Course: IDCP2022 - M24 Wrinkles and Collagen Breakdown
M24: Wrinkles and Collagen Breakdown
Raja Sivamani, MD MS AP +4

Welcome to module 24 exploring aesthetics!

Wrinkles: Pathophysiology and Ayurveda

This session reviews the basic background to photoaging and the associated role of oxidative stress along with intrinsic and extrinsic factors.
After completing this activity, participants will be able to:
  1. Discuss the pathophysiological mechanisms behind the formation of wrinkles and photoaging
  2. Describe the role of the environment on the skin’s oxidative stress

Sun Overexposure and Skin Damage

The sun is critical for health and well-being on planet Earth, yet too much sun can be damaging to individuals. We review the pathophysiology and clinical implications of sun overexposure.
After completing this activity, participants will be able to:
  1. Describe the damaging effects of sun overexposure both acutely and chronically
  2. Outline some potential ways to prevent damage as well as to reverse damage
  3. Identify areas that require further research and understanding

Wrinkles: Diet and Oral Supplements

Dietary factors can impact collagen function and the development of wrinkles, which will be explored in this session.
After completing this activity, participants will be able to:
  1. Discuss advanced glycation end products and how they are introduced into the body 
  2. Review an optimal anti wrinkle diet
  3. List foods that contribute to increased photodamage and wrinkling

Botanicals, Topicals, and Supplements for Wrinkles

In this session, we will review topical and oral botanicals and supplements that help slow the aging process.
After completing this activity, participants will be able to:
  1. Describe the evidence for the use of topical and oral botanicals and supplements for photoaging
  2. Describe the mechanisms of action by which botanicals and supplements act when considering photoaging
  3. Evaluate the evidence for the use of collagen supplements for facial wrinkles

Acupressure for Enhancing Facial Appearance

Acupressure is an effective treatment for enhancing facial appearance. This lecture details the foundation of acupressure and its clinical benefits for improving systemic health while delaying the signs of aging.
After completing this activity, participants will be able to:
  1. Discuss Traditional Eastern Asian Medicine (TEAM) approach to enhancing facial appearance
  2. Review TEAM acupressure theory as it relates to enhancing facial appearance
  3. Apply TEAM acupressure for enhancing facial appearance

Additional Resource:

Dermatologic Care of the Transgender Patient

The role of the dermatologist in the care of the transgender individual is multifaceted. Hormones used for transitioning affect both hair and sebum, each with consequences from paucity to excess. 
Gender-confirming surgeries may have dermatologic pre- and post-operative interventions, and create sometimes-novel anatomy for disease presentation. Cosmetic procedures classically used for rejuvenation can be used to help create an appearance more congruent with an individual’s self-image. The objective of this presentation is therefore to explore these issues and the challenges the dermatologist may face when doing so in order to provide both medically sound and culturally competent care. 
After completing this activity, participants will be able to:
  1. Develop cultural competence in caring for transgender individuals
  2. Describe the impact of exogenous hormones on the skin and hair
  3. Recall aesthetic techniques for the purpose of gender affirmation


User: Raja Sivamani
Raja Sivamani

Dr. Raja Sivamani is a board-certified dermatologist and practices as an integrative dermatologist at Pacific Skin Institute. He is an Adjunct Associate Professor of Clinical Dermatology at the University of California, Davis and Director of Clinical Research and the Clinical Trials Unit.He is also an Adjunct Assistant Professor in the Department of Biological Sciences at the California State University, Sacramento and an Associate Professor of Dermatology at California Northstate University, College of Medicine.He engages in clinical practice as well as both clinical and translational research that integrates bioengineering, nutrition, cosmetics, and skin biology. With training in both Allopathic and Ayurvedic medicine, he takes an integrative approach to his patients and in his research.He has published over 100 peer-reviewed research manuscripts, 10 textbook chapters, and a textbook entitled Cosmeceuticals and Active Cosmetics, 3rd Edition with a passion for expanding the evidence and boundaries of integrative medicine for skin care.

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Peter Lio

Dr. Peter Lio is a Clinical Assistant Professor of Dermatology and Pediatrics at the Northwestern University Feinberg School of Medicine. He received his medical degree from Harvard Medical School, completed his internship in Pediatrics at Boston Children's Hospital, and his Dermatology training at Harvard where he served as Chief Resident in Dermatology. Dr. Lio is the founding director of the Chicago Integrative Eczema Center and has spoken nationally and internationally about atopic dermatitis, as well as alternative medicine.

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User: Apple Bodemer
Apple Bodemer

After finishing Medical School and Dermatology Residency at the University of Wisconsin, Dr. Bodemer completed a fellowship in Integrative Medicine at the University of Arizona. She was the first Dermatologist to be board certified in both Dermatology and Integrative Medicine and currently is the only Dermatologist to serve on the Integrative Medicine Board. She has authored academic texts and curriculum and has spoken widely on a variety of topics related to Integrative Dermatology. She has always been drawn to exploring how lifestyle choices impact skin health and disease and feels that the most powerful role a physician can play is as an educator and guide, empowering people to get healthy and stay healthy.

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Shellie Goldstein

Ms. Goldstein has been featured on ABC Good Morning America, NBC Telemundo, MARTHA, and Sirius radio. She is the author of her book Your Best Face Now: Look Younger in 20 Days With The Do-It-Yourself Acupressure Facelift and the Touch+Glow®: Beauty-Enhancing Acupressure Facelift Kit. She is an instructor at Tri State College of Acupuncture (TSCA) in Manhattan, NY teaching advanced cosmetic acupuncture and writes distance learning courses in cosmetic acupuncture for acupuncturists around the country.

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User: Brian Ginsberg
Brian Ginsberg

Dr. Brian Ginsberg is a general and cosmetic dermatologist at Chelsea Skin & Laser and Assistant Clinical Professor of Dermatology at Mount Sinai Hospital in New York, NY. He received his medical degree from NYU where he was elected in the Alpha Omega Alpha Honor Society and was awarded the Marion B. Sulzberger Award for excellence in Dermatology. During this time he did research at Memorial Sloan-Kettering in melanoma immunotherapy. He completed a pediatrics internship and dermatology residency also at NYU, the latter for which he was chief resident.

Dr. Ginsberg's area of academic expertise is in the care of sexual and gender minority (LGBTQ) patients, in particular transgender individuals. He published the first major survey study on the dermatologic attitudes and practices of transgender persons. He regularly contributes to a number of medical journals, textbooks and commercial publications, and speaks both nationally and internationally on such topics.

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