Over the past 5 years, there has been a paradigm shift in the treatment of fat. The clear trend is toward noninvasive fat removal technologies over more traditional forms of fat removal such as liposuction. While these devices do not yet approach the results seen with liposuction, noninvasive treatments are gaining popularity due to their ability to safely and effectively reduce fat with little downtime and typically no need for anesthesia. The optimal candidate is relatively fit with localized areas of adiposity, rather than an obese patient. It is important to note that there are numerous noninvasive fat devices including low-level light, radiofrequency, laser, cryolipolysis, and ultrasound. Some of these technologies have more robust data to support their efficacy than others. This review will focus on only 2 noninvasive fat technologies: cryolipolysis and ultrasound.
Semin Cutan Med Surg 34:129-133 © 2015 Frontline Medical Communications

Rosacea is a chronic inflammatory skin condition characterized by cutaneous hypersensitivity. There are many therapeutic options available for the treatment of rosacea, but none are curative. Since the pathogenesis of rosacea remains elusive, it is not surprising that no single treatment is paramount and that many patients find therapies unsatisfactory or even exacerbating. Treatments are prescribed to work in concert with each other in order to ameliorate the common clinical manifestations, which include: papules and pustules, telangiectasias, erythema, gland hypertrophy, and ocular disease. The most validated topical therapies include metronidazole, azelaic acid, and sodium sulfacetamide-sulfur. Many other topical therapies, such as calcineurin inhibitors, benzoyl peroxide, clindamycin, retinoids, topical corticosteroids, and permethrin have demonstrated varying degrees of success. Due to the inconsistent results of the aforementioned therapies patients are increasingly turning to alternative products containing natural ingredients or botanicals to ease inflammation and remit disease. Additional research is needed to elucidate the benefits of these ingredients in the management of rosacea, but some important considerations regarding the natural ingredients with clinical data will be discussed here. Semin Cutan Med Surg 30:148-155 © 2011 Elsevier Inc. All rights reserved.

Mesotherapy is an intradermal or subcutaneous injection of therapeutic agents to induce local effects, and was pioneered in Europe during the 1950s. For the past 2 decades, there has been significant interest in the use of mesotherapy for minimally invasive local fat contouring. Based on the theorized lipolytic effects of the agent phosphatidylcholine, initial attempts involved its injection into subcutaneous tissue. With further studies, however, it became apparent that the activity attributed to phosphatidylcholine mesotherapy was due to the adipolytic effects of deoxycholate, a detergent used to solubilize phosphatidylcholine. Since then, clinical trials have surfaced that demonstrate the efficacy of a proprietary formulation of deoxycholate for local fat contouring. Current trials on mesotherapy with salmeterol, a b-adrenergic agonist and lipolysis stimulator, are underway—with promising preliminary results as well.
Semin Cutan Med Surg 34:134-137 © 2015 Frontline Medical Communications

The use of laser resurfacing for cutaneous rejuvenation has become an important tool in the modern dermatologist’s armamentarium. To ensure a successful outcome, proper preoperative and postoperative skin care is essential. Incorporating cosmeceuticals into the perioperative skin care regimen can promote a better overall patient experience by hastening postoperative healing, reducing common side effects, and enhancing overall rejuvenation. This article aims to explore the use of various cosmeceuticals in conjunction with laser resurfacing procedures. In particular, the overall mechanisms of action behind each selected therapy will be discussed, followed by a brief discussion of the existing literature on each agent’s use with laser resurfacing. Theoretical considerations and a limited body of evidence suggest a potential benefit for the use of these agents in conjunction with laser resurfacing procedures; however, further placebo-controlled studies are needed to truly confirm these benefits. Semin Cutan Med Surg 30:156-162 © 2011 Elsevier Inc. All rights reserved.