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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Page 13 of 59

14 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 T The growth of the facial cosmetic industry reflects the increasing demand of patients seeking treatments to look younger. Steadily growing, the number of surgical and minimally invasive cosmetic procedures performed in the United States in 2015 totaled 15.9 million, a growth of two percent from the previous year, with minimally invasive procedures comprising the majority at 14.9 million. 1 Facial wrinkling has been shown to strongly correlate with one's perceived age 2 and is one of the key features of diminished skin quality due to photodamage and intrinsic aging, along with dyspigmentation and uneven skin texture. 3,4 From the patient perspective, the presence of facial lines or wrinkles is one of the top skin quality concerns that motivates patients to seek treatment. This demand is reflected by the growing number of neuromodulator injection procedures performed and supports why it is a key target for aesthetic treatments and procedures. Since it received United States Food and Drug Administration (FDA) approval for the treatment of glabellar lines in 2002, the neuromodulator onabotulinumtoxinA has hailed in a new era of minimally invasive cosmetic procedures. Growing over 700 percent since 2000, neuromodulator injections in general were the number one minimally invasive procedure performed in 2015. 1 The efficacy of neuromodulator injection procedures for the treatment of moderate- to-severe facial lines and wrinkles has been well-established. 5–7 The mechanism of action focuses on addressing the associated muscle activity causing the line or wrinkle formation. In addition to cosmetic in-office procedures, the topical skin care or "cosmeceutical" industry has also grown tremendously, with products targeting the improvement of skin quality. However, many of these cosmeceuticals lack the testing to support their efficacy. Recently, a novel topical serum, HA 5 Rejuvenating Hydrator (SkinMedica, Inc., Irvine, California), was developed to restore diminished epidermal function and skin hydration associated with aging and improve the appearance of fine lines and wrinkles. When applied twice A B S T R A C T BACKGROUND: Neuromodulator injection procedures are an effective treatment for moderate-to-severe facial wrinkles, but do not address the superficial fine lines and wrinkles caused by age-related loss of intrinsic hyaluronic acid levels in the epidermis. OBJECTIVE: In this study, the authors assess overall facial skin quality and patient satisfaction when combining topical treatment with the a topical cosmetic serum (HA 5 ) and applying to the entire face following a pre-elected neuromodulator injection treatment to the lateral canthal areas. METHODS AND MATERIALS: Twenty female subjects aged 36 to 63 years with moderate-to-severe under-the-eye fine lines and/ or wrinkles enrolled in the study. HA 5 was applied the entire face at baseline immediately post-injection and twice daily for eight weeks. Clinical assessments were conducted at baseline; 15 minutes post-procedure; and at Weeks 2, 4, and 8. RESULTS: Statistically significant improvements were observed immediately post- procedure and after eight weeks, along with high patient satisfaction. CONCLUSION: The combination of topical serum and injectable procedure provided a rapid onset of improvements in fine lines/wrinkles appearance and skin texture and long-term overall improvements in areas not treated by the injection. These results support how this novel combination can provide physicians with a comprehensive approach to optimize patient outcomes. KEYWORDS: Neuromodulator injection, cosmeceutical, post-procedure, combination treatment, facial rejuvenation Optimizing Facial Rejuvenation with a Combination of a Novel Topical Serum and Injectable Procedure to Increase Patient Outcomes and Satisfaction by SABRINA G. FABI, MD; LISA ZALESKI-LARSEN, DO; JOANNA BOLTON, MD; RAHUL C. MEHTA, PhD; and ELIZABETH T. MAKINO, BS, CCRA, MBA Dr. Fabi is with Cosmetic Laser Dermatology and is a volunteer Assistant Clinical Professor at the University of California, San Diego in San Diego, California. Drs. Zaleski-Larsen and Bolton are with Cosmetic Laser Dermatology in San Diego, California. Dr. Mehta and Ms. Makino are with SkinMedica, Inc., an Allergan Company in Irvine, California. J Clin Aesthet Dermatol. 2017;10(12):14–18 FUNDING: Financial support for this study was provided by SkinMedica, Inc., an Allergan Company. DISCLOSURES: Dr. Fabi serves as an investigator, consultant, and speaker for Allergan, Galderma, and Merz. Drs. Zaleski-Larsen and Bolton have no financial conflicts relevant to the content of this article. Dr. Mehta and Ms. Makino are employees of SkinMedica, Inc., an Allergan Company. CORRESPONDENCE: Elizabeth T. Makino, BS, CCRA, MBA; Email:

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