Dana Jaalouk, Anesh Prasai, David J. Goldberg, Jane Y. Yoo
Background
With the rising demand for natural-looking aesthetic improvements, regenerative aesthetic medicine (RAM) has become essential for addressing aging, damage, and imperfections. The regulatory landscape overseeing RAM is dynamic, evolving with new technologies to ensure safety and efficacy.
Objective
This study reviews and compares regulatory frameworks for RAM across North America, Europe, Asia, Australia, and Latin America.
Methods
Regulations in the United States, European Union (EU), Australia, Singapore, South Korea, Brazil, Argentina, and Mexico were reviewed, focusing on risk-based approaches, the extent of manipulation, and intended use of biological components.
Results
Frameworks in the United States, EU, Australia, Singapore, and South Korea share a risk-based approach, adjusting regulations based on risks associated with biological components like stem cells and extracellular vesicles. Minimal alteration is categorized as low risk, emphasizing disease transmission prevention and material quality. Regulatory landscapes vary in Latin America. Brazil's comprehensive framework, managed by ANVISA, categorizes products by manipulation levels. Argentina's ANMAT has made progress, while Mexico lacks a unified framework, leading to unregulated operations and patient risks.
Conclusion
The diverse regulatory frameworks underscore the need for continuous collaboration between regulatory bodies, healthcare providers, and stakeholders to promote innovation and ensure safety in regenerative medicine.
{"title":"Regulatory Aspects of Regenerative Medicine in the United States and Abroad","authors":"Dana Jaalouk, Anesh Prasai, David J. Goldberg, Jane Y. Yoo","doi":"10.1002/der2.244","DOIUrl":"https://doi.org/10.1002/der2.244","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>With the rising demand for natural-looking aesthetic improvements, regenerative aesthetic medicine (RAM) has become essential for addressing aging, damage, and imperfections. The regulatory landscape overseeing RAM is dynamic, evolving with new technologies to ensure safety and efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study reviews and compares regulatory frameworks for RAM across North America, Europe, Asia, Australia, and Latin America.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Regulations in the United States, European Union (EU), Australia, Singapore, South Korea, Brazil, Argentina, and Mexico were reviewed, focusing on risk-based approaches, the extent of manipulation, and intended use of biological components.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Frameworks in the United States, EU, Australia, Singapore, and South Korea share a risk-based approach, adjusting regulations based on risks associated with biological components like stem cells and extracellular vesicles. Minimal alteration is categorized as low risk, emphasizing disease transmission prevention and material quality. Regulatory landscapes vary in Latin America. Brazil's comprehensive framework, managed by ANVISA, categorizes products by manipulation levels. Argentina's ANMAT has made progress, while Mexico lacks a unified framework, leading to unregulated operations and patient risks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The diverse regulatory frameworks underscore the need for continuous collaboration between regulatory bodies, healthcare providers, and stakeholders to promote innovation and ensure safety in regenerative medicine.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.244","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141967034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Introduction to the Regenerative Medicine—PRP, Exosomes, and Stem Cells and Their Role in Aesthetics Issue","authors":"Michael H. Gold","doi":"10.1002/der2.255","DOIUrl":"https://doi.org/10.1002/der2.255","url":null,"abstract":"","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.255","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141967035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Exosomes have gained significant attention in aesthetic dermatology for their potential in skin rejuvenation. Despite numerous studies investigating the use of exosomes in aesthetic applications, no adverse events have been reported thus far. This case series presents patients with noticeable adverse effects following the application of exosomes to the skin for aesthetic purposes in South Korea.
Methods
A consortium of concerned aesthetic dermatologists from South Korea provided a case series of patients who developed complications after receiving exosome treatments for skin rejuvenation. The case series included eight female patients, ranging in age from 26 to 52 years old, who developed delayed-onset granulomatous lesions at the treatment sites.
Results
All patients in the case series developed erythematous, indurated papules or nodules at the sites of exosome injections, with onset ranging from 2 weeks to 3 months posttreatment. Histopathological examination of biopsied lesions revealed necrotizing granulomas not related to mycobacterial infections. The patients' response to topical and oral steroids, as well as other treatments, varied.
Conclusion
Although exosome-based therapies hold great promise in aesthetic dermatology, this case series highlights the potential for delayed-onset granulomatous complications following exosome treatments for skin rejuvenation. Standardized protocols for exosome isolation and purification, as well as rigorous safety and efficacy standards, are needed to ensure the successful implementation of exosome-based products in clinical settings.
{"title":"Complications After Exosome Treatment for Aesthetic Skin Rejuvenation","authors":"William J. Nahm, Sukruthi Thunga, Jane Yoo","doi":"10.1002/der2.242","DOIUrl":"https://doi.org/10.1002/der2.242","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Exosomes have gained significant attention in aesthetic dermatology for their potential in skin rejuvenation. Despite numerous studies investigating the use of exosomes in aesthetic applications, no adverse events have been reported thus far. This case series presents patients with noticeable adverse effects following the application of exosomes to the skin for aesthetic purposes in South Korea.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A consortium of concerned aesthetic dermatologists from South Korea provided a case series of patients who developed complications after receiving exosome treatments for skin rejuvenation. The case series included eight female patients, ranging in age from 26 to 52 years old, who developed delayed-onset granulomatous lesions at the treatment sites.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All patients in the case series developed erythematous, indurated papules or nodules at the sites of exosome injections, with onset ranging from 2 weeks to 3 months posttreatment. Histopathological examination of biopsied lesions revealed necrotizing granulomas not related to mycobacterial infections. The patients' response to topical and oral steroids, as well as other treatments, varied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although exosome-based therapies hold great promise in aesthetic dermatology, this case series highlights the potential for delayed-onset granulomatous complications following exosome treatments for skin rejuvenation. Standardized protocols for exosome isolation and purification, as well as rigorous safety and efficacy standards, are needed to ensure the successful implementation of exosome-based products in clinical settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.242","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141968388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Plasma-rich plasma (PRP), exosomes, and stem cells represent promising new treatments for facial rejuvenation and to enhance other cosmetic procedures. Although these treatments are rapidly advancing, there are no universally accepted treatment protocols for their use. The goal of the following review is to describe some of the possible benefits of PRP, exosomes, and stem cells in aesthetic medicine.
Results
A review of available studies showed that potential uses of PRP include wound healing after facial surgery, facial rejuvenation, androgenetic alopecia, acne scars, striae distensae, and vitiligo. Exosomes may provide beneficial treatment for skin rejuvenation, scar reduction, hyperpigmentation, and hair growth. Stem cells show promise for androgenetic alopecia, scar improvement, and treatment of photoaged skin. These new technologies may be used alone, but are often combined with existing aesthetic treatments.
Conclusion
PRP, exosomes, and stem cells may play an important role in restoring youthful tissue structure and function. Interpretation of some study results is sometimes challenged by the lack of standardized treatment protocols, including routes of application and dosing. When combined with other devices and techniques, results are sometime unclear as to which treatment plays the greater role.
{"title":"Applications of Plasma-Rich Plasma, Exosomes, and Stem Cells in Aesthetics: A Narrative Review","authors":"Glynis Ablon, Zoë Indigo Smith, Girish (Gilly) Munavalli","doi":"10.1002/der2.250","DOIUrl":"https://doi.org/10.1002/der2.250","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Plasma-rich plasma (PRP), exosomes, and stem cells represent promising new treatments for facial rejuvenation and to enhance other cosmetic procedures. Although these treatments are rapidly advancing, there are no universally accepted treatment protocols for their use. The goal of the following review is to describe some of the possible benefits of PRP, exosomes, and stem cells in aesthetic medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A review of available studies showed that potential uses of PRP include wound healing after facial surgery, facial rejuvenation, androgenetic alopecia, acne scars, striae distensae, and vitiligo. Exosomes may provide beneficial treatment for skin rejuvenation, scar reduction, hyperpigmentation, and hair growth. Stem cells show promise for androgenetic alopecia, scar improvement, and treatment of photoaged skin. These new technologies may be used alone, but are often combined with existing aesthetic treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PRP, exosomes, and stem cells may play an important role in restoring youthful tissue structure and function. Interpretation of some study results is sometimes challenged by the lack of standardized treatment protocols, including routes of application and dosing. When combined with other devices and techniques, results are sometime unclear as to which treatment plays the greater role.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.250","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141968387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khalid Nabil Nagshabandi, Asem Shadid, Mohammed Al-Mashali
Background
Dissecting cellulitis of the scalp (DCS), also known as perifolliculitis capitis abscedens et suffodiens or Hoffmann disease, is a rare chronic inflammatory scalp condition with an unknown etiology. The US Food and Drug Administration (FDA) has recently approved multiple interleukin-23 (IL-23) inhibitors for chronic-plaque psoriasis, and their off-label use has shown promise in treating various dermatological conditions, including DCS. This review assesses the efficacy and safety of IL-23 inhibitors for DCS, aiming to support potential FDA approval for severe refractory cases.
Methods
A comprehensive literature search was conducted in February 2024 using MEDLINE, PUBMED, and Google Scholar with the keywords “Dissecting cellulitis,” “DCS,” “Interleukin-23 inhibitors,” “IL-23,” and “Biologics.” The search focused on identifying studies reporting the use of IL-23 inhibitors in DCS treatment.
Results
The search identified five cases where IL-23 inhibitors were used to treat DCS. All patients were male, aged 17–65 years, with multiple comorbidities in four cases, primarily hidradenitis suppurativa and acne conglobata. The IL-23 inhibitors Risankizumab, Guselkumab, and Tildrakizumab were used, resulting in significant clinical improvement, near-complete remission, and hair regrowth. Additionally, psychosocial improvements were noted in two cases, with no reported adverse effects.
Conclusion
IL-23 inhibitors have shown remarkable efficacy in treating severe DCS, with significant clinical and psychosocial improvements and a favorable safety profile. These findings support the consideration of FDA approval for IL-23 inhibitors as a treatment option for refractory DCS cases, offering hope for patients with this challenging condition.
背景头皮剥脱性蜂窝织炎（DCS）又称毛囊周围炎（perifolliculitis capitis abscedens et suffodiens）或霍夫曼病（Hoffmann disease），是一种罕见的慢性头皮炎症，病因不明。美国食品和药物管理局（FDA）最近批准了多种白细胞介素-23（IL-23）抑制剂用于治疗慢性斑块型银屑病，这些抑制剂的标示外使用已显示出治疗包括DCS在内的各种皮肤病的前景。本综述评估了IL-23抑制剂治疗DCS的疗效和安全性，旨在支持FDA对严重难治性病例的潜在批准。 方法 2024 年 2 月，我们使用 MEDLINE、PUBMED 和 Google Scholar 进行了一次全面的文献检索，关键词为 "裂解性蜂窝组织炎"、"DCS"、"白细胞介素-23 抑制剂"、"IL-23 "和 "生物制剂"。搜索的重点是确定报道在 DCS 治疗中使用 IL-23 抑制剂的研究。 结果 搜索发现了五例使用IL-23抑制剂治疗DCS的病例。所有患者均为男性，年龄在 17-65 岁之间，其中四例患者患有多种并发症，主要是化脓性扁平苔藓和痤疮。使用IL-23抑制剂Risankizumab、Guselkumab和Tildrakizumab后，患者的临床症状明显改善，病情接近完全缓解，毛发也重新生长。此外，两个病例的社会心理也得到了改善，且无不良反应报告。 结论 IL-23 抑制剂在治疗重度 DCS 方面疗效显著，临床和社会心理均有明显改善，安全性良好。这些研究结果支持 FDA 考虑批准 IL-23 抑制剂作为治疗难治性 DCS 病例的一种选择，为这种具有挑战性病情的患者带来了希望。
{"title":"Exploring the Efficacy and Safety of Interleukin-23 Inhibitors in Dissecting Cellulitis of the Scalp: A Comprehensive Review","authors":"Khalid Nabil Nagshabandi, Asem Shadid, Mohammed Al-Mashali","doi":"10.1002/der2.247","DOIUrl":"https://doi.org/10.1002/der2.247","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dissecting cellulitis of the scalp (DCS), also known as perifolliculitis capitis abscedens et suffodiens or Hoffmann disease, is a rare chronic inflammatory scalp condition with an unknown etiology. The US Food and Drug Administration (FDA) has recently approved multiple interleukin-23 (IL-23) inhibitors for chronic-plaque psoriasis, and their off-label use has shown promise in treating various dermatological conditions, including DCS. This review assesses the efficacy and safety of IL-23 inhibitors for DCS, aiming to support potential FDA approval for severe refractory cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature search was conducted in February 2024 using MEDLINE, PUBMED, and Google Scholar with the keywords “Dissecting cellulitis,” “DCS,” “Interleukin-23 inhibitors,” “IL-23,” and “Biologics.” The search focused on identifying studies reporting the use of IL-23 inhibitors in DCS treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The search identified five cases where IL-23 inhibitors were used to treat DCS. All patients were male, aged 17–65 years, with multiple comorbidities in four cases, primarily hidradenitis suppurativa and acne conglobata. The IL-23 inhibitors Risankizumab, Guselkumab, and Tildrakizumab were used, resulting in significant clinical improvement, near-complete remission, and hair regrowth. Additionally, psychosocial improvements were noted in two cases, with no reported adverse effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>IL-23 inhibitors have shown remarkable efficacy in treating severe DCS, with significant clinical and psychosocial improvements and a favorable safety profile. These findings support the consideration of FDA approval for IL-23 inhibitors as a treatment option for refractory DCS cases, offering hope for patients with this challenging condition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.247","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141968380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Since its inception, the Neodymium-doped yttrium aluminum garnet (Nd:YAG) 1064-nm laser has been widely used for the treatment of hair removal. Selective photothermolysis forms the basis of its function. Without harming the skin, the laser damages the hair follicle, offering safety and potentially positive outcomes. Many years after its debut, newly developed Nd:YAG laser technology and additional indicators have been found.
Methods
The quality of the evidence was evaluated using PubMed and Google Scholar searches. A selection of articles published between 2019 and 2024 underwent a retrospective review.
Results
Updated technology, including the “in-motion” technique, submillisecond pulse, and the combination of alexandrite and Nd:YAG lasers, achieves effective hair reduction with a higher safety profile. Other effects of the Nd:YAG laser on sweat glands, its bactericidal effects, and its long-term effects on laser providers are discussed in this literature.
Conclusion
With minimal short- and long-term side effects, the latest technology and techniques of Nd:YAG laser treatment at a wavelength of 1064 nm have been shown to be beneficial and promising for hair removal.
{"title":"Nd:YAG Technology for Laser Hair Removal: What's New?","authors":"Thanyathorn Nuchanatanon, Natthachat Jurairattanaporn, Vasanop Vachiramon","doi":"10.1002/der2.249","DOIUrl":"10.1002/der2.249","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Since its inception, the Neodymium-doped yttrium aluminum garnet (Nd:YAG) 1064-nm laser has been widely used for the treatment of hair removal. Selective photothermolysis forms the basis of its function. Without harming the skin, the laser damages the hair follicle, offering safety and potentially positive outcomes. Many years after its debut, newly developed Nd:YAG laser technology and additional indicators have been found.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The quality of the evidence was evaluated using PubMed and Google Scholar searches. A selection of articles published between 2019 and 2024 underwent a retrospective review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Updated technology, including the “in-motion” technique, submillisecond pulse, and the combination of alexandrite and Nd:YAG lasers, achieves effective hair reduction with a higher safety profile. Other effects of the Nd:YAG laser on sweat glands, its bactericidal effects, and its long-term effects on laser providers are discussed in this literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>With minimal short- and long-term side effects, the latest technology and techniques of Nd:YAG laser treatment at a wavelength of 1064 nm have been shown to be beneficial and promising for hair removal.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.249","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141798844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohamad Goldust, Leslie Baumann, Michael H. Gold, Marina Landau
Objective
This article provides a comprehensive overview of recent advancements in cosmetic dermatology and aesthetics. It covers topics including dermal fillers, botulinum toxin (BTX anti-aging cosmeceuticals, artificial intelligence (AI) applications, and energy-based devices.
Methods
The review summarizes the current literature on dermal fillers, BTX, cosmeceuticals, AI applications, and energy-based devices. It explores emerging technologies, new treatment methods, and ongoing research in these areas. The sources of data include peer-reviewed journals, clinical trials, and expert opinions to provide a thorough understanding of recent developments and future trends.
Results
Dermal fillers, particularly hyaluronic acid (HA), are popular in cosmetic treatments, with innovations like Bioorthogonal strategies and thiomer-based technology emerging. Biostimulators such as poly-l-lactic acid and calcium hydroxyapatite promote neo-collagenesis. BTX remains a cosmetic standard, with new recombinant toxins, hybrid BTXs, and delivery methods enhancing safety and efficacy. Anti-aging trends include cellular senescence-targeting treatments like exosomes, NMN, and PDRN, which need further validation. AI improves diagnosis, personalized treatments, and patient consultations but faces data privacy and bias challenges. Advanced energy-based devices (RF, HIFU, lasers) and treatments like cryolipolysis and MFU-V enhance skin rejuvenation and body contouring.
Conclusion
Recent advancements in cosmetic dermatology and aesthetics, including innovative dermal fillers, BTX developments, anti-aging cosmeceuticals, AI applications, and energy-based devices, are transforming the field. These innovations provide enhanced treatment options and improved patient outcomes, although further research is necessary to validate efficacy and address emerging challenges. The future of cosmetic dermatology is promising, with ongoing technological advancements driving continuous improvements in aesthetic medicine.
{"title":"Advancements in Cosmetics and Aesthetics: A Comprehensive Review","authors":"Mohamad Goldust, Leslie Baumann, Michael H. Gold, Marina Landau","doi":"10.1002/der2.245","DOIUrl":"https://doi.org/10.1002/der2.245","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This article provides a comprehensive overview of recent advancements in cosmetic dermatology and aesthetics. It covers topics including dermal fillers, botulinum toxin (BTX anti-aging cosmeceuticals, artificial intelligence (AI) applications, and energy-based devices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The review summarizes the current literature on dermal fillers, BTX, cosmeceuticals, AI applications, and energy-based devices. It explores emerging technologies, new treatment methods, and ongoing research in these areas. The sources of data include peer-reviewed journals, clinical trials, and expert opinions to provide a thorough understanding of recent developments and future trends.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Dermal fillers, particularly hyaluronic acid (HA), are popular in cosmetic treatments, with innovations like Bioorthogonal strategies and thiomer-based technology emerging. Biostimulators such as poly-<span>l</span>-lactic acid and calcium hydroxyapatite promote neo-collagenesis. BTX remains a cosmetic standard, with new recombinant toxins, hybrid BTXs, and delivery methods enhancing safety and efficacy. Anti-aging trends include cellular senescence-targeting treatments like exosomes, NMN, and PDRN, which need further validation. AI improves diagnosis, personalized treatments, and patient consultations but faces data privacy and bias challenges. Advanced energy-based devices (RF, HIFU, lasers) and treatments like cryolipolysis and MFU-V enhance skin rejuvenation and body contouring.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Recent advancements in cosmetic dermatology and aesthetics, including innovative dermal fillers, BTX developments, anti-aging cosmeceuticals, AI applications, and energy-based devices, are transforming the field. These innovations provide enhanced treatment options and improved patient outcomes, although further research is necessary to validate efficacy and address emerging challenges. The future of cosmetic dermatology is promising, with ongoing technological advancements driving continuous improvements in aesthetic medicine.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In the realm of dermatological advancements, the alexandrite laser has carved out a significant niche in hair removal treatments. Operating at a 755 nm wavelength, it is adept at targeting melanin in hair follicles, making it particularly suitable for individuals with fair skin tones. Despite its advantages, the application of alexandrite lasers presents challenges, especially in individuals with darker skin tones due to a higher risk of adverse effects.
Objective
This comprehensive review explores the literature to examine the role and advancements of the alexandrite laser within the evolving landscape of laser hair removal. It discusses the technology's strengths, limitations, and prospects, aiming to provide a comprehensive understanding of its current state and identify avenues for further research.
Methods
Comprehensive searches were conducted in databases such as PubMed, Google Scholar, and the Cochrane Library from January 1990 to April 2024. The search included keywords and MeSH terms like ‘laser therapy,’ ‘hair reduction,’ ‘phototherapy,’ ‘hair removal,’ and ‘alexandrite.’ Studies focusing specifically on alexandrite lasers for hair removal, including reviews and clinical trials, were included.
Results
The alexandrite laser is highly effective for light skin tones but poses risks for darker skin. Nd:YAG lasers are safer for darker skin but may require more sessions for fine or light-colored hair. Diode lasers are versatile for various skin types but less efficient for very dark or very light skin. IPL is adaptable but often needs more sessions and has higher side effect risks. Long-term studies show sustained hair reduction with alexandrite lasers, resulting in high patient satisfaction. Side effects are generally mild and temporary, such as redness and swelling. Recent advancements in alexandrite laser technology, such as integration with other laser types, larger spot sizes, and improved cooling systems, have enhanced its safety and efficacy. Combining alexandrite with Nd:YAG lasers has expanded its applicability to darker skin tones. These innovations, along with high-frequency treatments and shorter pulse durations, promise improved patient outcomes. However, considerations of cost and the need for multiple sessions must be weighed.
Conclusion
No single hair removal technology is universally superior; the optimal choice varies based on individual s
{"title":"Alexandrite Laser for Hair Reduction: Updates and What Is New","authors":"Diala Haykal","doi":"10.1002/der2.246","DOIUrl":"https://doi.org/10.1002/der2.246","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In the realm of dermatological advancements, the alexandrite laser has carved out a significant niche in hair removal treatments. Operating at a 755 nm wavelength, it is adept at targeting melanin in hair follicles, making it particularly suitable for individuals with fair skin tones. Despite its advantages, the application of alexandrite lasers presents challenges, especially in individuals with darker skin tones due to a higher risk of adverse effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This comprehensive review explores the literature to examine the role and advancements of the alexandrite laser within the evolving landscape of laser hair removal. It discusses the technology's strengths, limitations, and prospects, aiming to provide a comprehensive understanding of its current state and identify avenues for further research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Comprehensive searches were conducted in databases such as PubMed, Google Scholar, and the Cochrane Library from January 1990 to April 2024. The search included keywords and MeSH terms like ‘laser therapy,’ ‘hair reduction,’ ‘phototherapy,’ ‘hair removal,’ and ‘alexandrite.’ Studies focusing specifically on alexandrite lasers for hair removal, including reviews and clinical trials, were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The alexandrite laser is highly effective for light skin tones but poses risks for darker skin. Nd:YAG lasers are safer for darker skin but may require more sessions for fine or light-colored hair. Diode lasers are versatile for various skin types but less efficient for very dark or very light skin. IPL is adaptable but often needs more sessions and has higher side effect risks. Long-term studies show sustained hair reduction with alexandrite lasers, resulting in high patient satisfaction. Side effects are generally mild and temporary, such as redness and swelling. Recent advancements in alexandrite laser technology, such as integration with other laser types, larger spot sizes, and improved cooling systems, have enhanced its safety and efficacy. Combining alexandrite with Nd:YAG lasers has expanded its applicability to darker skin tones. These innovations, along with high-frequency treatments and shorter pulse durations, promise improved patient outcomes. However, considerations of cost and the need for multiple sessions must be weighed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>No single hair removal technology is universally superior; the optimal choice varies based on individual s","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.246","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141607996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clara Michelle Tan Hwei Sian, Lai Cher Yenn, Janet Pei Ling Dua
Background
Body-focused repetitive behaviors (BFRBs) are recurrent, habitual behaviors, such as skin picking, hair pulling, and other compulsions, that can result in distressing cutaneous manifestations of varying severity. Many patients with BFRBs present primarily to dermatologists and a significant proportion subsequently resist engaging with psychological or psychiatric healthcare professionals. Habit reversal therapy (HRT) is one of the most effective evidence-based management strategies for BFRBs and it can be facilitated by a range of healthcare professionals including general practitioners, dermatologists, and nurses, as well as psychologists. Few dermatologists are comfortable offering HRT, making it a severely underutilized technique in the management of various skin conditions associated with BFRBs.
Objectives
This article aims to highlight strategies that dermatologists can learn to offer to positively influence the patient experience. A practical approach to implementing simplified HRT for patients with BFRBs will be demonstrated through two case studies.
{"title":"Habit Reversal Therapy by Dermatologists to Treat Body-Focused Repetitive Behaviors: Review and Case Reports","authors":"Clara Michelle Tan Hwei Sian, Lai Cher Yenn, Janet Pei Ling Dua","doi":"10.1002/der2.240","DOIUrl":"https://doi.org/10.1002/der2.240","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Body-focused repetitive behaviors (BFRBs) are recurrent, habitual behaviors, such as skin picking, hair pulling, and other compulsions, that can result in distressing cutaneous manifestations of varying severity. Many patients with BFRBs present primarily to dermatologists and a significant proportion subsequently resist engaging with psychological or psychiatric healthcare professionals. Habit reversal therapy (HRT) is one of the most effective evidence-based management strategies for BFRBs and it can be facilitated by a range of healthcare professionals including general practitioners, dermatologists, and nurses, as well as psychologists. Few dermatologists are comfortable offering HRT, making it a severely underutilized technique in the management of various skin conditions associated with BFRBs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This article aims to highlight strategies that dermatologists can learn to offer to positively influence the patient experience. A practical approach to implementing simplified HRT for patients with BFRBs will be demonstrated through two case studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.240","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141488941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The neck is typically the earliest and most visible site of aging-related esthetic changes; it is an area about which patients frequently express esthetic concerns and seek approaches to rejuvenation. This narrative review examines the current understanding of age-related structural and cellular changes in the neck and skin, treatment approaches to neck rejuvenation, specifically noninvasive and minimally invasive approaches including skincare, and key patient factors to consider.
Methods
A literature search of relevant publications was performed. Experience-based recommendations for clinical assessment and treatment approach are provided to complement the current literature.
Results
Neck aging results from a combination of intrinsic factors, such as genetic background, and extrinsic factors, primarily ultraviolet light exposure. Positive treatment outcomes begin with thorough patient assessment, including neck aging status, patient-specific intrinsic and extrinsic factors, and evaluation of skin type, which may help predict positive (e.g., skin tightening) and negative (e.g., dyspigmentation) dermal responses to specific procedures. In addition to skincare, a range of noninvasive, directed-energy techniques (e.g., chromophore-based lasers, ablative lasers, intense pulsed light, microfocused ultrasound, cryolipolysis, laser-assisted lipolysis, and radiofrequency irradiation) and minimally invasive techniques (e.g., neurotoxins, microneedling, and fillers) are currently used for neck rejuvenation. A comprehensive approach to assessment and treatment contributes toward improved patient outcomes.
Conclusions
The neck aging process develops over time, and a prejuvenation strategy, including effective skincare, should be considered. The development of comprehensive noninvasive and minimally invasive techniques geared toward the neck and face as a single entity should provide better outcomes and fulfillment of patient esthetic goals for this critical area.
{"title":"Neck Aging and Rejuvenation: A Balanced Approach to Assessment and Treatment","authors":"Wendy E. Roberts, Tsing Cheng","doi":"10.1002/der2.238","DOIUrl":"https://doi.org/10.1002/der2.238","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The neck is typically the earliest and most visible site of aging-related esthetic changes; it is an area about which patients frequently express esthetic concerns and seek approaches to rejuvenation. This narrative review examines the current understanding of age-related structural and cellular changes in the neck and skin, treatment approaches to neck rejuvenation, specifically noninvasive and minimally invasive approaches including skincare, and key patient factors to consider.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A literature search of relevant publications was performed. Experience-based recommendations for clinical assessment and treatment approach are provided to complement the current literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Neck aging results from a combination of intrinsic factors, such as genetic background, and extrinsic factors, primarily ultraviolet light exposure. Positive treatment outcomes begin with thorough patient assessment, including neck aging status, patient-specific intrinsic and extrinsic factors, and evaluation of skin type, which may help predict positive (e.g., skin tightening) and negative (e.g., dyspigmentation) dermal responses to specific procedures. In addition to skincare, a range of noninvasive, directed-energy techniques (e.g., chromophore-based lasers, ablative lasers, intense pulsed light, microfocused ultrasound, cryolipolysis, laser-assisted lipolysis, and radiofrequency irradiation) and minimally invasive techniques (e.g., neurotoxins, microneedling, and fillers) are currently used for neck rejuvenation. A comprehensive approach to assessment and treatment contributes toward improved patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The neck aging process develops over time, and a prejuvenation strategy, including effective skincare, should be considered. The development of comprehensive noninvasive and minimally invasive techniques geared toward the neck and face as a single entity should provide better outcomes and fulfillment of patient esthetic goals for this critical area.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141488415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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