Fractionated microneedle radiofrequency for the treatment of periorbital wrinkles

Non‐ablative bipolar and monopolar radiofrequency devices have been shown to be effective for the treatment of facial wrinkles. Recently, novel fractionated microneedle radiofrequency (FMRF) devices have been introduced. The aim of this study was to evaluate the clinical effectiveness and safety of FMRF for the treatment of periorbital wrinkles. Eleven women, aged 34–59 years, with periorbital wrinkles underwent three sessions of FMRF at 3‐week intervals with a follow‐up period of 3 months after treatment. Clinical improvement was evaluated using the Fitzpatrick Wrinkle Classification System (FWCS) and subjective satisfaction on a visual analog scale (VAS). The FWCS scores demonstrated significant improvement in periorbital wrinkles after treatment (P < 0.001). A satisfaction VAS score of more than 5, indicating high satisfaction, was obtained from 10 of 11 patients (91%) 3 months after treatment, and the mean satisfaction VAS score (n = 11) was 6.7. Patients undergoing treatment reported minimal pain, and neither long‐lasting side‐effects nor significant downtime was noted. This clinical study suggests that FMRF is a safe and tolerable method for successful treatment of periorbital wrinkles.     

Evaluation of plasma skin regeneration technology for cutaneous remodeling

Plasma skin regeneration is a novel type of skin rejuvenation technology developed over the last 3 years. Plasma is the fourth state of matter in which electrons are stripped from atoms to form an ionized gas. Although high‐temperature plasmas have been used in surgery for over a decade, plasma had previously been used as a conduction medium for electric current. Unlike lasers, which rely on the principle of selective photothermolysis to deliver heat to specific targets in the skin, plasma technology delivers heat energy directly to tissue upon contact without reliance on skin chromophores. The plasma itself produces controlled thermal damage to the skin surface to elicit changes such as new collagen formation and improvement in photodamaged skin. The technology can be used at varying energies for different depths of effect, from superficial epidermal effects to deeper dermal heating.     

Treatment of periorbital wrinkles with 1550‐ and 1565‐nm Er:glass fractional photothermolysis lasers: a simultaneous split‐face trial

Objective This study aimed to compare the clinical efficacies of 1550‐ and 1565‐nm Er:glass lasers in the treatment of periorbital wrinkles and to evaluate histological changes after treatment. Methods Twenty patients received five treatments each at 3‐week intervals. The right periorbital area was exposed to the 1550‐nm Er:glass laser and the left periorbital area was exposed to the 1565‐nm Er:glass laser. Clinical improvement was evaluated by two blinded physicians who assessed comparative photographs using a four‐point scale at baseline and 3 months after the final treatments. Skin biopsies were performed in five volunteers before treatment and at 3 months after the final treatment. Results The mean improvement scores 3 months after treatment with the 1550‐ and 1565‐nm Er:glass lasers were 2.25 ± 0.62 and 2.28 ± 0.59 respectively. Histological examination revealed increased epidermal thickening and decreased solar elastosis 3 months after the final laser treatments. Conclusions Both 1550‐ and 1565‐nm Er:glass lasers are safe and effective modalities in the treatment of periorbital wrinkles with no significant differences between the two lasers.     

Objective,measurable assessment of the elasticity of the skin around the eyes following the carboxytherapy treatment

Background

Carboxytherapy is one of the most popular procedures used in dermatology. The treatments are known to be minimally invasive and highly effective for various skin disorders. Therefore, the research carried out in the paper is purposeful and addresses an important area of aesthetic therapies.

Aims

Objective, apparatus-based assessment of the effect of carboxytherapy on skin elasticity around the eyes.

Patients/Methods

The study included a group of 39 Caucasian individuals aged 35–55 years. Participants were subjected to a series of five carboxytherapy treatments of eye area at weekly intervals. The Cutometer measuring probe was used to assess skin elasticity. Additionally, photographic documentation was out using the Fotomedicus system.

Results

In this study, statistically significant increase in R2 parameter was found as the result of applied treatment. This parameter is considered to be the most important indicator of changes in skin elasticity. In 29 out of 39 subjects, the carboxytherapy treatment significantly improved skin tension and elasticity. Such therapy may also exert a beneficial effect on flexibility since in 28 participants the favorable change in the R7 parameter was visible.

Conclusions

The objective analysis of the impact of carboxytherapy treatment on parameters determining skin elasticity revealed that this therapy can be used as an anti-aging method in the eye area. Obtained results are in agreement with other biochemical, histological, and photographical documentation analyses of the effect of carboxytherapy on skin, performed by independent researchers.     

A cosmetic 'anti-ageing' product improves photoaged skin: a double-blind, randomized controlled trial

Summary Background  Very few over‐the‐counter cosmetic ‘anti‐ageing’ products have been subjected to a rigorous double‐blind, vehicle‐controlled trial of efficacy. Previously we have shown that application of a cosmetic ‘anti‐ageing’ product to photoaged skin under occlusion for 12 days can stimulate the deposition of fibrillin‐1. This observation infers potential to repair and perhaps clinically improve photoaged skin. Objective  We examined another similar over‐the‐counter cosmetic ‘anti‐ageing’ product using both the patch test assay and a 6‐month double‐blind, randomized controlled trial (RCT), with a further 6‐month open phase to assess clinical efficacy in photoaged skin. Methods  For the patch test, a commercially available test product and its vehicle were applied occluded for 12 days to photoaged forearm skin (n = 10) prior to biopsy and immunohistochemical assessment of fibrillin‐1; all‐trans retinoic acid (RA) was used as a positive control. Sixty photoaged subjects were recruited to the RCT (test product, n = 30 vs. vehicle, n = 30; once daily for 6 months, face and hands) with clinical assessments performed at recruitment and following 1, 3 and 6 months of use. Twenty‐eight volunteers had skin biopsies (dorsal wrist) at baseline and at 6 months treatment for immunohistochemical assessment of fibrillin‐1 (test product, n = 15; vehicle, n = 13). All volunteers received the test product for a further 6 months. Final clinical assessments were performed at the end of this open period. Results  In the 12‐day patch test assay, we observed significant immunohistological deposition of fibrillin‐1 in skin treated with the test product and RA compared with the untreated baseline (P = 0·005 and 0·015, respectively). In the clinical RCT, at 6 months, the test product produced statistically significant improvement in facial wrinkles as compared to baseline assessment (P = 0·013), whereas vehicle‐treated skin was not significantly improved (P = 0·11). After 12 months, there was a significant benefit of the test product over that projected for the vehicle (70% vs. 33% of subjects improving; combined Wilcoxon rank tests, P = 0·026). There was significant deposition of fibrillin‐1 in skin treated for 6 months with the test product [(mean ± SE) vehicle 1·84 ± 0·23; test product 2·57 ± 0·19; ancova P = 0·019). Conclusions  In a double‐blind RCT, an over‐the‐counter cosmetic ‘anti‐ageing’ product resulted in significant clinical improvement in facial wrinkles, which was associated with fibrillin‐1 deposition in treated skin. This study demonstrates that a cosmetic product can produce significant improvement in the appearance of wrinkles and further supports the use of fibrillin‐1 as a robust biomarker for the repair of photoaged dermis.     

Non-ablative radiofrequency associated or not with low-level laser therapy on the treatment of facial wrinkles in adult women: A randomized single-blind clinical trial

Objectives: The objective of this study was to evaluate the effects of Non-ablative Radiofrequency (RF) associated or not with low-level laser therapy (LLLT) on aspect of facial wrinkles among adult women. Methods: Forty-six participants were randomized into three groups: Control Group (CG, n = 15), RF Group (RG, n = 16), and RF and LLLT Group (RLG, n = 15). Every participant was evaluated on baseline (T0), after eight weeks (T8) and eight weeks after the completion of treatment (follow-up). They were photographed in order to classify nasolabial folds and periorbital wrinkles (Modified Fitzpatrick Wrinkle Scale and Fitzpatrick Wrinkle Classification System, respectively) and improvement on appearance (Global Aesthetic Improvement Scale). Photograph analyses were performed by 3 blinded evaluators. Results: Classification of nasolabial and periorbital wrinkles did not show any significant difference between groups. Aesthetic appearance indicated a significant improvement for nasolabial folds on the right side of face immediately after treatment (p = 0.018) and follow-up (p = 0.029) comparison. RG presented better results than CG on T8 (p = 0.041, ES = ?0.49) and on follow-up (p = 0.041, ES = ?0.49) and better than RLG on T8 (p = 0.041, ES = ?0.49). RLG presented better results than CG on follow-up (p = 0.007, ES = ?0.37). Conclusion: Nasolabial folds and periorbital wrinkles did not change throughout the study; however, some aesthetic improvement was observed. LLLT did not potentiate RF treatment.     

The clinical and histological effect of home‐use,combination blue–red LED phototherapy for mild‐to‐moderate acne vulgaris in Korean patients: a double‐blind,randomized controlled trial

Background Blue and red light have been reported to have beneficial effects on acne. However, there has been no double‐blind, randomized study of acne treatment for combined blue and red light‐emitting diode (LED) devices, and the associated molecular mechanisms have rarely been investigated. Objectives To evaluate the efficacy, safety and histological changes of combined blue and red LED phototherapy for acne vulgaris. Methods Thirty‐five patients with mild‐to‐moderate acne were randomly assigned to either a home‐use irradiation group using an LED device, or a control group using a sham device. The treatment group was instructed to serially irradiate their forehead and cheeks with 420‐nm blue light and 660‐nm red light for 2·5 min twice daily for 4 weeks. Results At the final visit at 12 weeks, both inflammatory and noninflammatory acne lesions had decreased significantly, by 77% and 54%, respectively, in the treatment group. No significant difference was observed in the control group. In the treatment group, sebum output reduction, attenuated inflammatory cell infiltrations and a decreased size of the sebaceous gland were found. The immunostaining intensities for interleukin (IL)‐8, IL‐1α, matrix metalloproteinase‐9, toll‐like receptor‐2, nuclear factor‐κB, insulin‐like growth factor‐1 receptor and sterol response element binding protein (SREBP)‐1 were reduced concomitantly. Messenger RNA expression of SREBP‐1c was also decreased. No severe adverse reactions were reported. Conclusions This LED phototherapy was safe and effective for treating not only inflammatory but also noninflammatory acne lesions, with good compliance. The experimental results correlated well with clinical results, partly elucidating the related molecular mechanisms.     

Fractional photothermolysis for the treatment of facial wrinkles – searching for optimal treatment parameters in a randomized study in the split‐face design

Background: Fractionated photothermolysis (FP) is used for the treatment of facial wrinkles. Objectives: Investigation of effects of different FP treatment parameters in the treatment of facial wrinkles. Patients and methods: In a randomized split‐face controlled study 11 patients received 3 FP sessions in 4‐week intervals. Keeping the total energy input for each facial side constant, one side was treated with 6 mJ/MTZ with relatively high MTZ density (up to 2,625 MTZ/cm²) and the contralateral side with 70 mJ/MTZ with lower MTZ density (up to 230 MTZ/cm²). Follow‐up (FU) visits were performed 1, 3, and 6 months after the last treatment. The cosmetic evaluation was done by the patient self‐assessments and by assessment of standardized photographs by 3 independent, blinded investigators. Post‐treatment side effects were documented daily in a patient diary up to 7 days after the procedure. Results: After 6 months, the patient self‐assessments indicated significant improvements (p < 0.005) in wrinkle severity from 5.2 ± 1.5 to 3.8 ± 1.3 and 3.7 ± 1.3 for 6 and 70 mJ/MTZ, respectively, but without significant difference between the energy levels. In contrast, the photographic evaluation by the blinded investigators showed that wrinkle severity was rated significantly better at the sites treated with 70 mJ/MTZ than at the sites treated with 6 mJ/MTZ (p < 0.01). Treatment with 70 mJ/MTZ was significantly more painful than treatment with 6 mJ/MTZ. The typical local reactions to FP, erythema and edema, were also significantly more intense after 70 mJ/MTZ and lasted longer. Conclusions: FP with higher energy per MTZ at constant total energy input is more effective in the treatment of facial wrinkles than lower energy. The gain in effectiveness is, nonetheless, accompanied by an increase in adverse reactions. The treating physician may use this information to adjust treatment to the preferences of the individual patient.     

A 12-week clinical and instrumental study evaluating the efficacy of a multisource radiofrequency home-use device for wrinkle reduction and improvement in skin tone,skin elasticity,and dermal collagen content

This study was performed in order to evaluate the safety and efficacy of a new handheld home-use multisource radiofrequency device on facial rejuvenation. Forty-seven male and female subjects were enrolled. All subjects received a NEWA^® 3DEEP^? home-use device (EndyMed Medical, Caesarea, Israel) to be used on facial skin three times per week for the first four weeks and then reduced to two times per week for the following eight weeks. Assessments included expert clinical grading for efficacy, instrumental evaluation, image analysis, and photography. Forty-five subjects completed the study; all subjects reported the treatment to be painless with only mild erythema lasting up to 15 minutes post-treatment. No other adverse events were reported. Statistically significant improvements were noted in the appearance of marionette lines, skin brightness, elasticity, firmness, lift (facial), lift (jawline), texture/smoothness, tone, and radiance/luminosity by expert visual assessment. Statistically significant improvements in skin firmness and elasticity were found using a Cutometer MPA 580, as well as in collagen and hemoglobin content of the skin using a SIAscope. The results of this study indicate that the NEWA^® multisource radiofrequency home-use device is effective in self-administered skin rejuvenation.