The arena of cosmeceuticals, cosmetics, and skincare has undergone dramatic changes in the past 25 years. Why, 25 years ago there were no cosmeceuticals, in fact the word had not yet been coined by Dr. Albert Kligman, and the most sophisticated product in the over-the-counter skincare market was a petrolatum, mineral oil, and glycerin moisturizer. Exciting changes have occurred on many fronts, including the development of new ingredients, new classes of products, and new biologic actives.
I am constantly impressed by the perceptions and misconceptions of my patients, which gives me cause to sit and reflect a moment on how our lives are shaped by marketing and economic forces that go unrecognized by most.
Q. After being very unsuccessful in buying individual stocks, I have decided to invest in actively managed mutual funds. What is the best way to compare mutual funds?
British Columbia - While dermatologists tend to think of Botox as a primary therapy, some are looking at it as an adjunctive therapy, offering benefits from longer- lasting results to better wound healing and less scarring.
Washington - Recent regulatory decisions about hyaluronic acids and hyaluronic gels have brought facial wrinkle fillers even further into the fold of the impulse purchase.
Waikoloa, Hawaii - Many modalities are available for minimizing patient discomfort during laser and radiofrequency procedures, but for optimal benefit, method selection should be tailored to the patient's needs as well as the type of procedure, said Suzanne L. Kilmer, M.D., at the annual Hawaii Dermatology Seminar in January.
Q. How do facial sebum- reducing products work?
Waikoloa, Hawaii - The increase in the number of topical anesthesia options available mandates that dermatologists consider how they compare with respect to efficacy, safety, and patient convenience when selecting an agent to minimize the pain of a cutaneous procedure, said Dina N. Anderson, M.D., at the annual Hawaii Dermatology Seminar in January.
Amsterdam -- Combined use of an artificial skin substitute and stem cells may promote healing of difficult wounds, according to Sadanori Akita, M.D., Ph.D., senior assistant professor in the division of plastic and reconstructive surgery at Nagasaki University, Japan. "When dealing with serious wounds, such as extensive burn wounds, acceleration of wound healing is critical for survival," Dr. Akita said. "There is an unmet surgical need for better treatments for difficult wounds, especially in cases requiring resurfacing of large skin defects, and in contaminated or poorly vascularized wounds caused by irradiation or systemic diseases such as diabetics."
Washington, D.C. - Should a biological attack reach American soil, dermatologists must position themselves on the front lines, according to Michael J. Franzblau, M.D., clinical professor of dermatology at the University of California at San Francisco's School of Medicine and a respected researcher and speaker on bioterrorism.
Ludwigshafen, Germany - The possibility of infection is quite real when the hand is injured, but a clinician can take steps to prevent or minimize infection. By doing so, he or she is helping to avoid further complications and the possible loss of hand function, and reducing the need for eventual cosmetic enhancement or repair.
Washington - Even though surgical complications are rare, they do not get as much attention as they should, according to Christopher J. Arpey, M.D., Hospitals, Department of Dermatology, Iowa City. Dr. Arpey says the topic of complications is avoided because of its inherent distastefulness, and he believes just the opposite should be happening.
Waikoloa, Hawaii - A new foam formulation of the antifungal drug ketoconazole (Extina 2 percent, Connetics Corp.), currently under FDA review, seems to be more completely absorbed into the skin than the same ingredient in other formulations and could be more effective in the treatment of sehorrheic dermatitis, said Linda F. Stein Gold, M.D., director of clinical research, department of dermatology, Henry Ford Health System, West Bloomfield, Mich.
San Diego - Healthcare and public-health workers vaccinated against smallpox have had few of the adverse events historically associated with smallpox vaccine, though unexpected cardiac events have occurred and continue to be investigated, according to Raymond A. Strikas, M.D.
Montreal - Drug-induced skin reactions present a major diagnostic challenge. While many resolve once the causative agent is removed, the trick is to realize the reaction is drug-related and to determine which drug is causing problems.
Richmond, Va. - Chronicity of nonhealing pressure ulcers appears to result from extensive invasion of neutrophils and destruction of growth factors, collagen, and other matrix components by neutrophil-derived enzymes, according to Robert F. Diegelmann, Ph.D., professor of biochemistry, anatomy, and emergency medicine at Virginia Commonwealth University in Richmond, Va.
Waikoloa, Hawaii - Psoriatic patients responding to efalizumab (Raptiva, Genentech Inc. and Xoma Ltd.) biologic medication are happy with the results after an extended period of continuous treatment.
Barcelona - In two Phase IV efficacy studies designed to evaluate pimecrolimus 1 percent cream (Elidel?, Novartis Pharmaceuticals Corp.) under "real world" conditions, treatment with pimecrolimus 1 percent cream for up to six months was found to be safe and effective in infants, children, and adults who were suffering from atopic dermatitis with all degrees of severity and who had received a wide variety of previous treatments. Moreover, in both trials, subjects reported improvements in quality of life and a high degree of cosmetic acceptability, according to clinical investigators Lyn C. Guenther, M.D., F.R.C.P.C., Professor of Dermatology at the University of Western Ontario in London, Ontario, Can., and Sheila Fallon Friedlander, M.D., Associate Clinical Professor of Dermatology at Children's Hospital & UCSD Medical Center in San Diego, Calif. Results of both trials were presented at the 12th Congress of the European Academy of Dermatology and Venereology in Barcelona.
Waikoloa, Hawaii - A combination topical treatment regimen consisting of the calcineurin inhibitor tacrolimus 0.1 percent ointment (Protopic, Fujisawa) plus the moderate potency corticosteroid clocortolone pivalate 0.1 percent cream (Cloderm, Healthpoint) is more effective in the treatment of atopic dermatitis and associated with fewer side effects than monotherapy with either agent alone, said Alan B. Fleischer, Jr., M.D., at the annual Hawaii Dermatology Seminar in January.
Washington - As the number of new cases of human immunodeficiency virus continues to grow, a topical microbicide might offer hope. Applied intravaginally, the agent has completely blocked intravaginal transmission of Simian Immunodeficiency Virus to female monkeys, according to Andrew Blauvelt, M.D.
Cincinnati - With wrestling season well under way, late fall and winter becomes a busy time for a sports dermatology clinic, said Brian B. Adams, M.D.
Waikoloa, HI - Dermatologists must keep informed about alternative medicine, said Wilma Bergfeld, M.D. "We need to build a knowledge base from the scientific literature and apply it to what patients are already doing."
Waikoloa, Hawaii - The U.S. Food and Drug Administration's recent approval of the cosmetic dermal filler Restylane (Medicis) indicates the beginning of a new phase for dermatologists due to the enhanced benefits it offers patients, according to Mark G. Rubin, M.D.
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The views and opinions expressed in this supplement are those of the faculty and do not necessarily reflect the views of Dermatology Times, Cosmetic Surgery Times, Advanstar Communications, Inc, or Allergan, Inc.Sponsored by an unrestricted education grant from Allergan
Washington - Medium and deep peels are the only peels to give appreciable results with skin tightening. And properly performed phenol peels can eliminate wrinkles "extraordinarily better than any TCA peel," said Harold J. Brody, M.D., clinical professor of dermatology, Emory University, Atlanta, Ga.
Personal digital assistants (PDAs), have now reached critical mass, and nearly 25 percent of physicians use them on a daily basis. If you haven't implemented this technology into your daily professional life, you might want to consider what these incredible electronic boxes can do for you and your practice. Now it is possible to have all of these functions included in a 3-inch by 5-inch PDA that fits into your pocket. There are software companies that offer more clinical and management PDA applications than most of us realize are available.
Dial-up modems, which opened the Internet to a vast audience and are still commonly found in medical offices, nominally create a 56k connection, although it is often closer to 44k and, depending on your line quality, 28k. With the prodigious amount of spam and viruses being circulated these days, it can often take 30 minutes or more just to download an e-mail, and if my colleagues have sent large picture files, it could take 45 minutes or more.
San Diego - Physicians enter medicine to take care of people, but to continue doing so, they need to master business principles as well, according to Walter Erhardt, M.D.
Tax planning long has been an extremely effective tool used by many dermatologists to keep their tax bills to a minimum. Often overlooked in this ongoing battle for legitimately lower tax bills, however, is the biggest tax bill faced by many dermatologists and their practices: property taxes. Even those who rent property for their practices are impacted by property taxes.
