Eliza Cabana

 examines the safety and efficacy of a single treatment of microfocused ultrasound with visualization (MFU-V).

Study author Antonio Araco, MD, describes three endpoints by which results were evaluated:

Improvement of facial skin laxity and ptosis (primary)

Improvement of wrinkles, texture, and amount of hemoglobin (secondary)

A total of 50 patients (47 women, 3 men) with mild to moderate facial skin laxity and ptosis underwent MFU-V between November 2017 and November 2018. All patients received 1200 spot lines of MFU-V. There were no major adverse events reported during duration of the study. All 50 patients completed 6-month follow up.

Compared with baseline, the study showed significant improvement in wrinkles and skin texture after a single session of MFU-V. Likewise, both Surgeon Assessment Scoring System scores and patient satisfaction questionnaire scores significantly improved. Notably, there were no significant differences in safety or efficacy found between smokers and nonsmokers enrolled in the study.

According to Araco, “The study proves that microfocused ultrasound with visualization in a single session of treatment in monotherapy is safe and effective for the treatment of face laxity and ptosis when a proper number of energy spot-lines is delivered in the correct tissue layer.”

Araco A. Prospective Study on Clinical Efficacy and Safety of a Single Session of Microfocused Ultrasound With Visualization for Collagen Regeneration. 

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A recent study examines the safety and efficacy of a single treatment of microfocused ultrasound with visualization.

Is a Single Session of MFU-V Effective?

, “Benchmarking Accomplishments of Leaders in American Surgery and Justification for Enhancing Diversity and Inclusion,” offers an analysis in leadership in surgery and ways to enhance diversity and inclusion, including what lead author Paris Butler, MD, calls a roadmap to those who aspire to be leaders.

 dissects the qualifications of association presidents of four key societies: the American College of Surgeons, the American Surgical Association, the Association of Women Surgeons, and the Society of Black Academic Surgeons.

Described by coauthor Colin A. Martin, MD, as a paper that sits at the intersection of data and action, Dr. Butler believes, “Moving forward, in my opinion, with disparity work, it’s not enough to just describe it anymore. We have to provide some suggestions. We have to provide some strategies on how we’re going to alleviate or at least mitigate some of these disparities, and that’s what we do in this manuscript.”

Butler PD, Pugh CM, Meer E, et al. Benchmarking Accomplishments of Leaders in American Surgery and Justification for Enhancing Diversity and Inclusion. 

. 2020; epub ahead of print. Doi: 10.1097/SLA.0000000000004151

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Described as a paper that sits at the intersection of data and action, plastic and reconstructive surgeon Paris Butler, MD, says this research provides a roadmap to diversifying surgical leadership.

Next Steps for Diversity in Medicine

Part 1: Skincare Ingredients: What Does ‘Clean’ Mean?

, Doris Day, MD, and S. Manjula Jegasothy, MD, discussed the state of so-called “clean skincare,” offering their perspective on the related science, claims, and how to advise patients, calling much of the current consumer conversation “sensationalism.”

There is a lack of clear definitions and FDA regulation

There is no scientific evidence behind claims that use the term “clean”

Physicians need to own and drive the narrative, namely data over words

According to Dr. Day, “People believe that if it’s ‘natural’ and ‘clean,’ it’s healthy. In reality, most things that can hurt or kill you are natural. Everything is a chemical. No matter what you’re putting on your skin, [it’s] a chemical—whether it comes directly from nature or [is] taken from nature and synthesized in a laboratory. There isn’t a simple answer to [whether or not ‘clean’ beauty is better]. Any time you take a product and make something else out of it, you’ve transformed it. It’s no longer in its original form, [so] it’s no longer truly ‘natural.’”

So, what does this mean for the skincare professional and the patients in the cosmetic surgery or dermatology practice? Be aware of what messaging your patients are being exposed to, educate them, and take a proactive position.

“It’s imperative as skin care professionals and dermatologists to educate [patients] that this is a very new and nascent field. We need to make sure they understand that virtually nothing is known about clean, organic and natural skin care—so they should take all product claims with a grain of salt,” says Dr. Jegasothy.

Dermatology experts offer their perspective on the science and claims related to so-called clean skincare and how to advise patients.

A Professional Perspective on Clean Skincare

With regard to skin, the word “clean” itself suggests clear skin, skin without flaw, perhaps it even connotes youth. Clean is also the opposite of dirty (and we know nobody wants “dirty” skin), and thus “clean” may offer subliminal appeal. Place it next to “skincare” or “beauty” and you’ve effectively captured consumer attention through the simple power of suggestion.

“Clean” generally refers to a widely accepted concept in the nutrition space, namely that of clean eating, or the ingestion of foods grown organically and/or lacking pesticides and other potentially harmful elements. Similarly, in skincare, it’s generally understood that “clean” products lack certain ingredients, some of which may be skin irritants. Others, for one reason or another, may be questionable in terms of safety and/or efficacy.

Skincare products are considered cosmetics by the FDA; therefore, they’re unregulated. In terms of “clean” skincare, there is no one accepted definition.

In 2018 Sephora took advantage of the “clean,” “green,” and “organic” trend and launched its “clean beauty” seal, which labels products that do not have the ingredients the company says their consumers don’t want, namely those without sulfates, parabens, oxybenzone, coal tar, hydroquinone, triclosan, triclocarban, and 40 more—their own definition of “clean.” While triclosan and triclocarban were banned in 2018 by the FDA, parabens, sulfates, and coal tar are associated with a risk of skin irritation.

But, as dermatologist Zoe Draelos points out in a recent 

 column, parabens are not the bad guys popular media have made them out to be:

The most commonly used preservatives in cosmetics are parabens. The incidence of allergic and irritant contact dermatitis due to parabens is extremely low and they are highly effective at killing bacterial contaminants at low concentration.

Lately, many cosmetics contain labels that state they are paraben-free. I find this to be an interesting and clever marketing ploy. The cosmetics industry thrives on new products, new formulations, and new packaging. If you have nothing new to put into your product, you can make it appear new by eliminating an ingredient and replacing it with something else. This is exactly what is happening in the preservative realm.

Many products are eliminating paraben preservatives and replacing them with Kathon-CG, also known as methylchloroisothiazolinone. The Kathons are effective preservatives, but they do not have as clean a safety record as parabens. There is a much higher incidence of allergic contact dermatitis, so much so that this category of preservatives is only allowed in rinse off products in the EU, such as hair shampoos and conditioners. The claim “paraben-free” may actually mean the product is less safe.

(Notably, Sephora’s seal also has methylchloroisothiazolinone on its list of non-clean ingredients.)

 takes the definition of “clean” and expands it further. Not only are many of the so-called harmful and questionable ingredients not included in their product formulations, but they also exclude human- and animal-derived ingredients.

“Certain types of disease and infections can be transferred from animals to humans and from humans to humans. The refusal to use such sources (humans and animals) eliminates these risks,” says Nikolay Turovets, PhD, co-founder, CEO and Chief Scientific Officer of DefenAge Skincare.

Instead, DefenAge formulations use biotechnology-based methods. For example, their defensins molecules are manufactured by fusing individual amino acids into sequence to mimic a precise bio-copy of the human molecule.

“The use of such an advanced technology enables DefenAge to offer to consumers natural-type ingredients, while maintaining outstanding purity and highest possible safety of activities,” he tells 

NEXT: A Professional Perspective on ‘Clean’ Skincare

Undefined and unregulated by the FDA, the term ‘clean’ isn’t enough to help patients select the best products for their skin.

Author | Eliza Cabana

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