Cosmetic Dermatology PRINCIPLES AND PRACTICE SECOND EDITION NOTICE Medicine is an ever-changing science As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work Readers are encouraged to confirm the information contained herein with other sources For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration This recommendation is of particular importance in connection with new or infrequently used drugs Cosmetic Dermatology PRINCIPLES AND PRACTICE SECOND EDITION LESLIE BAUMANN, MD Author and Editor Director, University of Miami Cosmetic Medicine and Research Institute Professor of Dermatology University of Miami Miami Beach, FL SOGOL SAGHARI, MD Associate Editor Department of Dermatology University of Miami Miami, FL Private Practice Los Angeles, CA EDMUND WEISBERG, MS Managing Editor Center for Clinical Epidemiology and Biostatistics University of Pennsylvania School of Medicine Philadelphia, PA New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto Copyright © 2009 by The McGraw-Hill Companies, Inc All rights reserved Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher ISBN: 978-0-07-164128-9 MHID: 0-07-164128-9 The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-149062-7, MHID: 0-07-149062-0 All trademarks are trademarks of their respective owners Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark Where such designations appear in this book, they have been printed with initial caps McGraw-Hill eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corporate training programs To contact a representative please e-mail us at bulksales@mcgraw-hill.com TERMS OF USE This is a copyrighted work and The McGraw-Hill Companies, Inc (“McGraw-Hill”) and its licensors reserve all rights in and to the work Use of this work is subject to these terms Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without McGraw-Hill’s prior consent You may use the work for your own noncommercial and personal use; 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You are an ideal husband, father, and friend Here’s to another 20 years together! Robert Edward Baumann I am so proud of what a good person you are growing up to be You are kind, have a great sense of humor, and have a love for others that is truly refreshing You have many talents, one of which is making me feel very special and proud to have you as a son Keep up the good work! Maximilian Carl Baumann When this book comes out, you will be years old It is hard to believe that you are growing up so fast; however, you will always be my baby I am very proud of what a great student and person you are I am so happy to have someone in the family who is so much like me and loves to read as much as I Never stop snuggling! Roger, Robert and Max, You all brighten my life, remind me of what is important, and make it all worthwhile Thank you for loving me! This page intentionally left blank CONTENTS Preface xi Acknowledgments xiii Basic Science of the Dermis Leslie Baumann and Sogol Saghari Fat and the Subcutaneous Layer 14 Voraphol Vejjabhinanta, Leslie Baumann, Suzan Obagi, and Anita Singh Immunology of the Skin Hormones and Aging Skin Nutrition and the Skin 16 Rosacea (Type Sensitive Skin) 121 128 Sogol Saghari, Jonette Keri, Stuart Shanler and Leslie Baumann Leslie Baumann Sharon E Jacob 19 Wrinkled Skin 20 Chemical Peels 45 21 Prevention and Treatment of Bruising Leslie Baumann 145 Sogol Saghari and Leslie Baumann 42 Leslie Baumann and Sogol Saghari Leslie Baumann and Jonette Keri 18 Contact Dermatitis (Type Sensitive Skin) 136 Photoaging 34 Cigarettes and Aging Skin 15 Acne (Type Sensitive Skin) 29 Leslie Baumann and Sogol Saghari Section Specific Skin Problems 22 Larissa Zaulyanov-Scanlan 109 17 Burning and Stinging Skin (Type Sensitive Skin) 133 H Ray Jalian and Jenny Kim Heather Woolery-Lloyd Leslie Baumann and Sogol Saghari Leslie Baumann and Sogol Saghari 14 Skin of Color Section Basic Concepts of Skin Science Basic Science of the Epidermis 13 Skin Pigmentation and Pigmentation Disorders 98 CONTENTS Contributors ix 148 Leslie Baumann and Sogol Saghari 163 Susan Schaffer, Sogol Saghari and Leslie Baumann Section Cosmetic Procedures Section Skin Types The Baumann Skin Typing System 22 Botulinum Toxin 69 75 Leslie Baumann and Edmund Weisberg 10 Oily Skin Leslie Baumann, Marianna Blyumin and Sogol Saghari 24 Lasers and Light Devices 83 Leslie Baumann 12 Sensitive Skin 169 23 Dermal Fillers 191 Mohamed L Elsaie and Leslie Baumann 11 Dry Skin Leslie Baumann, Mohamed L Elsaie and Lisa Grunebaum 212 Joely Kaufman 25 Sclerotherapy 221 94 Larissa Zaulyanov-Scanlan Leslie Baumann vii 26 Facial Scar Revision 227 Suzan Obagi and Angela S Casey 34 Antioxidants 292 Leslie Baumann and Inja Bogdan Allemann 35 Anti-inflammatory Agents 312 Section Skin Care Mari Paz Castanedo-Tardan and Leslie Baumann 27 Starting a Skin Care Product Line 237 Leslie Baumann 36 Fragrance 325 Edmund Weisberg and Leslie Baumann 28 Cosmetic and Drug Regulation 241 Edmund Weisberg and Leslie Baumann 37 Preservatives 329 Edmund Weisberg and Leslie Baumann 29 Sunscreens 245 Section Other Leslie Baumann, Nidhi Avashia and Mari Paz Castanedo-Tardan 30 Retinoids 38 Bioengineering of the Skin 256 CONTENTS Leslie Baumann and Sogol Saghari 31 Cleansing Agents 39 Scales Used to Classify Skin 263 Kumar Subramanyan and K.P Ananth 32 Moisturizing Agents 273 Leslie Baumann 33 Depigmenting Agents 335 342 Mari Paz Castanedo-Tardan and Leslie Baumann 40 The Psychosocial Aspects of Cosmetic Dermatology 347 Edmund Weisberg Leslie Baumann and Inja Bogdan Allemann viii Leslie Baumann and Mari Paz Castanedo-Tardan 279 Index 357 CONTRIBUTORS K P Ananth Chapter 31 Nidhi J Avashia, BS Miller School of Medicine, University of Miami, Miami, Florida Chapter 29 Marianna L Blyumin, MD Dermatology Resident, Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida Chapter 23 Angela S Casey, MD Assistant Professor, Dermatology and Mohs Surgery, University of Vermont College of Medicine, Fletcher Allen Health Care, Burlington, Vermont Chapter 26 Maria Paz Castanedo-Tardan, MD Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami Miami, Florida Chapters 29, 35, 38, and 39 Mohamed L Elsaie, MD, MBA Cosmetic Dermatology Fellow, Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida; Department of Dermatology and Venereology, National Research Center, Cairo, Egypt Chapters 10 and 22 Lisa Danielle Grunebaum, MD Assistant Professor, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology and Head and Neck Surgery, University of Miami, Miami, Florida Chapter 22 Sharon E Jacob, MD Assistant Professor, Divisions of Medicine and Pediatrics (Dermatology), University of California, San Diego, San Diego, California Chapter 18 H Ray Jalian, MD Resident Physician, Department of Medicine, Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, California Chapter Joely Kaufman, MD Assistant Professor, Department of Dermatology and Cutaneous Surgery and Director of Laser and Light Therapy, University of Miamia Cosmetic Medicine and Research Institute, Miami, Florida Chapter 24 Jonette Keri, MD, PhD Assistant Professor, Miller School of Medicine, University of Miami, Miami, Florida; Chief, Dermatology Service, Miami VA Hospital, Miami, Florida Chapters 15 and 16 CONTRIBUTORS Inja Bogdan Allemann, MD Cosmetic Dermatology Fellow, Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida; Dermatologic Clinic, University Hospital of Zurich Zurich, Switzerland Chapters 33 and 34 Jenny Kim, MD, PhD Associate Professor, Department of Medicine and Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, California Chapter Suzan Obagi, MD Assistant Professor of Dermatology, Director, The Cosmetic Surgery and Skin Health Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Chapters and 26 Sogol Saghari, MD Department of Dermatology, University of Miami, Miami, Florida; Private Practice, Los Angeles, California Chapters 1, 2, 7, 13, 16, 19, 20, 21, 23, and 30 Susan Schaffer, RN University of Miami, Cosmetic Medicine and Research Institute, Miami Beach, Florida Chapter 21 Stuart Daniel Shanler, MD, FACMS Private Practice, New York, New York Chapter 16 ix