
South Beach Symposium 2026: Gold's Top Pearls
Key Takeaways
- Chronic pigmentary disorders demand conservative device settings, rigorous photoprotection, combination regimens, and expectation management to minimize rebound hyperpigmentation and treatment fatigue.
- Peptide-based products can support barrier function and inflammation modulation, but clinical value hinges on formulation and penetration, and they should not displace established therapeutics.
Michael Gold, MD, shares insights on safer device use, peptides, GLP-1s, acne, hair therapies, and more.
In a wide-ranging conversation with Dermatology Times at
Pigmentary Disorders: Respect the Biology
For melasma and post-inflammatory hyperpigmentation, Gold emphasized what most seasoned clinicians learn the hard way: these are chronic, relapsing conditions. Energy-based devices can help, but only when used conservatively and in the right patient. Over-treatment remains a leading cause of rebound hyperpigmentation. Combination therapy, including topicals, sun protection, and cautious procedural intervention, remains the backbone. Patient education and expectation-setting are as important as any prescription pad.
Peptides: Promising, but Not Magical
Peptides continue to generate buzz, and Gold urged clinicians to separate marketing from mechanism. Some peptides show meaningful biologic activity, particularly in skin barrier support and inflammation modulation, but they are adjuncts, not replacements for established therapies. Understanding formulation, penetration, and realistic endpoints helps avoid overpromising and underdelivering.
GLP-1 Agonists: New Drugs, New Complications
As GLP-1 receptor agonists become commonplace, dermatologists are increasingly managing downstream aesthetic concerns. Rapid weight loss can unmask or worsen facial volume loss, skin laxity, and hair shedding. Gold stressed proactive counseling and early intervention—often with conservative energy-based tightening or biostimulatory approaches—rather than reactive overcorrection.
Acne: Beyond Antibiotics
Gold highlighted how devices have earned a legitimate role in acne management, particularly for patients who cannot tolerate or do not respond to systemic therapies. Lasers and light-based devices can address active disease, scarring, and erythema, but results depend on appropriate patient selection and combination regimens. Acne, he reminded, is rarely a single-modality problem.
Hair Rejuvenation: Incremental Gains Matter
In aesthetic hair restoration, Gold advocated for realistic goals. Whether using devices, injectables, or topical agents, consistency and combination therapy outperform any single intervention. Small improvements, when sustained, can translate into meaningful patient satisfaction over time.
What’s New in Technology: Use With Intention
Finally, in his technology updates, Gold cautioned against adopting devices simply because they are new. The question should always be: does this meaningfully improve outcomes or safety? Incremental advances can be valuable, but only when integrated thoughtfully into existing treatment algorithms.
Across all topics, Gold’s central message was clear: progress in dermatology is rarely about reinvention. It’s about refinement—using experience, evidence, and restraint to deliver better care.
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