Journal of Clinical and Aesthetic Dermatology

DEC 2017

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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17 JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY December 2017 • Volume 10 • Number 12 O R I G I N A L R E S E A R C H in the appearance of fine lines/wrinkles in the under-eye, forehead, and perioral facial areas were observed immediately after treatment at baseline (all p≤0.009; Student's paired t-test; n=20). Full-face tactile roughness grades also significantly improved immediately after HA 5 treatment (all p≤0.0006; Student's paired t-test; n=20). At the interim visits of Weeks 2 and 4, all efficacy parameters in both the injection- treated and non-treated sites demonstrated statistically significant improvements (n=19 and n=16, respectively; all p≤0.01; Student's paired t-test). Long-term effects at Week 8 showed a statistically significant improvement of fine lines and wrinkles in all facial areas (i.e., under-eye, perioral, forehead, cheek) when compared with the same at baseline (all p≤0.01; Student's paired t-test; n=15). Figure 3 includes representative standardized digital photographs of a 62-year-old female subject at baseline, immediately after neuromodulator injection and HA 5 application, and at Week 8, respectively. Figure 4 shows the subject's self-perceived efficacy at baseline immediately after the combination treatment and long-term at the Week 8 visit. Subjects rated their experience with this combination as compared with their past neuromodulator injections. Parameters focusing on the immediate effects of HA 5 application after the neuromodulator injection showed high ratings with 80 percent of subjects agreeing HA 5 "soothed my skin after the injection procedure," 85 percent of subjects agreeing HA 5 "made my skin feel more comfortable after the injection procedure," and 90 percent of subjects agreeing HA 5 "is something I would continue to use after future in-office injection procedures." Long- term effects at Week 8 were all consistently highly rated (all ≥93%), with 100 percent of subjects agreeing the HA 5 "improved my overall satisfaction with the outcomes of the injection procedure." CONCLUSION Increases in the variety of treatment options available to address facial aging allow for physicians to tailor in-office procedures with topical therapies for optimal outcomes. In this study, we demonstrated that a combination of a topical cosmetic serum used after a pre-elected neuromodulator injection provided a rapid onset of improvements in fine lines/wrinkles and skin texture and long-term overall improvements in areas not treated by the neuromodulator injection. The HA 5 serum used in this study contains a proprietary blend of Vitis vinifera flower stem cell extract, marine micro-organism polysaccharides, and a peptide complex to support the replenishment of endogenous levels of hyaluronic acid and epidermal homeostasis. Five forms of hyaluronic acid were also included in the formulation to provide immediate hydrating effects on the skin. As expected in this study, the neuromodulator injection improved wrinkles in the area of treatment, as shown by the FWS. Improvement in the appearance of superficial fine lines and wrinkles in the injected area are not typically expected immediately after a neuromodulator procedure, yet rapid-onset improvement was observed in this study following HA 5 ® application. Additionally, in facial areas not treated by the neuromodulator, HA 5 ® application provided significant improvements in the appearance of fine lines and wrinkles and skin texture. The immediate and long-term effects observed in this study are consistent with a previous clinical study assessing the effects of HA 5 on the appearance of fine lines and wrinkles and skin hydration. 8 The causes of superficial fine lines or wrinkles are multifactorial and are not solely due to muscle contraction nor loss of underlying tissue, which injection procedures address. Age-related reductions in epidermal levels of hyaluronic acid FIGURE 4. A) Subjects' self-perceived efficacy at baseline immediately after the combination treatment; B) Subjects' self-perceived efficacy at Week 8 A B

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