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Psoriasis

Experts Offer Recommendations for Use of Absorbable Suspension Sutures

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Used alone, absorbable suspension sutures offer a dual mechanism of action

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Used alone, absorbable suspension sutures offer a dual mechanism of action

Heather Onorati

As the use of absorbable suspension sutures continues to grow, it’s important for physicians to understand the technique and mechanism of action to optimize their use alone and in combination with other facial aesthetic tools, according to a recent paper published in the Journal of Drugs in Dermatology. 

First, patient selection is central to obtaining optimal results, write authors Sabrina Fabi, M.D., Robert Weiss, M.D., and Susan Weinkle, M.D., in “Absorbable Suspension Sutures: Recommendations for Use in a Multimodal Nonsurgical Approach to Facial Rejuvenation.”

Setting appropriate expectations is also important to an ideal outcome. Patients need to understand that nonsurgical positioning cannot produce the same results as surgery, the authors write, noting a study that demonstrated older patients (those ≤60), were less likely to view absorbable sutures as an effective treatment at 24 months compared with younger patients (those ≤50). Similarly, patients who had received prior surgical treatments were less likely to view absorbable suspension sutures as effective compared with patients who had no experience with surgical treatment.

In their paper, Drs. Fabi, Weiss and Weinkle discuss the mechanism of action for absorbable suspension sutures as well as provide guidance based on their extensive experience for combining absorbable suspension sutures with other nonsurgical modalities, including sequencing and timing.

Used alone, absorbable suspension sutures offer a dual mechanism of action, they write. They lift and stimulate collagen. Based on previous studies of duration, the authors suggest that with optimal technique, most patients should experience a duration of effect up to 24 months.

Through several case studies, the authors illustrate the utility of combining additional therapies, such as filers, toxins and energy-based devices.

When selecting an optimal combination of both sutures and filler, the authors note that it is important to determine whether the patient is in need of volume or tissue repositioning. If a patient has already received filler, absorbable sutures should be used six to 12 weeks later. If treating for residual ptosis, fillers should be placed after the sutures and in a separate anatomical plane or area. For patients naïve to fillers, sutures should be placed six to 12 weeks after filler.

The authors recommend administering toxin two weeks prior to suture placement, because the toxin effect can reduce the mechanical load on the suture and prevent the disengagement of the cones which may improve the lifting effect and duration, they write.

Ideally, treatment with ablative lasers should be performed six weeks prior to suture placement but no less than two weeks prior to allow for resolution of any swelling and inflammation that might interfere with placement. However, treatment with non-ablative lasers and IPL can generally be performed in the same day as suture placement, the authors note. Radiofrequency treatments should be performed four weeks before or after suture placement, they suggest. And, they add, microneedling should be performed at least two weeks before or five to eight weeks after suture placement.

“As the use of absorbable suspension sutures continues to increase, it is important that physicians are aware of how modalities can be safely layered and combined to produce an optimal aesthetic effect.”

Heather Onorati is an experienced medical writer and editor with more than 20 years covering the dermatology industry

Discover new clinical findings in  Aesthetics.  View the latest articles, case reports, supplements, CME activities, Podcast episodes and more.
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Experts Offer Recommendations for Use of Absorbable Suspension Sutures

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Used alone, absorbable suspension sutures offer a dual mechanism of action Used alone, absorbable suspension sutures offer a dual mechanism of action Heather Onorati As the use of absorbable suspension…

In Support of a More Useful Definition for ‘Moderate’ Psoriasis

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Psoriasis Clearance Motivates Patients to Seek Cometic Procedures, Study Finds

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Patients with moderate to severe psoriasis who achieved 75% or greater reduction in BSA showed an increased uptake in cosmetic procedures and this increase correlated with a reported improvement in quality of life after psoriasis clearance, the authors found.

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Patients with moderate to severe psoriasis who achieved 75% or greater reduction in BSA showed an increased uptake in cosmetic procedures and this increase correlated with a reported improvement in quality of life after psoriasis clearance, the authors found.

Heather Onorati

A significant reduction in psoriasis body surface area (BSA) may motivate patients to seek cosmetic procedures, according to findings from a recent study, “Increased Trend of Cosmetic Procedures in Patients With Psoriasis Who Attain 75% or Greater Improvement.”

Patients with moderate to severe psoriasis who achieved 75% or greater reduction in BSA showed an increased uptake in cosmetic procedures and this increase correlated with a reported improvement in quality of life after psoriasis clearance, the authors found.

Researchers lead by Michelle Walters, M.D., Harbor-UCLA Medical Center, Torrance, Calif., examined the relationship between improvement in quality of life following a reduction in BSA and the use of cosmetic procedures. They identified 138 patients with a history of moderate to severe psoriasis from  the Dermatology Institute and Skin Cancer Center in Santa Monica, Calif., and surveyed them using the Dermatology Life Quality Index (DLQI), adding an additional 5 questions related to the patients’ cosmetic procedures.

Of the group, 119 patients said they had never before undergone a cosmetic procedure due to their psoriasis. All of the patients responded that their quality of life had improved with their psoriasis treatment, and the majority (91%) said this improvement motivated them to undergo the cosmetic procedure.

The most common cosmetic procedures sought by these patients were neurotoxins, soft tissue augmentation and chemical peels. In addition, 79% of the patients purchased skincare products dispensed through the office.

“The improvement in quality of life following treatment of psoriasis with systemic or biologic agents noted in our study reflects results from previous studies,” the authors note. However, the authors state that there have been no studies that have examined a correlation between the improvement in quality of life following psoriasis treatment and an uptake in surgical or nonsurgical cosmetic procedures.

“We found that a common motive for patients who sought cometic procedures was the desire to further improve their quality of life after clearance of their psoriasis,” the authors say. They add that this study indicates that successful treatment of the condition may be a motivator for patients to seek cosmetic procedures for other skin indications.

Heather Onorati is an experienced medical writer and editor with more than 20 years covering the dermatology industry

Discover new clinical findings in Psoriasis.  View the latest articles, case reports, supplements, CME activities, Podcast episodes and more.

 

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Experts Offer Recommendations for Use of Absorbable Suspension Sutures

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Used alone, absorbable suspension sutures offer a dual mechanism of action Used alone, absorbable suspension sutures offer a dual mechanism of action Heather Onorati As the use of absorbable suspension…

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February issue highlights new perspectives in chronic skin conditions

| Acne, Aesthetics, Featured Articles, JDD Highlights | No Comments
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Topical Cannabinoids for the Management of Psoriasis Vulgaris: Report of a Case and Review of the Literature

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The interest in use of medical cannabis for chronic dermatologic conditions such as psoriasis, eczema, and acne has been growing mostly owing to rapidly emerging decriminalization across the country and impressive commercially driven popularization of a variety of cannabinoid preparations including topical forms such as creams, salves, lotions, lubricants, and many others.

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This report details a case of a young man with psoriasis managed with topical cannabinoids.

Adam J. Friedman MD, Kimia Momeni BS, Mikhail Kogan MD

 

The interest in use of medical cannabis for chronic dermatologic conditions such as psoriasis, eczema, and acne has been growing mostly owing to rapidly emerging decriminalization across the country and impressive commercially driven popularization of a variety of cannabinoid preparations including topical forms such as creams, salves, lotions, lubricants, and many others.

However, while the market is exponentially growing, the rate at which mechanistic and clinical evidence supporting the use of cannabinoids in a litany of diseases is significantly slower. In fact, Robinson et al highlighted significant gaps in dermatologists understanding of the biology of cannabinoids and comfort with this space, further highlighting the great need to disseminate information throughout the medical community.

Along this vein, we present a case of a young man with psoriasis managed with topical cannabinoids.

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Experts Offer Recommendations for Use of Absorbable Suspension Sutures

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Used alone, absorbable suspension sutures offer a dual mechanism of action Used alone, absorbable suspension sutures offer a dual mechanism of action Heather Onorati As the use of absorbable suspension…

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| Featured Articles, The Latest | No Comments
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February issue highlights new perspectives in chronic skin conditions

| Acne, Aesthetics, Featured Articles, JDD Highlights | No Comments
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