1
|
Nourmohammadpour P, Ehsani AH, Hatami P, Aref S, Aryanian Z, Goodarzi A. Striae gravidarum treatment: evaluating non-ablating fractional laser (NAFL) efficacy and safety. J COSMET LASER THER 2023; 25:20-24. [PMID: 37309187 DOI: 10.1080/14764172.2023.2221837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 07/17/2021] [Accepted: 06/01/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Striae gravidarum (SG) is a common pregnancy-related dermatologic problem, for which finding an effective treatment remains a challenge. AIM To evaluate the safety and efficacy of 1540 nm non-ablative fractional laser (Star lux 500) in the treatment of SG in Iranian women and peruse the relationship between clinical improvement rate and patient characteristics as well as clinical features of striae. METHOD A prospective before-after study was conducted on 50 patients with SG who received three monthly sessions of 1540 nm non-ablative fractional laser and were followed for 2 months after the last treatment session. Clinical changes were measured using both provider-rated outcome through before/after pictures represented by final clinical score (from 0 to 5) and patient-reported outcome (patient global assessment or PGA). RESULTS Over the course of the study both final clinical score and PGA increased significantly from week 4 to week 20 (P value: <0.001 and 0.048, respectively). Only modest adverse effects including erythema, edema and hyperpigmentation were noted. CONCLUSION In conclusion, patients with SG of different type (rubra/alba) or maturity may somehow benefit from treatment with NAFL experiencing minimal transient side effects.Therefore, NAFL may be considered a safe and partially effective treatment option for stretch mark of patients with SG.
Collapse
Affiliation(s)
- Pedram Nourmohammadpour
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Dermatology, School of Medicine Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Houshang Ehsani
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Dermatology, School of Medicine Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Aref
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Dermatology, Babol University of Medical Sciences, Babol, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, School of Medicine, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
2
|
Chandan N, Puyana C, Haber R. Combination Approaches to Hand Rejuvenation: A Review of the Literature and Discussion. Dermatol Surg 2023; 49:164-170. [PMID: 36728067 DOI: 10.1097/dss.0000000000003673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Various noninvasive/minimally invasive modalities for hand rejuvenation exist, and the efficacy and safety of these procedures as both monotherapy and same-day procedures is increasingly being studied. OBJECTIVE To review data on the efficacy and safety of hand rejuvenation modalities and suggest a practical combination approach for these procedures. METHODS The PubMed database was queried for peer-reviewed articles regarding hand rejuvenation techniques, including chemical peels, laser and light sources, sclerotherapy, autologous fat transfer, and injectable volumetric fillers. RESULTS Chemical peels have been studied the least, with most studies evaluating the use of fillers and laser/light-based devices. Most studies reported overall good results with high patient satisfaction. Satisfaction rates were lower in laser/light-based treatments compared with other modalities. Transient erythema, edema, or pain after procedures was common; most studies did not report serious postprocedure complications. Importantly, there was no significant increase in adverse effects after same-day procedures. CONCLUSION Using same-day procedures allows practitioners to address hand rejuvenation from different aspects, seems to improve outcomes, and reduces time spent in the office for patients. The authors suggest a practical framework for combining cosmetic approaches to achieve the most optimal outcome for hand rejuvenation.
Collapse
Affiliation(s)
- Neha Chandan
- All authors are affiliated with the Department of Dermatology, University of Illinois at Chicago, Chicago, Illinois
| | | | | |
Collapse
|
3
|
Wamsley CE, Vingan N, Barillas J, Culver A, Turer DM, Kenkel JM. A Single-Center Pilot Study to Classify Signs of Dorsal Hand Aging Using 3 Grading Scales. Aesthet Surg J Open Forum 2022; 4:ojab059. [PMID: 35211668 PMCID: PMC8862723 DOI: 10.1093/asjof/ojab059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background While validated scales must be created in order to systemically evaluate patients and quantify outcomes of aesthetic hand treatments, scales currently available are limited to the analysis of volume loss alone. Objectives The purpose of this study was to develop 3 validated scales for the assessment of dorsal hand aging that also take into consideration wrinkling and pigmentation. Methods Fifty (50) healthy volunteers (40 females and 10 males) with Fitzpatrick skin types I-IV were recruited, and standard photographs of their left and right dorsal hands were taken with a Nikon D7100 (Nikon; Minato, Tokyo, Japan) camera. Using 25 randomized photographs, 11 plastic surgery physicians (3 chief residents, 6 senior residents, and 2 aesthetic surgery fellows) were trained on the 3 scales under investigation as well as the already-validated Merz Hand Grading Scale (MHGS). The evaluators then viewed the remaining 75 photographs independently and assigned a grade for each of the 4 scales to each photograph. Inter-rater variability was calculated for each scale. Results The Kappa score for the MHGS was 0.25, indicating fair agreement; 0.40 for wrinkle scale, indicating fair agreement; and 0.48 and 0.46 for the pigmentation density and intensity scales, respectively, indicating moderate agreement (P < 0.001). Conclusions The results show that after receiving training, the inter-rater agreement for the 3 scales under investigation was similar or slightly higher than that for the MHGS. These 3 photographic classification systems can be used consistently and reliably to characterize multiple signs of dorsal hand aging. Level of Evidence: 2
Collapse
Affiliation(s)
- Christine E Wamsley
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Nicole Vingan
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Jennifer Barillas
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Abby Culver
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - David M Turer
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Jeffrey M Kenkel
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
4
|
Modified Jessner's Solution Combined With Trichloroacetic Acid 20% Versus Glycolic Acid 70% Combined With Trichloroacetic Acid 20% in the Treatment of Melasma. Dermatol Surg 2021; 47:e179-e183. [PMID: 33625140 DOI: 10.1097/dss.0000000000002964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Melasma is an acquired challenging pigmentary skin problem, which commonly affects the face. A wide range of therapeutic modalities is available, yet none is satisfactory. OBJECTIVE To compare efficacy and safety of trichloroacetic acid (TCA) 20% peeling with either modified Jessner's solution (MJs) or with glycolic acid (GA) 70% peeling in the treatment of melasma. PATIENTS AND METHODS Thirty adult Egyptian women with melasma were recruited in the study. After cleansing the face, MJs was applied on one side of the face and GA 70% on the other side. Then, TCA 20% was applied in one uniform coat on both sides of the face. Assessment of the clinical response was guided by calculating the melasma area, severity index (MASI), modified MASI, and hemi-MASI scores before and after the end of treatment. RESULTS Both combinations showed significant reduction in MASI, modified MASI, and hemi-MASI scores (p value = .000, for each). Moreover, the hemi-MASI score after MJs and TCA20% showed a significant decrease compared with GA70% and TCA20% (p value = .013). CONCLUSION Both modalities are successful, safe options for treating melasma. Moreover, combining MJs with TCA 20% is more efficacious.
Collapse
|
5
|
Yu Y, Wu H, Yin H, Lu Q. Striae gravidarum and different modalities of therapy: a review and update. J DERMATOL TREAT 2020; 33:1243-1251. [PMID: 33003983 DOI: 10.1080/09546634.2020.1825614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The term striae gravidarum (SG) refers to a kind of striae distensae (SD) that develops particularly during pregnancy. According to the level of maturity of the lesions, SG is divided into striae rubra (SR) and striae alba (SA). The pathogenesis remains unclear; recent studies have implicated abnormalities in elastic fibers, collagen fibrils, and other extracellular matrix (ECM) components. Changes in the expression of hormone receptors and hormone levels have also been hypothesized. Considering this new information, we reviewed successful treatments of SG and listed them in two tables. Our review found that topical treatments were relatively weak compared with laser and light treatment, with which the appearance of SR and SA can be significantly improved. Lasers combined with other modalities, such as additional energy devices and topical agents, were also proven effective, but more large-scale trials are necessary.
Collapse
Affiliation(s)
- Yangyiyi Yu
- Department of Dermatology, Second Xiangya Hospital, Central South University, Hunan Key Laboratory of Medical Epigenomics, Changsha, PR China
| | - Haijing Wu
- Department of Dermatology, Second Xiangya Hospital, Central South University, Hunan Key Laboratory of Medical Epigenomics, Changsha, PR China
| | - Heng Yin
- Department of Dermatology, Second Xiangya Hospital, Central South University, Hunan Key Laboratory of Medical Epigenomics, Changsha, PR China
| | - Qianjin Lu
- Department of Dermatology, Second Xiangya Hospital, Central South University, Hunan Key Laboratory of Medical Epigenomics, Changsha, PR China
| |
Collapse
|
6
|
Comparative Efficacy of a 35% Glycolic Acid Peel Alone or in Combination With a 10% and 20% Trichloroacetic Acid Spot Peel for Melasma: A Randomized Control Trial. Dermatol Surg 2019; 45:1394-1400. [DOI: 10.1097/dss.0000000000001964] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
7
|
|
8
|
Abstract
BACKGROUND Chemical peels are a mainstay of aesthetic medicine and an increasingly popular cosmetic procedure performed in men. OBJECTIVE To review the indications for chemical peels with an emphasis on performing this procedure in male patients. MATERIALS AND METHODS Review of the English PubMed/MEDLINE literature and specialty texts in cosmetic dermatology, oculoplastic, and facial aesthetic surgery regarding sex-specific use of chemical peels in men. RESULTS Conditions treated successfully with chemical peels in men include acne vulgaris, acne scarring, rosacea, keratosis pilaris, melasma, actinic keratosis, photodamage, resurfacing of surgical reconstruction scars, and periorbital rejuvenation. Chemical peels are commonly combined with other nonsurgical cosmetic procedures to optimize results. Male patients may require a greater number of treatments or higher concentration of peeling agent due to increased sebaceous quality of skin and hair follicle density. CONCLUSION Chemical peels are a cost-effective and reliable treatment for a variety of aesthetic and medical skin conditions. Given the increasing demand for noninvasive cosmetic procedures among men, dermatologists should have an understanding of chemical peel applications and techniques to address the concerns of male patients.
Collapse
|
9
|
Striae Distensae: Preventative and Therapeutic Modalities to Improve Aesthetic Appearance. Dermatol Surg 2017; 43:635-648. [DOI: 10.1097/dss.0000000000001079] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
10
|
Holzer G, Pinkowicz A, Radakovic S, Schmidt J, Tanew A. Randomized controlled trial comparing 35% trichloroacetic acid peel and 5-aminolaevulinic acid photodynamic therapy for treating multiple actinic keratosis. Br J Dermatol 2017; 176:1155-1161. [DOI: 10.1111/bjd.15272] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2016] [Indexed: 12/17/2022]
Affiliation(s)
- G. Holzer
- Department of Dermatology; Medical University of Vienna; Vienna, SMZ Ost, 122, Langobardenstrasse 1220 Vienna Austria
- Department of Dermatology; Donauspital; SMZ Ost Vienna Vienna Austria
- Medical Research Society Vienna DC; Vienna Austria
| | - A. Pinkowicz
- Department of Dermatology; Medical University of Vienna; Vienna, SMZ Ost, 122, Langobardenstrasse 1220 Vienna Austria
| | - S. Radakovic
- Department of Dermatology; Medical University of Vienna; Vienna, SMZ Ost, 122, Langobardenstrasse 1220 Vienna Austria
| | - J.B. Schmidt
- Department of Dermatology; Medical University of Vienna; Vienna, SMZ Ost, 122, Langobardenstrasse 1220 Vienna Austria
| | - A. Tanew
- Department of Dermatology; Medical University of Vienna; Vienna, SMZ Ost, 122, Langobardenstrasse 1220 Vienna Austria
| |
Collapse
|
11
|
|
12
|
|
13
|
Abstract
BACKGROUND Patients increasingly seek to enhance the appearance of their legs. Elimination of unwanted leg veins, reduction of epidermal photo-aging changes such as solar lentigines and keratoses, tightening of skin laxity and reduction of adipose tissue are among the most commonly requested goals. Many patients require a combination approach to address their concerns. It is important for dermatologists to be aware of the multitude of procedures that can be performed, often in combination, to rejuvenate the leg. OBJECTIVE The purpose of this review article was to discuss procedures for improving the appearance of the leg and to share the authors experience, especially in the combination approach to leg rejuvenation. METHODS A literature search was performed to investigate cosmetic procedures being performed on the leg, with an emphasis on controlled or randomized studies. In addition, the authors contributed their personal experience. RESULTS Our discussion of the literature review highlights the treatments for leg veins, unwanted fat, cellulite, and photodamage of the legs that are most supported in peer-reviewed publications. CONCLUSION A synergistic, combination approach to leg rejuvenation works best. This includes the use of injectable agents, energy-based devices, and more invasive surgical procedures.
Collapse
|
14
|
Evaluation of 70% glycolic peels versus 15% trichloroacetic peels for the treatment of photodamaged facial skin in aging women. Dermatol Surg 2014; 40:883-91. [PMID: 25068547 DOI: 10.1097/01.dss.0000452669.84787.bf] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chronic solar irradiation results in both morphological and functional changes in affected skin. Superficial peels have been shown to improve all symptoms of photodamaged skin. OBJECTIVE This study was designed to compare the efficacy and tolerability of glycolic acid (GA, 70%) with trichloroacetic acid (TCA, 15%) for the treatment of photoaging. MATERIALS AND METHODS Twenty female patients affected by photodamage were treated with graded concentrations of 70% GA and 15% TCA peel. Each patient was submitted to 5 sessions of these peels, with an interval of 14 days between each session. Four clinical parameters of surface evaluation of the living skin (hydration, elasticity, melanin, and erythema) were measured. The records were made before each treatment and 3 months after the last application. RESULTS The statistical significance in each group of patients was observed with elasticity and hydration. Decrease in melanin content in the skin occurred significantly after the application of a series of treatments with GA. Increase in severity of erythema showed statistical significance after the treatment with TCA. CONCLUSION Superficial peels, such as 70% GA and 15% TCA, proved to be an effective treatment modality for photodamaged facial skin. Both acids contribute to improvement of the photodamaged skin's parameters. Glycolic acid increases skin's hydration faster.
Collapse
|
15
|
Puri N. Comparative study of 15% TCA peel versus 35% glycolic acid peel for the treatment of melasma. Indian Dermatol Online J 2012; 3:109-13. [PMID: 23130283 PMCID: PMC3481880 DOI: 10.4103/2229-5178.96702] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Chemical peels are the mainstay of a cosmetic practitioner's armamentarium because they can be used to treat some skin disorders and can provide aesthetic benefit. OBJECTIVES To compare 15% TCA peel and 35% glycolic acid peel for the treatment of melasma. MATERIAL AND METHODS We selected 30 participants of melasma aged between 20 and 50 years from the dermatology outpatient department and treated equal numbers with 15% TCA and 35% glycolic acid. RESULTS Subjective response as graded by the patient showed good or very good response in 70% participants in the glycolic acid group and 64% in the TCA group. CONCLUSIONS There was statistically insignificant difference in the efficacy between the two groups for the treatment of melasma.
Collapse
Affiliation(s)
- Neerja Puri
- Punjab Health Systems Corporation, Punjab, India
| |
Collapse
|
16
|
Abstract
BACKGROUND The aged hand is characterized by cutaneous and dermal atrophy, with deep intermetacarpal spaces, prominent bones and tendons, and bulging reticular veins. Epidermal changes include solar lentigines, seborrheic keratoses, actinic keratoses, skin laxity, rhytides, tactile roughness, and telangiectasia. STUDY DESIGN A Medline search was performed on hand rejuvenation from 1989 to 2011, and results are summarized. Practical applications of these procedures are also discussed. RESULTS Reports of injectable hyaluronic acid, calcium hydroxylapatite, poly-L-lactic acid, autologous fat transfer, vein treatment, and chemical peels, along with lasers and light sources such as Q-switched laser, intense pulsed light, photodynamic therapy, nonablative resurfacing lasers, and ablative resurfacing lasers, in the rejuvenation of hands were found. CONCLUSION Review of the literature revealed options for minimally invasive treatment for rejuvenation of the skin and volume restoration of the dorsal hand. These treatments include injectables and fat transfer for volume restoration; sclerotherapy or vein ablation for dorsal hand vein treatment; and chemical peels, lasers, light, and energies for the treatment of epidermal and dermal changes.
Collapse
Affiliation(s)
- Sabrina G Fabi
- Goldman, Butterwick, Fitzpatrick, and Groff Cosmetic Laser Dermatology, San Diego, CA 92121, USA.
| | | |
Collapse
|
17
|
Safoury OS, Zaki NM, El Nabarawy EA, Farag EA. A study comparing chemical peeling using modified Jessner's solution and 15% trichloroacetic Acid versus 15% trichloroacetic acid in the treatment of melasma. Indian J Dermatol 2010; 54:41-5. [PMID: 20049268 PMCID: PMC2800869 DOI: 10.4103/0019-5154.48985] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Melasma is a symmetric progressive hyperpigmentation of the facial skin that occurs in all races but has a predilection for darker skin phenotypes. Depigmenting agents, laser and chemical peeling as classic Jessner's solution, modified Jessner's solution and trichloroacetic acid have been used alone and in combination in the treatment of melasma. Objectives: The aim of the study was to compare the therapeutic effect of combined 15% Trichloroacetic acid (TCA) and modified Jessner's solution with 15% TCA on melasma. Materials and Methods: Twenty married females with melasma (epidermal type), with a mean age of 38.25 years, were included in this study. All were of skin type III or IV. Fifteen percent TCA was applied to the whole face, with the exception of the left malar area to which combined TCA 15% and modified Jessner's solution was applied. Results: Our results revealed statistically highly significant difference between MASI Score (Melasma Area and Severity Index) between the right malar area and the left malar area. Conclusion: Modified Jessner's solution proved to be useful as an adjuvant treatment with TCA in the treatment of melasma, improving the results and minimizing postinflammatory hyperpigmentation.
Collapse
|
18
|
Jarmelo S, Reva ID, Lapinski L, Nowak MJ, Fausto R. Matrix-Isolated Diglycolic Anhydride: Vibrational Spectra and Photochemical Reactivity. J Phys Chem A 2008; 112:11178-89. [DOI: 10.1021/jp805603b] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S. Jarmelo
- Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal, and Institute of Physics, Polish Academy of Sciences, Al. Lotnikow 32/46, 02-668 Warsaw, Poland
| | - I. D. Reva
- Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal, and Institute of Physics, Polish Academy of Sciences, Al. Lotnikow 32/46, 02-668 Warsaw, Poland
| | - L. Lapinski
- Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal, and Institute of Physics, Polish Academy of Sciences, Al. Lotnikow 32/46, 02-668 Warsaw, Poland
| | - M. J. Nowak
- Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal, and Institute of Physics, Polish Academy of Sciences, Al. Lotnikow 32/46, 02-668 Warsaw, Poland
| | - R. Fausto
- Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal, and Institute of Physics, Polish Academy of Sciences, Al. Lotnikow 32/46, 02-668 Warsaw, Poland
| |
Collapse
|
19
|
Abstract
BACKGROUND The aging of the hands is typically characterized by wrinkles, skin thinning, and solar lentigines. The search for effective treatments has led to the use of laser and intense pulsed light (IPL) technologies. OBJECTIVE To assess the effectiveness of an IPL device for the improvement of dyspigmentation and overall skin quality on the dorsa of the hands. METHODS Twenty-three patients with sun damage and solar lentigines on the dorsal hands were treated with four IPL sessions at 3- to 4-week intervals. Prior to treatment, photographs were taken and informed consent was obtained. Pre- and post-treatment photography and investigator clinical assessment and patient questionnaires were collected for data analysis. RESULTS After four treatment sessions, good to excellent results in the improvement in solar lentigines and skin quality were assessed by investigators in 100% of the cases and in 86.94% (20 of 23 subjects) by patient self-assessments. No significant side effects were observed. CONCLUSION IPL is an effective and safe treatment option to improve solar lentigines and skin texture for hand rejuvenation.
Collapse
Affiliation(s)
- Alberto Goldman
- Department of Dermatology, Laser and Plastic Surgery, Clinica Goldman, Porto Alegre, RS, Brazil.
| | | | | |
Collapse
|
20
|
Kouba DJ, Dasgeb B, Deng AC, Gaspari AA. Effective treatment of persistent Grover's disease with trichloroacetic acid peeling. Dermatol Surg 2006; 32:1083-8; discussion 1088. [PMID: 16918573 DOI: 10.1111/j.1524-4725.2006.32233.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- David J Kouba
- Department of Dermatology, University of Maryand School of Medicine, Baltimore, Maryland 21201, USA
| | | | | | | |
Collapse
|
21
|
Effective Treatment of Persistent Groverʼs Disease with Trichloroacetic Acid Peeling. Dermatol Surg 2006. [DOI: 10.1097/00042728-200608000-00016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
22
|
Abstract
Therapy for solar lentigines is diverse but can be divided into two broad categories: physical therapy and topical therapy. Physical therapies are frequently used with excellent clinical success rates, but this has to be balanced against associated side effects and recurrence rates with certain therapies. A range of topical therapies have been used and, more recently, fixed combinations of topical agents have been investigated. The Pigmentary Disorders Academy undertook to evaluate the clinical efficacy of the different treatments of solar lentigines in order to generate a consensus statement on their management. Clinical papers published during the past 20 years were identified through MEDLINE searches and methodology and outcome were assessed according to guidelines adapted from the US Preventive Services Task Force (USPSTF) on health care. The consensus of the group was that first-line therapy for solar lentigines was ablative therapy with cryotherapy. Although no large-scale studies have been completed, there is also good evidence to suggest that lasers are an effective treatment. An alternative to ablative therapy is topical therapy and there is good evidence to support the use of a fixed double combination, as well as retinoids, such as adapalene and tretinoin. Topical therapy can also be considered as maintenance therapy after the primary therapy has been applied. Because of the diversity of scoring systems used in the assessment of treatment outcome, the group recommends the development of treatment guidelines.
Collapse
Affiliation(s)
- Jean-Paul Ortonne
- Department of Dermatology, University of Nice-Sophia Antipolis, Nice, France
| | | | | | | |
Collapse
|
23
|
Abstract
Chemical peels have become established over the past 40 years as an effective outpatient method for skin rejuvenation as well as the treatment of a variety of skin conditions. Although laser skin rejuvenation has claimed much attention in recent years, phenol peels, despite problems with scarring and hypopigmentation, remains the gold standard for skin resurfacing [11], against which other methods should be evaluated [21]. We present both a theoretical overview of chemical peels and practical step-for-step instructions.
Collapse
Affiliation(s)
- N Y Schürer
- Fachbereich Humanwissenschaften, Universität Osnabrück.
| | | |
Collapse
|
24
|
Abstract
This article reviews aging of the hand and the treatment options for cosmetic rejuvenation. Options available for cutaneous rejuvenation include microdermabrasion, chemical peeling, intense light sources, and laser therapy, including pigment lasers, ablative resurfacing, and noninvasive rejuvenation. Protuberant veins of the aging hand can be treated effectively with sclerotherapy. The soft tissue atrophy of the aging hand is best treated with fat augmentation. The article concludes with a mention of new fillers that are just beginning to be used for soft tissue atrophy of the hand.
Collapse
Affiliation(s)
- Kimberly J Butterwick
- Dermatology/Cosmetic Laser Associates of La Jolla, 7630 Fay Avenue, La Jolla, CA 92037, USA.
| |
Collapse
|
25
|
Abstract
Medium depth chemical peels offer an excellent tool for skin rejuvenation. The improvement in rhytids, dyschromias, and photodamage with relatively little downtime confirms its importance in the facial plastic armamentarium.
Collapse
|
26
|
Abstract
Chemical peeling for skin of color arose in ancient Egypt, Mesopotamia, and other ancient cultures in and around Africa. Our current fund of medical knowledge regarding chemical peeling is a result of centuries of experience and research. The list of agents for chemical peeling is extensive. In ethnic skin, our efforts are focused on superficial and medium-depth peeling agents and techniques. Indications for chemical peeling in darker skin include acne vulgaris, postinflammatory hyperpigmentation, melasma, scarring, photodamage, and pseudofolliculitis barbae. Careful selection of patients for chemical peeling should involve not only identification of Fitzpatrick skin type, but also determining ethnicity. Different ethnicities may respond unpredictably to chemical peeling regardless of skin phenotype. Familiarity with the properties each peeling agent used is critical. New techniques discussed for chemical peeling include spot peeling for postinflammatory hyperpigmentation and combination peels for acne and photodamage. Single- or combination-agent chemical peels are shown to be efficacious and safe. In conclusion, chemical peeling is a treatment of choice for numerous pigmentary and scarring disorders arising in dark skin tones. Familiarity with new peeling agents and techniques will lead to successful outcomes.
Collapse
Affiliation(s)
- Wendy E Roberts
- Loma Linda University Medical School, 39700 Bob Hope Drive, Hope Square, Suite 115, Rancho Mirage, CA 92270, USA.
| |
Collapse
|
27
|
Chun EY, Lee JB, Lee KH. Focal Trichloroacetic Acid Peel Method for Benign Pigmented Lesions in Dark-Skinned Patients. Dermatol Surg 2004; 30:512-6; discussion 516. [PMID: 15056140 DOI: 10.1111/j.1524-4725.2004.30166.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Benign pigmented lesions, including seborrheic keratosis, solar lentigines, melasma, and freckles, are common disorders, and various treatment modalities have been tried. We suggest a technique consisting of focal trichloroacetic acid (TCA) peel applied by pressing firmly onto the focal lesions. OBJECTIVE To evaluate the clinical effects of focal TCA peel on pigmented lesions in dark-skinned patients. METHODS An analysis was conducted of 106 patients with benign pigmented lesions who were treated using focal TCA peel. Seborrheic keratosis was treated with 65% focal TCA peel, solar lentigines, and freckles with 50% to 65% focal TCA peel, and melasmas with 10% to 50% focal TCA peel. Patients had Fitzpatrick skin types IV-V. RESULTS Patient treatment data indicated that 19 of 23 (83%) patients with seborrheic keratosis, 42 of 49 (86%) patients with solar lentigines, 8 of 14 (58%) patients with freckles, and 11 of 20 (55%) patients with melasma experienced a good clinical response. Good satisfaction rates in the seborrheic keratosis, solar lentigines, freckles, and melasma groups were recorded. No significant complications were observed. CONCLUSION The focal TCA peel method presented in this study is a safe and effective modality for the treatment of benign pigmented lesions with no significant complications.
Collapse
Affiliation(s)
- Eun Young Chun
- Department of Dermatology, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea
| | | | | |
Collapse
|
28
|
Focal Trichloroacetic Acid Peel Method for Benign Pigmented Lesions in Dark-Skinned Patients. Dermatol Surg 2004. [DOI: 10.1097/00042728-200404000-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
29
|
Rejuvenation of the Face and Neck: A Combination of Exoderm Peel and Neck Liposuction. ACTA ACUST UNITED AC 2003. [DOI: 10.1089/153082003769591263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
30
|
Ferrara LA, Fleischman AJ, Benzel EC, Roy S. Silicon dermabrasion tools for skin resurfacing applications. Med Eng Phys 2003; 25:483-90. [PMID: 12787986 DOI: 10.1016/s1350-4533(03)00031-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Miniature abrasion tools for potential skin resurfacing applications are created using microelectromechanical systems (MEMS) fabrication technology. The abrading microstructures are formed on silicon wafers by a bulk micromachining process based on isotropic xenon difluoride etching. The micromachined abraders (microdermabraders) are packaged and applied to human cadaveric skin to assess abrasion quality. Plastic (acrylic) microreplicated structures, non-coated and aluminum-coated versions, are also used in a similar fashion. Non-textured silicon and plastic samples are used as study controls. Dermabraded and intact skin regions are analyzed qualitatively and quantitatively by light microscopy, image processing techniques, and histology. The microdermabraders exhibit a cleaner, more uniform abrading pattern on the cadaveric skin compared to the plastic microreplicated structures. Furthermore, the microdermabraders provide a consistently uniform cut through the epidermal layer, leaving little debris and minimal pitting. In contrast, the plastic microreplicated structures exhibit non-uniform abrading patterns and leave behind more debris and eccentric pits. The results suggest micromachined dermabraders can successfully abrade fine dermatological flaws in human skin.
Collapse
Affiliation(s)
- L A Ferrara
- Spine Research Laboratory, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | | | | | | |
Collapse
|
31
|
Glycolic Acid Peels Compared to Microdermabrasion. Dermatol Surg 2002. [DOI: 10.1097/00042728-200206000-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
32
|
Alam M, Omura NE, Dover JS, Arndt KA. Glycolic acid peels compared to microdermabrasion: a right-left controlled trial of efficacy and patient satisfaction. Dermatol Surg 2002; 28:475-9. [PMID: 12081674 DOI: 10.1046/j.1524-4725.2002.01144.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Glycolic acid peels and microdermabrasion are widely recommended by dermatologists and others for facial skin rejuvenation, but few studies have assessed their clinical efficacy. OBJECTIVE To compare the relative efficacy of glycolic acid peels and microdermabrasion for facial skin rejuvenation. METHODS An unblinded, randomized controlled trial was used. Each of 10 patients received paired treatments with glycolic acid peels (20%) and microdermabrasion (mild setting) for 6 consecutive weeks. The right and left sides of the face were treated with different modalities. Once a patient was assigned to receive a particular modality to a particular side of the face, all subsequent treatments were delivered in the same manner. Patient ratings, investigator ratings, and photographs were obtained before the first treatment and 1 week after the last treatment. RESULTS In terms of overall preference for a given type of treatment, seven patients chose glycolic acid peels, one selected microdermabrasion, and two had no favorite treatment. The relative preference for glycolic acid peels approached significance (P =.0578). Investigator ratings and photographic comparisons did not reveal treatment-specific differences or significant improvement from baseline. No serious side effects were seen with either treatment, and even mild effects were seldom reported. CONCLUSION In this study, patients appeared to prefer low-strength glycolic acid peels to low-intensity microdermabrasion for facial rejuvenation. Differences in patient satisfaction were subtle and may be technique dependent.
Collapse
Affiliation(s)
- Murad Alam
- SkinCare Physicians, Chestnut Hill, Massachusetts, USA.
| | | | | | | |
Collapse
|