Apr 15, 2025

The beautiful and the bold

Cosmetic dermatology has a roadmap full of technical and therapeutic advancements that are expected to impact the aging process.

Experts in the field of cosmetic dermatology have been very busy behind the scenes researching and developing innovative technologies, tools, and treatments. The focus includes novel branches of medicine, such as bioregeneration, as well as advancements to existing therapeutics, like hair restoration and skin rejuvenation.

The collective ambition for this contemporary surge is to deliver top-quality, customized, patient-centric care, taking into account an individual’s unique genetics, health history, culture, and desired outcomes.

DermWorld Skin Care News assembled several leading cosmetic dermatologists to weigh in on the future of the specialty and what creations, changes, or challenges lie ahead for certain techniques and procedures.

Zoe Draelos, MD, FAADNutraceuticals and cosmeceuticals

Zoe Draelos, MD, FAAD, Dermatology Consulting Services, PLLC, in High Point, North Carolina

One year: Nutraceutical supplements are growing in popularity among consumers, as evidenced by exponential increases in product variety and sales. Good nutrition is essential to healthy hair, skin, and nails. Americans are consuming adequate calories but are not receiving key nutrients due to eating processed foods that are far removed from the food source. Eating food close to the food source, such as raw fruits and vegetables, is necessary to derive vitamins and minerals from the diet in addition to calories.

Five years: Aging cannot be stopped, so anti-aging therapies are not realistic. However, in five years, we should have an expanded field of regenerative dermatology aimed at restoring skin, hair, and nail functioning. There will be better developed exosomes and platelet rich plasma. Utilizing the body’s own materials and repositioning them within the body is an autologous method of delivering skin rejuvenation.

10 years: We should better understand how to effectively use restorative medicine therapies, such as those addressing epigenetics, to induce optimal functioning of aging cells.

Ronda Farah, MD, FAADGender-affirming care

Ronda Farah, MD, FAAD, associate professor of dermatology at University of Minnesota Health

One year: The current political landscape may present barriers to certain areas of gender-related care, so it is important that dermatologists stay on top of state and federal laws in this area. Regardless, patients will continue to seek out injectable and hair removal treatments.

Five to 10 years: Clinician comfort in this patient population will continue to grow, and patients will recognize that dermatologists are the experts in facial injections and the delivery of energy-based medicine. We will become the specialist of choice for their noninvasive aesthetic care.

Maria Hordinsky, MD, FAADMicrobiomes

Maria Hordinsky, MD, FAAD, R.W. Goltz Professor, department of dermatology, University of Minnesota

One year: Microbiome transplant therapy (MTT) is well studied and has been proven to be safe in the context of many diseases, including infectious disease of the gastrointestinal tract (e.g., C. difficile), autoimmune diseases such as lupus erythematosus, and dermatologic diseases, including hidradenitis suppurativa (HS) and in a small number of patients with alopecia areata. In one year, the expectation is there will be more knowledge about skin/gut dysbiosis not only in infectious, autoimmune, and inflammatory conditions but also in cosmetic dermatology. Causes of skin/gut dysbiosis, such as antibiotics, toxins (like pesticides), diet, and alcohol and tobacco, will become better understood. Additionally, we will know more about the role of probiotics versus MTT in correcting dysbiosis as well as the clinical outcome of these types of interventions.

Five years: Microbiome transplant therapy will have advanced to include more dermatologic disease and aesthetic conditions, such as scalp hair thinning, some pigmentary disorders, and possibly aging skin.

10 years: There will be even more conditions studied in relationship to skin/gut dysbiosis. There will also be new research on whether changes in the gut microbiome contribute to the onset, progression, or remission of these different conditions, including aging.

Robert Weiss, MD, FAADVein treatments

Robert Weiss, MD, FAAD, associate professor of dermatology at the University of Maryland, and clinical and research director at MD Laser Skin & Vein Institute

One year: Advancements in percutaneous lasers for veins are already in development. Within the next year, these devices will provide dermatologists with increased energy, better visualization, and improved cooling and post-cooling (thermal quenching) using water as a cooling agent instead of expensive and environmentally harmful cryogens. Artificial intelligence (AI)-assisted venous mapping is another innovation that is currently being marketed. This precision treatment option will create 3D models of the superficial venous system using a small ultrasound transducer connected to a cell phone with a USB-C port. We also will have better predictive analytics for evaluating treatment outcomes.

Five years: Coming soon are new hybrid treatment approaches, one of which will be to combine sclerotherapy with biologics or regenerative medicine (e.g., stem cell therapy). Controlled release sclerotherapy will use microencapsulation techniques that allow for slow, sustained release of sclerosants to minimize side effects and enhance long-term efficacy. We’ll also have the option to combine anti-inflammatory compounds with sclerosing lasers and agents, such as nanoparticle-enhanced agents which increase absorption of active ingredients and improve targeting of abnormal veins.

10 years: Within the next decade, I believe we’ll have completely automated analysis of reverse flow points using AI ultrasound. Robots will construct 3D models that can guide vein injections to be within microns of target zones.

Injectables

André Braz, MD, instructor of cosmetic dermatology at Policlínica Geral do Rio de Janeiro

One year: The vision for aesthetic medicine is becoming holistic. In other words, fillers replace the loss of volume, replace the loss of structure, but there’s also concern with the quality of the skin and improving it. This is why we already have hyaluronic acid, which has been widespread in the last 20 to 30 years. Also, stimulant agonists have gained a lot of traction due to the issue of collagen production.

Five years: The trend will be to use more biostimulators and products that we already have, such as duo effect fillers, a product that has hyaluronic acid and biostimulator in the same syringe. Products that only treat skin quality will gain more space, as will the holistic 360° view of the face because many people are afraid of having their face volumized, right? So, we have to show that this depends a lot on the assessment of the physicians performing the injections and also the technique and quality of the products.

10 years: We will still have hyaluronic acid, as it is a very safe and irreversible product that is sensitive to hyaluronidase, but we will also have more products that can still replace the loss of volume and structure but with different, more ecological cross-linking agents. We will also have other categories of products that are currently being researched in bioregenerative medicine.