The society just published results of a study that tested the effectiveness of 4% hydroquinone combined with tretinoin when used in conjunction with botulinum toxin type a.

Reported benefits include a significant improvement in:

• fine lines
• wrinkles
• hyperpigmentation

The 120 day study was a multi-center, randomized, investigator-masked, parallel-group study with 61 Botox patients. Patients were randomly prescribed either a hydroquinone system (cleanser, toner, 4% hydroquinone, exfoliant, and sunscreen) combined with 0.05% tretinoin cream, or a “standard skin care regimen” with cleanser, moisturizer, and sunscreen.

Investigators and patients alike were tasked with evaluation of the results. They found “significantly milder fine lines/wrinkles and hyperpigmentation at days 30, 90, and 120″ in the hydroquinone/tretinoin group. They also found “superior overall ratings” in patient surveys.

The ASAPS press release reports:

“Patients using the hydroquinone system plus tretinoin believed that their study treatment had further enhanced the improvements attained with botulinum toxin type A compared to those using the standard skin care regimen (86% vs. 8%).”

“The new hydroquinone system is not only effective, it is also easy for patients to use, increasing the likelihood that they will be able to get maximum benefits,” reported Dr. Joel Schlessinger, the study’s co-author.

You can read about the results in the July issue of Aesthetic Surgery Journal.

Images via Botox's before and after tool

Botox and Dysport have more than proven their popularity as injectable wrinkle fillers, and the companies that make them continue to look for new uses.

CBS Interactive Business Network reports that Medicis, maker of Dysport, is working with a company called Revance to create a “wipe-on, wipe-off” version of botulinum toxin to treat facial wrinkles and excessive sweating.

Meanwhile Allergan, maker of Botox, is researching the drug for use as a painkiller and as a treatment for juvenile cerebral palsy and enlarged prostate.

Allergan also continues to focus on Botox’s success as a wrinkle filler with a new website that allows users to upload their own photos and then create photos of what they might look like after Botox.

Botox was also recently approved as a preventive treatment for chronic migraine in October 2010.

The CBS report says sales of Allergan’s Botox began recovering last year after declining during the recession, and recent statistics from the American Society of Plastic Surgeons showed that cosmetic non-surgical procedures increased 5 percent in 2010 from 2009.

Dysport, which was released by Medicis in 2009, has also seen sales success. The company’s non-acne skin products were up 31 percent in 2010, and most of that increase is most likely due to Dysport.

Skin Speaks Spa M.D. is one of the Midwest’s leading provider of Botox® Cosmetic treatments.

On the site, those with psoriasis can navigate through videos from Gunn addressing how to embrace a personal style. The videos cover topics ranging from fabric choices, dressing for the season as well as how to accessorize new looks. Featured in the videos are five winners from a recent contest on the Address Your Psoriasis website. Each winner was flown to New York for a personal style consultation with Gunn, which included assistance in choosing a new outfit.

Gunn says he became involved with Address Your Psoriasis because he has a passion for helping others feel and look confident.

“Fashion has always been a great passion of mine,” Gunn says, “which is why I’m so happy to be able to share my style insights and help people with psoriasis embrace their personal style.”

Psoriasis, which is often diagnosed in early adulthood, is usually a genetically predisposed condition, which may be brought on by a trigger such as stress or an injury. This causes the skin to react and often become inflamed and to form “scales” on the skin’s surface, which can be itchy and uncomfortable. This can cause everyday difficulties for some people, including issues sleeping, walking and often working.

Several options are available to combat psoriasis and may include topical treatments in cases of limited psoriasis or phototherapy (ultraviolet radiation) for individuals with moderate to severe psoriasis.

To learn more about the causes, symptoms and possible treatments for psoriasis, check out the resources on Address Your Psoriasis or contact Skin Speaks Spa MD at one of its five Minnesota locations.

Conducted by plastic surgeon Dr. Steven H. Dayan, the study had 100 patients who were treated with either Botox or a saline placebo for facial wrinkles between the eyebrows, on the forehead and around the eyes.

Participants took a quality of life survey before the injections and two weeks and three months after the injections.

The findings revealed that Botox injections result in improvements in quality of life and self-esteem. Those treated with Botox showed statistically significant improvements in answers to many quality of life questions, including those pertaining to:

• Mood
• Overall life satisfaction
• Body satisfaction
• Self-worth
• Appearance
• Attractiveness
• Sense of well-being

The study also found increases in overall self-esteem and appearance-, social- and performance-related self-esteem for those treated with Botox. In addition, patients who received Botox for the first time demonstrated a greater improvement in quality of life and self-esteem when compared to participants who had previously received Botox.

“The findings in this study ask us to think much differently about Botox treatments,” says Dr. Dayan. “We have long known the physically enhancing benefits of Botox treatments, but to now have data that indicates Botox also improves one psyche, self-esteem and quality of life is very significant. The question now has to be asked is if getting Botox makes people feel better about themselves, could this translate into them being more productive in their professional lives and happier in their personal lives?”

Learn more about Botox at Skin Speaks Spa M.D.

Dr. Joel Schlessinger, a cosmetic surgeon, presented his findings at the American Society for Dermatologic Surgery 2010 Annual Meeting. His results were of a subset analysis of a phase 3 clinical trial designed to evaluate the effectiveness of Dysport.

An analysis of the Dysport group, which had 1160 participants, found that 19.7 percent of the patients responded to Dysport on day one, and that three days was the median response time to the Dysport treatment. Furthermore, Dr. Schlessinger said that Dysport appears to take effect slightly faster than Botox, by about two days.

Dr. Schlessinger explained, “There are many different neurotoxins out there, and they have different types of effects on the injected individual, depending on the physical and molecular makeup of the neurotoxin.”

Based on his findings, he points out that the quicker onset of Dysport “can be very helpful for a person who … has a social function coming up.”

Dr. Elliot Weiss from the Laser and Skin Surgery Center of New York in New York City, said the “study … validates what clinicians have observed clinically with the use of [Dysport] with regard to its early onset of action in many patients.”

Skin Speaks patients can view the comparable dosage and pricing charts for Botox and Dysport to get a better idea of pricing differences between the two.

Migraines, which are three times more common in women than men, are characterized by intense pulsing or throbbing pain. Patients with chronic migraine experience a headache more than 14 days a month.

Botox is given about every 12 weeks as multiple injections around the head and neck to try to dull future headache symptoms and prevent migraines. While researchers are still exploring how Botox works on migraines, one theory is that it blocks pain signals from reaching nerve endings.

Botox had worldwide sales of about $1.3 billion last year, divided equally between medical and cosmetic uses, according to the New York Times. Allergan, the maker of Botox, believes its sales as a medical treatment may eclipse its sales as a cosmetic wrinkle treatment.

In other Botox news, earlier this month it was reported that British scientists developed a way to refine the anti-wrinkle treatment to improve its use for treating chronic migraine, as well as Parkinson’s and cerebral palsy. The researchers’ method produced a refined Botox-like molecule, they said, which would be practical for clinical use but would not have unwanted toxic effects.

“It will now be possible to produce Botox-based medicines in a safer and more economical way,” said Bazbek Davletov, who led the study at Medical Research Council’s Laboratory of Molecular Biology.

Davletov said the new refining technique could allow scientists to produce new forms of Botox with wider practical medicinal uses, for example as a long-term painkiller.

Read the FDA press release on its approval of Botox to treat chronic migraine and the article on refining Botox, “Scientists Find Way to Refine Botox for New Uses.”

Statistics compiled by the American Society for Aesthetic Plastic Surgery (ASAPS) show that for those in the 51-64 age range:

• The number of facelifts dropped from over 75,000 in 2008 to just under 55,000 in 2009
• The number of Botox procedures increased from 672,840 in 2008 to 734,751 in 2009

“If you are a woman who has to come back to work full-time or a man who isn’t going to be able to retire any time soon, you’ve got to look like you can compete,” says Wendy Lewis, a New York–based plastic surgery and skin care consultant. “And if you are working in a field like media where everyone is really young, you don’t just want to look good for your age, you want to look good, period.”

Overall the number of facelifts in the U.S. dropped 29 percent from 2008 and eyelid surgeries dropped 23 percent during the same time frame, according to ASAPS. Meanwhile, Botox and Dysport injections increased 3.8 percent from 2008 to 2009.

Less invasive procedures have several benefits for those in the job market: they require less recovery time and are generally less expensive compared to cosmetic surgical procedures.

Lewis does point out that minimally-invasive treatments can be overdone. “There is a point at which you are going to have a better result and spend less money if you just have a facelift,” she says. In addition, there are some problems, like sagging jowls, that can only be fixed by surgery.

Skin Speaks Spa MD offers a wide array of cosmetic non-surgical procedures, including Fraxel, Thermage, IPL (intense pulsed light), and Juvederm.

The market for botulinum toxin-A drugs, which currently includes  Botox and Dysport in the U.S., is estimated to grow to $543 million by 2017, and the aesthetic laser and light therapy markets for skin resurfacing, hair removal, and laser lipolysis are expected to be the fastest growing cosmetic procedure markets.

The report was done by iData Research, which specializes in medical device and pharmaceutical market research. Dr. Kamran Zamanian, CEO of iData, commented, “Allergan has had a monopoly on botulinum toxin A drugs since 2002 [with Botox], but now faces competition from Dysport by Medicis as well as other new competitors expected to enter the market. Allergan and Medicis have been fierce rivals, as their Juvederm and Restylane facial dermal fillers compete in the lucrative dermal filler market.”

The report also speculated that competition will intensify with the expected entry into the market of another botulinum toxin—PurTox by Mentor. According to Mentor, PurTox is in Phase III clinical trials in the U.S.

The use of botulinum toxins is also expected to increase due to a growing number of therapeutic treatments that go beyond filling wrinkles; for example, the FDA is currently evaluating Botox as a treatment for severe migraines.

At present, the U.S. market for injectables is valued at almost $860 million, according to the report, which is titled “Markets for Cosmetic Surgery, Facial Aesthetics and Medical Laser Devices 2011.” The three-report series includes data, analyses and competitor profiles for botulinum toxins, dermal fillers, breast augmentation implants, liposuction aspirators, laser/light devices, and microdermabrasion.

In addition, Allergan is studying Botox as a possible treatment for overactive bladders, and it owns patents on dozens of other potential treatments, according to the New York Times.

While Allergan denies most of the complaints in lawsuits by whistle-blowers and federal prosecutors, documents released by the Justice Department related to the settlement outlined claims that Allergan had built Botox sales by promoting it for unapproved treatments to relieve conditions like migraines, pain, and cerebral palsy in children, according to the New York Times.

It is important to note that doctors are allowed to prescribe drugs for unapproved, i.e., off-label, uses that they deem medically appropriate, but it is illegal for the drug maker to promote these off-label uses.

Allergan has denied the criminal and civil accusations, except for the one misbranding charge, said Caroline Van Hove, an Allergan spokeswoman.

“I want to be clear that Allergan is not charged with misleading doctors or causing any patient harm,” Ms. Van Hove wrote in an e-mail to a reporter, “and we adamantly deny any implication that this occurred.”

She added that Allergan has spent hundreds of millions of dollars in medical research and development of new uses for Botox, and that the drug is approved in 81 countries to treat 21 different conditions.

Newsweek surveyed 202 corporate hiring managers and found that 56 percent of them said qualified but unattractive candidates are likely to have a harder time getting a job. More than half recommended spending as much time and money on “making sure they look attractive” as on perfecting a résumé.

When the hiring managers were asked to rate nine character attributes in order of importance for job candidates, looks came in third, after experience and confidence—and before where an applicant went to school.

The report also includes an interactive feature called “The Beauty Breakdown,” which estimates what a lifetime of cosmetic maintenance will cost a “modern diva.” Gathering data from a number of sources—including the American Society of Aesthetic Plastic Surgeons and Allure magazine—it looks at beauty costs from the tween years through 50 plus for American women, coming up with a lifetime total of $449,127.

For those in their 30s and 40s that included treatments like microdermabrasion, Botox, lip plumping, and laser varicose vein treatments, in addition to hair care, waxing, and tanning. For women over 50, chemical peels and deep line wrinkle fillers were added to the regimen.

For the lifetime total, the amount spent on the face was estimated at just over $314,000, more than treatments on hair, the body, and hands and feet combined.

In today’s economy, spending money on these treatments may not be “frivolous,” the magazine notes.

“Economists have long recognized what’s been dubbed the ‘beauty premium’—the idea that pretty people, whatever their aspirations, tend to do better in, well, almost everything. Handsome men earn, on average, 5 percent more than their less-attractive counterparts (good-looking women earn 4 percent more),” the report says.

Dr. Carney’s Skin Speaks Spa M.D., with five locations in the Twin Cities area of Minnesota, offers a range of treatments to help you look your best, including Botox, chemical peels, and wrinkle fillers. (image via Newsweek.com)