly to the ingredients. Once you know what is actually in a cosmeceutical, you can evaluate how it might perform.
Dr. Draelos is talking to dermatologists. I am talking to you, the consumer. You will notice I limit my content and products to those with proven efficacy. I only distill information and options based on my knowledge of what’s proven and well made.

What Is the Best Age to Start Anti-aging Treatments?

In an AAD educational session titled “Aging Gracefully”, the speakers outlined the options for rejuvenation and reversal of skin-aging and damage. They were all in agreement: the sooner you start, the better your results. Speakers echoed don’t wait until you see the signs of skin-aging to plan your anti-aging skin care. What does this mean for you? Dermatologist Dr. Sabrina Fabi pointed out the skin-aging process begins at 25. By 35, your bones give less support to muscles, including facial muscles. She says starting muscle relaxers like Botox (the gold standard) early has been shown to:
upregulates collagen expression (meaning you build collagen), increases skin pliability and elastic recoil, prevents etched lines, and improves skin quality.
According to Shannon Humphrey, MD, professor of dermatology at University of British Columbia, this translates into anti-aging skin tone results you want.

What Are the Best Skin Care Product Ingredients Proven to Repair and Slow Skin-aging?

Speaker Qian Zheng, MD, PhD of L’Oreal Research, outlined what he sees as skin care cosmeceutical ingredients with proven effectiveness for retarding and repairing skin aging and damage. Here is his list with my caveats in parenthesis: Sunscreens (I only recommend zinc oxide products). Hyaluronic Acid: He states HA products are shown to improve the quality of elastic fibers and the collagen architecture (They also immediately hydrate and plump skin to help it look radiant and youthful - I love our Instantly Luminous Serum for HA superpower). Retinol/vitamin A, which he points out is proven to reduce wrinkles, increase dermal density of collagen, and smooth texture. (One of my favorite ingredients to fight and prevent skin-aging is our Retinol Night Cream, is formulated with the best technology!) Vitamin C/ascorbic acid: Dr. Zheng focused on vitamin C’s proven ability to protect against sun damage. (In stable, professional products it will also fade hyperpigmentation and induce new collagen to reduce wrinkles. 'Devil is in the details' with vitamin c in skin care, and our Vitamin C Serum covers all the details for powerful, stable vitamin C efficacy).    Lastly, Dr. Zheng correctly points out the other ingredients in a product that constitute the ‘base’, as well as the packaging, are important factors which “determines efficacy of these active ingredients.” I’ve been saying this for years. It is part of my myth busting mission in skin care, set by seeing so many use products of dubious benefit. These products waste your time and money when your efforts could be fighting skin damage with effective products.

What Are the Hot Procedures to Fight Skin-aging?

In the same educational session, procedures such as fillers, fat digesters (like Kybella), IPL/BBL, and laser treatments were discussed. Speakers agreed these are best mixed and matched for each patient based on priorities, goals, and budget. They agreed any discussion of procedures needs to be done in the context of setting up a healthy lifestyle that maximizes the vitality of the body, and thus the skin. This includes diet, exercise, rest, and stress management. (My practice offer the full range of these cosmetic procedures, and always encourage our patients to maximize their vitality with lifestyle choices). The highlights of this session: According to Susan Weinkle, MD, affiliate professor at University of South Florida, “mature” women, who already have wrinkles and sun damage typically want to look 13 years younger as a skin rejuvenation goal. In this instant, we prefer fillers over surgery. Terrence Keaney, MD, professor at George Washington University says men age more quickly than women, and are more concerned about hairline, eyes, and jawline. New techniques being done include: Microneedling: (needs to be done by a trained person. My practice may begin offering this soon. It is similar to a component of the laser services we offer called ProFractional laser). Absorbable Lifting Sutures: Apparently, these are surgically placed under simple local anesthetic in the dermatologist’s office. The ‘lifting sutures’ are used to create traction, lift and repositioning of tissue on the jaw, eyebrows, and mid face. I remember a few years back when a similar technique was done with sutures that had little barbs like Velcro. They would come undone, resulting in asymmetry. These sutures were non-absorbable. There were also the endoscopic brow lifts with permanent suture. Those procedures fell in popularity. I’ll take a ‘watch and wait’ approach to this new ‘advance’. There you have it! What's new and what's hot in dermatology - that you can think about. My review saved me flying to Orlando upon my return from Australia. I do think I'll have to attend the smaller summer AAD in New York though. I need a fix of dermatology immersion from time to time.