• #5-4. Skin Care As an Adjunct Therapy



    Electroporation is very popular at my practice for replenishing collagen or hyaluronic acid. Cryo-electroporation is also widely used. Unlike Korea, where electroporation is used as an after-care following various treatments, it is used as a stand-alone treatment which is repeated several times in a month in Japan. Some doctors do offer electroporation as a post-treatment care but more prefer to perform it as a treatment by itself or in combination with a chemical peel.


    On the other hand, there are also patients who complain of excess sebum. It is important to confirm whether or not the excess oils are caused by underlying dryness. Electroporation can be beneficial if the cause is dryness. In inherently oily skin types, inhibiting sebum production is needed along with moisturization. Various oral therapies can be used for inhibiting sebum production but long-term inhibition is currently impossible.


    Medication can lead to blocked sebaceous glands and in such cases microdermabration can be used. Hydra-facial or diamond peel (using a metal rod with an abrasive diamond tip), which is less frequently used these days, can be used to remove excess sebum. I still use diamond peel often as it effectively clears sebum build-up, improve pores and texture. Educate patients on better skin care routines for long-term improvement and further inhibition of sebum build-up.


    The so-called “Water Gloss Injection,” a very popular procedure developed in Korea that uses hyaluronic acid injections, is also popular in Japan. As Japanese patients are particularly averse to downtime, I use shallower injections but major techniques are identical to those generally used in Korea. As the effect is immediate, many patients are satisfied and come back for repeated treatments. I think the Water Gloss Injection will soon become a standard for improving hydration and skin texture.


    Recently, platelet-rich plasma (PRP) is being added to HA in Water Gloss injection. In Japan, treatments using PRP falls under new laws regulating regenerative medicine. Due to strict regulation on reporting and patient management, many doctors are avoiding PRP treatments altogether.


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    Unlike Korea, there is no nationally recognized aesthetician certification in Japan and this is another big problem. Aestheticians are not certified or certified from private institutions and lack correct knowledge about skin care.


    The biggest problem is that unlicensed and unqualified personnel are performing skin care procedures and device treatments. This is a serious legal and medical problem. Japan currently has vague standards for qualifications of an aesthetician and many unqualified people are taking advantage of this. At my practice, nurses carry out skin care procedures.


    Lastly, I’d like to talk about cosmetic products sold in medical practices. Skin care plays an important role in aesthetic medicine and many doctors are concerned about skin care products their patients use. Some even manufacture their own products. However, it is more common to purchase from a reliable manufacturer to avoid the high cost of production and risk of unused inventory, although such products lack originality. This may be a new niche market for aesthetic clinicians.


    -To be continued

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