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American Academy of Cosmetic Surgery Opposes Botax
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November 20, 2009
The American Academy of Cosmetic Surgery released an opposition statement earlier this week to a 5 percent cosmetic surgery tax included in the U.S. Senate's health reform bill.
"Activating a cosmetic surgery tax is not the solution to funding a health care overhaul," states AACS Immediate Past President Steven Hopping, MD. "While it appears that this is currently a serious consideration, this idea concerns us."
The AACS argues that taxing elective cosmetic procedures is an unreliable revenue source. Furthermore, there's often a blurry distinction between elective versus medically necessary cosmetic surgery, and the tax unfairly targets working women and aging adults.
Similar taxes have been proposed and rejected in states in recent years. New Jersey is the only state to approve a cosmetic surgery tax, although little tax revenues have been generated, according to AACS.
For more information, visit the AACS website: www.cosmeticsurgery.org.
Related: The Botax is Back
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Quitting Smoking: Start your Plan Today
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Nov. 19, 2009
Been trying to kick the habit today for years?
Today marks the Great American Smokeout. Thus, the American Cancer Society urges smokers to use today's date to make a plan to quit. Quitting reduces cancer risk.
Smokers who quit at age 35 gain an average of eight years of life expectancy; those who quit at age 55 gain about five years; and even long term smokers who quit at 65 gain three years, according to research.
Smokers who want to quit can call the American Cancer Society Quit For Life® Program operated and managed by Free & Clear® at 1-800-227-2345 for tobacco cessation and coaching services that can help increase their chances of quitting for good.
"We know that quitting smoking is tough and that most smokers have to try several times before quitting for good," said Alan G. Thorson, MD, FACS, national volunteer president for the American Cancer Society. "The American Cancer Society offers a variety of effective resources ranging from online tips and tools to personalized telephone coaching by trained specialists. We hope that smokers will use the Great American Smokeout to map out a course of action that will help them to quit, and in turn to stay well and celebrate more birthdays."
The Great American Smokeout Web site contains user-friendly tips and tools towards a smoke-free life. In addition to tip sheets and calculators, the site also offers downloadable desktop helpers to assist with planning to quit and succeeding in staying tobacco-free. The Quit Clock allows users to pick a quit day within 30 days, then counts down the selected day with tips for each day; and the Craving Stopper helps smokers beat cravings by offering a fun distraction.
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November 19, 2009
Today the controversial cosmetic surgery tax, once thought to be more of a joke than a serious proposal, actually made it into the healthcare reform bill the Senate introduced last night.
The proposed Senate bill includes healthcare coverage for 31 million currently uninsured people, expands some Medicare benefits, restricts insurance companies from denying coverage due to pre-existing conditions and reduces the federal deficit by $130 billion, reports the New York Times.
To help offset the costs some new taxes and fees are proposed, including the so-called Botax, a tax on elective cosmetic procedures.
The Times describes it this way:
Desperately seeking money to pay for the legislation, Mr. Reid came up with a new source of financing: a 5 percent tax on elective cosmetic medical procedures. The tax would be paid by patients, but collected by doctors and clinics and forwarded to the government.
The tax would be calculated as 5 percent of the amount paid for an elective cosmetic procedure, whether by the patient, insurance or other sources. The tax would not apply to cosmetic surgery for people with congenital abnormalities, disfiguring diseases or traumatic injuries.
Some critic have argued that this tax unfairly penalizes middle class women.The Senate may vote on the bill this week.
What do you think? Leave a comment.
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New Book Promotes Wine for Better Health
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November 18, 2009
In his new book, Age Gets Better with Wine: New Science for a Healthier, Better and Longer Life (2nd edition), Seattle-area plastic surgeon (and Healthy Aging editorial advisor) Richard Baxter, MD, shares his insights on the health benefits of red wine and resveratrol.
As has been widely reported, red wine contains the chemical resveratrol, which has been linked to a long list of possible health benefits. Some of the resveratrol claims are more credible than others, so Dr. Baxter poured through more than 2,500 scientific studies to find the most convincing, reliable data.
Among some of the benefits of moderate daily wine consumption are:
- Preserves bone density
- Guards against Alzheimer's, breast cancer and heart disease
- Helps neutralize free radical oxidants and saturated fats in red meat
- Releases feel-good endorphins
- Helps burn fat
This updated edition examines fresh research into the effects polyphenols have on the human body and discusses how this family of chemicals may be harnessed medically.
"A glass of red wine a day with a meal is the suggested dose. In fact, epidemiologic studies have demonstrated that people who drink wine in moderation (one 5-oz. glass per day for women, two for men) live an average of five years longer than nondrinkers, and are healthier by several measures. However we don't know yet whether taking a resveratrol supplement will have the same effect, and what works in mice may not work for humans. We don't even know if resveratrol is the most important polyphenol in wine. So for now, continue your "vice" and enjoy a glass of wine," says Baxter.
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Study Compares 940 nm and 532 nm Diode Laser for Facial Telangiectasias
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Nov. 17, 2009
The 532-nm and 940-nm diode lasers are effective treatments for facial telangiectasias. In a study published recently in Lasers in Surgery and Medicine, researchers sought to determine which wavelength is superior.
In a randomized, blinded split-faced trial, researchers treated 24 facial sites with the 532-nm/940-nm dual wavelength vascular diode laser (VariLite, Iridex Corp., Mountain View, CA). They assessed the severity of side effects such as erythema, crusting, swelling and blistering on a five-point scale (0 = not present, 5 = severe.) Researchers also rated the severity of telangiectasias on a 10-point scale two months prior to treatment and after a series of two treatments (1 = focal telangiectasias, 10 = diffuse telangiectasias.)
They noted significantly less pain and erythema with the 940 nm compared with the 532 nm. They also noted a 63 percent improvement with the 940 nm versus 47.8 percent with the 532 nm. On photographic evaluation, 940 nm was significantly more efficacious for larger caliber vessels than 532 nm. Both wavelengths were equally efficacious for smaller caliber vessels.
The authors concluded that while both 532- and 940-nm diode laser produced significant improvement in facial telangiectasias, greater efficacy was found with 940 nm as well as a significantly more tolerable side effect profile. (Click here to learn more about the VariLite laser system.)
Click here to read the abstract.
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Study Analyzes Reminder Texts for Sunscreen
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November 17, 2009
If you've been trying to get your patients to wear sunscreen more and it just doesn't seem to be working, you may want to try a different strategy.
Daily text-message reminders appear to increase sunscreen use over a six-week period, according to a report in the November issue of Archives of Dermatology, one of the JAMA/Archives journals.
April W. Armstrong, M.D., of the University of California-Davis Health System, Sacramento, and colleagues assessed effectiveness of receiving daily text-message reminders to wear sunscreen.
Seventy individuals (age 18 and older) participated in the study and were asked to apply sunscreen daily. Half were randomly assigned to receive text-message reminders, while the other half did not receive any reminders. The text-messages consisted of two components: a text detailing daily local weather information and a text reminding users to apply sunscreen. Adherence was assessed through electronic adherence monitors adapted to participants' sunscreen tubes that would send electronic messages to a central station every time the cap of a tube was removed.
"At the end of the 42-day (six-week) study period, the control group had a mean [average] adherence of 12.6 days of sunscreen application, which corresponded to a 30-percent daily adherence rate. In comparison, the group that received daily reminder messages had a mean adherence of 23.6 days and a daily adherence rate of 56.1 percent," the authors write.
Twenty-four (69 percent) participants in the reminder group reported that they would continue to use the text-message reminders after the study and 31 (89 percent) said they would recommend the reminder system to others. There were no significant demographic factors that predicted adherence, a release stated.
The study was published in Arch Dermatol. 2009;145[11]:1230-1236.
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Long Life IS in Your Genes
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November 16, 2009
If you ever wondered why some families seemed to have more than their fair share of long-lived people, well, now scientists may have an answer.
A new report in the Proceedings of the National Academy of Sciences reveals that there's actually an inherited gene responsible for keeping some people going for a very long time. In particular, scientists at the Albert Einstein College of Medicine studied older individuals of the Ashkenazi Jewish community, plus their children and found that they shared high levels of the enzyme telomerase, which protects the DNA.
Telomerase repairs telomeres-short sections of DNA that become damaged as cells divide. The researches noted that centenarians and their offspring possessed higher levels of telomerase than those in a control group who tended to live a normal lifespan. A BBC News article on the research also noted that the enzyme is inheritable, which explains why some families may seem to live a long time.
The long-lived individuals shared other traits in addition to the lucky enzyme-high levels of good cholesterol (HDL) and lower average body mass index.
One of the paper's authors, Yousin Suh, associate professor of medicine and genetics at Einstein, speculated on the possibility of a therapeutic use for the discovery. "It may be possible to develop drugs that mimic the telomerase that our centenarians have been blessed with," he said
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Atrium Innovations Boosts its Scientific Backing
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November 13, 2009
Supplements offer varying degrees of quality. Thus, health care professionals may have trouble recommending a brand or knowing which is best.
These individuals often seek out assurances-one of which is the backing of The Council for Responsible Nutrition (CRN), the leading trade association committed to advocate for public policy based on sound science and consumer access to safe, beneficial, and high quality dietary supplement products.
Atrium Innovations Inc., a Quebec City based developer, manufacturer, and marketer of science-based and professionally supported products for the health and nutrition industry, has been named among the newest voting members of CRN.
"With its focus on development of science-based products and innovation, we are pleased to welcome Atrium to CRN," commented
Steve Mister
, CRN President and CEO. "The Atrium brands are extremely well regarded by health care professionals and in the aisles of health food stores. We trust that having Atrium as a member of CRN will further our mission to enhance consumer confidence in the dietary supplement industry."
In addition to complying with federal and state regulations governing dietary supplements in the areas of manufacturing, marketing, quality control, and safety, CRN members adhere to additional voluntary guidelines, as well as CRN's Code of Ethics. Atrium brands include Wobenzym, Garden of Life, Douglas Laboratories, Pure Encapsulation, Orthica, Nutri-Health Supplements, AOV and Alcrea Health.
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New Groove for Palomar Laser Skin Resurfacing
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November 13, 2009
Aesthetic laser device manufacturer Palomar has come out with a new fractional handpiece for its Lux2940 system. The handpiece, dubbed the Groove Optic is different from other fractional skin resurfacing devices in that it delivers a groove pattern on skin rather than delivering vertical column damage to tissue.
Palomar states that the groove fractional ablative approach allows for deep resurfacing, increased tissue coverage and rapid recovery that "disrupts the structural memory of wrinkles."
"Single treatments with the Groove Optic resulted in consistent and substantial reductions in wrinkles and dyschromia with excellent overall enhancement in the appearance of skin without corresponding increased side effects and downtime. This strategy improves the ratio of clinical benefits to side effects and downtime, representing a major advance in skin resurfacing treatment," said E. Victor Ross, MD.
In a recent clinical study at Scripps Clinic, patients treated with the Groove Optic for facial skin resurfacing reported minimal downtime (an average of four days), along with rapid resolution of side effects. Patient feedback from the study indicated that skin "felt tighter," "looked smoother," "wrinkles were reduced" and "skin had a more natural color and even skin tone."
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Regrow Your Own Breasts with Stem Cells
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November 12, 2009
Mastectomy patients may some day have a novel option when it comes to breast reconstruction thanks to stem cell research-regrow their breasts. According to an article in London's Times Online, scientists in Australia are investigating a new procedure that uses stem cells to grow fat tissue in a woman's breasts. The researchers suggest the new technique could replace traditional breast reconstruction within a few years.
The procedure, called Neopac, is being developed by scientists at the Bernard O'Brien Institute of Microsurgery in Melbourne. It involves surgically placing a breast-shaped chamber in the chest, connected to blood vessels under the patients arm. A 5ml does of the patient's own fat cells are then implanted into the chamber where they multiply with the assistance of stem cells of the fat tissue.
So far, the technique has only been tried on pigs. In pigs, the process took about six weeks to grow new breasts. It's likely to take longer in humans. Human trials involving six women will begin in the next few months. After that, a phase two trial would begin that uses a biodegradable breast chamber rather than the synthetic one that is currently developed.
"We hope it will have a significant impact around the world. There are a lot of women who don't have reconstructive surgery for whatever reason, or have silicone breast implants, but this will give them their own tissue back," said Dr Philip Marzella, Benard O'Brien's chief operating officer.
The procedure could possibly be available to patients by 2014.
This isn't the first instance of using stem cells for breast augmentation. In October we reported on an Arizona physician who uses a fat harvesting process combined with stem cell activation for cosmetic breast enhancement.
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Care-Tech Laboratories Introduces Spa Products
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Nov. 12, 2009
Care-Tech Laboratories, the makers of antiseptic cleansers for hospitals and medical facilities, has entered the aesthetics market with the launch of a spa product line.
The Trois product line includes:
- Loving Lather protein collagen enriched body wash designed to gently clean aging skin.
- Urban Skin moisturizer, formulated with lanolin to smooth dry and chapped skin on the legs, ankles heels and feet.
- Soft Skin After Bath Care formulated with apricot kernel oil to soften skin during harsh winter weather.
Care-Tech products are free of linear alcohols, which accelerate dryness and aging. They also don't contain sodium chloride (NACL) or other fillers that may negatively affect the dermis.
For more information, visit www.caretechlabs.com.
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DermaQuest Launches Peptide Cosmetic Line
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Nov. 12, 2009
DermaQuest of Hayward, Calif., has launched a mineral makeup line formulated with peptides to minimize the appearance of fine lines and wrinkles.
Dermaxyl peptide stimulates cell communication and repairs the cutaneous barrier to smooth wrinkles. This ingredient is viewed as an alternative to retinol and retinoic acid.
Other skin-rejuvenating ingredients include trace elements, honeysuckle extract, green tea and chamomile. An extension of DermaQuest's skincare line, the DermaMinerals line is free of talcs, synthetic dyes, artificial fragrance and parabens.
The DermaMinerals line consists of nine products, including concealer, finishing powder, foundation, eye shadow, lip treatment and bronzer.
For more information, visit www.dermaquestinc.com.
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Surgery Opens Smoking Cessation Opportunity
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November 9, 2009
With the American Cancer Society's Great American Smokeout Challenge just a week away, the American Society of Anesthesiologists (ASA) is giving smokers yet another reason to quit. Smoking has a direct negative impact on postoperative outcomes. Quitting smoking is one of the best things people can do to improve their chances of recovering from surgery without complications.
So if your patient is undergoing cosmetic surgery, think twice about using the opportunity to get them to quit-for good, not just weeks before surgery.
In addition to the well-established health risks associated with smoking, the ASA has additional compelling reasons for people who may be undergoing surgery to quit smoking:
- Patients who quit smoking heal better. Continuing to smoke after surgery greatly heightens a person's chances for complications, such as infections in the surgical incision. In one study, more than half of patients who continued smoking after surgery developed complications compared to less than 20 percent who quit. Plus, fewer complications means less time in the hospital for patients that have kicked the habit.
- Hospitals are smoke free. Once a patient is admitted to the hospital for a procedure, it becomes challenging to leave for a cigarette. Smokers can take advantage of that barrier and use it as the first step on their way to a smoke-free lifestyle. Plus, hospitals are filled with resources, including counselors and medications, which are readily available to help.
- The body begins to heal within hours of quitting. 'There's no point in quitting now because the damage is already done' is not a good excuse. Twelve hours after a person has given up the habit, his or her heart and lungs already begin to function better, as the nicotine and carbon monoxide levels start dropping. It takes less than a day for blood flow to improve, which reduces the likelihood for post-operative complications. The ASA recommends that patients abstain from smoking for as long as possible before and after surgery, but even quitting for a brief period is still beneficial.
- Help is always available. Whether someone is preparing for surgery or just thinking about quitting, free help is always available. By calling 1-800-QuitNow, smokers connect with trained specialists that provide advice and a customized plan to help them quit. Smokers who attempt to quit without treatment typically relapse within the first eight days and only 4 percent to 7 percent are likely to be successful. But services such as 1-800-QuitNow can double their chances of success.
On top of these reasons, it's always important to remind people that quitting adds years to one's life. On average, smokers die 13 to 14 years earlier than non-smokers.
Please visit www.LifelinetoModernMedicine.com for more information on smoking cessation.
Source: Newswise
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Lutronic MOSAIC Fractional CO2 Laser Under $50,000
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November 9, 2009
Lutronic announced the release of a new fractional CO2 aesthetic laser, the MOSAIC, which it's making available for under $50,000.
The new MOSAIC, says a Lutronic press release, provides one of the deepest levels of tissue penetration of any laser device on the market. It incorporates several of the company's proprietary technologies including a system it calls Controlled Chaos Technology (CCT), which is designed to minimize thermal damage and create a "neutral" post-treatment appearance.
"Lutronic recognizes both the economic reality and the fact that physicians don't want to compromise quality for value," says Dr. Jhungwon Hwang, Senior Director of Regulatory Affairs. "The MOSAIC CO2 meets both needs by offering superior technology at a competitive price within the industry."
For more about Lutronic lasers click here.
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Chocolate for Healthier Skin
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November 9, 2009
With Halloween just behind us and more candy-saturated holidays in the coming months, new research coming out the Journal of Cosmetic Dermatology seems almost too good to be true-chocolate is good for your skin, and you don't have to rub it on your body to reap the benefits.
The truth is a little more complex. Three researchers from London set out to evaluate the photoprotective effect of chocolate-they wanted to see if chemicals in chocolate would protect the skin from harmful UV rays. Certain chocolates are very high in flavanols, which are known to contain antioxidant and anti-inflammatory properties. Two groups of 15 individuals each participated in a double-blind study. One group was given a daily 20g portion of chocolate high in flavonols, while the other was given a conventional dark chocolate.
All subjects were exposed to controlled doses of UV light. At the end of the 12 week study, the subjects' minimal erythema dose (MED), the amount of light required to produce inflammation, was measured in order to determine if the chocolate had any impact. The subjects that consumed the high flavanol chocolate showed a mean increase in MED of more than double the conventional chocolate group. Apparently, the chocolate protected the subjects' skin from sun damage.
A 2005 study also showed that the flavanols in chocolate had a positive effect in reducing blood vessel impairment in smokers.
Unfortunately, the subjects who consumed the conventional chocolate showed no improvement in MED. The study noted that in conventional chocolate making the antioxidant capacity is severely reduced.
For more foods that show potential for fighting cancer click here.
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DermaBeam Cancer Treatment Prepares for Market
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November 6, 2009
At the recent Fall Clinical Dermatology Conference in Las Vegas, IntraOp Medical announced the formation of a clnical dermatology advisory board who will help raise awareness of the "clinical effectiveness" of the new DermaBeam electron radiation therapy, the company stated in a press release.
The board is made up of dermatologists and oncologists including Clay Cockerell, MD, and Darrel Rigel, MD past presidents of the American Academy of Dermatology and Roger Ceilley, MD, past president of the American Society of Dermatologic Surgery.
DermaBeam is an office-based electron beam radiation therapy system based on the company's Mobetron mobile linear accelerator. The system is small enough to be used in a dermatologists office so patients can receive treatment without traveling to a radiation oncology center.
In February of this year, Riverchase Dermatology in Ft. Myers, Florida became the first dermatology practice to use the Mobetron to treat skin cancer with electron radiation therapy. The patient outcomes in Ft. Myers were the focus of the validation study that was presented at the Fall Clinical Dermatology Conference in October.
The purpose of the study was to present the initial experience and results of the DermaBeam treatment. "Our experience with the Mobetron and the DermaBeam treatment so far has been encouraging," says Andrew Jaffe, MD, of Riverchase Dermatology, adding, "Our patients have responded positively, appreciating the choice of therapies, as well as the convenience of receiving the treatment inthe comfort of our office setting."
"We see dermatology developing into a significant market for the Mobetron in the United States," said Powers. "By enabling dermatologists to offer radiation therapy in the office setting, we are supporting a multi-disciplinary approach to treating skin cancer, and giving them the best tool to treat their patients."
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La Roche-Posay's DERM AOX Serum Combats Two Causes of Aging
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Nov. 5, 2009
La Roche-Posay introduces a new skin-revitalizing serum that combats two major causes of aging: glycation and oxidation.
The DERM AOX serum protects against cell oxidation and inhibits the glycation process to slow the skin-aging process and smooth wrinkles.
Glycation is comparable to a "caramelization" reaction. Sugar molecules naturally present in the skin adhere to collagen and elastin fibers, hardening them. As the skin ages, these sugar molecules create rigid bridges between fibers, stiffening the skin's internal structure. This creates a brittle, wrinkle-prone complexion.
Oxidation occurs when sun, pollution and stress trigger free radicals in the skin. This leads to an oxidative chain reaction in the skin and damages DNA. The result is loss of radiance and vitality in the skin.
To slow these aging processes, DERM AOX Anti-Glycation + Anti-Oxidation Serum contains these ingredients:
- Carnosine, a molecule stemming from diabetes research, acts like a "magnet" by attracting sugar molecules to itself instead of to collagen fibers, helping to prevent glycation and, thus, maintaining skin's suppleness.
- Pycnogenol, or maritime pine extract, is a potent antioxidant. Its free radical fighting action is 20 times greater than that of vitamin C and 50 times greater than vitamin E, research shows. This helps protect the skin from future sun damage.
- Vitamin C, a powerful anti-oxidant, helps neutralize chain reactions triggered by free radicals. Vitamin C also helps restore skin structure, smooth skin texture and increase radiance.
DERM AOX Anti-Glycation + Anti-Oxidation Serum is available this month in physicians' offices as well as discount retailers such as CVS/Pharmacy and Duane Reade for a suggested retail price of $55. To learn more, visit http://www.laroche-posay.us/.
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Leading Researcher Classifies Possible Egg Sensitivities to H1N1 vaccine
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Nov. 4, 2009
The process of using fertilized chicken eggs to grow a virus associated with influenza was a medical breakthrough in 1931.. Before that discovery, the only treatment for flu was to transfuse blood from a survivor of flu to one with the symptoms. The egg technology opened up vaccines to literally billions of people, said Bobby Q. Lanier, MD, clinical professor of pediatrics at the University of North Texas HSC in Fort Worth, Texas, and executive medical director of the American College of Allergy, Asthma and Immunology (ACAAI)
While the vaccine production now removes virtually every trace of chicken protein, there were historical issues of vaccines causing major allergic reaction because of retained egg protein. Amal Assa'ad, MD, professor at Cincinnati Children's Hospital Medical Center in Cincinnati, Ohio, and vice chair of the ACAAI Adverse Reactions Foods Committee, will be presenting a novel way to classify children (and adults) as to their risks at the ACAAI Annual Meeting in Miami Beach, Fla.
"Some allergic patients are at greater risk of a reaction to the 2009 vaccines, both H1N1 and the usual respiratory viruses in the normal flu shot and mist. This high risk group includes patients with a history of a positive skin test or an elevated blood test to egg, who have had allergic reactions to eating egg, or who had a reaction to flu vaccination in the past," Dr. Assa'ad said.
Dr. Ass'ad has classified possible reactors in five color-coded groups and makes these suggestions:
• Blue Group - Minimal Risk. Patients with a history of skin test or serum IgE positivity or clinical reaction to either egg or previous flu vaccines - who can eat whole eggs safely without allergic reaction - should receive either the inactivated (IM) or live (intranasal) vaccine at their general pediatrician's office. This should comprise the vast majority of patients this year.
• Green Group - Low Risk. Children who have had recent (less than 2 years) skin test or serum IgE positivity to egg, but who do not react to ingestion of baked products containing egg, should receive the inactivated flu vaccine at full-strength (or graded challenge in special cases) at their general pediatrician's office or the allergy clinic. Adrenalin should be available.
• Yellow Group - Moderate Risk. Any patient avoiding eggs entirely for any medical reason should be evaluated by an allergist. Patients who have had recent skin test or serum IgE positivity to egg who do react to baked products containing egg, or who have a history of allergic reaction to inactivated flu vaccine, should also be evaluated by an allergist. In order to provide the vaccine safely to these patients, we recommend skin testing with the full-strength inactivated flu vaccine and egg extract prior to vaccine administration. If the skin tests are negative, we recommend that the rest of the vaccine be given at full-strength or as a graded challenge. If the vaccine skin test is positive, we would either desensitize the patient to the vaccine and administer it or give chemoprophylaxis in special cases with a flu medication daily for the entire flu season.
• Red Group - High Risk. Patients who have a history of an anaphylactic reaction to egg ingestion or flu vaccination should be evaluated by an allergist. Even patients who have then gone on to tolerate the vaccine later in life should be evaluated by an allergist, as there is significant year-to-year and lot-to-lot variability in the egg protein concentration in the flu vaccine. We recommend that these patients be skin tested to egg and full-strength inactivated flu vaccine prior to administration. Patients with negative skin tests to the vaccine would receive a graded flu vaccine challenge, while patients with positive skin test to the vaccine would receive either desensitization or neuraminidase inhibitor prophylaxis for the entire flu season.
• Gray Group - Special Risks. Patients with immunodeficiency or other contraindications to either of the flu vaccines should be evaluated by an allergist or infectious disease specialist, and their close contacts and caregivers should strongly consider inactivated (i.e. not live) influenza vaccination. Most patients in this group may safely receive the inactivated flu vaccine as a single injection, provided they do not have a history of skin test positivity, serum IgE positivity, or clinical reaction to either egg or prior flu vaccines. Should a patient with immunodeficiency have such an issue, we would treat them similarly to whichever Green, Yellow or Red Group they would otherwise be in, with the general caveat that we do not recommend live vaccine use in this patient population or in pregnant women.
Source: Newswise
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TRIA New At-Home Hair Removal Device
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November 3, 2009
FDA-approved home laser hair removal has just become more affordable.
TRIA Beauty has upgraded its previous home hair removal device with new software and a lower price--$595, 25 percent less than the previous version. The new software incorporates revised energy settings intended to improve user comfort and device performance. The device settings can be customized to the particular color and thickness of the user's hair.
"As the leader in the at-home device category, TRIA Beauty is dedicated to offering the most advanced solutions at an affordable price point," said Kevin Appelbaum, CEO of TRIA Beauty. "Our scientists continue their fast pace of product innovation, continually seeking ways to upgrade and enhance the at-home hair removal experience."
The new TRIA LHRS is available starting this week at TRIABeauty.com as well as on QVC, QVC.com, and at Neiman Marcus, Nordstrom, Bergdorf Goodman, STUDIO at Fred Segal, Bliss Spas and select physician offices.
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AAD Releases New Guidelines for Psoriasis Management
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The American Academy of Dermatology has released new guidelines for the management of psoriasis with ultraviolet light therapy, based on an extensive literature review.
The guidelines make dosing recommendations for broadband-UVB, narrowband-uvb, PUVA photochemotherapy and targeted phototherapy.
"Over the years, phototherapy has been shown to effectively clear psoriasis, and it is a cost-effective therapy that generally does not suppress the body's immune response like traditional and biologic systemic therapies," says David M. Pariser, MD, FAAD, president of the Academy, in a press release. "However, because this therapy delivers UV light to the skin (a known carcinogen), patients need to be closely monitored by their dermatologists for the potential risk of skin cancer."
Broadband (BB)-UVB therapy has been used as a psoriasis therapy for 75 years and treats large areas by exposing the affected skin to a specific wavelength of UVB light.
Narrowband (NB)-UVB therapy has shown NB-UVB therapy to be more effective in clearing psoriasis than BB-UVB, according to the guidelines published in Journal of the American Academy of Dermatology.
With PUVA, oral or topical medications are administered to sensitize cells to the effects of UVA light. The reviewers noted PUVA treatment often leads to the clearing of psoriasis typically within 24 treatments with remissions lasting between three and six months. Skin cancer and photoaging are common side effects.
Targeted phototherapy with Excimer lasers selectively treat affected lesions without damaging unaffected skin, thus minimizing the risk of cancer to other parts of the skin. Although numerous studies have demonstrated that treatment with the excimer laser can clear psoriasis, there is limited information on the duration of remission and the recommended dosage and scheduling of therapy, according to the reviewers.
"For the right patients and with close monitoring by a dermatologist, UV light therapy can be a safe and effective treatment for psoriasis patients who might not have responded well to other traditional therapies or for various reasons might not be good candidates for systemic medications," says Dr. Pariser. "Dermatologists can recommend the best treatment plan for patients with mild to severe psoriasis, helping them improve their condition and overall quality of life."
Click here to read more.
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Cynosure Improves Smartlipo Laser Lipolysis
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October 22, 2009
This week at the American Society of Plastic Surgeons' meeting in Seattle, laser lipolysis manufacturer Cynosure will debut the new Smartlipo Triplex. What makes the Triplex unique is the incorporation of three laser wavelengths which combine fat absorption, tissue tightening and tissue coagulation.
The newest of the wavelengths is 1440 nm and employs what Cynosure calls MultiPlex technology, a system that combines the benefits of multipe wavelengths into one laser output. MultiPlex enables two wavelengths to be fired sequentially, creating a blended thermal and photomechanical effect to liquefy fat and tighten skin.
"With 20 times greater absorption in fatty tissue than any other single wavelength on the market, the 1440 nm wavelength puts Smartlipo in a new class," said Barry DiBernardo, M.D., Medical Director of New Jersey Plastic Surgery & MedNet Technologies, Inc. in Montclair, NJ. "Combining the photomechanical effects of the 1440 nm with the 1064 nm wavelength results in even greater disruption of fatty tissue for faster and deeper treatments than the 1064 wavelength alone."
"We believe that Smartlipo Triplex enables medical professionals to deliver the most accurate combination therapy available today by providing a superior mix of energy levels and wavelengths. Whether treating a small well-defined area or removing larger amounts of fatty tissue, Smartlipo Triplex offers doctors the ability to customize the treatment to achieve maximum results," said Cynosure President and Chief Executive Officer Michael Davin.
The system includes a new proprietary energy delivery systems, SmartSense with ThermaGuide, which detects the temperature under the skin to control energy output.
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Weight Loss Reduces Osteoarthritis Risk
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October, 19 2009
Physicians routinely recommend losing weight as a way to increase overall health, but new research from the University of North Carolina at Chapel Hill School of Medicine adds more even more incentive. The research suggests that even a moderate 5 percent weight loss could reduce a person's risk for developing osteoarthritis in the knees.
The research, presented this week at American College of Rheumatology scientific meeting by third-year medical student Lauren Abbate included 1,480 men and women 45 years old and older who were disease-free in at least one knee. The subjects were followed for approximately six years to see who developed radiographic osteoarthritis. The subjects were divided based on weight change, both positive and negative.
"OA is painful and debilitating. Effective treatments are limited and there's not a cure. But if we can get people to lose weight we may reduce their risk and reduce the pain and disability associated with this condition," Abbate says. Abbate noted that she had hoped that simply maintaining one's weight would be enough, but the results showed no significant benefit for weight maintenance. Weight loss, even as little as 5 percent, on the other hand, did reduce a person's risk.
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Johnson and Johnson Backs Out of OTC Aesthetic Laser but Palomar Continues
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October 16, 2009
Palomar Medical Technologies today announced that a prior agreement to market an over-the-counter home aesthetic laser device with Johnson and Johnson has been terminated. However, Palomar, which developed the technology, will continue with the product and expects to launch it commercially in the second half of 2010.
According to a Palomar news release, Johnson & Johnson made the decision to dissolve the agreement "despite Palomar having met all of its deliverables under the agreement." The most likely reason for the termination is the economy, as Palomar notes that Johnson & Johnson has now avoided making "a large commercialization payment . and avoids having to commit to the significant level of funding required to successfully launch a new product into the mass market.
Palomar now plans to commercialize the home laser device on its own.
Commenting on this development, Palomar Chief Executive Officer Joseph P. Caruso said, "We have developed game changing technology in the consumer area. Over the past few years we have developed advanced patented technology that allows us to penetrate the home market. Wrinkle treatments using OTC products are a multi-billion dollar market opportunity and we plan on entering that market with our products during the second half of next year. The current economic climate does not warrant a large scale investment in a mass market launch at this time. Therefore, we have adjusted our launch plans to be more in line with current economic conditions. In the short-term, our goal is to establish our consumer products in the market using certain specialty channels and gather the valuable information needed to fully execute our long-term strategy of a full mass market launch. Our long-term goal remains the same; to tap into the mass market using our patented technology in a number of key areas with multiple product offerings and multiple channels worldwide".
Caruso noted in a statement that light-based anti-aging therapy "will one day be an ordinary and necessary part of maintaining a healthy appearance done in the privacy and convenience of the home." Palomar in June received a 510(k) clearance from the FDA for the home laser product designed to treat wrinkles around the eyes.
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Solta Fraxel re:store Dual Gets FDA Pass
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October 15, 2009
Solta, manufacturer of medical aesthetic products including the Fraxel laser line and Thermage radio frequency line, has received 510(k) FDA clearance for its latest laser innovation, the Fraxel re:store Dual.
What makes this Fraxel different from previous iterations is the addition of the 1927nm wavelength Thulium laser. Solta states that the Thulium laser is optimized for large body areas, rather than just the face, where most aesthetic lasers are applied. The Thulium laser is non ablative and includes focal cooling built into the hand piece.
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Aesthetic Plastic Surgery Comes to iPhone
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October 14, 2009
Aesthetic plastic surgery physicians and patients may have felt left out when hearing Apple's "There's an app for that," campaign, but no longer. A Manhattan-based physician has developed an iPhone app that lets patients learn about popular procedures as well as send the doctor an email for an appointment.
The interactive program from David Shafer, MD, owner of Shafer Plastic Surgery, taps into his informational database of over 1,000 FAQ's covering invasive and non-invasive plastic surgery procedures and treatments. For example: "Is liposuction better than tummy tuck?" Answer: "It all depends on your body. If you have good skin elasticity, but a moderate amount of fat, then liposuction may be best. If you have loose skin and poor abdominal tone, then abdominoplasty (tummy tuck) may be your best option. . ."
The iTunes download, simply called Shafer Plastic Surgery, is available in a Lite version for free and includes a sampling of the questions. The full version costs $2.99, and in addition to the full compliment of topic questions, allows users to send the doctor a question which will then be added to the FAQ database. This way the database will be continually updated.
No stranger to technology, Shafer also offers online video chats via Skype or iChat for his out-of-town clients. A Palm Pre version of the app is also in the works.
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Study: Psoriasis Increases Stroke Risk
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Oct. 13, 2009
Psoriasis is typically viewed as a skin disorder. But emerging research suggests psoriasis puts people at greater risk for vascular diseases such as atherosclerosis and thrombosis.
Now, a population study published in October's Journal of Investigative Dermatology demonstrates psoriasis also raises patients' risk of stroke.
Psoriasis is a chronic Th-1 and Th-17 inflammatory disease. Researchers from the University of Pennsylvania conducted a population-based cohort study of psoriasis patients in the United Kingdom between 1987 to 2002. They compared these patients with a control group composed of people with no history of psoriasis.
After controlling for major risk factors for stroke, the researchers found psoriasis was indeed an independent risk factor for stroke. This risk increased for more severe psoriasis cases. They determined excess risk of stroke in patients with mild and severe psoriasis was 1 in 4,115 per year and 1 in 530 per year, respectively.
To read the abstract, click here.
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Rheumatoid Arthritis Pain Contributes to Divorce
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October 12, 2009
According a survey of American women by pharmaceutical company UCB, rheumatoid arthritis (RA) can have significant emotional and relationship repercussions for women, including divorce and trouble with intimacy. The survey found that nearly 60 percent of women with rheumatoid arthritis felt less confident in their sex life, and over a third reported that intimacy was painful. The study also noted that among divorced women with the disease, 25 percent identified RA as a contributing factor.
"My patients feel that their discomfort is not well-understood by family members and close associates which affects their social relationships significantly," said Roy Fleischmann, M.D., Clinical Professor of Medicine at The University of Texas Southwestern Medical Center in Dallas. "Many prefer to hide their degree of discomfort from others because they feel it is too difficult to try to explain pain and decreased ability and function to those who do not have these limitations."
The survey was conducted in August 2009 as part of a global initiative assessing the lifestyles of women with RA in seven major industrialized countries. In the US survey, about 300 women aged between 25-65 years with RA for more than six months participated.
Rheumatoid arthritis is an inflammatory disease that causes joint pain and swelling, commonly in the hands, wrists and knees. It is three times more common in women than in men and affects about 1 percent of the US population.
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New Anti-wrinkle Therapy Scrutinized By FDA
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October 12, 2009
A new treatment for filling in the wrinkles on an aging face has been reviewed by the FDA's Gene Therapies Advisory Committee. The therapy, called azfibrocel-T (Laviv), takes a patient's own fibroblast cells in order to grow more cells in a laboratory environment. The cells are then injected back into the patient where they stimulate the growth of new collagen.
Fibrocell Science (formerly known as Isolagen), the company that developed the process, reported in a press release that the FDA committee voted 11 to 3 that the submitted data show efficacy, and 6 to 8 that the data demonstrated safety. The company is currently seeking approval for use in wrinkles of the nasolabial fold. "We will continue to work closely with the FDA following the discussions and recommendations from today's Advisory Committee meeting," said Declan Daly, Fibrocell Science, interim chief executive officer.
Although it is not binding, the Committee's recommendation will be considered by the FDA as the agency completes its review of the BLA for azfibrocel-T, which was originally filed in March 2009. The FDA is expected to make a decision whether to approve Fibrocell's biologics license application for azfibrocel-T by January 4, 2010.
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Stem Cells for Breast Augmentation
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October 9, 2009
Stem cells hold great potential for modern medicine, and the recent regulation change over stem cell policy has a lot of researchers looking closely at the field. A Scottsdale, AZ, physician has pioneered a novel use for stem cells-breast augmentation. Todd A. Malan, MD, of the Innovative Cosmetic Surgery Center, calls the procedure Natural Breast Augmentation, which takes fat from a women's buttocks, thighs or abdomen and transfers it to her breasts. The patient's own activated adult stem cells are then used to enable the fat to grow its own blood supply.
Malan extracts the fat with an Eclipse Body-Jet fat harvesting device (water-jet assisted liposuction), says a press release. Cell-enhanced reconstruction uses adipose fat that is a rich source of stem and regenerative cells. These stem cells are not the controversial embryonic stem cells. Next, the procedure uses a special process to ensure that the transplanted cells will live and adapt to the transplantation site (breasts). The process was developed by Cytori, and uses a machine called Celution System.
After fat removal, the cells are transferred to the Cytori Celution System which is used to separate regenerative and stem cells from fat cells. The regenerative and stem cells are then washed, concentrated, and enzyme activated. The activated stem cell mixture is then combined with the fat cells and then injected into fat that is already present in the breast where it fills in and replaces tissue volume.
The injection of the fat along with the stem cells results in a permanent 250cc to 500cc overall breast size increase, allowing for a 1 or 2 bra cup size increase. A pressure splint is then used after the procedure to ensure that the fat remains in place and assists in promoting regeneration of the transferred fat and stem cells.
The release notes that because this procedure uses fatty tissue, there is no reactive inflammation, rejection or autoimmune disease complication and will not interfere with mammograms.
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Home Pulsed Light Hair Removal Now at Saks
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October 8, 2009
Home Skinovations has announced that its new pulsed light-based home hair remover, the Silk'n SensEpil, will soon be available at 13 Saks Fifth Avenue stores.
The Silk'n SensEpil is an FDA-cleared home pulsed light technology, designed to aid the removal of unwanted hair below the neck without seeing a professional laser hair removal expert. It retails $499.00. It delivers short burst of light to the skin, which is absorbed by the hair shaft pigment and converted to heat, disabling the growth of hair. The company notes that the product works best on dark hair, and should not be used on dark skin as it may cause blistering or skin color changes.
The product will be available at stores in popular markets including Beachwood, Ohio; Tyson's Galleria, Virginia; Atlanta, Georgia; Birmingham, Alabama; Palm Beach Gardens, Florida; Short Hills, New Jersey; Houston, Texas; New Orleans, Louisiana; Phoenix, Arizona; Beverly Hills, California; San Antonio, Texas and South Coast Plaza, California
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Tai Chi Aids Diabetes Patients
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October 6, 2009
One of the key activities diabetes patients can do for themselves is exercise. A new study from the University of Florida, suggests that incorporating tai chi into their exercise will allow patients to lower their glucose levels.
The study looked at adults with type 2 diabetes. Participants engaged in a supervised tai chi program twice a week plus three days of home practice for six months. The study, published in the Journal of Alternative and Complementary Medicine, found the patients significantly lowered their fasting blood glucose levels, improved disease management and enhanced mental health, vitality and energy.
The study involved 62 people, mostly Korean women-half of them participated while the other half served as a control group. Those who completed the tai chi exercises showed improved gluecose control and improved energy. "Those who participated in the tai chi sessions actually had lower blood glucose at three and six months," said Beverly Roberts, PhD, RN, of the UF College of Nursing. "Those individuals also had lower hemoglobin A1c, which means they had better diabetic control."
"People assume that for exercise to be beneficial you have to be huffing and puffing, sweating and red-faced afterward," Roberts said. "This may turn people off, particularly older adults. However, we have found that activities like tai chi can be just as beneficial in improving health."
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Lumenis Introduces AcuPulse Fractional CO2 Laser
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Oct. 2, 2009
Medical aesthetic device manufacturer Lumenis yesterday unveiled its latest laser device for the skin, the AcuPulse Fractional CO2 Laser System. The news was announced at the American Society of Dermatologic Surgery's annual meeting in Phoenix this week. The AcuPulse combines the effectiveness of an ablative laser with the reduced downtime of a fractional system. In addition, the AcuPulse includes Lumenis's SuperPulse and Continuous Wave technologies.
Lumenis states that the AcuPulse creates less less thermal damage per treatment spot than other continuous wave lasers. The scanning technology for the deep fractional application is a direct regeneration of Lumenis' UltraPulse DeepFXscanner, and provides the same spot size and variability in the size, shape, and density of the patterns. The AcuPulse also includes a state-of-the-art touchscreen user interface and safety control systems.
"The AcuPulse now gives physicians an affordable and efficient solution to their Pulsed Fractional Skin Resurfacing needs," said Mr. Robert Mann, General Manager of Lumenis Global Aesthetics and Dermatology. "It has been well established that pulsed CO2 lasers are superior in the treatment of wrinkles, skin dyschromias, certain types of scars, and the Lumenis' AcuPulse brings its SuperPulse technology with the unmatched fractional scanning excellence of the Lumenis portfolio to give physicians an excellent solution for their practice," added Mr. Mann.
"With ablative fractional laser treatments patients are offered significant wrinkle resolution with minimal downtime lasting only 4-7 days," said Dr. E. Victor Ross, Director of the Laser and Cosmetic Dermatology Center of Scripps Health in San Diego, California.
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Eclipse Acquires Dutch Aesthetic Laser Manufacturer Enlyten Medical Technologies
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September 30, 2009
Eclipsemed, manufacturer of the Body-Jet liposuction device, is forming a new "manufacturing and international sales entity," Eclipse Global, for the purpose of acquiring the controlling assets of Enlighten Medical Technologies, an Amsterdam-based manufacturer of intense pulsed light and laser technologies.
Tom O'Brien, CEO of Eclipsemed will also assume the role of Chief Executive Officer for Eclipse Global. Both companies will be headquartered in Dallas, Texas. Joining Eclipse Global as Chairman of the Board is Raz Avner, former CEO of Lumenis from 2003-2007. Ron Zakai, founder of Enlyten Medical Technologies, will join Eclipse Global as a consultant for the company.
"Eclipse, as a result of the Enlyten acquisition, is now positioned to control its destiny like never before," says Tom O'Brien CEO Eclipsemed and Eclipse Global. "Instead of waiting for the next big idea to come our way, we look forward to delivering those ideas from within, utilizing our talented organization."
"As a research and development based company, Enlyten found itself with a significant portfolio of products and limited capacity for sales distribution," says Ron Zakai, Enlyten founder. "After researching distribution options, we were pleased to have found Eclipse, based in the United States. To duplicate the infrastructure Eclipse had already created would have required an intense investment for Enlyten. We are very excited to be a part of the Eclipse Global team as we prepare for several product launches in 2010."
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Pain Relievers also May Prevent Aging Symptoms
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September 28, 2009
Acetaminophen, the pain relieving active ingredient in Tylenol, may actually do a lot more than simply fix headaches. Researches with Marshall University in Huntington WV, conducted animal studies to discover that acetaminophen helps replenish an enzyme (protein kinase B) that commonly decreases in skeletons with age. The study was published in the journal PLos One.
"Using a model that closely mimics many of the age-associated physiological changes observed in humans, we were able to demonstrate that chronic acetaminophen treatment in a recommended dosage is not only safe but might be beneficial for the treatment of the muscle dysfunction many people experience as they get older," study leader Dr. Eric Blough of Marshall University in Huntington, W.Va., said in a statement.
Further, research at the same university suggested that acetaminophen may also help age-related hyperglycemia.
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Nationwide Study Examines Youth Access to Indoor Tanning
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Sept. 21, 2009
Many indoor tanning businesses require parental consent for teenagers to use their facilities, but most would allow young tanners more than the government-recommended amount of exposure during the first week, according to a report in the September issue of Archives of Dermatology, one of the JAMA/Archives journals. Facilities with specific state laws regarding parental consent or accompaniment were more likely to require these steps.
"Exposure to UV radiation from indoor tanning lamps has been linked with both melanoma and squamous cell cancer, and first exposure before age 35 years may increase melanoma risk by as much as 75 percent," the authors write as background information in the article. Indoor tanning is especially popular among adolescent girls in the United States, which may contribute to the recently reported increase in melanoma rates among U.S. women ages 15 to 39. As of 2005, 28 states had laws regulating indoor tanning, including 21 with youth access restrictions.
Latrice C. Pichon, PhD, MPH, of San Diego State University/University of California, San Diego, and colleagues assessed indoor tanning practices at 3,647 facilities in 116 cities representing all 50 states. Data collectors phoned tanning salons posing as fair-skinned, 15-year-old female potential customers who had never tanned before. They asked whether the facility required a parent's consent or accompaniment, in addition to how frequently they would be allowed to tan during the first week. The U.S. Food and Drug Administration recommends but does not require or enforce a maximum of three exposures during the first week of tanning.
Approximately 87 percent of the facilities required teens to get parental consent, about 14 percent required a parent to accompany the tanner and 5 percent would not allow a 15-year-old to tan at all. "State law and youth access law each were significantly related to parental consent and parental accompaniment, with facilities in states with a law more likely to require these than facilities in states without such a law," the authors write. For example, 1,966 of 2,118 facilities (92.8 percent) required parental consent when mandated by state law, compared with 1,042 of 1,345 (77.5 percent) of facilities in states without consent laws.
Only around 11 percent of the facilities limited teens to the FDA-recommended three or fewer sessions the first week. The average number of sessions allowed the first week was 6.02, and about 71 percent of facilities reportedly indicated they would allow a teen to tan seven days a week.
More states should consider adopting complete bans on indoor tanning for minors, similar to existing laws in Wisconsin and pending in Ohio, the authors note.
To read more about a dermatologists' perspective on the indoor tanning controversy, click on the Skin & Beauty patient blog, by Melissa Bogle, MD.
Source: Arch Dermatol. 2009;145[9]:997-1002.
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Silicone Gel Reduces the Appearance of Scars
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August 13, 2009
Valeant Pharmaceuticals International of Aliso Viejo, Calif., introduces the Kinerase Scar Healing Therapy, a non-greasy silicone gel that has been clinically shown to improve the appearance, color, roughness and discomfort of scars.
Kinerase Scar Healing Therapy works by forming an invisible protective barrier to soften, flatten and smooth scars in eight weeks. The serum is formulated with several high-quality silicones such as Dimethicone, Phyenyl Trimethicone Polysilicone-1 and Polymethylsilsesquioxane.
Other key ingredients include Cyclopentasiloxane, an emollient that softens skin, as wells as a stable lipophilic form of Vitamin C. Vitamin C has been linked with promoting collagen synthesis, preventing lipid peroxidation and environmental-induced cell damage. It also may inhibit tyrosinase activity along with melanogenesis.
Kinerase Scar Healing Therapy dries quickly so it won't stain clothing, and it safe for use by pregnant women.
Kinerase is distributed by dermatologists and cosmetic surgeons. It also is available through select retailers.
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Clarisonic Launches Pink Travel-Size Brush Exclusively to Physicians
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Aug. 11, 2009
The Clarisonic sonic skin cleansing family of products now includes a pink-colored Mia, available only in physicians' offices.
The Mia is a travel-sized brush created by the primary inventor of the Sonicare toothbrush. Mia's one-speed sonic vibrations cleanse deep inside the pores to reduce the appearance of fine lines and wrinkles and improve the overall complexion.
The rechargeable brush is completely waterproof for use in the tub or shower. The brush heads are interchangeable with other Clarisonic skin cleansing models.
The white Mia became available in Sephora stores this month. But the pink version is available in doctors' offices as of August 10th. It won't be available to the general consumer in Sephora or on Clarisonic.com until October.
The pink Clarisonic Mia can be purchased for the suggested retail price of $149 at professional offices.
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Healthy Aging's Digital Edition Provides Medical Aesthetics Professionals Outside the U.S. More Access Online
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Aug. 5, 2009
ADVANCE for Healthy Aging has unveiled a digital edition of its popular print magazine, viewable anywhere physicians, dermatologists and plastic surgeons in medical aesthetics, skin care and age management can get online.
Available through www.advanceweb.com/healthyaging, the digital edition features the same information as the print version in a format that is also accessible to professionals outside the United States. Each interactive edition provides physicians with credible, unbiased information to help their patients look good and feel good as they age. It serves the medical aesthetics field by offering insight into the latest treatments and techniques, new products, professional trends and strategies that promote proper skin care and improved wellness.
Every one of your organizational members can subscribe to our digital edition for FREE. When visiting www.advanceweb.com/healthyaging, they can click on the "Current Digital Edition" button at the top left side of the page. After they click on "Create New Account," they will be asked to fill out a form. Once they've filled out the form and signed in, the digital edition will load-it's just like our print issue, only searchable. As a subscriber, they will also have access to our large library of past editions.
In addition to our digital edition, the ADVANCE for Healthy Aging Web site provides up-to-the-minute news in the medical aesthetics and age management profession, multimedia features, informative columns and much more! Plus, visitors have access to our patient resource center, which features an "Ask the Doctor" center, a video webcast series and exclusive articles. This special resource center also gives physicians the opportunity to participate in our physician forums and blogs.
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Shantel Launches Vitamin C-based Powder for Physician Skincare Line
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Aug. 4, 2009
The cosmeceutical manufacturer Shantel Medical Supply, of Arcadia, Calif., has launched the PerfectRxTM Duplex C Powder-to-Cream system, formulated with vitamin C, hyaluronic acid and amino acids.
The product can be used with most skin care products to improve skin brightness and youthfulness. Hyaluronic acid and the amino acid complex moisturize the cells and assist in rebuilding collagen and elastin, according to a press release.
Although effective at reducing the appearance of wrinkles, Vitamin C is notoriously unstable anti-aging ingredient in cosmeceuticals. DUPLEX C remains stable in its powder form to maximize delivery, according to the company.
Duplex C is exclusively sold to physicians in 10g/20ml units or as part of a treatment kit.
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Botox, Dysport, Myobloc Get FDA Name Changes
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August 4, 2009
The Food and Drug Administration sent an announcement out yesterday alerting healthcare professionals of official name changes to drugs marketed as Botox, Dysport and Myobloc. Previously, all three were referred to as botulinum toxin type A. The change, according to the FDA statement, is intended to "reinforce individual potencies and prevent medication errors."
- Botox/Botox Cosmetic is now onobotulinumtoxinA
- Dysport is now ababotulinumtoxinA
- Mybloc is now rimabotulinumtoxinA
The brand names of the drugs are not changing, merely the drug name. The FDA alert notes that the potency units are specific to each drug and doses from one drug can't be applied to the others. Each of these drugs now include the FDA-required box warning and a medication guide.
The complete update can be found here.
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AAD Industry News: Luminxyl Releases Non-irritating Hydroquinone Alternative
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July 30, 2009
With the historically negative reports of hydroquinone's toxicity, Basis Medical Technologies, Toronto, Canada, is introducing a peptide alternative to help doctors treat hyperpigmentation and melasma-without the signature irritation or side effects of other creams that treat discoloration.
Lumixyl,™ a non-toxic, non-irritating, synthetic peptide technology, was introduced at the American Academy of Dermatology Summer Meeting, which was held in Boston. The skin brightening cream has been shown to significantly improve the appearance of unwanted discoloration, age spots, sunspots and uneven skin tone.
Lumixyl's formula show potential, in that it restrains tyrosinase, the enzyme responsible for initiating the overproduction of melanin and causing uneven pigmentation and dark spots. In fact, studies show that Lumixyl, a chain of ten amino acids, promoted the moderation of melanin more efficaciously than hydroquinone. At equal concentrations, skin that was treated with the Lumixyl peptide expressed a reduced production of melanin by as much as 40 percent compared to those treated with hydroquinone, which reduced production by only 7 percent in the study.
In-use and Repeated Insult Patch Testing studies confirm that Lumixyl is safe for topical use and does not elicit irritation or allergic reaction. It does not cause increased sensitivity to sunlight as do many commonly used brightening agents and is gentle for all skin types and tones, according to company representatives.
This alternative might be one that physicians consider.
Lumixyl Topical Brightening Crème is available through physicians and can be used in an at-home regimen. In addition, physicians can use the product to compliment other treatments to diminish dark spots, uneven pigmentation and improve overall skin tone. This new skin brightening cosmeceutical is available for $120 per 1 ounce pump.
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Obagi Medical Releases New Clinical Results for Pre- and Post-Procedure Skincare Line
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July 30, 2009
Obagi Medical Products, Inc., announced the results of recent study of its Condition & Enhance System, which demonstrated the product line enhances the overall aesthetic results of surgical and nonsurgical facial rejuvenation procedures.
Obagi's Condition & Enhance system is formulated with 4% hydroquinone to correct premature photoaged skin and to prevent future skin damage.
Researchers assessed 2,500 patients, of whom 52 percent had non-ablative/non-surgical procedures such as botulinum toxin type A injections, intense pulsed light therapy, and filler injections. And 46 percent had ablative/surgical procedures such as laser therapy, chemical peels, and surgery. Patients used the Obagi product line for four weeks prior to their cosmetic treatment and six weeks after their treatment.
As rated by investigators, 83 percent of patients treated with the Condition & Enhance System and botulinum toxin type A injections experienced a 1-grade improvement in hyperpigmentation.
In addition, 33 percent of subjects achieved a 2-grade improvement in this type of sun damage related discoloration. Investigators also noted similar improvement levels in tactile roughness and sallowness. These results are independent of the effects of botulinum toxin type A, according to researchers.
The study also found:
· Investigators gave ratings of "good" or "excellent" improvement in overall skin quality in at least 80 percent of patients treated with the Obagi Condition & Enhance System as pre and post-conditioning in combination with:
- Botulinum toxin type A
- Intense pulsed light therapy
- Non-ablative laser therapy
- Ablative chemical peel
- Surgery
· Investigators gave ratings of "good" or "excellent" improvement in overall skin quality in at least 70% of patients treated with the Obagi Condition & Enhance System as pre and post-conditioning in combination with:
- Non-ablative chemical peel
- Microdermabrasion
- Ablative laser therapy
- Laser resurfacing
"Using the Condition & Enhance System, with 4% hydroquinone, improves overall skin quality and is an effective adjunct to both non-surgical and surgical facial rejuvenation procedures," says lead investigator Jody Comstock, MD, Skin Spectrum, Tucson, Ariz., in a press release.
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American Laser Centers Launches Online Training for Employees
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July 27, 2009
Employees of American Laser Centers, a chain of more than 220 providers of cosmetic laser treatments, now have access to a new company-developed online training program. American Laser Centers calls the program ALC University, which consists of over 400 courses covering technical, procedural and compliance topics. The initiative includes a tracking mechanism for training and a "method of ongoing communication with new and current employees," states a press release.
"With the swift growth ALC has experienced it was clear that the company's training initiatives needed to evolve in a way that served the quickly growing employee and facility network in an efficient and effective way," said Ted Villella, Learning and Performance Leader at American Laser Centers. "ALC University has helped to shift the company's focus from training to 'learning' and provides a platform that will continue to allow us to build the best team, grow the base business and expand the company's offerings."
According to the release, the company is in the process of applying for Authorized Provider status with the International Association for Continuing Education and Training. ALC plans to offer Continuing Education Credits for the majority of its courses.
ALC provides laser hair removal, skin rejuvenation, cellulite reduction therapy, body contouring and other services.
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GSK Acquires Steifel to Enhance Dermatology Business
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July 23, 2009
GlaxoSmithKline (GSK) announced that it has completed the acquisition of Steifel Laboratories to complete what the companies call "a new world-class specialist dermatology business."
In the deal, GSK acquired Stiefel for a cash consideration of $2.9 billion and also assumed $.04 billion of net debt. Additional cash payments may also be due depending on business performance, the press release states.
As a result of the acquisition, GSK will form a new dermatology business unit within GSK under the name Stiefel, A GSK Company.
"As part of GSK, we are stronger, more competitive and continue to be a driving force in dermatology around the world. We are excited to combine GSK's prescription dermatology products, such as Bactroban, Cutivate and Altabax, with Stiefel's portfolio, including brands such as Duac, Olux E and Soriatane. This combined portfolio, together with our specialty sales force and GSK's global presence, positions GSK's dermatology business for significant growth," says Charles Steifel, Chairman of Steifel.
"We now have established a new world-leading, specialist dermatology business that will immediately generate new revenue flows to GSK," notes Deirdre Connelly, President, North American Pharmaceuticals, GSK.
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La Roche-Posay Honors Top Customers with Trip to France
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July 23, 2009
La Roche-Posay recently hosted a group of dermatologists, plastic surgeons and nurse/aestheticians for four days at its headquarters in France as part of its annual Circle of Excellence program.
In May, the group toured La Roche-Posay's facilities and attended presentations on the company's latest research. The guests also visited the company's Thermal Dermatology Center, a hospital specializing in the treatment of dermatological diseases that don't respond to conventional medicine.
"Touring the actual hospital really brought home the concept of the Thermal Spring Water's efficacy in treating certain skin conditions like psoriasis and atopic skin: a unique and medically based treatment that demonstrated the brand's commitment to dermatology," says Miami Fla., dermatologist Frank Flores, MD, in a press release. The spring water flows naturally in the region and is rich in selenium, an antioxidant that promotes cellular preservation.
The Circle of Excellence program recognizes top customers who generated more than 10 percent growth in La Roche-Posay product sales. Membership into the program requires a minimum of $20,000 in annual La Roche-Posay sales.
Physicians interested in participating in the Circle of Excellence program can call interested (888) LRP-LABO for additional information.
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Lutronic Enters Contractual Agreement with Lifestyle Lift Despite Fake-Review Controversy
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July 22, 2009
The aesthetic laser manufacturer Lutronic, Inc., of Princeton Junction, N.J., has signed a contract with Lifestyle Lift to become its primary laser therapy provider with the eCO2 laser system.
"We tested Lutronic's eCO2 on over 1,000 patients and experienced the highest satisfaction among patients and physicians as well as exceptional results," says Lifestyle Lift CEO David M. Kent, DO, in a press release.
The Lifestyle Lift is among the growing trend of branded cosmetic surgery procedures. This one-hour procedure is marketed as a less invasive alternative to facelifts. It's touted as offering patients positive results with only local anesthesia and minimal downtime.
Earlier this month, Lifestyle Lift reached a settlement with the State of New York over its attempts to post fake customer reviews online. The company ordered employees to pose as patients and post glowing reviews of the procedure on websites. The company will pay $300,000 in penalties and costs to the state; Lifestyle Lift also has agreed not to post anymore fake reviews.
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Lumenis Honored for Exceeding Performance Expectations
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July 22, 2009
Medical laser company Lumenis was recently honored with a Supplier Performance Award by Premier Purchasing Partners, the group purchasing unit of Premier Healthcare Alliance.
"Premier is pleased to recognize our top performing suppliers with the Performance Award, which honors our valued suppliers that strive for collaboration and performance excellence to the benefit of the alliance," said Premier Purchasing Partners President Mike Alkire.
"Lumenis endeavors to bring the most state of the art technology to the market, fulfilling the highest standards of excellence, quality and reliability," stated Mr. Dov Ofer, Chief Executive Officer of Lumenis. "We believe that by persistently enhancing all aspects our operations, we are able to deliver the highest quality and best value systems to our customers."
Lumenis is a manufacturer and distributor of laser, light-based and radiofrequency devices for medical applications. Among its products are the Light Shear DUET for hair removal, the Aluma RF device for treating wrinkles, the ILP Quantum and UltraPulse Fractional CO2 laser.
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Cytori Gets Guidance from the FDA
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July 22, 2009
Cytori Therapeutics, which makes the Celution® 700 System, got further direction as it prepares to begin the U.S. Food and Drug Administration (FDA) approval process for its fat grafting technology that uses a patient's own stem cells to reconstruct and fill the areas of the bodies.
The FDA provided guidance, stating that device would be regulated as a medical device under the Federal Food, Drug and Cosmetic Act. The FDA's determination, in response to Cytori's Request for Designation, clears the way for Cytori to compile and submit a marketing application to the FDA for the Celution® 700 System for use as a medical device in aesthetic body contouring and/or filling of soft tissue voids, a press release stated.
The technology, which already is available in Europe, uses stem cells, which purportedly last longer than normal fat grafting procedures. Studies on the Celution are already underway for reconstruction on patients who've had mastectomies in Europe. Preliminary results of one such study on 70 European patients are expected to be released in December in the United States, according to Tom Baker, Cytori's director of investor relations.
The FDA designation will provide an important first step on the road to rolling out this technology to the U.S. market, according to Baker.
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Capstone Therapeutics Completes Enrollment for Keloid Scar Trial
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July 16, 2009
Capstone Therapeutics (Nasdaq:CAPS) has completed enrollment for the first of its two ongoing AZX100 Phase 2 pilot clinical trials in keloid scarring, the Arizona-based company announced earlier this week.
The Phase-2 pilot trials are blinded, placebo controlled, multicenter, parallel group dose ranging studies to evaluate the safety and preliminary efficacy of AZX100 following excision of keloid scars.
AZX100 is a novel synthetic 24-amino acid peptide. It belongs to a new class of compounds in the field of smooth muscle relaxation and fibrosis.
The studies will attempt to determine the most effective dosage levels in up to 120 participants. The efficacy AZX100 to reduce and prevent keloid scars also will be examined via scar assessment scales using both 2D and 3D digital photography.
Keloid scars are raised and extend beyond the site of the original wound. They are caused by an overgrowth of fibrous tissue following surgery, burn or other skin injury. Occuring most frequently in people with darker skin types, keloids can grow for years and typically do not resolve with time.
There is currently no prescription medication specifically labeled for treatment of keloid scars in the U.S. or Europe.
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Onset Therapeutics Announces FDA Approval of Hylatopic
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July 15, 2009
Cumberland, RI-based Onset Therapeutics has been granted FDA approval for the commercial launch of Hylatopic Emollient Foam for the management of atopic dermatitis, allergic contact dermatitis and radiation dermatitis.
Hylatopic is a non-steroidal prescription product formulated to rapidly hydrate the stratum corneum (the top layer of the skin) and provide a semi-permeable barrier against irritants and excessive water loss. The company claims the product is safe and ideal for patients who have disease coverage on greater than 10 percent of their body surface. The product contains no drying alcohols and leaves no oily or sticky residue.
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Catterton Aquires StriVectin Skin Care Brand
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The StriVectin brand of skin care products, which includes anti-wrinkle and stretch mark creams, has been acquired from Klien-Becker by private equity firm Catterton Partners. The management team Chrysallis will lead the newly acquired brand.
StriVectin was introduced in 2003 to reduce stretch marks, but has since become better known as an anti-wrinkle solution. A company press release calls StriVectin "the fastest growing anti-aging brand and one of the top 20 prestige skincare brands in the United States."
"The StriVectin brand is well positioned for today's skincare consumer wanting efficacious, solution-focused skin treatments with proven results," said Chrysallis chief marketing officer Jill Scalamandre.
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Jeffrey O'Donnell Resigns from PhotoMedex
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July 8, 2009
The Philadelphia Business Journal reports that PhotoMedex CEO Jeffrey O'Donnell has resigned his position to "pursue other interests." His position will be filled by former PhotoMedex CFO Dennis McGrath.
The company, based in Montgomeryvile, PA, markets excimer-laser and fiber-optic systems for the treatment of skin disorders like atopic dermatitis, psoriasis, acne and vitiligo as well as other products for hair and wound care.
The report notes that O'Donnell joined the company in 1999 and contributed to the company's growth in the dermatology market.
In June, PhotoMedex introduced its XTRAC Velocity Excimer laser, a follow-up to the XTRAC Ultra laser. The company claims the new product offers treatment times three times faster than the previous model.
In March the company completed a $13 million acquisition of Photo Therapeutics, a manufacturer of non-laser skin care products including the Omnilux Clear-U and Omnilux New-U over-the-counter LED-based devices.
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Osyris Medical USA Offers Trade-Up for Laser Technology
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July 6, 2009
Physicians facing the credit crunch on laser-assisted lipolysis technology can take advantage of Osyris Medical USA's new trade-up program.
Physicians can generate new revenue for their practice by purchasing a Lipotherme and upgrading to the LipoControl system when financing is available. Physicians can put 100 percent of their original purchase price toward the new system.
"This unique program reflects our core philosophy which aims to build a strong, lasting relationship with each of our owners, by ensuring that their investment will continue to be a successful part of their practice over time," says Peter Falzon, chief executive officer of Osyris Medical USA., in a press release.
The Lipotherme™ is a 980 nm diode laser for laser lypolysis. The system is a compact, portable unit for use in the operating room and office setting. Physicians also can expand the system's capabilities by adding endovenous and exovenous applications for vein removal. The LipoControl™, which is awaiting FDA approval, features a method for tracking and measuring energy, giving physicians an on-screen visual confirmation of the treatment site in real-time.
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Aesthetic International Association Honors Murad Founder
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July 2, 2009
Dermatologist Howard Murad, MD, UCLA professor and founder of the Murad skin care company, has been inducted into the Aesthetic International Association's Academy of Legends.
The AIA Academy of Legends aims to raise educational standards and public awareness of the aesthetics industry by recognizing leaders in the field. Dr. Murad has been recognized for his inclusive health approach to skincare.
"My focus has always been on science and research-and harnessing clinical findings in ways that can help people look and feel good, live healthier and improve their overall quality of life," says Dr. Murad in a press release. "It is an honor and a privilege for me to be recognized by my peers for doing what I love to do. I am touched and grateful."
Dr. Murad has treated more than 50,000 patients. He developed a comprehensive approach to understanding health and aging. Dr. Murad's research has examined the ability of cell membranes to hold water as the fundamental marker of a youthful appearance. As part of this philosophy, Dr. Murad has championed an inclusive health approach to help the body create stronger, healthier cells as the pathway to beauty.
The Murad brand includes 88 consumer products and 45 professional products sold in 45 countries. All of this products incorporate Dr. Murad's philosophy on cellular water.
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La Roche-Posay Introduces New Serum to Reduce Dark Spots
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June 29, 2009
La Roche-Posay has introduced the Mela-D Serum Anti-Dark Spot Concentrate, which corrects hyperpigmentation and evens skin tone.
The formula combines three ingredients to reduce dark spots without irritation:
- Lipo-Hydroxy-Acid (LHA) - 0.2 percent: A patented breakthrough pro-exfoliating molecule that provides precise cell-by-cell exfoliation to help reduce the size of dark spots.
- Kojic Acid - 1.0 percent: Inhibits the activity of tyrosinase (melanin activating enzyme) in the skin to help reduce the appearance and color intensity of dark spots.
- Glycolic Acid - 5.7 percent: Provides reinforced exfoliation to help reduce the size of dark spots and create a uniform complexion.
The keratolytic (exfoliative) action of LHA and the reinforced keratolytic action of glycolic acid prepares the skin to allow for even better penetration of the Kojic acid for optimal results, according to the company.
Clinical studies have shown patients experienced an 18 percent reduction in pigmentation, a 23 percent reduction in skin discoloration and a 50 percent increase in skin radiance after eight weeks, according to a company statement.
Mela-D Serum Anti-Dark Spot Concentrate from La Roche-Posay has a suggested retail price of $55.00 and can be purchased at select physicians' offices, CVS/pharmacy, Duane Reade, Longs and Rite Aid locations with Dermo-Skincare Centers, and online at www.laroche-posay.us beginning in August 2009.
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FDA Approves New Topical Retinoid
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June 4, 2009
Patients using prescription-strength topical retinoids to control acne and ward off the signs of aging will have one more choice in this fast-growing market.
Spear Dermatology Products received FDA clearance for Refissa, a 0.05% topical Tretinoin cream. Spear's product is a generic equivalent to Johnson & Johnson's Renova Cream. Refissa will be available to patients by prescription starting this month.
A 40 gram tube of Refissa may last 2-3 months, depending on individual usage patterns and costs on average, less than $2.00 per day, according to a company statement.
Refissa's emoillient formulation is for patients with normal to dry skin, and the product can be used in patients who want to reduce fine facial wrinkles and improve rough skin and irregular pigmentation.
Many dermatologists view topical retinoids as the cornerstone of treatment for sun damaged skin and acne. Prescription retinoids typically are formulated as acne treatments. Refissa, however, will be marketed as an anti-aging product.
"Despite the recession, luxury items like skin care and anti-aging products continue to be in high demand," says Stephen Basile, Sr. vice president sales and marketing. "This growing shift of consumers opting to use less invasive skin rejuvenation products is fueling an ever-growing market for Baby Boomers who want to spend less to effectively treat their sun damaged skin and improve the appearance of their skin."
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Clarisonic Introduces Travel-Size Cleansing Brush
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June 3, 2009
The family of Clarisonic sonic skin cleansing models now includes the new Mia, a lightweight and compact brush to use at home or on the go.
The Mia will be available for sale this month on Clarisonic's website, www.clarisonic.com. The brush will be available in Sephora stores nationwide in August. The suggested retail price is $149.
Mia's compact pLink™ power link charger magnetically attaches to the handle and allows for a full 20 minutes of use. The rechargeable brush is completely waterproof, making it perfect for use in the tub or shower. Brush heads are interchangeable with other Clarisonic skin cleansing models.
Created by the primary inventor of the Sonicare® toothbrush, Mia's gentle sonic vibrations cleanse deeply, clearing pores. According to the manufacturer, Pacific Bioscience, Mia reduces the appearance of fine lines and wrinkles; smoothes and softens skin; and reduces oily areas, dry skin patches and blemishes.
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Glycoproteins in Snail Secretions Help Repair Skin
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May 20, 2009
Biopelle introduces its Tensage product line, formulated with fibroblast growth factors to smooth wrinkles and improve the skin's texture elasticity.
Available through physicians, Tensage is formulated with glycoproteins secreted by a small type of snail known as the Cryptomphalus Aspersa. Studies show this secretion works to repair the snail's skin following injury in 24 hours, according to a company statement. Biopelle's patented growth factor blend is called SCA Biorepair Technology. The SCA Biorepair Techcnology has been used in Europe as a treatment option for radiodermatitis.
The Tensage regimen begins with the intensive ampoule treatments, which provide the highest strength SCA available. Patients may experience improvements in skin tone and texture in seven days, according to the manufacturer. The ampoules are supplemented with one of three creams, providing additional SCA repair. The Tensage line also includes the eye contour cream and body care lotion.
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Cynosure Upgrades its Smartlipo MPX System
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May 20, 2009
Cynosure Inc. of Westford, Mass., has upgraded its Smartlipo MPX laser lipolysis system to feature increased energy and intelligent temperature sensing.
The Smartlipo MPX 46-watt workstation allows physicians to liquefy and remove larger areas of fat in about half the time required by the original 32-watt Smartlipo MPX. Both generations of the laser system include Cynosure's ThermaGuide, which continually monitors the temperature under the skin and controls the energy output.
The system combines the 1064-nm and 1320-nm wavelengths in one laser output. This blended thermal and photomechanical effect efficiently liquefies fat and tightens skin through collagen remodeling. The two wavelengths also can be used individually.
"With the introduction of Smartlipo MPX 46 watts, we believe that we have strengthened the competitive advantage of our laser lipolysis technology not only from the standpoint of efficacy, but also in terms of patient safety," says Cynosure President and CEO Michael Davin in a statement.
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Palomar Marketing Push Targets Consumers Directly
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May 1, 2009
Grammarians will tell you not to mistake brand names for generic products. Avoid Popsicle, which is trademarked; say frozen confection. Don't throw your trash in a Dumpster. (It's a large steel waste receptacle.)
But the aesthetic-laser manufacturer Palomar hopes to turn its SlimLipo technology into a household name with a new direct-to-consumer marketing push. As part of the marketing initiative, Palomar, of Burlington, Mass., will rebrand its SlimLipo laser lipolysis system to consumers as LifeSculpt. SlimLipo will still be the name of the technology but the entire treatment from consultation to results will have the LifeSculpt name, according to marketing representatives.
Set to launch this month, the campaign will emphasize how the LifeSculpt procedure fits into patients' active lifestyles, according to a press release. Anchoring the campaign, a patient Web site will feature before and after photos and a find-a-physician directory.
Light and laser companies have traditionally directed their marketing efforts to physicians. But as competition in the industry remains fierce, Palomar joins a growing list of body contouring device manufacturers to target patients directly. Other companies offering patient Web sites include Cynosure's SmartLipo and CoolTouch's CoolLipo.
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Report Ranks Recession-friendly Marketing Tactics for Cosmetic Practices
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Feb. 23, 2009
The economic slowdown has impacted the majority of cosmetic physicians, however, a recent report offers strategies for increasing or maintaining sales during a recession.
CareCredit asked the market research firm Hiner & Partners, Inc., to survey 10,000 practices about their strategies to minimize the downturn's impact.
Among the survey's key findings, 61 percent of cosmetic physicians reported an average 32 percent dip in monthly sales as compared with 2007. And 80 percent of physicians surveyed reported reducing prices or offering price promotions for cosmetic procedures.
In the survey, physicians rated the effectiveness of 37 specific marketing tactics to stay afloat, ranging from price-based tactics to bundling services to advertising.
Physicians most frequently rated their practice websites as an effective strategy for reaching out to current and potential patients. Other effective tactics included bundling services, offering no-interest financing and rewarding repeat customer.
Advertising in mass media outlets offered the least bang for the buck, respondents reported. The least effective marketing strategies included free local print directories, television ads and radio ads.
To download the free report, visit the online physician community, Medical Spa MD. Log in is required.
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