Derms will need to take a more comprehensive approach to age management that will demand more than knowing how to inject the latest filler or toxin or dial in a laser setting.
As appearance-management products, procedures and treatments continue to increase in popularity, dermatologists are at the forefront of at least one facet of age management medicine - the preferred term, according to Dr. Werschler, immediate past president of the American Society of Cosmetic Dermatology and Aesthetic Surgery.
Cosmeceuticals are increasingly a larger component of most dermatology practices, and their emergence is a response to the focus on "external" age management, a distinct subset of the larger field of age management medicine, along with "internal" age management.
Worldwide, there is a growing emphasis on internal age management as an integral part of comprehensive healthcare, and along with this "internal" focus there has developed a realization that proper internal age management will have an effect on the skin, hair, nails and, ultimately, the overall appearance, according to Dr. Werschler.
"Age management medicine is something that both a 70-year-old and a 30-year-old can benefit from over their respective lifetimes," he says.
Dermatologists will have to increasingly take a proactive approach in managing their patients' health and appearance, because patients will come to expect such an approach, Dr. Werschler says.
Patients can take actions such as minimizing sun exposure and regularly applying sunscreen in a rigorous manner to minimize sun damage, but they can also take an overall proactive approach to their health.
Making internal age management the core of aesthetic therapy permits patients to take an active approach to their skin health, Dr. Werschler stresses.
"It's like restoring a classic car," he says. "You may repaint the outside of the car to make it look new again, but if you don't touch the engine and the transmission, that isn't going to change how the car runs. It really is no different when we look at the totality of optimizing health through the ages. It takes a comprehensive approach, inside and out."
The comprehensive approach toward external age management requires knowledge and recognition of more than just how to inject the latest filler or toxin, or dial in the laser settings.
Dr. Werschler points to the recent recognition that many North Americans have insufficient levels of vitamin D. Recent studies have shown that oral supplementation with vitamin D may have a protective effect against the development of lesions.
Other anti-oxidants include coenzyme Q10 (CoQ10), which is purported to offer numerous benefits including increasing alertness, treating hypertension and preventing gum disease. It occurs naturally in the body, but decreases with age.
CoQ10 is available as a supplement that can be taken daily. Research has shown that patients who are taking statin drugs have lower levels of CoQ10. This population, therefore, may particularly benefit from CoQ10 supplementation.
The skin has growth factors that occur naturally in the body, and cosmeceuticals are being formulated to supplement those growth factors.
While a topical agent such as Retin-A (tretinoin, Ortho Neutrogena) was initially prescribed to treat acne, it also has been found to smooth the skin and restore balance to the skin layers through a normalization of the epidermal growth and maturation process.
Private medical institutes are offering age-management programs to paying patients, including health assessment, genetic evaluation, nutrition and exercise programs, human growth hormone (HGH) therapy, plus advice and treatment for many "dermatologic" concerns such as photodamage, lines, wrinkles, etc.