reated in 1997, the University of Miami’s Cosmetic Center is the first of its kind in the nation—an academic center that offers research, training, and patient care in an emerging field that focuses on enhancing beauty and slowing the effects of aging. As part of a prestigious medical facility, the cosmetic dermatology center serves as an “honest broker,” according to Lawrence A. Schachner, M.D., professor and chairman of the Department of Dermatology and Cutaneous Surgery at UM’s Leonard M. Miller School of Medicine—a place where physicians can objectively determine which ingredients and procedures really do work.

“Skin is the largest organ in the body, and as dermatologists, we’re responsible for the skin,” Schachner says. “An increasing number of good and bad products and technologies are available for enhancing appearance and rejuvenating or caring for aging skin. We felt that a well-respected, ethical department could perform a service by objectively analyzing what was being offered.”

Directing the center is Leslie Baumann, M.D., associate professor of clinical dermatology and author of the first textbook on cosmetic dermatology and the recently released consumer book, The Skin Type Solution. Three full-time physicians offer a range of cosmetic procedures available in few other medical settings, from laser and newly developed light treatments to acid peels, dermabrasion, fillers, and botulinum toxins.

The UM program houses the only cosmetic dermatology fellowship in the nation; previously, physicians who’d completed residencies in dermatology would work in clinics or doctors’ offices to gain cosmetic dermatology experience. Dermatologists from as far away as Saudi Arabia, Thailand, and Germany come here for one-month training sessions. And a research budget of between $1 million and $2 million funds objective investigations into the safety and effectiveness of treatments.

Baumann completed her dermatology residency at the University of Miami before doing mentorships with cosmetic dermatologists around the nation. She now travels widely, training physicians in the use of botulinum toxin (Botox), which removes wrinkles through small quantities of a neurotoxin that relaxes muscle, and facial fillers, substances such as collagen that add lost volume to the face.

“People need someone they can trust when it comes to cosmetic dermatology,” Baumann says, explaining why she chose an academic rather than a private medical practice. “My salary doesn’t change with how many people I see, how many procedures I perform, or even with how much research I do. So I have no motivation to use or recommend procedures that research has shown are unnecessary.”

In the seventh-floor waiting room of the UM Cosmetic Center on Miami Beach, Baumann’s beautifully framed collection of vintage cosmetic and skin care advertisements adorn the walls, and a tiered wooden display case exhibits dozens of antique makeup bottles and bejeweled compacts and lipstick holders. By contrast, the walls of Baumann’s office are packed with medical texts. In the computer room around the corner, research associate Deborah Biele is compiling data on such parameters as the skin type, treatment, and ethnic background of the people at the center. Behind Baumann’s office is a room with a series of cameras that create close-up before-and-after images of the face showing sun damage, wrinkles, oily areas, and acne scars.

In the late 1990s the UM Cosmetic Center participated in its first major research project, the multicenter trial of botulinum toxin that led to FDA approval of this agent for the treatment of wrinkles. Baumann, who is frequently quoted in women’s magazines, has also done studies to investigate the safety and effectiveness of Botox for treating excessive sweating of the palms and underarms and participated in more than 20 clinical trials of products, such as Hylaform, Juvederm, and Sculptra, that replace fat and collagen lost with age.

Heather Woolery-Lloyd, M.D., a Jamaican-born physician, focuses on the unique problems of African-American, Latin American, and Asian women and women with olive skin. Woolery-Lloyd, who studied with ethnic skin specialists in Los Angeles and Washington, D.C., before joining the UM faculty, is looking at the melasma (skin darkening), keloids (protruding scars), and hyperpigmentation that occur more frequently among this group.

Joely Kaufman, M.D. ’97, who left private practice last summer to join the UM Cosmetic Center, focuses her research on lasers and other light-emitting technologies. Currently, she is investigating the effectiveness of the Fraxel laser for treating scars and stretch marks and of the Dornier laser for treating wrinkles around the eyes. In a third study, she will examine whether light emitting diode (LED) technology is helpful in healing psoriasis and eczema.

“When a new laser comes out, it has hundreds of different settings,” Kaufman says. “At the center, we try to fine-tune lasers to determine which settings will be optimally effective in treating different depths and types of wrinkles, wrinkles in different areas of the face, and problems such as stretch marks and scars.”

Kaufman notes that one of the greatest advantages of practicing in an academic environment isaccess to a wide variety of technologies. “Laser machinery is very expensive, so you can pick only two or three for private practice, whereas in a university setting, where new technologies are being tested, you have access to a lot more. So I can treat many more types of skin and skin problems.”

Almost every patient who enters the Cosmetic Center fills out a questionnaire designed to identify his or her skin type. This data is entered into a database that, the doctors hope, will eventually be used to investigate correlations between specific skin types and dermatologic diseases. Over the course of many years, as Baumann developed and then refined this questionnaire, she has identified 16 different skin types—significantly more than the four named by beauty mogul Helena Rubenstein a century ago. Baumann has drawn on her research into skin types in publishing The Skin Type Solution. Released this year in the United States, England, and Australia, the book helps readers identify their skin type and choose appropriate products.

Baumann, a redhead who avoids the sun and doesn’t look anywhere near her 38 years, admits to some self-interest in her research. “I also have a personal interest in finding out what works and what doesn’t,” she says, laughing. “I’m almost 40, so I’m on the cusp of needing these products myself.”

 

Joan Cochran is a freelance writer in Boca Raton, Florida.

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