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Innovations in Treating Photodamaged Skin
enhances the skin penetration of antioxidants,
13
so its addition to Figure 4: Antioxidant Protection of
topical antioxidants will increase their uptake in the skin. Previously,
Skinceuticals CE Ferulic
phloretin was not used for UV photoprotection of the skin, but it has
been found that a solution containing vitamin C, ferulic acid and
10
phloretin (Skinceuticals Phloretin CF) provides significant
photoprotection from UV damage.
14
8
In contrast to sunscreen, topical antioxidants are absorbed into the
6
skin and cannot be rubbed or washed off. They remain stabilised for
at least four days,
15
providing significant protection against acute UV
injury and offering more long-term photoprotection with continued
4
use, as well as neutralising ROS before they can damage the skin.
Antioxidant protection
2
In my practice, all patients with AK undergo a comprehensive
programme of sunscreen plus topical antioxidant after receiving
medical treatments such as liquid nitrogen cryotherapy, topical
0
Vehicle Vitamin C Vitamin E Vitamin C+E C+E+Ferulic
5-fluorouracil, topical imiquimod and photodynamic therapy. After
several years of observing hundreds of patients, the incidence Courtesy of skinceuticals.com
of AK and subsequent development of SCC has significantly
decreased. Therefore, the synergistic relationship between
Figure 5: The Number of Sunburned Cells After
sunscreen and topical antioxidants needs further investigation in
Ultraviolet Exposure Decreases with Use of CE Ferulic
vivo. Additionally, my patients have noted an improvement in their
appearance, with fewer wrinkles and solar lentigines. Further
100
randomised clinical trials are warranted to study these beneficial
cosmetic effects.
80
In conclusion, we advocate the daily use of topical antioxidant with
sunscreen as a means of maintaining healthy skin after medical
60
therapy. Many studies support the relationship of sun radiation and
oxidative stress in causing photocarcinogenic effects on skin in the 40
form of AK and SCC. Providing topical antioxidants to skin could
diminish the effect of photocarcinogenesis by neutralising free
Percentage of SBC reduction
20
radicals. Therefore, topical antioxidant treatment may complement
the skin’s innate antioxidant stores and work in synergy with
sunscreens in the photoprotection of human skin. 0
Vitamin E Vitamin C C+E C E Ferulic
Bordeaux’s Aesthetics
Courtesy of skinceuticals.com
by Dominique Boineau-Géniaux
In recent years, developments in the field of dermatology have consultations uniting surgeons, dermatologists and nutritionists,
redefined the role of the medical skin expert, leading dermatologists resulting in treatments that combine the skills of each medical expert
to become key players in numerous fields, including prevention and in accordance with the patient’s wishes.
treatment of skin cancers and management of chronic dermatoses
(psoriasis) using adapted treatments, where the dermatologist is Top-level Antiageing Expertise; Top-quality Treatment
now called on to also take into account the aesthetic concern. We have developed a specific cosmetic–dermatological consultation
protocol using both photographic analysis and biometrological
Skin ageing, along with its prevention and methods of treatment, analysis (measuring cutaneous hydration, elasticity, wrinkle depth
now represents a significant demand from patients who are not only and pigment irregularities). Analysis of the results obtained allows
better informed but also far more demanding. This observation has us to dispense cosmetic prescriptions adapted to each individual
inspired us to develop a unique concept that is unprecedented in patient (true personalised beauty prescription), as well as offering
France: a centre of cosmetic dermato-surgery and nutritional adapted skincare treatments such as filler techniques or botulinum
medicine, Aesthetics, situated in Bordeaux (see Figures 6–8). toxin injections.
A Global Approach Peels and laser procedures are practised by specialists, in
This unique centre is the result of a partnership forged between plastic accordance with the requirements of French law, which state
surgeons, dermatologists and nutritional specialists, all brought that the delegation of procedures is not authorised in this
together within one organisation to offer consultations and laser country. Complementary treatments offered by an assistant add
treatments: an ultra-modern platform established to respond to the an enjoyable aspect to the treatment, carried out in peaceful and
demand for treatment of vascular lesions, pigment irregularities, body- high-quality surroundings. Cosmetic advice is given at the end
hair-related concerns, skin ageing (heliodermia) and localised excess of each treatment in order to raise each patient’s awareness
fat. The originality of this multidisciplinary concept lies in the offer of of the need for UVB and UVA sun protection and offer optimum
EUROPEAN DERMATOLOGY 51
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