Medesthetics

MAR 2016

MedEsthetics magazines offers business education and in-depth coverage of the latest noninvasive cosmetic procedures for physicians and practice managers working in the medical aesthetics industry.

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UNDER THE SUN 46 MARCH 2016 | Med Esthetics He fi nds that the key to increasing compliance with daily sun protection use is helping patients fi nd products that they love and will be comfortable wearing daily. "My big thing is the aesthetics of the products," says Dr. Matthys. "I want my patients to fi nd a product that they love to wear. If it feels good aesthetically on the skin, doesn't sting the eyes or have a strong scent, they will wear it routinely." In the past 10 years, sun protection formulations have be- come both more effective and more elegant thanks to new ingredients. "Titanium dioxide and zinc oxide are the single two best ingredients for a broad-spectrum sunblock," says S. Manjula Jegasothy, MD, CEO and founder of the Miami Skin Institute in Coral Gables, Florida, and associate professor of dermatology at the University of Miami Miller School of Medicine. "It's not new science, but it still applies, and the better formulations now have the micronized zinc and tita- nium, which means they are split into microscopic particles so they don't leave that weird, white residue on the skin." To help his patients fi nd the right sun protection products, Dr. Matthys asks a series of questions. "I ask if they prefer a tinted or non-tinted product—a lot of women prefer tinted because they can use it as a BB or CC cream," he says. "I ask how much time they spend outdoors, if they prefer a spray-on or cream formulation and then it depends on their skin condition. If a patient has melasma, rosacea or acne, we want to use a lighter product that has zinc oxide or titanium dioxide rather than an organic, chemical absorbing agent." Protecting Compromised Skin Patients struggling with acne and rosacea often have diffi culty fi nding a sun block that will protect rather than irritate their sensitive skin. "For acne, the best product I've found is actu- ally an over-the-counter one called Neutrogena Ultra Sheer Dry-Touch—it doesn't have any drying agents, but it is less greasy than most formulations; some people also like the lightweight EltaMD UV Clear," says Dr. Jegasothy. "It is very diffi cult to fi nd a sunscreen that doesn't break out acne-prone patients. This is an unmet need." Rosacea patients have more options. "All of the physician- dispensed products that are indicated for sensitive skin and contain sunscreen are appropriate for rosacea patients, but every single rosacea patient is highly individual, so it becomes a trial-and-error process," says Dr. Jegasothy. "I tell all my rosacea patients, 'You're probably going to spend a good deal of money before you fi nd the one that really suits your skin and doesn't make you irritated.'" To reduce the cost, both Dr. Jegasothy and Dr. Matthys provide samples of the brands they carry. "I sell skincare products and I provide sampling, especially for my sensitive skin patients so they can try before they buy, and I advocate that," says Dr. Jegasothy. "But it's impossible to carry samples of every single brand that's out there, so in some cases, patients will have to buy before they try." Special Care for Aging Skin While daily sun protection helps patients maintain their skin health and prolong the outcomes of your aesthetic proce- dures, those who enter your offi ce with existing photodam- age benefi t from products that both protect against damage and treat existing concerns. Dr. Matthys looks for products with antioxidant ingredients, such as niacinamide, vitamin C, vitamin E, phloretin and green tea. But he cautions that, due to a lack of labeling regulations, it is often diffi cult to ascertain whether the percentage of antioxidants in sunscreen formulations is high enough to be effective. "This is why I often recommend people use an antioxidant product in addition to their sun protection. It's not uncommon for women to use multiple products in the morning—a moisturizer, a sun pro- tection product and their makeup," he says. "It's not as easy to get men to use multiple products. For my male patients who cite photodamage as a concern based on question- naires, I will recommend using a vitamin C/vitamin E product in the morning under their sunscreen, or an antioxidant product at night and then sun protection in the morning." Dr. Jegasothy also looks for products that include new ingre- dients—such as growth factors and DNA repair proteins—to help repair existing damage. "When people have photodam- aged skin or wrinkles, that means their skin cells are suffering from some sort of DNA damage due to chronic UV radiation," she says. "So the latest thing in treating them—in addition to sunscreen and vitamin C—is growth factors and DNA repair proteins that can help repair some of the damage." With so many high quality, physician-dispensed sun protec- tion products on the market, aesthetic providers can better serve their patients by stocking a few, well-proven brands. "You have to touch and feel a lot of products in order to fi nd which ones feel the best, and then you create a system to recommend them," says Dr. Matthys. "We recommend a sunscreen to every patient, no matter how young or old they are. If they can buy the product right where they are, there is a higher likelihood that they will actually use it. I feel passion- ately that if you fi nd products that are good, that your patients and staff love, you're doing a disservice if you don't recom- mend them and have them available in the offi ce." If you do not currently carry sun protection products or would like to broaden your retail offerings, you can review some the top-selling brands on the market on the following pages. The products are presented in three groups: protection for sensitive skin, products formulated specifi cally for aging, photodamaged skin and daily use sunscreens for all skin types. Inga Hansen is the executive editor of MedEsthetics.

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