A Practical Algorithm Integrating Skin Care With Nonenergy and Injectable Dermatologic Procedures to Improve Patient Outcomes and Satisfaction

April 2024 | Volume 23 | Issue 4 | 227 | Copyright © April 2024


Published online March 27, 2024

Edward Lain MD FAADa, Anneke Andriessen PhDb, Valeria Barreto Campos MDc, Sabrina Guillen Fabi MD FAAD FAACSd, Lisa Ginn MD FAADe, Ariel Haus MDf, Valerie M. Harvey MDg, Jean-Francois Tremblay MD FRCPCh

aSanova Dermatology, Austin Institute for Clinical Research, Austin, TX 
bRadboud UMC Nijmegen, Andriessen Consultants, Malden, NL
cUniversity of Jundiai, Sao Paulo, Brazil 
dCosmetic Laser Dermatology, San Diego; University of California, San Diego, CA 
eSkin@LRG, Bethesda, MD 
fDr Haus Dermatology, London, England 
gTPMG Hampton Roads Center for Dermatology, Virginia Beach and Newport News, VA
hFunctionalab Group, Dermapure, Project Skin MD, Montreal, Quebec, Canada 

Abstract


Background:
The most rapidly increasing medical aesthetic procedures for facial antiaging comprise nonenergy and injectable treatments. Currently, standards for skin care before, during, and after nonenergy and injectable treatments are lacking. The algorithm on supportive skin care for facial antiaging nonenergy and injectable treatments aims to stimulate healing, reduce downtime, and improve comfort and treatment outcomes. 
Methods: A panel of 7 global physicians employed a modified Delphi method and reached a consensus on an algorithm for supportive skin care for nonenergy and injectable antiaging treatments based on the best available evidence and the panel members' clinical experiences and opinions.
Results: The algorithm has a pretreatment (starts 2 - 4 weeks before the procedure) and treatment or ongoing (day of treatment) section, followed by care after the procedure (0 - 7 days) and follow-up care (1 - 4 weeks after the procedure). Applying a broad-spectrum sunscreen with an SPF 30 or higher, combined with protective measures, such as wearing a wide-brimmed hat and sunglasses, is recommended to protect the face from sun exposure. Dyschromia is a significant concern for those with richly pigmented skin. Clinicians may recommend skin care using a gentle cleanser and moisturizer containing vitamins C and E, retinoid, or other ingredients, such as niacinamide, kojic acid, licorice root extract, azelaic acid, and tranexamic acid, depending on the patient's facial skin condition.
Conclusion: Nonenergy and injectable procedures combined with skin care or topical treatments may improve outcomes and patient satisfaction. Topical antioxidants and free radical quenchers can combat photodamage and may offer a safe alternative to topical hydroquinone. 
 
J Drugs Dermatol. 2024;23(4):227-232.     doi:10.36849/JDD.7918

INTRODUCTION

Medical aesthetic procedures for facial antiaging treatment using nonenergy and injectable treatments are rapidly increasing.1,2 The American Society for Aesthetic Plastic Surgery (ASAPS) reported that in 2021 over 1 billion dollars were spent on injectables.1 Together, botulinum toxin and hyaluronic acid injectable procedures comprised the top two non-surgical treatments performed in 2021, with botulinum toxin as the number one medical aesthetic procedure.1 The injection-based device segment is projected to grow continuously by over 10% annually between 2022 and 2027 by many market research groups. Specifically, Fortune Business Insights shared that the global medical aesthetics market shows that the nonenergy-based segment is the largest portion of the global aesthetic market.3 Many publications have addressed methods to reduce adverse events related to nonenergy and injectable treatments; however, few algorithms exist on skincare measures before, during, and after nonenergy and injectable treatments.4,5 Currently, standards for skin care before, during, and after medical aesthetic procedures are lacking.4,5 As a result, skin care use for managing conditions associated with