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Kim EY, Wong JH, Hussain A, Khachemoune A. Evidence-based management of cutaneous scarring in dermatology part 2: atrophic acne scarring. Arch Dermatol Res 2023; 316:19. [PMID: 38059974 DOI: 10.1007/s00403-023-02737-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/05/2023] [Accepted: 10/18/2023] [Indexed: 12/08/2023]
Abstract
Atrophic acne scars are the most common type of acne scars and are classified into three main types: icepick, boxcar, and rolling scars. Various procedures and techniques for atrophic acne scarring are discussed in detail, with stronger evidence-based support for lasers (non-fractional, fractional, ablative, and non-ablative), platelet-rich plasma as adjunctive treatment, chemical peels (glycolic acid, trichloroacetic acid, and Jessner's solution), dermal fillers such as hyaluronic acid, and microneedling, and lesser quality evidence for microdermabrasion, subcision, and lipoaspirate grafting. Further research is needed to optimize treatment protocols, assess the efficacy of monotherapies, and establish standardized guidelines for clinicians. This paper will provide a comprehensive review of the evidence-based management of atrophic acne scars, including currently commonly utilized therapies as well as more innovative treatment options.
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Affiliation(s)
- Emily Y Kim
- Georgetown University School of Medicine, Washington, DC, USA
| | - Jasmine H Wong
- Georgetown University School of Medicine, Washington, DC, USA
| | - Aamir Hussain
- Galaria Plastic Surgery and Dermatology, LLC, Chantilly, VA, USA
| | - Amor Khachemoune
- Department of Dermatology, Veterans Affairs Medical Center, SUNY Downstate, 800 Poly Place, Brooklyn, NY, 11209, USA.
- Department of Dermatology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, NY, USA.
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2
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Ma Y, Wang N, Li K, Liang H, Bai J, Ji X. Effect of geometric parameters of electrodes on skin heating for the design of non-ablative radiofrequency device. Skin Res Technol 2023; 29:e13472. [PMID: 37881053 PMCID: PMC10560826 DOI: 10.1111/srt.13472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 09/07/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Non-ablative radiofrequency (RF) has been widely used in clinical and at-home cosmetics devices. RF electrode geometry can influence the heat distribution in the tissue. This study analyzes the influence of geometric parameters of the electrode on the heat distribution in the layered tissue. MATERIALS & METHODS The finite element simulation of the electrothermal coupling field was performed to obtain the three-dimensional (3D) temperature distribution of the four-layer tissue. The electrode geometric parameters including the inter-electrode spacing (5-12 mm), width (1-3 mm), length (3-10 mm), shapes (bar, dot and circle), and the coupling gel's electrical conductivity (0.2-1.5 S/m) were simulated. The maximum temperature at 2 mm depth (T-2 mm ) and the temperature difference (Tdiff ) between the maximum skin surface temperature and T-2 mm were obtained to evaluate the effectiveness and safety. RESULTS The effect of geometric parameters on the effectiveness and safety was mixed. The maximum T-2 mm occurred with the 5 mm inter-electrode spacing, 3 mm width, 10 mm length, the circle-shaped electrode, and the 1.5 S/m coupling gel's electrical conductivity. The ratio of inter-electrode spacing to width at around four can achieve rapid temperature rise and skin surface temperature protection. The electrode shape influenced the area of temperature rise in the tissue's cross-section. The coupling gel's electrical conductivity should be close to that of the skin to avoid energy accumulation on the skin surface. CONCLUSION The electrode's geometric parameters affect the effectiveness and safety of the RF product. This study has provided the simulation procedure for the electrode design.
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Affiliation(s)
- Yiyou Ma
- School of Biomedical EngineeringShanghai Jiao Tong UniversityShanghaiChina
| | - Nianou Wang
- School of Biomedical EngineeringShanghai Jiao Tong UniversityShanghaiChina
- Shenzhen Accompany Tech co., ltdShenzhenChina
| | - Ke Li
- Shenzhen Accompany Tech co., ltdShenzhenChina
| | - Huan Liang
- Shenzhen Accompany Tech co., ltdShenzhenChina
| | - Jingfeng Bai
- School of Biomedical EngineeringShanghai Jiao Tong UniversityShanghaiChina
| | - Xiang Ji
- School of Biomedical EngineeringShanghai Jiao Tong UniversityShanghaiChina
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3
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Rahman E, Philip-Dormston WG, Webb WR, Rao P, Carruthers JD, Carruthers A, Swift A, Goodman GJ, Mosahebi A, Nahai F. Developing Consensus-Based Guidelines for Case Reporting in Aesthetic Medicine: Enhancing Transparency and Standardization. Aesthet Surg J Open Forum 2023; 5:ojad076. [PMID: 37694226 PMCID: PMC10483583 DOI: 10.1093/asjof/ojad076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
Clinical case reporting plays a vital role in sharing detailed patient narratives, providing insights into rare conditions, innovative treatments, and unexpected outcomes. However, existing reporting guidelines in aesthetic medicine fail to capture the specific nuances of procedures and outcomes in this field. The authors' objectives were to develop comprehensive guidelines for Case REporting in Aesthetic Medicine (CREAM). The study employed a 3-phase consensus process, including a literature review, expert interviews, and a consensus meeting. A diverse group of 10 expert participants (plastic surgeons, dermatologists, noncore specialists, evidence-based medicine expert, and research scientist) in Phase I and 30 experienced aesthetic practitioners in Phase II contributed to the research. Statistical analysis was conducted to assess agreement levels among participants and explore associations and variations within the data. The participants represented various specialties, genders, LGBTQ+ identities, and ethnic backgrounds. The research resulted in the development of the CREAM guidelines, consisting of a 16-item checklist. The guidelines covered essential aspects of case reporting, such as patient and practice information, procedure details, clinical assessment and outcomes, adverse events, and ethical considerations. Statistical analysis indicated a high level of consensus among participants, as well as significant associations between checklist items. CREAM guidelines represent a step toward enhancing transparency and standardization in case reporting in aesthetic medicine. Adhering to these guidelines will allow authors to contribute to a robust evidence base, prioritize patient safety, and drive advancements aesthetic medicine.
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Affiliation(s)
- Eqram Rahman
- Corresponding Author: Dr Eqram Rahman, Pond Street, Hampstead NW3 2QG, UK. E-mail: ; Instagram: @Beyond_border_Aesthetics
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4
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Pang M, Zhao L, Liu S, Lei Y. Eschar Dermabrasion in Deep Dermal Partial-Thickness Burn: A Case Report. Adv Skin Wound Care 2023; 36:1-3. [PMID: 37338951 PMCID: PMC10289210 DOI: 10.1097/01.asw.0000936004.14772.21] [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] [Indexed: 06/21/2023]
Abstract
ABSTRACT Although dermabrasion is widely used to treat various skin diseases and for scar repair, relatively few reports have described its use with burn wounds. As a blunt debridement, eschar dermabrasion has unique advantages. For patients with deep burns, the boundary between active tissue and inactive tissue is unclear. With eschar dermabrasion, necrotic tissue can be removed to the greatest extent with minimal damage. Early use can help patients skip the scab-dissolving period, decrease local and systemic inflammation, reduce postoperative scarring, and significantly reduce the difficulty of early wound care. As a result, the patient's hospitalization costs and pain during treatment are both reduced, and thanks to less scarring, the patient is more likely to engage in social activities and has an improved quality of life.
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Affiliation(s)
- Mengru Pang
- At the Department of Burns and Plastic Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, China, Mengru Pang, MD, PhD; Liang Zhao, MD; and Siye Liu, MD, are Attending Physicians and Yu Lei, MD, DCOS, is Chief
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5
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Ahmadi N, Rincón M, Silva-Abreu M, Sosa L, Pesantez-Narvaez J, Calpena AC, Rodríguez-Lagunas MJ, Mallandrich M. Semi-Solid Dosage Forms Containing Pranoprofen-Loaded NLC as Topical Therapy for Local Inflammation: In Vitro, Ex Vivo and In Vivo Evaluation. Gels 2023; 9:448. [PMID: 37367119 DOI: 10.3390/gels9060448] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/13/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Pranoprofen (PRA)-loaded nanostructured lipid carriers (NLC) have been dispersed into blank gels composed of 1% of Carbomer 940 (PRA-NLC-Car) and 3% of Sepigel® 305 (PRA-NLC-Sep) as a novel strategy to refine the biopharmaceutical profile of PRA, for dermal administration in the treatment of skin inflammation that may be caused by possible skin abrasion. This stratagem intends to improve the joining of PRA with the skin, improving its retention and anti-inflammatory effect. Gels were evaluated for various parameters such as pH, morphology, rheology, and swelling. In vitro drug release research and ex vivo permeation through the skin were carried out on Franz diffusion cells. Additionally, in vivo assays were carried out to evaluate the anti-inflammatory effect, and tolerance studies were performed in humans by evaluating the biomechanical properties. Results showed a rheological profile common of semi-solid pharmaceutical forms for dermal application, with sustained release up to 24 h. In vivo studies using PRA-NLC-Car and PRA-NLC-Sep in Mus musculus mice and hairless rats histologically demonstrated their efficacy in an inflammatory animal model study. No signs of skin irritation or modifications of the skin's biophysical properties were identified and the gels were well tolerated. The results obtained from this investigation concluded that the developed semi-solid formulations represent a fitting drug delivery carrier for PRA's transdermal delivery, enhancing its dermal retention and suggesting that they can be utilized as an interesting and effective topical treatment for local skin inflammation caused by a possible abrasion.
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Affiliation(s)
- Negar Ahmadi
- Departament de Farmàcia, Tecnologia Farmacèutica, i Fisicoquímica, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona (UB), 08028 Barcelona, Spain
| | - María Rincón
- Departament de Ciència de Materials i Química Física, Facultat de Química, Universitat de Barcelona (UB), 08028 Barcelona, Spain
- Institut de Nanociència i Nanotecnologia IN2UB, University of Barcelona, 08028 Barcelona, Spain
| | - Marcelle Silva-Abreu
- Departament de Farmàcia, Tecnologia Farmacèutica, i Fisicoquímica, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona (UB), 08028 Barcelona, Spain
- Institut de Nanociència i Nanotecnologia IN2UB, University of Barcelona, 08028 Barcelona, Spain
| | - Lilian Sosa
- Pharmaceutical Research Group, Faculty of Chemical Sciences and Pharmacy, National Autonomous University of Honduras (UNAH), Tegucigalpa 11101, Honduras
| | | | - Ana Cristina Calpena
- Departament de Farmàcia, Tecnologia Farmacèutica, i Fisicoquímica, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona (UB), 08028 Barcelona, Spain
- Institut de Nanociència i Nanotecnologia IN2UB, University of Barcelona, 08028 Barcelona, Spain
| | - María J Rodríguez-Lagunas
- Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Mireia Mallandrich
- Departament de Farmàcia, Tecnologia Farmacèutica, i Fisicoquímica, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona (UB), 08028 Barcelona, Spain
- Institut de Nanociència i Nanotecnologia IN2UB, University of Barcelona, 08028 Barcelona, Spain
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6
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Chilicka K, Gold MH, Nowicka D. Acne vulgaris and the most popular and new cosmetological treatments. J Cosmet Dermatol 2023. [PMID: 37062752 DOI: 10.1111/jocd.15757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/15/2023] [Accepted: 03/22/2023] [Indexed: 04/18/2023]
Abstract
INTRODUCTION Acne vulgaris is a disease that has an enormous impact on appearance of the skin of the patients and also on their quality of life. Long-term dermatological treatment, which often lasts years, and disease relapses contribute to the occurrence of low self-esteem and depression. Acne is one of the 10 most common diseases in the world and the most common inflammatory skin disease. Many methods of dermatological treatment that bring very good results are available. However, educating people with acne on how to take care of their skin on a daily basis to minimize the bleak effects of the disease is an extremely important element. Contemporary cosmetology creates an environment for not only taking care of the skin at home, but also develops in-office treatments with exfoliation of the dead epidermis as an extremely important and priority part of treatment. The cosmetologist can propose both chemical and apparatus methods, which are selected individually for each client. OBJECTIVE The objective of this article is to provide information about cosmetological treatment used in acne vulgaris. METHODS In this article, we reviewed the published literature, article published in peer-reviewed journals. RESULTS There are many methods that work well in the case of acne skin care, more and more new treatments appear on the cosmetological market. CONCLUSION Acne skin care in beauty parlor is very important element.
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Affiliation(s)
- Karolina Chilicka
- Department of Health Sciences, Institute of Health Sciences, University of Opole, 45-040, Opole, Poland
| | - Michael H Gold
- Gold Skin Care Center, Tennessee Clinical Research Center, Nashville, Tennessee, USA
| | - D Nowicka
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, 50-368, Wroclaw, Poland
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7
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Frommeyer TC, Rohan CA, Spandau DF, Kemp MG, Wanner MA, Tanzi E, Travers JB. Wounding Therapies for Prevention of Photocarcinogenesis. Front Oncol 2022; 11:813132. [PMID: 35071017 PMCID: PMC8776632 DOI: 10.3389/fonc.2021.813132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 12/14/2021] [Indexed: 01/01/2023] Open
Abstract
The occurrence of non-melanoma skin cancer (NMSC) is closely linked with advanced age and ultraviolet-B (UVB) exposure. More specifically, the development of NMSC is linked to diminished insulin-like growth factor-1 (IGF-1) signaling from senescent dermal fibroblasts in geriatric skin. Consequently, keratinocyte IGF-1 receptor (IGF-1R) remains inactive, resulting in failure to induce appropriate protective responses including DNA repair and cell cycle checkpoint signaling. This allows UVB-induced DNA damage to proliferate unchecked, which increases the likelihood of malignant transformation. NMSC is estimated to occur in 3.3 million individuals annually. The rising incidence results in increased morbidity and significant healthcare costs, which necessitate identification of effective treatment modalities. In this review, we highlight the pathogenesis of NMSC and discuss the potential of novel preventative therapies. In particular, wounding therapies such as dermabrasion, microneedling, chemical peeling, and fractionated laser resurfacing have been shown to restore IGF-1/IGF-1R signaling in geriatric skin and suppress the propagation of UVB-damaged keratinocytes. This wounding response effectively rejuvenates geriatric skin and decreases the incidence of age-associated NMSC.
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Affiliation(s)
- Timothy C. Frommeyer
- Department of Pharmacology & Toxicology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
| | - Craig A. Rohan
- Department of Pharmacology & Toxicology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Department of Dermatology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Dayton Veterans Administration Medical Center, Dayton, OH, United States
| | - Dan F. Spandau
- Departments of Dermatology and Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, United States
- Richard A. Roudebush Veterans Administration (VA) Medical Center, Indianapolis, IN, United States
| | - Michael G. Kemp
- Department of Pharmacology & Toxicology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Dayton Veterans Administration Medical Center, Dayton, OH, United States
| | - Molly A. Wanner
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, United States
| | | | - Jeffrey B. Travers
- Department of Pharmacology & Toxicology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Department of Dermatology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Dayton Veterans Administration Medical Center, Dayton, OH, United States
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8
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Piccione M, Belloni Fortina A, Ferri G, Andolina G, Beretta L, Cividini A, De Marni E, Caroppo F, Citernesi U, Di Liddo R. Xeroderma Pigmentosum: General Aspects and Management. J Pers Med 2021; 11:1146. [PMID: 34834498 PMCID: PMC8624855 DOI: 10.3390/jpm11111146] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 01/25/2023] Open
Abstract
Xeroderma Pigmentosum (XP) is a rare genetic syndrome with a defective DNA nucleotide excision repair. It is characterized by (i) an extreme sensitivity to ultraviolet (UV)-induced damages in the skin and eyes; (ii) high risk to develop multiple skin tumours; and (iii) neurologic alterations in the most severe form. To date, the management of XP patients consists of (i) early diagnosis; (ii) a long-life protection from ultraviolet radiation, including avoidance of unnecessary UV exposure, wearing UV blocking clothing, and use of topical sunscreens; and (iii) surgical resections of skin cancers. No curative treatment is available at present. Thus, in the last decade, in order to prevent or delay the progression of the clinical signs of XP, numerous strategies have been proposed and tested, in some cases, with adverse effects. The present review provides an overview of the molecular mechanisms featuring the development of XP and highlights both advantages and disadvantages of the clinical approaches developed throughout the years. The intention of the authors is to sensitize scientists to the crucial aspects of the pathology that could be differently targeted. In this context, the exploration of the process underlining the conception of liposomal nanocarriers is reported to focus the attention on the potentialities of liposomal technology to optimize the administration of chemoprotective agents in XP patients.
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Affiliation(s)
- Monica Piccione
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35131 Padova, Italy
| | - Anna Belloni Fortina
- Pediatric Dermatology Unit, Department of Medicine DIMED, University of Padova, 35128 Padova, Italy; (A.B.F.); (F.C.)
| | - Giulia Ferri
- I.R.A. Istituto Ricerche Applicate S.p.A., 20865 Usmate Velate, Italy; (G.F.); (G.A.); (L.B.); (A.C.); (E.D.M.); (U.C.)
| | - Gloria Andolina
- I.R.A. Istituto Ricerche Applicate S.p.A., 20865 Usmate Velate, Italy; (G.F.); (G.A.); (L.B.); (A.C.); (E.D.M.); (U.C.)
| | - Lorenzo Beretta
- I.R.A. Istituto Ricerche Applicate S.p.A., 20865 Usmate Velate, Italy; (G.F.); (G.A.); (L.B.); (A.C.); (E.D.M.); (U.C.)
| | - Andrea Cividini
- I.R.A. Istituto Ricerche Applicate S.p.A., 20865 Usmate Velate, Italy; (G.F.); (G.A.); (L.B.); (A.C.); (E.D.M.); (U.C.)
| | - Emanuele De Marni
- I.R.A. Istituto Ricerche Applicate S.p.A., 20865 Usmate Velate, Italy; (G.F.); (G.A.); (L.B.); (A.C.); (E.D.M.); (U.C.)
| | - Francesca Caroppo
- Pediatric Dermatology Unit, Department of Medicine DIMED, University of Padova, 35128 Padova, Italy; (A.B.F.); (F.C.)
| | - Ugo Citernesi
- I.R.A. Istituto Ricerche Applicate S.p.A., 20865 Usmate Velate, Italy; (G.F.); (G.A.); (L.B.); (A.C.); (E.D.M.); (U.C.)
| | - Rosa Di Liddo
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35131 Padova, Italy
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9
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Hafezi H, Galehdari H, Rezaie M, Moeini R. Successful treatment of Becker's nevus with dermabrasion by sandpaper: A case report. Clin Case Rep 2021; 9:e04725. [PMID: 34484761 PMCID: PMC8405417 DOI: 10.1002/ccr3.4725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 11/10/2022] Open
Abstract
Lasers have been widely used for treatment of Becker nevus. Here, we report a case of Becker nevus which did not respond to laser therapy and was treated successfully by dermabrasion with sandpaper with no following complications.
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Affiliation(s)
- Hossein Hafezi
- Department of DermatologyIsfahan University of Medical SciencesIsfahanIran
| | - Hamid Galehdari
- Department of DermatologyIsfahan University of Medical SciencesIsfahanIran
- School of MedicineIsfahan University of Medical SciencesIsfahanIran
| | - Mina Rezaie
- Department of DermatologyIsfahan University of Medical SciencesIsfahanIran
- School of MedicineIsfahan University of Medical SciencesIsfahanIran
| | - Reza Moeini
- Department of DermatologyIsfahan University of Medical SciencesIsfahanIran
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10
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Guida S, Pellacani G, Bencini PL. Picosecond laser treatment of atrophic and hypertrophic surgical scars: In vivo monitoring of results by means of 3D imaging and reflectance confocal microscopy. Skin Res Technol 2019; 25:896-902. [DOI: 10.1111/srt.12755] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 06/28/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Stefania Guida
- Dermatology Unit University of Modena and Reggio Emilia Modena Italy
- I.C.L.I.D. Milano Italy
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11
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A Review and Update of Treatment Options Using the Acne Scar Classification System. Dermatol Surg 2019; 45:411-422. [DOI: 10.1097/dss.0000000000001765] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Guida S, Bencini P, Pellacani G. Picosecond laser for atrophic surgical scars treatment:
in vivo
monitoring of results by means of reflectance confocal microscopy. J Eur Acad Dermatol Venereol 2018; 33:e114-e116. [DOI: 10.1111/jdv.15289] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S. Guida
- Dermatology Unit Department of Surgical Medical, Dental and Morphological Science with Interest transplant Oncological and Regenerative Medicine University of Modena and Reggio Emilia via del Pozzo 71 41125 Modena Italy
- ICLID Istituto di Chirurgia e Laser‐Chirurgia in Dermatologia via della Moscova 42 20121 Milano Italy
| | - P.L. Bencini
- ICLID Istituto di Chirurgia e Laser‐Chirurgia in Dermatologia via della Moscova 42 20121 Milano Italy
| | - G. Pellacani
- Dermatology Unit Department of Surgical Medical, Dental and Morphological Science with Interest transplant Oncological and Regenerative Medicine University of Modena and Reggio Emilia via del Pozzo 71 41125 Modena Italy
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13
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Jang JY, Han JH, Yoon KC, Shin HW, Kim YS, Kim JK. Early Management of Scars Using a 532-nm Nd:YAG Laser. ARCHIVES OF AESTHETIC PLASTIC SURGERY 2017. [DOI: 10.14730/aaps.2017.23.2.62] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Jin Ho Han
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kun Chul Yoon
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun Woo Shin
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong Seong Kim
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - June-Kyu Kim
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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14
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Bravo BSF, Azulay DR, Luiz RR, Mandarim-De-Lacerda CA, Cuzzi T, Azulay MM. Oral isotretinoin in photoaging: objective histological evidence of efficacy and durability. An Bras Dermatol 2016; 90:479-86. [PMID: 26375216 PMCID: PMC4560536 DOI: 10.1590/abd1806-4841.20153703] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The off-label use of oral isotretinoin in photoaging is a therapeutic tool that has been used by dermatologists. There are few studies to corroborate its effectiveness and durability. OBJECTIVES To assess, both clinically and histologically, the changes caused by the use of oral isotretinoin in skin photoaging as well as the duration of the effects. METHODS 20 female patients, aged 45-50 years, with phototypes II-VI, none of whom had experienced menopause, were treated with 20mg oral isotretinoin, 3 days a week, for 12 weeks. They underwent clinical analysis and skin biopsies in the pre-auricular region, while histologic cuts enabled assessment of the solar elastosis level and morphologic analysis. RESULTS Clinically, patients, as well as the researching and the assessor physicians, noticed improvement in skin quality. One patient presented severe solar elastosis, 11 manifested the moderate form, while 8 presented the discreet type. According to histological analysis, 65% of the patients revealed alteration in the distribution and thickness of the elastic fibers, which can be interpreted as a histological improvement, while 60% showed an increase in collagen density. We observed an increase in collagen density, from 51.2% to 57.4%, (p=0.004). At the end of the 12-week follow-up period, this density decreased to 54.7% (p=0.050). There was an increase in the density of elastic fibers, from 26.5% to 31.3%, (p=0.02), which had dropped to 27.5% at the end of the 12-week follow-up period. CONCLUSIONS The study confirmed the role of oral isotretinoin in remodeling the extracellular matrix against photoaging, as well as its durability after 12 weeks, especially when we consider collagen fibers.
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Affiliation(s)
- Bruna Souza Felix Bravo
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, BR
| | - David Rubem Azulay
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, BR
| | | | | | - Tullia Cuzzi
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR
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15
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Carruthers J, Carruthers A. Non-operative facial rejuvenation. Plast Reconstr Surg 2015. [DOI: 10.1002/9781118655412.ch66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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16
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Effects of the combined PDL/Nd:YAG laser on surgical scars: vascularity and collagen changes evaluated by in vivo confocal microscopy. BIOMED RESEARCH INTERNATIONAL 2014; 2014:204532. [PMID: 25276770 PMCID: PMC4174963 DOI: 10.1155/2014/204532] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 08/03/2014] [Indexed: 01/24/2023]
Abstract
The aim of this study was to investigate the efficacy of the sequential combined 585 nm PDL and the 1064 nm neodymium:yttrium-aluminium-garnet laser (PDL/Nd:YAG) in the treatment of surgical scars and to evaluate the short-term effects by in vivo confocal microscopy (RCM) and the long-term effects by clinical assessment of the scars. Twenty-five patients were enrolled with 39 postoperative linear scars; each scar was divided into two fields. One half was treated with the combined PDL/Nd:YAG laser, whereas the other half remained untreated. Each scar was treated three times at monthly intervals. Scars were evaluated by an independent examiner, using the Vancouver Scar Scale. The combined PDL/Nd:YAG laser significantly improved the appearance of the scars. In order to study the short-term effects of combined laser treatment, six additional patients were enrolled with 7 postoperative linear scars. One half of scars was treated once with the combined PDL/Nd:YAG laser. One week after this laser treatment, both the treated and the nontreated parts of the scars were examined by dermoscopy and RCM. The dermoscopic pictures revealed improvements even in treated areas. In conclusion, the combined PDL/Nd:YAG laser was found to be effective in improving the quality and appearance of the surgical scars.
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17
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Sanchez FH. Treatment of Acne Scars. Dermatol Surg 2012. [DOI: 10.1002/9781118412633.ch26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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18
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Levy LL, Zeichner JA. Management of acne scarring, part II: a comparative review of non-laser-based, minimally invasive approaches. Am J Clin Dermatol 2012; 13:331-40. [PMID: 22849351 DOI: 10.2165/11631410-000000000-00000] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Acne scarring is a commonly encountered yet extremely challenging problem to treat for the dermatologist. As acne scarring can lead to significant psychological distress and low self-esteem, it is of utmost importance to have effective and satisfying treatments in the physician's armamentarium. However, many treatments are unsatisfying, leading to patient disappointment and frustration. Although early treatment of acne lesions and inflammation with isotretinoin is beneficial in preventing acne scarring, many patients still present with troubling noticeable scars. Despite the advances in pharmacology and technology, scar treatment still remains suboptimal and is tainted with several adverse effects. However, some treatments can provide benefits. This review article exhaustively discusses and analyzes the various minimally invasive approaches to the treatment of acne scarring with an emphasis on pharmacologic agents, such as isotretinoin for atrophic acne scars and corticosteroids and chemotherapeutic drugs for hypertrophic scars. Intralesional injections of corticosteroids are efficacious in reducing keloid scar formation in addition to preventing recurrence following surgical excision. In-office and minimally invasive procedural management, including chemical peels, dermabrasion, tissue augmentation, and punch excision is also discussed. Superficial chemical peels are efficacious in treating atrophic scars with relatively few adverse effects and complications. Although dermabrasion is used less often with the advent of laser resurfacing, this technique remains as a viable option for those with atrophic scars. Post-inflammatory hyperpigmentation can be managed successfully with topical agents such as azelaic acid and hydroquinone. The efficacy of various treatment modalities is highlighted with a focus on choosing the correct modalities for specific scar types.
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Abstract
This review presents skin anatomy, dermabraders, indications for dermabrasion and microdermabrasion, and dermabrasion techniques for the face, along with potential complications. Dermabrasion is a minimally invasive technique used for skin resurfacing. Its applications include treatment of rhytids, abnormal scarring, and premalignant lesions. The risks of complications are low and include pigment changes, hypertrophic scarring, and infection. Despite the introduction of newer therapies, such as lasers and chemical peels, dermabrasion remains an effective tool for physicians to combat the effects of aging without the downtime required for surgery.
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20
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Holla AP, Kumar R, Parsad D, Kanwar AJ. Modified Procedure of Noncultured Epidermal Suspension Transplantation: Changes are the Core of Vitiligo Surgery. J Cutan Aesthet Surg 2011; 4:44-5. [PMID: 21572682 PMCID: PMC3081485 DOI: 10.4103/0974-2077.79192] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Epidermal cell suspensions are being increasingly used in the surgical management of vitiligo. The procedure suffers from several drawbacks such as high cost of the procedure, difficulty of procuring the reagents etc. We hereby describe modifications which allow the use of cheaper, more commonly available alternatives.
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Affiliation(s)
| | - Ravinder Kumar
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Davinder Parsad
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - AJ Kanwar
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
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21
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Poore SO, Shama L, Marcus B. Facial Resurfacing of the Male Patient. Facial Plast Surg Clin North Am 2008; 16:357-369. [DOI: 10.1016/j.fsc.2008.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Conologue TD, Norwood C. Treatment of Surgical Scars with the Cryogen-Cooled 595 nm Pulsed Dye Laser Starting on the Day of Suture Removal. Dermatol Surg 2008; 32:13-20. [PMID: 16393593 DOI: 10.1111/1524-4725.2006.32002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cosmetic results after skin surgery are a key component of patient satisfaction and self-image. Various lasers have been used to attempt scar improvement, without consistent results. The optimal time to initiate laser treatment has not been determined. A recent study using a noncooled 585 nm pulsed dye laser starting on the day of suture removal demonstrated substantial improvement in scar appearance. OBJECTIVE To determine the efficacy of the 595 nm cryogen-cooled pulsed dye laser in the treatment of surgical scars starting on the day of suture removal. METHODS Sixteen patients with postoperative linear scars of greater than 2 cm were treated three times at 4- to 8-week intervals with a 595 nm cryogen-cooled pulsed dye laser. All patients had Fitzpatrick skin types I to IV. Each scar was divided at the midline into two fields, with half receiving treatment using a 7 mm spot size at 1.5 ms with 8 J/cm2 and a 30 ms spray duration with a 10 ms delay. The other half was not treated. Scars were evaluated for pigmentation, vascularity, pliability, and height by a blinded examiner using the Vancouver Scar Scale (VSS). In addition, the same blinded examiner evaluated the cosmetic appearance using a scale from 0 (worst) to 10 (best) prior to the second treatment and 1 month after the final treatment. RESULT SThe average sum of all parameters in the VSS showed significant improvement from 1-month post-treatment to the final evaluation of 60% compared with the control of -3%. Also, scars in the treated portions scored an average of 2 points higher in the overall cosmetic appearance by the same blinded examiner based on a scale of 0 (worst) to 10 (best). Among the individual parameters in the VSS, the most significant improvements were found in vascularity and pliability. CONCLUSION The cryogen-cooled 595 nm pulsed dye laser is a safe and effective option to improve the cosmetic appearance of surgical scars in skin types I to IV starting on the day of suture removal.
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Affiliation(s)
- Theresa Dressler Conologue
- Department of Dermatology, Walter Reed Army Medical Center, 6900 Georgia Avenue, Washington, DC 20007, USA.
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23
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Hegedus F, Diecidue R, Taub D, Nyirady J. Non-surgical treatment modalities of facial photodamage: practical knowledge for the oral and maxillofacial professional. Int J Oral Maxillofac Surg 2006; 35:389-98. [PMID: 16352420 DOI: 10.1016/j.ijom.2005.09.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2004] [Revised: 08/28/2005] [Accepted: 09/15/2005] [Indexed: 11/23/2022]
Abstract
With the increasing interest in cosmetic procedures, oral and maxillofacial surgeons are being asked not only to improve oral health and aesthetics but to extend their expertise to provide advice on improving the overall appearance of the face. For the discerning patient, improving overall facial skin appearance is becoming an integral part of the process of surgical cosmetic procedures. Here, some of the non-surgical options available for the treatment of photodamaged skin are reviewed and an overview of the specific treatments in this category provided. Sun avoidance and protection from harmful rays with appropriate sunscreens are primary to maintaining healthy skin and appearance. Among treatment options, topical treatments with preparations such as retinoids, alpha-hydroxy acids and antioxidants have been shown to provide some benefit and are relatively easy to use albeit with appropriate precautions and professional guidance. As a second-level option, facial rejuvenation procedures such as botulinum toxin injection, soft tissue augmentation with collagen or hyaluronic acid gel, skin resurfacing, use of chemical peels, dermabrasion and laser resurfacing procedures can be used but require administration by qualified practitioners. Overall, these treatments may be used to complement rehabilitative, reconstructive, or cosmetic oral and maxillofacial surgery to further improve and complement surgical results.
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Affiliation(s)
- F Hegedus
- Department of Oral and Maxillofacial Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
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24
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Treatment of Surgical Scars with the Cryogen-Cooled 595 nm Pulsed Dye Laser Starting on the Day of Suture Removal. Dermatol Surg 2006. [DOI: 10.1097/00042728-200601000-00003] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Bellew SG, Lee C, Weiss MA, Weiss RA. Improvement of atrophic acne scars with a 1,320 nm Nd:YAG laser: retrospective study. Dermatol Surg 2005; 31:1218-21; discussion 1222. [PMID: 16176774 DOI: 10.1111/j.1524-4725.2005.31929] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Facial acne scarring has been treated with multiple methods with varying degrees of improvement. Although the 1,320 nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser has been widely used to improve photoaging, studies analyzing its effects on atrophic acne scarring are limited. OBJECTIVE To evaluate the efficacy of a dynamic cryogen-cooled 1,320 nm Nd:YAG laser for the treatment of atrophic facial acne scars in a larger cohort of patients with long-term follow-up. METHODS Twenty-nine patients (skin phototypes I-IV) with facial acne scarring received a mean of 5.5 (range 2-17) treatments with a 1,320 nm Nd:YAG laser. Objective physician assessment scores of improvement were determined by side-by-side comparison of preoperative and postoperative photographs at a range of 1 to 27 months (mean 10.4 months) postoperatively. Subjective patient self-assessment scores of improvement were also obtained. RESULTS Acne scarring was significantly improved by both physician and patient assessment scores. Mean improvement was 2.8 (p < .05) on a 0- to 4-point scale by physician assessment and 5.4 (p < .05) on a 0- to 10-point scale by patient assessment. No significant complications were observed. CONCLUSIONS Nonablative laser skin resurfacing with a 1,320 nm Nd:YAG laser can effectively improve the appearance of facial acne scars with minimal adverse sequelae.
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Affiliation(s)
- Supriya G Bellew
- Maryland Laser, Skin and Vein Institute, Hunt Valley, MD 21030, USA
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26
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Guerra A, Cisneros JL, Eiros JM, Herrera E, Jaén P, Pérez-Macías JM. Profilaxis antiherpética en intervenciones de dermoexfoliación facial. ACTAS DERMO-SIFILIOGRAFICAS 2005; 96:479-97. [PMID: 16476283 DOI: 10.1016/s0001-7310(05)73120-3] [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: 11/19/2022] Open
Abstract
In recent years, a spectacular increase has taken place in the demand for techniques to improve the appearance of the skin, both for cosmetic and reparative purposes. The techniques used may have complications that interfere with the healing process, and therefore may affect the results from an aesthetic standpoint. The most significant complication is herpes simplex infection. Furthermore, accurate, early diagnosis of herpes infection makes greater individual and community control possible, thanks to the current availability of effective antiviral agents. The scientific literature relating to herpes simplex prophylaxis was reviewed, and this information was pooled with the knowledge and experience of a multidisciplinary group of experts. After all of this data was analyzed, the consensus was reached that all patients should be treated with specific oral medications for herpes simplex as a preventive measure.
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Affiliation(s)
- Aurora Guerra
- Hospital Universitario 12 de Octubre de Madrid, Spain.
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