New Webinar: Innovations in Med-Aesthetics Dermatology

How Can We Change the Complexion of Acne and Rosacea?

How Can We Change the Complexion of Acne and Rosacea?

Journal of Drugs in Dermatology | June 2017 | Volume 16 | Issue 6 | Editorials | 531 | Copyright © 2017

Del Rosso, J.Q.

In the field of psoriasis, advances in our understanding of immune dysregulation and pathophysiologic pathways have led to a revolution of therapies that have dramatically improved the lives of a myriad of affected individuals. The major advances have been with injectable biologic agents, although newer oral and topical agents have also been made available or are under formal development. More recently, a similar trend has emerged with atopic dermatitis (AD) with the release of a novel biologic agent and topical agent over the past few months, and other agents affecting specific pathophysiologic pathways that appear to correlate with clinical manifestations of AD. Such increased understanding of mechanisms of disease and advances in treatment are welcome among clinicians in dermatology as they facilitate optimal short-term and long-term care of patients.

So, what is happening recently with true advances in the understanding of pathophysiology and clinical management of acne and rosacea that are currently being researched? The pathophysiology of rosacea and of acne are constantly under investigative scrutiny in search of understanding pathways of disease formation that can be correlated with more targeted therapeutic approaches, both with monotherapy and with combination regimens.1,2 Although we are not nearly at a stage of developing injectable biologic agents for acne or rosacea, there are some agents that address different modes of action or alter drug delivery from oral to topical formulations.3 In acne, agents under formal development that incorporate unique modes of action (MOA) include a topical nitric oxide-releasing gel that exhibits anti-inflammatory and antimicrobial properties, and olumacostat glasaretil, an acetyl CoA carboxylase inhibitor that modulates sebum formation. Topical minocycline, under evaluation as a foam and also as a biphasic gel, may hopefully offer delivery of minocycline to skin for acne, and possibly for rosacea, with avoidance of systemic exposure including the gastrointestinal (GI) tract microbiome. The development of therapies that reduce or avoid contribution to antibiotic resistance and improvements in the prevention and treatment of acne scarring are areas of major focus in both acne and rosacea.4-6

The following highlights some areas of interest and/or observation that may alter how we currently approach these two common, inflammatory facial dermatoses. Acne will be addressed first followed by rosacea.

Treat Acne Beyond Visible Severity. In mild to moderate acne, it is important to magnify the clinical extent of acne lesions beyond what is seen. This correlates with utilizing more aggressive therapy to cover areas of disease that exceed the severity of acne that is seen during the exam visit. In addition, the presence of acne scarring warrants the need for more aggressive therapy, even when the current severity of active acne is mild.1 Unless the patient is considered a candidate for oral isotretinoin, it is important to optimize treatment with a rational combination therapy approach.7,8

Recognize the Importance of Subclinical Inflammation in Acne. In patients with acne-affected skin, subclinical inflammation is present prior to the emergence of both visibly non-inflammatory (comedonal) and visibly inflammatory lesions.1 It is important to consider the use of combination topical therapy to address both antimicrobial effects and multiple anti-inflammatory activities.1,7,8

Evaluate Duration of Antibiotic Use in Acne. Data from one study has demonstrated that acne was treated for at least 6 months, and at least 12 months, in approximately two-thirds of patients and one-third of patients, respectively, before progressing to the use of oral isotretinoin.9 It has been suggested that oral antibiotic use be limited to the shortest duration feasible in order to reduce the risks associated with antibiotic resistance.4,5 The threshold for the use of oral isotretinoin may need to be lowered in many patients in order to reach this goal and to achieve optimal clearance of persistent inflammatory acne.

Categorize and Manage Rosacea Based on Current Clinical Manifestations. The time has come to move beyond the categorization of rosacea by subtypes.10,11 Individual patients may respond differently to specific triggers and clinical presentations of rosacea exhibit marked interpatient variability. As a result, it is important to correlate therapy for rosacea with individual features that are observed clinically.11 From a medical therapy perspective, treatment of papulopustular rosacea warrants a combination of an agent directed against papulopustular lesions (ie, topical metronidazole, topical azelaic acid, topical ivermectin, and/or oral sub-antibiotic dose doxycycline) and a topical alpha-agonist directed against persistent non-transient facial erythema (ie, brimonidine, oxymetazoline). Physical devices may be integrated for the treatment of telangiectasias and facial erythema.

At the present time, although there are agents in development for acne and rosacea, our ability to improve management outcomes will depend on altering and optimizing our approaches to treatment using agents we currently have available. This includes the use of combination regimens and more aggressive management earlier during the course of disease. It will be important for research to increase in the development of newer agents that address novel MOAs, that can be integrated to optimize combination therapy, and that reduce or avoid antibiotic resistance.

James Q. Del Rosso DO FAOCD FAAD

Research Director JDR Dermatology Research, Las Vegas, NV Dermatology and Cutaneous Surgery Thomas Dermatology, Las Vegas, NV

References

  1. Del Rosso JQ, Kircik LH. The sequence of inflammation, relevant biomarkers, and the pathogenesis of acne vulgaris: what does recent research show and what does it mean to the clinician? J Drugs Dermatol. 2013;12(8 Suppl):s109-s115.
  2. Steinhoff M, Schmelz M, Schauber J. Facial erythema of rosacea – aetiology, different pathophysiologies, and treatment options. Acta Venereol. 2016;96:579-86.
  3. Del Rosso JQ. Future of acne therapy. Presentation at South Beach Symposium (Futures Therapies CME Symposium), Miami Beach, Florida, February 10, 2017.
  4. Rosen T. Antibiotic resistance: an editorial review with recommendations. J Drugs Dermatol. 2011;10(7):724-733.
  5. Del Rosso JQ, Webster GF, Roden T, et al. Status report from the Scientific Panel on Antibiotic Use in Dermatology of the American Acne and Rosacea Society: part 1. Antibiotic prescribing patterns, sources of antibiotic exposure, antibiotic consumption and emergence of antibiotic resistance, impact of alterations in antibiotic prescribing, and clinical sequelae of antibiotic use. J Clin Aesthet Dermatol. 2016;9(4):18-24.
  6. Tan J, Kang S, Leyden J. Prevalence and risk factors of acne scarring among patients consulting dermatologists in the United States. J Drugs Dermatol. 2017;16(2):97-102.
  7. Eichen eld L, Krakowski AC, Piggot C, et al. Evidence-based recommendations for the diagnosis and treatment of pediatric acne. Pediatrics. 2013;131 Suppl 3:S163-186.
  8. Zaenglein AL, Pathy AL, Schlosser BJ, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945-973.
  9. Nagler AR, Milam EC, Orlow SJ. The use of oral antibiotics before isotretinoin therapy in patients with acne. J Am Acad Dermatol. 2016;74273-279.
  10. Del Rosso JQ, Gallo RL, Tanghetti E, et al. An evaluation of potential correlations between pathophysiologic mechanisms, clinical manifestations, and management of rosacea. Cutis. 2013;91(3S):1-7.
  11. Del Rosso JQ, Thiboutot D, Gallo R, et al. Consensus recommendations from the American Acne & Rosacea Society on the management of rosacea, part 5: a guide on the management of rosacea. Cutis. 2014;93(3):134-138

Stay up to date with Aerolase!

Receive weekly newsletters, event & promotional alerts, and so much more!

Read more blogs

See what skin health professionals say about their experiences using
Neo Elite® Era Elite® Reverse® Exci308®

Learn what skin professionals say about using Aerolase technology in their practices and how their revenues have significantly increased.
Photo Courtesy of Ashlee Bunkelman, LE
Owner of Skin Boss Med Spa

Laser Optical Engineer

Aerolase is the fastest growing medical laser company, serving the high growth dermatology and aesthetic laser market. Nestled in the picturesque Hudson Valley in Tarrytown, NY, the location is also ideal for access to NY City and other areas of the Northeast and Mid-Atlantic U.S. We are hiring in many areas and currently seek laser optical engineers with a passion for creating new things. The company offers a friendly, team-oriented work environment and competitive compensation including salary, bonus, stock options, 401k, and health/dental/life insurance plans.

About the Team:

  • We are a diverse team of friendly, creative hard-working people with a passion for achieving our objectives
  • We are creative, hands-on and innovative with a strong orientation toward high customer satisfaction
  • We have created a very team-spirited company culture and believe it is important to have open and effective cross-functional collaboration and communications – and enjoy our work!

About the Role:

We’re looking for an enthusiastic, creative and detail-oriented problem solver to help support the production, service and repair of our unique solid-state laser devices.

Must have expertise working with assembly and/or development of small, sensitive, high precision instruments, preferably solid-state laser technology, with a high caliber technology company.  We prefer design and hands-on experience in multiple laser technologies including solid state lasers, semiconductor lasers, non-linear optical materials and devices, optical benches, and beam directors. Experience with the technical aspects of developing laser and laser-based products is strongly preferred.

Candidates should have proven ability to address complex challenges with ingenuity and innovation, and capability to work independently to manage multiple simultaneous tasks, and see all tasks to completion. Also should have the ability to work well in a collaborative multidisciplinary team environment, define and analyze system performance specifications, and ensure adherence to those specifications in the application environment.

  • Perform sensitive manual optical assembly of lasers.
  • Test, troubleshoot repair and assemble lasers, subassemblies and various components, including high-voltage laser power supplies and other electronics.
  • Support the development and implementation of test fixtures, equipment, procedures and documentation for the engineering and operations functions.
  • Support product design and development activities related to new products and product improvements.
  • Support development and maintenance of quality and regulatory documents and procedures.
  • Provide customer technical support as needed including product service, maintenance, and troubleshooting.
  • With suppliers, act as a technical and operational liaison as needed.
  • Maintain thorough, complete and accurate written records; comply fully with the company’s quality system and any regulatory requirements.
  • Follow safety rules for working with high-voltages and high-power lasers.
  • Perform other duties as completion of responsibilities necessitates or as assigned by supervisor.
  1. Minimum 5 years of experience in an engineering role involving sensitive high precision instruments, preferably involving solid state lasers.
  2. Theoretical and practical knowledge and skills of adequate policies and procedures for the control of laser hazards and high voltage hazards, using relevant protective equipment, ensuring adequate safety education and training of other personnel.
  3. Understanding of system and component design, testing and troubleshooting.
  4. Enjoy working with your hands/mechanical ability.
  5. Strong analytical and problem solving skills.
  6. Proven technical and project management skills.
  7. Experience with manufacturing within a Quality Management System (especially medical).
  8. Strong interpersonal and communication skills.
  9. Self-motivated, detail oriented and well organized. Ability to make decisions and work independently Strong work ethic and desire to help the company successful by producing a reliable product.
  10. Not afraid to ask questions and make suggestions for improvement.
  11. Be able to work under pressure due to customer demands.
  12. Strong computer skills (Windows™ software).
  13. Ability to successfully manage multiple projects and daily responsibilities. Ability to discern and appropriately communicate sensitive issues.
  14. Ability to walk, stand, bend, reach, stoop/squat, and crouch. Ability to carry heavy items.
  15. Will require working indoors and outdoors – work environment includes the office, the production areas, mechanical rooms, and customer and supplier facilities. Also includes regular contact with high-voltage equipment and laser light emissions.

BS. in Physics, Mechanical or Optical Engineering, Master’s Degree preferred

  • We are a diverse team of friendly, creative hard-working people with a passion for achieving our objectives
  • We are creative, hands-on and innovative with a strong orientation toward high customer satisfaction 
  • We have created a very team-spirited company culture and believe it is important to have open and effective cross-functional collaboration and communications – and enjoy our work!

We’re looking for an enthusiastic, creative and detail-oriented problem solver to help support the production, service and repair of our unique solid-state laser devices.

Must have expertise working with assembly and/or development of small, sensitive, high precision instruments, preferably solid-state laser technology, with a high caliber technology company.  We prefer design and hands-on experience in multiple laser technologies including solid state lasers, semiconductor lasers, non-linear optical materials and devices, optical benches, and beam directors. Experience with the technical aspects of developing laser and laser-based products is strongly preferred.  

Candidates should have proven ability to address complex challenges with ingenuity and innovation, and capability to work independently to manage multiple simultaneous tasks, and see all tasks to completion. Also should have the ability to work well in a collaborative multidisciplinary team environment, define and analyze system performance specifications, and ensure adherence to those specifications in the application environment.

  • Perform sensitive manual optical assembly of lasers.
  • Test, troubleshoot repair and assemble lasers, subassemblies and various components, including high-voltage laser power supplies and other electronics.
  • Support the development and implementation of test fixtures, equipment, procedures and documentation for the engineering and operations functions.
  • Support product design and development activities related to new products and product improvements.
  • Support development and maintenance of quality and regulatory documents and procedures.
  • Provide customer technical support as needed including product service, maintenance, and troubleshooting.
  • With suppliers, act as a technical and operational liaison as needed.
  • Maintain thorough, complete and accurate written records; comply fully with the company’s quality system and any regulatory requirements.
  • Follow safety rules for working with high-voltages and high-power lasers.
  • Perform other duties as completion of responsibilities necessitates or as assigned by supervisor.
  1. Minimum 5 years of experience in an engineering role involving sensitive high precision instruments, preferably involving solid state lasers.
  2. Theoretical and practical knowledge and skills of adequate policies and procedures for the control of laser hazards and high voltage hazards, using relevant protective equipment, ensuring adequate safety education and training of other personnel.
  3. Understanding of system and component design, testing and troubleshooting.
  4. Enjoy working with your hands/mechanical ability.
  5. Strong analytical and problem solving skills.
  6. Proven technical and project management skills.
  7. Experience with manufacturing within a Quality Management System (especially medical).
  8. Strong interpersonal and communication skills.
  9. Self-motivated, detail oriented and well organized. Ability to make decisions and work independently Strong work ethic and desire to help the company successful by producing a reliable product.
  10. Not afraid to ask questions and make suggestions for improvement.
  11. Be able to work under pressure due to customer demands.
  12. Strong computer skills (Windows™ software).
  13. Ability to successfully manage multiple projects and daily responsibilities. Ability to discern and appropriately communicate sensitive issues.
  14. Ability to walk, stand, bend, reach, stoop/squat, and crouch. Ability to carry heavy items.
  15. Will require working indoors and outdoors – work environment includes the office, the production areas, mechanical rooms, and customer and supplier facilities. Also includes regular contact with high-voltage equipment and laser light emissions.

BS. in Physics, Mechanical or Optical Engineering, Master’s Degree preferred

Let’s Discuss Your Acne Strategy.

Start Delivering Excellence.

Hyperpigmentation

Photos Courtesy of Cheryl Burgess, MD.

Photos Courtesy of Jennifer Parker-Porter, MD.

Learn more about treating hyperpigmentation today.

Vascular Lesions

Photos Courtesy of Dr. Guilia Kasimova.

Photos Courtesy of Michael Gold, MD.

Learn more about treating vascular lesions today.

Rosacea / Redness

Photos Courtesy of Yelena Kipervas, DO.

Photos Courtesy of Dr. Nabil Fakih.

Learn more about treating rosacea and redness today.

Hair Removal

Photos Courtesy of Sholema Clinics.

Photos Courtesy of Steik Spa.

Learn more about treating hair removal today.

PFB

Photos Courtesy of Dr. Michelle Henry.

Photos Courtesy of Wendy Roberts, MD.

Learn more about treating PFB today.

Scars

Photos Courtesy of Dr. William Watfa.

Photos Courtesy of Bradley Bloom, MD.

Learn more about treating scars today.

Autoimmune Disorders

Photos Courtesy of Dr. Passeron.

Photos Courtesy of Dr. Sakhiya.

Learn more about treating autoimmune disorders today.

Skin Rejuvenation

Photos Courtesy of Catie Cutler, LE.

Photos Courtesy of Chesahna Kindred, MD.

Learn more about skin rejuvenation today.

Acne

Photos Courtesy of Michael Gold, MD.

Photos Courtesy of Michael Gold, MD.

Learn more about treating acne today.

Staff Accountant / Junior Accountant

Aerolase Corporation, a leading aesthetic laser innovator, seeks a Staff Accountant / Junior Accountant. Having made the Inc. 5000 list as one of the world’s fastest growing private companies as well as annual best-in-class product awards, Aerolase has transformed the market with products that provide uniquely tolerable treatments to the patients and exceptionally high ROI for the practitioners. The company offers competitive and an exciting high-growth company culture.

Duties:

• Provide support to the Controller and the management team
• Maintain day-to-day financial accounting functions, including A/P, A/R, expense tracking
• Support the month-end close process, ensuring accurate and timely monthly, quarterly, and year-end financial statements.
• Uploading annual budget and tracking actual to budget variances
• Use of financial reporting software
• Support external auditors and other required outside reporting requirements
• Participation in quarterly inventory reconciliations
• Assist team with projects such as policy creation, system implementation, client support etc.

• Some experience with and strong understanding of the monthly close process and technical accounting
• Detailed oriented, with ability to see the big picture
• Self-starter who can work independently and employ time management skills to meet deadlines.
• Knowledge of MS Excel (V-lookup, formulas, pivot tables).
• Strong interpersonal and communication skills
• Sound judgment and problem-solving skills

• Bachelor’s or master’s degree in Accounting a MUST, good understanding of GAAP
• 1-3 years’ experience in an accounting function (including internship)
• General Ledger/Operational Accounting experience
• Knowledge of Quickbooks or other reporting software a plus (more the better)
• Industry experience a plus

Senior Accountant

Aerolase Corporation, a leading aesthetic laser innovator, seeks a Senior Accountant. Having made the Inc. 5000 list as one of the world’s fastest growing private companies as well as annual best-in-class product awards, Aerolase has transformed the market with products that provide uniquely tolerable treatments to the patients and exceptionally high ROI for the practitioners. The company offers competitive and an exciting high-growth company culture.

Duties:

• Provide support to the Controller and the management team
• Own day-to-day financial accounting functions, including A/P, A/R, expense tracking
• Assist in establishing and maintaining policies & procedures in accordance with GAAP and Aerolase policy
• Key contributor to the month-end close process, ensuring accurate and timely monthly, quarterly, and year-end financial statements.
• Assist in the preparation of management reports – (cash management, various projections, month end reporting package)
• Involvement with the annual budget process
• Use of financial reporting software
• Support external auditors and other required outside reporting requirements
• Prepare and submit payroll
• Participation in quarterly inventory reconciliation to the perpetual
• Ad hoc projects

• Strong knowledge of the monthly close process and technical accounting

• Detailed oriented, with ability to see the big picture

• Experience in continuous improvement and accounting best practices

• Self-starter who can work independently and employ time management skills to meet deadlines.

• System savvy – ability to learn new financial software

• Intermediate knowledge of MS Excel (V-lookup, formulas, pivot tables).

• Global consolidations experience a plus

• Strong interpersonal and communication skills

• Sound judgment and problem-solving skills

• Bachelor’s or master’s degree in Accounting a MUST, good understanding of GAAP

• 3+ years’ experience working as a staff/senior accountant

• General Ledger/Operational Accounting experience a must

• Extensive knowledge of Quickbooks and other reporting software

• Prior involvement with system implementation

• Prior public accounting experience (any size firm) a plus

• Industry experience a plus

Login To View Our Content

NOTE: This is not the same login as the Aerolase portal.

Your username or email *
Your password

Register Now To View Our Content

This content is available only to members, who signed up for webinars. Submit the form below and we will grant you immediate access to the recordings.

If you experience any trouble signing up, please email: information@aerolase.com

Your name(Required)
Your Password(Required)

Photo Courtesy of Dr. Diedre Nelson-Sands,
The Art of Skin Clinic, Bahamas.

Stay up to Date
with Aerolase!

Receive weekly newsletters, event & promotional alerts, and so much more!

Stay up to Date with Aerolase!

Join other industry professionals and keep up-to-date with the latest happening in your world. Receive weekly newsletters, event & promotional alerts, and so much more!

By registering you agree to our Terms and Conditions and Privacy Policy and understand that you will be receiving email communications.

Request Your Aerolase Demo Today!

"*" indicates required fields