Clinical application of enzyme therapy in the practice of a dermatocosmetologist

Modern Aesthetic Medicine – This is a progressively developing area, whose specialists every day are looking for new opportunities to correct aesthetic problems. Among the many effective methods that have recently been used in aesthetic medicine, enzyme therapy deserves special attention. In an exclusive interview for estet-portal.com, a dermatocosmetologist, chief physician of the Aristo laser cosmetology studio, Odessa, a member of the expert council of the Association of Injection Cosmetologists of Ukraine, Natalya Alikhanidi, spoke about the features of the use of enzyme therapy in the practice of a dermatocosmetologist.

Dermatocosmetologist, chief physician of the Aristo laser cosmetology studio, Odessa, member of the expert council of the Association of Injection Cosmetologists of Ukraine Natalia Alikhanidi.

Natalya Ivanovna, tell our readers what is enzyme therapy?

Enzyme therapy involves the use of enzyme-based preparations in cosmetology, both in topical preparations, in the form of topical, surface application, and by injection. The offer of TM PBSerum includes preparations based on collagenase, hyaluronidase, lipase and keratinase. These enzymes are not present in any other cosmetic offerings, so they are of great interest to us.

What is the mechanism of action of these enzymes?

Keratinase – It's about the epidermis. Controlled, safe exfoliation of obsolete epithelium, without side effects, complications and rehabilitation period, that is, it is a process of physiological exfoliation of skin cells. The uniqueness of the mechanism of action of collagenase lies in the fact that, as in the body, it physiologically and regularly destroys collagen, which has already lost its functional activity, thereby stimulating the production of collagen by fibroblasts again. All this provides the effect of lifting the skin, its elasticity, leveling the relief, and so on. Lipase is a unique enzyme that works directly on subcutaneous fat and compartments. It works purely physiologically, by embedding into the adipocyte membrane, which turns on the mechanism of physiological lipolysis – division of triglycerides to di- and mono-, and excretion through the circulatory and lymphatic channels of fatty acids. Thus, the fat cell is reduced in volume, but its integrity is not damaged, which allows us to work safely and efficiently. The unique mechanism of action of hyaluronidase is very diverse, because it is difficult to say where this enzyme does not act. First of all, these are vascular effects, improvement of microcirculation, correction of puffiness, pastosity of tissues, improvement of tissue metabolism, participation in the regulation of tissue permeability.

because it's hard to tell where this enzyme doesn't work. First of all, these are vascular effects, improvement of microcirculation, correction of puffiness, pastosity of tissues, improvement of tissue metabolism, participation in the regulation of tissue permeability.

because it's hard to tell where this enzyme doesn't work. First of all, these are vascular effects, improvement of microcirculation, correction of puffiness, pastosity of tissues, improvement of tissue metabolism, participation in the regulation of tissue permeability.

What are the main features of modern enzyme preparations? There has been hyaluronidase on the pharmaceutical market for many years, but we used it very carefully in our practice because it was of animal origin. The presence of accompanying protein agents – this is always the highest risk of allergic reactions, especially in patients with a aggravated allergic history. Everyone was looking forward to the emergence of modern recombinant enzymes, and it is precisely such an innovative line of enzyme preparations "PBSerum"; in Ukraine was presented by

company «Intercosmetic Group»

.

Recombinant DNA technology, better known as "genetic engineering", allows the incorporation of genes from higher organisms into the bacterial genome.

As a result, bacteria acquire the ability to synthesize "foreign" (recombinant) products – compounds that previously could only be synthesized by higher organisms.

For what problems can enzyme therapy be used in dermatocosmetology?

Using preparations that include several enzymes at once, for example, lipase, collagenase and hyaluronidase, we are able to correct various problems of the patient. First of all, this is a correction of the volume of fat deposits in the face area or fat deposits in the body area. And when we lose weight, naturally, there is a loss of skin turgor, its ptosis, and so on. In this case, collagenase works perfectly in tandem with lipase: lipase reduces volume, and collagenase eliminates skin flabbiness. And the combination of these two enzymes with hyaluronidase enhances the effect of both volume reduction and stimulation  fibroblast activity. A frequent request from patients – it is the correction of mature hypertrophic, normotrophic and atrophic scars, as well as the prevention of the formation of pathological scars, especially after plastic surgery. In this case, the use of an enzyme preparation containing collagenase and hyaluronidase gives good results. We also have the opportunity to use enzyme cocktails for atrophic changes in the form of stretch marks and post-acne, for the correction of facial fat pads, in particular, malar fat pads.

It is very important to remember the following: those doctors who use stabilized hyaluronic acid preparations in their practice are required to have hyaluronidase in order to provide emergency care in emergency situations, that is, in case of embolism, ischemia or complications resulting from extravascular compression.

In addition, it is hyaluronidase that helps to solve the problems of incorrectly delivered drugs or overcorrection, because the introduction of this enzyme in certain doses can solve a problem that can bother the patient for years in a few days.

What is the optimal number of enzyme therapy procedures that a patient should perform to obtain the maximum result?

Most often, we are talking about 4 procedures, with a permitted interval between them of one to two weeks. It all depends on the post-procedural rehabilitation of the patient, and how quickly he wants to get the result.

Your clinic has been working with PBSerum enzyme preparations for the past two years. How do you evaluate the results of this work? The results of working with PBSerum preparations, presented in Ukraine by

Intercosmetic Group, are evaluated not only by us, but also by our patients. Most often, they see the result after the first procedure, and this provides us with the opportunity to move on, getting a long-term, stable result from procedure to procedure. It is extremely rare for patients to apply earlier than six months later with a desire to correct something else, most often, they get a stable result from the 4 procedures performed, and repeat them no more than once a year.