Microneedle fractional radiofrequency in the treatment of periorbital dark circles

Background

Periorbital hyperpigmentation (POH) is a common disorder in the patients. Women are more upset with POH in compare to males. Several methods have been used to the POH, with different efficacy and adverse reactions.

Aim

The aim of the present study is to evaluate the efficacy of microneedle fractional radiofrequency (MRF) in treating POH.

Methods

So, nine patients with POH and the age range of 25–57 years, were treated by microneedle fractional radiofrequency (MRF). The outcome was evaluated via biometric assessment. The colorimeter was used to assess the skin lightness. Mexameter was used for evaluated the amount of Melanin in the periorbital skin. Cutometer was used for skin elasticity assessment. The skin ultrasound imaging system was utilized to estimate the epidermis and dermis diameter and density. Furthermore, Visioface was applied to assessed the skin color and wrinkles. Also patient's satisfaction and physician's assessment were evaluated.

Results

The results displayed that the periorbital skin lightness 32.38% ± 5.67 and elasticity of the R2: 40.29% ± 8.18, R5: 39.03 ± 5.38 and R7: 42.03% ± 14.16 were significantly improved after treatment (p < 0.05). Also the melanin content of the skin was decreased (49.41% ± 9.12). The skin layers were denser in the dermis and also in the epidermis (skin density: 30.21% ± 10.16 and skin thickness: 41.12% ± 13.21) (p < 0.05). The results revealed the decrease in the percent change of the skin color (30.34% ± 9.30) and wrinkle (area: 25.84% ± 6.43 and volume: 30.66% ± 8.12) (p < 0.05). Similarly, the physician and patient's assessment were confirmed the obtained outcomes.

Conclusion

In conclusion, the microneedle RF technique is practicable, effective and safe method for periorbital dark circles treatment.     

Fractional CO2 laser plus topical antifungal versus fractional CO2 laser versus topical antifungal in the treatment of onychomycosis

Onychomycosis is an important medical disorder affecting both health and quality of life of patients. This study was done to compare the efficacy of CO₂ laser in combination with topical tioconazole versus CO₂ laser only versus topical tioconazole alone in onychomycosis. A total of 120 patients with onychomycosis were randomly assigned to three groups. Group A patients were treated with fractional CO₂ laser followed by topical tioconazole 28% for five sessions with 3 weeks interval. Group B patients were treated with only fractional CO₂ laser for five sessions with 3 weeks interval. Group C patients were treated with only topical tioconazole 28% for 16 weeks. The clinical effect, KOH examination, and culture for the affected nails in the three groups were analyzed. One month after the last session, regarding clinical response, 55% showed complete clinical improvement in Group A versus 30% in Group B versus 25% in Group C with a significant difference in between. There was a significant difference between the three studied groups as regard KOH test and culture after treatment. Fractional CO₂ laser combined with topical antifungal is a safe and effective treatment for onychomycosis.     

The efficacy of fractional CO2 laser in acne scar treatment: A meta‐analysis

Fractional CO₂ laser is a good option for treating acne scars. However, the clinical efficacy of this treatment modality requires further evidence. To perform a meta‐analysis to assess clinical improvements in acne scars with fractional CO₂ laser and non‐CO₂ laser therapies. Databases (PubMed, Embase, Cochrane Library) were searched using the search strategy to identify eligible studies. All statistical analyses were performed using the Review Manager 5.0, and a meta‐analysis was conducted to assess the effects of fractional CO₂ laser used as a treatment for acne scars. Eight studies were included for further analysis. There was no significant difference between fractional CO₂ laser and non‐CO₂ laser therapies in terms of clinical improvement, observer assessment (P = .19), patient assessment (P = .91), and incidence of post‐inflammatory hyperpigmentation (P = .69). The subgroup analyses showed that the duration of follow‐up had little effect on the evaluation of treatment effect. The efficacy of fractional CO₂ laser therapy in acne scars appeared to be equal to that of non‐CO₂ laser therapies. More well designed randomized controlled trials and more credible and standard evaluation criteria are needed, and the efficiency of combination therapy requires further analysis.     

Effects of a Brazilian herbal compound as a cosmetic eyecare for periorbital hyperchromia ("dark circles")

Background Evidence suggests that periorbital hyperchromia (dark circles) occurs mainly as a consequence of postinflammatory hemodynamic congestion producing a typical bruising aspect on the lower eyelids. Aims To evaluate the clinical effects of Pfaffia paniculata/Ptychopetalum olacoides B./Lilium candidum L.‐associated compound (PPLAC) on periorbital hyperchromia and to study in vitro its underlying anti‐inflammatory and antioxidant mechanisms. Methods Twenty‐one volunteers presenting with periorbital hyperchromia received a serum sample containing 5.0% PPLAC, which was applied topically in the periorbital area twice a day for 28 days. Skin color was measured using variations in the individual typological angle (ΔITA⁰) and skin luminance (ΔL*) calculated in the area around the eyes and in the adjacent area. Colorimetric readings were taken at the onset and end of the 28‐day treatment. Volunteers were also asked to fill out a questionnaire concerning the improvement in “dark circles.” The anti‐inflammatory and antioxidant effects of PPLAC were measured by quantification of prostaglandin E₂, leukotriene B₄, histamine, and superoxide dismutase levels using an in vitro model of human skin culture. Results Topical application of PPLAC led to a significant improvement in skin luminance and tone in the periorbital area, which was demonstrated by increased values of ITA⁰ and L* in about 90% of volunteers. In addition, subjects reported reduced intensity and improved appearance of “dark circles.” A dose‐dependent decreased production of inflammatory mediators, concomitant to increased antioxidant enzyme levels, was observed in our in vitro studies, under basal and lipopolysaccharide‐stimulated conditions. Conclusions Although the precise mechanisms related to PPLAC remain to be clarified, our results indicate that the reduction in the inflammatory process as well as the antioxidant protection against deleterious elements may be considered as an integral approach to preserve the integrity of vascular endothelium, preventing the hemodynamic congestion that culminates in the formation of “dark circles” around the eyes.     

点阵CO_2激光联合液氮冷冻治疗鸡眼疗效评价

目的:评价点阵CO_2激光联合液氮冷冻治疗鸡眼的临床疗效。方法:85例鸡眼患者随机分为两组:治疗组43例,给予点阵CO_2激光联合液氮冷冻治疗;对照组42例,单用液氮冷冻治疗,10日1次,共治疗3次。结果:治疗组与对照组痊愈率分别为90.70%和52.38%,有统计学意义(P0.01);治疗组与对照组复发率分别为2.56%和9.09%,无统计学意义(P0.05)。结论:点阵CO_2激光联合液氮冷冻治疗鸡眼安全有效。     

超脉冲CO_2点阵激光联合外用药治疗顽固性白癜风的疗效评价

目的:评价超脉冲CO_2点阵激光联合外用药膏治疗顽固性白癜风的临床疗效。方法:将56例顽固性白癜风患者随机分成治疗组29例(皮损52块)和对照组27例(皮损48块),均外用丙酸氟替卡松乳膏及卡泊三醇每日1次,疗程12周。治疗组另给予CO_2点阵激光治疗,1次/3周,共4次。12周后评价疗效。结果:治疗组中有效皮损36块,有效率76.6%;对照组有效皮损18块,有效率42.9%,差异有显著性(P0.01)。结论:点阵激光联合外用药物治疗白癜风比单用药物疗效明显。     

点阵CO2激光治疗原发性皮肤淀粉样变病疗效评价

目的：评价点阵CO₂激光治疗原发性皮肤淀粉样变病的疗效。方法：采用点阵CO₂激光治疗躯干及四肢原发性皮肤淀粉样变病，60～80 mJ/脉冲,每4周1次，共治疗3次。根据皮损大小、色素沉着及瘙痒对皮损进行评分。结果：共收集2017年12月至2018年12月10例患者，其中苔藓样淀粉样变性4例，斑状淀粉样变性6例。皮损大小、色素沉着及瘙痒由治疗前的36分，35分，38分下降至9分,12分，4分。三次治疗后的总有效率为100%，显效率为90%。未出现严重不良反应。结论：点阵CO₂激光治疗原发性皮肤淀粉样变病安全有效。     

CO2点阵激光联合308 nm准分子激光治疗白癜风疗效和安全性meta分析

目的：评价CO₂点阵激光联合308 nm准分子激光治疗白癜风的临床疗效和安全性。方法：通过检索Cochrane Library、PubMed、Embase、万方、中国知网、维普数据库,收集CO₂点阵激光与308 nm准分子激光联合治疗白癜风相关的文献,运用软件（Revman 5.3）进行Meta分析。结果：13篇临床随机对照实验被纳入,其中1014处皮损给予CO₂点阵激光与308 nm准分子激光联合治疗,1005处皮损给予308 nm准分子激光单独治疗。结果显示：联合疗法总有效率和显效率优于单用308 nm准分子激光;两组不良反应发生率无明显差异。结论： CO₂点阵激光+308 nm准分子激光联合治疗白癜风的疗效优于单独使用308 nm准分子激光,且两种疗法的不良反应没有明显差异。     

CO2点阵激光与1550nm铒玻璃点阵激光治疗妊娠纹的自身对照研究

目的： 评价CO2点阵激光与1550nm铒玻璃点阵激光治疗妊娠纹的疗效及安全性。方法：收集妊娠纹患者,以前正中线分腹部为左右两侧,左侧妊娠纹采用10600nm CO2点阵激光,右侧妊娠纹采用1550nm铒玻璃点阵激光治疗。每次治疗间隔2个月,治疗3次,末次治疗后随访3个月。结果：剔除2例失访患者,共25例患者完成本研究。84%患者右侧和48%患者左侧的皮损改善51％～75％,差异有统计学意义（P<0.05）。自我满意度评分中80%患者对右侧满意,68%对左侧满意。治疗后20%患者左侧色素沉着,8%患者右侧色素沉着。患者在治疗过程中疼痛评分右侧（5.41±2.13分）高于左侧（4.19±2.12分）,两者差异有统计学意义（P<0.001）。两侧均未出现永久性色素改变。结论：1550nm铒玻璃点阵激光较10600 nmCO2点阵激光更能有效治疗妊娠纹。     

Treatment of striae distensae with needling therapy versus CO2 fractional laser

Background and objectives: Striae are atrophic dermal scars with overlying epidermal atrophy causing cosmetic concern. This study assesses and compares the efficacy and safety of needling therapy versus CO2 fractional laser in treatment of striae. Methods: Twenty Egyptian female patients with striae in the abdomen and lower limbs were involved in the study. The patients were treated with needling therapy and CO₂ laser every 1 month for 3 sessions. Follow-up by digital photography and skin biopsy was conducted at baseline and 6 months after treatment. Clinical improvement was assessed by comparing photographs and patient's satisfaction before and after treatment. Results: Nine of 10 (90%) needle-treated patients showed improvement. Among them, 3 (30%) had good, 4 (40%) had fair, and 2 (20%) had poor improvements; however, 1 (10%) did not show any improvement after the treatment. In CO₂-laser treated patients, 5 of 10 (50%) of the patients showed clinical improvement; 1 (10%) were good, 3 (30%) were fair, and 1 (10%) were poor; however, 5 (50%) did not show improvement. Conclusion: The results support the use of microneedle therapy over CO₂ lasers for striae treatment.     

Effects of CO2 fractional laser therapy on peripheral blood cytokines in patients with vitiligo

Vitiligo is a disease pathologically characterized by specific damage to melanocytes. The aim of this study was to explore the mechanism underlying CO2 fractional laser treatment of vitiligo by detecting the levels of Th1 cytokines (IL‐2 and IFN‐γ), Th2 cytokines (IL‐4 and IL‐10), and Th17 cytokines (IL‐17 and IL‐23) in peripheral blood. Twenty five vitiligo patients were enrolled in this study and were treated with a CO2 fractional laser four to eight times. The cytokines of 25 vitiligo patients and 20 healthy volunteers were measured by enzyme‐linked immunosorbent assay. After CO2 fractional laser therapy, six cases were cured, and the apparent efficiency was 72.0% (18/25), while the efficiency was 92.0% (23/25). Before CO2 fractional laser therapy, IL‐2 and IFN‐γ levels in vitiligo patients were higher than those in the control group, but the difference was not statistically significant (p > .05). IL‐4, IL‐10, IL‐17, and IL‐23 levels were also higher in vitiligo patients than those in the control group (p < .05). After treatment, IL‐2 and IFN‐γ levels in vitiligo patients were lower than before treatment, but the difference was not statistically significant (p > .05), while IL‐4, IL‐10, IL‐17, and IL‐23 levels were significantly lower compared with before treatment (p < .05). The results show that CO2 fractional laser treatment has a good curative effect in the treatment of vitiligo.     

皮秒翠绿宝石激光与超脉冲CO2点阵激光治疗面部萎缩性痤疮瘢痕的疗效与安全性比较

【摘要】 目的 通过前瞻性、半脸对照研究,比较皮秒翠绿宝石激光与超脉冲CO2点阵激光治疗面部萎缩性痤疮瘢痕的疗效与安全性。方法 2015年10月至2017年10月在中国医学科学院皮肤病医院激光科收集面部对称性萎缩性痤疮瘢痕患者,左侧面部痤疮瘢痕采用超脉冲CO2点阵激光治疗,右侧采用皮秒翠绿宝石激光点阵模式治疗,治疗间隔为2个月,共治疗3次。治疗前后由皮肤科医生根据ECCA评价表对瘢痕进行评分,患者根据四分法自评临床疗效。记录治疗时疼痛程度和不良反应。两侧间、治疗前后ECCA评分及疼痛程度评分比较采用配对t检验,组间四分法评分比较采用 Wilcoxon 秩和检验。结果 治疗前皮秒激光侧和点阵激光侧间ECCA评分差异无统计学意义（t = 1.06,P = 0.300）,治疗3次后差异有统计学意义［（70.98 ± 21.48）分比（58.04 ± 17.63）分,t = 3.76,P = 0.001］。与治疗前相比,皮秒激光侧瘢痕改善评分（2.21 ± 1.09）分,CO2点阵激光侧（2.83 ± 1.11）分,两组差异有统计学意义（z = 2.70,P = 0.007）。与CO2点阵激光侧相比,皮秒激光侧不良反应更少,表现为一过性红斑、水肿,治疗疼痛评分亦明显降低［（3.71 ± 0.62）分比（6.23 ± 1.06）分,t = 11.93,P < 0.001］。结论 皮秒翠绿宝石激光与超脉冲CO2点阵激光均能有效改善萎缩性痤疮瘢痕,CO2点阵激光疗效更显著,而皮秒激光不良反应更少。     

富血小板血浆联合CO2点阵激光治疗萎缩性痤疮瘢痕疗效和安全性Meta分析

目的：系统评价富血小板血浆联合CO₂点阵激光治疗面部萎缩性痤疮瘢痕的有效性及安全性。方法：检索从建库到2019年7月Cochrane Library、Embase、Medline、中国知网、万方数据库及维普数据库中富血小板血浆联合CO₂点阵激光治疗面部萎缩性痤疮瘢痕的随机对照试验,筛选符合要求的文献并根据Cochrane偏倚风险评估方法评价纳入文献质量, 采用Revman5.3软件进行Meta分析。结果：最终纳入5个RCTs和Meta分析,结果显示：①联合疗法的总有效率和治愈率均高于单用激光组（P=0.008,0.0002）;②联合疗法和单用激光组的红斑、水肿持续时间及疼痛评分无统计学差异（P=0.21,0.35,0.50）。结论：富血小板血浆联合CO₂点阵激光治疗萎缩性痤疮瘢痕的疗效优于单独使用CO₂点阵激光,不良反应无明显差异。     

CO2激光治疗20种皮肤病疗效观察

目的：评价CO2激光治疗多种皮肤病的疗效及其在皮肤科治疗上的应用。方法：利用CO2激光的热作用对病变组织进行凝固、汽化和／或切割治疗，而使病变组织破坏而清除。结果：共治疗皮肤性病科20个病种1516例患者，治疗次数1～2次，痊愈1459例(96.24％)，显效54例(3．56％)，有效3例(0．20％)，无效0例(0．00%)。结论：CO2激光对皮肤科多种疾病有较好疗效。