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Can a Topical Serum Work Like Botox? Dermatologist Breaks Down P-TIOX · The Science of Skin

• 0:00
  SPEAKER_00: The views presented in this podcast are based on clinicians' points of view and experience from clinical practice.
• 0:05
  SPEAKER_00: This episode is brought to you by Skin Suticles, the number one medical aesthetic skincare brand worldwide, and the leader in antioxidant science.
• 0:14
  SPEAKER_00: To learn more, visit www.skinseuticals.com.
• 0:27
  SPEAKER_01: Hello and welcome to the Science of Skin Podcast.
• 0:29
  SPEAKER_01: We are recording live in Paris, France.
• 0:32
  SPEAKER_01: We're here for the Skin Alliance conference, hosted and sponsored by L'Oreal.
• 0:37
  SPEAKER_01: This episode is sponsored by Skin Suiticals.
• 0:40
  SPEAKER_01: My name is Dr.
• 0:41
  SPEAKER_01: Ted Lane.
• 0:41
  SPEAKER_01: I'm a board certified dermatologist and your host for today.
• 0:44
  SPEAKER_01: And I have a very special guest.
• 0:47
  SPEAKER_01: Because we're so international, we have an international guest as well.
• 0:50
  SPEAKER_01: This is Dr.
• 0:51
  SPEAKER_01: Peter Bering from Denmark.
• 0:53
  SPEAKER_01: Dr.
• 0:53
  SPEAKER_01: Bering, how are you?
• 0:54
  SPEAKER_01: I'm good.
• 0:55
  SPEAKER_01: Thank you.
• 0:55
  SPEAKER_01: Thank you so much for being here.
• 0:56
  SPEAKER_01: Let me just introduce Dr.
• 0:57
  SPEAKER_01: Bering, and this is going to take half the episode.
• 1:00
  SPEAKER_01: So Dr.
• 1:01
  SPEAKER_01: Bering is a dermatologist.
• 1:03
  SPEAKER_01: He's a professor of dermatology at the University Clinic in Olberg, Denmark, which is on the western side of Denmark.
• 1:10
  SPEAKER_01: Copenhagen is on the eastern.
• 1:12
  SPEAKER_01: We're on the western side.
• 1:13
  SPEAKER_01: It's a more rural area, I understand, and also has the highest incidence of non-melanoma skin cancer, which has led to some very interesting research that Dr.
• 1:22
  SPEAKER_01: Bering was doing regarding the use of CO2 laser for non-melanoma skin cancer, which we will learn about much later.
• 1:29
  SPEAKER_01: Dr.
• 1:29
  SPEAKER_01: Bering also was the first dermatologist in Denmark to use a laser.
• 1:34
  SPEAKER_01: In fact, he developed his own laser and was integral in the development of the IPL laser technology.
• 1:40
  SPEAKER_01: So a true leader in dermatology, especially in cosmetic dermatology.
• 1:46
  SPEAKER_01: In fact, Dr.
• 1:47
  SPEAKER_01: Beering, you've you co-founded your own hospital.
• 1:49
  SPEAKER_01: Yes, I did.
• 1:51
  SPEAKER_01: And that's where you continue to see patients.
• 1:52
  SPEAKER_01: I do, yes.
• 1:53
  SPEAKER_01: So you do your research and you see patients there.
• 1:55
  SPEAKER_01: Yes.
• 1:56
  SPEAKER_01: Wonderful.
• 1:57
  SPEAKER_01: Dr.
• 1:57
  SPEAKER_01: Beering was also knighted by the Queen of Denmark in 2007, although we won't call him Sir Peter Beering.
• 2:04
  SPEAKER_01: Just don't.
• 2:04
  SPEAKER_01: Don't do that.
• 2:05
  SPEAKER_01: Okay.
• 2:06
  SPEAKER_01: I'll just do that in private.
• 2:07
  SPEAKER_01: Okay.
• 2:08
  SPEAKER_01: So let's talk.
• 2:11
  SPEAKER_01: Today we're going to talk about PTox, which is this novel technology developed by skin pseudocals.
• 2:17
  SPEAKER_01: Yes.
• 2:17
  SPEAKER_01: Dr.
• 2:18
  SPEAKER_01: Beering, it's very interesting, right?
• 2:19
  SPEAKER_01: We it's called PTox, which sounds kind of like neurotoxin.
• 2:23
  SPEAKER_02: It is neurotoxin.
• 2:25
  SPEAKER_02: Why is that?
• 2:26
  SPEAKER_02: It's because it contains two different neurotoxins, one working exactly like botulinum toxin, presynaptic, and the other one blocking the muscular receptors.
• 2:37
  SPEAKER_02: So we have a dual action here on the neuro blockage, which actually is provided by relatively small molecules.
• 2:45
  SPEAKER_02: You know, botulinum toxin would never penetrate the skin, but these are below 1,000 molecular weight, so uh they can penetrate, which means that you actually get a topical action.
• 2:57
  SPEAKER_02: What we have been talking about uh Botox in the bottle.
• 3:00
  SPEAKER_01: Yeah, Botox in a bottle, that's so interesting.
• 3:02
  SPEAKER_01: We know that there have been uh you know companies that have tried to develop a topical neurotoxin.
• 3:08
  SPEAKER_01: Unfortunately, it's failed in clinical trials.
• 3:10
  SPEAKER_01: Yeah, but this is this is using kind of neuropeptides.
• 3:14
  SPEAKER_02: Yes, what happened is I think they actually took uh the um temple viper toxin and cut the molecule down until it didn't work anymore and then won up again.
• 3:25
  SPEAKER_02: And then they got this small part of the of the um of this toxin from the viper that actually works.
• 3:32
  SPEAKER_02: So it is really uh nearly a natural toxin.
• 3:36
  SPEAKER_01: That's exactly what I was saying.
• 3:37
  SPEAKER_01: I that was I was thinking, you took the words right out of my mouth.
• 3:39
  SPEAKER_01: It sounds like it's a very naturally occurring toxin, and it works both pre- and post-synaptic.
• 3:45
  SPEAKER_02: With the two different toxins, yes.
• 3:47
  SPEAKER_01: So interesting.
• 3:48
  SPEAKER_01: So when we think about Botox or or any of the neurotoxins available right now that are injected, they work presynaptically, right?
• 3:53
  SPEAKER_01: The SNAP25 complex.
• 3:54
  SPEAKER_02: Exactly.
• 3:55
  SPEAKER_01: Uh, and and now we're talking about not only that, but we're we're postsynaptically where the acetylcholine would bind to the receptors, yes.
• 4:03
  SPEAKER_01: Yep, yep, bind to the receptors on muscles, and we're affecting that binding as well, which is really interesting because now we're starting to think about very fine superficial muscles that can help maybe even where an injected neurotoxin can't get to.
• 4:18
  SPEAKER_02: Exactly, and also in the sweat glands.
• 4:21
  SPEAKER_02: They are also innervated the same way.
• 4:24
  SPEAKER_01: Okay, exactly.
• 4:25
  SPEAKER_01: And we know, for example, that we use Botox for hyperhydrosis in the axilli, and many of us use it off-label in other areas to reduce squitting in the palms, even but on the face, for example.
• 4:36
  SPEAKER_01: Exactly.
• 4:36
  SPEAKER_01: Um, wonderful for the heat that we're having today in Paris.
• 4:39
  SPEAKER_01: If I didn't have Botox right now, you wouldn't want to see me.
• 4:42
  SPEAKER_01: So uh this this is really interesting.
• 4:44
  SPEAKER_01: And so you were involved in in a couple of different trials in with with PT docs.
• 4:49
  SPEAKER_01: Yes.
• 4:49
  SPEAKER_01: Um, we we started talking about sweats, let's move into that one first.
• 4:53
  SPEAKER_02: Okay, then.
• 4:54
  SPEAKER_01: Yeah, could you describe kind of what the methods and materials were for that small trial that you did?
• 4:58
  SPEAKER_02: Yes, you know, uh when we are using botulinum toxin for sweating, we normally do a test to find out which area has to be injected, not to waste too much botulinum toxin because it's expensive.
• 5:11
  SPEAKER_02: So we do what we call the minus test.
• 5:13
  SPEAKER_02: Minus test is a test where you apply iodine on the area and a little bit around it, and then uh where it's sweating, the sweat comes up slowly, and if you uh just sprinkle some uh potato flour or corn flour onto it, it turns blue, bluish black.
• 5:32
  SPEAKER_02: Easy to see where the sweating is actually taking place.
• 5:35
  SPEAKER_01: Yeah.
• 5:36
  SPEAKER_01: We used to do that a lot for the axilli.
• 5:38
  SPEAKER_01: I I don't know that we do that.
• 5:39
  SPEAKER_01: That's as in the United States at least, we don't do that as much anymore.
• 5:42
  SPEAKER_01: We'd kind of just do a diffuse treatment, but the the Myers-iodine starch test is something that very very very well.
• 5:48
  SPEAKER_01: Uh it gets a little bit messy.
• 5:50
  SPEAKER_01: But for the purposes of using the cream, it's an incredibly effective way to it to quantify the sweat production.
• 5:57
  SPEAKER_02: Because we applied it on one half of the forehead.
• 5:59
  SPEAKER_01: Yes.
• 6:00
  SPEAKER_02: Three times, sixteen hours before we get the test, four hours and two hours before we did the test.
• 6:07
  SPEAKER_02: Then we um had the patient to do squats.
• 6:10
  SPEAKER_02: Okay, and uh they got sweating, and then we applied the flour, uh-huh, and they turned black where the sweating was taking place and not on the side where the ptiox had been applied.
• 6:21
  SPEAKER_01: Let me reiterate what happened.
• 6:23
  SPEAKER_01: Okay, so it was uh the iodine was placed when the patients were at rest, the iodine was placed over their entire forehead.
• 6:29
  SPEAKER_01: Uh then the PTOx was was applied to one half of the forehead three times over 16 hours.
• 6:36
  SPEAKER_01: The the more the closest time to when the patient was exercising was two hours before.
• 6:41
  SPEAKER_01: Yes.
• 6:42
  SPEAKER_01: Uh then the patient was asked to squat, as as Dr.
• 6:44
  SPEAKER_01: Beering said, and uh then starch was applied because when starch is applied to the iodine with sweat, it turns black.
• 6:51
  SPEAKER_01: And so it's an easy way to quantify the sweating uh of one half with the PTOX versus the other half, which was essentially untreated.
• 7:01
  SPEAKER_01: And what did you find?
• 7:02
  SPEAKER_02: It worked.
• 7:03
  SPEAKER_01: Okay.
• 7:03
  SPEAKER_02: It worked, it became black on one side, not on the other side.
• 7:06
  SPEAKER_02: Yeah.
• 7:07
  SPEAKER_02: And I was really, really impressed because I actually expected it to work, but I didn't expect it worked so well.
• 7:14
  SPEAKER_02: So you won't.
• 7:15
  SPEAKER_02: So now we have a new indication for it.
• 7:18
  SPEAKER_01: No, it's and it's wonderful.
• 7:19
  SPEAKER_01: I totally, you know, again, for for in your professional uh if you're in front of people, if you're at a meeting and and it could be quite warm, or if you just are someone who sweats when you get a bit anxious, this could really be useful.
• 7:32
  SPEAKER_01: It could, yes.
• 7:32
  SPEAKER_01: Yeah.
• 7:33
  SPEAKER_01: So so even a medical use for this for this cream, and it speaks to, I think, the fact that you're able to get some penetration of those toxin molecules.
• 7:41
  SPEAKER_02: It shows, exactly.
• 7:42
  SPEAKER_02: Otherwise, it wouldn't work.
• 7:43
  SPEAKER_01: Now, you didn't see much change, and it was only three applications, but you didn't see much change in the muscle activity, right?
• 7:49
  SPEAKER_02: No.
• 7:50
  SPEAKER_02: Okay.
• 7:50
  SPEAKER_02: Because uh it was only three applications.
• 7:53
  SPEAKER_02: And you know, in order to have, for example, Botox to work, it takes seven days.
• 7:57
  SPEAKER_01: Yeah.
• 7:58
  SPEAKER_02: So um we should have applied it for longer to see that.
• 8:02
  SPEAKER_02: It might work, we don't know.
• 8:05
  SPEAKER_01: I'm gonna try it.
• 8:06
  SPEAKER_01: Put it on half of my forehead and see if one half doesn't move versus the other.
• 8:10
  SPEAKER_02: As long as you don't have Botox in now.
• 8:11
  SPEAKER_01: Yeah, I gotta, yeah, I've got to let that wash out.
• 8:16
  SPEAKER_01: Not having Botox in my forehead will be a a rare occurrence for the last 17 years.
• 8:20
  SPEAKER_01: So we'll we'll see how that goes.
• 8:21
  SPEAKER_01: Find somebody else, yes.
• 8:23
  SPEAKER_01: I love it.
• 8:24
  SPEAKER_01: Let's do that.
• 8:25
  SPEAKER_01: Okay.
• 8:25
  SPEAKER_01: Now let's talk about another trial that you were.
• 8:28
  SPEAKER_02: Yes, another trial here was because all studies until now have been done in women.
• 8:33
  SPEAKER_02: And males are different.
• 8:35
  SPEAKER_02: And therefore we did an all-male study.
• 8:39
  SPEAKER_02: Thirty-six persons in different races: Indian, Chinese, Caucasian, African Americans, Native Alaskan.
• 8:48
  SPEAKER_02: And uh we did the test with sorry, with PTOx serum, full face, eight weeks, and then we evaluated standardized clinical photos in VISIA and objective uh measurements uh of the wrinkles.
• 9:06
  SPEAKER_02: And what we could see here that we got a 15% reduction in forehead wrinkles and glabella wrinkles, and also reduction in uh marinate lines and nasolabial fold and even crow's feet.
• 9:19
  SPEAKER_02: Yeah.
• 9:20
  SPEAKER_02: So that really worked alone with no injections.
• 9:24
  SPEAKER_01: And this was compared to baseline, guys.
• 9:26
  SPEAKER_01: So there was no control on this.
• 9:28
  SPEAKER_01: These were the subjects compared to baseline.
• 9:30
  SPEAKER_01: Yeah.
• 9:31
  SPEAKER_01: Again, using this once a day, right?
• 9:33
  SPEAKER_02: Once.
• 9:33
  SPEAKER_02: Once twice a day.
• 9:35
  SPEAKER_01: Oh twice a day.
• 9:36
  SPEAKER_01: Twice two applications per day, morning and night.
• 9:38
  SPEAKER_01: At at both, look, I believe it was both four weeks and eight weeks.
• 9:42
  SPEAKER_01: We saw it.
• 9:42
  SPEAKER_02: Yes, yes, exactly.
• 9:44
  SPEAKER_02: Uh the the effect increased from four to eight.
• 9:47
  SPEAKER_02: Okay.
• 9:47
  SPEAKER_02: So actually there is a sort of uh increased activity the longer you use it.
• 9:52
  SPEAKER_02: We could have used it even longer, and we didn't know it might even be better.
• 9:57
  SPEAKER_01: That's an interesting idea.
• 9:58
  SPEAKER_01: Go off to twelve, six, yes, we should do that.
• 10:00
  SPEAKER_02: Yeah.
• 10:01
  SPEAKER_01: That would be really interesting.
• 10:02
  SPEAKER_01: Yeah, I was surprised as you know, I was surprised that we saw an effect at four weeks, but even greater at eight weeks.
• 10:08
  SPEAKER_01: Yes.
• 10:08
  SPEAKER_01: Usually we think about that for like retinoids or a lightning agent, right?
• 10:12
  SPEAKER_01: Where you're progressively improving.
• 10:14
  SPEAKER_01: But this this is interesting because you you you would think that if you attach to the nerves, you know, pre- and post-synaptically, what you see at four weeks, you should see at eight weeks.
• 10:22
  SPEAKER_02: It might not just be uh an action on muscles.
• 10:26
  SPEAKER_02: Yeah.
• 10:26
  SPEAKER_02: Because we also in the PTOX had uh ingredients that worked on static wrinkles as well.
• 10:33
  SPEAKER_02: Right.
• 10:34
  SPEAKER_01: That's a good point.
• 10:35
  SPEAKER_01: So these were actually improvements in static.
• 10:38
  SPEAKER_01: This was not dynamic, this was static, right?
• 10:40
  SPEAKER_02: If that was ex- We don't know because we didn't have them to move their face as we normally do if we evaluate static from dynamic wrinkles.
• 10:48
  SPEAKER_01: Okay, but but the results are these are for just from the static wrinkles.
• 10:51
  SPEAKER_01: Exactly.
• 10:52
  SPEAKER_01: Okay, so at rest we saw a reduction in the in the appearance of the wrinkles in multiple areas.
• 10:58
  SPEAKER_01: Yes.
• 10:58
  SPEAKER_01: And I'm glad you mentioned the marionette lines because they're difficult.
• 11:02
  SPEAKER_01: Very yes, that's exactly what I was saying.
• 11:04
  SPEAKER_01: They're very difficult.
• 11:04
  SPEAKER_01: And to see an improvement in marionette lines speaks to possibly some some improvement in sagging as well.
• 11:10
  SPEAKER_01: Exactly.
• 11:11
  SPEAKER_00: This episode is brought to you by Skin Suticles, the number one medical aesthetic skincare brand worldwide, and the leader in antioxidant science.
• 11:20
  SPEAKER_00: To learn more, visit www.skinseuticals.com.
• 11:24
  SPEAKER_01: Well, let's talk about you know, we talked about the hero ingredients, right?
• 11:28
  SPEAKER_01: The two neuropeptides, but there's a few others, as you mentioned.
• 11:31
  SPEAKER_02: Yes.
• 11:31
  SPEAKER_02: What what let's talk about?
• 11:32
  SPEAKER_02: Yeah, we've got the uh polylactic acids.
• 11:35
  SPEAKER_01: So the uh polyhydroxy acid.
• 11:37
  SPEAKER_02: Yes, for the uh exfoliation.
• 11:39
  SPEAKER_02: We've got niacinamide for even out the yes, for anti-inflammatory effect and for even out the pigmentation and so forth.
• 11:47
  SPEAKER_02: And we've got laminaria for collagen uh improvement.
• 11:51
  SPEAKER_01: Laminaria is is derived from, I believe, brown kelp.
• 11:55
  SPEAKER_01: It is, yes, from from Japan.
• 11:56
  SPEAKER_01: From Japan.
• 11:57
  SPEAKER_01: And it's it's a strong antioxidant.
• 11:59
  SPEAKER_01: It is, yes, as well.
• 12:00
  SPEAKER_01: Niacinamide, as Dr.
• 12:02
  SPEAKER_01: Ferris always says, is is the gentle giant, right?
• 12:04
  SPEAKER_01: It is the B3 vitamin.
• 12:06
  SPEAKER_01: Yeah, yeah.
• 12:06
  SPEAKER_01: And it it has so many great benefits, improving the barrier as well as an antioxidant benefit, has anti-pigmentation benefit as well.
• 12:13
  SPEAKER_01: And so not only did we see an improvement in the wrinkles, but we also saw key parameters that that were improved as well.
• 12:20
  SPEAKER_02: The radiance.
• 12:21
  SPEAKER_02: Radiance.
• 12:22
  SPEAKER_02: And that is fantastic because that is actually what people are asking for these days.
• 12:27
  SPEAKER_02: Not only wrinkles, but also radiance.
• 12:30
  SPEAKER_02: Look less tired and more fresh and more relaxed and so forth.
• 12:35
  SPEAKER_02: It actually works.
• 12:37
  SPEAKER_01: Such an interesting product, right, guys?
• 12:39
  SPEAKER_01: I mean it's it's it's something where it's it's almost like a Swiss Army knife product, where you're not only are you improving the wrinkles through a very unique mechanism, but you're also improving kind of the clinical attributes of healthy skin.
• 12:50
  SPEAKER_01: Exactly.
• 12:50
  SPEAKER_01: So so one product twice a day achieves multiple goals, which I think is what the consumer now demands.
• 12:57
  SPEAKER_01: And so I love that that um Skin Piticals is is trying to meet those demands with novel technology and novel formulation.
• 13:03
  SPEAKER_02: Right.
• 13:04
  SPEAKER_01: You know, you mentioned the improvement in radiance, and I remember there were a couple of cases that were uh published, and and one was used in sun damaged skin.
• 13:14
  SPEAKER_01: It was a 43-year-old Fitzpatrick skin type 3 baseball player.
• 13:18
  SPEAKER_02: Who never used any sunscreen at all.
• 13:20
  SPEAKER_02: Oh my gosh.
• 13:21
  SPEAKER_02: Yeah.
• 13:22
  SPEAKER_01: Like you can imagine the amount of sun damage.
• 13:24
  SPEAKER_02: And he wasn't old, but he already had sun damage.
• 13:27
  SPEAKER_01: Yeah.
• 13:27
  SPEAKER_02: And that could also be improved.
• 13:30
  SPEAKER_02: And that could be due to the neuropeptides, but also to the niacinamide and the other ingredients, of course.
• 13:37
  SPEAKER_01: Well, I think so, because even at seven days after starting, the patient noticed visible change and smoothness and radiance, um, with a global aesthetic improvement score of of two, so significant improvement.
• 13:50
  SPEAKER_02: I think that might be also the hydration.
• 13:53
  SPEAKER_02: Ah.
• 13:54
  SPEAKER_02: Because that would that would work very, very quickly.
• 13:56
  SPEAKER_02: Very quickly.
• 13:57
  SPEAKER_02: While the other agents might work a little bit slower.
• 14:00
  SPEAKER_01: Yeah.
• 14:00
  SPEAKER_02: But it's very good to have a quick starting agent and something which kicks in later.
• 14:06
  SPEAKER_01: Kicks in later over time.
• 14:07
  SPEAKER_01: Exactly.
• 14:07
  SPEAKER_01: Yeah.
• 14:08
  SPEAKER_01: No, it made sense to me when I saw the polyhydroxy acid in particular at 5%.
• 14:13
  SPEAKER_01: That made a lot of sense.
• 14:13
  SPEAKER_01: It's a very gentle exfoliation, but but that will lead to quick, as you mentioned, quick.
• 14:18
  SPEAKER_02: It does.
• 14:19
  SPEAKER_02: And it is gentle because in our study here, we didn't see any side effects.
• 14:23
  SPEAKER_01: Mm-hmm.
• 14:24
  SPEAKER_01: Mm-hmm.
• 14:25
  SPEAKER_01: And that's that's actually very impressive, right?
• 14:27
  SPEAKER_01: When you're talking about a male, a 43-year-old male who's never used anything on his skin, has no background knowledge of what it's like to apply something to the skin, and then you have them immediately start applying a cream with 5% pH, polyhydroxy acids, twice a day.
• 14:42
  SPEAKER_01: Yeah, you know, I'm not saying men are babies, but but we they they definitely tend to be a little bit more sensitive.
• 14:49
  SPEAKER_01: And so having absolutely no side effects related to irritation or dryness or stinging, it speaks to the formulation.
• 14:56
  SPEAKER_02: It does.
• 14:57
  SPEAKER_02: And in this study, we also asked the patients whether they had sensitive skin or non-sensitive skin.
• 15:03
  SPEAKER_02: And more than 50% of them actually had reported themselves that they had sensitive skin.
• 15:08
  SPEAKER_02: And still then we didn't see side effects.
• 15:11
  SPEAKER_01: Mm-hmm.
• 15:12
  SPEAKER_02: Now this was used in addition to disport.
• 15:15
  SPEAKER_02: This patient had a disport.
• 15:16
  SPEAKER_02: That is the combination which I think most people will use when they use the PTRC serum together with injections.
• 15:24
  SPEAKER_01: Yeah.
• 15:25
  SPEAKER_02: I think that would probably be their praxis.
• 15:28
  SPEAKER_01: Yeah.
• 15:28
  SPEAKER_01: And as you mentioned, the initial study that was done, kind of what I would consider the pivotal study for this for this product, right?
• 15:34
  SPEAKER_01: Not FDA-approved pivotal study, but but this pivotal study is is was really just used in females.
• 15:40
  SPEAKER_01: Yeah.
• 15:40
  SPEAKER_01: Yeah.
• 15:41
  SPEAKER_01: And we saw really nice results in that study as well, where it seemed to extend the life of the toxin treatment.
• 15:48
  SPEAKER_02: Exactly.
• 15:48
  SPEAKER_02: So it's it's and it also attacks these kind of wrinkles that toxins don't address the superficial wrinkles, the very fine, the um the very texture.
• 15:59
  SPEAKER_02: Texture.
• 16:00
  SPEAKER_02: Exactly.
• 16:00
  SPEAKER_01: Yeah.
• 16:01
  SPEAKER_01: And so when you start thinking about texture, we've historically tried to treat the texture and thought about that even as maybe an elastin issue, right?
• 16:09
  SPEAKER_01: As a collagen degradation issue, an elastin issue.
• 16:12
  SPEAKER_01: So we've treated that with other peptides, certainly with with uh lactic acid or alpha hydroxy acids, beta hydroxyacetelph exfoliate and smooth that away.
• 16:21
  SPEAKER_01: This is a novel approach to treating irregular texture.
• 16:25
  SPEAKER_02: It might work on the erectopili muscle.
• 16:28
  SPEAKER_02: Because if if that relaxes, the surface becomes more smooth.
• 16:34
  SPEAKER_02: Yeah.
• 16:35
  SPEAKER_02: There's a lot more data to be produced about this phase, isn't there?
• 16:38
  SPEAKER_02: I'm looking forward to that.
• 16:39
  SPEAKER_01: Yeah, me too, because it really is interesting.
• 16:41
  SPEAKER_01: And if if we do find that it's affecting at the you know the the erector peli muscle, boy, that's so interesting.
• 16:48
  SPEAKER_01: And I wonder if this helps, much like Botox, I've wondered we if we could see a reduction in erythema as well.
• 16:53
  SPEAKER_02: SIBA promise.
• 16:55
  SPEAKER_02: We might.
• 16:56
  SPEAKER_02: But but again, now we've got niacinamide in it.
• 16:58
  SPEAKER_02: Yeah.
• 16:58
  SPEAKER_02: That also helps there.
• 17:00
  SPEAKER_02: That's true.
• 17:01
  SPEAKER_02: We should try it without the niacinamide then to see if the neurotoxins can or can do that.
• 17:06
  SPEAKER_01: Yeah.
• 17:07
  SPEAKER_01: Spoken like a true professor.
• 17:09
  SPEAKER_01: Splitting it.
• 17:11
  SPEAKER_01: I don't know that they'll do that for us.
• 17:13
  SPEAKER_01: No, they I don't think they will.
• 17:15
  SPEAKER_02: They are happy with this product.
• 17:16
  SPEAKER_01: Yeah.
• 17:16
  SPEAKER_01: Yeah.
• 17:17
  SPEAKER_01: So interestingly.
• 17:18
  SPEAKER_01: They should be.
• 17:18
  SPEAKER_01: They should be.
• 17:19
  SPEAKER_01: This is a very interesting product.
• 17:20
  SPEAKER_01: Well, Dr.
• 17:21
  SPEAKER_01: Bering, thank you so much for your time.
• 17:23
  SPEAKER_01: You're welcome.
• 17:23
  SPEAKER_01: I really learned a lot.
• 17:24
  SPEAKER_01: And I I just want to reiterate, this is such an interesting product, right?
• 17:28
  SPEAKER_01: With the combination of neuropeptides, which at the very least we've shown to decrease the sweat formation.
• 17:34
  SPEAKER_01: So we know that they're that they are absorbed into the skin, that they're targeting their neuromuscular junction, and the junction of the nerve to the sweat gland, which may be a little bit more superficial and easier than the erector pili or or even the frontalis muscle of the forehead, for example.
• 17:52
  SPEAKER_01: But then as Dr.
• 17:53
  SPEAKER_01: Bering was saying, we saw improvement not only in these superficial lines, but when you know used all over the face twice daily, we saw a 15% improvement, forehead, globeller, crow's feet.
• 18:04
  SPEAKER_01: And then we also saw improvement in marionette.
• 18:07
  SPEAKER_01: Not as much, but saw improvement in marionette.
• 18:10
  SPEAKER_01: It's really difficult, I find, to get much improvement in etched globellar lines in particular.
• 18:17
  SPEAKER_01: And so to see that kind of improvement makes you really want to consider using this with a neurotoxin treatment.
• 18:24
  SPEAKER_01: Because those etched lines, while they can be improved with neuropeptide, with neurotoxins, excuse me, those that remain really bother patients.
• 18:32
  SPEAKER_01: Exactly.
• 18:33
  SPEAKER_01: You know, and so some of us use a bit of filler in there very carefully, off-label, extremely carefully.
• 18:38
  SPEAKER_01: But otherwise, if you could use this cream twice daily to help reduce the interesting to include this in a formulation that maybe has a little bit more exfoliation.
• 18:48
  SPEAKER_01: Yes.
• 18:48
  SPEAKER_01: Yeah.
• 18:49
  SPEAKER_01: Very interesting.
• 18:50
  SPEAKER_01: Well, I've really enjoyed this.
• 18:51
  SPEAKER_01: Thank you again, Dr.
• 18:52
  SPEAKER_01: Biering.
• 18:53
  SPEAKER_01: Thank you for having me.
• 18:54
  SPEAKER_01: Absolutely.
• 18:54
  SPEAKER_01: Anytime.
• 18:55
  SPEAKER_01: We'd love to have you back, actually.
• 18:57
  SPEAKER_01: Yeah.
• 18:57
  SPEAKER_01: Thanks.
• 18:58
  SPEAKER_01: My name is Dr.
• 18:58
  SPEAKER_01: Ted Lane.
• 18:59
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• 19:24
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• 19:28
  SPEAKER_01: Again, thank you.
• 19:41
  SPEAKER_00: This episode is brought to you by Skin Suiticals, the number one medical aesthetic skincare brand worldwide, and the leader in antioxidant designs.
• 19:50
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