Concomitant Use of Hyaluronic Acid and Laser in Facial Rejuvenation

An International Survey on the Use of a Polyrevitalizing Solution With or Without Other Aesthetic Procedures in the Daily Practice of Aesthetic Physicians

OBJECTIVE

NCTF135HA, a versatile polyrevitalizing solution, is a potent agent for enhancing skin quality, radiance, moisture, vitality, and diminishing fine wrinkles caused by aging factors. Data demonstrate a divergence in its application from skin quality enhancement to treatment of vitiligo lesions. To know more precisely about the protocol of use among providers, alone or in combination with other procedures, we performed an international survey.

METHOD

A Steering Committee of dermatologists, aesthetic surgeons, and physicians developed a 32-question questionnaire based on a literature review. Hosted online from January to March 2024, it targeted healthcare professionals experienced in polyrevitalization. Responses were analyzed anonymously and reported descriptively.

RESULTS

Practitioners adopt a balanced approach: half of their patients receiving classic Polyrevitalization (NCTF135HA alone) and the other half undergoing combination therapy (NCTF135HA with another aesthetic procedure). Most administer NCTF135HA across multiple sessions, typically three (39.7%). In combination therapy, 55.5% of practitioners use NCTF135HA for medical purposes, targeting Melasma (53.1%) and Rosacea (45.0%) for instance. Aesthetic use is prevalent, with 94.2% employing NCTF135HA for skin wrinkles (79.9%), and refreshment, rejuvenation, and hydration (73.4%). Combining NCTF135HA with hyaluronic acid (71.2%) and botulinum toxin (49.1%) is common, alongside microneedling (50.2%), peelings (32.4%), and fractional radiofrequency (25.6%).

LIMITATIONS AND CONCLUSION

Our survey showed a homogenous distribution of NCTF135HA utilization, indicating a consensus on its application across diverse demographics. This consistency highlights its widespread acknowledgment and efficacy in various aesthetic and clinical settings. Limitations include a large respondent group from Mexico and many respondents with less than 10 years of experience.

An 18-year comprehensive safety study on microfocused ultrasound and monopolar radiofrequency combined with cosmetic injectables in 1,040 patients

Microfocused ultrasound (MFU) and (MRF) are non-invasive modalities widely used for skin rejuvenation and are often combined with injectables, including neuromodulators and soft tissue fillers. However, large-scale, long-term safety data on such combination therapies are lacking. To address this gap, we conducted a retrospective chart review at two private practice dermatology clinics in South Korea from June 2005 to December 2023. A total of 1,040 patients were included, comprising 515 (49.5%) and 525 (50.5%) patients undergoing MFU and MRF, respectively. Regarding combination therapy, the patients received neuromodulators (76.9%) or dermal filler injections using hyaluronic acid (HA) (17.3%) or poly-L-lactic acid (PLLA) (5.8%) in conjunction with MFU/MRF. Documented adverse events included one case of paradoxical bulging and three cases of eyelid ptosis among those treated with MFU/MRF and neuromodulators (overall incidence: 0.1% and 0.4%, respectively), two cases of surface irregularity among those treated with MFU/MRF and HA fillers (overall incidence: 1.1%), and one case of cheek asymmetry among those treated with MFU/MRF and PLLA injections (overall incidence: 1.7%). No adverse events such as infection, necrosis, burn, filler migration, or unexpected premature loss of filler were reported. While limited by its retrospective design and the inclusion of only two dermatology clinics, which restricts the generalizability of the findings, our study highlights the favorable long-term safety profile of combining MFU and MRF with cosmetic injectables. Our study offers reassurance to clinicians and patients considering these approaches.

Efficacy of Topical Hydroxypinacolone Retinoate-Peptide Product Versus Fractional CO2 Laser in Facial Aging

BACKGROUND

Many people are interested in addressing visible signs of aging with non-invasive cosmetic treatments. Development of effective topical products will provide options to delay or support cosmetic procedures.

AIMS

This study assessed and compared the efficacy and tolerance of a topical product used over the course of 16 weeks to a single ablative laser treatment on women with moderate global photodamage on the face.

METHODS

Subjects in Cell 1 (Laser Cell) were treated over the entire face with a fractional CO2 laser system. Subjects in Cell 2 (Topical Serum Cell) were treated with a topical serum containing hydroxypinacolone retinoate and peptides over the entire face, twice per day for 16 weeks. The study was composed of 71 women, with 29 in the Laser Cell (mean age 56.2) and 42 in the Topical Serum Cell (mean age 55.0), between 40 and 65 years old. Expert grading was used to determine efficacy parameters.

RESULTS

Participants in the Topical Serum Cell achieved more significant improvement (p < 0.05) in Marionette lines, fine lines (global face), wrinkles (global face), wrinkles (crow's feet), nasolabial folds, texture, smoothness (tactile), global hyperpigmentation, lift, and photodamage compared to participants in the Laser Cell. Participants in the Topical Serum Cell achieved parity in the look of fine lines (crow's feet), forehead lines, glabella, firmness/bounce (tactile), skin tone evenness, radiance.

CONCLUSIONS

While no statistically significant differences in tolerability were observed, treatment with the topical cosmetic product achieved parity or statistically better improvement in parameters compared to laser treatment at 16 weeks.

A clinical study on the efficacy of high frequency therapy on nasolabial and periorbital wrinkles

The high-frequency generator is considered a collagen stimulator and skin revitalizer, however there are few studies exploring its effects in the field of rejuvenation and aesthetics. Thus, this study aimed to investigate the impact of high frequency generator therapy on facial aging. A total of 26 participants aged between 50 and 60 years were selected and received high frequency generator treatment for eight weeks. The evaluation was conducted using a combination of photographic records and assessment tools, including Rosenberg scale, perception and satisfaction with treatment evaluation, overall aesthetic improvement scale, and modified Fitzpatrick scale. The analysis conducted by the Global Aesthetic Improvement Scale yielded significant results. The Modified Fitzpatrick Wrinkle Scale showed that high frequency therapy led to statistically significant improvements in the appearance of nasolabial wrinkles (right T0: 1.48, T8: 0.87; left T0: 1.51, T8: 1.05) and periorbital wrinkles (right T0: 1.69, T8: 1.05; left T0: 1.71, T8: 1.08). In conclusion, high frequency generator therapy can be a highly effective tool for treating skin aging on the face, however, we recommend that future research includes control groups, and adopts objective measures to expand knowledge about the effects of high frequency.

Energy-based devices and hyaluronic acid filler, polymer filler, and threads: Cadaveric study

INTRODUCTION

The objective of this experiment was to investigate the thermal effects on hyaluronic acid fillers, PCL fillers, and PDO threads when exposed to controlled heat. This study aims to provide insights into how these materials respond to thermal energy, which is crucial for safe and effective cosmetic procedures involving combined modalities.

MATERIALS AND METHODS

Cadaveric tissue was utilized to simulate clinical conditions. Hyaluronic acid fillers were injected at approximately 1 mm and 5 mm thicknesses, with variations in G' value (high and low). PCL fillers were similarly injected in 1 mm and 5 mm thicknesses. PDO threads were also inserted. All materials were injected at a depth of 2 cm. A thermometer was used to measure heat penetration, and a multi-wavelength laser was applied to the tissue. The temperature was maintained at 60°C for 5 min to assess whether heat penetrated more than 3 cm in thickness. Observations were made regarding the heat distribution and any physical changes in the fillers and threads.

RESULTS

In thick layers, heat accumulated above the PCL filler without penetrating deeper layers. In thin layers, heat penetration was observed. For the HA fillers, heat energy was not blocked, regardless of the G' value or thickness. For the threads, no significant heat blockage effect was observed. For all materials, no visual changes were detected in any of the materials due to temperature exposure.

DISCUSSION

The findings suggest that the thickness and composition of fillers significantly influence heat penetration. Thick PCL fillers act as a thermal barrier, whereas thin PCL fillers allow deeper heat penetration. Hyaluronic acid fillers do not impede heat transfer, regardless of their physical properties. PDO threads do not exhibit any notable thermal resistance. These insights are essential for optimizing the safety and efficacy of combined filler and energy-based device treatments in esthetic medicine.

Combined multilevel anti-aging strategies and practical applications of dermocosmetics in aesthetic procedures

Management of the signs of facial aging and other cosmetic skin problems have greatly evolved in the past years. People are also seeking to improve their well-being and global skin appearance, and when they consider using cosmetic procedures, they expect natural and long-lasting aesthetic results. Combined dermocosmetic approaches that address the signs of facial aging at all levels are increasingly being used by dermatologists to meet patient expectations while ensuring their safety. Minimally invasive and reversible procedures that can be performed in only one session are popular approaches for skin restructuring and volumizing as they are flexible, rapid and less burdensome for patients. These interventions can achieve even better outcomes when they are combined with cosmeceuticals as pre- or post-procedural adjuvants to prepare the skin, accelerate recovery and sustain results. The use of topical dermocosmetics is also recommended as part of the daily skin care routine to improve skin quality and help maintain skin barrier function. This review thus outlines the most commonly used combined multilevel anti-aging strategies, which start by addressing the deepest skin layers and then the more superficial signs of skin aging. Examples of multi-active cosmeceuticals and skin delivery enhancing systems are also presented, together with examples of the use of dermocosmetics as supportive care for aesthetic procedures, to provide insights into current applications of dermocosmetic products.

Intradermal Treatment with a Hyaluronic Acid Complex Supplemented with Amino Acids and Antioxidant Vitamins Improves Cutaneous Hydration and Viscoelasticity in Healthy Subjects

Intradermal injection of bioactive compounds is used to reduce the effects of aging skin. The aim of this work is to study the response of facial injection of a hyaluronic acid complex supplemented with amino acids and antioxidant vitamins on skin rejuvenation. A total of 40 healthy adult subjects were recruited to whom this complex was injected into the facial skin, three consecutive times every two weeks. Together with assessing the degree of skin hydration, the level of skin microcirculation, wrinkles, skin color, and skin biomechanical parameters were evaluated. Using the GAIS scale, the degree of satisfaction of the participants was assessed. At 42 days (D42), there was an 11-12% increase in skin hydration and viscoelasticity, a 23% increase in skin density, a 27% increase in skin microcirculation, and a significant lightening and whitening of skin color, but without causing changes in skin wrinkles. A value between 1 and 3 on the GAIS scale was observed between 70 and 92% of the participants, and 87% of subjects found their skin more beautiful, 85% would recommend this treatment, and more than 50% found their face rejuvenated. In summary, the intradermal treatment tested suggests skin rejuvenation, with a good degree of safety.

Fat or fillers: The dilemma in eyelid surgery

The aging of the periocular region has always aroused great interest. A fresh, young, and attractive sight determined an ever-greater attention to surgical and non-surgical techniques to obtain this result. In particular, the change in the concept of a young look, considered then "full", led to the increasing use of surgical (fat grafting) or medical (hyaluronic acid) filling techniques. Eyelid rejuvenation became increasingly popular in the field of cosmetic treatments, with a focus on achieving a youthful and refreshed appearance. Among the various techniques available, the choice between using fat grafting or fillers presented a clinical dilemma. In particular, what surgery considered of fundamental importance was a long-lasting result over time. On the other hand, aesthetic medicine considered it fundamental not to have to resort to invasive treatments. But what was the reality? Was there one path better than the other, and above all, was there a better path for patients? The minireview aims to explore the physiopathology, diagnosis, treatment options, prognosis, and future studies regarding this dilemma. We analyzed the literature produced in the last 20 years comparing the two techniques. Current literature reveals advancements in biomaterials, stem cell research and tissue engineering held promise for further enhancing the field of eyelid rejuvenation. The choice between fat grafting and fillers in eyelid cosmetic treatments presented a clinical dilemma. Understanding physiopathology, accurately diagnosing eyelid aging, exploring treatment options, assessing prognosis, and conducting future studies were essential for providing optimal care to patients seeking eyelid rejuvenation.

The effect of combined hyaluronic acid filler injection and radiofrequency treatment: A clinic histological analysis

BACKGROUND

Hyaluronic acid (HA) filler injections have increased in popularity. They are usually performed in combination with other treatment modalities, including lasers and energy-based devices, to enhance cosmetic results. Theoretically, HA and other filler injections should be performed after laser- or energy-based device treatments. In some instances, however, practitioners are asked to administer laser- or energy-based device treatment after HA dermal filler injection. There is a concerning possibility of HA filler degradation as a result of bulk heating generated by lasers or energy-based devices, especially radiofrequency (RF).

AIM

To evaluate the effect of RF treatment at different time points on HA degradation in vivo, using clinicohistological analysis.

PATIENTS/METHODS

Fourteen volunteers were recruited and received intradermal HA filler injections in four sites on the abdomen. One site served as the control, and the other three sites were treated with monopolar RF on the same day after injection, at 14 and 28 days post-injection. Skin biopsies were performed at baseline and 56 days after HA injection. Histopathological sections were reviewed for residual filler in the tissue.

RESULTS

The results showed that HA grading scores decreased in five (35.71%), one (7.14%), and one (7.14%) participants when RF was performed immediately, 14 and 28 days after injection, respectively.

CONCLUSION

In conclusion, RF treatment after HA filler injection may affect the integrity of the HA filler in the tissue, especially if RF treatment was performed on the same day after HA injection.

Intradermally delivered mRNA-encapsulating extracellular vesicles for collagen-replacement therapy

The success of messenger RNA therapeutics largely depends on the availability of delivery systems that enable the safe, effective and stable translation of genetic material into functional proteins. Here we show that extracellular vesicles (EVs) produced via cellular nanoporation from human dermal fibroblasts, and encapsulating mRNA encoding for extracellular-matrix α1 type-I collagen (COL1A1) induced the formation of collagen-protein grafts and reduced wrinkle formation in the collagen-depleted dermal tissue of mice with photoaged skin. We also show that the intradermal delivery of the mRNA-loaded EVs via a microneedle array led to the prolonged and more uniform synthesis and replacement of collagen in the dermis of the animals. The intradermal delivery of EV-based COL1A1 mRNA may make for an effective protein-replacement therapy for the treatment of photoaged skin.

Current regenerative medicine-based approaches for skin regeneration: A review of literature and a report on clinical applications in Japan

Current trends indicate a growing interest among healthcare specialists and the public in the use of regenerative medicine-based approaches for skin regeneration. The approaches are categorised in either cell-based or cell-free therapies and are reportedly safe and effective. Cell-based therapies include mesenchymal stem cells (MSCs), tissue induced pluripotent stem cells (iPSCs), fibroblast-based products, and blood-derived therapies, such as those employing platelet-rich plasma (PRP) products. Cell-free therapies primarily involve the use of MSC-derived extracellular vesicles/exosomes. MSCs are isolated from various tissues, such as fat, bone marrow, umbilical cord, menstrual blood, and foetal skin, and expanded ex vivo before transplantation. In cell-free therapies, MSC exosomes, MSC-derived cultured media, and MSC-derived extracellular vesicles are collected from MSC-conditioned media or supernatant. In this review, a literature search of the Cochrane Library, MEDLINE (PubMed), EMBASE, and Scopus was conducted using several combinations of terms, such as ‘stem’, ‘cell’, ‘aging’, ‘wrinkles’, ‘nasolabial folds’, ‘therapy’, ‘mesenchymal stem cells’, and ‘skin’, to identify relevant articles providing a comprehensive update on the different regenerative medicine-based therapies and their application to skin regeneration. In addition, the regulatory perspectives on the clinical application of some of these therapies in Japan are highlighted.

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The use of regenerative medicine-based therapy for skin rejuvenation is expanding.

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Therapies can be categorised as either cell-based or cell-free therapies.

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MSCs can be isolated from various tissues for cosmetic applications.

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MSC-derived exosomes increase skin cell proliferation and migration.

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In Japan, most cell-based treatments carry class II/III regenerative medicine risks.

Facial Rejuvenation in Indonesian Skin With a Picosecond 755-nm Laser

Introduction: The aging process in the skin naturally happens over time, affected by several factors, of which ultraviolet irradiation is a major factor, and this leads to the appearance of wrinkles, pigmentations, and textural irregularities. Lasers for facial rejuvenation are very popular in Asian patients, but melanin rick skin types like Asians are more susceptible to pigmentary alterations. Most Indonesians have brown skin, and just a few have light skin. The purpose of this study was to know the efficacy and safety of the picosecond 755 nm laser in facial rejuvenation in Indonesian skin. Methods: This is an analysis of 20 healthy patients with Fitzpatrick skin type III-V with facial photoaging from 36 to 55 years. Examinations were evaluated before therapy and 4 weeks after the second therapy. The front and side of both cheeks were photographed and analyzed by using VISIA. Clinical improvement was categorized as excellent-mild. The patients were also asked and examined about the presence of adverse events. Results: The patients were predominantly female with an average age of 44 years. Sixty percent of the patients had a good improvement and 40% of the patients had a moderate improvement. The VISIA analysis showed a significant improvement in wrinkles, pigments, and textures (P < 0.001). Only mild anticipated adverse events were observed, and there was no post-inflammatory hyperpigmentation or hypopigmentation. Conclusion: the picosecond 755 nm laser is effective and safe for facial rejuvenation in the skin of Indonesian patients without significant adverse events.

Benefit of Hyaluronic Acid to Treat Facial Aging in Completely Edentulous Patients

Hyaluronic acid (HA) is widely used in aesthetic medicine for its moisturizing and anti-aging action. This molecule, which is naturally present in the body, has an interesting response to aging, accentuated in totally edentulous patients. While its aesthetic benefits for facial rejuvenation are well-documented, there is a lack of description and investigation on its therapeutic usefulness for edentulous patients. The management of completely edentulous patients is a daily reality in dental practice and requires specific attention. The aesthetic and functional challenge is considerable. The displacement of the bone base, which is often marked, and lack of soft tissue support are sometimes difficult to correct with prosthetic reconstruction. This review aims to present the physiological processes appearing in completely edentulous patients and prosthetic solutions available to recreate oral functions and counteract facial aging. As prosthetic rehabilitations are not fully satisfying for counterbalancing the impression of excessive facial aging, we investigated the applications of HA injection in the perioral area, in order to improve edentulism treatment, and discussed the advantages and disadvantages, compared to other dermal fillers and rejuvenation therapies. Considering the specific situations of edentulous patients, dermal HA injections help to correct uncompensated bone losses and mucous volume losses and appear to be a therapeutically beneficial for treating completely edentulous patients, without the requirement to full rejuvenation therapy.

Effectiveness of High-Intensity Laser Therapy Plus Ultrasound-Guided Peritendinous Hyaluronic Acid Compared to Therapeutic Exercise for Patients with Lateral Elbow Tendinopathy

Lateral elbow tendinopathy (LET) is a common painful musculoskeletal disorder. Several treatments have been proposed to provide pain reduction and functional recovery, including laser therapy, hyaluronic acid peritendinous injection (Hy-A), and therapeutic exercise (TE). Our study aims to assess the effectiveness of a combined approach with high-intensity laser therapy (HILT) and Hy-A injections compared to TE on pain, muscle strength, and disability in patients with painful LET. A retrospective longitudinal study was carried out by consulting the medical records of patients with a diagnosis of painful LET formulated by clinical and instrumental findings that received functional evaluations, including the Patient-Rated Tennis Elbow Evaluation (PRTEE) and muscle strength measurement at least four times: T0 (“baseline”), 1-month (T1), 3-month (T2), and 6-month follow-ups (T3). Medical records of 80 patients were analyzed. In the HILT + HyA group, the Peak-strength (p < 0.001) and mean strength (p < 0.001) significantly increased compared to the TE group between study times. For the PRTEE-total-score as for the subscales, the HILT + HyA group reported statistically significant reductions only for the comparisons of baseline versus T1 and baseline versus T2. No serious adverse events occurred. Our findings suggest that Hy-A associated with HILT might be more effective than TE for people with LET in the short−medium term.

Hybrid fractional laser treatment for photodamaged facial skin rejuvenation 6 years following fractional CO2 : Comparison of clinical outcome and patients' satisfaction

OBJECTIVES

Fractional carbon dioxide (CO₂ ) laser resurfacing is considered an effective treatment for skin rejuvenation. The request for clinical effectiveness with shorter downtime has led to the development of new hybrid technologies, including a traditional Er:YAG (erbium-doped yttrium aluminium garnet) fractional laser 2940 nm combined with a simultaneous nonablative 1470 nm wavelength. The aim of this study is to compare clinical outcomes and patients' satisfaction with face resurfacing performed with both the CO₂  laser and the hybrid laser.

METHODS

Nineteen women underwent ultrapulsed CO₂ fractional resurfacing for photodamaged facial skin; the same patients underwent the hybrid laser after almost 6 years. Clinical outcomes and patients' satisfaction were evaluated 6 months after the treatment and compared between the two technologies.

RESULTS

After both CO₂ and hybrid treatment a significant improvement was found in terms of fine lines (p < 0.001 and p = 0.004, respectively), tactile roughness (p < 0.001 and p = 0.002, respectively), and mottled pigmentation (both p < 0.001). Healing times and complications were greater with the CO₂ laser. Comparing the two technologies, patients showed better results with the CO₂ laser for each score's item, but greater satisfaction with the hybrid laser (p = 0.012).

CONCLUSIONS

The present study confirms CO₂ laser as the most effective treatment; however, the new hybrid technology revealed good results associated with faster healing and less discomfort.

Use of Cosmetic Facial Injectables After Facial Aesthetic Surgery

BACKGROUND

Over the last two decades, both invasive and minimally-invasive aesthetic procedures have proliferated. Aesthetic surgeons often recommend injectable treatments after cosmetic facial surgery for multiple reasons. Yet, literature is lacking on how cosmetic surgery affects post-operative facial injectable use.

OBJECTIVES

The authors aim to identify predictors of facial injectable use after cosmetic facial surgery.

METHODS

All adult patients operated on by a single surgeon between 2013 and 2021 were retrospectively reviewed. Patients who had any of the following cosmetic facial surgeries were included: rhytidectomy, blepharoplasty, rhinoplasty, or genioplasty. Patient demographics, clinical history, intraoperative factors, and use of cosmetic facial injectables (neurotoxin, facial fillers, deoxycholic acid, poly-L-lactic acid) were recorded.

RESULTS

A total of 227 patients who underwent facial cosmetic surgery were reviewed, of which 158 were included. 89 patients had rhytidectomy (56.3%), 112 had blepharoplasty (70.9%), 28 had rhinoplasty (17.7%), and 7 had genioplasty (4.4%). 44.3% patients received injectables after their surgery (n=73), compared to only 17.7% before surgery (n=28) (p<0.001). The most common post-operative injectables were neurotoxins (48.5%) and facial fillers (46.0%), followed by deoxycholic acid (2.7%) and poly-L-lactic acid (2.7%). Multivariate regression revealed factors positively correlated with future injectable use were index blepharoplasty or rhinoplasty, and history of pre-operative neurotoxin injection (p<0.05).

CONCLUSIONS

Cosmetic facial injectables are an important consideration in achieving and maintaining optimal facial aesthetics. Their use, especially neurotoxins and facial fillers, increases among patients post-operatively. These results highlight the contribution of injectable procedures in the context of multidimensional care for augmenting facial aesthetics.

Hyaluronic Acid: Known for Almost a Century, but Still in Vogue

Hyaluronic acid (HA) has a special position among glycosaminoglycans. As a major component of the extracellular matrix (ECM). This simple, unbranched polysaccharide is involved in the regulation of various biological cell processes, whether under physiological conditions or in cases of cell damage. This review summarizes the history of this molecule's study, its distinctive metabolic pathway in the body, its unique properties, and current information regarding its interaction partners. Our main goal, however, is to intensively investigate whether this relatively simple polymer may find applications in protecting against ionizing radiation (IR) or for therapy in cases of radiation-induced damage. After exposure to IR, acute and belated damage develops in each tissue depending upon the dose received and the cellular composition of a given organ. A common feature of all organ damage is a distinct change in composition and structure of the ECM. In particular, the important role of HA was shown in lung tissue and the variability of this flexible molecule in the complex mechanism of radiation-induced lung injuries. Moreover, HA is also involved in intermediating cell behavior during morphogenesis and in tissue repair during inflammation, injury, and would healing. The possibility of using the HA polymer to affect or treat radiation tissue damage may point to the missing gaps in the responsible mechanisms in the onset of this disease. Therefore, in this article, we will also focus on obtaining answers from current knowledge and the results of studies as to whether hyaluronic acid can also find application in radiation science.

Ultrapulsed CO2 Resurfacing of Photodamaged Facial Skin in Vegan and Omnivore Patients: A Multicentric Study

BACKGROUND AND OBJECTIVES

Skin photoaging is related to extrinsic environmental exposures, mainly represented by ultraviolet radiation. One of the treatment options is laser resurfacing. As nutritional status is involved in cutaneous photodamage, we evaluated whether dietary patterns can also influence the response to facial resurfacing. Our prospective multicentric study involves three dermatologic centers specialized in laser therapy in northern Italy. The study aims to compare the outcome of a CO₂ ablative laser therapy between omnivore and vegan patients.

STUDY DESIGN/MATERIALS AND METHODS

Fifty-three omnivore and fifty-three vegan women undergoing ultrapulsed CO₂ resurfacing for photodamaged facial skin were enrolled in this study. Clinical improvement was evaluated 3 and 6 months after the treatment using the modified Dover score.

RESULTS

After laser treatment, vegans showed slower complete re-epithelialization (P < 0.001*) and disappearance of the erythema (P < 0.001*). After 3 and 6 months, vegans showed worse outcomes in terms of fine lines (P < 0.001* and P < 0.001*, respectively) and tactile roughness (P = 0.003* and ​​​​P = 0.002*, respectively) compared with omnivores, while they did not differ in mottled pigmentation.

CONCLUSIONS

The present study suggests that diet influences the clinical outcome of fractioned CO₂ laser treatment. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.