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October 30, 2019
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Updates on medical innovations in aesthetics: Hair growth is 'holy grail'

Natasha Mesinkovska, MD 
Natasha Mesinkovska
Christopher Zachary, MD 
Christopher Zachary

NEWPORT BEACH, Calif. — The unmet needs in the medical aesthetics market currently reside in hair growth, skin tightening and texture, and acne device-based technologies, according to researchers here at a session on medical innovation in aesthetics.

“Hair growth was an $87 billion market last year and most of it is over-the-counter, but we have no medical advancements,” Natasha Mesinkovska, MD, director of clinical research in dermatology at University of California, Irvine, said at the OCTANe Medical Technology Innovation Forum. “For many patients, it’s OK for your face and your chest to wrinkle, but it’s not OK for your hair to fall out.”

She added that 70% of patients with hair concerns who visit her practice are women.

Christopher Zachary, MD, cited the nationwide Magic Wand Initiative as a way to spur innovation at an institution. He is chair and professor of dermatology at University of California, Irvine.

“The concept is that the clinicians can find the problems, they understand them, and they can find those worth solving,” Zachary said. “I think we have to ask ourselves throughout the day to find a problem that’s worth solving and then move on.”

He is currently focused on new microscopic techniques for imaging the skin using multifocal microscopy to diagnose melanoma in situ without sending a biopsy to a pathologist.

“This is not yet FDA approved but it’s coming, and any pathologist will have to learn that light-based technology using noninvasive microscopy will be a big deal in the future,” Zachary added.

Skin tightening is a common problem that the industry is not well equipped for, E. Victor Ross, MD, director of laser and cosmetic dermatology center at Scripps Clinic, said.

“Noninvasive skin tightening is a huge noninvasive need,” he said.

Acne is another issue that needs more creative options in the space, according to Ross.

“I think clinicians are one of the key reasons why we find answers to problems that plague us,” Steve Yoelin, MD, ophthalmologist, chair and professor of dermatology at University of California, Irvine, said.

“I feel strongly that a prostaglandin analog will allow us to grow hair on the head of females and males,” Yoelin said. “The holy grail is hair growth. I think some patients who have been waiting to come to our practices will come [once improved hair growth therapy is available].”

Patients want surgical outcomes with nonsurgical approaches, according to Darin Messina, vice president of device biology research and development at Allergan.

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“In skin texture, tone and hydration, Europe has some products on the pipeline which will make their way to the FDA pipeline,” Messina said.

Yoelin believes regenerative medicine is another large opportunity with a lot of potential.

“The rewards are extremely hefty,” he added.

Allergan is undertaking research for therapeutic indications in products such as Botox (onabotulinumtoxinA), Yoelin said. “This instills a level of confidence in these products so more people are willing to come to our offices and be treated. ... The therapeutic piece can be a catalyst to the aesthetic piece and vice versa.”

Allergan is also working on a depression study using Botox, he said.

As for the biggest bang for the buck for clinicians, the most important molecule is Botox or serotype A toxin, Yoelin said.

“It’s a smaller cost point than fillers, but it’s very consistent. It’s a wonderful gateway drug [to other aesthetic procedures],” Yoelin said.

The issue with serotype A is durability, he said. “Now you have products that are reversible, and hyaluronic acid can last 2 years. We are approaching a surgical outcome with an in-office procedure. In a perfect world, we would get 6 or 9 months of durability. That product will open the door to dermal fillers and then also maybe aesthetic energy devices and some of the other things we are talking about.”

Messina is excited about a company called Elastagen, which Allergan acquired in 2018. The company is based in Australia and has early clinical data in stretch marks and acne scars.

“Our typical approach is to bring this to market in Europe in a few years and then maybe around the 5-year horizon for U.S. regulatory approvals,” Messina said. – by Abigail Sutton

 

Reference:

Mesinkovska N, et al. Medical innovations in aesthetics. Presented at: OCTANe Medical Technology Innovation Forum; Oct. 28-29, 2019; Newport Beach, Calif.

 

Disclosures: Healio Dermatology could not confirm relevant financial disclosures at the time of publication.