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CLENZIderm M.D. Normal to Dry System Normal to Oily System

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Objectives

Review of AcneCLENZIderm M.D. Systems Review:Normal to Oily and Normal to Dry Systems

• Clinical Studies• Product Description• Product Application

Combining with Other Acne TreatmentsDrug Classification of Ingredients in the Systems

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The Background

• Acne is so prevalent, it’s estimated that more than 85% of people between the ages of 11 and 50 have breakouts at some point

• Approximately 1/3 of adult women are estimated to suffer from acne

• Although acne is generally associated with oily skin, for many, their skin may actually be dry or sensitive– Dermatology Times (2002) reported that adults

generally prefer less drying topical acne medications

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Pathogenesis of Acne: The Principal Factors

Increased sebum production

Abnormal keratinization (cell production) ofthe follicular epithelium

Proliferation of P. acnes

Inflammation

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Forms of Acne

Acne lesions can be:• Open comedos: blackheads• Closed comedos: whiteheads• Lesions containing pus: pustules• Lesions that appear reddened/inflamed:

papules(These lesions may be painful)

• More severe: nodules and cysts, may lead to scarring

Photographs courtesy of Dan W. Kern

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Treatment Goals

ScarringPost-inflammatory hyperpigmentationAge (is acne the primary concern or is photoaging)Skin type (more oily or more dry/sensitive)Lifestyle/Patient complianceTreatment history (any possible reactions with prior

treatments)

Match the most effective form of treatment with the form of acne presented by the patient

Other factors must also be considered including:

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Treatment Options

Topical• Best for non-inflammatory and inflammatory mild to moderate

acneOral/Systemic

• Prescribed for non-responsive moderate inflammatory acne and severe nodular/cystic acne

• Topical treatments may be done in conjunction with most oral medications

Surgical/Physical Therapy• Provides relief and enhances the appearance of the existing

lesion• Does not address the primary causes of acne

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Penetrating Acne Therapeutic System

• Normal to oily• Normal to dry

CLENZIderm M.D. Systems:Three products Formulated to work together Clinically proven solutions to clear acne fast Easy to use, highly effective acne Systems

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Benzoyl Peroxides

Current formulations contain insoluble crystals of BPO• Too large to enter hair follicle• Impending lesion reduction

CLENZIderm M.D. BPO• Uses solubilized technology (SoluZyl)• Enhancing follicular penetration• Producing a greater reduction in P. acnes• Creating enhanced lesion reduction in as early as two

weeks

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Targeting acne at the source

• Current BPO acne products are made up of macro-crystals which primarily sit on the surface of the skin

• CLENZIderm M.D. was shown to penetrate more deeply than the leading Rx acne product

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BPO Comparison Chart

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SEM Demonstrating Penetration

Skin shows topical prescription 5% BPO formulation remaining on the surface 30 minutes post-treatment

Skin shows CLENZIderm M.D. 5% BPO solubilized formulation has penetrated below the surface 30 minutes post- treatment

CLENZIderm M.D. offers a new liquefied form of benzoyl peroxide that is 1/10,000 the size of any other benzoyl peroxide

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Choosing the Right Systemfor your patients . . .

Normal to Oily Or

Normal to Dry

It all comes down to the

3-C’s!

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The 3-C’s

CLENZIderm M.D. System for the patients:• Condition• Concern• Commitment

Ask questions about:• The results the patient desires; their

concerns• Determine their commitment to achieving

those results

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CLENZIderm M.D. Normal to Oily or Normal to Dry

What is the condition of the skin?• More oily or dry?• How severe is their acne?

What is their concern?• Do they try to control oil or do they try to

hydrate their skin?• Do they prefer gels or lotions?

What is the commitment?• Okay with transient stinging/tingling to

get fast reduction in acne lesions?• Do they understand there may be some

transient stinging/tingling but would really prefer to minimize it?

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The 3-C’s: Normal to Oily

Condition: • Patients with inflammatory and non-inflammatory

acne• Patients with normal to oily skin who may need

the additional benefits of salicylic acid (keratolytic)

Concern: • Acne is primary concern• Patient wants fast reduction in acne lesions• Patient prefers gels• Patient comments about their skin being too oily

Commitment:• Patient understands, she/he has acne and to

transform their skin there may be some transient stinging/tingling in the beginning

• Patients with less sensitive skin who can tolerate topical acne treatments

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Clinical Studies,Product Description and

Product Usage

Normal to Oily System

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Rapid Onset of Results: Efficacy Normal to Oily System

• The study used follicular biopsies – 12 patients per cell

• In both hours, 3 and 8, there is significant change in colony forming units

Graph: significant reduction in follicular P. acnes bacteriaClenziderm vs. a leading BPO/Clindamycin combination acne medication

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Rapid Onset of Results: Inflammatory Lesions Normal to Oily System

• 23% reduction in inflammatory lesions after 1 week

• Twice the reduction compared to patients using a benzoyl peroxide/Clindamycin combination

• at 2 weeks, there is a 52% reduction in inflammatory lesions

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Rapid Onset of Results: Non-inflammatory lesions Normal to Oily System

• 13% reduction in non- inflammatory lesions after 1 week• Twice the reduction compared

to patients using a benzoyl peroxide/Clindamycin combination

• After two weeks, a 34% reduction in non- inflammatory lesions

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Base Line At 2 Weeks

Normal to Oily SystemBefore and After Photograph

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Base Line At 4 Weeks

Normal to Oily SystemBefore and After Photograph

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Product Description & Usage Normal to Oily

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Daily Care Foaming Cleanser Normal to Oily System

Daily Care Foaming Cleanser• Removes dirt and excess oil leaving

skin clean and refreshed• Key Ingredients:

• 2% salicylic acid based cleanser to help reduce sebum levels on the surface of the skin

• Menthol cools and calms irritated skin• Goal: Reduce sebum levels on the

surface of the skin

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Daily Care Foaming Cleanser Application Normal to Oily System

Daily Care Foaming Cleanser• Wet face with warm water• Dispense dime-size amount into palm

of hand• Lather and gently massage over

entire face for at least 20 to 30 seconds

• Avoid getting close to eyes• Rinse skin thoroughly and pat dry• Do not dry aggressively with towel• Wait 10 to 15 minutes to allow skin to

dry before applying Pore Therapy

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Pore Therapy Normal to Oily System

Pore Therapy• Unclogs pores and clears dead skin

cells while preparing skin to deeply absorb a liquefied serum that targets acne at its root

• 2% salicylic acid to help unclog pores• Menthol helps eliminate surface

bacteria • Denatured alcohol helps kill acne-

causing bacteria quickly • Goal: Unclog pores and remove

dead skin cells

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Pore Therapy Application Normal to Oily System

Pore Therapy– Before applying make sure skin

has been cleansed and it is completely dry

– Moisten a cotton ball or pad with Pore Therapy

– Apply over entire face– Avoid getting near eyes or in nose

or mouth– Do not rinse off– Allow to dry before applying Serum

Gel

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Serum Gel Normal to Oily System

Serum Gel• Potent gel turns to liquid serum on contact with

skin• Key Ingredients: 5% Solubilized Benzoyl

Peroxide• 5% liquefied benzoyl peroxide is delivered deep

within the pores where acne starts• Quickly clears acne to prevent new breakouts• Patented SoluZyl Technology delivers greater

penetration and effective reduction in P. acnes bacteria

• Note: Due the nature of BPOs in general, and the Serum Gel’s superior penetration, patients may feel a transient stinging or burning when using the System

• Goal: Quickly reduces P. acnes

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Serum Gel Application Normal to Oily System

Serum Gel– Pump Serum Gel 1 time onto a

cotton pad– First apply Gel to areas of skin where

the acne is more prevalent• Apply to areas with most pimples to

areas with least pimples– Avoid eyes and in nose or mouth– Wash hands after applying but do

not wash medication off face– A moisturizer may be used after

Serum Gel. Sunscreen is advised if going outside

– Note: Benzoyl peroxide can bleach fabric

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The 3-C’s CLENZIderm M.D. Normal to Dry System

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Normal to Dry System

Condition:

Patients with inflammatory and non-inflammatory acne

Patients with sensitive skin, or skin that is naturally dry and flaky

Concern:

Acne is primary concern

Patient wants fast reduction in acne lesions

Patient prefers lotions

Patient comments about their skin being too dry and is looking for hydration while treating the acne

Commitment:

Patient understands, she/he has acne and to transform their skin there may be some transient stinging/tingling in the beginning but would prefer to minimize it as much as possible

Patients looking to minimize the drying effects of other acne treatments

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Clinical Studies,Product Description

andProduct Usage

Normal to Dry System

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Fast Reduction in Acne: Efficacy Normal to Dry System

• 50% reduction in inflammatory lesions

• 29% reduction in non- inflammatory lesions

Once-daily use of the System

In a clinical study with once a day application, the 2 week data reported:

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Dryness/Tolerability Normal to Dry System

Once-daily use of the System

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In a split-face tolerability study, patients reported:

no dryness after 3 weeks compared to the leading topical prescription BPO/clindamycin in an emollient vehicle

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Comfort/Tolerability Normal to Dry System

Once-daily use of System

In terms of comfort level of treatment, 91% of patients reported their skin was “Very Comfortable” after 3 weeks

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Phototracking Study Normal to Dry System

Baseline Week 2 Week 4

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Phototracking Study Normal to Dry System

Baseline Week 2

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Phototracking Study Normal to Dry System

Baseline Week 2

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Daily Care Cream Cleanser Normal to Dry System

Daily Care Cream Cleanser• Gently and effectively removes dirt and excess oil• Leaves skin clean and soft• Non-soap, hydrating cleanserCleansing Ingredients: • arginine cocoate, sodium cocoyl glutamate, disodium cocoyl

glutamate• Contains glycerin• Other soothing ingredients:

– Willow Bark Extract - Helps ease inflammation and helps unclog pores

– Licorice Root Extract - Cleansing and antiseptic properties

Note: Non-foaming cleanser - The cleanser is formulated so that it does not foam-up while applying it to the skin

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Daily Care Cream Cleanser Application Normal to Dry System

Daily Care Cream Cleanser• Wet face with warm water• Dispense a nickel sized amount into palm of hand• Gently massage over entire face for at least 20 to 30

seconds• Rinse thoroughly• Wait 10 minutes to allow skin to dry completely before applying

Therapeutic Lotion• Do not dry aggressively with towel, hairdryer set on cold may be

used

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Therapeutic Lotion Normal to Dry System

Therapeutic Lotion• Quickly clears acne without drying the skin• Helps prevent breakouts from occurring

Key ingredients• 5% Solubilized (liquefied) BPO in a lotion base• More hydrating than the gel

• SoluZyl Technology • Delivers medication deep within the pore where acne

starts

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Therapeutic Lotion Application Normal to Dry System

Therapeutic Lotion• Apply one pump onto fingertips, once daily • First apply Lotion to areas of skin where the acne is more prevalent

• Apply to areas with most pimples to areas with least pimples• Avoid eyes and in nose or mouth• Wash hands after applying but do not wash medication off face• Allow Lotion to absorb completely before applying Therapeutic

Moisturizer• Sensitive skin may feel temporary tingling/stinging during first week

of use which can be minimized by reducing frequency of applicationNote: Benzoyl peroxide can bleach hair and dyed fabric

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Therapeutic Moisturizer Normal to Dry System

Therapeutic Moisturizer• A non-comedogenic moisturizer that protects skin while

enhancing the comfort level during acne treatment• Tested on acne prone skin

Key Ingredients:• 20% Glycerin

• A strong humectant• High levels of glycerin are known to rapidly restore skin to normal

hydration• Makes the skin more resistant to dryness as well as helping protect

the skin from drying out• 1% Dimethicone

• Skin softener and superior emollient• Helps treat and prevent over-drying of the skin

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Therapeutic Moisturizer Application Normal to Dry System

Therapeutic Moisturizer• Apply with fingertips to areas of dryness on

face• Can be used more than once a day to help address

over-drying of skin• To protect against UV exposure, use a broad-spectrum

sunscreen after moisturizer application: Healthy Skin Protection spf 35Physical UV Block spf 32C-SunGuard spf 30rosaclear spf 30

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Ingredient Drug Classification

Benzoyl Peroxide 5%• OTC Drug• Category C

• No studies/If benefit outweighs risk

Glycerin 20%• OTC Drug• Category A

Dimethicone 1%• OTC Drug• Category A

Salicylic Acid 2%• OTC Drug/Category A• Higher strengths: Greater than 2% re-classifies to Category 3

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Tolerability of Systems

CLENZIderm M.D. Systems use is recommended once a day

It should be well tolerated by most patients

For those patients with more sensitive skin there may be some mild to moderate stinging and burning

If these side effects become a hindrance to treatment, minimize them by reducing the frequency of application

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How long will each System last?

Usage tests indicated the System will last approximately:• Once a day usage = 4 months• Twice a day usage = 2 months

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Quick Review of the Benefits of Tretinoin

Available in:• .01% & .025% gel• .025%, .05% and .1% cream

• Prevents the development of acne micro-comedones by breaking up the embedded material in the pore

• Normalizes keratinocyte turnover • Reduces skin cell build up and helps address

inflammatory acne• Improves pore function resulting in less hypertrophy of

pore size

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Tretinoin

Normal to Oily• Use the full CLENZIderm M.D.

Normal to Oily System in the morning ONLY

• Use tretinoin - 0.01% or 0.025% Gel in the evening

• Patient may wash skin with Daily Care Foaming Cleanser in evening, then apply tretinoin

• If patient is experiencing excessive dryness, they may incorporate the Therapeutic Moisturizer from the Normal to Dry System in evening after tretinoin

Normal to Dry• Use the full CLENZIderm M.D.

Normal to Dry System in the morning ONLY

• Use tretinoin - 0.1% or 0.025% Gel in the evening

• Patient may wash skin with Daily Care Cream Cleanser in evening, then apply tretinoin

• If patient is experiencing excessive dryness, they may use Therapeutic Moisturizer in evening after tretinoin

• If directed by the physician, Therapeutic Lotion (BPO) can be used in the evening after the cleanser and before the tretinoin

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Additional Therapies

• Topical Antibiotics• Oral Antibiotics• Professional Extractions• Hydroquinone for PIH• Microdermabrasion• IPL/Photo Facials• Blu-U, Clearlight, Isolaz• Salicylic Acid, AHA peels

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In Summary

• Exclusive penetrating technology• Two week lesion reduction• Convenience of being physician dispensed leads to:

• Patient convenience• Therapy compliance• Patient satisfaction• Patient referrals• Practice revenue opportunity

Experience the value of dispensing CLENZIderm M.D. Systems to your acne patients: