Tom Branna, Chief Content Officer02.01.24
Heart disease, cancer, Alzheimer’s Disease—an older population is putting pressure on health care systems around the world. It’s too soon to tell if aging Gen Xers and Millennials, not to mention Baby Boomers, will overwhelm dermatologist offices one day. There about 8,500 practicing dermatologists in the US, and the global dermatology market is expected to reach $34.4 billion by 2026, according to Gitnux, a market data company.
All dermatologists tell their patients about the importance of applying sunscreen on a regular basis (for much more on sunscreen, click here).
“The most important thing patients can do for their skin is apply sunscreen,” according to Dermatologist Aanand Geria, MD.
Geria has offices in Rutherford and Verona, NJ, where he treats a range of medical issues including rosacea, acne, eczema, psoriasis and vitiligo. Among the cosmetic treatments available from Geria Dermatology are dermaplaning, microneedling and chemical peels.
For long-term topical treatments, Geria recommends vitamin C, retinol, alpha hydroxy acids, peptides and growth factors.
“Those are the power five,” he told Happi. “You don’t need to use all of them. Vitamin C and retinol have the most research behind them. I recommend vitamin C in the morning and retinol in the evening, because it is photo-deactivated.”
Geria also recommends products to patients based on their specific needs and bank accounts.
“CeraVe and La-Roche Posay are great options when you don’t want to break your budget,” he explained. “Both L’Oréal brands have every formula a patient could need.”
Another L’Oréal product that Geria recommends is CE Ferulic from Skinceuticals.
“L’Oréal does a great job investing in research and marketing,” he explained.
For patients willing to spend more, Geria recommends Skinbetter Science. Its AlphaRet Overnight Cream contains a retinoid combined with AHAs, to impart visible skin rejuvenation with little-to-no irritation, according to the company.
For more skincare insights from Geria, click here.
“The first thing I ask an 11-year-old is if she is concerned about her acne,” recalled Baldwin. “If so, we put her on a topical, tolerable retinoid.”
Retinoids may be irritating, but they can work wonders for many patients, according to Baldwin and other dermatologists. Specifically, retinoids:
“Normally, I would prescribe retinoids and benzoyl peroxide, but the patient wasn’t using one drug, so there was no reason to believe she would use two,” recalled Baldwin.
Instead, the dermatologist prescribed a benzoyl peroxide and tretinoin combination.
“Benzoyl peroxide is 60 years old, but it’s still a hero ingredient to treat acne,” noted Baldwin.
A few years later, the patient returned to Baldwin’s office; but now, she wanted to be called Ella and was making plans to attend her high school prom in a month. Unfortunately, Ella’s acne had returned and was also on her chest and back. For the best and fastest response, Baldwin prescribed benzoyl peroxide, tretinoin and prednisone to reduce swelling and inflammation.
At 18, Ella’s acne had gotten worse after losing faith in her treatment and turning to homemade remedies. And Ella was mildly depressed, according to Baldwin, who put her on isotretinoin. But just two months later, the patient, now known as Gabe and using him/his pronouns, returned. He had not taken his medications and was unable to take spironolactone or OCP due to preliminary medical transition prior to gender-affirming surgery.
“In many instances, trans-feminine individuals see an improvement in acne, but trans-masculine patients get worse, because they start taking testosterone,” explained Baldwin. “Gender identity is different from sexual orientation. Medical providers must ask a lot of questions to find a solution for their patients.”
Sobering Statistics
Baldwin prescribed oral antibiotics plus topicals, along with isotretinoin and laser/light therapy. She added that several studies showed no connection between isotretinoin use and depression. In fact, use of isotretinoin is associated with significantly improved depression systems. Still, Baldwin keeps a close eye on some of her patients.
“Was I comfortable keeping Gabe on isotretinoin? I make sure my isotretinoin patients have good support systems and give all of them my phone number. I tell them, ‘if you’re worried at 2 o’clock in the morning, I want to be worried at 2 o’clock in the morning.’”
She noted that being 18 to 25 years old is an independent risk factor for mental health issues. In fact:
Gabe continued to fight acne from 18 to 45 years of age. Baldwin said long-term acne treatments must be effective and tolerable, yet simple, elegant, unobstructive and non-antibiotic.
Gabe went on a decades-long journey with his dermatologist, but there was a happy ending. Baldwin said Gabe is now a happy and acne-free 50-year-old.
More companies are aware of the skin/mental health connection, like Selfmade, which was founded in 2018 by Stephanie Lee, a former member of Michelle Obama’s White House team and a MAC Cosmetics product development specialist. According to Lee, those with a higher feeling of self-worth are 10 times more likely to see themselves as beautiful.
Selfmade formulas include Avocado Mango Mask, Glycolic Cherry Peel, Grape Skin Tonic, Green Tea Citrus Cleanser, Hibiscus & Ceramide Soufflé and Hyaluronic-Elixir Serum. The company insists Selfmade is not just a skin care brand; “it’s a movement that encourages self-care, entrepreneurship, and a deeper connection to oneself and the world.”
Selfmade has an eager audience—72% of Gen Z and Millennials took part in or are interested in beauty engaged in or are interested in beauty and self-care activities to combat stress and anxiety, and 81% appreciate brands incorporating mental health in their marketing and messaging, according to Y Pulse.
“I have to admit, I was always very into skin care as a teenager, thanks to my mother who was diligent with me in that aspect,” recalled Anesthesiologist Azza Halim. “Which is why I have made it a mission to educate, early on, everyone about the importance of proper nutrition, skin care and sunblock.”
Halim’s practice is focused on health, beauty and longevity, with locations in Florida, Chicago and California. She describes her patient base as a well-balanced mix of women and men, young and old, ranging in age from teens to late 70s.
“More and more men are becoming better informed in regards to skin care and in-office treatments to help slow down aging,” she explained.
Halim offers all of them a combined approach that integrates skin care, nutrition, lifestyle modification and hormonal balancing in conjunction with aesthetics and functional medicine. Halim explained that treating acne varies greatly from individual to individual.
“Many think it’s as simple as applying a spot treatment or drying agent—that’s not accurate,” she said. “We know acne can be triggered by various things; therefore, as I tell my patients, ‘I treat the cause not just the effect.’ In order to treat cause, we must make the proper evaluation to diagnose root cause and underlying condition.”
Skin care professionals also must differentiate between active acne vs cystic acne and other types as well. Treatments can include everything from topical to systemic medication to blue light therapy to specific lasers. Treating active acne is very different than treating acne scars, noted Halim.
Once proper diagnosis is made and treatment plan customized, then Halim creates a homecare regimen as well as proper home treatment are equally as important as In-office treatments.
“Depending on the type of acne, I always address triggers in diet and gut microbiome as we know there is a link between the gut-skin-brain axis/microbiome as to how all relate to inflammation and inflammatory triggers or dysbiosis,” she explained.
To get to the root of the problem, Halim runs various blood test panels and obtains a patient history. Then, an at-home cleansing routine is developed that involves medicated topical and moisturizing products so skin isn’t stripped nor the barrier disrupted, which can exasperate inflammation, irritation and breakouts.
Among Halim’s preferred brands are ZoSkinHealth, SkinBetter, Promoitalia and BuffRx. Newer ingredients that have captured her attention include PDRN and exosomes, which address inflammation while providing proper skin balance and growth factors which are necessary for all skin types regardless of condition.
“The products transformed my skin,” she told Happi. “After I moved to Los Angeles, I wanted them in the US.”
So much so that she formed NewGen Science, the official US distributor of Biophora products. Wolkove launched a direct-to-consumer website last year; now, Biophora is expanding distribution to medispas in the US. The line includes AHA Active Gel; Bioactive Cleanser, Firming Cream and Gel; Bioactive Retinol; Calming Cleanser and Toner; DermaRich Moisturizer; Enzyme Exfoliators; Hydration Serum; and Pure C Vitamin C powder to dissolve into any Biophora cream or gel.
“When I came to the US, I didn’t see any innovation in affordable, medical grade skin care. There is an opening for Biophora to deliver a great product to someone interested in medical grade skin care without spending $250 on a vitamin C formula.”
According to Wolkove, Biophora’s AHA Active Gel and Pure C Vitamin C powder are top sellers.
“I’ve been passionate about skin care since I was little,” said Wolkove, now 45. “No product has ever given me the results that Biophora gave me.”
Passionate enough to build a distributorship around the brand!
All dermatologists tell their patients about the importance of applying sunscreen on a regular basis (for much more on sunscreen, click here).
“The most important thing patients can do for their skin is apply sunscreen,” according to Dermatologist Aanand Geria, MD.
Geria has offices in Rutherford and Verona, NJ, where he treats a range of medical issues including rosacea, acne, eczema, psoriasis and vitiligo. Among the cosmetic treatments available from Geria Dermatology are dermaplaning, microneedling and chemical peels.
For long-term topical treatments, Geria recommends vitamin C, retinol, alpha hydroxy acids, peptides and growth factors.
“Those are the power five,” he told Happi. “You don’t need to use all of them. Vitamin C and retinol have the most research behind them. I recommend vitamin C in the morning and retinol in the evening, because it is photo-deactivated.”
Geria also recommends products to patients based on their specific needs and bank accounts.
“CeraVe and La-Roche Posay are great options when you don’t want to break your budget,” he explained. “Both L’Oréal brands have every formula a patient could need.”
Another L’Oréal product that Geria recommends is CE Ferulic from Skinceuticals.
“L’Oréal does a great job investing in research and marketing,” he explained.
For patients willing to spend more, Geria recommends Skinbetter Science. Its AlphaRet Overnight Cream contains a retinoid combined with AHAs, to impart visible skin rejuvenation with little-to-no irritation, according to the company.
For more skincare insights from Geria, click here.
A Case for Personalized Care
Prescription retinoids are part of every dermatologist’s arsenal. During the Society of Cosmetic Chemists’ Annual Meeting in December, Dermatologist Hilary Baldwin, MD detailed a unique acne case that underscored the need for personalized care. Baldwin met Gabby as an 11-year-old and treated the patient as a tween, teen and adult.“The first thing I ask an 11-year-old is if she is concerned about her acne,” recalled Baldwin. “If so, we put her on a topical, tolerable retinoid.”
Retinoids may be irritating, but they can work wonders for many patients, according to Baldwin and other dermatologists. Specifically, retinoids:
- Decrease visible, existing lesions;
- Inhibit development of new lesions;
- Accelerate resolution of hyperpigmentation;
- Increase penetration of other medications;
- Improve acne scars; and
- Serve as maintenance therapy.
“Normally, I would prescribe retinoids and benzoyl peroxide, but the patient wasn’t using one drug, so there was no reason to believe she would use two,” recalled Baldwin.
Instead, the dermatologist prescribed a benzoyl peroxide and tretinoin combination.
“Benzoyl peroxide is 60 years old, but it’s still a hero ingredient to treat acne,” noted Baldwin.
A few years later, the patient returned to Baldwin’s office; but now, she wanted to be called Ella and was making plans to attend her high school prom in a month. Unfortunately, Ella’s acne had returned and was also on her chest and back. For the best and fastest response, Baldwin prescribed benzoyl peroxide, tretinoin and prednisone to reduce swelling and inflammation.
At 18, Ella’s acne had gotten worse after losing faith in her treatment and turning to homemade remedies. And Ella was mildly depressed, according to Baldwin, who put her on isotretinoin. But just two months later, the patient, now known as Gabe and using him/his pronouns, returned. He had not taken his medications and was unable to take spironolactone or OCP due to preliminary medical transition prior to gender-affirming surgery.
“In many instances, trans-feminine individuals see an improvement in acne, but trans-masculine patients get worse, because they start taking testosterone,” explained Baldwin. “Gender identity is different from sexual orientation. Medical providers must ask a lot of questions to find a solution for their patients.”
Sobering Statistics
Baldwin prescribed oral antibiotics plus topicals, along with isotretinoin and laser/light therapy. She added that several studies showed no connection between isotretinoin use and depression. In fact, use of isotretinoin is associated with significantly improved depression systems. Still, Baldwin keeps a close eye on some of her patients.
“Was I comfortable keeping Gabe on isotretinoin? I make sure my isotretinoin patients have good support systems and give all of them my phone number. I tell them, ‘if you’re worried at 2 o’clock in the morning, I want to be worried at 2 o’clock in the morning.’”
She noted that being 18 to 25 years old is an independent risk factor for mental health issues. In fact:
- Mental illness is highest in the 18-25 age group (25.8%);
- Major depression is highest in the 18-25 age group (13.1%);
- Suicide is the No. 2 cause of death in the 18-25 age group (after accidental death).
Gabe continued to fight acne from 18 to 45 years of age. Baldwin said long-term acne treatments must be effective and tolerable, yet simple, elegant, unobstructive and non-antibiotic.
Gabe went on a decades-long journey with his dermatologist, but there was a happy ending. Baldwin said Gabe is now a happy and acne-free 50-year-old.
More companies are aware of the skin/mental health connection, like Selfmade, which was founded in 2018 by Stephanie Lee, a former member of Michelle Obama’s White House team and a MAC Cosmetics product development specialist. According to Lee, those with a higher feeling of self-worth are 10 times more likely to see themselves as beautiful.
Selfmade formulas include Avocado Mango Mask, Glycolic Cherry Peel, Grape Skin Tonic, Green Tea Citrus Cleanser, Hibiscus & Ceramide Soufflé and Hyaluronic-Elixir Serum. The company insists Selfmade is not just a skin care brand; “it’s a movement that encourages self-care, entrepreneurship, and a deeper connection to oneself and the world.”
Selfmade has an eager audience—72% of Gen Z and Millennials took part in or are interested in beauty engaged in or are interested in beauty and self-care activities to combat stress and anxiety, and 81% appreciate brands incorporating mental health in their marketing and messaging, according to Y Pulse.
Anesthesiologist Focuses on Aesthetic Medicine
Even anesthesiologists get inspired by skin care regimens.“I have to admit, I was always very into skin care as a teenager, thanks to my mother who was diligent with me in that aspect,” recalled Anesthesiologist Azza Halim. “Which is why I have made it a mission to educate, early on, everyone about the importance of proper nutrition, skin care and sunblock.”
Halim’s practice is focused on health, beauty and longevity, with locations in Florida, Chicago and California. She describes her patient base as a well-balanced mix of women and men, young and old, ranging in age from teens to late 70s.
“More and more men are becoming better informed in regards to skin care and in-office treatments to help slow down aging,” she explained.
Halim offers all of them a combined approach that integrates skin care, nutrition, lifestyle modification and hormonal balancing in conjunction with aesthetics and functional medicine. Halim explained that treating acne varies greatly from individual to individual.
“Many think it’s as simple as applying a spot treatment or drying agent—that’s not accurate,” she said. “We know acne can be triggered by various things; therefore, as I tell my patients, ‘I treat the cause not just the effect.’ In order to treat cause, we must make the proper evaluation to diagnose root cause and underlying condition.”
Skin care professionals also must differentiate between active acne vs cystic acne and other types as well. Treatments can include everything from topical to systemic medication to blue light therapy to specific lasers. Treating active acne is very different than treating acne scars, noted Halim.
Once proper diagnosis is made and treatment plan customized, then Halim creates a homecare regimen as well as proper home treatment are equally as important as In-office treatments.
“Depending on the type of acne, I always address triggers in diet and gut microbiome as we know there is a link between the gut-skin-brain axis/microbiome as to how all relate to inflammation and inflammatory triggers or dysbiosis,” she explained.
To get to the root of the problem, Halim runs various blood test panels and obtains a patient history. Then, an at-home cleansing routine is developed that involves medicated topical and moisturizing products so skin isn’t stripped nor the barrier disrupted, which can exasperate inflammation, irritation and breakouts.
Among Halim’s preferred brands are ZoSkinHealth, SkinBetter, Promoitalia and BuffRx. Newer ingredients that have captured her attention include PDRN and exosomes, which address inflammation while providing proper skin balance and growth factors which are necessary for all skin types regardless of condition.
A New Player
A newcomer to the US skin care market is Biophora. For more than 20 years, the brand was a household name with Canadian dermatologists, but the Toronto-based company never entered the US market. That changed when Madeline Wolkove was introduced to the brand by her dermatologist.“The products transformed my skin,” she told Happi. “After I moved to Los Angeles, I wanted them in the US.”
So much so that she formed NewGen Science, the official US distributor of Biophora products. Wolkove launched a direct-to-consumer website last year; now, Biophora is expanding distribution to medispas in the US. The line includes AHA Active Gel; Bioactive Cleanser, Firming Cream and Gel; Bioactive Retinol; Calming Cleanser and Toner; DermaRich Moisturizer; Enzyme Exfoliators; Hydration Serum; and Pure C Vitamin C powder to dissolve into any Biophora cream or gel.
“When I came to the US, I didn’t see any innovation in affordable, medical grade skin care. There is an opening for Biophora to deliver a great product to someone interested in medical grade skin care without spending $250 on a vitamin C formula.”
According to Wolkove, Biophora’s AHA Active Gel and Pure C Vitamin C powder are top sellers.
“I’ve been passionate about skin care since I was little,” said Wolkove, now 45. “No product has ever given me the results that Biophora gave me.”
Passionate enough to build a distributorship around the brand!