A CRC Press FreeBook RSM AESTHETICS 9 TABLE OF CONTENTS 003 :: INTRODUCTION 007 :: 1. TREATING MELASMA, CHLOASMA, AND POSTINFLAMMATORY HYPERPIGMENTATION 017 :: 2. HYDROXYACIDS 027 :: 3. PLATELET-RICH PLASMA AND STEM CELLS 044 :: 4. COSMETIC BOTULINUM TOXIN TREATMENT 076 :: 5. COMPLICATIONS OF FILLERS 099 :: 6. SURGICAL SCAR REVISION, DERMABRASION, AND OTHER PHYSICAL TREATMENTS 112 :: 7. TREATMENT OF SCARS INTRODUCTION TO RSM AESTHETICS 9 Over the last 100 years, life expectancy in the developed world has increased by 25-30 years. Not only do people live longer, they also feel younger. Feeling younger, it is natural to want to look younger for longer. Enormous advances in the field of aesthetic and cosmetic medicine & surgery mean that much is therapeutically possible now that, not long ago, would have existed only in the realm of science fiction. For these reasons, aesthetics has become the most rapidly expanding area of medicine, and it has grasped the imagination of the general public in an unprecedented way. CRC Press-Taylor & Francis Group, each year, make an immense contribution to the canon of cosmetic medical literature by their publication of major works in the field. In recent years, international authors, drawn from all of the relevant medical and surgical disciplines, have produced a number of fascinating, informative and authoritative texts. A selection of chapters from these recent books are presented here. I hope you will enjoy reading these taster chapters as much as I have. Here indeed science meets art. Christopher Rowland Payne 149 Harley Street, London W1 January 2017 Consultant Dermatologist to The London Clinic Formerly Professeur Universitaire, Université de Paris-Creteil Founding Editor-in-Chief of the Journal of Cosmetic Dermatology Past President & Past Sec-Gen of the European Society for Cosmetic & Aesthetic Dermatology This FreeBook was put together to mark the RSM Aesthetics 9 meeting, the 9th international multidisciplinary annual meeting, covering a range of aesthetic subjects. Melasma and chloasma are common skin conditions, and chemical peels are often avoided due to their potential to turn into hyper-pigmentation. Chapter 1 “Treating melasma, chloasma, and postinflammatory hyperpigmentation” from Textbook of Chemical Peels considers the use of the Easy TCA peels and gives advice about decision making during the course of melasma treatment. Hydroxyacids are used widely as cosmetic and dermatologic ingredients. Chapter 2 “Hydroxyacids” from Cosmeceuticals and Active Cosmeceuticals considers the use and effects of hyroxyacids as well as safety precautions. CRC PRESS 3 CRCPRESS.COM INTRODUCTION TO RSM AESTHETICS 9 Chapter 3 “Platelet-rich plasma and stem cells” is taken from the The Alopecias and covers the use of platelet-rich plasma (PRP) and stem cells to treat alopecia. PRP is an alternative for those who cannot use other treatments, while biological cellular therapy may be a safe and effective paradigm in hair restoration. Chapter 4 “Cosmetic botulinum toxin treatment” is taken from Cosmetic Medicine & Surgery. Botulinum can benefit patients in a number of ways; this chapter looks at M-M BTX and the advantages of precise placement mini-dose injections. Fillers are frequently used in aesthetic medicine, and despite all precautions being taken, adverse effects may occur, which can be catastrophic for the affected person. Chapter 5, “Complication of fillers”, from Cosmetic Medicine & Surgery covers the adverse effects, immediate, late, or delayed for different fillers and the importance of initiating treatment as soon as possible. Chapter 6 “Surgical Scar revision, Dermabrasion, and Other Physical Treatments” is taken from Mohs and Cutaneous Surgery and deals with revisions of facial scars. Primarily dealt with by Mohs and dermatological surgeons, revisions need to be efficiently evaluated and managed to ensure the maximum improvement to the scar. Scarring can be a problematic side-effect of traumas – such as burns – of acne and of medical procedures. Chapter 7 “Treatment of Scars” from Lasers and Energy Devices for the Skin describes evidence that the combined use of Pulsed Dye Lasers (PDLs) and dyspigmentation treatments could reduce the symptoms of scarring in both keloids and hypertrophics scars, and that while early treatment is most effective it may be possible to reduce scarring several months after formation. Note to readers: References from the original chapters have not been included in this text. For a fully-referenced version of each chapter, including footnotes, bibliographies, references and endnotes, please see the published title. Links to purchase each specific title can be found on the first page of each chapter. As you read through this FreeBook you will notice that some excerpts reference previous chapter – please note that these are references to the original text and not the Freebook. CRC PRESS 4 CRCPRESS.COM INTRODUCTION TO RSM AESTHETICS 9 AUTHORS CHAPTER 1 Philippe Deprez, MD, Clinical Hera, Empuriabrava, Spain CHAPTER 2 Claudine Piérard-Franchimont, Department of Dermatopathology, Liège University Hospital; Department of Clinical Sciences, Liège University, Liège Belgium Didier Saint Léger, DSL Consult, Paris, France Sarah Peters, Department of Clinical Sciences, Liège University, Liège Belgium Gerald E. Piérard, Department of Clinical Sciences, Liège University, Liège Belgium CHAPTER 3 Gilbert Amgar, Private Practice, Paris, France Joseph Greco, Greco Medical Group, Sarasota, Florida, Fabio Rinaldi, Private Practice in Dermatology, Milan, Italy CHAPTER 4 Christopher M.E Rowland Payne, The London Clinic, London, UK Wolfgang G. Phillip-Dormston, Hautzentrum Köln, Cologne, Germany CHAPTER 5 Eckhart Haneke, Department of Dermatology, Inselspital, University of Bern, Bern, Switzerland; Dermatology Clinic Dermaticum, Freiburg, Germany; Centro Dermatology, CUF Porto Instituto, Porto, Portugal; Department of Dermatology, Ghent University, Ghent, Belgium CHAPTER 6 Ian A. Maher, MD Department of Dermatology Saint Louis University Saint Louis, Missouri Jeremy S. Bordeaux, MD, MPH Department of Dermatology University Hospitals Case Medical Center Case Western Reserve University Cleveland, Ohio CHAPTER 7 Richard E. Fitzpatrick, University of California and Goldman, Butterwick, Fitzpatrick, Groff, and Fabi Cosmetic Laser Dermatology San Diego, California, USA CRC PRESS 5 CRCPRESS.COM READ THE LATEST CHAPTERS ON AESTHETIC AND COSMETIC MEDICINE & SURGERY WITH THESE KEY TITLES VISIT CRCPRESS.COM TO BROWSE OUR FULL RANGE OF BOOKS AND SAVE 20% WITH THE DISCOUNT CODE RSM01 CRCPRESS.COM CRC Press, Taylor & Francis Group is a global publisher of world- class references, handbooks, and textbooks for the medical, scientific and technical communities including academics, professionals, and students. For a complete catalog of our aesthetic medical books including bestselling and forthcoming titles, or to sign up for our email list to receive exclusive offers, visit www.crcpress.com today. >> CLICK HERE CHAPTER 1 TREATING MELASMA, CHLOASMA, AND POSTINFLAMMATORY HYPERPIGMENTATION 1 :: TREATING MELASMA, CHLOASMA, AND POSTINFLAMMATORY HYPERPIGMENTATION PHILIPPE DEPREZ The histological features of melasma and chloasma are discussed elsewhere in this book. The standard recommendations for treatment often mention only the topical applications tretinoin, hydroquinone, fluorinated corticosteroids, sun protection, and tyrosinase inhibitors; chemical peels are considered as a last resort because of their potential to turn melasma into postinflammatory hyperpigmentation (PIH). Conventional peels require conscientious prepeel preparation to avoid this danger. Easy TCA (ETCA), in combination with appropriate postpeel care, can be used to treat The following is excerpted from melasma without the constraints of prepeel preparation (Figures 1.1–1.5). Laser Textbook of Chemical Peels, Second therapy is not recommended for treating melasma because lasers are difficult to use Edition: Superficial, Medium, and Deep Peels in Cosmetic Practice by and have been linked to many common side effects. The numerous evolutions and Philippe Deprez. promises of laser therapy have not solved these problems. ©2016 Taylor & Francis Group. All rights reserved. Before performing an Easy TCA Classic or Easy TCA Pain Control peel, it is not Purchase a copy HERE . usually necessary to prepare the skin, but for patients with long-standing or resistant melasma or with a skin phototype higher than Fitzpatrick III, preparing the skin can be worthwhile and improve results. Figure 1.1 • Melasma on the neck. The position might suggest poikiloderma of Figure 1.4 • Treatment of melasma with ETCA Civatte, but there is neither telangiectasias and Blending Bleaching Cream. Patient with light nor any atrophy of the skin around the follicle. skin phototype. Figure 1.3 • Results after four ETCA peels and Blending Bleaching Cream. Figure 1.2 • On the third day after ETCA Figure 1.5 • Treatment of melasma with ETCA treatment, epidermal melanin has been and Blending Bleaching Cream. Patient with dark eliminated. skin phototype. CRC PRESS 8 CRCPRESS.COM 1 :: TREATING MELASMA, CHLOASMA, AND POSTINFLAMMATORY HYPERPIGMENTATION PHILIPPE DEPREZ PREPARING THE SKIN The following are recommended to prepare the skin before the peel: • Blending Bleaching Cream (see Chapter 3): Applied twice a day on the melasma itself and once a day on the rest of the face. • Melablock-HSP 50+ (see Chapter 3): Applied all over the face in the morning and then reapplied every