*Sponsored post: ISDIN South Africa*
Dr Lev Naidoo provides a comprehensive overview on a recently launched skincare cream that allows for the successful delivery of topical vitamin K.
While the Nobel Prize for the discovery of vitamin K was awarded as far back as 1943, it has only seemingly retained its wallflower status in the family of skincare vitamins. This then begs the question as to why topical vitamin K is only now becoming an interesting vitamin to look out for in redressing your patient’s skin health and finessing your delivery of aesthetic care?
Vitamin K explained
Vitamin K refers to a group of essential, fat-soluble vitamins needed by the body for blood clotting. It is essential for both the extrinsic clotting pathways (initiated by trauma to a blood vessel) and the intrinsic pathway that is offset by abnormalities within the vessel wall structure itself.
Not only is vitamin K important for the repair of the blood vessel, but it also has an important role in the ‘mop-up’ of extravasated breakdown products of blood – i.e. haemosiderin deposition. This is responsible for the change from reddish to brownish colour of the bruise, but also for the facilitation of the ultimate resolution in the aftermath of the bruising process. 
What are the potential physiological benefits of topical vitamin K use in patients presenting with primary or secondary skin pathology?
Dermatological presentations where the inherent structure of the cutaneous vasculature may prove compromised include erythrosis, rosacea, spider veins, the vasculitides and vasculopathies and purpura. These may all potentially derive benefit from the introduction of topical vitamin K into the skincare regime.
Could vitamin K improve your patients’ satisfaction regarding your aesthetic care?
Patients are increasingly wanting to achieve improved clinical parameters from the aesthetic interventions we deliver, with decreasing tolerability for post-procedural downtime.
Will a patient’s skin potentially be a little on the pinkish to red scale following a cosmetic intervention such as chemical peels, microdermabrasion and microneedling? Yes.
Is there potential for bruising following a procedural cosmetic intervention – be it via injectables that include delivery of cutaneous neurotoxins or dermal fillers, medical laser use, post-liposuction or post-sclerotherapy – or following a surgical procedure? More so, a resounding yes.
On that note, bruising or erythema has been shown to influence a patient’s rating of both their satisfaction with the quality of your care and the success of the intervention performed.
What are the challenges with traditional vitamin K formulations?
Vitamin K’s lipophilic nature meant that it was often trapped within the lipid content of the cream in which it was formulated. Furthermore, its inherent instability impeded the development of a formulation with sufficient clinical benefit. Lastly, the irritating nature of its breakdown products limited cutaneous tolerability.
Why should you be excited about the launch of Isdinceutics Auriderm in SA?
The launch of Isdinceutics Auriderm (2% vitamin K oxide) in the country is certainly exciting, as it finally allows for successful delivery of topical vitamin K.
First, Isdinceutics Auriderm introduces a patented inclusion of vitamin K oxide – the natural stable metabolite of vitamin K. Vitamin K oxide’s structure eradicates the concerns of heat and photosensitivity associated with traditional vitamin K formulations.
Second, the gel encapsulates vitamin K oxide in liposomes. This ensures vitamin K oxide penetrates the epidermis, allowing for delivery to the site of the bruise. Its nanosome-delivery technology further allows for a controlled release of vitamin K oxide, decreasing irritancy potential while maintaining clinical efficacy.
Lastly, it has been compounded with vitamins C and E with demonstrated synergistic activity when formulated alongside vitamin K oxide. 
What have the clinical studies shown?
An excellent demonstration of Isdinceutics Auriderm’s efficacy was shown in its use post-upper-eyelid blepharoplasty. Isdinceutics Auriderm was massaged into the area (not directly on to the wound), around the patient’s right eye from the second day after surgery.
An emulsion gel containing vitamin K (not the oxide form) was used on the left eye area.
After only four days of use and six days after surgery, the eye area treated with Isdinceutics Auriderm exhibited significantly less bruising – assessed as a 54% reduction across the study patient group (Karavani et al., 2004).
Vitamin K oxide gel has also been found to hasten resolution of postprocedural laser-induced purpura (Cohen & Bhatia, 2009). 
Is Isdinceutics Auriderm safe in all skin types?
Isdinceutics Auriderm is a well-tolerated cream formulation that may even be introduced in those with sensitive skin types. It is recommended to be used as the first step following cleansing of the affected site, as a thin layer, twice daily for 10 to 15 days following the procedure or trauma. 
Why am I interested in introducing Isdinceutics Auriderm into my dermatology practice?
I have currently started incorporating topical vitamin K oxide into four broad groups of patients and, given the results in previous studies, I am keenly interested in tracking their clinical improvement.
These groups include:
- Patients who are on medications that increase their risk of bruising – e.g. patients on oral or topical steroids or those on salicylates, as well as those who state they are predisposed to easy bruising and prolonged wound healing following trauma or cosmetic interventions.
- Patients where Isdinceutics Auriderm is medically indicated, including erythrosis, rosacea – the telangiectatic phase – and in those with spider veins, stasis purpura and cutaneous vasculitis.
- Patients undergoing non-invasive cosmetic procedures including chemical peels, microdermabrasion, laser resurfacing and radiofrequency procedures to decrease erythema, as well as those with possible bruising following filler and neurotoxin injection.
- Patients referred to me to facilitate optimal wound healing following cosmetic surgical procedures, especially on the face, post-liposuction or post-sclerotherapy.
Final thought
I am a firm believer in constantly improving not only what we do for our patients, but the way we go about caring for them.
With patient consent, I look forward to sharing the clinical results achieved in those commenced on Isdinceutics Auriderm, as I do believe topical vitamin K oxide has the potential to go from being the wallflower to centre stage in the skincare repair portfolio.
Until then, please keep safe and here’s hoping you stay skin healthy.
For Isdinceutics Auriderm stocking enquiries,
contact glenmarksa@glenmarkpharma.co.za | +27 11 564 3900
Disclaimer: this article was commissioned by Glenmark Pharmaceuticals South Africa, though, the article therein is based on the author’s experience and opinion.
Dr Lev Naidoo
Written by Dr Lev Naidoo
MBChB (cum laude), FCDerm (SA) (with distinction), MMed (Derm)
- Obtained the Fellowship of the College of Dermatology
- Awarded the Peter Gordon Smith medal for academic excellence
- Awarded a scholarship from the African Association for Research and Training in Cancer
- Founder of The Dermatology Room www.thedermatologyroom.com
- Executive committee member of AAMSSA (The Aesthetic and Anti-ageing Society of South Africa) and the VSSA (Vitiligo Society of South Africa)
- Member of SASDS (South African Society For Dermatologic Surgery)
- Co-founder of iClass Anatomy Africa
Dr Lev is a specialist dermatologist specialising in great skin. MBChB (cum laude), FCDerm (SA) (with distinction), MMed (Derm) • Obtained the Fellowship of the College of Dermatology • Awarded the Peter Gordon Smith medal for academic excellence • Awarded a scholarship from the African Association for Research and Training in Cancer • Founder of The Dermatology Room www.thedermatologyroom.com • Executive committee member of AAMSSA (The Aesthetic and Anti-ageing Society of South Africa) and the VSSA (Vitiligo Society of South Africa) • Exco member of SASDS (South African Society For Dermatologic Surgery) and member of DSSA (Dermatology Society of South Africa • Co-founder of iClass Anatomy Africa