Michael H. Gold, MD, is the founder and medical director of Gold Skin Care Center, Advanced Aesthetics Medical Spa, The Laser & Rejuvenation Center.

How to Deal With Cosmetic Complications in Dermatology, With Michael H. Gold, MD

 practice, cosmetic procedures have become an increasingly central element, with energy-based devices and other aesthetic interventions now being used routinely in a wide array of clinical settings.

However, dermatology clinicians know complications occur, even in the most experienced hands. A session, titled ‘Complications of Cosmetic Procedures,' was presented at the 

2026 American Academy of Dermatology (AAD) Annual Meeting

 by several speakers, including Michael H. Gold, MD, the founder and medical director of Gold Skin Care Center, Advanced Aesthetics Medical Spa, & The Laser & Rejuvenation Center.

“Everybody will see a complication,” Gold explained. “If you don't, the old adage is you haven't done enough. The issue is understanding that it is a complication early, working with the patient to make sure they understand you know what you're doing, and coming up with a solution that makes it get better fast.”

Gold described complications as not a matter of if, but when. His core message throughout his session was that the ability to recognize a complication early, communicate openly with those involved, and to move quickly toward a solution is what separates a manageable setback from a lasting problem. He described the vast majority of complications are reversible when approached properly.

Throughout his talk, Gold drew on his 35-plus years of experience, sharing a variety of examples from cases in both his own practice and colleagues with whom he runs complication panels throughout the year. Intense pulsed light (IPL) was highlighted as 1 unique focus. Gold described newer machines as having diminished the incidence of burns, blistering, and shifts in pigment, yet he added that the risks have not been eliminated completely.

Additionally, Gold cautioned clinicians in the dermatology space against cutting corners on device quality, describing less expensive machines as often less rigorously assessed. He also touched on the medical-legal dimensions of complication management, noting clinicians should consider informed consent, detailed documentation, and pre-procedure photography as essential.

For any additional information on complications, view the full video interview from AAD 2026 posted above.

The quotes contained in this interview summary were edited for clarity.

Gold reports relationships with multiple companies, including roles as a consultant (honoraria) for Acclaro Medical, Aesthetic Management Partners, Aesthetics Biomedical, Alastin Skincare, Inc., Allergan, Inc., Benev, Galderma, Hugel, InMode, La Mer, Mindera, MTF Biologics, Nutrafol, Pierre Fabre, Prescriber’s Choice, Revision Skincare, Rohrer Aesthetics, Sciton Inc., Sensus Healthcare, Sente Labs, SkinBetter Science, SkinCeuticals LLC, SkinMedica, Inc., Sofwave, Stratapharma, and VIOL. He has served as a speaker (honoraria) for Alma Lasers, Cutera, Inc., EndyMed Medical Inc. USA, Lumenis, Merz Pharmaceuticals, LLC, and Venus Concept. He is an investigator (grants/research funding) for Bausch Health, Leo Pharma Inc., Revance Therapeutics, Inc., Revision Skincare, and SkinBetter Science. He also reports stockholder status with Aerolase and stock options with Venus Concept.

Perez SM, Kennedy DJ, Landau M, et al. Implications of Dermatologic Disorders in Facial Cosmetic Surgery: A Systematic Review. Ann Plast Surg. 2026 May 1;96(5):404-412. doi: 10.1097/SAP.0000000000004731. Epub 2026 Mar 19. PMID: 41848703.

Gold M, et al. S051 Complications of Cosmetic Procedures. Session presented at: 2026 American Academy of Dermatology Annual Meeting; March 27–31, 2026; Denver, CO.

Videos

During this video interview at AAD 2026, Gold touches on key points made in his session titled ‘Complications of Cosmetic Procedures.’

Dermatology

The HCPLive dermatology page is a resource for medical news and expert insights on skin disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for dermatologic conditions, and more.

News

news page, resources on the topics of disease- and specialty-specific medical news and expert insight can be found. Content includes articles, interviews, videos, podcasts, and breaking news on health care research, treatment, and drug development.

Clinical

clinical page is a resource for content on every specialty, disease, and topic available on our medical news site.

Conference

 conference coverage page features articles, videos, and expert-led live coverage from major medical meetings throughout the year.

TETON-2 Supports Antifibrotic Benefit of Inhaled Treprostinil in IPF, With Steven Nathan, MD

Inhaled treprostinil (Tyvaso; United Therapeutics) significantly preserved lung function and reduced the risk of clinical worsening compared with placebo over 52 weeks in patients with idiopathic pulmonary fibrosis (IPF) — findings that Steven D. Nathan, MD, FCCP, argues position the drug as a first inhaled antifibrotic therapy and validate a years-long hypothesis derived from an earlier pulmonary hypertension trial.

Nathan, medical director of the Advanced Lung Disease and Lung Transplant Program at Inova Fairfax Hospital in Falls Church, Virginia, and chair of the TETON steering committee, was the presenting author of the TETON-2 results at the European Respiratory Society meeting in Amsterdam in September 2025., and later the full paper published in the 

spoke with Nathan to learn more about TETON-2, a phase 3, multicenter, randomized, double-blind, placebo-controlled trial enrolling 593 patients with IPF across sites in Asia-Pacific, Europe, and Latin America. Patients in the trial were randomly assigned 1:1 to receive nebulized treprostinil or placebo, titrated from 3 breaths 4 times daily to a target regimen of 12 breaths 4 times daily over 52 weeks. The mean patient age was 71.7 years, 80.1% were men, mean baseline forced vital capacity (FVC) was 76.8% predicted, and 75.4% were receiving background antifibrotic therapy with nintedanib or pirfenidone.

The trial met its primary endpoint: the median change in absolute FVC at week 52 was −49.9 mL (95% CI, −79.2 to −19.5) in the treprostinil group versus −136.4 mL (95% CI, −172.5 to −104.0) in the placebo group, yielding a between-group difference of 95.6 mL (95% CI, 52.2 to 139.0; 

 <.001). Treprostinil also significantly reduced the risk of clinical worsening, with events occurring in 81 patients (27.2%) in the treprostinil group versus 115 (39.0%) in the placebo group (hazard ratio, 0.71; 95% CI, 0.53 to 0.95; 

 = .02), a 29% risk reduction. These benefits were observed across all analyzed subgroups, including patients with and without background antifibrotic therapy, across smoking histories, and in those using supplemental oxygen. No substantial between-group difference in time to acute IPF exacerbation was observed, precluding formal inference on subsequent prespecified secondary endpoints per the hierarchical testing procedure. The most common adverse event was cough, reported in 48.3% of treprostinil-treated patients versus 24.1% of those receiving placebo; the overall safety profile was consistent with prior Tyvaso experience and known prostacyclin-related adverse events, with no new safety signals identified.

Nathan described the conceptual underpinning of the TETON program as originating from an ad hoc analysis of the INCREASE trial — a phase 3 study of inhaled treprostinil in pulmonary hypertension associated with interstitial lung disease (PH-ILD), published in the 

 in March 2021, which supported the drug's approval for that indication. Although FVC was assessed in INCREASE as a safety measure rather than an efficacy endpoint, patients who received inhaled treprostinil demonstrated better lung function at week 16 than those on placebo, and patients who crossed over to open-label treprostinil from placebo showed subsequent FVC gains — a signal Nathan characterized as suggesting independent antifibrotic properties beyond vasodilation. That hypothesis became the foundation for the TETON program, which also includes a third study, TETON-PPF, evaluating inhaled treprostinil in progressive pulmonary fibrosis beyond IPF.

TETON-1, the North American sister study enrolling 598 patients in the United States and Canada, reported positive topline results in March 2026, with treprostinil demonstrating superiority over placebo for absolute FVC change from baseline to week 52 by 130.1 mL (Hodges-Lehmann estimate, 95% CI, 82.2 to 178.1 mL; 

 <.0001) — a treatment effect exceeding that observed in TETON-2. TETON-1 also achieved statistical significance for reducing the risk of clinical worsening. United Therapeutics plans to submit a supplemental New Drug Application to the FDA by the end of summer 2026 seeking to add IPF to the labeled indications for nebulized Tyvaso, with integrated analyses of both TETON studies to be presented at the American Thoracic Society Annual Meeting in Orlando in May 2026.

“In fact, when the placebo arm got converted to open label with treprostinil, the FVCs went up. So this gave us some kind of indication that maybe treprostinil had independent anti fibrotic properties, and that was the foundation and underpinning for the TETON program,” Nathan said.

Nathan’s reported disclosures include AstraZeneca, Avalyn Pharma, Boehringer Ingelheim, Pliant, and United Therapeutics.

Nathan SD, Smith P, Deng C, et al; TETON-2 Trial Investigators. Inhaled treprostinil for idiopathic pulmonary fibrosis. 

. Published online March 11, 2026. doi:10.1056/NEJMoa2512911

United Therapeutics Corporation. United Therapeutics Corporation announces TETON-1 pivotal study of Tyvaso® meets primary endpoint for treatment of idiopathic pulmonary fibrosis, exceeding impressive treatment effect seen in TETON-2. Press release. March 30, 2026. Accessed April 10, 2026. 

https://ir.unither.com/press-releases/2026/03-30-2026-120037465

Treprostinil significantly slowed FVC decline and reduced clinical worsening events over 52 weeks in patients with IPF.


Pulmonology

Infectious Disease condition center page is a comprehensive resource for clinical news and insights on respiratory health. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for asthma, COPD, interstitial lung disease, COVID-19, and more.

Pulmonary Fibrosis

Eingun James Song, MD, is the director of clinical research for Frontier Dermatology. 

Linda Stein Gold, MD, is a dermatologist at Henry Ford Health. 

In this episode, ‘Redefining Treatment Success in Psoriasis,’ the expert dermatologists explore the remarkable evolution of treatment expectations in psoriasis, moving from modest improvements to ambitious goals of complete skin clearance and sustained remission. The faculty reflect that in earlier treatment paradigms even a 50% improvement in disease severity was considered a meaningful success. 

Redefining Treatment Success in Psoriasis

In this episode, ‘Redefining Treatment Success in Psoriasis,’ the expert dermatologists explorethe remarkable evolution of treatment expectations in psoriasis, moving from modest improvements to ambitious goals of complete skin clearance and sustained remission. The faculty reflect that in earlier treatment paradigms even a 50% improvement in disease severity was considered a meaningful success.

As advances in immunology and targeted biologic therapies have transformed the treatment landscape, expectations have shifted dramatically. Clinicians now have a deeper understanding of the underlying inflammatory pathways driving psoriasis, enabling the development of therapies that can deliver high levels of skin clearance with improved safety profiles. As a result, conversations with patients have evolved, with many now expecting near-complete or complete resolution of their disease.

The panelists also discussed the National Psoriasis Foundation consensus definition of on-treatment remission, representing an important step toward aligning clinical goals with patient-centered outcomes. The faculty examine the rationale for establishing a formal definition, emphasizing the importance of setting clear, achievable targets that reflect both clinical efficacy and quality of life. By incorporating perspectives from clinicians, patients, and other stakeholders, this definition underscores a broader shift in psoriasis care toward sustained disease control and meaningful remission. Overall, this discussion reinforces how far the field has progressed and sets the stage for applying these elevated expectations in clinical practice.

The next episode in this series, ‘Remission as a Goal in Psoriasis,’ features the panelists examining the clinical relevance of achieving and sustaining remission in psoriasis, emphasizing that ambitious treatment goals are increasingly attainable with modern therapies. It highlights the importance of maintaining disease control over time while aligning treatment strategies with patient quality of life and long-term outcomes.

Video Series

Redefining Treatment Success in Psoriasis April 2026

Welcome back to another HCP Live Peer Exchange series. In this episode titled, ‘Evolving Treatment Expectations in Psoriasis,’ the panelists discussed how treatment goals in psoriasis have evolved alongside advances in therapeutic innovation and disease understanding. The expert faculty began by reflecting on the historical limitations of traditional therapies, including topicals, phototherapy, and early systemic agents, which were often insufficient for achieving sustained disease control. In earlier eras, treatment success was defined and accepted by improvement rather than complete clearance of the skin. 

Evolving Treatment Expectations in Psoriasis

Welcome back to another HCP Live Peer Exchange series. In this episode titled, ‘Evolving Treatment Expectations in Psoriasis,’ the panelists discussed how treatment goals in psoriasis have evolved alongside advances in therapeutic innovation and disease understanding. The expert faculty began by reflecting on the historical limitations of traditional therapies, including topicals, phototherapy, and early systemic agents, which were often insufficient for achieving sustained disease control. In earlier eras, treatment success was defined and accepted by improvement rather than complete clearance of the skin.

As the conversation progresses, the panel highlighted how the advent of biologic therapies has fundamentally reshaped expectations for both clinicians and patients. With increasing insights into psoriasis pathophysiology, particularly the role of targeted cytokine pathways, modern treatments have enabled deeper and more durable responses. This has shifted the paradigm from partial improvement to ambitious goals such as near complete or complete skin clearance.

The panelists introduce the concept of drug remission as an emerging clinical objective. The faculty discussed how advances in precision medicine have not only improved efficacy but also enhanced safety profiles, allowing clinicians to pursue sustained disease control with greater confidence. The discussion emphasized how these developments have transformed patient-provider conversations, with patients now expecting high levels of clearance without significant trade-offs in safety.

In the next episode, ‘Redefining Treatment Success in Psoriasis’, panelists will highlight how treatment expectations in psoriasis have evolved from modest improvements to achieving complete clearance and sustained remission. It will also introduce the National Psoriasis Foundation definition of on-treatment remission and its implications for aligning clinical goals with patient-centered outcomes.

Clara Bohm, MD, is a nephrologist and associate professor in the Department of Internal Medicine at the University of Manitoba. 

Intradialytic Cycling Does Not Significantly Reduce Myocardial Stunning in Hemodialysis Patients

A multisite randomized trial found intradialytic exercise led to a modest, nonsignificant reduction in myocardial stunning among patients receiving hemodialysis, highlighting both the promise and limitations of exercise as a cardiovascular intervention in this population.

Clara Bohm, MD, a nephrologist and associate professor in the Department of Internal Medicine at the University of Manitoba, presented results from a multicenter, randomized 12-week trial of intradialytic cycling targeting hemodialysis-induced myocardial stunning at the World Congress of Nephrology (WCN).

Myocardial stunning is defined by transient, repeated episodes of ischemia-induced left ventricular dysfunction and is common during hemodialysis. It has been associated with increased cardiovascular morbidity and mortality. Given the substantial symptom burden and elevated cardiovascular risk faced by patients on dialysis, investigators have increasingly explored exercise as a potential therapeutic strategy.

Intradialytic exercise refers to physical activity performed during hemodialysis sessions, typically involving low- to moderate-intensity movements such as stationary cycling or resistance training, designed to improve physical function and potentially mitigate treatment-related complications.

The rationale for targeting myocardial stunning with exercise is grounded in both clinical need and biological plausibility. Exercise may address several contributing mechanisms, including underlying cardiac disease and vascular dysfunction. Additionally, aerobic exercise has been shown in the general population to induce ischemic preconditioning, in which repeated, low-level cardiac stress improves resilience to more severe ischemic events.

Despite this rationale, prior research has been limited. Many studies have been small, observational, and conducted in highly selected populations, raising concerns about generalizability. These studies have also often been cross-sectional or nonrandomized, introducing potential bias and limiting insight into long-term effects.

To address these limitations, investigators designed a multicenter randomized trial with minimal exclusion criteria to better reflect real-world patients receiving hemodialysis. Participants in the intervention arm completed 60 minutes of intradialytic exercise three times per week over a 12-week period.

At study completion, the control group demonstrated no change in the number of stunned myocardial segments from baseline. In the exercise group, investigators observed a reduction of approximately 1.3 stunned segments after 12 weeks; however, the difference did not reach statistical significance.

“We did not detect a significant effect of exercise on myocardial stunning,” Bohm said. “It’s possible the effect is still there, but smaller than what’s been seen in more selective populations.”

Importantly, the study cohort differed meaningfully from those in prior trials. The population included a higher proportion of women, approximately 20% Indigenous participants in the US, and about 35% of patients in each arm with significant heart failure—groups often underrepresented in earlier studies.

Adherence to the exercise intervention was consistent with other behavioral trials, with participants completing approximately 65% of prescribed sessions and achieving target intensity overall. However, subgroup analysis suggested disparities in engagement, particularly among women, who participated in fewer sessions, exercised for shorter durations, and at lower intensity.

“There’s a lot of enthusiasm around exercise as a therapy,” Bohm said. “But it’s critical that we test these interventions in larger, representative populations so we know what truly works.”

The study was conducted through a collaborative network of researchers focused on advancing exercise science in kidney disease, including the Global Renal Exercise Network.

Bennett PN, Penny JD, McIntyre CW, et al. Randomized Controlled Trial of Intradialytic Cycling as Kidney Exercise Rehabilitation for Cardiac Stunning in Hemodialysis (TICKERS_HD): A Clinical Research Protocol. 

Canadian journal of kidney health and disease

https://doi.org/10.1177/20543581251391112

Safoora Shahzeidi, Firouzeh Moeinzadeh, Shahidi S. Evaluating the effect of intradialytic cycling exercise on quality of life and recovery time in hemodialysis patients: A randomized clinical trial. 2022;27(1):84-84. doi:

A multicenter RCT of intradialytic cycling showed a modest, nonsignificant reduction in myocardial stunning in hemodialysis patients.

Nephrology

The HCPLive nephrology page is a resource for medical news and expert insights on kidney disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments in nephrology, and more.

Victoria Johnson joined MJH Life Sciences in 2020 and has written for NeurologyLive, CGTLive, and is now an assistant managing editor for HCPLive and RheumatologyLive. She doesn’t have enough time for her numerous hobbies. You can reach her at vjohnson@mjhlifesciences.com.

Articles

Experts unpack new T2-targeted biologics for severe asthma and eosinophilic COPD, sharing biomarker tips, sequencing debates and payer hurdles,

COPD

COPD condition center page, resources on the topics of medical news and expert insight into chronic obstructive pulmonary disease can be found. Content includes articles, interviews, videos, podcasts, and breaking news on COPD research, treatment, and drug development.

Asthma

The HCPLive asthma page is a comprehensive resource for clinical news and insights on asthmatic disease. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for allergic and severe asthma, and more.

Biologics Across the Airway: Selection, Remission Goals, and Real-World Barriers

Nicole Chase, MD, is a board-certified allergist/immunologist at St. Paul Allergy Asthma, Minneapolis VA Health Care System (part-time), and an associate professor of medicine at the University of Minnesota Medical School.

Chase explains how the weight-based labeling update for epinephrine nasal spray (neffy) may improve access, adherence, and real-world use in young children.


Allergy

Allergy condition center page is a comprehensive resource for clinical news and insights on allergic and inflammatory diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for food and seasonal allergies, as well as allergic asthma and related conditions.

Anaphylaxis

The HCPLive anaphylaxis page is a comprehensive resource for clinical news and insights on acute allergic reactions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for preventing anaphylaxis, and more.

FDA Removes Age Restriction for Epinephrine Nasal Spray, With Nicole Chase, MD

Anjali Vaidya, MD, is the director of the Advanced Pulmonary Hypertension, Right Heart Failure & CTEPH Program and the Pulmonary Hypertension Fellowship at Temple University Hospital and a professor of medicine at Temple University

Vaidya discusses the 2022 pulmonary arterial hypertension guidelines and how they can be made more accessible for clinicians just entering the field.

Cardiology

Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...

Hypertension

The HCPLive hypertension page is a resource for medical news and expert insights on high blood pressure. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for hypertension, and more.

Strategic Alliance Partnership

The Mechanics Behind PAH Diagnosis and Management, With Anjali Vaidya, MD

Alex Hillenbrand is an assistant editor for 

. She earned her BA in English from Lafayette College in 2023 and went on to write for pop culture, entertainment, and sports media outlets before joining MJH Life Sciences in 2025. In her free time, Alex enjoys cooking, going on walks, and meeting new people. Contact her at mjhlifesciences.com.

Hematology

Q1 2026 Recap: Hematology News and Updates

Catch up on nephrology headlines you missed from Q1 2026.

Chronic Kidney Disease

IgA Nephropathy

The HCPLive Berger disease page is a resource for medical news and expert insights on IgA nephropathy. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments in Berger disease, and more.

FDA News

Q1 2026 Recap: Nephrology News and Updates

Ryan Livingston joined the MJH Life Sciences team in March of 2025, shortly after graduating from TCNJ with a bachelor’s degree in English. He enjoys creative writing, reading, and scuba diving. He can be reached at rlivingston@mjhlifesciences.com.

Catch up on FDA decisions, new GLP-1 agonists, and more.

Endocrinology

The HCPLive endocrinology page is a comprehensive resource for clinical news and insights on endocrine system conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for diabetes, hormonal disease, and more.

Type 1 Diabetes

Type 2 Diabetes

Obesity Management

Obesity Management condition center page, resources on the topics of medical news and expert insight into clinical weight management can be found. Content includes articles, interviews, videos, podcasts, and breaking news on obesity research, treatment, and drug development.

Q1 2026 Recap: Endocrinology News and Updates

Expert dermatologists urge aggressive psoriasis control to prevent heart and joint risks, highlight unmet needs, and preview TYK2 inhibitors as a safer oral option.

Defining Treatment Goals and Addressing Unmet Needs in Psoriasis

Explore how TYK2 inhibitors reshape psoriasis care, as experts weigh comorbidities, infection screening, and treat-to-target goals to overcome real-world treatment hurdles.

Addressing Challenges in Psoriasis with Evolving Treatment Landscape

Ali Rezaie, MD, is medical director of the GI Motility Program at Cedars-Sinai.

New long-term data link antidepressant use in IBS to higher mortality risk. Rezaie explains key findings and clinical implications.

Gastroenterology

Gastroenterology condition center page is a comprehensive resource for clinical news and insights on digestive and GI conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for 

, IBS and IBD, Crohn's disease, and more.

Irritable Bowel Syndrome

On the HCPLive irritable bowel syndrome page, resources on the topics of medical news and expert insight into IBS can be found. Content includes articles, interviews, videos, podcasts, and breaking news on IBS, IBD, and more.

Are We Overlooking Long-Term Risks in IBS Management? New 20-Year Safety Data, With Ali Rezaie, MD

Catch up on major trial results, groundbreaking guideline updates, and more.

Heart Failure

The HCPLive heart failure page is a resource for medical news and expert insights on HF. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for heart disease, reduced and preserved ejection fraction, and more.

Atherosclerotic Cardiovascular Disease

Arrhythmia

Dyslipidemia

Stroke

On the HCPLive stroke page, resources on the topics of medical news and expert insight into CVA can be found. Content includes articles, interviews, videos, podcasts, and breaking news on stroke medicine, and more.

Structural Heart Disease

Cardiomyopathy

Venous Thromboembolism

The HCPLive venous thromboembolism page is a resource for medical news and expert insights on VTE. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for thrombotic disease, and more.

Latest News

How to Deal With Cosmetic Complications in Dermatology, With Michael H. Gold, MD

TETON-2 Supports Antifibrotic Benefit of Inhaled Treprostinil in IPF, With Steven Nathan, MD

Redefining Treatment Success in Psoriasis April 2026

Evolving Treatment Expectations in Psoriasis

Intradialytic Cycling Does Not Significantly Reduce Myocardial Stunning in Hemodialysis Patients