Medesthetics Special

AR Supplement

Surgical Aesthetics and Acne & Rosacea are special editions of Medesthetics. To see Surgical Aesthetics, go to http://surgicalaestheticsmagazine.epubxp.com

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Prescribing Topicals "Both gluconolactone and benzoyl peroxide had a significant effect in improving patients' acne by reducing the number of lesions." Totarol, an antibacterial derived from the heartwood of the Totara tree is finding its way into homecare lines for both acne and rosacea. "It has serious antioxidant action, offering valuable free-radical scavenging properties thus reducing inflammation while controlling P. acnes," says Rhonda Allison, founder and CEO of Rhonda Allison Cosmeceuticals (rhondaallison.com). "Another ingredient receiving attention for acne is mandelic acid, an AHA from bitter almonds. It has documented antibacterial properties as well lightening and antiaging benefits and has become an important ingredient for acne sufferers, particularly those with dry acne conditions and sensitive skin types." For rosacea patients, Allison highlights sea buckthorn oil as an exciting, naturally derived ingredient. "It has more than 190 varieties of bioactive substances, some of which include 8 July/August 2012 | MedEsthetics Current rosacea topicals address papules, but are less effective at reducing the general erythema experienced by most patients. plant sterols, vitamins C, E and K, and carotenoids." The oil offers anti-inflammatory, antioxidant and antibacterial properties. "It is also a vascular healer, working to strengthen blood vessels and the capillary wall," says Allison. In a December 2011 study, researchers at the All India Institute of Medical Sciences in New Delhi reported that sea buckthorn oil "mitigates myocardial damage in ISO-induced cardiac injury in rats." (International Journal Of Toxicology). A popular antiaging ingredient—kinetin (N6-furfuryladenine)—may help to reduce the generalized erythema of rosacea. A 2006 poster presented at the American Academy of Dermatology showed a 32% improvement in general erythema—as rated by investigators—in 88% of subjects. The study followed 18 rosacea sufferers who applied a 0.1% kinetin product (Valeant Pharmaceuticals, valeant.com) twice daily for 12 weeks. The non-prescription topical showed "no appreciable decrease in the inflammatory lesion count, nor a clinically appreciable effect on telangiectasia at 12 weeks," said the researchers, led by Gerald D. Weinstein, MD. Rosacea: A New Topical Emerges The three most commonly prescribed topicals for rosacea are Finacea (Bayer Healthcare, finacea.com), Metrogel (metronidazole, metrogel.com) and ACZONE (Allergan, aczone.com). All three address the papular component of rosacea and each offers some reduction in general erythema—possibly as a result of reducing the number of papules on the skin. Patients with significant redness and telangiectasias are typically steered toward laser and light-based devices, gentle homecare regimens and counseled on avoiding lifestyle triggers, including hot foods, alcohol, strenuous exercise and stress. But there soon may be a new topical option that specifically targets the general erythema of rosacea. Continued on page 23 Photo courtesy of the National Rosacea Society A 2007 study that appeared in the Australasian Journal of Dermatology compared a 14% gluconolactone solution to a 5% benzoyl peroxide formulation for 150 patients with mild-to-moderate acne. In the double-blind study, Michelle J. Hunt, et al, found that "both gluconolactone and benzoyl peroxide had a significant effect in improving patients' acne by reducing the number of lesions (inflamed and non-inflamed). Furthermore, fewer side effects were experienced by patients treated with gluconolactone when compared with benzoyl peroxide." Syringa vulgaris, a Lilac stem cell extract, is one of the latest ingredients to make its way into acne homecare products. "The major component in the stem cell extract is verbascoside, which suppresses the activity of 5-alpha reductase—an enzyme that converts testosterone to dihydrotestosterone," says Veljkovic. "Increased testosterone levels are linked to increased sebum production, so the decrease in 5-alpha reductase activity consequently reduces sebum production." Syringa vulgaris offers additional benefits as a broadspectrum antioxidant and tyrosinase inhibitor.

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