Do you believe in transformation? - Serenity by Stephanieserenitybystephanie.com/obagi/NuDerm.pdf · 2009-07-02 · Elastiderm Eye. Other products you will customize usage within

Do you believe in

You will with the Obagi Nu-Derm system

transformation?

UV Radiation

UV rays have several harmful effects on the skin

•Cumulative•All skin types are vulnerable•Current SPF system incomplete

UVB rays impact the skin’s surface•Primary cause of sunburn

UVA rays are longer; penetrate 30-40x deeper

•Heavily contribute to premature agingBoth UVA and UVB rays contribute to skin cancer

15 years sun exposure through glass UVA damage on left side

Goals of Obagi Nu-Derm

The Obagi Nu-Derm System triggers a Therapeutic Cascade

• Normalizes cellular turnover rate & exfoliation

• Reduces overactive melanocytes• Repairs intracellular transcription of

keratinocytes• Stimulates fibroblasts, increasing collagen

formation

Obagi Nu-Derm Study Results

In a 301-patient, multi-center study, Obagi Nu-Derm System was

2X (100%) more effective than tretinoin at reducing wrinkles and improving skin firmness (laxity)

Almost 3X (150%) more effective than hydroquinone and over 2X more effective than tretinoin at reducing mottled hyperpigmentation and sallowness

Mean change from baseline analysis at 12 weeks

Obagi Nu-Derm - Key Ingredients Correcting from Inside the Cell

Tretinoin 0.05% or 0.1% Rx (Retinoic Acid)Tretinoin (Retin-A) and tazarotene (Tazorac and/or Avage) are

the only topical products proven to reverse the effects of both extrinsic and intrinsic agingStimulates increased cell production in the dermisSpeeds up keratinocyte turnover and renewal Increases epidermal thicknessSlows down natural thinning of the dermis Improves stratum corneum compactionReduces collagen breakdown

Different from retinyl esters (retinols), which are antioxidants – influence only from outside cell

Obagi Nu-Derm - Key Ingredients Correcting from Inside the Cell

Hydroquinone – 4%

•• Most effective inhibitor of Most effective inhibitor of melanogenesismelanogenesis•• Produces its Produces its depigmentingdepigmenting effect by selective action on effect by selective action on

melanocytemelanocyte metabolismmetabolism•• Lightens areas of darkened skin such as freckles, age spots, Lightens areas of darkened skin such as freckles, age spots,

Post Inflammatory Post Inflammatory HyperpigmentationHyperpigmentation and and melasmamelasma•• Evidence of improvement is usually observed at 4Evidence of improvement is usually observed at 4--6 weeks6 weeks

•• Improvement continues for about 4 monthsImprovement continues for about 4 months•• Proven safe and effective by FDA for 50 yearsProven safe and effective by FDA for 50 years•• 2% Over2% Over--thethe--counter cosmeticscounter cosmetics•• 4% Gold standard prescription therapy for Obagi Products4% Gold standard prescription therapy for Obagi Products

Obagi Nu-Derm – Key Ingredients

Influencing & Protecting from Outside the Cell

Phytic AcidLarger molecule

Less penetration = less irritationNon-AHA gentle exfoliantPlant-derived

Glycolic AcidBenefits covered on an earlier slide

Lactic AcidLarge molecule = less exfoliationPrimarily used as a moisturizer

All three ingredients provideExfoliationEnhance penetrationSmoother compact stratum corneum

Do you believe in


transformation?

Obagi NuDerm – Key Ingredients

Antioxidants (Obagi Professional-C Serums)

• Prepares and protects skin from free radicals and ultimately oxidative stressors

Sunscreens• Micronized Zinc Oxide - Z-Cote• Octinoxate• Benefits of sunscreen ingredients

covered on earlier slides Do you believe in


transformation?

Influencing & Protecting from Outside the Cell

Obagi Nu-Derm’s 3-Cs

Condition • Cellular change and correction with all three cells:

keratinocyte, melanocyte and fibroblast

Concern• Moderate to severe wrinkles/laxity• Stubborn hyperpigmentation• Smoother looking skin• Acne where photoaging is the #1 concern

Commitment• Patient understands, she/he has photodamage and to

transform their skin it will take some time and perhaps some mild irritation in the beginning

Nu-Derm System Products

#1 Gentle Cleanser/Foaming Gel• Gentle Cleanser – Normal to dry skin

• Fragile, sensitive, menopausal skin• Foaming Gel – Normal to oily skin*Both cleansers remove dirt, oil and impurities from skin

#2 Toner• Reduces pH of skin quickly• Prepares skin for the penetration of active

ingredients


#3 Clear, Hydroquinone, 4% USP• AM and PM usage • ½ gram applied evenly over entire face• Upper epidermis pigment correction

#4 Exoderm/Exfoderm Forte (AM usage):Exfoderm

• Phytic acid 3%• Gentle exfoliation of stratum corneum• ½ gram applied evenly over entire face

Exfoderm Forte• Glycolic Acid 6% and Lactic Acid 4%• Stronger exfoliation of stratum corneum• ½ gram applied evenly over entire face


#5 Blender, Hydroquinone 4%, USP• Standard protocol = ½ gram PM• Apply to entire face• Lower epidermal pigment correction• Always partner with tretinoin

Tretinoin cream - 0.1%, 0.05%• ½ gram partnered with Blender in PM• Reduce gram to ¼ or every other night if

irritation becomes an issue


#6 Sunfader, Hydroquinone, 4% USP, SPF 15• Chemical UV protection (primarily UVB)• Extra sun protection with an added dose of HQ

#6 Healthy Skin Protection SPF 35• Physical and chemical UVA and UVB protection• Micronized Zinc Oxide 9%• Octinoxate 7.5%• Recommended for daily use

#6 Physical UV Block – SPF 32• Physical UVA and UVB protection• Micronized Zinc Oxide 18.5%• Recommended post-invasive procedures and outdoors

for skin types I-III

Compliance Products

Tolereen - 0.5% hydrocortisone • Apply as needed to help reduce itching/burning• Apply before HSP or Physical UV Block• Use as needed only in areas of sensitivity

Action – Skin hydrator• Apply as needed to help reduce dryness/peeling• Apply before HSP or Physical UV Block• Use as needed only in areas of sensitivity• Menopausal patients (pre/post) may use more frequently

Eye Cream – Skin hydrator • Apply as needed to help reduce dryness/peeling• Apply before HSP or Physical UV Block• Use as needed only in areas of sensitivity• Menopausal patients (pre/post) may use more frequently

Obagi Nu-Derm System Usage

Usage – optimal results approximately 18-24 weeksAM

#1 Foaming Gel or Gentle Cleanser#2 TonerObagi Professional-C Serum (optional)#3 Clear#4 Exfoderm or Exfoderm Forte#6 Sunfader (optional)ELASTIderm Eye Cream or Gel (Optional)Action or Eye Cream (Optional)#6 HSP SPF 35 or Physical SPF 32

PM#1 Foaming Gel or Gentle Cleanser#2 Toner#3 Clear#5 Blender

Applied with Tretinoin .05% or 0.1%ELASTIderm Eye Cream or Gel (Optional)Action or Eye Cream (Optional)

Do you believe in


transformation?

Nu-Derm System Maintenance

Once skin transformation has been achieved (approx 18-24 weeks on full System)Look back to the patient’s skin condition before

they started the Nu-Derm system• Large pores• Thin skin• Tendency towards hyperpigmentation• Acne

These factors will determine how often they’ll use active products during the week

Maintaining Skin Health Nu-Derm System

Patient always use products 1, 2 and 6 daily#1 Foaming Gel or Gentle Cleanser#2 Toner#6 SunscreenElastiderm Eye

Other products you will customize usage within the week#3 Clear#4 Exfoderm (Forte)#5 Blender with TretinoinAction and/or Eye CreamObagi Professional-C Serums

Do you believe in


transformation?


Continuous Program Patient remains on an adjusted skin care program without

varianceIdeal for patients with problematic skin:

• Acne• Oily skin &/or large pores• Tendency towards hyperpigmentation – PIH, melasma• Especially thin or thick skin

Products 1, 2 and 6 are used on a daily basisProducts 3, 4, 5 and tretinoin, control products, and

Professional-C Serums are used regularly within the week


Shock (“Booster”) Program • Monitor skin closely for first few weeks on reduced program• Pulling back too much will allow symptoms to return• Adjust as needed

Patient uses an adjusted program with variance in the regimen

After complete transformation, 6 weeks full system using all the products, then 4 to 5 months on a reduced program

Then back to 6 weeks on full systemProducts 1, 2 and 6 used daily; other products used

less frequently within the week

Before and After Obagi Nu-Derm

Baseline 18 weeks


BaselineBaseline 14 weeks14 weeks





Baseline 18 Weeks


Baseline 18 Weeks




Baseline 18 weeks

Skin Typing

Now let’s bring it all togetherand skin type

to determine the

right Obagi System foryour patients

Let’s Skin Type Together

Classic Case of MelasmaSkin Color:

Fitzpatrick IVSkin Thickness:

Thick SkinSkin Oiliness:

Normal to OilySkin Laxity/Wrinkles:

Moderate LaxityJowling

FragilityNone

What System?What System?The condition indicates The condition indicates Obagi NuObagi Nu--DermDerm


And her concerns and commitment And her concerns and commitment matched up to Obagi Numatched up to Obagi Nu--DermDerm as wellas well

Skin Care Protocol

First 18 weeksAM

#1 Foaming Gel #2 Toner#3 Clear#4 Exfoderm Forte#6 SunfaderAction or Eye Cream

(when needed)#6 HSP SPF 35

PM#1 Foaming Gel #2 Toner#3 Clear#5 Blender

Applied with tretinoin 0.1%Action or Eye Cream

(when needed)

MaintenanceAM

#1 Foaming Gel #2 Toner#3 Clear (M,W,F)#4 Exfoderm Forte (T, Th)#6 Sunfader

(spring/summer only)Action or Eye Cream

(when needed)#6 HSP SPF 35

PM#1 Foaming Gel #2 Toner#3 Clear (T, TH)#5 Blender


(when needed)

Skin TypingClassic Case of PhotodamageSkin Color:

Fitzpatrick IIMelasma

Skin Thickness:Thin skin

Skin Oiliness:Normal/T-ZoneMild Acne

Skin Laxity/Wrinkles:Mild fine wrinkles

Fragility:Mild



And her concerns and commitment And her concerns and commitment matched up to Obagi Numatched up to Obagi Nu--DermDerm as wellas well


Skin Care ProtocolFirst 18 weeksAM

#1 Gentle Cleanser #2 Toner#3 Clear#4 ExfodermEye Cream (when needed)#6 HSP SPF 35Action was added 8 days into

protocolPM

#1 Gentle Cleanser #2 Toner#3 Clear#5 Blender

Applied with tretinoin 0.05%Eye Cream (when needed)

MaintenanceAM

#1 Gentle Cleanser #2 Toner#3 Clear (T, Th)#4 Exfoderm (M, W)Eye Cream (when needed)#6 HSP SPF 35

PM#1 Gentle Cleanser #2 Toner#3 Clear (M,W)#5 Blender (every other night)


(when needed)

Skin Typing

Moderate Skin Discoloration/ PhotodamageSkin Color:

Fitzpatrick II or IIIModerate skin discoloration

Skin Thickness:Medium

Skin Oiliness:Normal to oily

Skin Laxity/Wrinkles:ModerateWrinkles and jowling

Fragility:None


Before and After

Baseline 12 WeeksHowever, her commitment did not match However, her commitment did not match up so she went on Obagiup so she went on Obagi--C RxC Rx

Skin Care Protocol

First 14 WeeksAM

C-Cleansing GelC-Clarifying SerumC-Exfoliating Day LotionC-SunGuard SPF 30

PMC-Cleansing GelC-Therapy Night Cream

MaintenanceONLY CHANGE

• Pro-C 15%• C-Clarifying Serum

Every Other Day

Let’s Skin Type Together

VOLUNTEERS?

Condition•Color•Thickness•Oiliness•Laxity•Fragility

ConcernsWhat results are the patient looking for?

CommitmentHow badly do they want skin transformation?

Obagi Systems

Utilize your knowledge of the 3 C’s and Skin Typing to identify which Obagi System is

right for every one of your patients that walk through your practice door!

Documents

Do you believe in transformation? - Serenity by Stephanieserenitybystephanie.com/obagi/NuDerm.pdf · 2009-07-02 · Elastiderm Eye. Other products you will customize usage within