SEP 2017

MedEsthetics—business education for medical practitioners—provides the latest noninvasive cosmetic procedures, treatment trends, product and equipment reviews, legal issues and medical aesthetics industry news.

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Page 11 of 76 | SEPTEMBER 2017 9 Peptides can have a benefi cial effect on skin health, but typically offer poor transdermal penetration due to their hydrophilic nature. In an effort to improve penetration and cellular uptake, researchers Takahiro Fujimoto, MD, PhD, et al, irradiated the skin of Yu- catan micropigs using a CO 2 fractional laser at varying energy levels prior to application of hydrophilic pep- tide drugs 5-carboxyfl uorescein (CF) and fl uorescein isothiocyanate-conjugated ovalbumin (OVA-FITC) encapsulated in liposomes. The size of the CF and OVA-FITC encapsulated liposomes was 324 ± 75nm. Encapsulating the peptides in liposomes increased cellular uptake of OVA-FITC tenfold when compared to OVA-FITC delivered in solution form. The addition of fractional laser irradiation increased the skin permeation rate of CF liposomes (0–10%) and OVA-FITC liposomes (4–40%) in a dose-dependent manner—increasing laser power and irradiation time further increased liposome uptake by the cells and trandermal penetra- tion of the peptide drugs. The authors concluded, "High-energy CO 2 frac- tional laser overcomes the rate-limiting barrier function of the stratum corneum. Further investiga- tions are required to establish the safety and effi cacy of fractional laser irradiation-assisted delivery of liposome-encapsulated drugs as a transcutaneous drug delivery system." The study was published in Lasers in Surgery and Medicine (July 2017). FRACTIONAL LASERS ENHANCE LIPOSOME DELIVERY Physicians can support their hair loss patients by sharing information on the different products now available to camoufl age thinning hair, according to a study published in the June 2017 issue of the Journal of the American Academy of Dermatology. Researchers Christina M. Ring, et al, of Thomas Jefferson University in Philadelphia, posted a 12-question survey on various online hair loss forums and blog sites. A total of 359 individuals responded; 348 reported hair loss and 281 (78%) consulted a physician about their hair loss. Seventy-nine percent of respondents (283) reported using camoufl aging agents. The most pop- ular of which included hair-building fi bers (59%), followed by hairpieces and wigs (51%). Respon- dents said that the use of these products improved their appearance (216) and self-esteem (173). When asked about their topical concealer experiences and preferences, the respondents noted that topical concealers work well for minimal-to-moderate hair loss, but a hairpiece is preferred as hair loss progresses. The downsides of topical concealers included messiness, application time, expense, itchiness, anxiety over concealers being conspicuous or unnatural looking, and removal by wind, rain and swimming. The researchers noted that, "although most respondents saw a physician for hair loss, only 8 of 270 respondents (3%) reported learning about concealing products from their physician." HAIR LOSS CAMOUFLAGE PRODUCTS IMPROVE SELF-ESTEEM © GETTY IMAGES In an effort to provide guidance to prescribers and encourage further research on the risk of antibiotic resistance in acne treatment, JAMA Dermatology pub- lished a clinical evidence synopsis (online June 21, 2017). Brandon L. Adler, MD, et al, reviewed fi ve clinical trials published in 1987-2002 and 2007-2008. They found evidence that the widespread use of bacteriostatic antibiotics (topical erythromycin, clindamycin and oral tetracyclines) may encourage the emergence of antibiotic-resistant strains of P. acnes, via point mutations. Some of the key fi ndings included: resistant P. acnes found on the skin of untreated contacts of acne patients prescribed antibiotics; and a retrospective cohort study of more than 100,000 acne patients which revealed that subjects treated with topical and/or oral antibiotics for at least six weeks were signifi cantly more likely to develop upper respiratory infections during one year follow-up than patients who had not received antibiotics. To help reduce antibiotic usage in acne treatment, the American Academy of Dermatology (AAD) recommends coadministration of benzoyl peroxide (BP), alongside both topical and/or oral antibiotics. Dr. Adler and co-authors noted that the body of research and data on antibiotic resistance in acne is limited in both scope and quality, and call for additional studies to help quantify the reduction in antibiotic resistance through the use of BP and fi xed-dose topical formulations. "It is unclear how effectively adding BP to systemic antibiotics impedes resistance formation, contrasting the limited application of BP with the antibiotic's distribution throughout the body. Subantimicrobial antibiotic dosing, which may discourage resistance, is still poorly understood and merits further inquiry," they wrote. Reviewing Antibiotic Resistance in Acne

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