Dec
2014
Vol. 33. No. 4
Convergence of anatomy, technology, and therapeutics: a review of laser-assisted drug delivery
This is a very exciting time in cutaneous laser surgery with
an ever-expanding therapeutic armamentarium and an
increased sophistication of available technology. These recent
trends have allowed for both a rapid development of
interest and exploration of laser-assisted drug delivery and
its potential applications. We review the current literature
on anatomy, technology, and therapeutics as it relates to
laser-assisted drug delivery. The focus of our review is on
two areas of interest that have received much attention to
date — photodynamic therapy in the treatment of actinic
keratoses and nonmelanoma skin cancers as well as the
treatment of scarring. We will also discuss potential complications
of existing modalities used independently and
in laser-assisted drug delivery and conclude with future
indications for this burgeoning therapeutic methodology.
Semin Cutan Med Surg
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Dec
2014
Vol. 33. No. 4
Filler frontier: what’s new and heading West to the US Market
The amount of fillers approved by the United States Food
and Drug Administration (FDA) for use in facial volume
augmentation is diminutive in comparison to filler products
employed worldwide. In the near future, several new
hyaluronic acid filler products will be available to the
United States market. Already approved fillers include
Belotero Balance for fine lines, Juvéderm Voluma XC for
midfacial volume loss replacement, and Restylane Silk
for perioral lines and lip augmentation. Volbella, currently
under FDA evaluation, will be used for fine-line correction
and lip augmentation. The physiochemical properties, best
practices, clinical uses, and side effects of these fillers are
discussed. Additionally, evolving techniques such as the
use of blunt-tipped microcannulas are explained.
Semin Cutan Med Surg 33:157-163 © 2014 Frontline Medical
Communications
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Dec
2014
Vol. 33. No. 4
Home-use devices in aesthetic dermatology
The world of aesthetic medicine is increasingly a consumer-
driven market with a wide variety of home-use
devices from which the consumer can choose for treating
hair removal, hair loss, acne, facial rejuvenation, and
other dermatologic conditions. Where these devices fit
in the physician practice and consumer routine can be
confusing, as scientific studies may be weak or lacking.
The specifications, price, ease-of-use, maintenance, and
technology can differ greatly between devices. Thus, the
physician and consumer need to define expectations and
goals before deciding upon an apparatus.
Semin Cutan Med Surg 33:198-204 © 2014 Frontline Medical
Communications
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Dec
2014
Vol. 33. No. 4
Men’s aesthetic dermatology
Cosmetic dermatology is continuing to see a dramatic
increase in both procedures performed and technological
advancements. Men’s aesthetic dermatology is burgeoning
with more men seeking cosmetic consultations and
intervention. Whether it is targeted cosmeceuticals for
men or male-specific procedures, dermatologists must
be aware of this evolving demographic and understand
the biological, anatomical, and psychological aspects
that separate this cohort from their female counterparts.
Cosmetic dermatology has moved beyond just applying
the same techniques used for females onto males. The
use of our cosmetic toolbox can differ for men in terms of
technique and dosage. This article will review the state of
men’s aesthetic dermatology with an emphasis on the
nuances that separate the sexes.
Semin Cutan Med Surg 33:188-197 © 2014 Frontline Medical
Communications
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Dec
2014
Vol. 33. No. 4
Picosecond lasers: the next generation of short-pulsed lasers
Selective photothermolysis, first discussed in the context of
targeted microsurgery in 1983, proposed that the optimal
parameters for specific thermal damage rely critically on
the duration over which energy is delivered to the tissue.
At that time, nonspecific thermal damage had been an
intrinsic limitation of all commercially available lasers,
despite efforts to mitigate this by a variety of compensatory
cooling mechanisms. Fifteen years later, experimental
picosecond lasers were first reported in the dermatological
literature to demonstrate greater efficacy over their
nanosecond predecessors in the context of targeted
destruction of tattoo ink. Within the last 4 years, more than
a decade after those experiments, the first commercially
available cutaneous picosecond laser unit became
available (Cynosure, Westford, Massachusetts), and
several pilot studies have demonstrated its utility in tattoo
removal. An experimental picosecond infrared laser has
also recently demonstrated a nonthermal tissue ablative
capability in soft tissue, bone, and dentin. In this article, we
review the published data pertaining to dermatology on
picosecond lasers from their initial reports to the present
as well as discuss forthcoming technology.
Semin Cutan Med Surg 33:164-168 © 2014 Frontline Medical
Communications
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