Acne / Dermatology / Skin Care
News Overview 2.0
As popular as aesthetic and cosmetic procedures are now, there’s room for conventional skin treatment products and services. Global sales of over-the-counter acne medications generate an estimated $3.0 billion annually. One source estimates that global valuation of the top five beauty brands alone totals nearly $40.0 billion: Avon, L’Oreal, Neutrogena, Nivea, and Olay, 
What drives demand? For acne, consumers seek affordable effective ways to manage this and other skin conditions such as eczema, psoriasis, etc. The following excerpts describe products, regulation, research, and treatment developments from the past ten years.
Acne Research & Treatments, October 2008
Approximately 80% of individuals between 11 and 30 years of age are affected by acne (National Institutes of Health). A specific bacterium (Propionibacterium acnes) has been associated with acne, but not confirmed as the causative agent.
In an article published in the October 2008 edition of the Journal of Clinical Microbiology, Danish researchers at Arhus University found P. acnes as the only bacteria collected from follicles in healthy subjects, while many other species (12 – 16) were identified from follicle and superficial skin samples in patients with acne. The study contends that “yet-uncultured bacteria” are unlikely to be associated with acne.
[M. Bek-Thomsen, H.B. Lomholt, M. Kilian. Acne is Not Associated with Yet-Uncultured Bacteria. Journal of Clinical Microbiology, 2008; 46 (10): 3355 DOI: 10.1128/JCM.00799-08]
Marketing Regulations (U.S. Food & Drug Administration)
In early October 2008, an FDA warning letter was issued to Bayer Corporation for its direct-to-consumer “Not Gonna Take It” commercial for Yaz. As indicated on the product label, Yaz is approved for treatment of moderate acne and pre-menstrual dysphoric disorder (PMDD). The commercial, however, broadens the message to suggest a wide-ranging efficacy for acne (regardless of severity) and does not adequately differentiate premenstrual syndrome from PMDD.
Skin Care Product Reviews
Skincare-News.com released its first “best-rated skin care brand” reviews in early October 2008. Skinceuticals is acknowledged for its preventive and regimen products, ranging from antioxidant serums to sunscreens, with individual or synergistic combo packages. In addition to fading stretch marks, Strivectin SDis identified as a Botox® alternative for restoring and restructuring the skin with its elasticizing, firming, and hydrating ingredients.
Improving skin as a barrier while also minimizing moisture loss, Elizabeth Arden’s line is recognized for combining botanicals with advanced technology in dermatologist-tested products. For dullness, hyperpigmentation, and under-eye circles, the Dr. Brandt brand enhances active botanicals with unique delivery systems for basic skin care or damage control. The Skincare-News review of Cellex-C lauds its Patented Complex as “proven to reduce the appearance of fine lines and wrinkles by 84.2%.” [Note: In 2007, Skinceuticals ranked in the top ten skin care brands among respondents from cosmetic/plastic surgery, dermatology, and medical spa practices surveyed by Feed-back.com from a pool of approximately 700 facilities.]
Dermatology News, March 2008
Some dermatology practices employ estheticians to perform procedures such as chemical peels and facials. More typically, dermatologists focus on providing medical care for common skin ailments and conditions. The following abstracts highlight recent news.
Galderma’s Acquisition Of CollaGenex Pharmaceuticals
In late February 2008, Galderma Laboratories Inc. (the U.S. holding company of Galderma Pharma S.A.) released details of the planned acquisition of CollaGenex and its dermatology products / portfolio. Sales of Oracea® and Alcortin® contributed to 2007 revenues of $63.6 million for CollaGenex (a 141% increase over 2006). In 1981, Galderma was formed as a joint venture between L’Oreal and Nestle. Within the dermatology market, Galderma sells products in 85 countries for the treatment of conditions such as acne, fungal nail infections, psoriasis, rosacea, etc.
Competition for Dermatology and Plastic Surgery Residencies
A feature article [The Price of Beauty] recently published by The New York Times  explores the job outlook for newly graduated physicians by following one couple’s efforts to gain employment. Two of the most competitive disciplines are dermatology and plastic surgery, which also offer the highest average annual salaries (more than twice as much as for family physicians). The New York Times article noted that only two-thirds of American medical school seniors seeking dermatology as a first choice got residencies from the few hundred that were available. In contrast, thousands of family medicine and internal medicine residencies were available, where the first choice acceptance figures were 99% and 98%, respectively (Association of American Medical Colleges and National Resident Matching Program).
As observed in an article published by The Tennessean, there was a slight increase in the match percentage in family medicine this year (a 7.6% increase over 2006) and a smaller-than-expected decline in internal medicine (-1%). One explanation is that family and internal medicine provides opportunities for physicians to develop personal relationships with their patients (despite the lower pay scale).
Dermatology News, March – April 2007
The good news for dermatologists and skin care product manufacturers is that most people have trouble changing their behavior to achieve future benefits. Consumer demand is likely to remain high for skin care products and services as most individuals ignore simple preventive measures that can minimize sun damage over their lifetimes.
Adolescents & Young Adults Purposely Tan Their Skin
Despite having family or personal experiences with skin cancer, college students continue tanning their skin using indoor devices or outdoor sun exposure. The research findings were published in the Journal of the American Academy of Dermatology, which conducted a study of 385 college students. The majority of college students with a family member who had skin cancer did not change their tanning behavior outdoors (77%) and 45% tanned indoors. Other experiments indicate that individuals may become addicted to ultraviolet light, which stimulate release of endorphins and generate a euphoric sensation. [UPI; “College Students Addicted To Tanning”, Earth Times, March 17th, 2007.]
Dermal Filler Manufacturers Pursue New Consumers
As noted by the Arizona Republic in mid-March 2007, two well-established competitors in the cosmetic procedures industry are expanding advertising efforts for their dermal filler products. Allergan Inc. (Irvine CA) manufactures and markets BOTOX® and JUVEDERM®, while Medicis Pharmaceutical Corporation (Scottsdale AZ) sells the leading product, Restylane®, and is developing two new dermal fillers.
The current market consists of approximately 1 million Americans, but as many as 30 million more women are candidates for the treatments and can afford them. Strategists at Medicis focus on delivering product information to cosmetic surgeons and dermatologists at conferences, while also appealing directly to consumers. A film project is in the works to find the “Hottest Mom in America” which Medicis officials are expected to also pitch to networks as a reality television show. Through the Internet, a web video is being distributed that features a new tagline to go along with more provocative content.
The goal is to streamline the message, get it out to potential customers, and increase awareness of Restylane as an alternative to BOTOX®. In 2006, Medicis generated approximately 10% of the total corporate revenues posted by Allergan, a larger and historically dominant competitor. Funding is available for costly promotional campaigns, such as the Fall 2006 giveaway of JUVEDERM® samples for physicians to use on approximately 10,000 patients who had previously been treated with Restylane. As of March 2007, fourth quarter 2006 JUVEDERM sales information was not publicly available, but Medicis financial results posted a 20% increase in Restylane sales for the same period of time.
DUSA Pharmaceuticals’ Year-End Financial Results
For the year ending December 31st, 2006, DUSA Pharmaceuticals (Wilmington MA) posted total product revenues of $25.6 million versus $11.3 million for 2005. The Company generated record revenue of $8.2 million for the last quarter of 2006 through increased unit volume sales of Levulan Kerastick® photodynamic therapy (PDT) and non-PDT products acquired from Sirius Laboratories Inc. (which closed in March 2006). DUSA’s products help patients with common skin conditions such as acne and rosacea.
New “LipoDissolve Ultra” Provides Better Results
As a minimally invasive cosmetic procedure, LipoDissolve is a form of mesotherapy that breaks down fat cells in specific parts of the body. The treatment involves injecting lecithin into target areas such as the chin, stomach, or hips to dissolve fat. In March 2007, Crutchfield Dermatology (Eagan MN) introduced an improved protocol, LipoDissolve Ultra, which is currently under investigation to qualify for FDA approval. The new technique incorporates ultrasound massage before and after LipoDissolve treatment to make fat tissue more receptive to treatment.
PhotoMedex XTRAC® Laser System Achieves “Medically Necessary” Status
The Blue Cross Blue Shield Association (BCBSA; Chicago IL) revised a portion of its National Reference Policy so that the PhotoMedex XTRAC® Laser System may be considered medically necessary for treatment of mild-to-moderate psoriasis that is not responsive to other products or procedures. The XTRAC® laser is manufactured and marketed by PhotoMedex (Montgomeryville PA). XTRAC® may also be considered medically necessary for moderate-to-severe psoriasis that affects less than 20% of body area. The National Reference Policy is available to 39 Blue Cross and Blue Shield Plans, each of which makes independent coverage decisions.
 “The Price of Beauty – As Doctors Cater to Looks, Skin Patients Wait,” NYTimes.com, July 28, 2008.
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