Stem Cells a Growth Area in Cosmetic Dermatology

PASADENA, Calif. - Stem cell therapies, molecular medicine, less-invasive procedures and robotic surgery might play prominent roles in the future of cosmetic dermatology.

That's what Dr. Ronald Moy sees when he looks into his figurative crystal ball. And it means many, many cosmetic procedures, he said at the annual meeting of the Pacific Dermatologic Association.

"Stem cell research is most exciting," said Dr. Moy, who practices in Beverly Hills, Calif. and is president-elect of the American Academy of Dermatology. As many as an eighth to a quarter of presentations at cosmetic surgery meetings these days mention stem cells, he estimated. Cosmetic procedures in general have increased by 228% since 1997 in the United States, he said.

Dermatologists in his area who do a lot of marketing are advertising "stem cell facelifts," he added. In his own office, he or his partner may extract fat from a patient and then centrifuge or decant it to get fat for reinjecting, and that fat contains some stem cells. Fat injections can improve skin quality over the injection area and may add volume; however, volume results are not as predictable, compared with injections of other fillers.

Once researchers find a way to extract stem cells reliably, they might replace use of these fillers in many cases, he suggested. Stem cells also might be used in the future to grow skin, fat, and hair. "Fillers that we are using might be considered archaic; it will be people’s own skin" used in procedures and, hair cloning and gene therapy will replace hair transplants, he predicted.

A forerunner of this scenario that is widely used today is the biostimulator Sculptra, an injectable poly-l-lactic acid, he said. Sculptra can help thicken the skin and stimulate collagen production.

Molecular tools also will be part of cosmetic dermatologists' armamentarium, switching genes on and off via synthetic medicines individualized to patients. These "are in the near future," Dr. Moy predicted.

Cocktails of immunostimulants that cure skin cancer are close at hand and probably will replace surgical treatments, he added: "Many of our Mohs surgeons and probably many of our skin cancer surgeons will probably be dinosaurs in the near future."

As baby boomers age, they’ll want less-invasive procedures, so radiofrequency devices that tighten the skin and fractional laser resurfacing to remove some wrinkles and sun-damaged skin will be used more and more, he believes. The results aren't as dramatic as with phenol peels or conventional carbon dioxide laser resurfacing, but those techniques require longer recovery times and carry a higher risk for complications. When surgery is used for brow lifts, facelifts, or fat removal, the trend will be toward smaller incisions.

Lasers will evolve like other mobile devices to become hand-held and used by patients to remove hair, fat, wrinkles, lentigos, and more, Dr. Moy said.

More muscle-relaxing products will come on the market to compete with Botox or Dysport, including a topical version that’s now being tested and seems to work well for superficial areas, he said.

He also foresees new concoctions of creams that will go beyond sunscreens to prevent skin cancers, adding that prevention already is a booming trend, with some emphasis shifting toward greater attention to the molecular benefits of nutrition in preventing skin problems, he said. "Nutrition is important, and we haven't thought about that much in dermatology," he remarked.

Still, much of cosmetic dermatology will continue to involve new and expensive technology, which will affect not just how patients are treated, but how dermatologists practice, he said. Machines that cost $100,000 will be hard for solo practitioners to afford. "Unless you're practicing as a group, it's going to be very difficult" to offer the most modern services."

Dr. Moy made no disclosures.

PASADENA, Calif. - Stem cell therapies, molecular medicine, less-invasive procedures and robotic surgery might play prominent roles in the future of cosmetic dermatology.

That's what Dr. Ronald Moy sees when he looks into his figurative crystal ball. And it means many, many cosmetic procedures, he said at the annual meeting of the Pacific Dermatologic Association.

"Stem cell research is most exciting," said Dr. Moy, who practices in Beverly Hills, Calif. and is president-elect of the American Academy of Dermatology. As many as an eighth to a quarter of presentations at cosmetic surgery meetings these days mention stem cells, he estimated. Cosmetic procedures in general have increased by 228% since 1997 in the United States, he said.

Dermatologists in his area who do a lot of marketing are advertising "stem cell facelifts," he added. In his own office, he or his partner may extract fat from a patient and then centrifuge or decant it to get fat for reinjecting, and that fat contains some stem cells. Fat injections can improve skin quality over the injection area and may add volume; however, volume results are not as predictable, compared with injections of other fillers.

Once researchers find a way to extract stem cells reliably, they might replace use of these fillers in many cases, he suggested. Stem cells also might be used in the future to grow skin, fat, and hair. "Fillers that we are using might be considered archaic; it will be people’s own skin" used in procedures and, hair cloning and gene therapy will replace hair transplants, he predicted.

A forerunner of this scenario that is widely used today is the biostimulator Sculptra, an injectable poly-l-lactic acid, he said. Sculptra can help thicken the skin and stimulate collagen production.

Molecular tools also will be part of cosmetic dermatologists' armamentarium, switching genes on and off via synthetic medicines individualized to patients. These "are in the near future," Dr. Moy predicted.

Cocktails of immunostimulants that cure skin cancer are close at hand and probably will replace surgical treatments, he added: "Many of our Mohs surgeons and probably many of our skin cancer surgeons will probably be dinosaurs in the near future."

As baby boomers age, they’ll want less-invasive procedures, so radiofrequency devices that tighten the skin and fractional laser resurfacing to remove some wrinkles and sun-damaged skin will be used more and more, he believes. The results aren't as dramatic as with phenol peels or conventional carbon dioxide laser resurfacing, but those techniques require longer recovery times and carry a higher risk for complications. When surgery is used for brow lifts, facelifts, or fat removal, the trend will be toward smaller incisions.

Lasers will evolve like other mobile devices to become hand-held and used by patients to remove hair, fat, wrinkles, lentigos, and more, Dr. Moy said.

More muscle-relaxing products will come on the market to compete with Botox or Dysport, including a topical version that’s now being tested and seems to work well for superficial areas, he said.

He also foresees new concoctions of creams that will go beyond sunscreens to prevent skin cancers, adding that prevention already is a booming trend, with some emphasis shifting toward greater attention to the molecular benefits of nutrition in preventing skin problems, he said. "Nutrition is important, and we haven't thought about that much in dermatology," he remarked.

Still, much of cosmetic dermatology will continue to involve new and expensive technology, which will affect not just how patients are treated, but how dermatologists practice, he said. Machines that cost $100,000 will be hard for solo practitioners to afford. "Unless you're practicing as a group, it's going to be very difficult" to offer the most modern services."

Dr. Moy made no disclosures.

PASADENA, Calif. - Stem cell therapies, molecular medicine, less-invasive procedures and robotic surgery might play prominent roles in the future of cosmetic dermatology.

That's what Dr. Ronald Moy sees when he looks into his figurative crystal ball. And it means many, many cosmetic procedures, he said at the annual meeting of the Pacific Dermatologic Association.

"Stem cell research is most exciting," said Dr. Moy, who practices in Beverly Hills, Calif. and is president-elect of the American Academy of Dermatology. As many as an eighth to a quarter of presentations at cosmetic surgery meetings these days mention stem cells, he estimated. Cosmetic procedures in general have increased by 228% since 1997 in the United States, he said.

Dermatologists in his area who do a lot of marketing are advertising "stem cell facelifts," he added. In his own office, he or his partner may extract fat from a patient and then centrifuge or decant it to get fat for reinjecting, and that fat contains some stem cells. Fat injections can improve skin quality over the injection area and may add volume; however, volume results are not as predictable, compared with injections of other fillers.

Once researchers find a way to extract stem cells reliably, they might replace use of these fillers in many cases, he suggested. Stem cells also might be used in the future to grow skin, fat, and hair. "Fillers that we are using might be considered archaic; it will be people’s own skin" used in procedures and, hair cloning and gene therapy will replace hair transplants, he predicted.

A forerunner of this scenario that is widely used today is the biostimulator Sculptra, an injectable poly-l-lactic acid, he said. Sculptra can help thicken the skin and stimulate collagen production.

Molecular tools also will be part of cosmetic dermatologists' armamentarium, switching genes on and off via synthetic medicines individualized to patients. These "are in the near future," Dr. Moy predicted.

Cocktails of immunostimulants that cure skin cancer are close at hand and probably will replace surgical treatments, he added: "Many of our Mohs surgeons and probably many of our skin cancer surgeons will probably be dinosaurs in the near future."

As baby boomers age, they’ll want less-invasive procedures, so radiofrequency devices that tighten the skin and fractional laser resurfacing to remove some wrinkles and sun-damaged skin will be used more and more, he believes. The results aren't as dramatic as with phenol peels or conventional carbon dioxide laser resurfacing, but those techniques require longer recovery times and carry a higher risk for complications. When surgery is used for brow lifts, facelifts, or fat removal, the trend will be toward smaller incisions.

Lasers will evolve like other mobile devices to become hand-held and used by patients to remove hair, fat, wrinkles, lentigos, and more, Dr. Moy said.

More muscle-relaxing products will come on the market to compete with Botox or Dysport, including a topical version that’s now being tested and seems to work well for superficial areas, he said.

He also foresees new concoctions of creams that will go beyond sunscreens to prevent skin cancers, adding that prevention already is a booming trend, with some emphasis shifting toward greater attention to the molecular benefits of nutrition in preventing skin problems, he said. "Nutrition is important, and we haven't thought about that much in dermatology," he remarked.

Still, much of cosmetic dermatology will continue to involve new and expensive technology, which will affect not just how patients are treated, but how dermatologists practice, he said. Machines that cost $100,000 will be hard for solo practitioners to afford. "Unless you're practicing as a group, it's going to be very difficult" to offer the most modern services."

Dr. Moy made no disclosures.