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FDA advises against Enhancement intranasal splint as dermal filler
The Food and Drug Administration has issued a warning about adverse events associated with use of the Expression intranasal splint as a dermal filler – an unapproved indication for this product.
The FDA released its statement on Aug. 5.
Expression, also known as "Expression Injectable," manufactured by Enhancement Medical LLC, is a hyaluronic acid product packaged in a syringe, and it is cleared by the FDA for use only as an intranasal splint.
But off-label use of the product as a dermal filler has been associated with reports of swelling, tenderness, firmness, bruising, pain, redness, discoloration, itching, and the development of hard nodules, according to the FDA statement. The reports include one case of a patient who developed firm masses in the face after the Expression product was injected as a dermal filler. "An attempt was made to dissolve the masses, but the report notes that the patient was left with an ‘obvious deformity,’ " the FDA statement said.
The agency noted that the components of Expression are similar to those of dermal fillers approved by the FDA, and the adverse event reports "appear similar" to those reported with those approved products. However, dermal fillers are classified by the agency as class III, high-risk medical devices and "without reviewing clinical data supporting the safety and effectiveness the FDA cannot not fully understand the nature, severity, or rate of occurrence of adverse events associated with Expression and has no assurance of this product’s safety or effectiveness when used as a dermal filler," the statement said.
A list of FDA-approved dermal fillers is available here.
Health care professionals and consumers should report adverse events associated with this product by visiting the FDA’s MedWatch site, or by calling 800-332-1088.
The Food and Drug Administration has issued a warning about adverse events associated with use of the Expression intranasal splint as a dermal filler – an unapproved indication for this product.
The FDA released its statement on Aug. 5.
Expression, also known as "Expression Injectable," manufactured by Enhancement Medical LLC, is a hyaluronic acid product packaged in a syringe, and it is cleared by the FDA for use only as an intranasal splint.
But off-label use of the product as a dermal filler has been associated with reports of swelling, tenderness, firmness, bruising, pain, redness, discoloration, itching, and the development of hard nodules, according to the FDA statement. The reports include one case of a patient who developed firm masses in the face after the Expression product was injected as a dermal filler. "An attempt was made to dissolve the masses, but the report notes that the patient was left with an ‘obvious deformity,’ " the FDA statement said.
The agency noted that the components of Expression are similar to those of dermal fillers approved by the FDA, and the adverse event reports "appear similar" to those reported with those approved products. However, dermal fillers are classified by the agency as class III, high-risk medical devices and "without reviewing clinical data supporting the safety and effectiveness the FDA cannot not fully understand the nature, severity, or rate of occurrence of adverse events associated with Expression and has no assurance of this product’s safety or effectiveness when used as a dermal filler," the statement said.
A list of FDA-approved dermal fillers is available here.
Health care professionals and consumers should report adverse events associated with this product by visiting the FDA’s MedWatch site, or by calling 800-332-1088.
The Food and Drug Administration has issued a warning about adverse events associated with use of the Expression intranasal splint as a dermal filler – an unapproved indication for this product.
The FDA released its statement on Aug. 5.
Expression, also known as "Expression Injectable," manufactured by Enhancement Medical LLC, is a hyaluronic acid product packaged in a syringe, and it is cleared by the FDA for use only as an intranasal splint.
But off-label use of the product as a dermal filler has been associated with reports of swelling, tenderness, firmness, bruising, pain, redness, discoloration, itching, and the development of hard nodules, according to the FDA statement. The reports include one case of a patient who developed firm masses in the face after the Expression product was injected as a dermal filler. "An attempt was made to dissolve the masses, but the report notes that the patient was left with an ‘obvious deformity,’ " the FDA statement said.
The agency noted that the components of Expression are similar to those of dermal fillers approved by the FDA, and the adverse event reports "appear similar" to those reported with those approved products. However, dermal fillers are classified by the agency as class III, high-risk medical devices and "without reviewing clinical data supporting the safety and effectiveness the FDA cannot not fully understand the nature, severity, or rate of occurrence of adverse events associated with Expression and has no assurance of this product’s safety or effectiveness when used as a dermal filler," the statement said.
A list of FDA-approved dermal fillers is available here.
Health care professionals and consumers should report adverse events associated with this product by visiting the FDA’s MedWatch site, or by calling 800-332-1088.
The Asterisk
In early July, a media blast regarding the safety of spray sunscreens was disseminated. Consumer Reports commented on a US Food and Drug Administration (FDA) investigation of sunscreen in the spray vehicle, stating that consumers should not apply them on children until the safety of these agents is determined by an ongoing FDA analysis. The focus of FDA concern is the inhalation of nanoparticles in these products, particularly those containing titanium dioxide. The report also provided instructions for safe application of spray sunscreen in adults, such as avoiding the face and applying evenly for best results.
What’s the issue?
I read this consumer article with great interest and attention. I not only use spray sunscreen on my toddler and myself, but I also often recommend it to patients who despise the feel and inconvenience of cream-based sunscreens. Also, the ability to independently reach areas such as the mid-back provides ease of application in the spray form. That being said, I do note that these sunscreens should not be used on the face and should be applied outdoors to reduce inhalation. The age of nanomedicine provides an unknown risk, given the potential of new and more invasive chemical exposure. However, the aggressiveness with which this report was disseminated through the press was not well founded.
The FDA started this investigation in 2011, which was disclosed by Consumer Reports using a tiny asterisk in the July 2014 report. The FDA has not made any statements for or against spray sunscreens except to say that consumers should avoid open flames during application. In fact, the American Academy of Dermatology’s educational page on sunscreen has acknowledged the unknown risk of spray sunscreens since 2011. Given that this consumer “update,” which did not provide any new information, was released by the press in the throes of the summer sun, it has bolstered patient doubts about what dermatologists recommend regarding sunscreen and its safety. Do you use or recommend spray sunscreens? How do you feel about the manner in which the popular media depicts sunscreens in recent years?
We want to know your views! Tell us what you think.
Reader Comments
I usually ask our patients to apply sprays outside and directed so the spray is dispersed downwind if possible. This at the beach or golf course. I also ask them to hold their breaths to not inhale the mist. I still however ask to use a cream or lotion at home and use the sprays as a secondary application.
--Michael A. Scannon, MD
Darrel Rigel showed several years ago that most people use one quarter to one third the proper amount of sunscreen needed to attain the SPF on the label. Sprays encourage using even less. In a use test I performed for a sunscreen company several years ago, our subjects had white round patches of unburned skin among their sunburns. Uniform coverage is difficult to achieve.
--Christopher G. Nelson, MD
In early July, a media blast regarding the safety of spray sunscreens was disseminated. Consumer Reports commented on a US Food and Drug Administration (FDA) investigation of sunscreen in the spray vehicle, stating that consumers should not apply them on children until the safety of these agents is determined by an ongoing FDA analysis. The focus of FDA concern is the inhalation of nanoparticles in these products, particularly those containing titanium dioxide. The report also provided instructions for safe application of spray sunscreen in adults, such as avoiding the face and applying evenly for best results.
What’s the issue?
I read this consumer article with great interest and attention. I not only use spray sunscreen on my toddler and myself, but I also often recommend it to patients who despise the feel and inconvenience of cream-based sunscreens. Also, the ability to independently reach areas such as the mid-back provides ease of application in the spray form. That being said, I do note that these sunscreens should not be used on the face and should be applied outdoors to reduce inhalation. The age of nanomedicine provides an unknown risk, given the potential of new and more invasive chemical exposure. However, the aggressiveness with which this report was disseminated through the press was not well founded.
The FDA started this investigation in 2011, which was disclosed by Consumer Reports using a tiny asterisk in the July 2014 report. The FDA has not made any statements for or against spray sunscreens except to say that consumers should avoid open flames during application. In fact, the American Academy of Dermatology’s educational page on sunscreen has acknowledged the unknown risk of spray sunscreens since 2011. Given that this consumer “update,” which did not provide any new information, was released by the press in the throes of the summer sun, it has bolstered patient doubts about what dermatologists recommend regarding sunscreen and its safety. Do you use or recommend spray sunscreens? How do you feel about the manner in which the popular media depicts sunscreens in recent years?
We want to know your views! Tell us what you think.
Reader Comments
I usually ask our patients to apply sprays outside and directed so the spray is dispersed downwind if possible. This at the beach or golf course. I also ask them to hold their breaths to not inhale the mist. I still however ask to use a cream or lotion at home and use the sprays as a secondary application.
--Michael A. Scannon, MD
Darrel Rigel showed several years ago that most people use one quarter to one third the proper amount of sunscreen needed to attain the SPF on the label. Sprays encourage using even less. In a use test I performed for a sunscreen company several years ago, our subjects had white round patches of unburned skin among their sunburns. Uniform coverage is difficult to achieve.
--Christopher G. Nelson, MD
In early July, a media blast regarding the safety of spray sunscreens was disseminated. Consumer Reports commented on a US Food and Drug Administration (FDA) investigation of sunscreen in the spray vehicle, stating that consumers should not apply them on children until the safety of these agents is determined by an ongoing FDA analysis. The focus of FDA concern is the inhalation of nanoparticles in these products, particularly those containing titanium dioxide. The report also provided instructions for safe application of spray sunscreen in adults, such as avoiding the face and applying evenly for best results.
What’s the issue?
I read this consumer article with great interest and attention. I not only use spray sunscreen on my toddler and myself, but I also often recommend it to patients who despise the feel and inconvenience of cream-based sunscreens. Also, the ability to independently reach areas such as the mid-back provides ease of application in the spray form. That being said, I do note that these sunscreens should not be used on the face and should be applied outdoors to reduce inhalation. The age of nanomedicine provides an unknown risk, given the potential of new and more invasive chemical exposure. However, the aggressiveness with which this report was disseminated through the press was not well founded.
The FDA started this investigation in 2011, which was disclosed by Consumer Reports using a tiny asterisk in the July 2014 report. The FDA has not made any statements for or against spray sunscreens except to say that consumers should avoid open flames during application. In fact, the American Academy of Dermatology’s educational page on sunscreen has acknowledged the unknown risk of spray sunscreens since 2011. Given that this consumer “update,” which did not provide any new information, was released by the press in the throes of the summer sun, it has bolstered patient doubts about what dermatologists recommend regarding sunscreen and its safety. Do you use or recommend spray sunscreens? How do you feel about the manner in which the popular media depicts sunscreens in recent years?
We want to know your views! Tell us what you think.
Reader Comments
I usually ask our patients to apply sprays outside and directed so the spray is dispersed downwind if possible. This at the beach or golf course. I also ask them to hold their breaths to not inhale the mist. I still however ask to use a cream or lotion at home and use the sprays as a secondary application.
--Michael A. Scannon, MD
Darrel Rigel showed several years ago that most people use one quarter to one third the proper amount of sunscreen needed to attain the SPF on the label. Sprays encourage using even less. In a use test I performed for a sunscreen company several years ago, our subjects had white round patches of unburned skin among their sunburns. Uniform coverage is difficult to achieve.
--Christopher G. Nelson, MD
Filler Placement
In a recently published article in the Journal of Cosmetic Dermatology (2014;13:91-98), Goodier et al compared low volume deep placement cheek injection and mid to deep dermal nasolabial fold injection for the correction of nasolabial folds with hyaluronic acid (HA) filler. In this split-face study, 3 injection techniques were utilized: (1) deep bolus injection into the mid to lateral cheek, (2) mid to deep dermal injection into the nasolabial fold, or (3) both techniques. Results were assessed in 4 to 6 weeks by a blinded investigator.
Globally, patients and investigators noted no statistical difference using the wrinkle severity score. All 3 techniques showed improvement. Patients preferred injection using both techniques, which was associated with the greatest amount of filler product injected. The authors concluded that injection of a dermal HA filler into either the nasolabial fold or mid to lateral cheek resulted in similar improvement for the correction of the nasolabial folds.
What’s the issue?
Although this study used a single HA agent, it showed that patients’ nasolabial folds improved using both techniques: deep depot placement in the cheeks and mid to deep dermal nasolabial fold injection. It may come as no surprise that patients in this study showed a slight preference for both techniques. Although the trend now is to add volume and not fill, a combination of these techniques may give the best outcomes. What do you use in your practice? A study comparing different HA fillers available or one comparing HA to non-HA products would be interesting. Which agents do you use in your practice for nasolabial fold correction?
In a recently published article in the Journal of Cosmetic Dermatology (2014;13:91-98), Goodier et al compared low volume deep placement cheek injection and mid to deep dermal nasolabial fold injection for the correction of nasolabial folds with hyaluronic acid (HA) filler. In this split-face study, 3 injection techniques were utilized: (1) deep bolus injection into the mid to lateral cheek, (2) mid to deep dermal injection into the nasolabial fold, or (3) both techniques. Results were assessed in 4 to 6 weeks by a blinded investigator.
Globally, patients and investigators noted no statistical difference using the wrinkle severity score. All 3 techniques showed improvement. Patients preferred injection using both techniques, which was associated with the greatest amount of filler product injected. The authors concluded that injection of a dermal HA filler into either the nasolabial fold or mid to lateral cheek resulted in similar improvement for the correction of the nasolabial folds.
What’s the issue?
Although this study used a single HA agent, it showed that patients’ nasolabial folds improved using both techniques: deep depot placement in the cheeks and mid to deep dermal nasolabial fold injection. It may come as no surprise that patients in this study showed a slight preference for both techniques. Although the trend now is to add volume and not fill, a combination of these techniques may give the best outcomes. What do you use in your practice? A study comparing different HA fillers available or one comparing HA to non-HA products would be interesting. Which agents do you use in your practice for nasolabial fold correction?
In a recently published article in the Journal of Cosmetic Dermatology (2014;13:91-98), Goodier et al compared low volume deep placement cheek injection and mid to deep dermal nasolabial fold injection for the correction of nasolabial folds with hyaluronic acid (HA) filler. In this split-face study, 3 injection techniques were utilized: (1) deep bolus injection into the mid to lateral cheek, (2) mid to deep dermal injection into the nasolabial fold, or (3) both techniques. Results were assessed in 4 to 6 weeks by a blinded investigator.
Globally, patients and investigators noted no statistical difference using the wrinkle severity score. All 3 techniques showed improvement. Patients preferred injection using both techniques, which was associated with the greatest amount of filler product injected. The authors concluded that injection of a dermal HA filler into either the nasolabial fold or mid to lateral cheek resulted in similar improvement for the correction of the nasolabial folds.
What’s the issue?
Although this study used a single HA agent, it showed that patients’ nasolabial folds improved using both techniques: deep depot placement in the cheeks and mid to deep dermal nasolabial fold injection. It may come as no surprise that patients in this study showed a slight preference for both techniques. Although the trend now is to add volume and not fill, a combination of these techniques may give the best outcomes. What do you use in your practice? A study comparing different HA fillers available or one comparing HA to non-HA products would be interesting. Which agents do you use in your practice for nasolabial fold correction?
Pros and Cons of Devices for Rosacea
For more information, access Dr. Goldenberg's article from the July 2014 issue, "Devices and Topical Agents for Rosacea Management."
For more information, access Dr. Goldenberg's article from the July 2014 issue, "Devices and Topical Agents for Rosacea Management."
For more information, access Dr. Goldenberg's article from the July 2014 issue, "Devices and Topical Agents for Rosacea Management."
Cosmetic Corner: Dermatologists Weigh in on Eye Creams
To improve patient care and outcomes, leading dermatologists offered their recommendations on the top eye creams. Consideration must be given to:
- Eye Firming Complex
- Lumière
- RoC Retinol Correxion Sensitive Eye Cream
- Tensage Radiance Eye Cream
- Youth Eye Complex
Cutis invites readers to send us their recommendations. Toners and OTC antioxidants will be featured in upcoming editions of Cosmetic Corner. Please e-mail your recommendation(s) to cutis@frontlinemedcom.com.
Disclaimer: Opinions expressed herein do not necessarily reflect those of Cutis or Frontline Medical Communications Inc. and shall not be used for product endorsement purposes. Any reference made to a specific commercial product does not indicate or imply that Cutis or Frontline Medical Communications Inc. endorses, recommends, or favors the product mentioned. No guarantee is given to the effects of recommended products.
To improve patient care and outcomes, leading dermatologists offered their recommendations on the top eye creams. Consideration must be given to:
- Eye Firming Complex
- Lumière
- RoC Retinol Correxion Sensitive Eye Cream
- Tensage Radiance Eye Cream
- Youth Eye Complex
Cutis invites readers to send us their recommendations. Toners and OTC antioxidants will be featured in upcoming editions of Cosmetic Corner. Please e-mail your recommendation(s) to cutis@frontlinemedcom.com.
Disclaimer: Opinions expressed herein do not necessarily reflect those of Cutis or Frontline Medical Communications Inc. and shall not be used for product endorsement purposes. Any reference made to a specific commercial product does not indicate or imply that Cutis or Frontline Medical Communications Inc. endorses, recommends, or favors the product mentioned. No guarantee is given to the effects of recommended products.
To improve patient care and outcomes, leading dermatologists offered their recommendations on the top eye creams. Consideration must be given to:
- Eye Firming Complex
- Lumière
- RoC Retinol Correxion Sensitive Eye Cream
- Tensage Radiance Eye Cream
- Youth Eye Complex
Cutis invites readers to send us their recommendations. Toners and OTC antioxidants will be featured in upcoming editions of Cosmetic Corner. Please e-mail your recommendation(s) to cutis@frontlinemedcom.com.
Disclaimer: Opinions expressed herein do not necessarily reflect those of Cutis or Frontline Medical Communications Inc. and shall not be used for product endorsement purposes. Any reference made to a specific commercial product does not indicate or imply that Cutis or Frontline Medical Communications Inc. endorses, recommends, or favors the product mentioned. No guarantee is given to the effects of recommended products.
VIDEO: Biogels boost targeted delivery of growth factor in severe wounds
DANA POINT, CALIF.– Materials science meets medicine. That’s the new frontier for many specialties, thanks to advances in the understanding of native tissue dynamics and how bioengineered materials will perform in vivo.
Sarah Heilshorn, Ph.D., of the department of materials science and engineering and the department of bioengineering at Stanford (Calif.) University, was one of several presenters at this year’s Summit in Aesthetic Medicine, with a focus on the use of synthetic materials for reconstructive surgery and treatment for acute and traumatic tissue injury.
In this video, Dr. Heilshorn explains how materials science and bioengineering are promoting angiogenesis to help patients who have suffered spinal injuries, chronic wounds, and conditions involving severe tissue injury at the meeting held by Global Academy for Medical Education. GAME and this news organization are owned by Frontline Medical Communications. She describes how revascularization, bone regeneration, and tissue growth are all possible through the use of highly specific and targeted biogels injected into the body to improve delivery of growth factors.
Dr. Heilshorn said she had no relevant financial conflicts to disclose.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
DANA POINT, CALIF.– Materials science meets medicine. That’s the new frontier for many specialties, thanks to advances in the understanding of native tissue dynamics and how bioengineered materials will perform in vivo.
Sarah Heilshorn, Ph.D., of the department of materials science and engineering and the department of bioengineering at Stanford (Calif.) University, was one of several presenters at this year’s Summit in Aesthetic Medicine, with a focus on the use of synthetic materials for reconstructive surgery and treatment for acute and traumatic tissue injury.
In this video, Dr. Heilshorn explains how materials science and bioengineering are promoting angiogenesis to help patients who have suffered spinal injuries, chronic wounds, and conditions involving severe tissue injury at the meeting held by Global Academy for Medical Education. GAME and this news organization are owned by Frontline Medical Communications. She describes how revascularization, bone regeneration, and tissue growth are all possible through the use of highly specific and targeted biogels injected into the body to improve delivery of growth factors.
Dr. Heilshorn said she had no relevant financial conflicts to disclose.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
DANA POINT, CALIF.– Materials science meets medicine. That’s the new frontier for many specialties, thanks to advances in the understanding of native tissue dynamics and how bioengineered materials will perform in vivo.
Sarah Heilshorn, Ph.D., of the department of materials science and engineering and the department of bioengineering at Stanford (Calif.) University, was one of several presenters at this year’s Summit in Aesthetic Medicine, with a focus on the use of synthetic materials for reconstructive surgery and treatment for acute and traumatic tissue injury.
In this video, Dr. Heilshorn explains how materials science and bioengineering are promoting angiogenesis to help patients who have suffered spinal injuries, chronic wounds, and conditions involving severe tissue injury at the meeting held by Global Academy for Medical Education. GAME and this news organization are owned by Frontline Medical Communications. She describes how revascularization, bone regeneration, and tissue growth are all possible through the use of highly specific and targeted biogels injected into the body to improve delivery of growth factors.
Dr. Heilshorn said she had no relevant financial conflicts to disclose.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
EXPERT ANALYSIS FROM THE SUMMIT IN AESTHETIC MEDICINE 2014
Summer care for atopic skin
Summer months can be dreadful for patients with atopic dermatitis. The chlorine, heat, and humidity can lead to flares. Furthermore, noncompliance with skin care regimens because of changing summer routines, travel, and the use of hotel products can exacerbate even the calmest skin disease.
Share these tips with your patients to help them keep their atopic skin under control in the summer heat, and stop flares before they start.
• Rinse the skin well after swimming. Chlorine and saltwater can dry out the skin. Showers after swimming in chlorinated pools can help retain the skin’s natural oils.
• Avoid hot tubs. Cracks and fissures in atopic skin can become infected in hot tubs with Staphylococcus and Pseudomonas. Advise your atopic patients to avoid hot tubs, even if they claim the tubs have been cleaned.
• Bring your own products. Many soaps and shower gels available in hotels and resorts are extremely drying, and may contain ingredients that could irritate atopic skin.
• Don’t switch from thick creams to thin lotions just because it is summer. Remind your patients that a thin lotion does not provide the same occlusive and humectant properties as thicker creams, although they are not as easy to apply, and can feel thick and sticky on the skin with humidity.
• In case of an active eczema flare, topical steroids should be used and sun exposure should be avoided. Topical steroids are the most effective treatment when used correctly. However, any occurrence of hypopigmentation as a result of their use becomes more evident if the skin tans around the area of treatment.
• Wear physical sunscreen. This seems obvious, but most chemical blockers – even the formulations made for babies – can burn on cracked, inflamed skin. Instead, stress to your patients that they use a physical blocker made of pure titanium dioxide or zinc oxide on inflamed skin.
• Oral steroids and sun do not mix. Oral steroids can be potent photosensitizers. If they are needed, UV exposure should be avoided.
Dr. Talakoub and Dr. Wesley are co-contributors to a monthly Aesthetic Dermatology column in Skin & Allergy News. Dr. Talakoub is in private practice at McLean (Va.) Dermatology Center. Dr. Wesley practices dermatology in Beverly Hills, Calif. This month’s column is by Dr. Talakoub.
Summer months can be dreadful for patients with atopic dermatitis. The chlorine, heat, and humidity can lead to flares. Furthermore, noncompliance with skin care regimens because of changing summer routines, travel, and the use of hotel products can exacerbate even the calmest skin disease.
Share these tips with your patients to help them keep their atopic skin under control in the summer heat, and stop flares before they start.
• Rinse the skin well after swimming. Chlorine and saltwater can dry out the skin. Showers after swimming in chlorinated pools can help retain the skin’s natural oils.
• Avoid hot tubs. Cracks and fissures in atopic skin can become infected in hot tubs with Staphylococcus and Pseudomonas. Advise your atopic patients to avoid hot tubs, even if they claim the tubs have been cleaned.
• Bring your own products. Many soaps and shower gels available in hotels and resorts are extremely drying, and may contain ingredients that could irritate atopic skin.
• Don’t switch from thick creams to thin lotions just because it is summer. Remind your patients that a thin lotion does not provide the same occlusive and humectant properties as thicker creams, although they are not as easy to apply, and can feel thick and sticky on the skin with humidity.
• In case of an active eczema flare, topical steroids should be used and sun exposure should be avoided. Topical steroids are the most effective treatment when used correctly. However, any occurrence of hypopigmentation as a result of their use becomes more evident if the skin tans around the area of treatment.
• Wear physical sunscreen. This seems obvious, but most chemical blockers – even the formulations made for babies – can burn on cracked, inflamed skin. Instead, stress to your patients that they use a physical blocker made of pure titanium dioxide or zinc oxide on inflamed skin.
• Oral steroids and sun do not mix. Oral steroids can be potent photosensitizers. If they are needed, UV exposure should be avoided.
Dr. Talakoub and Dr. Wesley are co-contributors to a monthly Aesthetic Dermatology column in Skin & Allergy News. Dr. Talakoub is in private practice at McLean (Va.) Dermatology Center. Dr. Wesley practices dermatology in Beverly Hills, Calif. This month’s column is by Dr. Talakoub.
Summer months can be dreadful for patients with atopic dermatitis. The chlorine, heat, and humidity can lead to flares. Furthermore, noncompliance with skin care regimens because of changing summer routines, travel, and the use of hotel products can exacerbate even the calmest skin disease.
Share these tips with your patients to help them keep their atopic skin under control in the summer heat, and stop flares before they start.
• Rinse the skin well after swimming. Chlorine and saltwater can dry out the skin. Showers after swimming in chlorinated pools can help retain the skin’s natural oils.
• Avoid hot tubs. Cracks and fissures in atopic skin can become infected in hot tubs with Staphylococcus and Pseudomonas. Advise your atopic patients to avoid hot tubs, even if they claim the tubs have been cleaned.
• Bring your own products. Many soaps and shower gels available in hotels and resorts are extremely drying, and may contain ingredients that could irritate atopic skin.
• Don’t switch from thick creams to thin lotions just because it is summer. Remind your patients that a thin lotion does not provide the same occlusive and humectant properties as thicker creams, although they are not as easy to apply, and can feel thick and sticky on the skin with humidity.
• In case of an active eczema flare, topical steroids should be used and sun exposure should be avoided. Topical steroids are the most effective treatment when used correctly. However, any occurrence of hypopigmentation as a result of their use becomes more evident if the skin tans around the area of treatment.
• Wear physical sunscreen. This seems obvious, but most chemical blockers – even the formulations made for babies – can burn on cracked, inflamed skin. Instead, stress to your patients that they use a physical blocker made of pure titanium dioxide or zinc oxide on inflamed skin.
• Oral steroids and sun do not mix. Oral steroids can be potent photosensitizers. If they are needed, UV exposure should be avoided.
Dr. Talakoub and Dr. Wesley are co-contributors to a monthly Aesthetic Dermatology column in Skin & Allergy News. Dr. Talakoub is in private practice at McLean (Va.) Dermatology Center. Dr. Wesley practices dermatology in Beverly Hills, Calif. This month’s column is by Dr. Talakoub.
VIDEO: Lasers plus angiogenesis inhibitors equal potential for treating port wine stains
DANA POINT, CALIF. – Although lasers are standard in the treatment of port wine stains, they don’t give full clearance or prevent recurrence, according to Dr. Kristen M. Kelly of the University of California, Irvine.
Using imaging, Dr. Kelly and her team observed that lasers provided patients with "very nice" destruction of blood vessels, but in as little as a week, revascularization would begin. The investigators sought a way to interfere with angiogenesis in order to extend clearance of the port wine stains.
In this video, recorded during the Summit in Aesthetic Medicine 2014, Dr. Kelly says that she doesn’t think "we have the optimal treatment yet." However, a proof of concept study she and others conducted that combined laser treatment with Food and Drug Administration–approved agents, such as imiquimod and rapamycin, showed "a slight improvement over lasers alone."
Dr. Kelly added that the current research is only a "first step," and that other agents will prove equally or more effective as antiangiogenesis gains recognition as a viable treatment for a range of cutaneous conditions.
The Summit in Aesthetic Medicine is held by the Global Academy for Medical Education. GAME and this news organization are owned by Frontline Medical Communications.
Dr. Kelly said she had no relevant financial conflicts to disclose.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @whitneymcknight
DANA POINT, CALIF. – Although lasers are standard in the treatment of port wine stains, they don’t give full clearance or prevent recurrence, according to Dr. Kristen M. Kelly of the University of California, Irvine.
Using imaging, Dr. Kelly and her team observed that lasers provided patients with "very nice" destruction of blood vessels, but in as little as a week, revascularization would begin. The investigators sought a way to interfere with angiogenesis in order to extend clearance of the port wine stains.
In this video, recorded during the Summit in Aesthetic Medicine 2014, Dr. Kelly says that she doesn’t think "we have the optimal treatment yet." However, a proof of concept study she and others conducted that combined laser treatment with Food and Drug Administration–approved agents, such as imiquimod and rapamycin, showed "a slight improvement over lasers alone."
Dr. Kelly added that the current research is only a "first step," and that other agents will prove equally or more effective as antiangiogenesis gains recognition as a viable treatment for a range of cutaneous conditions.
The Summit in Aesthetic Medicine is held by the Global Academy for Medical Education. GAME and this news organization are owned by Frontline Medical Communications.
Dr. Kelly said she had no relevant financial conflicts to disclose.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @whitneymcknight
DANA POINT, CALIF. – Although lasers are standard in the treatment of port wine stains, they don’t give full clearance or prevent recurrence, according to Dr. Kristen M. Kelly of the University of California, Irvine.
Using imaging, Dr. Kelly and her team observed that lasers provided patients with "very nice" destruction of blood vessels, but in as little as a week, revascularization would begin. The investigators sought a way to interfere with angiogenesis in order to extend clearance of the port wine stains.
In this video, recorded during the Summit in Aesthetic Medicine 2014, Dr. Kelly says that she doesn’t think "we have the optimal treatment yet." However, a proof of concept study she and others conducted that combined laser treatment with Food and Drug Administration–approved agents, such as imiquimod and rapamycin, showed "a slight improvement over lasers alone."
Dr. Kelly added that the current research is only a "first step," and that other agents will prove equally or more effective as antiangiogenesis gains recognition as a viable treatment for a range of cutaneous conditions.
The Summit in Aesthetic Medicine is held by the Global Academy for Medical Education. GAME and this news organization are owned by Frontline Medical Communications.
Dr. Kelly said she had no relevant financial conflicts to disclose.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @whitneymcknight
EXPERT ANALYSIS FROM SUMMIT IN AESTHETIC MEDICINE
VIDEO: Lasers – The scar treatment tools you already have
DANA POINT, CALIF. – When you think of lasers, do you consider them as the standard of care for treatment of a range of scars, from dog bites to burns? If not, Dr. Jill Waibel, director of the Miami Dermatology and Laser Institute, thinks you should.
"The sooner you get the lasers on the scars, the better," she emphasizes in this video, recorded during Summit in Aesthetic Medicine 2014. "They [lasers] are both preventative and therapeutic."
Dermatologists can combine lasers and medications that they already have in their practices to great effect to help make scars nearly invisible, Dr. Waibel explained at the meeting, held by Global Academy for Medical Education. GAME and this news organization are owned by Frontline Medical Communications.
Dr. Waibel disclosed that she has financial relationships with Alma, Syneron/Candela, Sciton, Lutronics, and Lumenis.
On Twitter @whitneymcknight
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
DANA POINT, CALIF. – When you think of lasers, do you consider them as the standard of care for treatment of a range of scars, from dog bites to burns? If not, Dr. Jill Waibel, director of the Miami Dermatology and Laser Institute, thinks you should.
"The sooner you get the lasers on the scars, the better," she emphasizes in this video, recorded during Summit in Aesthetic Medicine 2014. "They [lasers] are both preventative and therapeutic."
Dermatologists can combine lasers and medications that they already have in their practices to great effect to help make scars nearly invisible, Dr. Waibel explained at the meeting, held by Global Academy for Medical Education. GAME and this news organization are owned by Frontline Medical Communications.
Dr. Waibel disclosed that she has financial relationships with Alma, Syneron/Candela, Sciton, Lutronics, and Lumenis.
On Twitter @whitneymcknight
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
DANA POINT, CALIF. – When you think of lasers, do you consider them as the standard of care for treatment of a range of scars, from dog bites to burns? If not, Dr. Jill Waibel, director of the Miami Dermatology and Laser Institute, thinks you should.
"The sooner you get the lasers on the scars, the better," she emphasizes in this video, recorded during Summit in Aesthetic Medicine 2014. "They [lasers] are both preventative and therapeutic."
Dermatologists can combine lasers and medications that they already have in their practices to great effect to help make scars nearly invisible, Dr. Waibel explained at the meeting, held by Global Academy for Medical Education. GAME and this news organization are owned by Frontline Medical Communications.
Dr. Waibel disclosed that she has financial relationships with Alma, Syneron/Candela, Sciton, Lutronics, and Lumenis.
On Twitter @whitneymcknight
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
EXPERT ANALYSIS FROM THE SUMMIT IN AESTHETIC MEDICINE
VIDEO: Stems cells may offer more equipoise in traumatic scar treatment
DANA POINT, CALIF. – It’s possible that burn victims and others with traumatic scarring will no longer need to have skin grafted from one part of their body, thus adding new scars, to mend the deeper scars, according to Dr. Jill Waibel, a speaker at Summit in Aesthetic Medicine 2014.
"As surgeons, we don’t have the right to take healthy tissue and create more scars," said Dr. Waibel, director of the Miami Dermatology and Laser Institute and a voluntary clinical professor of dermatology at the University of Miami.
Dr. Waibel and her colleagues are working with the Department of Defense to study whether stem cells can be applied directly to wounds to facilitate new skin tissue growth in service personnel with traumatic injuries from bomb blasts they suffered while fighting in Afghanistan.
She and her team also have been working with the DOD to refine the delivery system for these stem cells, using lasers and a hydrogel developed by the military that can used safely in vivo. Dr. Waibel discusses her hopes and concerns for stem cell use in traumatic scar treatment in this video from the meeting, which was held by Global Academy for Medical Education. GAME and this news organization are owned by Frontline Medical Communications.
Dr. Waibel disclosed she has financial relationships with Alma, Syneron/Candela, Sciton, Lutronics, and Lumenis.
On Twitter @whitneymcknight
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
DANA POINT, CALIF. – It’s possible that burn victims and others with traumatic scarring will no longer need to have skin grafted from one part of their body, thus adding new scars, to mend the deeper scars, according to Dr. Jill Waibel, a speaker at Summit in Aesthetic Medicine 2014.
"As surgeons, we don’t have the right to take healthy tissue and create more scars," said Dr. Waibel, director of the Miami Dermatology and Laser Institute and a voluntary clinical professor of dermatology at the University of Miami.
Dr. Waibel and her colleagues are working with the Department of Defense to study whether stem cells can be applied directly to wounds to facilitate new skin tissue growth in service personnel with traumatic injuries from bomb blasts they suffered while fighting in Afghanistan.
She and her team also have been working with the DOD to refine the delivery system for these stem cells, using lasers and a hydrogel developed by the military that can used safely in vivo. Dr. Waibel discusses her hopes and concerns for stem cell use in traumatic scar treatment in this video from the meeting, which was held by Global Academy for Medical Education. GAME and this news organization are owned by Frontline Medical Communications.
Dr. Waibel disclosed she has financial relationships with Alma, Syneron/Candela, Sciton, Lutronics, and Lumenis.
On Twitter @whitneymcknight
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
DANA POINT, CALIF. – It’s possible that burn victims and others with traumatic scarring will no longer need to have skin grafted from one part of their body, thus adding new scars, to mend the deeper scars, according to Dr. Jill Waibel, a speaker at Summit in Aesthetic Medicine 2014.
"As surgeons, we don’t have the right to take healthy tissue and create more scars," said Dr. Waibel, director of the Miami Dermatology and Laser Institute and a voluntary clinical professor of dermatology at the University of Miami.
Dr. Waibel and her colleagues are working with the Department of Defense to study whether stem cells can be applied directly to wounds to facilitate new skin tissue growth in service personnel with traumatic injuries from bomb blasts they suffered while fighting in Afghanistan.
She and her team also have been working with the DOD to refine the delivery system for these stem cells, using lasers and a hydrogel developed by the military that can used safely in vivo. Dr. Waibel discusses her hopes and concerns for stem cell use in traumatic scar treatment in this video from the meeting, which was held by Global Academy for Medical Education. GAME and this news organization are owned by Frontline Medical Communications.
Dr. Waibel disclosed she has financial relationships with Alma, Syneron/Candela, Sciton, Lutronics, and Lumenis.
On Twitter @whitneymcknight
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
EXPERT ANALYSIS FROM THE SUMMIT IN AESTHETIC MEDICINE