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such as chemical peels, laser rejuvenation, and neuromodulator injections.5 While younger patients historically have sought care, primarily for acne scarring and tattoo removal, they are increasingly seeking non-invasive enhancement procedures that will fight the earliest signs of aging and brighten skin while accommodating busy lifestyles that do not allow for downtime after procedures.5 Having few existing algorithms, cosmetic dermatology requires personalized treatment plans for each patient case.
Integrated skin care is the personalized and complementary use of topical treatments and nonsurgical facial rejuvenation procedures such as lasers and microneedling radiofrequency (MRF) to produce optimal aesthetic results. Ablative, non-ablative, and fractional lasers are the most commonly used lasers in facial skin rejuvenation.6 Lasers generally heat the skin layers to resurface the epidermis and stimulate collagen synthesis in the dermis.4 Ablative lasers (CO2, Er: YAG) are more aggressive treatments that thermally ablate and vaporize the epidermis, heat the dermis to tighten the skin bed, and treat severe facial wrinkles and pigmentation.4 Non-ablative lasers (intense pulsed light [IPL]), infrared, vascular, ultrasound, and radiofrequency [RF] devices) target the dermis to stimulate collagen synthesis without affecting the epidermis.4 Fractional lasers may be ablative or non-ablative and work by delivering small columns of epidermal destruction while sparing injury to spaces between columns.4 MRF delivers RF currents through insulated needles to produce thermal zones in the skin without damaging the overlying epidermis. MRF leads to lasting dermal remodeling, elastin, and collagen synthesis.1
Complications of Skin Rejuvenation Techniques and Integrated Skin Care
Common complications of laser and MRF treatments include bruising, edema, itching, crusting, erythema, and pigment changes.4 Erythema is to be expected after almost any procedure using an energy device and can be worse in more aggressive treatments or patients with a history of rosacea or "sensitive skin."4 The risk of adverse events depends on the type of laser used, the area treated, patient skin type, and treatment goals.
Botanical Serum-Containing Corrective Gel
In general, ablative and fractional lasers carry a greater risk of adverse events than non-ablative ones. Combining topical treatments as adjunctive therapy can help mitigate the adverse effects of lasers and provide supportive skincare practices to improve patient quality of life and results.1 In this way, the integrated skincare approach optimizes clinical outcomes and increases patient comfort, satisfaction, and commitment to treatment goals.
Botanical Serum-Containing Corrective Gel
The botanical serum-containing corrective gel (botanical corrective gel) (Phyto Corrective gel, SkinCeuticals) is a lightweight botanical serum composed of 9.5% glycerin, 4.5% botanical extracts, and 0.2% hyaluronic acid, that hydrates, calms and soothes irritated skin to help reduce visible redness. The botanical corrective gel blend combines 6 botanical extracts, cucumber, thyme, and extracts of olive and mulberry leaves, to decrease inflammation, draw in moisture, and support the skin's barrier function (Table 1). Combining these ingredients produces synergistic anti-inflammatory and antioxidant effects on the skin. In vitro studies have demonstrated significant downregulation of inflammatory cytokine IL-8 expression in botanical corrective gel blend-treated cells (unpublished data). This suggests efficacious disruption of an inflammatory axis by the botanical corrective gel blend ingredients. Clinically, the botanical corrective gel has been shown to ameliorate inflammation and redness after rejuvenating procedures, thereby reducing post-procedure healing times.7 The anti-inflammatory antioxidant properties of the botanical corrective gel make it an appealing option for an integrated skincare plan in patients undergoing energy-based rejuvenation procedures.
As more treatments become available, it will be important for clinicians to partner with their patients to develop integrated skincare plans to optimize outcomes and support desired enhancement treatment goals. Herein, selected real-world cases are presented to illustrate how adding botanical corrective gel as an adjunct to laser or MRF treatments leads to improved outcomes in a variety of patients.
