New in My Practice: Device

With Roy G. Geronemus, MD

In each issue, Practical Dermatology® magazine spotlights a device or over-the-counter or prescription medication that dermatologists are recommending to patients. Here, Roy G. Geronemus, MD, Director of the Laser & Skin Surgery Center of New York and a clinical professor of dermatology at New York University Medical Center in New York City, shares insights on the first-in-category ellacor system from Cytrellis, which recently scored FDA approval for moderate-to-severe wrinkling in the mid- to lower-face.

What is ellacor?

Roy G. Geronemus, MD: ellacor is a mechanized non-thermal device that uses hollow needles to remove small cores of skin that, when healed, can lead to reduction in facial wrinkles. It’s a first-of-its-kind procedure that provides patients—and physicians—with the natural-looking results they’re looking for without evidence of scarring and faster healing time than many energy-based procedures.

Who makes a good candidate for ellacor?

Dr. Geronemus: ellacor is indicated for the treatment of moderate-to-severe wrinkles in adults 22 years of age or older with Fitzpatrick skin types I-IV. ellacor provides a non-surgical solution for patients who aren’t yet ready for surgery; I would typically recommend this to someone looking for that next level of results who is in their mid-40s to 60s.

What results are patients seeing with ellacor?

Dr. Geronemus: My patients have seen a very natural-looking reduction in facial wrinkles, without any scarring, which is significant for a cosmetic procedure.

Is there a learning curve?

Dr. Geronemus: There is a short learning curve for the physicians, but the device is very intuitive once trained.

How often are treatments needed for best results?

Dr. Geronemus: Improvement can be seen after a single session, with additional benefits seen with a second or third treatment. A single treatment typically takes 30 minutes or less, and the physician will determine the number of treatments that are appropriate based on the patient’s specific needs.

How does ellacor compare with other skin rejuvenation technologies?

Dr. Geronemus: Because this is a mechanical device and not thermal like lasers or radiofrequency, it allows for rapid healing without scarring. And unlike microneedling, where skin is temporarily displaced, ellacor actually removes skin on the micro-scale and is the first device to do so.

Learn more about micro-coring. Jill S. Waibel, MD previewed the technology in our October 2020 edition.

Read it now: PracDerm.com/MicroCore

BEAUTY COUNTER MD

Expert insight on the hottest products, ingredients, and trends your patients are talking about.

With Jeanine B. Downie, MD, FAAD

To bathe your kids daily or not? That is the question. Recently, celeb couple Aston Kutcher and Mila Kunis sparked a debate after they revealed that they don’t believe in washing their young kids—or themselves—with soap every day.

But this is not really that controversial, says Jeanine B. Downie, MD, FAAD, director of image Dermatology PC in Montclair, NJ. “Young children do not sweat a lot yet and have not developed secondary sex characteristics that can lead to body odor,” she says.

So how often should young kids bathe? “I agree with the American Academy of Dermatology. Kids should be bathed at least briefly three to four times a week, especially children with eczema, psoriasis, or another dry skin condition, as washing off the natural body oil daily is not great for the skin and can make one itchy and uncomfortable.”

It’s a fine balance, she says. “Make sure you moisturize the child, bathe them enough but not too much, and make sure that you are not stripping their skin of too many natural body oils,” she says.

To do this, Dr. Downie recommends gentle, unscented soaps like Aveeno or Cetaphil and limiting the length of bath time. “After the bath, I like putting on an unscented baby oil before toweling dry and then would recommend a creamy moisturizer over it.”

And on hot humid days, she suggests at least a “birdbath” where you wash under their chin, arms, their groin area, and their buttocks. “After a hot humid day, they too can smell very musty.”

New in My Practice: OTC

With Peter Schalock, MD

In each issue, Practical Dermatology® magazine spotlights a product that dermatologists are recommending to patients. Here, Peter Schalock, MD an adjunct associate professor of dermatology at the Geisel School of Medicine at Dartmouth in Hanover, NH, discusses why his patients are loving the skin-friendly SEEN hair care product line.

What is the SEEN hair care line?

Peter Schalock, MD: SEEN is a dermatologist-designed hair care line that includes shampoos, conditioners, and styling products. They were initially formulated to provide gentle, non-irritating, non-comedogenic hair care that would not worsen facial and body acne. The line has expanded to include fragrance-free products suitable for most fragrance-sensitive and fragrance-allergic individuals. All products are formulated without sulfates, silicones, phthalates, parabens, dyes, and gluten. SEEN also avoids common causes of allergic contact dermatitis: methylisothiazolinone, methylchloroisothiazolinone, formaldehyde and formaldehyde releasers and cocamidopropyl betaine. All product research avoids animal testing and is vegan.

Two special ingredients are used in all products. Bisabolol, a botanical ingredient, is used for its anti-inflammatory properties. Hemisqualane is a plant-derived alternative to silicone, used for smoothing, hair protection, as well as decreasing frizz.

Which of your patients do you recommend SEEN products to?

Dr. Schalock: I recommend the standard SEEN line to many of my patients. First and foremost, I recommend it to those wanting well-formulated, low allergen, and irritant hair care. Secondly, I recommend SEEN to acne patients due to its non-comedogenic properties. SEEN has a fragrance-free line of products that are useful for my fragrance-sensitive or allergic patients. SEEN is included in the American Contact Dermatitis Society CAMP (Contact Allergen Management Program) list, which provides patch-tested individuals a list of safe products based on their unique set of allergens. The SEEN Fragrance-Free Shampoo and Conditioner were formulated to avoid additives from the patch test hapten mixes fragrance I and fragrance II. The shampoo and conditioner both contain bisabolol and sodium benzoate, which may cause reactions in a minority of fragrance-allergic patients. Despite this, SEEN provides a cosmetically elegant shampoo and conditioner that is useful for many fragrance-sensitive and allergic patients.

What results are your patients seeing?

Dr. Schalock: Results are excellent. Acne patients are happy with the cosmetic elegance and ease of use, plus it does seem to cause less acne than standard hair care products. I have added the products to my acne care information sheet that I give to all patients. Fragrance-allergic patients are happy with the SEEN line. Most are able to use them, with the exception of those with bisabolol or benzoate allergy. Having this available is a great addition to the fragrance-free spectrum of products.

How does SEEN compare to other hair care lines?

Dr. Schalock: SEEN products are designed with care, are vegan, and are formulated to be beneficial to everyone, though those with fragrance allergy and acne stand to benefit more than others. Having a hair care line that is designed to limit induction of acne and/or contact dermatitis is not unique, but there are few products that are similar in benefit and cosmetic elegance.