Acne, Regenerative Aesthetics & Individualized Treatments Top the Trends at SCALE 2024

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In our first two pieces about the aesthetic trends highlighted at Music City SCALE 2024, we discussed the rising trend and shift in aesthetics toward clinically proven, dermatologic skin care that is guided by dermatologist expertise across the board, from traditional professional-grade brands to OTC skin care. We then dove a bit deeper into this dermatologic focus, exploring two significant skin health trends, inflammaging and sun care. In our third installment, we are looking at three more trends that had attendees buzzing with interest at this year’s SCALE meeting, acne, regenerative aesthetics and the rising interest in enhancing individual beauty and individually tailored treatments in aesthetics.  

Alleviating Acne 

The annoyance of acne and the genuinely horrible emotional tole it takes on patients across the spectrum is spurring on ever more rapid innovations in oral, topical and energy-based treatments. These include treatments developed specifically for treating the source of acne in men, women and adolescents, as well as treatments to address acne scarring in all skin tones.

Cutting Edge Acne Treatments

Stubborn acne requires a durable solution to treat active, inflammatory acne and prevent future breakouts. OneAviClear recently received FDA clearance as the first long-term treatment for mild to severe inflammatory acne vulgaris.AviClear recently received FDA clearance as the first long-term treatment for mild to severe inflammatory acne vulgaris.Photo courtesy of Cutera of the leading energy-based acne treatments is Cutera’s AviClear, which recently received FDA clearance as the first long-term treatment for mild to severe inflammatory acne vulgaris. According to the results of Cutera’s FDA clearance clinical study, “In three, 30-minute treatment sessions 90% of patients experienced visible improvement in their acne six months after their third session. According to 12-month clinical data, improvement increases to 92%, confirming long-term efficacy of acne clearance and skin quality over time.”

We asked what the company finds unique about Music City SCALE, particularly as it relates to innovations in acne treatments. “Music City SCALE is a microcosm of the larger medical and aesthetic dermatology industry as it brings well established dermatology leaders alongside the up-and-coming next generation of practitioners emerging into this industry. This is important to Cutera as AviClear, our category defining and leading dermatology focused technology, integrates into each of their overall treatment approaches to acne and offers novel technology to drive innovation. AviClear is the first and original FDA-cleared energy device for the treatment of mild to severe acne boasting a 1726nm wavelength that treats acne at the source by selectively targeting and suppressing the sebaceous gland. At Cutera, we are driven by science and powered by partnerships, and that’s why being immersed in environments such as Music City SCALE are critical to ensure we continue to build and communicate with our incredible community of medical and aesthetic dermatologists.”

Related: How to Subdue Stubborn Acne for Good

STRATA Skin Sciences’ TheraClearX is a photopneumatic device that combines gentle vacuum with pulsed broadband light, and is FDA-cleared as a noninvasive, in-office treatment for mild-to-moderate acne, including comedonal, pustular and inflammatory acne vulgaris. The vacuum pulls dermal structures toward the skin surface and withdraws the contents of the follicles, while broadband light activates porphyrins to destroy Cutibacterium acnes and reduce sebum production. Once the process is completed, the vacuum is released. The handheld delivery system is liquid-cooled for optimal patient comfort, and the treatment requires no patient downtime, pre-medication or anesthesia.

A recent clinical study published in the Journal of Clinical and Aesthetic Dermatology (June 2024) found that six weekly stand-alone TheraClearX treatment sessions over a period seven weeks “effectively reduces acne lesions across all Fitzpatrick skin types with favorable tolerability and participant satisfaction, with the customizable settings allowing for tailored treatment for mild-to-moderate acne.”

One thing that really makes STRATA stand out, however, is their unique business model, which provides an alternative option to the traditional purchase or rental models for acquiring aesthetic devices. “We don't offer our devices for purchase. Instead, we partner with dermatology practices to make it work in their practice, charging a fee per treatment rather than the traditional model of charging for the device purchase or time-based rental fee. This means there's no investment required on the part of the practitioner. We bring it in, we do all the insurance certifications for them, all the marketing, all the clinical training, handle all the maintenance, and just charge a fee per treatment. Additionally, they're also both covered by insurance.”

WINLEVI (clascoterone) cream 1% by SunPharma is a topical androgen receptor inhibitor for the treatment of acne vulgaris in both FEMALE and MALE acne patients ages 12 years and older. Acne pathogenesis begins because of hormonal fluctuations that result in excess stimulation of androgens in the sebaceous glands. This is known as the androgen-sebum pathway, which then sets off the acne cascade. To break it down a bit further, in the case of acne vulgaris, “Dihydrotestosterone (DHT), a potent androgen present in circulation and produced in the skin, binds to androgen receptors within sebocytes. The skin of FEMALES and MALES with acne vulgaris produces higher levels of DHT and testosterone. Receptor-bound androgens stimulate sebaceous gland development, sebocyte proliferation, and sebum production in both FEMALES and MALES. Androgen-induced excess sebum and inflammation create an environment conducive to C acnes growth.” 

WINLEVI is unique in its mechanism in its ability to bind to androgen receptors within the skin, “competing with the binding of androgens such as DHT. Studies suggest this inhibits the action of androgen receptors on cells in the sebaceous gland, reducing sebum production and inflammation.” Per WINLEVY, “In clinical studies, when used twice daily as a monotherapy, at week 12 WINLEVI was statistically more effective than vehicle with a mean absolute reduction in inflammatory lesion count of 19.7 vs 14.0 (P<0.0001).” In addition, it is also safe for all skin tones, as highlighted in a study of its efficacy and safety in darker Fitzpatrick tones presented at this year’s SCALE.

Acne Scar Treatment InnovationsNewmedical Technology's Silagen Acne Scar Refinement + Spot CorrectorNewmedical Technology's Silagen Acne Scar Refinement + Spot CorrectorPhoto courtesy of Newmedical Technology

Newmedical Technology's Silagen Acne Scar Refinement + Spot Corrector is a new acne scar product that utilizes ReTex-5 technology to deliver a powerful combination of acne scar correcting ingredients directly to the treated area. ReTex-5 technology allows multiple targeted ingredients to coexist in one formula while remaining active and stable. Identified and selected based on rigorous clinical research, the formulation utilizes the most effective ingredients at proven potencies for smoother, more even skin tone. 

Next Level Cleansers for Compromised Skin

CLn Skin was designed by dermatologists to “meet the therapeutic cleansing needs of those prone to eczema, acne, infection, folliculitis and other compromised skin conditions.” The company’s professional line, CLnMD, is specifically developed for use by practitioners for, “pre- and post- aesthetic procedures to prep the skin, bring it to a nice clean baseline and help eliminate risk for secondary infection,” according to a spokesperson for CLn Skin at SCALE 2024. CLnMD specializes in providing next-level cleansers to use as an adjunct of therapy with traditional medications to enhance patient experience and optimize results with little to no downtime. The cleansers are formulated to be safe for all ages, from infants 6 months old to grown adults, and designed to be utilized from a general dermatologic standpoint to surgical procedures and aesthetic treatments. The brand’s motto really says it all, “Think Clinically Clean.”

Regenerative Aesthetics

Regenerative aesthetics is evolving at an ever faster rate, captivating the aesthetics industry and changing the way we approach medical aesthetics treatments. Out of all the current trends, regenerative aesthetics is truly shaping the future of the industry, beauty and the world of health and longevity in general. 

Innovations in Regenerative Energy-Based Devices

Accoustic wave therapy (AWT) is a newer technology being utilized in medicine in general as well as in medical aesthetics. CelluWave (body sculpting) and Vanesse (facial rejuvenation) are non-invasive acoustic wave devices originally used for musculoskeletal concerns, ED and enhancing recovery post-injury. According to one of the brand’s representatives at SCALE, “Now we've brought it to dermatology and it's ideal for treating cellulite as well as facial and body rejuvenation. An acoustic wave will actually have a cellular component to it, and it will increase your angiogenesis so you're getting more blood flow.”  

This helps to boost collagen production, improve skin elasticity and clarity, reducing the appearance of wrinkles in facial treatments and cellulite when used for the body, leading to improved muscle tone and a more sculpted physique. The discovery of the technology’s cosmetic benefit for cellulite reduction and body sculpting actually occurred after it was used to treat an athlete’s hamstring injury. “There was an athlete being treated for a hamstring issue, and her leg was being treated with acoustic wave therapy. She noticed afterwards that there was a difference between her leg treated with ACT and the other, and they found out through studies that it was because of this side effect from the ACT therapy, so that's how the cosmetic benefits were initially discovered.” 

Reveal Lasers' AgeJET uses nitrogen plasma energy to stimulate the natural cell regeneration processes of neocollagenesis and elastogenesis for skin rejuvenation and resurfacing without the use of ablation. AgeJET is most unique in its ability to provide a non-invasive, safe and effective alternative to traditional blepharoplasty procedures in a mere 10 minutes with no need for ocular shields due to its targeting the epidermal layer rather than the vascular layer. Treatments don’t require significant downtime, typically ranging from 5 to 7 days, sometimes extending to 10 days, depending on the patient and energy settings used during the procedure.  

The Secret to Skin Aging: Regenerative Ingredient Innovations 

Protection for the Skin Proteome

Institut Esthederm's Age Proteom Advanced Serum, featuring a molecule extracted from the snow bacterium, a biomimetic active ingredient that acts as a biological shield for the skin's proteome.Institut Esthederm's Age Proteom Advanced Serum, featuring a molecule extracted from the snow bacterium, a biomimetic active ingredient that acts as a biological shield for the skin's proteome.Photo courtesy of NAOS/Institut EsthedermThe latest product launch from Institut Esthederm, the Age Proteom Advanced Serum, has been decades in the making. At the heart of this serum is a molecule extracted from the Arthrobacter agilis bacterium, discovered in a snowflake. The snow bacterium is “unique due to its ability to fight against carbonylation, a type of oxidation that alters our proteins and is very harmful for the complete set of proteins in the skin, known as the proteome.”

When researchers determined the mechanism behind these quasi-immortal microorganisms, they found that rather than the integrity of the bacterium's DNA being the key to this regenerative miracle, the resilience of their proteome was the true secret to their longevity and near indestructibility. This decades-long research into cell longevity identified the main biological cause of skin aging, the degradation of proteins and the skin proteome. Since proteins are at the heart of cell life, whether it’s the proteins responsible for preserving skin’s youthfulness, such as elastin or collagen, or DNA repair proteins, protecting the integrity of the proteome is crucial to long-term preservation of skin’s youthfulness. The proteome of these microorganisms is actually protected by a specific molecule that acts as a biological shield.

The discovery of the “snow bacterium’s active substance, a biomimetic active ingredient with demonstrated strong affinity with skin proteins,” led to the development of the Age Proteom Advanced Serum, formulated with Age Proteom Biotechnology. According to Institut Esthederm, this “antioxidant chaperone molecule diminishes the effects of carbonylation, while preventing irreversible cell and tissue damage. The DNA repair proteins in the skin are protected while the damaging effects of carbonylation caused by environmental factors such as UV damage, blue light and pollution are also deterred, maintaining the biological health and strength of all skin proteins and the natural repair systems.”

Plant-Derived Exosomes

Exosomes are now popping up all over aesthetics and in skin care. The entrance of an ever-growing number of brands formulating topical exosome products has created a bit of a rivalry between those offering plant-derived vs. mammalian-derived exosomes. Both plant and mammalian-derived exosomes have their own distinct advantages, making them both useful tools in the aesthetics arena. Researchers are now actually fusing plant and mammalian-derived exosomes to get the best of both worlds, but this innovation hasn’t quite reached the world of skin care just yet.

Induction Therapies PRX⁸ Plant-Exo Stimulation Serum is a great example of the innovations being made inInduction Therapies PRX⁸ Plant-Exo Stimulation Serum utilizes the power of plant-derived exosomes to enhance skin health and amplify treatment results.Induction Therapies PRX⁸ Plant-Exo Stimulation Serum utilizes the power of plant-derived exosomes to enhance skin health and amplify treatment results.Photo courtesy of Induction Therapies skin care formulations utilizing plant-derived exosomes. The serum features a synergistic blend of four key collagen nourishing ingredients, plant exosomes, copper tripeptides, all-trans retinol and hyaluronic acid, to stimulate conditions for cellular turnover, revitalizing cells and improving the appearance of healthy hair and skin, as well as amplifying treatment results. Plant-derived exosomes help improve intercellular communication, post-procedure recovery, are universally compatible and remain stable in fluctuating temperatures, giving them a fairly long shelf life of up to two years. 

Individualized Aesthetics 

Individualized and custom tailored aesthetic treatments that enhance a patient's natural, individual beauty are rising steadily in popularity, with the natural or no-makeup look far surpassing the popularity of the previous pillowy look trend. If you've caught our features on Nicole Frontera's Natural Needle Lift, you'll notice she emphasizes that it, "was developed to create a treatment protocol to address the signs of aging at each decade through injectables in the most natural way possible, working with the client’s own face to maintain their natural beauty. Facial injectables are never one-size-fits all, so this gives me the opportunity to be creative while educating the client on what we are doing and ideally maintaining a more affordable price for treatments."  

Expanding Options for Dermal Fillers

One particularly exciting development revealed at this year’s SCALE meeting is Evolus’ upcoming launch of five new HA fillers under the name Evolysse next year. This will mark a significant step for Evolus in the medical aesthetics market, as having a full injectable portfolio enhances their positioning in the U.S. aesthetics injectable market. “Jeuveau derives from the French word nouveau, which means modern and new. We are launching five fillers next year, so 2024 is the last year that we're going to have a toxin alone in our portfolio. So, to be a full portfolio is a big deal for us,” said a spokesperson for Evolus.

Evolus announced the positive topline results from the U.S. pivotal nasolabial fold (NLF) clinical trial for the first two Evolysse dermal fillers, Evolysse Lift and Smooth, at the meeting.  Per Evolus, the “dermal filler, Evolysse Lift, met primary endpoint of non-inferiority and demonstrated superiority to Restylane-L at 6 months. Secondary endpoints for improvement in nasolabial fold severity showed statistically significant differences compared to Restylane-L at all measured timepoints for the entire 12-month study period. Evolysse Smooth met primary endpoint of non-inferiority and demonstrated superiority to Restylane-L at 6 months. Secondary endpoints for improvement in nasolabial fold severity showed statistically significant differences compared to Restylane-L at 6 and 9 months. On track to submit Premarket Approval (PMA) applications for the first two Evolysse dermal filler products with the FDA within the next 90 days.”

Genetic Testing for Tailored Treatments

Mind.Px from Mindera Health genetic analysis test uses a dermal biomarker patch (DBP) to determine response to a biologic drug class for psoriasis patients.Mind.Px from Mindera Health genetic analysis test uses a dermal biomarker patch (DBP) to determine response to a biologic drug class for psoriasis patients.Photo courtesy of Mindera HealthGenomic testing is a game-changer for the aesthetics industry, benefitting everything from precision customization of whole body treatments plans to targeting the root cause of individual patients' specific skin conditions such as psoriasis. Mind.Px from Mindera Health is a genetic analysis test that uses a dermal biomarker patch (DBP) to determine response to a biologic drug class for psoriasis patients. AAD guidelines state, “There is…an important need to identify biomarkers that can potentially predict the appropriate biologic agent for individual patients.”¹

According to Mindera Health, “Psoriasis pathogenesis involves a complex interplay between IL-17, IL-23, and other cytokines that play crucial roles as key regulators of the chronic Inflammatory condition.” The test works by “deciphering the immune pathway in an individual psoriasis lesion,” thus giving providers the preferred disease immunopathologic pathway to target for managing an individual patient’s treatment of the disease. “The positive predictive value (PPV) of Mind.Px is >90%, where a positive result is defined as a patient having a minimum of a PASI75 response at 12-16 weeks after dosing,” per Mindera Health.

Genetic tests like this one to predict treatment response are a significant advantage when it comes to determining the proper treatment without going through what can otherwise be an extensive trial and error process. A recent survey of community dermatologists² revealed overwhelming consensus amongst those surveyed that such genetic tests would, “enable more informed decisions about drug selection, improve patient outcomes and significantly reduce wasted spending.”

1. Menter A, Strober BE, Kaplan DH, et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with Biologics. JAAD. Volume 80, Issue 4, P1029-1072, April 01, 2019.

2. Strober, B., Pariser, D., Deren-Lewis, A. et al. A Survey of Community Dermatologists Reveals the Unnecessary Impact of Trial-and-Error Behavior on the Psoriasis Biologic Treatment Paradigm. Dermatol Ther (Heidelb) (2021).

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