Non-invasive and minimally invasive cosmetic procedures and treatments are evolving with interest growing in all corners of the globe, says Wendy Lewis
Medical aesthetics continue to evolve as the world of advanced skin care and anti-ageing treatments matures, from skin tightening devices to ‘liquid facelifts’. Non-surgical treatments lead the way across the globe, loosely divided into three major categories: injectable products (neurotoxins as in Botox and dermal fillers such as Restylane) is the largest segment, followed by energy based devices (for example lasers, radio frequency and intense pulsed light (IPL)) and active cosmetics (topical anti-ageing therapies, peels). The most popular non-invasive procedure globally is hyaluronic acid based dermal fillers, which are in plentiful supply at all price points throughout Europe and Asia.
In the emerging markets, all eyes are on the BRIC countries. Brazil has held its place as a strong market for aesthetics and cosmetic procedures and the origin of many new developments in the field, while Russia is outpacing some of the major players in the EU in the growing arena of anti-ageing, particularly with devices and topicals.
Although the North American market has been estimated to represent 45% of the global market, the dominant position is shifting towards Asia especially in the energy based devices segment. Asia is widely considered to be the next frontier and the number of physicians and clinics in China and India has been steadily rising, along with medical tourism in the region. In the categories of injectables and devices, the EU ranks second behind the US.
The injectables market, comprising wrinkle relaxing agents and wrinkle fillers, is considered to be a more mature market with a lot of small players and a handful of global giants such as Allergan, Galderma and Merz. Most of these products have temporary effects and will need to be repeated to maintain optimal correction. Permanent fillers are more accepted in Asia than in the EU and US.
By combining several formulations of fillers along with wrinkle relaxers like Botox, injectables can deliver a facelift like effect that consumers are craving, without surgery. The concept of volume replacement using off the shelf dermal fillers has caught on and fillers containing lidocaine for pain management have become the new gold standard in the EU and US markets.
Practitioners are also stepping up their game in terms of advanced techniques, layering products and new instrumentation. More efficient injections using soft or bendable needles, blunt-tip cannulas and injector pens that cause less trauma and bruising are revolutionising the way fillers are injected. From ‘microbotox’ to ‘bro-tox’, the uses and consumer segments for toxins and dermal fillers are showing steady growth.
Another growth category for cosmetic beauty treatments is biorejuvenation, also called mesolifting. These are microneedle treatments administered via handheld guns, machines or hand injection, which offer consumers another option between creams and full on wrinkle fillers for restoring skin with vitamins, amino acids and hyaluronic acid.
Regenerative medicine is another important segment of the market. Growth factors and stem cells have gone mainstream as consumers seek advanced technologies for rejuvenation. Adipose derived stem cells (ADSC) found in human fat are widely accepted for rejuvenating the face and breasts, while plant stem cells from green apples, lilac and alpine roses are making their way into topical cosmetics.
Body shaping procedures are also cited as a huge growth segment with new and improved options for fat reduction, cellulite, skin laxity and vein removal that range from non-invasive to minimally invasive. In addition, an injectable drug is currently under clinical investigation for the reduction of submental fat. It is poised to be a game changer in the body contouring segment.
Although facial treatments continue to capture the most significant market share, new technologies are being used for off face indications, often off label. Among the newest device segments attracting interest include treatments for excessive sweating, cryoneuromodulation for wrinkles, vaginal tightening and toenail fungus that allow physicians to reach new segments of consumers.
Uses for skin lightening products are also expanding into niche areas, including the underarms and genitals, and hydroquinone alternatives such as innovative peptides and enzymes for skin lightening are attracting attention in the market.
In cosmeceuticals, the US market leads the way, less hindered by the restrictions on the ability to dispense products than in some EU countries. However physicians are finding new ways of integrating products into a global offering and the market is expanding. Peels have had a resurgence in this segment as an affordable alternative to lasers and light based systems and as an adjunct to skin care and other treatments. In addition, microneedling systems and pens are being used to enhance, penetrate and stimulate collagen for more youthful looking skin, often combined with other topical solutions.
Consumers are also eagerly embracing battery powered or plug-in devices, particularly in the anti-ageing category and the range of benefits offered by home care devices continues to expand with technologies targeting sun damage, hair removal, skin discolouration, acne, hair growth, skin texture and tone, cleansing, microdermabrasion and cellulite showing up at premium retailers, pharmacies and online outlets. A new category of light based systems is also bridging the gap between home care devices and hybrid models prescribed by doctors for therapeutic skin conditions such as acne, actinic keratosis, eczema, seborrhoeic dermatitis, psoriasis and hair growth. These systems do not, however, take the physician out of the equation. Instead, treatment is initiated in the doctor’s office and the patient self treats at home.
As for developments in the near future, transepidermal drug delivery technologies to facilitate topical treatments in less invasive ways is one of the key ones to watch out for.
