Journal of Cosmetic Dermatology最新文献

Background: One of the worst long-term effects of acne is scarring, which leads to significant physical, psychological, and economic burdens. Limited studies have specifically studied the risk factors for acne scarring. This study aims to explore risk factors associated with facial acne scarring in Thai patients with acne.

Methods: Exploratory cross-sectional risk factor research was conducted using an online questionnaire on Thai patients aged ≥ 18 years who were diagnosed with acne between September and December 2023. The primary objective was to identify significant determinants of acne scars in patients with acne, including sociodemographic factors, clinical factors of acne, lifestyle factors, dietary habits factors, and treatment factors. Univariable and multivariable logistic regression were used to identify significant risk determinants.

Results: Of 225 patients with 61.33% prevalence of acne scarring, acne scarring was found to be independently associated with the following variables: moderate acne (mOR 3.51, 95% CI 1.31-9.40, p = 0.012) or severe-to-very severe acne (mOR 8.98, 95% CI 2.71-29.73, p < 0.001), sometimes squeezing and picking behaviors (mOR 2.69, 95% CI 2.71-29.73, p = 0.033), and postacne erythema (PAE) (mOR 4.46, 95% CI 1.96-10.14, p < 0.001).

Conclusion: The risk factors associated with acne scarring in individuals include the severity of acne, squeezing and picking behaviors, and experiencing PAE. One of this study's essential findings confirms that PAE is a notable component that could contribute to the development of acne scars. Early treatment of individuals at risk is crucial to reduce scar formation.

Background: Tranexamic acid (TXA) is a promising active to treat hyperpigmentation disorders, such as melasma and acne scars. However, TXA is highly hydrophilic and its penetration into the skin is poor and formulation dependent.

Aims: In this study, our aim was to evaluate the in vivo skin penetration of an ester-modified TXA, TXVector, directly on the skin of volunteers.

Methods: For the analysis of in vivo skin penetration of TXVector, we used in vivo confocal Raman spectroscopy (CRS). The use of CRS on live skin allows us to study directly how a compound affects skin composition at different depths and how this compound penetrates into the skin in real time.

Results: Our results showed that the TXA absorption into the skin via TXVector was 2.1-fold and 3.8-fold higher compared to free TXA 3% and TXA 1% formulations, respectively. Most importantly, upon application of TXVector, the TXA penetration flux into the skin was 107% and 280% higher than that of the free TXA 3% and TXA 1% formulations, respectively.

Conclusions: In summary, this study shows that the esterification-based TXVector formulation enhances the penetration flux of TXA and increases its bioavailability in the skin.

Background: Marionette lines are a feature of the aging face, descending from the oral commissures towards the jaw. VYC-17.5 L is a dermal filler that contains 17.5 mg/mL of hyaluronic acid (HA) and lidocaine (3 mg/mL); it is intended for the treatment of skin depressions. VYC-17.5 L has been shown to be safe and effective in different conditions, but there is a lack of published literature on its effectiveness in marionette lines.

Aims: This 12-month prospective, open-label, post-marketing study evaluated the effectiveness and safety of the injectable HA filler VYC-17.5 L for the improvement of marionette lines.

Methods: Adults (≥ 18 years) with mild-to-severe marionette lines on the validated Allergan Marionette Line Scale (AMLS) received VYC-17.5 L on Day 1 with optional touch-up on Day 14. The primary endpoint was proportion of participants with ≥ 1-point change in AMLS from baseline at Month 1 (M1). Secondary endpoints were investigator- and participant-rated Global Aesthetic Improvement Scale (GAIS), FACE-Q satisfaction with facial appearance, and appraisal of lines: marionette. Safety was assessed throughout.

Results: A total of 83 participants completed the study; 69.9% of participants had ≥ 1-point change in AMLS at M1. Investigator and participant GAIS showed improvement. Both FACE-Q scores significantly improved from baseline (p < 0.0001). A significant volume improvement was seen and maximized at M1. Most participant-reported injection site reactions were mild or moderate and resolved within 8 days; 14 subjects reported adverse device effects, with the most common being pain, which resolved within 8 days.

Conclusion: This prospective, open-label study showed that VYC-17.5 L effectively improved marionette lines and was well tolerated.

Background: Periocular static wrinkles, which are common cosmetic concerns, lack an established effective treatment. Microneedling radio frequency (MNRF) has shown promise in skin rejuvenation; however, there is limited objective information on its long-term effectiveness with regard to periocular static wrinkles.

Aims: This study aimed to evaluate the clinical efficacy and safety of MNRF treatment for periocular static wrinkles.

Method: Eighteen participants with moderate to severe wrinkles were enrolled in this study. MNRF treatment was applied to the periocular skin using MicroRF9 microneedles, which have a depth of 0.5-1.5 mm and a pulse width of 200-300 ms. MNRF treatment was administered twice with a 1-month interval, and the participants were followed up for 6 months. The evaluation included four areas, namely the outer canthi, lower eyelid, inner canthi, and upper eyelid, by using clinical assessments and Antera 3D measurements by digitalized images and grading by clinicians.

Results: The results showed significant improvement in all four areas assessed. Participants expressed high satisfaction with the treatment, and any adverse events, such as mild pain and redness, were temporary and resolved within a week.

Conclusion: These findings confirm that MNRF is a safe and effective method for reducing periocular static wrinkles.

Background: Actinic keratosis (AK) is a common skin condition treated by dermatologists; however, the effectiveness, superiority, and potential side effects of current treatment protocols are still debated.

Aim: This study aimed to compare the effectiveness and safety of 5% fluorouracil topical cream and 1% niacinamide topical gel in patients with AK.

Methods: In a randomized clinical trial, 26 patients with 95 AK lesions were assigned to receive either 5% fluorouracil topical cream twice daily for 4 weeks or 1% niacinamide topical gel twice daily for 3 months. Photography and dermoscopy before and after treatment were used to evaluate the outcomes.

Results: The study included 26 patients who underwent randomization and treatment. Analysis of the improvement response after treatment through photography and dermoscopy scores, as well as patients' perspectives, showed that the fluorouracil group had significantly better outcomes than the niacinamide group. However, treatment complications including burning, itching, and erythema were significantly more frequent in the fluorouracil group than in the niacinamide group.

Conclusions: Although 5% fluorouracil cream is more effective than 1% niacinamide gel in treating AK lesions, it is also associated with more frequent side effects.

Background: VYC-25L is a robust, structural hyaluronic acid (HA) filler designed for facial volumizing, lifting, and contouring. It was first approved in 2019.

Methods: A group of doctors with various specialties, who have used VYC-25L extensively since it first became available in their countries (3-5 years), share clinical experience and guidance on optimal use.

Results: VYC-25L has a unique rheological and physicochemical profile that provides elevated lift capacity and enhanced projection, significant moldability immediately after injection, high levels of tissue integration, reversibility with hyaluronidase, and a long duration of clinical effects-typically lasting at least 24 months. The properties of VYC-25L have created new possibilities for nonsurgical facial medical aesthetics. However, as with any novel product, it is important that injectors recognize how best to use it for the benefit of patients. When first utilizing VYC-25L, it is advisable to start with the chin and jawline to gain familiarity with the gel characteristics before moving into other facial areas, and to consider splitting treatment over two or more sessions. Attention must also be given to injection volume, with less product typically required with VYC-25L compared to other fillers with similar indications. Key principles of good practice should be followed, including appropriate patient selection and pretreatment education, suitable choice of injection device and plane, aseptic technique, slow and careful administration method, and sufficient posttreatment follow-up.

Conclusions: By adhering to these principles, VYC-25L can produce natural-looking and highly durable outcomes without substantial safety concerns.

Background: The integration of artificial intelligence (AI) and ultrasound (US) technology is reshaping facial aesthetics, providing enhanced diagnostic precision, procedural safety, and personalized patient care. The variability in US imaging, stemming from patient anatomy, operator skills, and equipment diversity, poses challenges in achieving consistent and accurate outcomes. AI addresses these limitations by standardizing imaging protocols, automating image analysis, and supporting real-time decision-making.

Objective: To explore the applications of AI-enhanced US in facial aesthetics, focusing on its potential to improve diagnostic accuracy, procedural safety, and personalized treatments while identifying future prospects and challenges.

Methods: A comprehensive review of current literature and advancements was conducted, examining the integration of AI with US in facial aesthetics. Key areas of focus included AI algorithms for image enhancement, real-time guidance during procedures, postprocedure assessment, personalized treatment planning, and workflow optimization.

Results: AI-enhanced US significantly improved diagnostic accuracy by automating the identification of critical anatomical structures and reducing operator variability. Real-time guidance during procedures enhanced safety, reducing complications such as vascular occlusion and nerve damage. Postprocedure assessments facilitated early detection of complications and improved patient outcomes. Personalized treatment plans tailored to individual anatomy and clinical needs resulted in higher patient satisfaction. Additionally, AI optimized workflow efficiency through seamless integration with electronic health records and advanced training simulators.

Conclusion: The integration of AI and US technology represents a transformative advancement in facial aesthetics. By enhancing precision, safety, and personalization, AI-powered US sets new benchmarks in diagnostic accuracy and treatment outcomes. Despite challenges related to data diversity, ethical considerations, and training, this synergy holds immense potential to revolutionize the field, offering improved outcomes and satisfaction for practitioners and patients alike. Further research and innovation are essential to fully realize the benefits of this technology.

Background: Recent preclinical studies have demonstrated the potential efficacy of stem cell exosomes in the treatment of hair loss. However, there is a paucity of clinical studies investigating the application of exosomes for this purpose. This case series presents three patients treated with exosomes for acquired trichorrhexis nodosa (ATN), a condition characterized by hair shaft abnormalities and breakage.

Objectives: This study aims to evaluate the effectiveness and safety of utilizing mesenchymal stem cell (MSC) exosomes as a novel therapeutic approach for the management of ATN.

Methods: A standardized process was employed to prepare 0.1 mL of exosomes, which were subsequently injected into bilateral regions of the patients' scalps at 0.5-1 cm intervals on a monthly basis. Each injection comprised a total volume of 5 mL, and all three patients underwent a minimum of four treatment sessions. The comparative efficacy of the treatment was evaluated using clinical photographs, dermatoscopy, and scanning electron microscopy (SEM) for all three patients post-intervention.

Results: The hair condition of the three patients demonstrated significant improvement, characterized by increased length and density, enhanced pigmentation with a reduced presence of dusty white dots, and the disappearance of dermoscopic black dots and broken hairs. SEM analysis revealed a remarkable recovery in the hair cuticle layers. At the 1-year follow-up, hair growth essentially remained normal.

Conclusion: Exosomes derived from mesenchymal stem cells demonstrate efficacy in treating ATN, presenting a novel therapeutic approach for this condition.