Innovations in anti-aging treatments

National report - Every eight seconds, a member of the baby boom generation turns 50 - and an increasing number of these baby boomers are looking to turn back the clock.

"The baby boom generation is getting older and more eligible for skin-rejuvenation procedures," he tells Dermatology Times. "There are more than 80 million baby boomers who are potential candidates for skin-rejuvenation procedures."

It is the topical agents that Dr. Goldberg says represent "the new kid on the block."

Collagen formation

In the collagen formation category, laser technology has been adopted as an innovative way to form collagen.

"Ablative laser resurfacing is the time-honored approach to forming new collagen, but it can result in terrible wounds that take a long time to heal," Dr. Goldberg says. "For the past couple of years, we've had a new laser device, fractional. Photothermolysis is a more refined laser treatment that rejuvenates skin by means of microscopic sites of thermal impact, as opposed to the larger areas characteristic of standard laser resurfacing, so wounds have been virtually eliminated."

Skin tightening

In the skin-tightening category, Dr. Goldberg says the gold standard for the past few years has been ThermaCool(tm) TC (Thermage), a radiofrequency (RF) device. Relatively new additions in this category are Polaris (Syneron), which combines intense pulsed light (IPL) with monopolar RF, and Titan (Cutera), an infrared light source. Dr. Goldberg says the former can improve skin colors and pores, while the latter is best for rejuvenation of thin-skinned areas such the knees and elbows.

Skin toning

In the skin toning category, Dr. Goldberg, in a joint study with British colleagues that was completed last October, reports that treatment on 36 subjects with 633 nm and 830 nm LED irradiation, evaluated over a four-month period, resulted in statistically significant profilometric changes, clinical improvement in skin softness, smoothness and firmness, and cell changes that are consistent with new collagen formation.

Filler agents

As for fillers and botulinum neurotoxin - Botox (Allergan) being by far the most well-known brand - Marsha Gordon, M.D., clinical professor and vice chair at New York's Mount Sinai School of Medicine, offers a look back to give context to current preferences and what lies ahead.

"The first temporary fillers approved by the Food and Drug Administration (FDA) were bovine collagen fillers in the early 1980s," she says.

Although a significant milestone, she says, bovine collagen was not without downsides.

"Bovine collagen's durability is only about three months," Dr. Gordon says.

ArteFill (Artes Medical), the next generation of a filler currently used in Canada and Europe, combines bovine collagen with beads, and may become the first permanent filler available in the United States.

"Here the collagen becomes the transport medium for the beads," Dr. Goldberg says. "Because the filler contains bovine collagen, skin tests are required before treatment."

Artes Medical is still is awaiting final FDA approval.

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