Advances in skincare technology continue apace, with more recent advances in wound healing, skin brightening, inflammation control, and photoprotection, as well as general maintenance of the health and wellness of the skin. While in-office minimally-invasive procedures like neurotoxin and filler injections continue their double-digit growth, patients and doctors are re‑awakening to the need of supplementing these gains with evidence-based skincare regimens. It is likely that this trend was the motivating factor for the recent acquisition of the three leading ethical skincare companies by Merz, Allergan, and Valeant, the three multinational companies that supply fillers and neurotoxins.
A return to skin wellness
Since the advent of cosmetic fillers and the approval of cosmetic botulinum toxin nearly two decades ago, the emphasis in aesthetic medicine has shifted from promoting anti-ageing skin wellness regimens to appearance-enhancing procedures. The business of medical skincare slowed, stuttered, and stalled as injection and energy based procedures grew at a phenomenal rate.
Women still make up 90% of the market and the most common procedures for women aged 35–50 years were: botulinum toxin, hyaluronic acid injection, laser hair removal, intense pulsed light (IPL) laser treatment, and microdermabrasion. However, according to the American Society for Aesthetic Plastic Surgery (ASAPS), trends within the men’s category — the holy grail for aesthetic marketers for the past 30 years — show a growth for both invasive and non-invasive anti-ageing options1.
Equipment-based therapy continues to lead the cosmetic category with microdermabrasion, microcurrent ultrasound, radiofrequency, cold laser, LED, and IPL. Physicians are making an investment and bringing equipment into their treatment rooms and patients are accounting for these procedures in their monthly budgets.
However, while the demand for in-office procedures and the instant gratification that they provide continue to drive the traffic into the aesthetic office, an increasing number of patients are complaining that their skin looks ‘drab’ or ‘tired’, and those aesthetic physicians with expertise and experience in skincare are again looking to skincare that can supplement procedures and enhance the results by improving skin wellness in addition to appearance. In addition, an increasing number of patients are beginning to understand that skincare isn’t just a pampering experience, but a choice in overall skin wellness and a necessary component to their in-office procedures.
Skincare providers know to include sunscreen, antioxidants, and retinoids in general skincare, but now have many more options available — some particularly suited to pair with procedures.
Owing to more coverage in the press and more data coming in from clinical studies, the anti‑ageing modality at the forefront of consumers’ minds is growth factors (GFs). Topical skincare treatments that include epidermal growth factors (EGFs) stimulate tissue regeneration and collagen production by re-energising waning cellular DNA synthesis and triggering our skin’s natural ability to heal, making it invaluable against premature ageing.
Growth factors promote skin tissue repair and regeneration, as well as the formation of collagen and elastic fibres, which give the skin its softness and suppleness. Synergistic interaction of multiple growth factors with other proteins in the epidermis and dermis results in skin repair and regeneration.
Growth factor products are also the ideal modality to pair with procedures, many of which involve either a deliberate or unintentional wounding of the skin. The use of growth factors to mitigate the damage or enhance the results of these procedures is logical and effective, as well as providing the added benefit of improving general skin wellness. Coincidently, it provides the skincare advisor an opportunity to discuss general skincare and to sell other beneficial products. It is probably not a coincidence that the key technology of two of the three skincare companies recently gobbled up by the multinationals is growth factors.
Perhaps the newest skincare buzz has to do with increasing the proliferation of stem cells. This is an ideal pathway to stimulate for skin repair — perhaps even more so than growth factors — and like growth factors, is ideal to pair with procedures. Unfortunately, so far there is scant evidence that this is yet possible. The idea of applying plant stem cells topically has been pretty much discredited (just as the use of plant growth factors was a decade ago), and the evidence that topical human stem cells are stable, absorbable, and active is still yet to be seen. Much work is being done to find agents that can stimulate the skin’s natural stem cell production mechanism. This seems a more likely route to success, but the concern is, as always with anti‑ageing mechanisms, whether too much success can increase the likelihood of skin cancer.
DNA damage has a significant impact on skin health and appearance. The repair of DNA has become a vital part of the skincare armamentarium to help achieve and maintain healthy skin. Patented Photosomes®, Roxisomes®, and Ultrasomes® from the Barnet Corporation work with the body’s natural repair process to help reverse, excise, and extract DNA damage and also help protect against future damage. A number of companies have since developed other modalities, which are similar (or identical) to those developed at Barnet, although not all use a liposomal delivery system as Barnet’s products do. Also, regardless of the source of extract or species of microorganism, they all work on the same three basic principles:
- Photosomes® (plankton extract) harnesses UV rays to activate the body’s natural repair process and break dimer chains
- Roxisomes® (Arabidopsis thaliana extract) provides OGG-1, the body’s enzyme that excises DNA damage by oxidation
- Ultrasomes® (micrococcus lysate) are T4N5, the body’s enzyme that extracts DNA mutations.
DNA repair is one of the fastest growing areas for dealing with the ageing skin.