Journal of Cosmetic Dermatology最新文献

Background

Skin hyperpigmentation is a dermatological concern for pigmented skin phototypes. Despite availability of multiple treatment options, hyperpigmentation management continues to be a challenge.

Aims

Efficacy and safety assessment of the skincare regimen [topical formulation of trihydroxybenzoic acid glucoside 10% (THBG) and α-arbutin 2% (twice-daily) + sunscreen (once daily)] in Indian females with pigmentary spots (facial dark spots or melasma).

Methods

This prospective, open-label, single-arm, interventional study was conducted in Indian females (n = 124), aged 18–45 years, having FitzPatrick skin type III–IV, dull skin, and facial dark spots or melasma. Efficacy of 90-day skincare regimen was evaluated using mexameter, modified melasma area and severity index (mMASI) score, cross-polarized light photography, chromameter, and color–luminosity–brightness–transparency (CLBT) technique. Student's t-test (paired data) was used for statistical analysis.

Results

In efficacy analysis [modified intention-to-treat (mITT) population], 120 subjects were included. Melanin content of pigmentary spots (on mexametry) significantly reduced (−16.3%, p < 0.001) at Day 90 versus baseline. Significant reduction in severity of melasma was observed (−18.4% in mMASI score) at Day 90. Significant improvement in ΔEab (−8.7%) (change in color difference between pigmentary spot and normal skin) on cross-polarized photographs, in skin-brightening parameters L* (relative brightness/lightness) (−2.7%), ITA° (individual typology angle) (−37.7%), and ΔE* (skin-tone evenness) (−19.0%) using chromameter. Significant improvement in skin radiance was observed in CLBT parameters, color (pink: 32.8%, yellow: –5.5%, and olive: −7.8%), luminosity (6.0%), brightness (4.6%), and transparency (0.2%). Regimen did not cause itching, burning, or irritation.

Conclusions

Skincare regime of 10% THBG and 2% α-arbutin along with sunscreen was effective in reducing pigmentary spots (dark spots and melasma) and was well tolerated in Indian women.

Trial Registration: Clinical Trial Registry of India (CTRI Reg. No. CTRI/2021/11/038345; date: 30/11/2021)

Objective

To report six patients with penile papules after circumcision to attract the attention of clinicians and patients to the complication associated with circumcision.

Methods

We reported several clinical cases presenting with these papules following circumcision. Cases were reassessed for clinical characteristics, histopathological features, and potential risk factors.

Results

A series of six adult male cases were identified, with papules appearing asymptomatically months to years after circumcision. The papules were larger, exhibited uneven distribution, and lacked the typical arrangement of pearly penile papules, posing a cosmetic concern and a risk of misdiagnosis as genital warts.

Conclusion

This study presents a previously unreported complication of circumcision with significant implications for patient care. Further investigation is warranted to understand the etiology and develop strategies for prevention and management.

Background

Melasma, a condition with complex and multifactorial pathogenesis, has traditionally been linked to factors such as ultraviolet (UV) exposure, hormonal changes, and genetic predisposition. Despite societal advances and shifts in lifestyle, updates on causal factors remain limited. Our study aims to address this gap by investigating emerging pathogenic factors that differ from those conventionally reported.

Objective

We conducted a case–control study to explore novel etiological factors contributing to the onset of melasma in Chinese patients, with an emphasis on how these differ from previously established causes.

Methods

The study included 150 patients (144 women and 6 men) diagnosed with melasma at Jiangsu Province Hospital of Chinese Medicine from April to October 2023. A control cohort of individuals without melasma was enrolled from the community. Demographic and clinical characteristics were collected, along with exogenous factors and histories of related dermatoses and non-dermatoses, through a questionnaire administered with the guidance of a dermatologist. Etiological factors were assessed using univariate analysis followed by multivariate analysis.

Results

Overall, our results were consistent with previous studies. In addition, alcohol intake (OR: 20.05, 95% CI: 1.17–343.17) and breast cystic hyperplasia (OR: 15.98, 95% CI: 4.28–59.72) were found to be novel triggering factors of melasma, whereas change of residence (OR: 0.03, 95% CI: 0.00–0.30), house renovation (OR: 0.13, 95% CI: 0.03–0.58) and soft drink intake (OR: 0.04, 95% CI: 0.00–0.83) were protective.

Conclusion

These findings suggest that diet and the living environment are novel etiological factors for melasma.

Background

The efficacy of laser treatment for facial café au lait macules (CALMs) is random.

Aim

To compare the response of different characteristics of CALMs skin lesions to laser treatment.

Patients/Methods

In this single-center retrospective case series, patients with café au lait macules who received laser treatment between 2015 and 2022 at our clinic were reviewed. A total of 319 consecutive patients were eligible and were treated with either a 755-nm-alexandrite picosecond laser or a quality-switched 755-nm-alexandrite laser. Observers were blinded to the final patient groups. Efficacy was graded according to four levels of treatment response: poor (Grade 1, 0%–25% improvement), fair (Grade 2, 26%–50% improvement), good (Grade 3, 51%–75% improvement), and excellent (Grade 4, 76%–100% improvement). Treatment effects evaluated as Grades 2–4 were considered effective.

Results

Of the 319 patients, excellent and good responses were observed in 80 (25.08%) and 66 (20.69%) cases, respectively. Fifty-two patients (16.30%) displayed an outcome of Grade 2 (26%–50% improvement), whereas 121 (37.93%) cases showed an outcome of Grade 1 (0%–25% improvement). The overall treatment effective rate (Grades 2–4) was 62.07%. Binary logistic regression analysis showed a significant association of therapeutic efficacy with lesion distribution (segmental vs. non-segmental CALMs) and lesion border (irregular vs. regular) (p < 0.05 for both).

Conclusions

Segmental and irregular border CALMs tended to respond well to laser therapy. Clinicians can leverage these characteristics to predict efficacy and manage patient expectations more effectively.

Introduction

With the growing demand for skin-enhancing products in the market, research into edible plants has expanded significantly. Numerous studies have shown that plant extracts rich in phytochemicals can effectively improve skin issues such as wrinkles, pigmentation, and dullness. However, clinical studies focusing on the effects of combined ingredients are still limited.

Objective

This study combined three plant ingredients known for their skin-beautifying effects and clinically tested their functional properties.

Methods

Sixty healthy subjects were screened and randomly divided into two groups: a test group (TG) and a placebo group (PG). TG took two tablets of multi-plant concentrated powder daily, while PG took placebo tablets without active ingredients. The study lasted 12 weeks. Plasma Trolox equivalent antioxidant capacity (TEAC), superoxide dismutase (SOD), and glutathione peroxidase (GPx) were measured at week 0 (W0), week 8 (W8), and week 12 (W12). Skin brightness (L* value), skin tone (Individual Typological Angle (ITA°)), erythema (a* value), skin spots, and wrinkles were assessed at week 0 (W0), week 4 (W4), week 8 (W8), and week 12 (W12).

Results

The study showed significant improvements in all three antioxidant markers in the blood after consuming the compound ingredient tablets compared to the PG (p < 0.01). L* value and ITA° significantly increased from 8 weeks (p < 0.1). Skin spots significantly decreased at W8 and W12 (p < 0.1). While a* value and skin wrinkles showed noticeable reductions within the group in week 12 (p < 0.1), there were no significant differences compared to the PG.

Conclusions

Consumption of multi-plant concentrated powder improved skin whitening, brightened skin tone, reduced skin spots, and showed some improvement in wrinkles and erythema.

Trial Registration

ClinicalTrials.gov identifier: NCT05988567

Background and Purpose

Laser-induced post-inflammatory hyperpigmentation (PIH)is a common adverse reaction in Asian individuals. Dark skin and incorrect laser parameters are common causes, but PIH is often unexpected for patients. Obvious hyperpigmentation can lead to an ugly appearance and severe anxiety. Therefore, a fast and effective treatment for laser-induced PIH is necessary. In this article, we attempted to demonstrate that a low-fluence Q-switch (QS) 1064 nm laser combined with oral tranexamic acid (TXA) is a quick and safe method for the clearance of laser-induced PIH.

Materials and Methods

A retrospective cohort study, adhering to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, spanning 2 years (2021–2023) was conducted on 23 patients aged between 29 and 58 years. These patients were diagnosed with laser-induced PIH for < 3 months. The treatment regimen was a low-fluence QS1064 nm laser combined with oral TXA, oral TXA was first taken, and a low-fluence QS1064 nm laser was used for at least 1 month after the last laser was applied. Three to six laser treatments were subsequently applied. After treatment, the pigment color and patient satisfaction were assessed to evaluate the effectiveness of the treatment options.

Results

Twenty patients were enrolled in the study, the average laser treatments were 4.3 ± 0.865 times. The Melasma Area and Severity Index (MASI) score decreased from 9.325 ± 3.38 before treatment to 5.97 ± 2.37. After the first treatment, the MASI score decreased by approximately 40%. Two months after the last treatment, the MASI score decreased to 0.93 ± 1.06, and there was a statistically significant difference in the MASI score before and after treatment (p < 0.05). Patient satisfaction scores revealed that 95% of patients were highly or strongly satisfied with the decrease in the intensity of the PIH color, with a moderate response rate of 1 (5%). The patients thought that the pigment removal speed was 75% (15) very fast or fast, 20% (4) moderate, and 5% (1) slow.

Conclusion

The results of this study demonstrated the quick and safe removal of laser-induced PIH following treatment with low-fluence QS1064 nm laser combined with oral TXA. Providing such a protocol is indeed one of the primary objectives of this article.

Background

Periorbital hyperpigmentation (POH) is a common complaint worldwide. Although this cosmetic condition is not a medical concern, it can impact emotional well-being. Few investigations have evaluated the association of various factors with POH, which is contradictory in some ways.

Aim

The present study is conducted to elucidate the accurate impact of risk factors on the severity of POH.

Patients/Methods

This cross-sectional study was performed on 116 patients attending a skin Outpatient Department in Iran from March to August 2022. A complete physical examination divided patients into mild, moderate, severe, and very severe classes. Valid questionnaires were filled out by participants about their demographic data, underlying diseases, and their habits. The chi-square and linear regression tests were done. All data were analyzed using SPSS version 24.

Result

Among demographic factors, positive family history had a significant association with POH. There was a significant association between POH and stress, prolonged exposure to sun or television, and taking hormonal pills. Surprisingly, sleep quality was not significantly related to POH. In addition, there was a relationship between POH and some underlying diseases.

Dissuasion

The present study agreed with others about the significant impact of factors like family history, prolonged sun exposure, stress, and anemia. The current investigation elucidated doubts about the insignificant effect of sleep quality on the severity of POH. In contrast to previous studies, a remarkable relationship between POH and atopy was not revealed.

Conclusion

POH is an undesirable condition. Two key factors associated with this cosmetic problem are rubbing eyes and prolonged exposure to television.

Background

Small extracellular vesicles from adipose-derived stem cells (ASC-sEVs) are gaining attentions rapidly for inherent therapeutic values in skin care and cosmetics. However, the optimal combinations of ASC-sEVs and certain natural compounds for synergistic anti-aging effects have not been systematically studied.

Methods

Human ASC-sEVs were purified from culture supernatant of ASCs and multi-omics datasets of miRNAs, proteins and lipids of ASC-sEVs were analyzed for pathways regulating skin homeostasis. ASC-sEVs were then loaded with nicotinamide riboside (NR), resveratrol (RES), vitamin C (VITC), retinol (RET) and arbutin (ARB) at different concentrations by the sonication-incubation method. Their anti-oxidant, anti-wrinkle and anti-melanogenic effects were tested in vitro using the human keratinocyte HaCaT cells exposed to UVB radiation and human melanocyte B16F10 cells.

Results

Multi-omics data analysis of ASC-sEVs identified key bioactive molecules regulating collagen formation, pigmentation, oxidative stress and inflammation. In the in vitro screenings for anti-aging effects, the compound-loaded ASC-sEVs outperformed the sEV- and compound-only treatments. Specifically in UVB-exposed HaCaT cells, 2 μg/mL sEVs loaded with 20 μg/mL NR, 2 μg/mL RES, 5 μg/mL VITC reduced reactive oxygen species level by 22.0%; while combination of sEVs and 2 μg/mL RES, 2.8 μg/mL RET significantly reduced MMP3 and upregulated PLOD1 expressions. B16F10 cells incubated with 2 μg/mL sEVs loaded with 2 μg/mL RES, 0.5 mM ARB had intracellular and extracellular melanin content lowered by 21.4% and 22.4% respectively. All the combinations caused no cytotoxicity.

Conclusion

Our study demonstrated the superiority of ASC-sEVs to deliver both endogenous biocargos and exogenous compounds to achieve synergistic skin anti-aging effects.

Background

Rosacea is a chronic inflammatory skin disease that affects a notable proportion of the adult population. Platelet-rich plasma (PRP) has been widely used to treat various inflammatory diseases due to its potent anti-inflammatory and antibacterial properties. Considering its therapeutic potential, PRP is emerging as a promising option for managing rosacea.

Aims

To evaluate the efficacy and safety of PRP therapy in treating distinct clinical presentations of rosacea and explore its potential as an alternative to systemic treatments, particularly in cases where conventional therapies are contraindicated.

Methods

Five patients of rosacea with distinct presentations were treated with PRP therapy. The treatment outcomes were analyzed, and a brief review of relevant literature was conducted to contextualize the findings. Clinical efficacy was assessed using clinical photographs captured at 0 and 30 days after baseline according to the National Rosacea Society Standard (NRSS) grading system. Additionally, the efficacy of combining PRP injections with delicate pulsed light therapy or botulinum toxin injections was assessed.

Results

PRP therapy demonstrated significant efficacy and safety in treating rosacea, offering a viable alternative to systemic treatments. The combination of PRP with delicate pulsed light therapy or botulinum toxin injections showed enhanced therapeutic outcomes, not only alleviating rosacea symptoms but also reducing or eliminating patients' dependence on oral medications.

Conclusions

PRP therapy, both as a standalone treatment and in combination with other modalities, represents a promising approach for managing rosacea. These findings highlight the potential of PRP to address the limitations of conventional therapies and improve patient outcomes. Further research is warranted to validate these results and optimize treatment protocols.