Patients’ Overall Skin Health Needs: Treating the Aesthetic Patient

As aesthetic providers assess patients’ skin health, they may identify medical dermatology conditions that need to be addressed. Whether they treat the conditions themselves or refer to a medically focused dermatologist, the aesthetic provider can play a vital role in managing patients’ skin health.

Everything from over-the-counter skincare to prescription products to injectables and devices plays a role in skin quality, says Deirdre Hooper, MD, a dermatologist in New Orleans. Addressing medical dermatologic conditions is essential—and it’s the responsibility of the aesthetic provider to point out any issues they notice and explain that there are treatment options available. “I’m very comfortable saying ‘I notice that you have some red pimples on your cheeks, some discoloration, some scaling rashes. I notice that you have this issue on your face, and I have a plan for you to get that better as well, because I want your whole skin to look beautiful.”

In addition to its range of aesthetic options including hyaluronic acid fillers, a neuromodulator, and poly-L-lactic acid biostimulator, and well-known consumer brands like Cetaphil® and Differin® OTC, Galderma offers a portfolio of prescription solutions to treat dermatological conditions, including acne, rosacea, and melasma. The company also continues to investigate new solutions in dermatology and aesthetics.

Dermatologic Solutions

Sabrina Fabi, MD, a California-based dermatologist, has a 100 percent aesthetic-based practice with patients who seek her out for energy-based device treatments, injectables, and other aesthetic interventions. But if a patient has an underlying medical skin condition, like rosacea, or untreated acne, she knows she must address it. “They’re not going to appreciate the full result of their injectables if their skin is covered with redness and blood vessels or acneiform lesions,” she says.

When it comes to improving skin quality, Dr. Fabi is a fan of energy-based device treatments, but she knows that what patients do every day to treat their skin conditions really matters. “If a patient has rosacea and they have bumps from rosacea, Doxy 40 mg (30 Immediate/10 delayed release) is a great treatment and ivermectin cream 1% is an excellent formulation to get the rosacea under control. I think patients appreciate the benefit from their neuromodulators and fillers when their skin quality matches.”

Dr. Fabi favors photodyanamic therapy as an in-office treatment for acne, but she recommends topical treatments to encourage and maintain clearance. “Whether it’s a prescription prescription containing trifarotene or Differin OTC to help control their acne, that’s going to make a difference in their skin appearance. It also has a huge impact on mind and mood,” Dr. Fabi explains. Laser treatments in conjunction with prescriptions offer optimal results, she says. “Patients like that I can do an energy-based procedure right there in the office and also recommend at-home prescription grade products to maintain those results so they don’t need to see me as frequently.”

Corey L. Hartman, MD, FAAD, an AL-based dermatologist who also focuses on aesthetic treatments, acknowledges the need to treat any medical skin conditions may have. Sometimes, he says, patients don’t understand that their aesthetic concerns need a multifactorial approach. For example, he has had patients present for management of acne scarring and discoloration, but they still have active acne. He has to educate patients about why treating their acne or rosacea may be necessary before he can move forward with aesthetic treatments. With education, patients sometimes recognize the need for a child or family member to be seen for a skin condition—especially with the goal to prevent additional long-term pigmentation changes or scarring.

“I like to make sure that we are addressing any underlying skin conditions. My practice is focused on injectables, lasers, acne, and pigment. That comes with rosacea and melasma because those are so intimately connected to the injectables and successful anti-aging regimens that we put people on with the procedures that we do in office. You can’t ignore those conditions,” Dr. Hartman says. “One of my favorite lines to tell patients is that there is a rosacea medication—ivermectin cream 1%—that has revolutionized the way that I treat rosacea,” Dr. Hartman explains. “I tell them it’s from the same company that makes Cetaphil. They really like that—they know Cetaphil and they know that Cetaphil is something that is good for them.”

If the patient has a condition he doesn’t feel comfortable treating, Dr. Hartman refers his patients to one of the other dermatologists or nurse practitioners in his practice to ensure they get the appropriate care they need.

Building Trust

Like Dr. Hartman, Duke Health Oculofacial Plastic Surgeon Julie Woodward, MD, treats medical dermatologic conditions like rosacea, which she’s been treating since her fellowship more than 20 years ago, but she refers out for any complicated conditions. “Many of my patients are referred by their dermatologist, and I make sure those patients return to their dermatologists for their medical skincare,” she adds.

Young Cho, MD, PhD, a plastic surgeon, also refers when necessary. He is in practice with a partner dermatologist who can treat patients who may have medical dermatology concerns or issues. “Having both core aesthetic specialties in one practice enables us to really offer our patients an integrated approach to facial aesthetics,” he says.

Referrals can build trust and loyalty in your aesthetic patients. Suneel Chilukuri, MD, an aesthetic-focused dermatologist in Houston, knows the benefits of referring his patients when needed. “I’m very blunt about what I know and don’t know, because I want to make sure that every single person who comes to the office knows I consider them to be part of my Refresh Dermatology family and that I have their best interest at heart. If there is another provider in the community who can do more than I can, I refer,” Dr. Chilukuri says. “We’ve trained our patients to know that if there’s someone who can do something better, I’m going to refer them.”

He says he may ask a patient if a condition he notices bothers them. “We refer to some amazing general dermatologists in the community—they’ll see the patient, they’ll put them on the proper regimen. And then the patients come back to me for what I call the mechanical side of things.”

It’s about building trust, ensuring all of your patients’ skincare needs are addressed, and providing them with the best treatments possible.

Comprehensive Care

“When you can take care of patients’ comprehensive skincare needs and focus on skin health rather than one particular treatment, it’s a far superior way to brand yourself as the expert for skin health and beauty. I think the way to make the best outcomes everywhere is always combination treatment,” says Dr. Hooper. She adds that it makes sense, especially as you’re starting out, to partner with a company that can help you take that comprehensive approach.

Dermatologist Heidi Prather, MD agrees. “Galderma is heavily invested in skin health from A to Z. Galderma is elevating our perspective on skin health through clinical research, product developement and delivering everything from OTC to prescription treatments to in-office procedural-based skincare and injectables.”

Dr. Hartman also appreciates this investment into the specialty. He says, “It’s really refreshing to see a company with the stature of Galderma continue to embrace our little tiny specialty, and the things that are important, and bring things to market that provide us and our patients value. It makes me want to work with them, continue to work with them, and find new and more innovative ways to work with them, because that’s important.”

Disclosure: Drs. Suneel Chilukuri, Sabrina Fabi, Corey L. Hartman, Deirdre Hooper, Heidi Prather, Julie Woodward, and Young Cho are all consultants for Galderma. None of the participants has received any financial consideration for their participation in this series.