Retinol Tolerance: What You Need to Know

Retinoids are found in the skincare routines of many, as these are the second-best methods for preventing aging, right after sunscreen. Comprising vitamin A and its derivatives, retinoids work by binding to nuclear receptors and modulating the expression of genes that regulate cell differentiation and proliferation. This causes normalisation of cell keratinisation, which is the process of the outermost cells of the epidermis being replaced by keratin.

Tretinoin is a natural retinoid available by prescription, and tazarotene and adapalene are synthetic retinoids. There are also many over the counter products made with retinol and retinyl esters, such as the Zo product line, that are easy to incorporate into a routine for people seeking skin rejuvenation and a youthful complexion. While retinoids are sometimes avoided due to their side effects, these can be overcome with proper use.

Benefits of Topical Retinoids

When Kligman and Willis introduced the first topical retinoids in 1975, they noted beneficial properties of the active compounds, including the improvement of wrinkles, skin texture, and skin tone. Histological experiments demonstrated that retinoids reduce corneocyte adhesion and epidermal hyperplasia, and increase collagen and elastin production. Five years later, they discovered that they could also block collagenase activity, which is an enzyme responsible for collagen degradation.

Most literature mentions tretinoin when discussing retinoids, and how the benefits of topical vitamin A derivatives manifest on the skin. Tretinoin enhances cell turnover in the epidermis and promotes the loss of pigment through epidermopoiesis. This is what creates the more even complexion. Furthermore, numerous clinical trials have reproduced the findings and are the reason why dermatologists recommend this product to patients seeking smooth, firm, and evenly pigmented skin.

Retinoids should be used continuously to see the best results as they do not show up until three months into regular product use. Smoother skin, however, will be visible after one month. Using retinoids long-term is required to maintain results, and there is no limit to treatment duration. Pregnant and breastfeeding women are the exception and must avoid these products due to teratogenic effects on fetuses.

Patient Tolerability

Retinoids unfortunately cause retinoid dermatitis in 95% of patients – this redness, flaking, and sensitivity can be unpleasant and limit patient tolerability and compliance to long-term use. Retinol has been reported to cause similar cellular changes to retinoids, but it is milder and has less side-effects. In studies comparing the two compounds, it is assumed that retinol induces the same effects but at a lower magnitude. The most attractive aspect is the milder side-effects.

Treatment should be individualized to increase patient compliance, and other skincare products may be used if needed. For example, patients should be advised that dermatitis is normal and will appear within the first two weeks of use but subside after approximately one month of use. Scaling and stinging are normal and are even a good way to know that the product has been properly dosed. Application frequency may be adjusted by the patient to prevent these side effects, according to the recommendations of their dermatologist.

Tips for Compliance

The following are tips adapted from the original Tretinoin product guidelines by Kligman:

• Patients should begin treatment with a low dose of retinol – the strength can be increased over time. It is best to start at 0.3% retinol.

• The face should be cleansed in the morning and evening, using warm water and clean hands. The skin must be dried thoroughly before using retinol. Moisturizer can be used in the morning.

• Due to its photosensitizing properties, retinoids should be used at night. A pea-sized amount is enough. Stinging will indicate the correct amount of product was used. It should be applied alone as other products might dilute the retinoid.

• A good daytime moisturizer can reduce peeling – if acne is a concern, lighter moisturizers are better. Continue to moisturize even on days retinoids are not used. At night once it has been applied, wait 30 minutes to moisturize so that the retinol fully absorbs first.

• Retinoids should be introduced slowly by tapering the application frequency, especially for those with sensitive skin. Short-contact therapy can also be used by rinsing the product off 30 minutes after application.

• Retinoids can also treat hands and forearms, but the eyes and lips should be avoided as they are sensitive. However, the product can be applied right up to the margins. Eye products have been designed with much lower concentrations of retinol. The décolletage should also be treated with caution as it is thin – treat it every third night.

• Patients should be advised of side effects as some will experience retinoid dermatitis beyond one month – they should know that this is normal, and not a reason to quit treatment.

• The retinol dose can be slowly increased after three months of use. Eventually, a retinoid prescription may be given by a dermatologist, and patients may experience irritation or dryness even if they managed to avoid it at lower doses.

• Sunscreen with SPF 30 minimum must be used while using retinoids due to the thinning of the stratum corneum. Avoid products such as scrubs and enzyme peels, as they can cause irritation.

• Results will be evident after three months of use, and continuing use is a must in order to maintain results. After about eight months, the number of applications can be reduced to twice weekly.

Conclusions

Retinols and retinoids can largely improve the appearance of skin by reducing wrinkles, increasing smoothness, and evening out skin tone. Retinols are milder than prescription retinoids and will help patients gain similar effects without irritation. Retinoid dermatitis is often unavoidable but resolves quickly – patients should be educated about the side effects in order to increase their compliance and allow them to achieve optimal results.

When it comes to fine lines and wrinkles, there are many different potential causes. It is important to understand what causes you can attribute to your specific case, as this is often the deciding factor when considering treatments. It also helps to understand the general causes of fine lines and wrinkles so that you can be proactive in slowing down their appearance.

Common Causes of Fine Lines and Wrinkles

Some of the most common causes of fine lines and wrinkles include the following:

• Age: Unfortunately, there is little to be done for the aging process. As the skin ages, the body slows down its collagen and elastin production. This mostly happens in areas surrounding the eyes, mouth, neck and forearms, causing fine lines and wrinkles.

• The Sun: Exposure to the sun’s ultraviolet rays breaks down your skin’s connective tissue and speeds up the skin’s aging process.

• Facial Movement: Repeated facial movements that tense the muscles also cause wrinkles and fine lines. These include nasolabial folds, laugh lines, and brow furrows from expressions like squinting and frowning.

• Smoking: Smoking changes how the blood oxidizes and circulates throughout the body. It also damages the production of collagen and elastin in the body, essentially speeding up the body’s aging process.

• Alcohol: Drinking alcohol depletes the body of vitamin A, which is crucial to skin health, and dehydrates the skin, which can cause wrinkles.

How to Protect Yourself from Fine Lines and Wrinkles

While there is little to be done to stop some of the causes of fine lines and wrinkles, there are many options available for slowing down the process. These include the following:

1.  Protect Your Skin: Avoiding direct contact with the sun’s rays is a great way to slow down or prevent early signs of aging.

2. Healthy Diet: When it comes to the skin, foods that contain vitamins D, A, and E are excellent for the skin. Removing sugars, bad starches, and saturated fats from your diet is also recommended.

3. Water: Drinking plenty of water is key to healthy skin. Water provides the body with much-needed hydration that keeps the skin soft and voluminous. It also helps flush toxins out of the body.

4. Moisturize: Applying a high-quality moisturizer helps the skin retain its elasticity.

How to  Get Rid of Fine Lines and Wrinkles

No matter how vigilant you are, wrinkles and fine lines are a normal part of the aging process. When they do appear, dermal fillers and injectables are a popular and effective way of reducing their appearance that is more affordable and less invasive than plastic surgery. Popular dermal fillers brands include the following:

• Juvederm, Restylane: Used for many purposes, including filling in fine lines and deep wrinkles and folds around the eyes, mouth, brows, neck, and chin. These formulas contain a mixture of hyaluronic acid that is cross-linked with BDE or lidocaine.

• Botox: Used to smooth the skin by preventing muscle contractions that highlight wrinkles, Botox contains botulism toxin type A.

• Radiesse: Excellent for reducing the appearance of deep wrinkles and folds like frown lines, brow creases, and nasolabial folds around the mouth. Radiesse dermal injection contains calcium hydroxylapatite.

The fillers above are commonly used by physicians and contain minerals and compounds that are already found in the body, making them unlikely to cause serious side effects. If you wish to get rid of wrinkles and fine lines, consider talking to your doctor or dermatologist about dermal fillers today.

Juvéderm Voluma XC, commonly referred to as Voluma, is a popular dermal filler variant from the Juvederm family. Manufactured by Allergan, it was one of the first dermal fillers approved by the Food and Drug Administration (FDA).Juvéderm Voluma XC is a dermal filler that is hyaluronic acid-based. It is FDA-approved for adding volume to the cheeks and midface area, but is also used in off-label areas like the nose, temples, and chin.

Its mild side effects include swelling and its effects last for up to 2 years. Juvederm Voluma XC costs up to $1000 per syringe and treatment cost varies depending upon individual clients needs.

What is Juvéderm Voluma?

Juvéderm Voluma is a smooth gel that retains its shape over a long period of time. It is commonly used to correct symptoms of aging, such as volume loss in the cheeks and surrounding areas.

All of the Juvéderm fillers beginning with the letter V are created using Vycross technology. This method is highly concentrated and cross-linked, allowing for more points of attachment between molecules.

Hyaluronic acid (HA), the main active compound in Voluma, is a naturally occurring sugar that is found in the human body. It also contains lidocaine, an anesthetic that reduces pain and discomfort in the treated area.

Where Should Juvéderm Voluma be Used?

Voluma was developed for use in the midface and cheek areas and is currently only FDA-approved for this. That being said, there are a handful of off-label uses for the dermal filler that have had desirable results, such as around the nose, chin, temples and under the eyes.

Aesthetic Surgery Journal found Voluma nose injections to have a positive effect in 96% of people who used the product, while JAMA Facial Plastic Surgery looked at Voluma for use in the undereye area, with 71% of patients reporting great results. In a study done in Europe, Voluma injections into the chin found a 98% success rate in improving the aesthetic.

Although further study may prove positive, currently Juvéderm Voluma is not a suitable filler to use in the lips and the surrounding areas. Due to high viscosity, this may result in a lumpy appearance.

Treating these areas may not be FDA-approved due to a lack of published evidence supporting the effectiveness or due to the manufacturer not seeking approval.

How Does Juvéderm Voluma Work?

Juvéderm Voluma operates similarly to other dermal fillers. It is injected into the desired area and the areas surrounding it, penetrating deep into the skin. It is then massaged evenly into the treatment area. The result is a plumper face with more volume in the cheeks.</

How Effective is Juvéderm Voluma?

In order to achieve FDA approval, a 2-year controlled clinic trial was performed. Random and multicentered, its goal was to prove the safety and effectiveness of Juvéderm Voluma XC.

The study found that nearly 50% of the group maintained their positive outcomes for 24 months, with most of the patients experiencing an objective improvement in volume and appearance.

Many subjects reported looking an average of 5 years younger, with full results being seen after only 6 months of treatment. 90% of subjects felt satisfied with the results after 6 to 12 months.

Two additional studies corroborated this outcome, with the first seeing a 95% satisfaction rate in patients after only 3 weeks. The second study ran for 2 years and found 91% of patients to be satisfied with the results of Voluma.

All of the studies conducted concluded that Voluma is effective with very few negative side effects.

Safety and Side Effects

All dermal fillers, Voluma included, are considered safe treatments. All studies have shown serious complications and side effects to be rare and not directly linked to the use of Voluma alone.

However, some side effects can occur with the use of Juvéderm, including pain, redness, itching, swelling, tenderness and bruising after treatment.

In 94% of cases, these issues resolved themselves in an average of 2 weeks, although some subjects experienced infections and longer lasting side effects.

A small number of these cases required additional treatment with antibiotics, hyaluronidase or anti-inflammatories. Side effects are also noted to have lasted longer in subjects who are over the age of 50, and who received larger volumes Voluma.

In all cases, the symptoms were resolved either naturally or with treatment.

Aftercare and Recovery

Following treatment, it is advised that you avoid physically taxing activities, such as sports and exercising, harshly washing your face for 24 to 48 hours and direct sunlight for 24 to 48 hours.

If you are taking any type of herbal supplement or medication, primarily those that thin the blood, you may be at risk of bleeding during Voluma treatment.

All Juvéderm products have a typically short recovery time. In almost all cases the swelling, redness, and tenderness go away within 15 days.

If you experience symptoms that last longer or are more painful than expected, please contact your doctor immediately.

How Much Does Juvéderm Voluma Cost?

The average cost of Juvéderm Voluma is $800 to $1,000 per syringe. Most treatments require only one syringe, but some may require more. For example, injections to the midface on those who are over 50 years old are likely to need 2 syringes, as well as treatments to the nose ands chin.

Due to the difference in desired results, the price varies and can be as high as $1,500 or more per syringe. Additionally, you are required to pay facility and physician fees, which also vary depending on the treatment and desired results.

While the price varies, Juvéderm Voluma generally provides a cost-effective alternative to other, more invasive, solutions for improving these areas.

Juvéderm Voluma is a safe and effective facial dermal filler offering long-lasting results of up to 2 years. While Voluma is only approved for the cheek area by the Food and Drug Administration (FDA), it has had great results in the nose, chin, and undereye areas as well.

As the popularity of the vegan lifestyle and of minimally invasive cosmetic treatments grows, it can only lead to one thing: more patient inquiries regarding vegan-friendly cosmetic injections. While you may be an expert at restoring youth and beauty, these lifestyle questions can be difficult to address. Read on to find out whether top brand names like Juvederm, Restylane, Botox, and more fit the bill.

What makes a product vegan?

Two main factors determine if a product is vegan: its ingredients and its testing.

Ingredients

For a product to be considered vegan, it must contain no animal products and no ingredients derived from animals. A vegan individual does not consume meat, eggs, dairy or other products obtained from animals and also does not wear leather, fur or wool.

Product testing

For a product to be considered vegan, it must not be tested on animals. While, legally, a product can be labelled as vegan if it does not contain animal ingredients, most vegans prefer that their products not be tested on animals.

Is Botox vegan?

Among the most popular cosmetic injectables, Botox contains botulinum toxin, which is produced by Clostridium botulinum bacteria. While this ingredient is vegan, a secondary ingredient in Botox is human albumin, which is a protein from human blood. Although the main ingredient in Botox comes from bacteria, Botox is not vegan.

Botox is also tested on animals. To determine the Lethal Dose (LD50) of each batch, Allergan injects mice with the solution and records how many die. Allergan is working to reduce its animal testing by 95% by switching to a cell-based assay. Although this has not completely eliminated their animal testing, it is a large improvement.

Are other botulinum toxins vegan?

Botox’s main rivals, Xeomin/Bocouture and Dysport/Azzalure, also contain human albumin. The two manufacturers also test on animals, although Merz is switching testing types for a 95% reduction in animal testing for Xeomin and Bocouture. Ipsen has pledged to stop animal testing of its Dysport and Azzalure.

The South Korean company Medytox produces a botulinum toxin that does not contain human albumin. Neuronox contains a plant protein, which makes its ingredients vegan and, arguably, safer for human use. Unfortunately, this vegan Botox alternative is not available in the U.S.

Is Juvederm vegan?

Juvederm products are made of hyaluronic acid, which is a natural wrinkle-filling substance found throughout animal tissues. While many orthopedic injectables are made with hyaluronic acid found in rooster combs, most dermal fillers, including Juvederm, source theirs from bacterial fermentation. Since Juvederm fillers are produced using bacterial fermentation, their ingredients are vegan.

However, most medical products, including dermal fillers, are required by law to be tested. Juvederm has been tested on animals, but just as with Botox, Allergan has committed to greatly reducing their animal testing.

Is Restylane vegan?

Like Juvederm, Restylane fillers are made from non-animal hyaluronic acid. Produced by bacterial fermentation, this hyaluronic acid does not come from animal sources, and is therefore vegan-friendly. However, Restylane has been tested on animals.

Is Filorga vegan?

Similar to Juvederm and Restylane, Filorga fillers are made with vegan hyaluronic acid that is produced through bacterial fermentation. According to Filorga, they do not test their cosmetic products on animals, although it is unclear if this applies to their cosmetic injectables as well.

Are other lip fillers and dermal fillers vegan?

Most lip fillers and dermal fillers are made of hyaluronic acid from bacterial fermentation. Although this is a vegan-friendly ingredient, most medical products in the U.S. have undergone some sort of animal testing, which means that these fillers are likely not cruelty-free.

Can vegans receive cosmetic injections?

As more people choose to become vegan, and still others become more aware of animal testing and other ethical concerns, you will likely receive more questions about the ingredients and testing of the products in your clinic.

For vegan patients with dynamic wrinkles, there is no botulinum toxin currently available in the U.S. that is both made with vegan ingredients and not tested on animals. Some vegan patients may opt for lip and dermal fillers, as the majority of hyaluronic acid fillers are produced with bacterial fermentation, making them non-animal products. However, most have been tested on animals. While some vegan individuals may accept products that have been tested on animals, others may not. It is important to provide all relevant information to your patients and let them determine what they are comfortable with.

The loss of bladder control is a common condition, especially in women. This condition, which is also known as urinary incontinence or bladder leakage, can be caused by muscular factors—such as the weakening of the pelvic wall, a condition commonly seen after childbirth—or by neurological factors due to the uncontrolled contractions or spasm of the bladder wall. Botulinum toxin products, especially Botox, have been used in the treatment of incontinence caused by muscle hyperactivity for over a decade. In the United States, the FDA has granted approval for Botox to treat two types of bladder dysfunction: an overactive bladder, and detrusor overactivity associated with a neurologic condition.This article will delve deeper into the use of Botox for treating urinary incontinence in part by focusing how Botox works and how to administer the drug.

What is botulinum toxin and how does it treat urinary incontinence?

Botulinum toxin treatments are best known as a type of cosmetic injection. For aesthetic indications like the treatment of dynamic facial wrinkles, toxins like Botox treat these wrinkles in order to counteract the effects of aging. However, that is not all that botulinum toxins can do. Botox is a highly versatile injectable, and this is due in part to its ability to relax treated muscles and prevent them from contracting. This mechanism of action makes Botox very useful in the treatment of movement and neuromuscular disorders; certain pain-associated disorders, such as chronic migraines; and certain bladder dysfunctions.

When treating an overactive bladder or detrusor overactivity associated with a neurologic condition, Botox is injected into the detrusor, the muscle in the bladder wall, to prevent hyperactivity.

Which patients are not good candidates for Botox treatment?

Patients that have an existing medical condition that may impede on neuromuscular function-such as myasthenia gravis, Eaton-Lambert syndrome, or amyotrophic lateral sclerosis-should not receive Botox treatment. Additionally, female patients who are expecting or nursing should be excluded from treatment. Finally, patients who currently have a urinary tract infection (UTI) or are not able to empty their bladder on their own (and are not routinely catheterizing) should not receive Botox injections for their bladder dysfunction.

Administration of Botox: professionals

For these purposes, Botox is administered to the detrusor muscle via cystoscopy. Botox is supplied in the form of a white lyophilized powder that will have to be reconstituted prior to use. To reconstitute Botox, the following steps are recommended:

• The diluent of choice is sterile, preservative-free 0.9% sodium chloride Injection, USP.

• Determine the appropriate dose. For an overactive bladder, the recommended dilution is 100 units/10ml; for detrusor overactivity associated with a neurologic condition, the recommended dilution is 200 units/30 ml. Draw up the suitable amount of diluent in an appropriately-sized syringe, and slowly dispense the diluent into the vial by injection. Gently mix by rotating the vial.

• Store the reconstituted solution in a refrigerator (2-8°C). Administer the solution within 24 hours after reconstitution.

The following are considerations and precautions of treating bladder dysfunction with Botox injections:

• Prior to treatment, start the patient on a course of prophylactic antibiotics that excludes aminoglycosides three days before treatment and extends this course to one to three days post-treatment. This is to minimize the risk of contracting a urinary tract infection.

• If the patient is receiving anti-platelet therapy, they should stop taking the medication at least three days before the injection procedure. These patients should be managed with caution to prevent excessive bleeding.

• Choice of anesthesia comprises either the intravesical instillation of diluted local anaesthetic with or without sedation, or general anaesthesia. If a local anesthetic instillation is used, the bladder should be drained and irrigated with saline before injection.

• Prior to the cystoscopy procedure, instil the bladder with saline with an amount sufficient for visualization but not enough to cause overdistension.

• Prime the needle with 1ml of reconstituted Botox before the start of injections to remove any air.

To administer Botox for the treatment of an overactive bladder, do the following:

• Inject reconstituted Botox solution into the detrusor muscle in 20 injections of 0.5ml each for a total volume of 10ml. Injection should be achieved via a rigid or flexible cystoscope. Be sure to avoid the trigone when injecting.

• The needle should be injected about 2mm into the detrusor.

• Once the procedure is complete, the patient should be observed for 30 minutes and should be released only once they have demonstrated their ability to adequately discharge urine.

To administer Botox for the treatment of detrusor overactivity associated with a neurologic condition, do the following:

• Inject reconstituted Botox solution into the detrusor muscle while avoiding the trigone. The injection regimen entails a total of 30 injections of 1ml each for a total volume of 30ml. Injection should be achieved via a rigid or flexible cystoscope.

• The needle should be inserted approximately 2mm into the detrusor.

• Upon completion of the procedure, drain the bladder of the saline used for visualization. The patient should be then observed for half an hour.

What are the complications that can potentially develop as a result of Botox treatment?

After treatment, Botox will start to take effect after about two weeks, and patients should plan for repeat treatments about every six months but no sooner than three months from the preceding treatment. The side effects associated with Botox treatment for overactive bladder are mild and minimal. They can include dysuria (pain during urination), urinary tract infection, and temporary urinary retention (inability to empty the bladder spontaneously).

Conclusion

Botox has a wide variety of therapeutic indications, including the management of symptoms of certain types of bladder dysfunction. If you think you could benefit from Botox for incontinence, talk to your doctor about treatment options.

What Are They?Synvisc (Hylan G-F 20) is the brand name for the high-molecular-weight injectable fluid that contains both hylan A and hylan B polymers. The polymers in Synvisc, like most hyaluronic derivatives, are derived from rooster combs and are classified as avian-derived hyaluronic acid (AV-HA).

Euflexxa, on the other hand is made from a very highly purified product extracted from bacterial cells. It is a polysaccharide consisting of a repeating disaccharide of N-Acetylglucosamine and sodium glucuronate that are linked by glycosidic bonds.

What are the Differences?

While viscosupplements from Supartz, Synvisc, and other AV-HA brands are similar in their efficacy, Synvisc offers a one-dose treatment that prevents multiple trips to a doctor’s office. According to the National Institute of Health, AV-HA treatments all appear to relieve pain for between 4 and 14 weeks by restoring both mechanical and biomechanical homeostasis in the joint.

A difference in price gives Euflexxa a bit of an edge. At present, Euflexxa is about 20% cheaper than AV-HA treatments. However, in a free-market economy, the price difference between Euflexxa and AV-HA treatments is likely to switch repeatedly. Both treatments are significantly cheaper than total knee replacement, which can cost over $20,000 in the United States.

Hyaluronic Derivative Treatments for Osteoarthritic Joints

Hyaluronic derivatives, called antirheumatics, are used for treating osteoarthritis and other joint conditions in which the body’s natural lubricant no longer functions as an adequate shock absorber—this is most notable in the arthritic knee.

These pharmaceuticals are used when other treatments fail. Viscous substances, they are injected into the osteoarthritic joint, lubricating it and thereby diminishing friction, inflammation, and the resulting pain.

The real benefit of this treatment is to delay— or even prevent—total knee replacement. This is especially important because artificial knees have a short life span, so a young knee-replacement recipient would be likely to require a second replacement.

The Importance of Sodium Hyaluronate

Sodium hyaluronate is a natural and common polysaccharide that is found in both connective tissue and synovial fluid. The lubricative properties in synovial fluid are important to the smooth functioning of a joint. Because it is both viscous and elastic, sodium hyaluronate injections can help supplement joint lubrication when the natural processes fall short.

Most hyaluronic derivatives come from rooster combs. One hyaluronic derivative in particular— Euflexxa— is different in that it is produced commercially from bacterial cells. Thus, Euflexxa is the first non-avian-derived hyaluronic derivative.

Treatment Considerations

Typically, the treatment prescribed is based on a risk-vs-benefit scale. Cost-effectiveness also comes into play when third-party payers implement cost-containment measures.

Sometimes the cost of these treatments can be misleading. For example, the cost of the single dose Synvisc One is about three times higher than the cost of the same treatment given in three weekly doses. Therefore, the only savings would come from fewer co-pays resulting from fewer office visits.

However, the scientific literature on various joint treatments incorporates a very important factor into the cost: the delay in total knee replacement that can be achieved. The longer the delay, the more the cost savings. It is on this measure that Euflexxia seems to score slightly higher than other hyaluronic derivatives.

Disclaimer: The contents of this article are not to be constructed as medical advise but for informational purposes only. MedicaDepot staff does not review any of this articles for medical validity. Opinions and views expressed in this article are not endorsed by MedicaDepot. Please always consult your doctor for professional medical advise.

Study Finds Best Filler for Chinese Patients

Experienced doctors know that patients need tailored treatment plans. The best way to get the most effective treatment is to discuss a patient’s expectations and goals for receiving any kind of facial rejuvenation, so that a personalized treatment plan can be administered based on the patient’s age, skin type, the severity of the issues being treated, and many more factors. But, what if there is more to determining the best treatment for your patients?

Finding the right filler

While there is a distinct and obvious difference between the kinds of wrinkles and lines that are most effectively treated certain fillers, there is also a difference in effectiveness even amongst dermal filler products. With such a large variety of products available to choose from, including popular brands such as Juvederm, Restylane, fillers family from Radiesse, and fillers made by Sculptra, to name a few, it can sometimes be a challenge to know which cosmetic injectable will be the right fit for any given patient. The thickness of the product, the concentration of the active ingredient, and the technology used to produce the gel are all factors that can determine which product will be the most effective on a specific issue. When it comes to the patient, their age, the severity of their lines or wrinkles, and even their ethnicity may play a role in which product will give them the best results.

 

Juvederm vs. Restylane

For example, a recent study found very specific results about the effectiveness of Restylane and Juvederm Ultra Plus in treating severe nasolabial folds in a Chinese population. In the study, 124 men and women received treatment with Restylane (20mg/ml) on 1 side of their face to treat a nasolabial fold and received Juvederm Ultra Plus (24mg/ml) on the other side. Researchers assessed the appearance of each patient’s nasolabial folds on a scale of 0 to 4, with 0 meaning no wrinkle, and 4 meaning the wrinkle is very deep. The researchers and subjects then assessed the results after 6 months.

 

Cosmetic filler effectiveness

The study found that not only did patients require less volume injected when treated with Juvederm Ultra Plus compared to Restylane, with an average of 1.0ml of Restylane filler used compared to an average of 0.8ml of Juvederm Ultra Plus, but that Juvederm Ultra Plus was more effective. In fact, 6 months after treatment, investigators assessed that 90.4% of nasolabial folds injected with Juvederm Ultra Plus showed at least 1-point improvement in severity, compared to 89.6% with Restylane.

 

The Study Concluded:

Subjects were also asked to do their own self-assessment 6 months after treatment and reported similar results to those reported by researchers. Patient-reported responder rates were 87.3% for Juvederm Ultra Plus, compared to 83.9% for Restylane. Additionally, of the subjects who reported a preference between the 2 products, 62.1% reported that they preferred Juvederm Ultra Plus. Overall, this study showed that Juvederm Ultra Plus is more effective for treating nasolabial folds than Restylane in Chinese patients.

This study is just 1 example of how choosing the right product for treatment will not only vary by the facial issue that the patient wishes to correct, but also by the patient profile. Researchers are currently studying the effectiveness of certain fillers in other ethnic groups. As researchers continue to study product effectiveness in certain populations and doctors continue to assess their own patient’s results, determining which product is right for each situation will only become easier.