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 

Topical Hydroquinone, Niacinamide, Kojic Acid, Licorice Root Extract, Azaleic Acid
Neuromodulator injections, a hydroquinone skincare regime, and daily topical retinoids improved signs of photoaging.26 A further study combined neuromodulator injections for antiaging treatment with skincare containing retinol adenosine and HA, which optimized total treatment outcomes.28 

Pre-procedure or follow-up care with skin care using topical products containing niacinamide, KA, AzA, and TXA may be recommended.29  Niacinamide inhibits melanosome transfer to keratinocytes and may be combined with TXA. A randomized, double-blind, vehicle-controlled study showed improvement in irregular facial hyperpigmentation.30

KA is a radical oxygen scavenger and inhibits tyrosinase. A study compared a combination of topical KA and glycolic acid with topical hydroquinone 4% and found superior results for the KA and glycolic acid product.31

LIMITATIONS

The panelists agreed that standardization for supportive skin care for nonenergy and injectable facial treatments is lacking, and many products are recommended without expert consensus. Clinical studies on skin care for these procedures mostly have a small sample size, but some used biophysical assays to support the findings. The discussion of skin care containing various ingredients supporting outcomes of nonenergy and injectable treatments was mostly limited to studies that combined skin care with these treatments. As data is lacking on combining nonenergy treatments and injectables with topical products containing niacinamide, KA, licorice root extract, AzA, and TXA, the discussion was limited to informing clinicians on the action of these ingredients.

CONCLUSION

The algorithm provides clinicians with skincare recommen-dations when treating nonenergy-based and injectable facial antiaging treatments to stimulate healing, reduce downtime, and improve comfort and treatment outcomes. A structured literature search was conducted to guide the algorithm's devel-opment. Clinical studies suggest that periprocedural skin care may improve outcomes and patient satisfaction with aesthet-ic procedures. Procedures combined with skin care or topical treatments improved skin condition. 

Dyschromia is a significant issue for richly pigmented skin, and the literature suggests that topical antioxidants and free radical quenchers can protect against photodamage. The use of hydroquinone remains controversial, especially given the alternatives currently available.

DISCLOSURES

This work was supported by an unrestricted educational grant from SkinCeuticals International. The authors contributed to the development of the manuscript, reviewed it, and agreed with its content.

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AUTHOR CORRESPONDENCE

Anneke Andriessen PhD anneke.a@tiscali.nl
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