The MedSpa industry in the United States has experienced a growth rate of 133% in the past five years. Moreover, “as the current economic environment continues, the myriad of minimally invasive and less expensive procedures offered at Medical Spas, including Wellness Centers and Anti-Aging Clinics is expected to continue to garner more and more of the aesthetic medicine market,” comments Jeff Russell, Executive Director for the International Association for Physicians in Aesthetic Medicine (IAPAM). To capitalize on this profitable field of medicine, more physicians and non-physicians are launching offerings into the Medical Spa market, by opening separate facilities or turning parts of their existing practices into medspa treatment areas.
However, the confidence of the public is a driving factor in the intervention of some state medical regulators to demand “tougher rules for the exploding medical spa business.” In January 2009, the Massachusetts State Board of Registration’s Medical Spa Task Force published its recommendations that, “draft legislation be developed that included authorization and direction to the Department of Public Health to license medical spas for renewable terms of two years, similar to clinic and nursing home licensure already performed by the Department. The legislation also sets forth requirements and restrictions for medical spa ownership, staffing and inspection.” Further, regarding hands-on, didactic training, the Board of Registration recommended, “that the various Boards of Registration establish education and training standards for their licensees desiring to perform medical spa procedures outside their existing scope of experience.”
The medical malpractice insurance industry has become an ally in ensuring trained physicians can properly perform these procedures. Many medical malpractice insurance companies are now requiring physicians not formally trained in aesthetic procedures to attain accredited Continuing Medical Education (CME) credits in aesthetic medicine, before being eligible for favorable insurance coverage.
Jeff Russell applauds these initiatives, which medical insurers and medical regulatory boards are taking. As in Massachusetts, “the IAPAM concurs that all states should enact educational requirements to ensure that all aesthetic practitioners are properly trained in the aesthetic procedures they perform.” This training should include a combination of: didactic instruction, hands-on training, and CME testing. “As well the IAPAM believes that medical spas should be treated as medical facilities and be licensed as such,” says Russell.
Concurrently, there has recently been great discussion regarding the “board certification” of aesthetic medicine. Presentely, the American Board of Medical Specialties (ABMS) does not offer a board certification in aesthetic medicine. The ABMS’s position is that “antiaging is not a medical specialty,” and therefore no association or organization can officially be offering “board certification” in aesthetic medicine at this time. “The timing may be right for the ABMS to consider developing a board certification for aesthetic medicine,” says Russell.
In the meantime, leading nonsurgical aesthetic medicine groups like the IAPAM are offering physician members comprehensive didactic and hands-on training with CME educational credits in aesthetic medicine procedures. As an industry leader, the IAPAM’s educational programs are quarterbacked by a fully accredited faculty, including two board certified dermatologists, who are experts in cosmetic injectables and nonsurgical aesthetic medicine treatments.
About the International Association for Physicians in Aesthetic Medicine (IAPAM)
The International Association for Physicians in Aesthetic Medicine is a voluntary association of physicians and supporters, which sets standards for the aesthetic medical profession. The goal of the association is to offer education, ethical standards, credentialing, and member benefits. IAPAM membership is open to all licensed medical doctors (MDs) and doctors of osteopathic medicine (DOs). Information about the association can be accessed through IAPAM’s website at http://www.IAPAM.com. Additional information about the Symposium and other educational programs can be accessed through http://www.aestheticmedicinesymposium.com or by contacting:
Jeff Russell, Executive-Director
International Association for Physicians in Aesthetic Medicine (IAPAM)
The benefits from the oral intake of caffeine in the many beverages in which it is found: teas, coffee, sodas etc. has long been the subject of study in the medical and pharmaceutical arenas. Many studies have concluded that: whether working as a powerful antioxidant within the body, as an active ingredient in the prevention of Parkinson’s disease or gallstones, or as a possible inhibitor in the development of certain cancers, moderate consumption of caffeine is generally accepted to do a healthy body more good than harm.
However, consumers are now seeing an increase in caffeine being used topically. This has lead to the question, eloquently posed by Dr. Bernard Gram founder of SKIN1, “what is the safety and efficacy of topical caffeine on human skin,” and moreover, as Dr. Linder queries, “what long-term improvement can be expected” through the topical application of caffeine?
Caffeine in “EyeJuvenation”
Appreciating that scientific data is lacking, caffeine is clearly being heralded as “a new exciting product used in many topical creams both as an anti-inflammatory product as well as an anti-oxidant.” Dr. Melissa Babcock explains why caffeine is now finding itself one of the more pre-eminent ingredients in the cosmetic industry. “First off, caffeine is best known for its ability to cause vasoconstriction (the ability to make blood vessels smaller) and therein to decrease redness in skin.” Dr. Babcock shares that, “for patients with rosacea, this can be a wonderful product.” However, she reminds us that “the effects are not long term so the product needs to be applied daily for best results.
Dr. Jennifer Linder echos the sentiment that “caffeine seems to be one of those “miracle” ingredients that is getting a lot of hype for the moment.” Especially in support of the trend toward “EyeJuvenation,” one of the top anti-aging trends identified by the International Association of Physicians in Aesthetic Medicine (IAPAM). The vasoconstrictive properties of caffeine are being marketed in eye products designed to reduce puffiness. However, Dr. Linder is equally careful in recognizing that there is “little research supporting these claims,” and while the short term “benefit” of reduced puffiness can be attributed to an increase in circulation, “again no studies have been performed for eye-area usage.”
Caffeine Contributes to Cellulite Improvements
In a recent study, coffee was declassified as a diuretic. Previously thought to contribute to fluid loss, coffee consumption has now been found to be no more effective as a diuretic than water. However, Dr. Linder notes that, “in studies, caffeine-containing products increased cutaneous microcirculation and reduced the appearance of cellulite.” Further, Dr. Linder found several studies “on the physiology of cellulite that support microvascular changes in cellulite-effected tissue.” She is wary, though, that while “these studies show caffeine increasing microcirculation, topical products cannot typically penetrate the skin and devices like ultrasound may be needed for proper absorption.”
Amos Lavian, founder of Dermalect Cosmeceuticals, builds upon Dr. Linder comments. He has seen improvement in clients who use cellulite products which utilize caffeine to reduce the dimpling of cellulite. Given that cellulite is not a “fat condition”, dimpling that may be caused by vasodilatation may be successfully, albeit temporarily, improved through the topical application of caffeine containing products. Further, in a Finish study done in 2000, cellulite products that listed caffeine as “an active ingredient” reported “to reduce thigh diameter during treatment,” likely resulting in a reduction in the overall breadth of cellulite dimpling.
Caffeine Combats Photoaging
Caffeine has antioxidant properties as well. Antioxidants fight free radicals in the body which damage cells, and research shows specifically that caffeine can decrease the formation of skin cancers after exposure to UVB radiation (a component of sun light that leads to the majority of skin cancers). “Caffeine appears to accomplish this by causing the damaged skin cells to die; therefore, they are unable to divide and form skin cancers,” notes Dr. Babcock. Moreover, Dr. Gram references similar studies where ultraviolet rays were introduced to skin that was treated with caffeine. Interestingly, “the caffeine targeted abnormal skin cells to destroy, but kept the healthy, normal skin cells intact.”
Therefore, “while antioxidants prevent wrinkles but do not treat wrinkles,” comments Dr. Leslie Bauman, caffeine applied topically as an ingredient in sunscreens or foundations may enhance these products’ ability to virtually stop photoaging of the skin.
Dr. Babcock also comments on the use of caffeine in hairloss remedies. “Caffeine has increased hair growth in vitro (outside the human body). Studies have shown caffeine increased hair growth and prevented the negative effects of testosterone on hair growth in cultured hairs.”
Equally, Dr. Linder tentatively touts caffeine’s ability to spur hair growth in male pattern baldness. She mentions a Swiss company Alpecin, whose hair loss restoration products claim that caffeine causes increased hair growth. In support of Alpecin’s claim, Dr. Linder cited a study from the Department of Dermatology and Allergology, at the University of Jena, in Germany, that found that caffeine did seem to stimulate hair growth during in vitro testing. However, in an effort to be duly diligent regarding the long term benefits of caffeine for hairloss, Dr. Linder cautions that, while this is “a creative use of a ingredient to try to improve an often frustrating problem, I would need to see more data, clinical results and proof that their delivery vehicle insures the caffeine is absorbed before making a conclusion.”
Can Caffeine Permanently Turn back the Clock?
Ultimately, after reviewing the findings of many pre-eminent dermatologists and cosmeceutical experts, there clearly is not enough clinical data to definitively determine whether a product relied upon to wake us up in the morning can also have a lasting effect on the ravages of time?
Dr. Babcock offers some sage advice to those looking for the fountain of youth in a product containing caffeine. “People should consider where they buy products with caffeine or other antioxidants. It is important to determine what the concentration of the active ingredients is. Cosmetic companies understand what ingredients are popular and try to include them in their products for advertising purposes. Sometimes the levels of active ingredients are so low that they are ineffective. Products sold in physicians offices many times have higher concentrations of active ingredients and are better made.”
So the caffeine controversy continues. Enjoy a cup of green tea with breakfast, and afterwards, appreciate that cellulite cream with caffeine, even if its benefits last only for the few hours you are on the beach.
About the Jeff Russell and the International Association for Physicians in Aesthetic Medicine (IAPAM)
Jeff Russell is the executive-director of the International Association for Physicians in Aesthetic Medicine (IAPAM). Which is a voluntary association of physicians and supporters, which sets standards for the aesthetic medical profession. Information about the association can be accessed through IAPAM’s , or by contacting: Jeff Russell or calling 1-800-219-5108 x705