I was invited to the annual meeting of International Society of Dermatology Surgery (ISDS) held from June 7 to 9 in Rome. It was that time of the year when the latest advancements in the field of aesthetics were discussed and debated by KOLs from around the world. Discussion topics included botulinum toxins, dermal fillers, cosmetic threads, lasers, and other emerging technologies in aesthetic dermatology. There was a lot of focus around important anatomic considerations during these procedures as well as improvements in procedure delivery techniques.

The key takeaway from the conference was the understanding that a combination treatment regime involving the use of botulinum toxins, dermal fillers, cosmetic threads, and lasers over an elongated period is the way forward for a wholesome facial rejuvenation therapy. This is because facial aging is a complex process which involves many different changes including shrinkage of face’s bony structure, loss of volume from facial fat compartments, increased skin laxity, muscular rigidity, loss of retaining ligaments, and decrease in collagen content and therefore, each change requires a focused treatment. Physicians have also started to stress the need to care for facial skin from an early age and have highlighted the importance of maintenance therapy to better manage the effects of aging.

One of the treatment options for skin rejuvenation highlighted during the conference was photobiomodulation. Photobiomodulation is the non-thermal photochemical or photobiological action of low level light to activate a range of endogenous photoreceptors and chromophores contained in the human skin—such as opsins, flavo-proteins, and ion-gated channels—for both cosmetic and therapeutic purposes. In particular, my interest was sparked by an innovative emerging technology called Kleresca, a non-ablative, non-invasive photobiomodulation skin rejuvenation treatment. Kleresca uses a multi-LED lamp in combination with a photoconverter gel. Light falling on the chromophore gel enhances the properties of light, which further activates different healing pathways in the skin.

Kleresca involves an LED lamp exciting the chromophores in the gel, which in turn emits a band of hyper-pulsed fluorescent wavelength of light. These wavelengths are absorbed by the photoreceptors in the skin and activate healing cascades. For cosmetic purposes, initial research has suggested that biophotomodulation works through two cascades: the first increases collagen deposition, while the second decreases collagen degradation by upregulating fibroblast activity.

A single sitting of treatment involves light exposure for 10 to 15 minutes, and an effective treatment requires two sessions per week for 3 to 4 weeks. Additionally, photobiomodulation is not an instant treatment. The results take weeks or even months because the activation of cascades involving collagen deposition is a slow process.

Studies have shown statistically significant results for the improvement of wrinkles, facial acne, and solar lentigines using biophotomodulation. The procedure offers several other advantages. It is non-thermal, non-ablative, non-invasive, atraumatic, and offers less downtime compared to other facial aesthetics procedures. The effects occur through reactivation of natural pathways for collagen deposition and fibroblast activity, and therefore has a long-lasting effect. Not only has the treatment been shown to be effective during initial studies, but it has also been demonstrated to be very safe, with only few adverse events reported, including mild edema and hyperpigmentation.

The market implication of this device is difficult to determine because of the increasing use of combination treatments in the field of facial aesthetics. Technically, photobiomodulation will compete against many other aesthetic treatments, such as dermal fillers (including collagen stimulators), cosmetic threads, as well as aesthetic lasers; however, for practical purposes, it will likely be used in combination with these treatments, especially for patients who wish to see long-term results. Having said that, success of photobiomodulation as a therapy will drive new patient populations to undergoing antiaging procedures given its simplicity and safety.

Overall, there was great excitement about these results among the attendees at the conference and it will be interesting to see how Kleresca and photobiomodulation impact the aesthetics market going forward.

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