How to improve infraorbital hollows with neuromodulators–A clinical prospective interventional study about the application of facial biomechanics

Background

A previous injection algorithm termed the “Toxin Lift” was recently introduced and described volume increases in the midface following neuromodulator treatments of the jawline. Increase in midfacial volume due to soft tissue repositioning could also affect the severity of infraorbital hollows.

Objective

The objective is therefore to evaluate whether the severity of infraorbital hollows can be improved by injecting neuromodulators in the supra-mandibular segment of the platysma.

Materials and Methods

A total of 35 volunteers (11 males/24 females) with a mean age of 39.8 (9.6) years and a mean BMI of 25.2 (5.2) kg/m² were investigated. Bilateral infraorbital regions were evaluated via clinical assessment and semi-quantitative 3D imaging. The applied injection technique targeted the platysma via four injection points administering 5 I.U. per injection point resulting in a total of 20 I.U. per facial side.

Results

Volume increase of the infraorbital region was 0.13 cc at 15 days (p = 0.001) and was 0.02 cc at 30 days (p = 0.452) whereas the skin displacement in cranial direction was 0.54 mm at 15 days (p < 0.001) and was 0.31 mm at 30 days (p < 0.001). Clinical evaluation revealed a highly statistically significant improvement of the tear trough, palpaebromalar groove, and of the lid-cheek junction when compared to baseline with all p < 0.001.

Conclusion

The results of this clinical prospective interventional analysis revealed that the “Toxin Lift” injection technique is capable to improve the clinical appearance of infraorbital hollows. The effects can be explained by the concepts of facial biomechanics.     

Comparison of the two techniques for measurement of the density of Demodex folliculorum: standardized skin surface biopsy and direct microscopic examination

Background In daily dermatological practice, many dermatologists do not include demodicosis in their differential diagnoses, or the diagnosis of demodicosis is frequently masked by other skin diseases such as papulopustular or erythematotelangiectatic rosacea, seborrhoeic dermatitis, perioral dermatitis and contact dermatitis. There are two methods for measurement of the density of Demodex folliculorum (Dd): standardized skin surface biopsy (SSSB) and direct microscopic examination of fresh secretions from sebaceous glands (DME). No study has been reported in the literature comparing the diagnostic value of these two techniques. Objectives To compare the value of the two techniques, SSSB and DME, for the measurement of Dd in patients with suspected demodicosis. Methods Mite density was investigated using SSSB and DME in 37 patients with facial skin lesions suggesting demodicosis. Two samples, one for SSSB and one for DME, were obtained from a cheek lesion of each patient. Results Twenty‐three (62%) patients were diagnosed with demodicosis according to their clinical manifestations combined with a high Dd (Dd > 5 mites cm^?2) with SSSB and/or DME. In all the patients, the mean Dd measured with SSSB was higher than that with DME (22·9 ± 5·9 and 2·2 ± 0·8, respectively; P = 0·001). Also, among the 23 patients with demodicosis, the mean Dd measured using SSSB was higher than the mean Dd with DME (36·5 ± 8·3 and 3·4 ± 1·2, respectively; P = 0·0001). Conclusions We recommend the use of SSSB for the measurement of Dd as more patients with demodicosis can be diagnosed with this method compared with the DME method.     

Anatomic evaluation of the normal variants of the arteries of face using color Doppler ultrasonography: Implications for facial aesthetic procedures

Background

Knowledge of normal facial vascular variations could prevent catastrophic complications of cosmetic procedures as well as providing a guide for surgical planning. Color Doppler ultrasound is a safe and noninvasive method for real time vascular evaluation.

Objective

The aim of this study was to evaluate the normal variations of the facial, angular, transverse facial, supratrochlear and supraorbital arteries in a sample of normal individuals.

Methods

Normal individuals referred for dermal filler injection to the tertiary dermatologic center, were selected. Patients who were smoker or had a history of facial filler injection, facial surgery, or trauma were excluded from the study. Facial artery at three levels as well as angular, supratrochlear, supraorbital, and transverse facial arteries were evaluated by an 18 MHz ultrasound linear probe regarding their distance from facial reference lines and landmarks, and also their depths in various regions of face.

Results

A total number of 43 individuals were evaluated in this study. Thirty-one (72.1%) were women. The number of absent facial artery was zero in level one, three (3.48%) in level two, and nine (10.46%) in level three. The angular artery was absent in 10 (11.62%) participants. The transverse facial artery was absent in 27 (31.39%) assessed individuals. Distance from reference lines at level 2 and 3 of facial artery and its depth at level 2 were significantly different between left and right side (p-values: <0.001, 0.01, and 0.03, respectively). No significant difference was seen between depth and distance of two sides for angular and transverse facial arteries. The comparison of the depths and distances from the reference lines of the assessed arteries between two sexes revealed only a significantly greater value of facial artery distance in level 1 in males (p-value: 0.001). BMI was also significantly correlated with the depth of facial artery in level 2 (Pearson correlation coefficient = 0.471, p-value = 0.002) and level 3 (Pearson correlation coefficient = 0.357, p-value = 0.03) and the distance of the facial artery in level 1 (Pearson correlation coefficient = 0.333, p-value = 0.029).

Conclusions

Color Doppler ultrasound could be used to map the arteries of face to prevent vascular complications and safely guide cosmetic procedures.     

Filler injections in the pre-auricular space: Be aware of the parotid gland

Backgroud

In recent years the pre-auricular area is increasingly used for filler injections.

Aims

Assessment of depth of the subcutaneous fat and the process of realtime filler injection.

Materials & Methods

Ultrasonographic data of two cases and a video are studied.

Results

These show how filler injections may very easily be delivered inside the parotid gland. This may go unnoticed by injector and client.

Discussion

This study and data from literature prove that filler injections in the pre-auricular area may end up inside or in the vicinity of the parotid gland, and this can lead to an inflammatory response.

Conclusion

It is recommended to be careful with filler injections in this area. Prior sonographic assessment of the subcutaneous depth in this area is advised.     

Efficacy and safety of a facial serum and a mask containing salicylic acid and lipohydroxy acid in acne management: A randomized controlled trial

Background

Inflammatory and non-inflammatory acne lesions constitute a significant clinical challenge in acne subjects.

Aim

To evaluate the efficacy and safety of a facial serum and a mask containing salicylic acid and lipohydroxy acid for improving skin conditions.

Methods

This randomized controlled trial included adults with comedones, post-inflammatory erythema (PIE) and/or hyperpigmentation (PIH) in Shanghai, China in July 2021. Participants were randomly assigned 1:1 to receive the study Serum + Mask or serum alone for 8 weeks. Acne severity, comedones, papules, pustules, PIE, PIH, skin pores, skin tone evenness, sebum secretion, skin hydration, and trans-epidermal water loss were evaluated at T0d, T1d, T7d, T14d, T28d, and T56d.

Results

Eighty-three participants were included, including 41 and 42 in the Serum + Mask and Serum groups, respectively. Acne severity, density of skin pores, skin tone evenness, PIH foci on face, PIE foci on nose, intensity of PIE and PIH, closed comedones on face, open comedones on nose, sebum secretion, and skin hydration were significantly improved from baseline after 8 weeks of treatment in both groups (all p < 0.05). Addition of the mask improved the number of closed comedones (−6.56 ± 0.39 vs. −5.19 ± 0.44, p = 0.022) and acne severity (−0.39 ± 0.08 vs. −0.12 ± 0.09, p = 0.026) substantially more than using the serum alone. No adverse reaction was reported in either group.

Conclusions

The study serum improved skin conditions by regulating skin barrier function and achieving a balance of skin hydration and sebum secretion, removing comedones and improving PIE and PIH. Addition of the mask accelerated the effects without compromising safety.     

Superficial versus deep injections of the upper midface—A prospective interventional split-face study

Background

Various injection algorithms have been proposed in the past which are in line with the three aesthetic principles: upper face first, lateral face first, and deep regions first. However, increasing evidence is provided that the upper midface can be targeted with superficial soft tissue filler injections alone too.

Objective

To investigate in a prospective split-face study design whether superficial or deep upper midfacial injections provide superior aesthetic outcomes.

Methods

A total of n = 20 study participants (100% females; age 43.95 (11.7) years; BMI 22.92 (2.6) kg/m²) were treated with superficial soft tissue filler injections on side of their face and deep injections on the contralateral side with a mean volume of 0.78 cc. Outcome was evaluated at 7 weeks follow-up for midfacial, and lower facial volume, for medial and lateral facial skin vector displacement, and for improvement of nasolabial, crow's feet, and upper cheek fullness severity scores.

Results

No adverse events related to safety or product tolerability were observed during the entire study period. All semiquantitative scores improved statistically significantly after the observational period (p < 0.001) but displayed no difference between the two applied injection techniques (p > 0.05).

Conclusion

The results of this split-face study revealed that both the superficial and the deep cannula injection technique for midface volumization statistically significantly improve the midfacial volume, reduce nasolabial fold and crow's feet severity. No statistically significant difference was observed between the two injection techniques when compared via semiquantitative and objective outcome evaluation after 7 weeks follow-up.     

Ghrelin in the pilosebaceous unit: alteration of ghrelin in patients with acne vulgaris

Background

Ghrelin in the pilosebaceous tissues of human skin and ghrelin levels in patients with acne vulgaris have not yet been investigated.

Objective

The purpose of this study was to screen ghrelin immunoreactivity by immunohistochemistry in human pilosebaceous tissues of human skin and also to determine the quantities of ghrelin in the serum of the patients with acne vulgaris.

Methods

30 patients presenting with acne vulgaris and 30 control subjects participated in this study. Ghrelin levels were determined by enzyme linked immunosorbent assay (ELISA). Human hair follicles and sebaceous glands were immunohistochemically examined.

Results

Immunohistochemistry results showed that there is a strong ghrelin immunoreactivity in the hair follicles and sebaceous glands in sections of human skin. The mean serum ghrelin levels (27.58 ± 15.44 pg/mL) in patients with acne vulgaris was significantly lower than those of controls (35.62±20.46 pg/mL).

Conclusions

Ghrelin produced in hair follicles and sebaceous glands of the skin might participate in the pathogenesis of acne vulgaris and also acne vulgaris in humans might be associated with decreased serum ghrelin.

     

Selective photothermolysis with a novel 1726 nm laser beam: A safe and effective solution for acne vulgaris

Background

Selective photothermolysis on sebaceous glands is an effective method for treating acne vulgaris (AV); however, safety, efficacy, and discomfort hinder its utilization in clinical settings.

Aims

The primary objective is to evaluate the safety and efficacy of a novel 1726 nm laser with contact cooling to treat AV.

Methods

Seventeen patients aged 18 to 36 were enrolled and treated in this IRB-approved, single-center, open-label study. Patients received up to three facial laser sessions up to seven weeks apart. Follow-up visits happened ten days post-session and at the 4 and 12 weeks following the final session. The investigator assessed the severity of device-related adverse events (AEs). Investigator Global Assessment (IGA) and inflammatory lesion counts (ILC) were used as metrics to evaluate acne resolution and skin condition enhancement. Patients' perspectives on satisfaction and comfort using this technology were assessed using Subject Experience Questionnaires (SEQ).

Results

Safety assessment showed mild and transient AEs. All subjects tolerated anesthetics-free treatments well, with a mean treatment discomfort score of 4.9 ± 1.5. Compared to baseline, a statistically significant reduction in ILC (p = 0.003) of 52% to 56% is achieved four to twelve weeks following treatment. Long-term follow-ups showed progressive improvement 24 months post-treatment with a 97% reduction in ILC. SEQs revealed high subject satisfaction (71%) with psychosocial improvement three months post-treatment.

Conclusion

The novel 1726 nm laser appears safe and effective for treating mild-to-severe acne. Acne resolution is apparent within the first month and progresses beyond the study duration.     

Psychosocial and financial impact of facial hair among female patients of hirsutism: A cross-sectional study

Background

Literature on psychosocial impact, financial burden, and worry in hirsute females with facial hair is limited.

Objective

To assess psychosocial impact and financial burden, worry among females with hirsutism.

Methods

In this cross-sectional, questionnaire based observational study, 50 females with hirsutism having facial hair were interviewed and provided with questionnaires examining the psychosocial impact and financial burden. Psychosocial impact in participants was assessed by the Dermatology Life Quality Index (DLQI) questionnaire, and the financial burden was evaluated using a composite financial burden score. Self-reported financial worry was also calculated.

Results

A total of 50 completed DLQI surveys and financial burden surveys were taken for analysis. The mean DLQI of 50 hirsute females was 15.98 ± 5.79. The mean value of financial burden score was 0.98 ± 1.45, and financial worry was 1.5 ± 0.90. There were 16% of total hirsute females who commonly used trimming/ shaving and Laser therapy as a treatment modality followed by 12% females who did not use any treatment modality for their facial hair. There were 10% females who used waxing and followed by 6% who used a combination of waxing, trimming, and bleaching for managing facial hair. The financial burden impact of laser therapy was significant (p = 0.013) among all treatment modalities.

Conclusion

The present study concludes that hirsutism poses a very large effect or psychosocial impact on hirsute females with a significant financial burden with laser therapy as compared to other treatment modalities.     

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.     

Macrocystis pyrifera ferment-containing creams for optimizing facial skin rejuvenation

Background

There is an increasing demand for facial skin rejuvenation. Specialized aesthetic skincare treatments may be one of the first steps to help prevent or treat facial signs of aging. This article discusses aesthetic skin care for facial skin rejuvenation, particularly data on two creams containing Macrocystis pyrifera ferment.

Methods

The authors convened a dermatology advisory board to discuss challenges and practices in using skincare for facial rejuvenation, combining their expert opinion and experience on facial rejuvenation with preclinical and clinical data on two creams containing Macrocystis pyrifera ferment and a review of the literature.

Results

Preclinical and clinical studies on Macrocystis pyrifera ferment and two creams containing the ferment exhibit anti-inflammatory, anti-aging, and healing properties. In preclinical studies, the ferment demonstrated collagen type I enhancing properties in ex vivo skin models, and skin cells treated with the ferment migrated faster than untreated cells in the in vitro study. In clinical studies measuring visible anti-inflammatory activity, the ferment alone and the ferment-containing products significantly decreased erythema, and in anti-aging studies, they improved visible skin aging parameters. Finally, in clinical studies on the stratum corneum, the two creams increased moisture levels and decreased transepidermal water loss (TEWL), reflecting healing by enhancing barrier strength and recovery.

Conclusions

The Macrocystis pyrifera ferment and creams containing the ferment are effective skin care treatment products to decrease the visible effects of inflammation and signs of aging while promoting healing by enhancing barrier resilience and recovery.     

Peptide-pro complex serum: Investigating effects on aged skin

Background

Effective anti-aging treatments are an unmet consumer need.

Aim

Ex vivoand clinical tests have evaluated the efficacy of a topical facial serum containing a proprietary blend of neuropeptides, proteins, amino acids, and marine extracts on aged skin.

Methods

In the ex vivo study the facial serum was compared to a commercially marketed face serum and to an untreated control on skin explants using microrelief, smoothness, and epidermal thickness endpoints. The 12 weeks monadic clinical study was designed for the test product to be used on the whole face. Subjects functioned as their own control; evaluating change from baseline. Skin was evaluated clinically by a Dermatologist for tolerability and for efficacy. Also part of the product assessment was skin hydration measurements, imaging, and a subject questionnaire.

Results

The facial serum improved skin condition by significant reductions in skin surface area occupied by microfolds and in skin roughness. Additionally, it increased epidermal thickness as compared to the untreated control as well as the commercially marketed face serum. The facial serum provided a statistically increased skin moisturization compared to pretreatment values. Dermatological evaluation of the skin concluded that there were statistically and clinically significant improvements in skin smoothness, wrinkles severity, fine lines visibility and lifting, and tightening effects at crow's feet area, forehead, and upper lip.

Conclusion

A facial serum, containing a proprietary blend of neuropeptides, proteins, amino acids, and marine extracts, has been shown to improve the overall quality of aged skin in a series of ex vivo and clinical tests.     

Topical Lactiplantibacillus plantarum LB244R® ointment alleviates skin aging: An exploratory trial

Background

The skin is of vital importance for health and well-being. As people age, the skin undergoes visual and morphological changes such as wrinkling, loss of elasticity, increased pigmentation, and decreased cell turnover. This is not only visually unappealing to many but can also pose health issues.

Aim

In this study, a probiotic ointment (PO) containing live lactic acid bacteria (LAB) (Lactiplantibacillus plantarum LB244R®) was investigated for its ability to alleviate symptoms of skin aging in an exploratory clinical trial.

Methods

The PO was applied twice daily for 56 days by 21 subjects. Anti-aging efficacy was evaluated by skin ultrasonography, skin biomechanical properties, skin hydration, and clinical evaluations at day 0, 28, and 56.

Results

Sub-epidermal low echogenic band thickness decreased (0.261 ± 0.069 mm to 0.247 ± 0.055 mm) after 56 days. Dermal density increased (324.689 ± 57.506 pixel/mm² to 367.831 ± 75.790 pixel/mm²). Skin hydration increased (34.1 ± 6.9 to 51.3 ± 10.0 AU). Additionally, skin firmness increased, as shown by decreasing values (0.264 ± 0.038 to 0.228 ± 0.037 mm). Skin elasticity increased (0.578 ± 0.045 to 0.618 ± 0.044). Trans-epidermal water loss decreased (9.1 ± 2.0 g/h/m² to 8.5 ± 1.3). All clinical evaluations, Crow's feet, spot score, smoothness score, and complexion radiance, were improved.

Conclusion

The PO improved all measured parameters with statistical significance after 56 days of application, clearly demonstrating the potential of the PO as an anti-aging agent and reaffirming the potential of topical probiotic LAB. Future studies need to elucidate the mode of action of anti-aging effects by probiotics, but at present time, this study paves the way for the use of probiotic LAB topically to alleviate aging of the skin.     

Facial psoriasis in the etiology of prolonged erythema following medium-depth chemical peels for severe photodamage

Background

Chemical peeling is the controlled wounding of the epidermis and dermis for skin rejuvenation, involving the application of ablative agents to induce keratolysis and regeneration of damaged cell layers. Prolonged erythema is one complication of this procedure. We report the prevalence and probable etiology of prolonged facial erythema in a cohort of patients treated with medium-depth chemical peels.

Materials and Methods

A retrospective audit was conducted of all medium-depth facial chemical peels performed at two major teaching hospitals. All patients had severe facial photodamage affecting at least 75% surface area of the face. The occurrence of prolonged erythema following this peel was then identified and analyzed.

Results

Of our treatment cohort (n = 82, 51 women, 31 men) with 60 years mean (61.3 years for women, 56.7 years for men), 10 patients (12%; eight women, two men) experienced prolonged erythema beyond a month of treatment. Facial psoriasis was not apparent at the time of chemical peel but manifested as prolonged erythema beyond the expected timeframe following the procedure.

Conclusion

When patients experience prolonged erythema beyond a month of treatment and fail to respond to standard treatments, clinicians should examine carefully for extra-facial psoriasis prior to this procedure, and also consider facial psoriasis a possible cause of prolonged post-peel erythema.     

Roles of bovine sialoglycoproteins for anti-skin aging and accelerating skin wound healing

Background

Fibroblasts are the most predominant cell subpopulation in the dermal layer of human skin, they play an important role in maintaining skin architecture and function. The senescence of fibroblasts is one of major causes of skin aging and chronic wound in the elderly, which is accompanied with a reduction of α2,6-sialylation on the cell surface.

Aims

In this study, we investigated the effects of the bovine sialoglycoproteins on normal human dermal fibroblasts (NHDF).

Results

The results showed that bovine sialoglycoproteins could promote the proliferation and migration of NHDF cells, and accelerate the contraction of fibroblast-populated collagen lattice (FPCL). The average doubling time of NHDF cells treated with bovine sialoglycoproteins (0.5 mg/mL) was 31.1 ± 1.0 h whereas that was 37.9 ± 2.7 h for the control (p ˂ 0.05). Moreover, the expression of basic fibroblast growth factor (FGF-2) was upregulated, while that of transforming growth factor-beta 1 (TGF-β1) and human type I collagen (COL-I) were downregulated in treated NHDF cells. Furthermore, bovine sialoglycoproteins treatment significantly enhanced the α2,6-sialylation on the cell surfaces, which was consistent with the upregulation of α2,6-sialyltransferase I (ST6GAL1) expression.

Conclusions

These results indicated that the bovine sialoglycoproteins might be developed as a reagent against skin aging in the cosmetic industry, or as a new candidate for accelerating skin wound healing and inhibiting scar formation.     

Efficacy and safety of Politranexamide® liposomal emulsion on facial melasma: A comparative study

Introduction

Melasma is a human melanogenesis dysfunction that results in localized, chronic acquired hypermelanosis of the skin difficult to treat.

Methods

This prospective, randomized, single-blind, study aimed to compare the efficacy and tolerability of a liposomal emulsion based on Politranexamide® (SAMPLE A) with that of a competitor based on acetylglucosamine, ethyl linoleate and phenyl ethyl resorcinol (SAMPLE B) in patients affected by facial melasma on 26 patients. Disease severity was assessed by the Melasma Area Severity Index (MASI) at baseline and after 6 and 12 weeks of therapy. All patients were subjected to photo documentation using DermaView camera and Antera 3D camera.

Results

The mean MASI score at baseline was 10.93 ± 7 in the group A and 9.34 ± 6.29 in the group B, respectively. A significant decrease in MASI score from baseline was noted in both treatment groups as early as 6 weeks of follow-up (p = 0.00096 for SAMPLE A and p = 0.0049 for SAMPLE B) and was confirmed at the end of the treatment (p = 0.0006 for SAMPLE A and p = 0.00039 for SAMPLE B). Intergroup comparison revealed a greater improvement of melasma among patients in group A compared to those in group B that was quite statistically significant at weeks 6 (p = 0.055009) and significant after 12 weeks of follow-up (p = 0.032942). Both treatment groups experienced an improvement in Antera average level of melanin.

Conclusion

Our results suggested Politranexamide® to be a useful and safe therapeutic option in treating melasma, more effective than competitor used in this study.     

Stab access fascia suspension lift: A facelift technique without skin excision and visible scar

Background

Traditional middle and lower facelifts are not suitable for patients with mild skin laxity or who wish to avoid incision scars.

Objective

We present the stab access fascia suspension lift (SAFS-lift) technique, which does not require regular skin incisions, as a reliable surgical facelift strategy for the lower and middle face.

Methods

From September 2020 to September 2021, 38 patients underwent SAFS-lift. SAFS-lift involved (1) incomplete subcutaneous undermining with hydrodissection-assisted tunneling; (2) complete subcutaneous undermining with a dissecting cannula in the zygomatic buccal groove area and hollow below zygomatic arch; and (3) maximal firm superficial musculoaponeurotic system suspension with polydioxanone barbed threads in loops. All patients evaluated the outcome according to the Global Aesthetic Improvement Scale. Four plastic surgeons evaluated postsurgery result with a five-point Likert scale (5 = excellent, 4 = good, 3 = fair, 2 = no change, and 1 = worse).

Results

Thirty-six patients were successfully enrolled. The mean follow-up period was 14.72 ± 3.89 months. No patients showed visible scarring 6 months after surgery. The minor complication rate was 19.4%. They all subsided within 1–6 weeks without treatment. No infection, hematoma, seroma, or facial nerve injury was observed. Patients’ outcome ratings were 4.22 ± 0.58 (3 months), 4.69 ± 0.46 (6 months), and 4.69 ± 0.54 (1 year). Surgeons' outcome scoring was 3.98 ± 0.95.

Conclusions

Stab access fascia suspension-lift is a predictable, effective, and safe facelift technique that can be performed without making noticeable incisions and resecting the skin.     

Dermatoses in overweight and obese children and their relationship with insulin and skin color

Background/Aim

The aim of the present study was to investigate the prevalence of obesity-related dermatoses in obese children, and the association between these dermatoses and insulin resistance as well as skin color.

Methods

Obese, overweight, and normal weight children according to body mass index who were followed up and treated in the outpatient clinics were included in the study. Dermatological examinations of the participants were performed, and fasting insulin and glucose levels were checked.

Results

The obese and overweight children were evaluated as the patient group (70 girls, 41 boys, mean age: 12.37 ± 3.14 years). One hundred one healthy children with normal weight were determined as the control group (59 girls, 42 boys, mean age: 12.15 ± 2.43). The first five common dermatoses in the patient group when compared with the control group were keratosis pilaris (KP), striae distensae, hyperhidrosis, acanthosis nigricans (AN), and plantar hyperkeratosis. The first five dermatoses which were positively correlated with formation and insulin resistance were KP, striae distensae, AN, hyperhidrosis, and plantar hyperkeratosis. According to the Fitzpatrick skin scale, we found that the darker the skin color, the higher the probability of AN and KP (OR, 0.298; 95% CI, 0.106–0.834, p = 0.021; OR, 0.306; 95% CI, 0.117–0.796, p = 0.015, respectively).

Conclusion

Some dermatoses associated with obesity and insulin resistance were not found in obese children, or there was no significant association. These results indicate that many skin morbidities may be prevented by preventing and treating obesity and insulin resistance in the early period.     

Novel laser hair removal in all skin types

Background

Laser has been long accepted as a solution for excess or unwanted hair growth yet traditional lasers are not always ideal for safe and effective outcome for all skin types and hair characteristics. A diode laser module combining three wavelengths (755, 810, and 1064 nm) in a single pulse was developed to provide a fast and long-term solution for subjects with various profiles.

Aims

To evaluate the safety and efficacy of a Triple wavelength diode laser module for hair removal treatment in all skin types (Fitzpatrick I–VI).

Subjects and methods

This was a prospective, dual centered, single-arm study. Subjects were treated with a novel diode laser module. Thirty-six subjects were enrolled, sixteen with Fitzpatrick skin types I–IV (46%) and twenty with Fitzpatrick skin types V–VI (54%). Treatment areas were axilla and bikini lines. Subjects underwent 4 treatment sessions at 6 weeks ± 5 days intervals and attended a follow-up visit 3 months after the last treatment session. 2D digital photographs were taken at baseline and at the follow-up visit, and a hair count was conducted by three blinded evaluators.

Results

A significant reduction in hair count between baseline and the 3-month follow-up visit was observed in both axilla and bikini lines for all skin types. The mean hair reduction was 41.5 ± 19.4% and 48.1 ± 20.9% in the axilla and bikini line, respectively. A significant hair reduction was also observed within skin type groups; mean hair reduction 45.5 ± 16.9% and 40.3 ± 17.2% in skin types I–IV and V–VI, respectively, indicating similar efficacy for both light and dark skin types. No serious adverse events were reported.

Conclusions

This study demonstrates that the Soprano Titanium laser platform is safe and effective for hair removal treatment in all skin types.     

Human dermal fibroblast-derived extracellular matrix reduces postinflammatory hyperpigmentation after fractional carbon dioxide laser facial resurfacing in Asians

Background

Extracellular matrix (ECM) components promote the development of skin wounds by providing biological scaffolds and regenerative microenvironments.

Aims

To evaluate the beneficial effects of human dermal fibroblast-derived ECM after fractional carbon dioxide laser resurfacing in Asians.

Patients/Methods

In this double-blind, randomized, vehicle-controlled, split-face study, 15 participants with features of facial skin aging were treated with a single session of fractional carbon dioxide laser, followed by the application of either ECM (ECM group) or placebo (control group). In vivo skin parameters were measured at baseline and after 4 and 12 weeks of treatment using the Antera 3D®, Cutometer® MPA580, Dermascan®, and Tewameter®.

Results

A total of 14 participants (mean age 45.1 ± 9.7 years) completed the study. The change in melanin level was significantly lower in the ECM group than in the control group at week 12 (p < 0.05). Transient increase in erythema level was observed at week 4 in the control group, and the change in the erythema level was greater in the control group than in the ECM group (p = 0.014). Though the ECM group showed improvements in the dermal density, texture, transepidermal water loss, marionette lines (volume, maximum depth, and average depth), and nasolabial folds (volume, maximum depth, and length), no significant differences were found between the two groups. Treatment-related adverse events were not reported.

Conclusions

We suggest that human dermal fibroblast-derived ECM may be used as adjunctive therapy after fractional carbon dioxide resurfacing to prevent postinflammatory hyperpigmentation in Asians.