Which cosmeceuticals have proven clinical efficacy?
In a review in theInternational Journal of Dermatology, study authors explain the mechanism of action and evaluate the efficacy of popular over-the-counter cosmeceutical ingredients, including retinoids, vitamins C and E, hyaluronic acid, collagen, charcoal, and more.
Retinol has strong evidence supporting its efficacy in improving lines, wrinkles, pigmentation, elasticity, firmness, brightness, and overall photodamage. Additionally, retinol causes less irritation than retinoic acid. The authors recommend that formulations should contain at least 0.25% retinol to be effective.
Cosmeceutical products advertise topical collagen for restoring a youthful face with the idea that the topical collagen will be absorbed by the skin. While newer studies have noted that oral collagen is efficacious, there are no clinical studies evaluating the effects of topical collagen. Since collagen is a large molecule, direct absorption via topical application is unlikely.
Hyaluronic acid (HA), one of the most advertised ingredients in skin care products, has clinical support for improving skin hydration, elasticity, firmness, wrinkles, and roughness. Endogenous hyaluronic acid is a large molecule which may have trouble penetrating the epithelial barrier, but lower molecular weight HA and nanoparticle-sized HA can overcome this limitation.
The authors believe continued high-quality clinical research is necessary to evaluate the efficacy of cosmeceutical ingredients, especially considering many marketing claims are based on in vitro studies, which do not always correlate with clinical results.
Find out how to meet patients’ desire for alternative medicine with evidence-based care in Dermatology World.
DW Insights and Inquiries: Thoughts on hyaluronidase and The House of God
I was reminiscing about my internship at Bellevue-NYU 40 years ago after reading Stephen Bergman’s (pseudonym Samuel Shem) reflections on the 40th anniversary of his irreverent, but hilariously accurate, The House of God — a portrayal of resident life in that era. I recall the wisdom of the senior resident (“the Fat Man”) working toward the “big fortoona” to come, but offering profound guidance to his underlings. All of my peers devoured the book with gusto.
One of my patients in the summer of 1979 was an embittered (probably justifiably so), elderly, blind, diabetic woman admitted for congestive heart failure. During my examination, I commented that her back felt hard.
“I have scleredema!” she barked.
“You mean scleroderma, don’t you?” I countered.
“No, I mean SCLEREDEMA, you moronic, stupid intern. It’s a complication of diabetes. Didn’t you learn anything in medical school? Look it up! Maybe you’ll figure out a way to help me — although from my first impression of you, I highly doubt it!”Keep reading!
Cancer death rate falls by largest one-year drop on record
The overall cancer death rate in the U.S. dropped 2.2% from 2016 to 2017 — the sharpest single-year decline ever recorded, according to The New York Times, which covered a recent report from the American Cancer Society. The reduction is driven largely by progress against lung cancer deaths, although the most rapid declines in the report occurred in melanoma.
For metastatic melanoma, the report identifies FDA approval of drugs like vemurafenib, ipilimumab, and newer generations of targeted immunotherapies as playing a bigger role in declining cancer death rates. After these drugs came to market in 2011, the one-year survival rate for metastatic melanoma jumped from 42% for patients diagnosed in 2008-2010 to 55% in 2013-2015.
The overall melanoma mortality rate dropped 7% annually from 2013 to 2017 in people aged 20 to 64 years old. Notably, the rate also dropped 5-6% per year for individuals 65 and older even though the melanoma mortality rates had previously been increasing in the 2000s. The five-year survival rate for melanomas diagnosed between 2009 and 2015 came in at 92%, the second highest of all the cancer types studied.
To see an illustration of how melanoma incidence and mortality have evolved over the past 40 years, see Dermatology World’s Facts at your Fingertips.
How do physicians run for office? The AMA’s workshop will guide you.
Ever wonder how physicians get elected to Congress or state legislatures? Considering a run for office for yourself? The American Medical Association’s AMPAC Candidate Workshop will teach you how to run a winning political campaign. The workshop is designed to help you make the leap from the exam room to the campaign trail and give you the skills and strategic approach you will need to make a run for public office. Get answers to your questions, and determine if running for public office is for you.
Use CMS’s Quality Payment Program Participation Status Tool to check your initial 2020 eligibility for the Merit-based Incentive Program (MIPS). Enter your National Provider Identifier (NPI) to find out whether you need to participate in MIPS for the 2020 performance period.
Low-volume threshold requirements:
Bill more than $90,000 a year in allowed charges for covered professional services under the Medicare Physician Fee Schedule (PFS), AND
Furnish covered professional services to more than 200 Medicare Part B beneficiaries, AND
Provide more than 200 covered professional services under the PFS.
If you do not exceed all three of the above criteria for the 2020 performance period, you are excluded from MIPS. However, physicians can opt-in to MIPS to receive a payment adjustment if one or two (but not all) of the above low-volume threshold requirements are met or exceeded. Find out whether you’re eligible for the 2020 MIPS performance period today.
MIPS 2020 payment adjustments in effect
2020 MIPS payment adjustments, based on each MIPS eligible clinician’s 2018 MIPS final score, will now be applied to payments made for Part B covered professional services payable under the Physician Fee Schedule. Payment adjustments are determined by the final score associated with your Taxpayer Identification Number (TIN)/NPI combination.
For more information and resources for 2019 MIPS reporting, visit the Academy’s MIPS reporting resource center. If you’re reporting using DataDerm™, the 2019 MIPS Reporting Module can still be purchased by calling the Academy’s Member Resource Center at 866-503-SKIN (7546).
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