Reference

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7/31/2010
New hyaluronic acid filler formulation rehydrates skin, boosts volume
Juvderm Hydrate composed of 13.5 mg/g uncross-linked HA and 0.9 percent mannitol, resulting in reduced free-radical degradation of HA where injected
New hyaluronic acid filler formulation rehydrates skin, boosts volume

Juvderm Hydrate composed of 13.5 mg/g uncross-linked HA and 0.9 percent mannitol, resulting in reduced free-radical degradation of HA where injected
Study results showed the best hydration was achieved in the neckline area
Juvderm Hydrate not yet approved by the FDA
A new hyaluronic acid (HA) filler formulation appears to volumize the skin while significantly increasing hydration. Juvderm Hydrate (Allergan) improves on and surpasses the level of skin hydration achieved from the typically used HA fillers, potentially setting a new standard for skin-rejuvenation therapy, according to results from a recent study presented at the 8th Anti-Aging Medicine World Congress in Monte Carlo, Monaco, in April.


Dr. Friedman

Hyaluronic acid is a natural polysaccharide found in skin that has the property of retaining water, and this sponge-like effect is important in keeping the skin hydrated. Over time, the loss of HA results in older-looking skin that is characterized by static fine lines, wrinkles and folds.

"The skin tends to dry out as we age because it gradually loses the natural hyaluronic acid that we have in our skin. As a result of that, our skin is losing its elasticity, smoothness and brightness. Juvderm Hydrate can more effectively rehydrate the skin compared to the currently available HA fillers and help restore these vital characteristics of youthful skin," says Nimrod Friedman, M.D., a plastic surgeon in Tel Aviv, Israel.


STACKING UP All of the currently available HA-based fillers, including Juvderm, are composed of cross-linked HA. These aesthetic gels are useful in the treatment of fine lines and wrinkles not only because of their filling effect, but also because HA attracts water to it, resulting in fuller and smoother skin where injected. Juvderm Hydrate, on the other hand, is composed of 13.5 mg/g uncross-linked HA and 0.9 percent mannitol, a formulation that results in a reduced free-radical degradation of HA where injected. This leads to extended longevity of the HA, allowing it to attract water over a longer period of time and ultimately improve the aesthetic outcomes of the filler treatment.

In a recent prospective multicenter study in France, the efficacy of Juvderm Hydrate on skin hydration was evaluated. The trial consisted of 27 female patients with a mean age of 42.6 years who received Juvderm Hydrate injections in their skin, including the eye, cheek, perioral and neckline areas. Investigators used the depot injection technique, which is composed of small injections into the middle to deep dermis. Here, approximately 20 to 40 sites were injected with gel drops, which are then gently massaged to spread the gel.

The mean total volume injected into the face and neckline areas at each visit was approximately 1 ml and 0.8 ml, respectively. At each of the four visits, skin measurements were performed with the Visio Probe (IntuiSkin), a high-resolution sensor device capturing precise skin images, and the Physio Probe (IntuiSkin), a device which determines skin hydration, trans-epidermal water loss and skin temperature. Assessments were made at baseline and at days 15, 30 and 60.

RESULTS Results showed that at day 60, Juvderm Hydrate significantly improved the hydration of the skin at the cheek, perioral and neckline areas compared to baseline, demonstrating a 59.3 percent, 59.3 percent and 65.3 percent improvement in hydration, respectively, at these targeted sites. The physician and subject satisfaction of aesthetic results showed that skin texture, brightness, hydration and appearance were "improved" or "very improved" for more than 90 percent and more than 80 percent of subjects at day 60, respectively.

"Rehydration plays a critical role in returning the skin to a younger, more vibrant look," Dr. Friedman says. "Most HA fillers can achieve a good hydration; however, this new filler clearly takes skin rejuvenation treatments to the next level."

According to Dr. Friedman, the parameters of the skin of the neck and of the face are different. The neckline is notoriously more challenging to treat in terms of hydration, probably due to advanced cumulative actinic damage, and the results of the study show that the best hydration was achieved in this area.
LONGEVITY RESULTS The effects of cross-linked HAs are said to last up to one year following treatment. However, these HAs hydrate the skin significantly less than Juvderm Hydrate with its uncross-linked HA and mannitol combination formulation, Dr. Friedman says. Though the positive aesthetic outcomes with Juvderm Hydrate were achieved with repeated treatments that only lasted up to 60 days, Dr. Friedman says that the treatments were well worth the effort, as reflected in patient testimonials. With respect to face fullness, 100 percent and 80 percent of study patients found their overall global aesthetic effect and skin revitalization to be "very improved" or "improved," respectively. Approximately 85 percent of patients said they would undergo repeat treatment and would recommend the treatment to a friend.

"Using Juvderm Hydrate is part of a rejuvenation philosophy. If you want to take care of your skin, it is something that you may need to address more frequently, just as any other part of the aging body," Dr. Friedman says.

Aesthetic surgical interventions alone may not be enough to achieve skin rejuvenation, and all must be approached on different levels. Moreover, a noninvasive, nonsurgical approach to skin rejuvenation is often preferred by the patient, and, in some cases, it may be the optimal approach.


"Using HA fillers once a year in combination with Juvderm Hydrate treatments spaced one or two months apart appears to be a very effective approach in maintaining a brilliant and youthful appearance of the skin," Dr. Friedman says.

Juvderm Hydrate is not approved by the Food and Drug Administration, and there are currently no plans for it to enter the U.S. market, according to Allergan. However, the new filler is currently available in England, Italy, France, Germany and Spain.

DISCLOSURES:
Dr. Friedman reports no relevant financial interests.


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