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Topical skin treatments are the least invasive group of procedures in aesthetic medicine. They are also the simplest to conduct, with a low risk of complications. Therefore, primary care providers can include them in their services with minimum additional training and investment.

For further information on this topic, you may be interested to learn more about the HealthCert Professional Diploma program in Aesthetic Medicine.

Topical skin treatments produce satisfying but limited results. However, they are usually affordable and do not require any downtime. Many users decide to include them in their regular skincare routine, expanding the care providers’ patient base.

Overview

Topical cosmetic treatments are non-invasive or minimally invasive (chemical peels and lasers). That means there are no needles, scalpels, incisions, or bleeding.

Instead, the physicians use lasers, chemical agents, or skincare products containing certain active ingredients.

Their topical application facilitates positive changes in the skin’s colour, texture, and overall appearance. The goal is to boost the natural regenerative mechanism within the skin. The method to achieve that involves exfoliation, removal of lesions, controlled destruction of skin layers, and brightening.

The use of anaesthetics is rarely necessary, as most topical treatments do not cause discomfort.

The most popular topical skin treatments in primary care are:

• Laser skin resurfacing,
• Chemical peels,
• Hydroquinone,
• Tretinoin,
• Retinoids, and
• Secretome application

Indications for topical skin treatments in primary care

Topical skin treatments mainly address the changes that affect the epidermis. These are usually signs of damage, such as sunspots and age-related changes.

Common indications include:

• Acne and superficial acne scars,
• Fine lines,
• Pigmentary disorders, and
• Benign epidermal growths

Active viral, fungal, or bacterial infections are contraindicative for cosmetic treatments. Likewise, keloid formations and dermatitis require a dermatological assessment.

Physician’s qualifications

All doctors in primary care can complete training in topical aesthetic skin treatments. A certified course will provide adequate information about:

• Application technique
• Various agents, devices, and active ingredients used
• Identification and management of potential complications

Facility requirements

A primary care setting, such as a doctor’s office or a procedure room, is adequate for conducting topical skin treatments.

Pre-treatment counselling and informed consent

Unrealistic expectations are a common issue with aesthetic medicine patients. That’s why pre-treatment counselling and informed consent are vital.

A doctor needs to list all the procedure details and their limitations. The necessary number of treatments for optimal results, aftercare guidelines, and possible complications are invaluable.

They need to make sure the patient fully understands the treatment’s potential and likely outcomes. Enabling diverse sources of information to patients through photos, brochures, and presentations is essential.

Once the pre-treatment counseling meets all the requirements, the patient signs an informed consent form.

Side effects and complications

Side effects and complications are rare with topical skin treatments. They also depend on the type of treatment.

When the adverse reactions occur, they may include:

• Redness
• Burning
• Stinging
• Dryness
• Cracking
• Bleeding
• Blistering
• Oozing
• Discolouration
• Acne
• Thinning
• Unusual hair growth
• Bumps
• Scaling and peeling
• Swelling
• Photosensitivity

– Dr Rosmy De Barros

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References:

• Dunlop N, Abramowicz S, Fisher E. Pharmacology of Aesthetic Medicines. Oral Maxillofac Surg Clin North Am. 2022;34(1):189-200. doi:10.1016/j.coms.2021.08.017
• Zouboulis CC, Ganceviciene R, Liakou AI, Theodoridis A, Elewa R, Makrantonaki E. Aesthetic aspects of skin aging, prevention, and local treatment. Clin Dermatol. 2019;37(4):365-372. doi:10.1016/j.clindermatol.2019.04.002
• Barbieri JS, Spaccarelli N, Margolis DJ, James WD. Approaches to limit systemic antibiotic use in acne: Systemic alternatives, emerging topical therapies, dietary modification, and laser and light-based treatments. J Am Acad Dermatol. 2019;80(2):538-549. doi:10.1016/j.jaad.2018.09.055
• Dayan SH, Bacos JT, Ho TT, Gandhi ND, Gutierrez-Borst S, Kalbag A. Topical skin therapies in subjects undergoing full facial rejuvenation. J Cosmet Dermatol. 2019;18(3):798-805. doi:10.1111/jocd.12977