Anti-Aging Skin Care at Moradi M.D.


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Cosmetic Moradi M.D., San Diego CA offers some useful information on medical grade skin care for anti-aging.

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  • INTRO SLIDE Welcome to the SkinMedica CORE product overview. By now, you should have completed reviewing the Science Behind the Beauty section of the SkinMedica manual and read and reviewed each of the following products which we group as our CORE products: TNS Recovery Complex, TNS Essential Serum, Vitamin C+E Complex, Dermal Repair, TNS Eye Repair, and TNS Illuminating Eye Cream. SkinMedica asserts that patients should wear a broad spectrum SPF product daily and those products will be covered in a separate module on sun protection. The objectives for this section of training: Highlight key ingredients, technologies, and benefits of the CORE PRODUCTS Discuss positioning tips and strategies Differentiate SM products in a crowded market place So, let’s get started
  • Skin is constantly damaged by free radicals Young skin can repair the damage very effectively Older skin has reduced ability to repair the damage resulting in degradation of extracellular matrix leading to wrinkles and fine lines
  • In this slide you can see a cross section of the skin and the damaging effects that aging has on the skin. You can see a reduction in fibroblast function leads to a loss in collagen. There is HA and GAG degradation as well as elastin degradation which leads to a collapse in the ECM. Additionally, you’ll see an increase in melanin production leading to hyperpigmentation. The result of these is the two main reasons patients present to the medical provider: Pigmentary issues and wrinkles.
  • Subject DW (015) Age : 43 Ethnicity: Caucasian Fitzpatrick Skin Type : III Condition: Acne, acne scarring, post-inflammatory hyperpigmentation, and overall photodamage
  • As you can see, there are 6 simple steps to a daily skin care regimen that SkinMedica recommends. Cleanse, tone, skin rejuvenation (main growth factors), age defense, the home of our treatment products such as antioxidants and AHA’s and some of the TNS extension products, Moisturize and sun protection. A patient will follow their skincare experts recommendation for products in each category that are idea for their skin type and condition. The beauty of this architecture is that there are several options for patients within various price ranges where other lines are holes or require a patient to invest in a pre-determined system. Layering products with SkinMedica becomes easy to understand with the steps and the formulations compliment one another and work synergistically. Following the steps, we categorize special condition categories of Acne and Visible Redness. Since not all patients will have these special conditions, we felt it prudent to separate them. It also gives SkinMedica the flexibility to build upon this with new conditions. The categories have been color coded for easy identification for the customer and consumer. You’ll notice there are icons assigned to each step/condition that should help indicate what the category pertains to. Some additional advantages of having the line organized in this fashion are: It shows that the SkinMedica line has an extensive offering that can be totally customized to the individual’s condition and budget Since the line contains around 40 SKU’s it is critical to simplify things in groupings that allow for competitive positioning The categories also help to keep product training on track in a simple to follow way. All that said, let’s look at the CORE Products which are a focus for SkinMedica.
  • SkinMedica prioritizes the product elements that contribute to overall skin care health and rejuvenation. Science has established that Growth Factors, Retinoids, Antioxidants, and sunscreen are critical components. Of course, maintaining a healthy moisture balance in the skin is key and that is why we’ll discuss one of our premier moisturizers in the CORE Products. Last, the CORE products for SM include two of the three SM eye treatment products. I refer to these product categories as game changers for patients and you’ll hear them referred to as our MUST HAVES or Non-Negotiables. To that end, we start our training on these products and ask that you educate your accounts on these products first. Once a patient incorporates these important elements, then it is easy to build on from there.
  • So what are SM CORE PRODUCTS? TNS Recovery Complex., TNS Essential Serum, Vitamin C+E Complex, Tri-Retinol Complex and TRC ES, Dermal Repair Moisturizer, TNS Illuminating Eye cream and TNS Eye Repair.
  • TNS Recovery Complex was developed and launched in 2002 after Dr. Fitzpatrick was introduced to the patented process that was used for growing dermal skin replacement and collagen fillers for FDA approved and marketed products to treat patients with diabetic foot ulcers and burns. Through evaluating this process, he found that the nutrient rich mixture that the skin tissue was being grown in was not be utilized. The process for manufacturing TNS followed. You’ll learn more of the specific process in the Initial Sales Training course in Carlsbad. TNS stands for tissue nutrient solution. The TNS Recovery Complex contains 93.6% of TNS which is a mixture of Growth Factors, cytokines (which are a specific type of growth factor involved in our system’s immune response) and matrix proteins. The combination of growth factors in TNS used to be branded as Nouricel-MD, but we have since simplified that name to just TNS. TNS Recovery Complex contains over 110 identified growth factors. Growth factors are naturally occurring proteins that reside in our skin and work in concert to help stimulate dermal fibroblasts. There are four components that are key to a product containing growth factors: 1) PB which means TNS is a physiologically balanced mixture of growth factors and cytokines that is produced during the production of collagen. 2) High concentration, which is important for two reasons: stability and penetration, stability is key because proteins are inherently unstable and it is important that end product shows growth factors are present. High concentration relative to penetration is important because proteins are known large molecules that are not likely to penetrate the skin at a very high level. It has been theorized that gf’s can enter the skin via the hair follicle, the sweat glands, or small abrasions in the skin so it is important that you have a high concentration so there is a greater chance of penetration. 3) Stability. As mentioned, proteins are not naturally stable. TNS has proven stability at 24 months at room temperature. The last component is naturally secreted. This refers to how the growth factors are extracted from the dermal fibroblast. TNS is made from cells that are seeded, fed, and grown on a 3D matrix like the skin naturally grows. These cells naturally secrete the growth factors as opposed to other methods which burst the cell and extract gfs prior to being fully mature or active. Additionally, TNS is free of oil, alcohol and surfactants—all known to break down proteins and lend to the stability of TNS Recovery Complex. In the following slides I’ll reveals some tests that were done to show stability of TNS. So what are the benefits of TNS recovery complex? Clinical studies have shown that when used twice daily, patients will see an improvement in fine lines and wrinkles, firmness and resilience and may see improvement in tone and texture. You’ll be educated on a number of studies that substantiate these claims. TNS can be added to any skin care regimen a patient is using and should be applied immediately following cleansed and toned skin. Best results were seen 90 days and beyond with regular use so SkinMedica recommends patients use the product for a minimum of 90 day. 1 .63 ounce bottle used twice daily will last around one month depending on use.
  • Introducing TNS Essential Serum, the all in one anti-aging product. There are two main components to the product-TNS Recovery Complex –and APS Corrective Complex. As you know, TNS helps improve the appearance of fine lines, wrinkles and improves tone and texture. APS (which stands for antioxidant, peptides serum) is a powerful combination of antioxidants, peptides, and specialty ingredients to help strengthen the skin’s ability to rejuvenate itself, fights against environmental damage, and may brighten the skin. The ES is packaged in a dual chamber 1 oz airless pump. Let’s take a closer look at the ingredients
  • As you can, the product dispenses two separate components. The white portion of the product is the APS Corrective complex. It is a powerful combination of peptides and antioxidants as well as some spc. Ingredients. SkinMedica searched for a synergistic combination of ingredients know for a number of different functions and benefits. Additionally, we strategically looked for lipid and water soluble ingredients known to address various part of the cells. The peptides are: Dipalmitoyl hydoxyproline, palmitoyl tripeptide 5 and hydrolyzed silk also know as seracin. The antioxidants in APS are EGT, ubiquinone also known as coQ10, tocopheryl acetate, tetrahexyldecyl ascorbate, rubus fruticosus/blackbery leaf extract, Camellia sinensis Green tea extract, and saccharomyces ferment filtrate lysate. We will discuss these ingredients further in a moment. As for specialty ingredients, the ES contains a tyrosinase inhibitor call alpha arbutin which over time will brighten the skin. Stand alone arbutin products are sold in departments stores and on line and can be VERY expensive. Finally, hyaluronic filling spheres are dehydrated HA spheres that will plump when they come in contact with moisture in the skin. This ingredient is key for patients as well because the growth factors, peptides and other ingredients to effect and show results with continued use, but the patients want to see results quickly and they receive immediate gratification with the filling spheres. Let’s look at a description of the activity of each of these special ingredients.
  • From another study with 6 month follow-up, Results not published
  • SkinMedica’s vitamin C+E is a highly stable combination of two forms of C that work together with lipid soluble vitamin E to fight free radical damage and develop collagen. Packaged in a 1 oz airless pump, this product stands out from it’s competitors which are often packaged in glass amber bottles and subject to oxidation. There are two main elements that cause Vitamin C products to break down. One is air, the other is water. SkinMedica’s C+E is in the airless pump and formulated in a water free formulation. Additionally, it has a beauty poly-silicone base that leaves a silky finish and helps to deliver the actives over time which can lessen irritation. No other currently marketed product incorporates two forms of vitamin c. The l-ascorbic acid works on the aqueous portions in and around the cells and the lipid soluble THD helps penetrate the cell membrane and other lipid cellular components. Vitamin C+E is available in a deluxe travel size and a .13oz sample. Recent clinical data has shown SkinMedica’s C+E to perform on par with one of the main competitors SkinCeutical’s CE Ferulic. Additionally, the SkinMedica formulation is elegant and stable. Since we have learned that antioxidants are critical in protecting our skin from free radicals, it should be paired with TNS RC ,TRC and SPF to address all the MUST HAVEs. For patients that have chosen to use TNS ES, data shows that the combination of APS works better than C+E so those patients can add the TRC and SPF to the ES in order to cover the MUST HAVES.
  • Dermal Repair cream is like a multivitamin for your skin. This product was the first launched by SkinMedica. Packaged in an iconic 1.7 oz jar, it contains the highest levels of antioxidants in a moisturizer known in today’s market. DR contains 10% THD (lipid C) and 8% lipid soluble E as well as moisturizing ingredients to rehydrate the skin. The is a 4 on SkinMedica’s moisture scale and can be used for patients with normal to dry skin. This product is great for patients in arid dessert or mountain climates, is wonderful for skin that dehydrates easily or for those traveling and can be used in combination with one of SkinMedica’s other lighter moisturizers when daily humidity levels rise. For example, in hot summer months in Houston, a patient may choose to use ultra sheer moisturizer in the day under makeup and then at night when the skin and body are resting, they could use DR. It is important to note that there is a bit more scent in this product than others from SkinMedica. This is a very active product and would not be recommended following procedures.
  • Dark circle may be caused by a number of factors that affect changes in the subcutaneous vascular network. What are those?
  • Dark circle may be caused by a number of factors that affect changes in the subcutaneous vascular network. What are those?
  • Now let’s take a look at the TNS EYE REPAIR. This the luxurious and rich eye treatment product is a 4 on the SkinMedica moisture scale so it is perfect for those patients who design more moisture in the eye area. This product was originally named TNS Night Eye Repair, but so many patients loved to use it in the day, that SkinMedica gave it a more general name and currently position it for am/pm usage. It has similar technology to the TNS IL eye so it helps to address fine lines and wrinkles thanks to the PBGF combination while the peptides lend a hand in developing the strength of the ECM. The same chelating agents go to work on the dark circles and this product adds antioxidants vitamin C at 5% and vitamin E at 3% as well as HA, Shea Butter and Squalane for moisturizing the delicate area around the eyes and crow’s feet. You’ll notice this jar is a mini version of the DR and is a signature pot that women in this demographic love to place on their bathroom vanity. There is an inside liner or cover that helps to protect the ingredients from oxidation. As a tip, in humid climates or those who can not tolerate quite that much moisture can use the TNS IL EC in the morning and the EYE Repair at night.
  • To summarize the difference between the three products, you can see the patient concern and which product will address those concerns.
  • Anti-Aging Skin Care at Moradi M.D.

    1. 1. SkinMedica Skincare at
    2. 2. Dr. Moradi’s Staff Sara Aguilar, licensed esthetician 15 years skin care experience • Participated in multiple Allergan advisory boards for skin care, chemical peels and lash rejuvenation Magdalena Weber, licensed esthetician 11 years skin care experience • Participated in multiple Allergan advisory boards for skin care, chemical peels and lash rejuvenation Jackie Doyle, licensed esthetician 4 years skin care experience • Participated in SkinMedica’s advanced peel training, focusing on the latest skin lightening technologies
    3. 3. Manifestations of Skin Aging Skin is constantly exposed to external and internal insults that result in damage to extracellular matrix Healthy/younger skin repairs this damage efficiently Aged skin has reduced ability to completely repair the damage, resulting in: Up to 20% reduction in collagen1 Type 3 / Type 1 collagen imbalance Loss of skin elasticity Wrinkle & fine line formation Pigmentary changes References: 1. Schwartz E et al. Photochem Photobiol 1993;53:841-844.
    4. 4. Effects of Photodamage and Aging Fine lines & Wrinkles Hyper- pigmentation HA-GAG Degradation Collagen Degradation Elastin DegradationDecreased Fibroblast Function ECM Collapse Healthy Skin Aging Skin
    5. 5. • What is the #1 skin care concern of patients? • Fine lines and wrinkles • What is the #2 skin care concern of patients? • Skin tone/ Hyperpigmentation Moradi MD has treatment options for all your concerns!
    6. 6. Treatments for uneven skin tone and hyperpigmentation Skin care products: Lytera Brightening System Peels: Vitalize peels, Rejuvenize peels Laser procedures: Sciton Profractional Microlaser Peel Fraxel Laser Gentle YAG- SkinTyte IPL/BBL Vbeam Blu U Light Therapy
    7. 7. SkinMedica Peel Portfolio: Illuminize Peel - The gentlest of all SkinMedica peels, appropriate for first-time chemical-peel patients or patients looking for a mild chemical peel treatment Vitalize Peel - Recommended for mild to moderate skin imperfections, such as photo-damaged skin, fine lines and wrinkles, pigmentary irregularities, superficial scarring and acne Rejuvenize Peel - The strongest and most powerful SkinMedica peel, recommended for the patients with moderate to severe skin imperfections
    8. 8. Vitalize Retinol Solution Baseline After Peel 2
    11. 11. The “must haves”
    12. 12. TNS Recovery Complex® n All Skin Types/AM/PM Following Cleansing and Toning Benefits: Improves the appearance of fine lines and wrinkles Improves firmness and resiliency May improve appearance of age spots and pigmentation
    13. 13. Copyright ©2006 SkinMedica, Inc. All rights reserved. TNS Essential Serum® The all-in-one anti-aging complex BENEFITS: TNS Recovery Complex TNS helps improve the appearance of fine lines, wrinkles and the overall tone and texture of skin APS Corrective Complex Strengthens the skin’s natural ability to regenerate itself Fights against environmental damage Brightens and lightens age spots Multiple time beauty award winner e beauty award winner
    14. 14. Dual Chamber Efficacy 93.6% TNS® –110 Growth Factors/Cytokines –Antioxidants –Matrix proteins Aqueous Gel Formulation –Surfactant free, alcohol free –Oil-free, non-comedogenic High Protein Concentration: 50 mg/mL –Ensures stability of growth factors –May improve chance of delivery –Includes penetration enhancers Stabilized Cytokines and Growth Factors –Surfactant-free formula protects growth factors –Proven stability at 24 months storage at room temperature Chamber 2: TNS Recovery Complex® Peptides: Extracellular matrix building – Dipalmitoyl Hydroxyproline – Palmitoyl Tripeptide-5 – Hydrolyzed Silk Antioxidants: Free-radical scavengers – Ergothioneine (EGT) – Ubiquinone (Coenzyme Q10) – Tocopheryl Acetate – Tetrahexyldecyl Ascorbate – Rubus Fruticosus (Blackberry) Leaf Extract – Camellia Sinensis (Green Tea) Leaf Extract – Saccharomyces Ferment Filtrate Lysate Specialty Ingredients – Alpha-Arbutin-tyrosinase inhibitor – Hyaluronic Filling Spheres: Immediate filling of fine lines Chamber 1: APS Corrective Complex™
    15. 15. Improvement in Elasticity TNS No Treatment Pinch-Recoil Test shows hand treated with TNS has much better elasticity than untreated hand
    16. 16. 6 Months Usage Study BaselineBaseline 3 Months3 Months 6 Months6 Months
    17. 17. Antioxidants: Vitamin C+E Complex Vitamin C and E work synergistically to fight free radicals. Silicone suspension system prevents oxidation and delivers vitamins C and E to the skin throughout the day. Clinical data suggests an increase in collagen production.
    18. 18. Dermal Repair Cream A Multivitamin for Your Skin Patient profile: Normal-Dry Skin Use AM/PM Key ingredients: Antioxidants Hydrating ingredients Benefits: Re-hydrates, conditions and firms the skin • Encourages the skin’s ability to repair and re-hydrate itself • Protects against environmental aggressors • Dramatic results for a more vibrant, younger and healthier complexion • Contains highest levels of lipid- soluble antioxidant vitamins C and E
    19. 19. TRI-RETINOL COMPLEX™ TRI-RETINOL COMPLEX ES™ 3 forms of vitamin A improve the appearance of fine lines, aging, and sun- damaged skin. Enhances skin texture and accelerates exfoliation. Sustained release technology delivers the vitamin A slowly to minimize irritation allowing nightly use. • of fine lines and increases exfoliation
    20. 20. Taking Care of Your Eyes Question: At what age should you begin using eye cream? Answer: 18!
    21. 21. Why are eye products important? Reasons tually no sebaceous glands in the eye area innest and most transparent skin w moisture retention ndency to bruise more easily ibility of blood under the skin
    22. 22. TNS Eye Repair™ The ultimate eye treatment cream Benefits: Improves the appearance of fine lines and wrinkles • Strengthens the delicate skin around the eyes • Reduces the appearance of dark circles • Hydrates the fragile skin around the eyes • Provides excellent antioxidant protection
    23. 23. Eye Treatment Chart
    24. 24. Daily Physical Defense™ SPF 30+ For all skin types including post-procedure and sensitive skin Benefits: •Ultra-sheer, broad spectrum UVA/UVB protection •100% dual mineral formulation •Hypoallergenic and non-comedogenic •Oil-free, PABA-free, fragrance-free •Light enough to be applied under make-up •Helps protect against free radical damage
    25. 25. THANK YOU! Questions and Answers