APR 2018

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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Eskata, a new treatment being marketed as a cosmetic solution to seborrheic keratosis (SKs), is now commercially available after receiving FDA approval in December. The 40 percent hydrogen peroxide solution is delivered via a penlike applicator and requires one to three treatments, depending on the size of the SK. Aclaris Therapeutics, a pharmaceutical company found- ed by former Vicept Therapeutics' executives, developed the treatment. "We are the same team that developed Rhofade," says dermatologist and Aclaris CEO Neal Walk- er, MD. "After that was sold to Allergan, we got the gang back together to create an affordable treatment for SKs, because these treatments are not covered by insurance." While most physicians utilize cryosurgery or electro- surgery and curettage to remove unsightly SKs, the new treatment may offer some benefi ts. "There is no pain, no smoke and it is priced to be affordable for cash-pay patients," says Dr. Walker. "It's ideal for the face and neck because there is no downtime, no blisters, no dispigmen- tation and no wounds, so the patient can apply makeup right after treatment." The pens are sold for $130 and each pen can treat about seven SKs. The high-concentration hydrogen peroxide solution is applied directly to the affected area and causes apoptosis and cell necrosis. The SK cells then slough off. "High-concentration hydrogen peroxide beads up on the skin, so we had to create a formulation that would pen- etrate the SK and not bead up," says Dr. Walker. Eskata's FDA approval was based on two pivotal Phase 3 trials. Patients received up to two treatments with Es- kata—one at treatment initia- tion and a second at week three. The patients treated with Eskata were more likely to have all four treated SKs completely cleared after two treatments than patients who received a placebo. The most common side effects were itching, stinging, crusting, swelling, redness and scaling at the application site. The company chose to offer Eskata as an in-offi ce treat- ment rather than an over-the-counter consumer product out of concern that consumers may try to self-diagnose their skin growths. "SKs are unsightly but harmless, but other changes in the skin may be cancerous. So we want patients to see their doctors for diagnosis before applying anything," says Dr. Walker. Aclaris is now investigating the use of its proprietary hy- drogen peroxide solution at 45 percent strength for the treatment of common warts. Inga Hansen is the executive editor of MedEsthetics. 64 APRIL 2018 | Med Esthetics PHOTOS COURTESY OF ACLARIS THERAPEUTICS NEWSMAKERS | By Inga Hansen A hydrogen peroxide-based topical that removes seborrheic keratoses is now available to physicians. ESKATA Results after two treatments with hydrogen peroxide-based Eskata. BEFORE AFTER

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