PracticalDermatology

The fact that I write “Year in Review” and don’t shudder simultaneously is a good sign. I really can’t say that for many of the previous years, so that’s a bonus, but at the same time it hasn’t been an easy year in many ways.

For many of my patients, 2023 has been one of the toughest years in recent memory. Clearly, the economic ripples of the pandemic and the resultant inflation has left us with long term, possibly structural challenges. These will continue to hamper many of our patients as they pay mortgages that are higher than expected or will soon reset to a higher monthly rate if they have a home on an adjustable-rate mortgage. This will decrease their overall discretionary spending and impact trips to the dermatologist for neurotoxins, fillers, and other cosmetic procedures. Those who don’t have mortgages are left with high rent that could eat away at their monthly paycheck, all without accruing to their future wealth and well-being.

Having said this, our clinic had a good year in many ways and benefitted from the introduction of several new cosmetic treatment options. Those that stood out this year were:

• Volux, a new filler from the Juvederm family that I like to use for definition of the chin and jawline. So far, I love it and my patients do as well.
• SkinVive, a new “booster,” also from the Juvederm family of hyaluronic acid injectables. This has already been a huge success in my practice as we are using it on cheeks (to get the rosy look and hydrate), crepey skin, and scarring on the face and cheeks. It has very little likelihood of Tyndall effect, so it is a perfect choice for an intradermal application. It is not meant as a filler, so I don’t promote it that way, but it does seem to have a lovely effect on those with fine lines and wrinkles on the lower face, in particular.
• Upneeq, a drug that helps to widen and whiten the eyes from RVL Pharmaceuticals, did well in our practice as an adjunctive treatment, but the company declared bankruptcy in October and it remains to be seen what will happen with the drug in the future. This, as well as the precipitous drop in some aesthetic-company stocks this year, highlight the vulnerability of cosmetic/disposable income-related companies in this tenuous economy.
• Galderma introduced Restylane Eyelight this year, another NASHA product that is intended for the undereye hollows. While I will probably try it at some point, I fell in love with Belotero for undereye hollows this year and have been using that (as well as SkinVive) in that area with great success.

In the skincare arena, we saw many introductions of new lines of extension for various products, including new SkinCeuticals (A.G.E. Advanced Eye and A.G.E. Interrupter Advanced Corrective Cream and Phyto Corrective Essence Mist), SkinMedica (Even and Correct Treatment Regimen, 3 pieces, which replaces the Lytera line), Revision (C+ Brightening Eye Complex), Epionce (Luminous Eye Serum) and Colorescience (Total Protection No-Show Mineral Sunscreen SPF 50). There is still innovation in this arena and the No-Show mineral sunscreen from Colorescience has quickly become one of my go-to products for facial sunscreen as it goes on beautifully and avoids any chemicals!

There have been a wealth of new JAK inhibitors and other molecules over the past few years, but it’s exciting to see them become more accepted as insurance companies get used to considering them for treatments ranging from psoriasis to alopecia areata and vitiligo. Additionally, age ranges that can access these new drugs have widened significantly, allowing us to use biologics even in the very youngest of individuals with atopic dermatitis, which is a true miracle for so many of our patients and their families. My hope is that these will continue to have the investment in clinical research and the commensurate heavy lift to make them available to our patients via patient accessibility programs.

One aspect worth mentioning is the return of staff to the clinic and a somewhat better employee retention/recruitment opportunity than in the worst of the pandemic years. During these years, many dermatologists struggled greatly to retain or attract nurses as the hospitals participated in an all-out talent war, with salaries that approached or eclipsed physicians during the COVID years. Not only has this (and the travel-nurse phenomenon) cooled down significantly, but the companies that were responsible for this have now laid off hundreds of their recruiters in our area. Hopefully, this disruption and dislocation of employees won’t happen again in our lifetimes.

As stated in an editorial last month, there has been a resurgence in anti-Semitism this year, which unfortunately affected several academic institutions and (of course) many social media feeds. This has led to new statements from the American Board of Dermatology about the responsibility of careful consideration when engaging with social media, which is an important and timely reminder for all of us. Thinking twice before posting anything or waiting until the morning after is always a good idea.

Of course, 2024 will bring newness to all of us and further distance from the painful years many, if not all of us, have endured. My best wishes to all readers for a happy and healthy New Year, full of new discoveries and joy.