ELASTIderm™ Scientific Overview And Product Review

Objectives

Science of Elastin and CollagenAging in the Human SkinELASTIderm Cream and GelProduct Review

ELASTIderm ApplicationCombining with other Obagi Systems

Elastin

• Dermal fibroblasts secrete tropoelastin (protein precursor molecule of Insoluble Elastin) into the dermis

• Tropoelastin is then escorted and deposited onto a microfibrillar scaffold

• Once on the scaffold, an enzyme called lysyl oxidase cross- links tropoelastin molecules to one another to form Insoluble Elastin

• At this point, you have functional Insoluble Elastin

Dermal Fibroblast Tropoelastin Tropoelastin is deposited on Tropoelastin molecules are microfibrillar scaffold joined or cross-linked together.

The cross-link is called desmosine (shown in red).

How is Tropoelastin Cross-linked?

Tropoelastin monomer proteins when cross-linked together yield a functional elastin polymer

TropoelastinMonomer

DesmosineCrosslink that joins

tropoelastin monomers together

Cross-link Sites on tropoelastin

Elastin Polymer

Elastin vs. Collagen

Elastin can stretch like a rubber band

Collagen is strong like a steel cable

Elastin provides elasticity

Collagen provides tensile strength to skin

The skin comprises 70% collagen and 2-4% elastin

• COLLAGEN synthesis decreases gradually over time (normal human development)

• ELASTIN synthesis decreases after puberty (normal human development)

SOLAR ELASTOSIS increases gradually over time

0 10 20 30 40 50 60 70 80 900

25

50

75

100 Elastin SynthesisCollagen Content early

photodamage first wrinkle

hyperpigmentation

wrinkles / sags

dry, poor circulation

Solar Elastosis Content

Age

% S

ynth

esis

/ C

onte

ntPhotoaging Affects: Elastin & Collagen

Skin Aging: Intrinsic & Extrinsic

Intrinsic Aging (Chronological)• Steady degradation of

cutaneous tissue over time

Extrinsic Aging (Photoaging)• Increased solar elastosis• Reduced production of

collagen

Two distinct processes; both processes contribute to the aged cutaneous phenotype

Elastic Fibers: Intrinsic vs. Extrinsic Aging

REFERENCES

(1) El-Domyati M, Attia S, Saleh F, Brown D, Birk DE, Gasparro F, et al. Intrinsic aging vs. photoaging: a comparative histopathological immunohistochemical, and ultrastructural study of skin. Exp Dermatol 2002;11(5):398-405.

Property of OMP, Inc. Property of OMP, Inc. Property of OMP, Inc.

Normal elastic fibers

are long & fine

Intrinsically aged elastic fibersare degraded and appear as dots

Extrinsically aged elastic fibersare thick and clumped together (solar elastosis)

Solar Elastosis

Dermal Fibroblast Tropoelastin Tropoelastin is deposited on Tropoelastin molecules are Fully elastic skinmicrofibrillar scaffold joined or cross-linked together.

The cross-link is called desmosine.

Normal Elastogenesis

Development of Solar Elastosis in Aged Skin

Chronic exposureto sunlight

Dermal Fibroblast Tropoelastin Solar ElastosisDegraded and calcified elastic fibers

Wrinkled, lax skin

ELASTIderm Eye Cream and Eye Gel

ELASTIderm Eye Cream and Eye Gel

• ELASTIderm brings back the lift, SNAP and resilience of the skin around the eyes

• ELASTIderm is a one of kind eye treatment clinically proven to help restore elasticity to the skin around the eyes and reduce visible fine lines and wrinkles in as little 2 weeks

• ELASTIderm works like no other topical eye treatment can

ELASTIderm Eye Cream and Eye Gel

ELASTIderm is NOT a moisturizer, it is a periocular anti- aging therapy

ELASTIderm incorporates Obagi Penetrating Therapeutics, malonic acid and a proprietary bi- mineral complex

• Copper zinc malonate

Restore elasticity

Build collagen

Stimulate the natural ability of the skin to restore depleted elastin

ELASTIderm has been clinically proven to help:

Key Ingredients in ELASTIderm™

Components of Copper Zinc Malonate and their benefits to skin

MalonicAcid

Zinc Copper

Helps stimulate proliferation of healthy new dermal fibroblast cells

Helps stimulate new production of elastin and collagen precursor proteins

Helps skin cross- link elastin (tropoelastin) and collagen (procollagen) precursor proteins into functional insoluble elastin and collagen fibers respectively

More cells can help build elastin and collagen faster

Helps initiate restoration of elastin and collagen in skin

Helps restore beneficial elasticity and firmness to skin

Action

Benefit to Skin

Clinical Study Design

• 33 females between 45 and 70 years old• 8-week in-use study with measurements every two weeks

and one week post-treatment• Use ELASTIderm™ 2x daily around the eyes after

washing face• Subjects were instructed not to use any other products

around the eyes during the study and one week thereafter• Subjects were also instructed to avoid excessive sun

exposure

Clinical Endpoints

Elasticity (Cutometer®)Moisturization (Corneometer®)Visible Wrinkles

• Silicone Impressions• Digital Photography

Subjective Feedback

Above endpoints were measured at baseline and every 2-weeks

ELASTIderm Enhances Skin Elasticity

• 46% increase in Functional Elasticity after 9 weeks

• 7% increase in moisturization from baseline values

Elasticity was measured using a Cutometer® device

ELASTIderm Reduces Number of Periorbital Rhytids (wrinkles)

• Number of coarse wrinkles were measured via optical profilometry of silicone impressions of the outer lateral canthus

• 16% reduction in number of periocular wrinkles after 9 weeks

Number of Course Wrinkles

Number of coarse wrinkles significantly decreased at 8 weeks and one week post- treatment

Subjective Feedback

Subjects were shown their photographs once the study concluded and asked to re- evaluate their laxity and wrinkle severity (PS)

Patient Self-Evaluation:

Subjective Feedback

88% report lax or loose skin was mild, barely or not noticeable compared to their base line photo

78% report better overall appearance compared to their base line photo

97% report their rough/crepey skin was mild, barely or not noticeable compared to base line photo

9 weeks8 weeks6 weeks4 weeks

ELASTIderm improves appearance of wrinkles

BaselineBaseline

56 year-old female

ELASTIderm improves appearance of wrinkles

Baseline

60 year-old female

6 weeks4 weeks2 weeksBaseline

ELASTIderm improves appearance of wrinkles

Baseline

58 year-old female

9 weeks8 weeks6 weeks4 weeksBaseline

9 weeks

ELASTIderm improves appearance of wrinkles

Baseline

51 year-old female

9 weeks8 weeks6 weeks4 weeks2 weeksBaseline

Safety Tests Potential Side Effects

Pregnancy/Breast-feeding: • It is a safe product to use; however, if your patients have any

concerns, please have them consult with their OB/GYNTested:Non-comedogenicAs a non-irritant and safe around the eyesScored safe for use with patients who wear contacts

A temporary side effect: simple redness, dryness, itching, tearing is normal for patients on any new product

No side effects were seen in the clinical study

ELASTIderm Cream or Gel Recommendation

Patient preferenceSome patients like creamsSome patients like gels

If the patient is undecided:Eye Cream for patients who may

• Have normal to dry skin• Live in or frequent a cooler more arid

climate• Prefer creams

Eye Gel for patients who may• Have normal to oily skin• Live in or frequent a topical or humid

climate

ELASTIderm Application

• ELASTIderm Eye Cream/Gel should be applied after washing the face

• Place a few dots all around the entire eye area and smooth in until thoroughly absorbed

• Your patients should use it morning and evening

Can It be Applied to Other Areas of the Face?

• Obagi ELASTIderm Eye Cream/Gel is specially formulated for the delicate skin around the eyes

• However, it can be safely applied on other areas of the face

Choose the Right Obagi Eye Product

Obagi Nu-Derm Eye Cream remains an excellent control product and moisturizer for the eye areaObagi Professional-C Serum 5% Eye Serum should be recommended/offered as an antioxidant to help prevent damage to the keratinocyte, melanocyte and fibroblastObagi ELASTIderm Eye Cream/Gel is a corrective eye product that clinically proven to help improve the appearance of wrinkles and enhances elasticity

ELASTIderm & Nu-Derm/Condition & Enhance Systems

AMFoaming Gel or Gentle CleanserTonerClearExfoderm (Forte)SunfaderELASTIderm Cream or GelAction/Eye Cream (Optional)Healthy Skin Protection or Physical UV Block

PMFoaming Gel or Gentle CleanserTonerClearBlender/TretinoinELASTIderm Cream or Gel Action/Eye Cream (Optional)

ELASTIderm & Obagi-C Rx System

AMC-Cleansing GelC-Clarifying Serum

(everywhere except eye area)C-Exfoliating Day LotionELASTIderm Cream or GelC-Sunguard

PMC-Cleansing GelC-Therapy Night CreamELASTIderm Cream or Gel

Note: When applying to the skin, avoid applying ELASTIderm and C-Clarifying Serum “on-top” of each other

ELASTIderm & Obagi Professional-C Serums

AMCleanse skin with Obagi cleanserApply 10%, 15% or 20% Obagi Professional-C

Serum over face, neck and chestELASTIderm Cream or Gel (eye area only)Apply Obagi sunscreen

PMCleanse skin with Obagi cleanserApply 10%, 15% or 20% Obagi Professional-C

Serum over face, neck and chestELASTIderm Cream or Gel (eye area only)

Note: When applying to the skin, avoid applying ELASTIderm Cream or Gel and Obagi Professional-C Serums “on-top” of each other

In Summary

ELASTIderm Eye Cream/Gel:• Increase elasticity so that the skin looks

and acts younger• Clinically proven to reduce wrinkles in

as little as two weeks• Increased patient satisfaction in overall

appearance• Complements their other aesthetic

procedures

Ageless BeautyYour patients will love the way they look!