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Erasing the Mark There have been big developments in the world of fillers in recent months. The "most promising new treatments on the market," Dr. Narukar says, include Artefill dermal filler and LaViv (azficel-T), an autologous fibroblast therapy. LaViv (Fibrocell Science, mylaviv.com)—currently indicated for treatment of moderate to severe nasolabial folds in adults—is created from collagen-producing cells (fibroblasts). Fibrocell Science, the manufacturer of LaViv, coaxes the cells into growing and producing millions of new cells, which are frozen and then made available for treatment in about three months. The company recently announced that it has completed a Phase II study to evaluate the safety and efficacy of LaViv for acne scarring. The findings demonstrated what the company calls "clinically meaningful improvement in acne scar appearance." "In this study, both patients and physicians reported significant improvements from the autologous fibroblast injections, so the research is very promising," lead investigator Gilly S. Munavalli, MD, MHS, FACMS, a dermatologist in Charlotte, North Carolina, said in a statement provided by Fibrocell Science. Results from LaViv as a treatment for smile lines have been shown to last for at least six months. Side effects include redness, bruising and bleeding; 86% of side effects at the injection site vanished within a week. Meanwhile, Suneva Medical, which markets Artefill, hopes it will become the first dermal filler with an FDA-approved indication as a treatment for acne scars, says Dr. Karnik. 14 July/August 2013 | ACNE & ROSACEA Artefill is now used as a wrinkle filler to treat nasolabial folds. It is made of bovine collagen and microspheres plus lidocaine. "The benefit of treating acne scars with fillers is that they raise the scar to the level of the skin surface so it becomes less noticeable," Dr. Karnik says. "The hope is that you won't need multiple re-treatments over the years. When you have a scar, you don't want it to be improved just for a couple months or a year. You want it to be improved for a long time." "We are creating holes, so why not use the holes to send topicals through them to aid even further?" Artefill has a real benefit compared to other treatments because the effect is immediate and downtime for the patient is minimal, Dr. Karnik says. Last September, Suneva Medical announced that it has completed the enrollment and initial treatment of patients in its Phase III acne scar study, which is being conducted at aesthetic medical practices across the country. The treatment is being tested on moderate to severe atrophic acne scars. Dr. Karnik says the filler will ideally be used with other treatments to improve scarring. "My hope is that we'll start to understand how to combine things to get the best treatments ever," she says. Dr. Gold likes the idea of combining laser therapy with other treatments. "Perhaps using devices as drug-delivery devices may even help more," he says. "We are creating holes, so why not use the holes to send topicals through them to aid even further? We are going to see in the future how advantageous this is." What's next on the horizon? Dr. Narurkar predicts major improvements on a variety of fronts: "We foresee more predictable outcomes for acne scars with energy devices, possibly requiring fewer treatments; longer-lasting and possibly permanent dermal fillers and autologous fibroblasts; and the combination of energy-based devices and the use of stem cells for enhanced neocollagenesis." z Randy Dotinga is a San Diego-based freelance medical writer. © istockphoto.com Biologics and Fillers