Dr. David Goldberg Lectures at L'oreal Corporate Headquarters

Last week, CosmeticMDNation Cosmetic Dermatologist, David J. Goldberg, MD, was invited to speak at L'oreals US research center in Clark, NJ. The talk was in honor of the 100 year anniversary of L'oreal's commitment to skin care. Dr. Goldberg's lecture focused on various devices used to rejuvenate the skin on the face and body. Devices discussed included Fraxel, FX, eMatrix, CoolSculpting by Zeltiq, Accent, Viora, and VelShape. The final portion of his presentation focused on the future of skin rejuvenation combining energy based treatments such as described in combination with great skin care products such as those made by L'oreal.

Using Light-Activated Technologies for Battlefield Injuries

A recent research study by the Air Force Office of Scientific Research shows that conventional sutures as well as glues and staples used to repair wounds in the skin or to reconnect nerves, blood vessels, tendons and corneal incisions, can be replaced with Photochemical Tissue Bonding. According to Dr. Irene Kochevar (Massachusetts General Hospital Wellman Center researcher and Harvard Med School professor), "We have demonstrated that this technology is very helpful in medicine for the Air Force because it produces better healing and functional outcomes than the same wounds that were treated with conventional materials.”

Bonding (aka nanosutures) is achieved when a dye is applied to the wound, after which the wound is exposed to green light for a brief time. The dye absorbs the light and then proceeds to molecularly bond proteins on the surface of the tissues. "No glues, proteins or other materials are used that might stimulate an inflammatory response," said Kochevar. "An immediate, water-tight seal is formed between the tissue surfaces leading to reduced inflammation in the near term and better scar formation in the long term."

Researchers plan to continue to assess the efficacy of this new technology, particularly as to how it might be made even more effective in the field. If all goes well, they hope to create a shorter treatment time and an even stronger bond. "We are approaching this challenge by identifying the basic molecular mechanisms responsible for light-activated crosslinking," she said. "We believe that this information will show us how to improve the efficiency and effectiveness of the nanosuturing technology on the battlefield."

New Injection for Small Varicose Veins Approved by the FDA

The FDA announced on March 31st that polidocanol (marketed in the US as Asclera) has been approved as a treatment for varicose veins. Asclera works its magic by damaging the cell lining in the blood vessels, causing them to close. Eventually the blood vessel is replaced by other types of tissue. The product is approved for veins less than 1 mm in diameter and reticular veins 1-3mm in diameter. (As a reference, there are 24 mm to one inch).

There are three primary types of venous problems: varicose veins, reticular veins and spider veins. Spider veins are generally very tiny, while varicose veins are quite noticeable and generally develop on the legs. Reticular veins are mild and generally cause little in the way of discomfort. Vein treatments generally include lasers, broad band light and/or sclerosing agents.

Few side effects were noted by the FDA, including leakage or blood collection from the injected vessels at the injection site, as well as potential for bruising, irritation, discoloration and discomfort at the injection site.

Hawaii Dermatology Seminar #2

The recently-ended 34^th annual Hawaii Dermatology Seminar has lived up its reputation of being the original and, perhaps, the most well organized of all the Hawaii dermatology meetings. The first 4 days of the meeting were dedicated to medical and pediatric dermatology. The last 2 days were dedicated to advances in cosmetic dermatology. Some of the most well know leaders in the field lectured. These included Drs. Suzanne Kilmer from Sacramento, Michael Gold from Nashville, Roberta Sengelman from Santa Barbara, Thomas Rohrer from Boston and Christopher Zachary from Irvine, CA.

Among the more interesting discussions was a talk about Zeltiq cryolipolysis of women’s fatty upper arms, the soon-to-be-released Belotero wrinkle filler and the role of Matrix fractional radiofrequency treatment. Also discussed were more controversial issues such as Zerona low level light treatment’s effect on dissolving fat. Attendance was up at this year’s Hawaii Dermatology Seminar. Dermatology, and specifically Cosmetic Dermatology, is alive and well.

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Most valuable skin treatment? Try sunscreen.

This article from U.S. News & World Report by Lindsay Lyon gives away the biggest secret in dermatology: patients wouldn't need us so much if they would just protect their skin!

Aging of the skin comes in 2 kinds: intrinsic aging and extrinsic aging. Intrinsic aging is genetic and cannot be changed. The apple does not fall too far from the tree. So if your parents have great skin you may be lucky as well.

Extrinsic skin aging has nothing to do with genetics. It is related to environmental exposure. Such exposure includes wind, the elements and most importantly ultraviolet exposure from the sun. The more sun you get, the quicker your skin will age. The answer is easy. The most important thing we can all do is to protect our skin with sunscreens. Topical antioxidants and retinols also can help. Sunscreens at any age are a great idea. The problem is that over 90% of our sun exposure has occurred by the time we are 20 years old.

What happens in our 30s, 40s 50s and beyond? What do we do about the wrinkles, red spots and sunspots we have accumulated during the years beyond our teens? Yes, it is wise to use sunscreens at any age, but unfortunately ultraviolet protection does not reverse any of the sun damage we already have. Thankfully today we have a whole variety of non-surgical lasers that can rejuvenate the skin and reverse a lot of the damage: Fraxel, ProFractional, Titan, Accent, and Thermage treatments. You can easily erase so much cosmetic extrinsic skin aging.

Today’s laser technology has revolutionized the treatment of extrinsic aging of the skin. But don’t even think about such treatments unless you combine them with the simplest of all cosmetic treatments – a sunscreen.

Thanks for reading,

Dr. David J. Goldberg
Skin Laser Surgery Specialists of NY/NJ
Sanctuary Medical Aesthetic Center

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center