Designed as a stand-alone skincare regimen, DefenAge® from Progenitor Biologics, LLC (Carlsbad, Calif.) and its scientifically-proven Age-Repair Defensins® may have unforeseen applications. When used with microneedling and microneedle-like treatments, even greater results are achieved than those seen with PRP, according to a study in press.
Plastic surgeon Diane Duncan, M.D., founder and medical director of Plastic Surgical Associates in Fort Collins, Colo. recently completed a manuscript (in press) detailing the current results of her ongoing investigation combining the power of DefenAge defensins with different microneedling-like modalities. “By using DefenAge 8-in-1 BioSerum about 48 hours after therapy we see smoother outcomes, faster healing and improved skin quality with fewer side effects when compared to similar use of platelet-rich plasma (PRP).”
Used twice daily with 24/7 Barrier Balance Cream, the Defensin-based 8-in-1 BioSerum contains a variety of helpful constituents. Liposome encapsulated hyaluronic acid, niacinamide, sea whip and other ingredients soothe, hydrate and protect skin, as well as promote healthy cellular processes and maximize synergy with Age-Repair Defensins. It is also free of parabens, formaldehyde, propylene glycol, gluten, sulfates and other compounds that are known or suspected to be deleterious, yet are commonly found in skincare products.
Age-Repair Defensins in DefenAge mobilize inactive LGR6+ master stem cells residing in skin; these are the antecedent for all skin cell lines and play a pivotal role in wound healing. “Defensins are part of the same molecular pathway activated in skin by microneedling,” Dr. Duncan explained. “Exogenous defensins from DefenAge’s BioSerum simply amplify microneedling results because they accompany the activity of endogenous defensins released by the immune system in response to microneedling procedures. The availability of defensins as a product is a unique situation because as we age, our skin produces fewer of these peptides. Therefore, augmentation of microneedling treatments with DefenAge’s defensins, which mimic endogenous defensins, may be a crucial amplification of the naturally occurring regenerative process.”
The mechanism of action of defensins differs from that of other ‘stem cell’ or ‘growth factor’ skincare products because they awaken key cells that are lying dormant, and are thus younger and healthier, rather than taxing the limited ability of currently active skin cells to affect healthy therapeutic processes. The safety, efficacy and mechanism of action of DefenAge defensins was powerfully demonstrated in a recent multicenter clinical trial1, which was much more rigorous than usually associated with skincare products, according to Dr. Duncan, who was not affiliated with the study. “Defensins stimulate your own stem cells at the LGR6+ receptor site into action, which has not been scientifically shown for other biologics such as PRP.”
PRP, the harvest and concentration of autologous blood constituents high in growth factors, is highly touted and growing in popularity. “There is a lot of variability among PRP products, and the science is still soft on them,” Dr. Duncan continued. “It certainly does something, but we have much work to do to figure out what/how that is, and the best information comes from anecdotal evidence. The science behind the safety, efficacy and mechanism of action of DefenAge defensins is strong and compelling.”
Dr. Duncan’s split face study uses DefenAge with three oft-used modalities including cold (needle only) microneedling, radiofrequency (RF) microneedling, and ‘thermal’ microneedling (ablative fractional laser treatment using one of two similar devices, which provides a microneedle-like effect). “Our target depth is the superficial dermis (50 μ to 300 μ) where dermaceuticals act, so we’re not penetrating as deeply as some devices are capable of going.” To standardize treatment between options Dr. Duncan performed microneedling with a stamping motion to mimic the direct penetration of a laser, rather than a sweeping or dragging motion, and chose depth and density settings that were as similar as possible given the devices she used.
One half of the face received autologous PRP immediately after treatment, which was left in place for about 24 hours. “This use of PRP is acceptable because it comes from the patient’s own body,” Dr. Duncan said. Approximately 48 hours later the non-PRP side of the face was treated with DefenAge 8-in-1 BioSerum. “We gave patients a sample size bottle of the 8-in-1 BioSerum and simple instructions on how to use it and when.” While it may be very beneficial to deliver the 8-in-1 BioSerum’s constituents via newly created channels into the skin, “the FDA has recently published directives regarding these sorts of procedures and to avoid clashing with those, we apply the product 48 hours after treatment, after re-epithelialization has taken place. PRP is autologous, but DefenAge is classified differently.” Patients returned for pictures and a quick check the day after treatment, as well as follow-up at six weeks, three months and six months after treatment. “Photographs were taken using a rigid, standardized method and then evaluated using special imaging technology, so the results aren’t as subjective as we see with many studies, thus we have empirical data we can rely on and build from.”
Use of either DefenAge or PRP would likely improve the overall result somewhat, Dr. Duncan stated, but study data shows that the DefenAge side heals more rapidly than the PRP side and the outcome is smoother. Additionally, with DefenAge the incidence of side effects was profoundly lower than that seen with PRP; in some cases, patients experienced acne breakouts immediately afterward that were occasionally dramatic.
One limitation of the study is that if looked at from a general perspective one must bear in mind variability in the marketplace. “There are numerous ablative fractional lasers as well as thermal and RF microneedling devices, each allowing for different ranges of micro-wound densities and depths or penetration,” Dr. Duncan indicated. “Also, there’s variability among PRP products in how they’re harvested, handled and concentrated, and this greatly affects the final product and its concentration of growth factors. To study these more thoroughly using the fuller spectrum of devices and products in the marketplace would have been impractical due to the size, scope and cost, but we can still learn a great deal from this work.”
1. Taub AF, Bucay V, Keller G, Mehregan D. Multi-center, double-blind, vehicle-controlled clinical trial of an alpha and beta defensing-containing anti-aging skin care regimen with clinical, histopathologic, immunohistochemical, photographic, and ultrasound evaluation. In press.