Cosmetic dermatology : products and procedures

Cosmetic Dermatology Products and Procedures
Contents
Contributors
Foreword
Preface
Part I Basic Concepts
	Section 1: Skin Physiology Pertinent to Cosmetic Dermatology
		Chapter 1 Epidermal Barrier
			Introduction
			Structural components of the epidermal barrier
				Corneocytes
				Proteins of the cornified envelope
				Lamellar granules and inter‐corneocyte lipids
				Lipid–protein cross‐links at the cornified envelope
				Desmosomes and corneodesmosomes
				Keratohyalin granules
			Functions of epidermal barrier
				Water evaporation barrier (epidermal permeability barrier)
				Mechanical barrier
				Antimicrobial barrier and immune protection
				NMF and skin hydration/moisturization
				Protection from environmental toxins and topical drugs penetration
				Desquamation and the role of proteolytic enzymes
				Melanin and UV barrier
				Oxidative stress barrier
			Regulation of barrier homeostasis
				Desquamation
				Corneocyte maturation
				Lipid synthesis
				Environmental and physiological factors
				Hormones
				pH and calcium
				Coordinated regulation of multiple barrier functions
			Methods for studying barrier structure and function
				Physical methods
				Instrumental methods
				Biological methods
			Relevance of skin barrier to cosmetic product development
				Topical products that influence barrier functions
				Cosmetics that restore skin barrier properties
				Skin irritation from cosmetics
			Summary and future trends
			References
		Chapter 2 Photoaging
			Introduction
			Definition
			Physiology
				Photoaged versus chronically aged skin
				Photobiology
				Cutaneous microvasculature
			Molecular mechanisms of photoaging
				Collagen
				How does UV irradiation stimulate photoaging?
				Reactive oxygen species
				UV radiation inhibits procollagen production: TGF‐β/Smad signaling pathway
				UV‐induced matrix metalloproteinases stimulate collagen degradation
				Fibroblasts regulate their own collagen synthesis
				Elastosis and cathepsins
				UVA induces the aging‐associated progerin
				Evolving data
			Ethnic skin: photoaging
			Prevention
				Primary prevention
				Secondary prevention
				Inherent defense mechanisms
			Failure of prevention: immunosuppression
			Conclusions
			References
		Chapter 3 Pigmentation and Skin of Color
			Introduction
			Melanocytes
			Dyspigmentation
			Natural sun protective factor in skin of color
			Skin of color
				Epidermis
				Transepidermal water loss
				Skin reactivity
				Dermis
				Intrinsic skin aging in ethnic skin
				Extrinsic aging (photoaging) of ethnic skin
			Hair
			References
		Chapter 4 Sensitive Skin and the Somatosensory System
			Introduction
			Peripheral nervous system
				Touch
				Temperature
				Pain
				Itch
				Pleasure
				Sympathetic nerves
			The central projections
				Spinal cord
				Brain
			Conclusions
			References
		Chapter 5 Novel, Compelling, Non-invasive Techniques for Evaluating Cosmetic Products
			Introduction
			Commonly used non-invasive bioinstrumentation methods in cosmetic studies
			Use of digital photography as a non-invasive technique for assessing skin features
			Review of terminology in clinical photography
				Visible light photography
				Raking light photography
				Polarized photography
				UV reflectance photography
				UV fluorescence photography
			Use of raking light optical profilometry (RLOP) to detect improvements in periocular fine lines and wrinkles
			A non-invasive method for assessing the antioxidant protection of topical formulations in humans
			Use of image analysis for assessing a variety of skin conditions
			Emerging technology for skin imaging and assessment
			Conclusions
			References
		Chapter 6 Contact Dermatitis and Topical Agents
			Introduction
			Pathophysiology and clinical presentation
				Irritant contact dermatitis
				Allergic contact dermatitis
				Phototoxic dermatitis
				Contact urticaria
				Foreign body reactions
			Common irritants and allergen groups
				Irritants
				Fragrances
				Preservatives
				Botanicals
			Specific cosmetic products
				Cleansing agents
				Moisturizers
				Skin bleaching agents
				Topical corticosteroids
				Hair dyes and bleaches
				Permanents
				Nail products
				Cosmetic application devices
				Tattoos
				Local anesthetics
				Injectables
			Diagnosis
			Treatment
			Conclusions
			References
	Section 2 Delivery of Cosmetic Skin Actives
		Chapter 7 Percutaneous Delivery of Cosmetic Actives to the Skin
			Introduction
			The basics
				Skin physiology
				Active composition
				Fick’s law
			Vehicle effect
				Delivery of actives from emulsions
				Formulation strategies
			Penetration enhancers
				Chemical enhancers
				Physical enhancers
			Penetration enhancement vectors
				Liposomes
				Niosomes
				Solid lipid nanoparticles
				Nanocapsules
			Devices for penetration enhancement
				Ultrasound waves
				Patches
				Microneedles
				Iontophoresis
			In vitro and in vivo delivery assessment
				Franz cell
				Tape stripping
				Microdialysis
				Confocal Raman microspectroscopy
			Conclusions and future trends
			References
		Chapter 8 Creams and Ointments
			Definitions of creams (and lotions) and ointments
				Creams (and lotions)
				Ointments
			Composition of a cream and an ointment
				Oil-in-water cream
			Ointments
			References
Part II Hygiene Products
	Section 1 Cleansers
		Chapter 9 Bar Cleansers
			Introduction
				Cleansing bars – historical perspective
				Formulation technology of cleansing bars
				Continuous processing
				Batch processing
				Soap bars
				Preservatives
			Impact of cleansing bars on skin structure and function
				Surfactant interaction with the skin–stratum corneum
				Soap bar interactions with the stratum corneum
				Synthetic detergent bar interactions with the stratum corneum
				The role of pH
				Cycle of dryness
			Studies comparing mildness properties of soap and syndet cleansing bars
				Controlled exposure trials
				Normal usage trials
				Benefits of mild cleansing for ashy skin
				Benefits of mild cleansing for photodamaged skin
			Practical implications of mild cleansing for patients with common skin disease
				Benefits of mild cleansing for adults and children with mild atopic dermatitis
				Benefits of mild cleansing for acne and rosacea patients
			The future of cleansing bars
			Conclusions
			References
			Further reading
		Chapter 10 Personal Cleansers: Body Washes
			Background
			Types of body wash
			Major formula components of body washes
				Water
				Surfactants
				Skin benefit agents
				Other ingredients
			In‐use performance considerations for body washes
				Cleansing ability
				Consumer understanding and need for moisturizing body washes
				Moisturization from body washes
			Who will benefit from using body washes?
				Ashy skin
				Atopic dermatitis
			Conclusions
			References
		Chapter 11 Facial Cleansers and Cleansing Cloths
			A brief history of facial cleansing
			How facial cleansers work
				Chemistry of cleansing
				Physical cleaning
			Types of facial cleanser
				Lathering cleansers
				Emollient (oil-based) cleansers
				Scrubs
				Cleansing milks
				Toners
				Substrate cleansers
			Guide to selecting facial cleansers
				Selection based on skin type
				Selection based on cleanser form/cleansing ritual
				Selection based on skin problems
			Summary
			References
		Chapter 12 Hand Cleansers and Sanitizers
			Introduction
			Hand microbiota
			Hand hygiene guidelines
			Hand Hygiene Techniques and Compliance
			Antimicrobial handwash and hand sanitizer formulations
			Efficacy of antimicrobial handwashes and hand sanitizers
				In vitro assays for potency and spectrum of activity
				In vivo models with artificial inoculate to mimic transient flora
				In vivo models with artificial inoculate to mimic resident flora
				Clinical studies to demonstrate efficacy in reducing the burden of hand microbiota
			Effectiveness of antimicrobial hand washes and hand sanitizers in institutional and community settings
				Impact on nosocomial infections
				Effectiveness of hand hygiene in the community setting
			Handwash and hand sanitizer safety
				Irritation associated with handwashes and hand sanitizers
				Safety concerns specific to alcohol-based hand sanitizers
				Development of microbial resistance to antimicrobial agents
				Long-term effects on the skin microbiota
			Future directions
			References
		Chapter 13 Shampoos for Normal Scalp Hygiene and Dandruff
			Definition
			Introduction
			Product and formulation technology overview
			Unique attributes of scalp care products
				Retention of active on scalp
				Spatial distribution of deposited active
				Chemical bio-availability
			Advantages and disadvantages of the use of therapeutic shampoos
			Effective use of products
			Benefits of use of scalp care shampoos
			Summary
			References
	Section 2 Moisturizers
		Chapter 14 Facial Moisturizers
			Introduction
			Dry facial skin
			Facial moisturization
			Facial moisturizer formulation
			Moisturizer ingredients and function
				Humectants
				Occlusives
				Emollients
				Fragrance
				Preservatives
				Photoprotection and facial moisturizers
			Facial moisturizer testing
			Use of facial moisturizers in common inflammatory dermatoses
			Conclusions
			References
			Further reading
		Chapter 15 Hand and Foot Moisturizers
			Introduction
			Moisturization needs of the hand and foot
			Moisturizing formulations and technologies
			Natural moisturizing factors
			Ultrastructural effects
			Clinical demonstrations of product efficacy of sodium lactate and urea formulations
				Hand care
				Improvements in urea content
				Improvement in eczema and xerosis
				Foot care
			The future: Next‐generation moisturizers
				Enhanced glycerol derivatives
			Conclusions
			References
		Chapter 16 Sunless Tanning Products
			Introduction
			Sunless tanning products
				Definition
				Active ingredients
				Mechanism of action of DHA
				Alternate actives
			Formulation challenges
				pH and buffers
				Processing and storage of DHA
				Nitrogen-containing compounds
				Sunscreens
			Delivery vehicles
				Creams and lotions
				Gels and gelees
			Regulatory considerations
			Product attributes
				Coloration
				Evaluation
				Moisturization
			Trends in sunless tanning
				Daily use moisturizers/glow
				No-rub mists
				Sunless tanning spray booths
				Sunless tanning products with UV protection
			Conclusions
			References
		Chapter 17 Sunscreens
			Introduction
			Regulatory status of sunscreens
				Sunscreen classification
				Approved UV filters
			Development of sunscreens
				Organic UV filters
				Inorganic UV filters
				Steps toward more efficient sunscreens
				Formulation of sun protection products
			Criteria and methods for evaluating the efficacy of sunscreen products
				Determination of the sun protection factor (SPF)
				SPF labeling
				Determination of UVA protection level
				UVA protection criteria
			Conclusions
			References
	Section 3 Personal Care Products
		Chapter 18 Antiperspirants and Deodorants
			Introduction
			Physiology
				Sweat glands and how they work
				Wetness and odor control and testing
			Chemistry and formulation of antiperspirants
			Delivery systems
			Dermatologic concerns
			Strengths and weakness of antiperspirants
			Conclusions
			References
		Chapter 19 Blade Shaving
			Introduction
			Hair biology basics
				The pilosebaceous unit
				Hair growth cycle
				Properties of hair – impact on shaving
			Shaving and the razor explored
				Evolution of the system razor
				Cutting edge technology
				The shaving process
				Challenges within male blade shaving
			Summary
			References
Part III Adornment
	Section 1 Colored Facial Cosmetics
		Chapter 20 Facial Foundation
			Introduction
			Complexion makeup – an ancient practice
				Ancient Mesopotamia (2500 bc)
				Ancient Egypt (3rd millennium bc)
				Ancient Greece
				Ancient Rome
				From the Middle Ages to the 19th century
				20th century: the industrial era and diversification
			Formulation diversity
				Variety of formulations
				Fluid foundations: emulsions
			Compact foundations
				Powders
				Color creation
				Pigments and coverage
				Importance of fillers
				When color and skincare combine
			Facial foundation application
			Emphasis on quality, safety and confirmed performance
				Design stage
				Formulation stage
				Performance stage
			Conclusions and prospects
			References
		Chapter 21 Camouflage Techniques
			Introduction
			Definitions
			Camouflage makeup application procedures
			Other camouflage therapies
			Medical indications for camouflage makeup
			Beginning a camouflage clinic
			The camouflage therapist
			Camouflage makeup and quality of life
			Conclusions
			References
		Chapter 22 Lips and Lipsticks
			Introduction
			Lip anatomy
				Labial epidermis
				Lip dermis and lamina propria
				Lip topology
				Sensitivity of lips to the environment
				Aging of the lips
				Lip plumpness and cheilitis
				Defects of lip pigmentation
			Lipsticks
				Lipstick formulation
				Waxes
				Waxy pastes
				Oils
				Texturing agents
				Pigments
				Antioxidants and preserving agents
				Perfume
				Active ingredients
				Lip glosses and brilliances
			Conclusions
			References
		Chapter 23 Eye Cosmetics
			Definition
			Eye cosmetic history
			Eyelash physiology
			Mascara
				Mascara composition
				Mascara applicator technology
				Other eyelash treatments
			Eyebrows
			Eyeshadow
			Eyeliners
			Product application
			Safety and regulatory considerations for eye area cosmetics
			The future of eye cosmetics
				Long wear
				Pushing the applicator envelope
				Lash conditioners and growers
			References
	Section 2 Nail Cosmetics
		Chapter 24 Nail Physiology and Grooming
			Introduction: Nail physiology
				Nail unit anatomy
				Nail matrix
				Nail folds
				Hyponychium
				Nail bed
				Other structures
				Nail growth
			Physical properties of nails
				Nail composition
				Nail flexibility
				Nail thickness
			Nail grooming principles
				Nail care
				Nail trimming
				Nail buffing and filing
				Nail painting
				Care for brittle nails
				Adverse effects from nail grooming
				Allergic reactions to nail cosmetic ingredients
				Irritant reactions
				Nail cosmetic procedures
			Conclusions
			References
			Further reading
		Chapter 25 Colored Nail Cosmetics and Hardeners
			Introduction
			Application techniques
			Lacquers, topcoats, and basecoats
				Resins
				Solvents
				Plasticizers
				Colorants
				Thixotropic agents
				Color stabilizers
				Minor ingredients
				Antifungal agents
				Preservatives
			Nail hardeners
			Formaldehyde issues
			UV gel “lacquers” (aka UV gel polish)
			Nail lacquer removers
			Conclusions and future developments
			References
		Chapter 26 Cosmetic Prostheses as Artificial Nail Enhancements
			Introduction
			Liquid and powder
			Rebalancing
			UV gels
			Nail wraps
			Artificial nail removal
			Gel manicure/polish
			Adverse reactions
			Nail damage and infection
			Education
			UV nail lamp safety
			References
	Section 3 Hair Cosmetics
		Chapter 27 Hair Physiology and Grooming
			Definitions
			Physiology
				Hair follicle
				Product of the hair follicle: the hair fiber
				Human hair keratins
			Grooming
				Shampoos: formulations and diversity
				Formulations
				Conditioners
			Conclusions
			References
		Chapter 28 Hair Dyes
			Introduction
			Definitions
			Product subtypes
				Temporary dyes
				Semi-permanent dyes
				Demi-permanent and permanent dyes
				Bleaches
			Chemistry
				Natural hair pigmentation
				Permanent hair dyes
				Melanin bleaching
				Oxidative dye formation
			Formulation
			Advantages and disadvantages
				Advantages
				Challenges
			Product choice and application
			Impact of hair dyes on hair structure
				Recent technology strategies to minimize fiber damage
				Caring for colored hair
			Safety and regulatory considerations
				Allergy
				Key hair dye allergens
				Allergy prevalence of hair dye allergy
				Are children at higher risk to develop hair dye allergic reactions?
				Allergy Alert Test
				Permanent hair dyes with reduced allergy risk
				Cancer
			Conclusions
			Acknowledgment
			References
		Chapter 29 Permanent Hair Waving
			Introduction
			Hair physiology
			Permanent wave hair relevant properties
				Hair geometry
				Hair and water interaction
				Hair aging
				Hair chemical structure
			Chemophysical principles of hair waving
			Perm products and types
				Role of permanent waving product ingredients
				Different product types
				Regulatory aspects of permanent hair waving
			Perming practice – how to achieve a perfect curl
			Safety of and adverse reactions to perm products
			References
		Chapter 30 Hair Straightening
			Introduction
			Thermal processing
			Reducing agents
				Ammonium thioglycolate
				Sulfite
			Hydroxide straighteners
				Chemistry of relaxing
				Application
				Effect of relaxers on hair
			Conclusions
			Appendix
				Thiol procedure with heat
			References
		Chapter 31 Hair Styling: Technology and Formulations
			Introduction
			Definitions
			Physiology
			Formulation
				Polymer formulations
				Wax and emollient formulations
			Product forms, application, and uses
				Hairsprays and liquid settings
				Mousse
				Gels and spray gels
				Creams, pomades, and emulsions
				Waxes and clays
				Silicone serums and sprays
				Products designed for African hair types
				Protecting the hair structure with styling aides
			Considerations for consultations with patients about hair styling
			Future of hair styling aids – trends and technologic development
			Conclusions
			Acknowledgment
			References
Part IV Anti-aging
	Section 1 Cosmeceuticals
		Chapter 32 Botanicals
			Introduction
			Regulatory
			Factors affecting concentration and quality of active ingredients
			Safety
			Effectiveness
			Mechanism of action
			Cosmeceutical products
			Specific herbs to treat or prevent photoaging
				Aloe
				Charentais cantaloupe
				Coffee
				Cucumber
				Feverfew
				German chamomile
				Golden fern
				Grape
				Green tea
				Licorice
				Milk thistle
				Mushrooms
				Maitake mushroom
				Shiitake mushroom
				Oat
				Oleander
				Papaya
				Pineapple
				Pomegranate
				Pumpkin
				Pycnogenol
				Rosemary
				Sage
				Soy
				Swiss apple
				Tamarind
				Turmeric
				Apple
				Date palm fruit
				Flaxseed
				Meadowfoam
				Mountain rose
				Safflower
			Recent herbal clinical trials
			Conclusion
			References
		Chapter 33 Antioxidants and Anti-inflammatories
			Antioxidants
				Introduction
				Antioxidants, free radicals and reactive oxygen species (ROS)
				ROS effects on signaling pathways
				ROS and glycation: effects on skin aging
				Antioxidants protect cells from free radicals, ROS, and glycation
				Antioxidants as anti-inflammatories: effects on cell signaling pathways
				Biology of the skin inflammatory process
				Topical formulation of antioxidants
			Anti-inflammatories
				Prescription medicines for inflammation and mechanism of action
				NSAIDs
				Immunomodulators
				Topical antioxidant anti-inflammatories
				Designing effective anti-inflammatory and anti-aging topicals targeting three key mediators: TNF-alpha, IL-1, and PGE-2
			Conclusion
			References
		Chapter 34 Peptides and Proteins
			Introduction
			Definitions
				Amino acids
				Peptides
				Proteins
			Biological functions of peptides and proteins in the skin
				Peptides
				Obstacles to peptide use in cosmetic formulation
				Antioxidant peptides
				Neuropeptides
				Skin elasticity
				Melanogenesis
			Proteins
				Proteolytic enzymes
				T4 endonuclease V
				Superoxide dismutase and catalase
			Conclusion
			References
		Chapter 35 Cellular Growth Factors
			Introduction
			Physiology
				Skin aging and wound healing
				Role of cellular growth factors in skincare
			Unique attributes
			Advantages and disadvantages
				Clinically proven benefits in reversal of skin aging and post-procedure healing
				Risks associated with growth factors
				Maintaining activity of growth factors through product shelf-life
			Ingredients
				Natural growth factors
				Growth factors secreting stem cells
				Synthetic growth factors
			Related products
				Phytokinins
			Alternate delivery methods
			Conclusions
			References
		Chapter 36 Topical Cosmeceutical Retinoids
			Biological concepts
				Therapeutic and cosmeceutical retinoids
				Epidermal vitamin A
				The intracrine pro-ligand concept
				Hyaluronan as a partner for cosmeceutical retinoids
			Specific profiles of cosmeceutical retinoids
				Retinaldehyde
				Retinol and retinyl esters
				Associations
			Summary
			References
		Chapter 37 Topical Vitamins
			Introduction
			Vitamin A
				Forms
				Mechanisms
				Topical effects
				Formulation challenges
			Vitamin B3
				Forms
				Mechanisms
				Topical effects
				Formulation challenges
			Vitamin B5
				Forms
				Mechanisms
				Topical effects
				Formulation challenges
			Vitamin C
				Forms
				Mechanisms
				Topical effects
				Formulation challenges
			Vitamin E
				Forms
				Mechanism
				Topical effects
				Formulation challenges
			Other vitamins
				Vitamin D
				Vitamin K
				Vitamin P (flavonoids)
			Discussion
			References
		Chapter 38 Clinical Uses of Hydroxyacids
			Introduction
			Chemical categorization and natural occurrence of hydroxyacids
				Alpha-hydroxyacids
				Beta-hydroxyacids
				Polyhydroxy acids
				Aldobionic acids or bionic acids
				Aromatic hydroxyacids
			Physicochemical and biological properties distinguishing HAs
				Water binding properties/gel matrix formation
				Antioxidant properties
				Antiglycation effects of PHA and bionic acids
				Sun sensitivity
				Sensory responses
				MMP inhibition effects of bionic acids
			Effects of HAs on skin – similarities and differences
				Stratum corneum and epidermis
				Dermis
			Clinical uses of HAs
				Dry skin and hyperkeratinization
				Keratoses and dyspigmentation
				Wrinkles and photoaging
				Uses as a peeling agent
				Synergy with topical drugs
			Conclusions
			References
		Chapter 39 The Contribution of Dietary Nutrients and Supplements to Skin Health
			Introduction
			Nutrients and their role in protecting against UV-induced damage
			Nutrients and their role in improving skin appearancwe
			Nutrients shown to provide additional skin benefits
			Nutrients and their potential in improving dermatologic disorders and wound healing
			Conclusions
			References
	Section 2 Injectable Anti-aging Techniques
		Chapter 40 Botulinum Toxins
			Introduction
			Mechanism of action
			Neurotoxin physical characteristics
			Product stability
			Safety and contraindications
			Standard injection techniques
				General considerations
				Treatment of the upper face
				Treatment of the mid-face
				Treatment of the lower face
			Combination of botulinum toxin with fillers
			Complications and management
				Upper face
				Lower face
			On the horizon
			References
		Chapter 41 Hyaluronic Acid Fillers
			Introduction
			Chemical composition and properties of hyaluronic acid fillers
			Indications
			Injection techniques
			Complications
			Treatment optimization: persistence of dermal fillers and in vivo collagen stimulation
			Summary
			References
		Chapter 42 Calcium Hydroxylapatite for Soft Tissue Augmentation
			Introduction
			Physiology and pharmacology
			Indications and techniques
			Complications
			Conclusions
			References
		Chapter 43 Autologous Skin Fillers
			Introduction
			Platelet-rich plasma
				Introduction
				Preparation of platelet-rich plasma
				Techniques for PRP injection
				Adverse reactions
			Autologous fibroblast cell therapy
				Introduction
				Preparation
				Techniques for autologous fibroblast injection
				Adverse reactions
			Adipose-derived stem cells
				Introduction
				Preparation
				Techniques for adipose-derived stem cell injection
				Adverse reactions
			Conclusion
			References
		Chapter 44 Polylactic Acid Fillers
			Introduction
			Advantages and disadvantages
			Standard injection techniques
			Advanced techniques
			Complications
			PLLA compared with other fillers
			Conclusions
			References
	Section 3 Resurfacing Techniques
		Chapter 45 Superficial Chemical Peels
			Definition
			Physiology
				Indications
				Depth of peel
				Histologic changes
			Formulation
				Alfa-hydroxy acids (glycolic, lactic, malic, oxalic, tartaric, and citric acid)
				Pyruvic acid (alfa-keto acid)
				Jessner’s solution (resorcinol 14%, lactic acid 14%, and salicylic acid 14% in alcohol)
				Trichloroacetic acid
				Salicylic acid (ortho-hydroxybenzoic acid)
				Tretinoin peel
				Resorcinol (m-hydroxybenzene)
				Solid carbon dioxide (dry ice)
			Advantages and disadvantages
			Standard technique
				Initial consult
				Priming
				Peel procedure
				Post-care
			Advanced techniques/specific uses
				Depth controlled TCA peel
				Fluor-hydroxy pulse peel
				Chemical reconstruction of skin scars
				Treatment of acne vulgaris
				Treatment of post-inflammatory hyperpigmentation/melasma
			Complications
			Conclusions
			References
		Chapter 46 Medium Depth Chemical Peels
			Introduction
			Formulations
				Trichloracetic acid
			Advantages and disadvantages
			Indications
			Contraindications
			Standard technique
				Jessner’s TCA peel procedure after Monheit
			Informed consent
			Setup
			Patient preparation
			Analgesia and sedation
			Application technique
			Post-procedure
			Complications
			Long-term care
			Conclusions
			References
		Chapter 47 CO2 Laser Resurfacing: Confluent and Fractionated
			Introduction
			CO2 laser resurfacing
			Fractionated CO2 laser resurfacing
				Active and Deep FX-Lumenis
				Fraxel Re:Pair – Solta Medical
				MiXto SX – Lasering USA
				Mosaic eCO2™ – Lutronic
				Pixel CO2 – Alma Lasers
				SmartXide DOT – DEKA, Italy
				CO2RE – Syneron–Candela
				SmartSkin – Cynosure
				ProFractional and ProFractional-XC – Sciton
				Pixel 2940 – Alma
				Lux 2940 – Cynosure
				Xeo Pearl Fractionated – Cutera
			Technique and procedures for fractionated laser treatment (Active/Deep FX)
				Preoperative
				Postoperative
			Identification and management of complications
			Conclusions
			References
			Further reading
		Chapter 48 Nonablative Lasers
			Introduction
			Pathophysiology
			Nonablative modalities
			Potassium titanyl phosphate (KTP) 532 nmlaser
			Pulse dye laser (PDL) 585 nm or 595 nm
			Intense pulsed light (IPL)
			1320 nm Neodymium yttrium aluminium garnet (Nd:YAG)
			Q-switched (QS) Nd:YAG 1064 nm laser
			Erbium:glass 1540 nm
			1450 nm diode laser
			Infrared light devices (1100–1800 nm)
			Radiofrequency devices (RF)
			Advanced approaches
			Complications
			Conclusions
			References
		Chapter 49 Dermabrasion
			Definition and history
			Mechanism of action
			Indications
			Advantages and disadvantages
			Patient selection and preoperative consultation
			Instrumentation
			Standard technique
			Advanced technique
			Postoperative wound care
			Summary
			References
	Section 4 Skin Modulation Techniques
		Chapter 50 Laser-assisted Hair Removal
			Introduction
			Biology of hair follicles
			Basic concepts of laser-assisted hair removal
			Preoperative management
			Description of techniques
				Long pulsed 694 nm ruby laser
				Long pulsed 755 nm alexandrite laser
				Long pulsed 800 nm diode laser
				1064 nm Nd:YAG laser
				Intense pulsed light
			Radiofrequency combinations
			Other removal methods for non-pigmented hair
			Postoperative management
			Complications
			Future directions
			Conclusions
			References
		Chapter 51 Radiofrequency Devices
			Introduction
			Radiofrequency devices
			Monopolar radiofrequency
				Complications
				Future directions
				Summary
			Bipolar radiofrequency and light
			Bipolar radiofrequency and vacuum
			Unipolar and bipolar radiofrequency device
			Subdermal radiofrequency
			Conclusions
			Further reading
		Chapter 52 LED Photomodulation for Reversal of Photoaging and Reduction of Inflammation
			Introduction
			Clinical applications
				Photorejuvenation
			Anti-inflammatory effects
				Photodynamic therapy
			Conclusions
			References [CH3]
	Section 5 Skin Contouring Techniques
		Chapter 53 Liposuction: Manual, Mechanical, and Laser Assisted
			Introduction: history of liposuction with tumescent local anesthesia
			Physiology: what skin contour problem does the procedure address and how does this procedure alter the contour problem?
			Advantages and disadvantages
			Indications for tumescent liposuction, by anatomic site
				Abdomen
				Hips, outer thighs, and buttocks
				Arms
				Neck and jowls
				Female breast
				Male chest
			Anesthesia technique
			Standard and advanced operating technique
			Equipment
			Complications
				Preoperative phase
				Intraoperative phase
				Postoperative phase
			Conclusions and future directions
				Laser-assisted liposuction
				Liposuction with TLA for lipedema
			References
		Chapter 54 Liposuction of the Neck
			Introduction
			Anatomy
			Aesthetic considerations
			Patient selection
			Consultation and physical examination
			Procedure
				Markings
				Anesthesia and infiltration
				Liposuction: standard operative techniques
				Postoperative course
			Complications
			Advanced and ancillary operating techniques
			Conclusions
			References
		Chapter 55 Hand Recontouring with Calcium Hydroxylapatite
			Introduction
			Physiology of the hand
			Advantages of calcium hydroxylapatite for treatment of the aging hand
			Technique of injection of CaHA into the hand
				Preparing the Radiesse-lidocaine mixture
				Where to inject
				How to inject
				Post-injection hand massage
				Post-treatment care
			Adverse events
			Results
			Discussion
			Conclusions
			References
	Section 6 Implementation of Cosmetic Dermatology into Therapeutics
		Chapter 56 Anti-aging Regimens
			Introduction
			Cleansing
			Exfoliation
			Protection
			Treatment
				Hydroxyacids
				Retinoids
				Antioxidants
				Vitamin C
				Vitamin E (d-α-tocopherol)
				Vitamin C with vitamin E
				Vitamin C with vitamin E and ferulic acid
				Other antioxidants
			Conclusions
			References
		Chapter 57 Over-the-counter Acne Treatments
			Introduction
			Soaps and syndets
			Benzoyl peroxide
			Alpha-hydroxy acids
			Salicylic acid
			Polyhydroxy acids
			Sulfur
			Triclosan and triclocarban
			Retinols
			Cleansing cloths
			Mechanical treatments
			Essential oils
			Oral vitamins
			Conclusions
			References
		Chapter 58 Rosacea Regimens
			Introduction
			Physiology of rosacea
			Rosacea flare
			Rosacea skincare: available OTC products
			Cleansing and moisturizing
			Cosmetics
			Sunscreens
			Available prescription agents
			Oral antibiotic therapy
			Topical therapy
			Other treatment modalities
				Light-based therapies
				Natural actives
			Conclusions
			References
		Chapter 59 Eczema Regimens
			Introduction
			Etiology
			Moisturizer mechanism of action
			Moisturizer goals in eczema
			Moisturizer delivery systems
				Moisturizing emulsions
				Moisturizing serums
				Moisturizing liposomes and niosomes
				Multivesicular emulsions
				Moisturizing nanoemulsions
			Developing a moisturizer regimen
			Conclusions
			References
		Chapter 60 Psoriasis Regimens
			Introduction
			Physiology
			Role of OTC medications
				Psoriasis education
				Role of self-treating
				OTC products recommended by physicians
				Compliance in psoriasis treatment
			Moisturizers and keratolytics
			Tar
			Hydrocortisone
			Other OTC products
			Ultraviolet light (UV) therapy
			Combination regimens
			Summary
			References
Index
EULA