光子嫩肤技术治疗92例面部色素性皮肤病的临床观察

目的研究光子嫩肤技术对面部色素性皮肤病治疗效果。方法应用光子多功能治疗仪治疗92例面部色素性皮肤病,并进行临床观察。结果雀斑47例,有效率95.7%;痤疮后色素沉着22例,有效率95.5%;黄褐斑11例,有效率18.2%;脂溢性角化12例,有效率58.3%。结论光子嫩肤技术适合治疗雀斑和痤疮后色素沉着。     

Combination of microneedle radiofrequency (RF), fractional RF skin resurfacing and multi-source non-ablative skin tightening for minimal-downtime,full-face skin rejuvenation

Background: In the recent years, there is a growth in demand for radiofrequency (RF)-based procedures to improve skin texture, laxity and contour. The new generation of systems allow non-invasive and fractional resurfacing treatments on one platform. Objective: The aim of this study was to evaluate the safety and efficacy of a new treatment protocol using a multisource RF, combining 3 different modalities in each patient: [1] non-ablative RF skin tightening, [2] fractional skin resurfacing, and [3] microneedling RF for non-ablative coagulation and collagen remodelling. Methods: 14 subjects were enrolled in this study using EndyMed PRO^? platform. Each patient had 8 non-ablative treatments and 4 fractional treatments (fractional skin resurfacing and Intensif). Results: The global aesthetic score was used to evaluate improvement. All patients had improvement in skin appearance. About 43% had excellent or very good improvement above 50%, 18% had good improvement between 25 and 50%, and the rest 39% had a mild improvement of < 25%. Downtime was minimal and no adverse effect was reported. Conclusions: Our data show significant improvement of skin texture, skin laxity and wrinkle reduction achieved using RF treatment platform.     

Therapeutic Hotline: Facial skin rejuvenation in a patient treated with photodynamic therapy for actinic keratosis

The aim of the most used treatments of actinic keratoses (AKs) is to avoid the conversion into invasive squamous cell carcinoma through the destruction of the lesion; a lot of therapeutic modalities (imiquimod, 5-fluorouracil, electrosurgery with curettage, cryosurgery) are effective and safe in this field, but not many can do it with excellent cosmetic results like treatment with photodynamic therapy (PDT). We have treated with this technique an old patient, whose AK was resistant to other treatments; the most interesting feature of our case comes from the esthetic effects of the PDT employing a methyl-ester of 5-aminolevulinic acid as topical photosensitizer. This kind of therapy has removed not only the lesion but also the photoaging manifestations like the wrinkles and the ugly lines, leaving a smooth skin, as we have proved with 3D-profilometry technique.     

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.     

A Chinese experience of fractional Ultrapulsed CO2 laser for skin rejuvenation

Abstract

Background and objectives: The ablative fractional CO₂ laser has been successfully used in treating photoaged skin in the Caucasian population. However, its application in Asian skin has not been widely reported. The purpose of this study is to observe the efficacy and safety of the protocol ‘ActiveFX’ for photodamaged facial skin in Chinese patients. Methods: A non-sequential fractional ultrapulsed CO₂ laser with specific settings is used in addition to a new computer pattern generator (CPG). Twenty patients received a single-session, single-pass, ablative fractional treatment on a split face. The patients were evaluated at baseline, and 1 and 3 months (M1, M3) after the treatment using a quartile grading scale. They were also asked to assess their overall satisfaction using a 4-point scale. The improvement of the coarse wrinkles was also quantitatively analyzed with a 3D in vivo imaging system. Results: At M1 and M3, the blinded investigator rated global improvement as 2.8 ± 0.95 and 3.00 ± 0.73, which was consistent with the patients' assessment (2.55 ± 0.83 at M1 and 3.15 ± 0.88 at M3). The roughness analysis (Rz) demonstrated a significant decrease in periorbital wrinkles (p < 0.0001). Minimal and reversible adverse side effects and rapid healing were noted. Conclusions: Non-sequential fractional ultrapulsed CO₂ laser resurfacing (ActiveFX) is considered an excellent treatment modality for photodamaged Chinese facial skin.     

A retrospective study on the clinical efficacy of the intense pulsed light source for photodamage and skin rejuvenation

Objective: The objective of this retrospective review is to investigate the long-term effect of skin rejuvenation by the intense pulsed light (IPL) source for the treatment of photoaging. Methods: From 5300 clinical cases that our department has treated with the IPL, the first 2534 were chosen for this study. Each patient received a minimum of 3 IPL treatments during this time—many were yearly treatments. Clinical photographs were taken on a yearly basis for up to 12 years and sent to a blinded independent panel to study the effects of continuous IPL treatments. Results: Results showed that the effective rate for the IPL was between 88.24% and 96.45%. Conclusions: IPL therapy is an effective treatment for photoaging and can truly have an effect on reversing the signs of photodamage on skin.     

The lamellar peel: A sequential nonablative and ablative laser treatment for facial skin rejuvenation

Objectives. Ablative and nonablative laser treatments have established themselves independently in the rejuvenation of aging skin. This study was designed to determine the effects of sequential nonablative and ablative laser treatments on facial skin.

Materials and methods. Twelve patients, ages 32–56 years, with skin phototypes I‐IV, received three treatments spaced six weeks apart. Each treatment consisted of one pass with 1319‐nm Nd:YAG laser at 16 J/cm², 50 ms pulse duration. This was immediately followed by one pass of 2940‐nm Er:YAG laser at 5 J/cm². Photographs and biopsies were taken prior to the first treatment and following the third treatment.

Results. Clinical improvements in facial skin tone and texture, acne scarring and dyschromia were noted in all patients. Histologic changes included a more compact epidermal granular layer and lamellar collagen formation with decreased solar elastosis in the dermis. Compared to controls, treated skin had a thicker, more homogeneous papillary dermis.

Conclusion. The sequential use of nonablative and superficial ablative laser treatments clinically and histologically improved photodamaged and chronologically aged skin. This occurred with minimal recovery and little morbidity, demonstrating this laser application to be a safe and effective method for facial rejuvenation.     

Comparison of the effects of carboxytherapy and radiofrequency on skin rejuvenation

Background: Carboxytherapy (CA) refers to the cutaneous and subcutaneous administration of CO₂ for therapeutic purposes. Radiofrequency (RF) is a method that uses electric current for heating layers of the skin. Both techniques are indicated for the treatment of skin laxity. Objective: The aim of this study was to compare the effects of CA and RF on human skin. Methods: After eight patients underwent abdominoplasty, each of them received a single treatment of CA and a single treatment of RF on the right and left infra-umbilical regions, respectively. In the infra-umbilical region, CA was performed on the right and RF was performed on the left side. Untreated skin was used as a control. The sample collection period lasted 120 days. CA was administered at a velocity of 40 mL/min, and the total quantity of CO₂ infused was approximately 20 mL. RF was carried out at a temperature higher than 40°C on the epidermis for 5 min. Results: CA and RF led to collagen remodeling; however, this result was more evident and lasted longer with RF. With CA an increase in elastic fibers was observed, whereas with RF no alteration was observed. Conclusion: Our results suggest that RF is more efficient than CA in stimulating collagen synthesis.     

The comparison of skin rejuvenation effects of vitamin A,fractional laser,and their combination on rat

Background: Because of long-term exposure of skin, skin aging is an unavoidable natural law with age. Traditional Vitamin A and novel ablative fractional laser technique both have the effects of skin rejuvenation, and studies have demonstrated both of them have apparent clinical efficacy and histology-improving effects on photo-aging skin. Materials and methods: 45 female healthy Wistar rats were selected and the depilation areas of every rat were divided into four regions: control region(Region A), Vitamin A acid region(Region B), combination treatment region(Region C), and fractional laser region(Region D). 0.025% Vitamin A acid cream was applied to Region B and C every day for 3 weeks; Region C and D were irradiated once with 10600nm CO₂ fractional laser on the first day of the trail. The skin tissue was dissected and placed into liquid nitrogen according to the design. The real-time quantitative PCR and western blotting methods were taken to detect the expression changes of miR-29a, Akt, TGF-β, and mRNA of type III pre-collagen. Results: It can be seen from the results of the real-time quantitative PCR that the mRNA expression levels of type III pre-collagen, Akt, and TGF-β in the treatment regions are up-regulated and the expression levels of miR-29a mRNA are down-regulated compared to the Region A. The hybridization tests showed that changes of the expression of type III pre-collagen, Akt gene, miR-29a gene, and TGF-β gene across the experiment regions are all significantly different in the third week, and the expression levels of them all achieve the highest value in the third week, the expression level of miR-29a gene achieves the lowest value in the third week, which are consistent with the results of real-time quantitative PCR. Conclusion: It is indicated that the combination region of Vitamin A acid and fractional laser may lead to low expression of miR-29a, thus the inhibition of downstream Akt activation is loss, Akt activation is enhanced, enhancement of the expression of TGF-β is induced, leading to proliferation of fibroblasts, and promotion of the collagen proteins’ synthesis in skin. Therefore miR-29a/Akt/TGF-β signal pathway may participate in the skin rejuvenation mechanism of action Vitamin A acid and fractional laser. This may provide a new treatment approach for skin rejuvenation.     

射频技术治疗面颈部皮肤皱纹和松弛的临床疗效观察

目的 评估射频技术治疗面颈部皮肤皱纹和松弛的疗效和安全性。 方法 30例皮肤老化志愿者，每2周使用AlumaTM FACES射频治疗仪治疗面颈部皮肤皱纹和松弛1次，共6次，分别在治疗前、治疗第4、6次时（即完成3次、5次治疗后）以及治疗结束后1个月对志愿者皮损的改善和满意度进行评价，并记录不良反应。结果 24例志愿者治疗3次后总有效率66.7%，5次后总有效率90.5%，停止治疗后1个月，总有效率94.4%。志愿者满意度评价：治疗3次后为50.0%, 5次后为90.5%，停止治疗后1个月为100%。治疗中主要不良反应为皮肤轻度紫癜。结论 射频技术治疗面颈部皮肤皱纹和松弛安全、有效。     

Histological evidence for skin rejuvenation using a combination of pneumatic energy,broadband light,and growth factor therapy

Abstract

Background and objective: A variety of laser or light-based devices have been developed for skin rejuvenation. This study evaluates the efficacy (at the microscopic level) of a combination of pneumatic energy, broadband light, and profusion tip-delivered epidermal growth factor (EGF). Methods: Healthy adult Japanese volunteers were recruited for this study. The posterior parts of the left and right arms were treated with a device that combines pneumatic energy and broadband light (Isolaz device). The left arms were also treated with EGF through a tip. Each subject received four treatments at 10-day intervals. Biopsy specimens obtained 3 weeks after the second treatment and 3 weeks after the fourth treatment were examined for histological study. Results: After two treatments, elastin fibers and fibroblasts in the dermal papillary layers of the left arms were increased compared to the right arms. A mean of 173.9 cells positive for proliferating cell nuclear antibody (PCNA) were observed on the left arm compared to 101.0 on the right arm. After the fourth treatment, angiogenesis and increased collagen fibers were observed in the dermal papillary layers of both arms. Conclusion: Four treatments with the addition of the profusion tip appear to hasten new collagen and elastin fiber formation, and the increase of PCNA positive cells so that dermal remodeling begins at an earlier stage than with the Isolaz alone.     

Stem cell and skin rejuvenation

Stem cell-based therapies have been widely used for their abilities to repair and regenerate different types of tissues and organs in cosmetic and plastic surgeries. It involves the clinical application of different types of stem cells. Different stem cells have been reported to be applicable in different areas of cosmetic surgeries like face lipoatrophy, skin rejuvenation, breast enhancement, and body contouring. However, adipose-derived stem cells remain the most widely used by cosmetic surgeons as they have the potential and capability to differentiate into mesenchymal, ectodermal, and endodermal lineages and are easily accessible to harvest. The purpose of this review is to summarize available applications of stem in cosmetic and plastic surgeries.     

Kinetics and tissue repair process following fractional bipolar radiofrequency treatment

Introduction: Fractionated radiofrequency (RF) tissue tightening is an alternative method to fractionated laser treatment of skin wrinkling, laxity and acne scars, with reduced risk of scarring or persistent pigmentation. The aim of this study was to evaluate and quantify the wound healing process after RF treatment.

Materials and methods: 12 patients were treated with a 64-pin fractional bipolar RF device with 60 mJ/pin applied energy. Confocal laser scanning microscopy (CLSM) examination was performed on day 1, day 2, day 7 and day 14 after treatment. Clinical wound healing process was measured and expressed as a percentage.

Results: All patients developed erythema, mild edema and crusts at the treated areas. Two weeks after treatment clinical symptoms resolved. During ablation patients reported moderate pain. Directly after ablation microscopic ablation zones could be detected in CLSM. Measurement of MAZ at epidermis, dermo–epidermal junction and papilary dermis showed a constant diameter until two weeks after treatment. Re-epithelization of the MAZ could be detected already 1 week after treatment. However, 2 weeks after ablation the honeycomb pattern of the epidermis was not yet completely restored.

Discussion: Bipolar fractionated RF treatment demonstrates clinically a rapid wound healing response. The subepidermal remodelling process still ongoing after 14 days, showing new granulation tissue. Therefore, treatment intervals of at least 14 days should be recommended to allow completion of the remodelling process.