The December issue of the JDD has so much to offer to the aesthetic and medical dermatologist.
Papers that specifically relate to both fillers and botulinum toxin show that these treatments
are entering maturity, as well as being practiced in comprehensive approaches. In
addition, many of our international colleagues are contributing to the journal as well as
partnering with US colleagues for studies. Having just come back from my second DASIL
congress (Dermatologic and Aesthetic Society International League) held in Bangkok in
November, I could tell you that it was nothing short of intellectually intoxicating. Although
we may not have all specific brands of fillers or toxins available that our colleagues from
around the world do, we have much to learn from their creative approach and how they
combine treatments in new ways.
Extending the theme of comprehensive international approaches, an internationally recognized
aesthetic and cellulite expert, Doris Hexsel, joins with colleagues from South America
to gives us two papers demonstrating that using botulinum toxin in a full face approach leads
to significant improvement in patient’s quality of life and satisfaction; they also give us the
first safety and efficacy study showing similarities and differences between 3 different dosing
schemes for incobotulinum toxin.
More than 50 French aesthetic physicians have contributed a consensus paper on the similarities
of onabotulinum toxin and incobotulinum toxin. There has been an ongoing debate
at meetings about whether there are substantial differences between the available Botulinum
A preparations and this paper will add a very significant voice(s) to that conversation.
Wendy Roberts takes the comprehensive approach one step farther and discusses her approach
to generational dermatology, or taking care of your patients needs over 2 decades or
more. I see this in my practice as I age with my patients. They look to me to help them keep
their face and body looking how they feel. The younger patients come in wanting to maintain
what they have. It is our job to guide them on their journey, and Dr. Roberts will help us
realize and rethink this.
This issue also includes an evaluation of the neck. Debby Sarnoff, a well-known New York
dermatologist, did a solo evaluation of a new 1440 nm laser with a unique side-firing fiber
for neck tightening and fat reduction. She got great results with minimal adverse events in 24
patients without performing any liposuction.
Even if you aren’t an aesthetic aficionado, you can still enjoy this issue. There are two
papers on new topical formulations for formulas. Remember when we thought ointments
were the best vehicles for thick plaques? Sprays have changed our thought processes, especially
as they also help immensely with compliance, an ongoing everyday frustration for
the general dermatologist. Leon Kircik and colleagues have evaluated a desoximetasone
.25% spray that has been formulated to reduce stratum corneum irritation and be super
potent at the same time. Steven Feldman and colleagues have shown that clobetasol proprionate
spray can diminish signs and symptoms of psoriasis in one week and that this
correlates with effectiveness at week 4.
In the one paper that gives me pause, Diane Thibotout and esteemed international acne
experts call on us to prescribe fewer antibiotics for acne, due to concerns over increasing
bacterial resistance. How can we keep our patients clear without them? We are all going to
have to really lobby our insurance carriers to pay for blue and red light as well as photodynamic
therapy, or put a lot more people on isotretinoin. Yes, retinoids and benzoyl peroxides
