首页 > 最新文献

Journal of Cosmetic Dermatology最新文献

英文 中文
Consensus Panel Recommendations for Optimizing Use of a Contact-Cooled 1726 nm Laser for the Treatment of Acne 共识小组建议优化使用接触冷却1726纳米激光治疗痤疮。
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2026-01-29 DOI: 10.1111/jocd.70699
Andrei Metelitsa, R. Sonia Batra, Anne Chapas, Jeffrey Fromowitz, Emmy Graber
<p>The contact-cooled 1726 nm laser (Aviclear, Cutera Inc., Brisbane, CA) treats acne vulgaris by selective thermolysis of sebaceous glands [<span>1</span>]. The device has demonstrated efficacy and safety across a broad range of patients with mild to severe inflammatory acne in clinical trials [<span>2, 3</span>]. In the pivotal trial leading to FDA clearance, 104 subjects (103/104 were graded as moderate or severe at baseline) received three treatments at 2–5 week intervals [<span>3</span>]. A per-protocol analysis of the trial (Table 1) showed significant improvements in both inflammatory lesion count (ILC) and investigator global assessment (IGA) [<span>3, 4</span>]. While study findings are promising, guidance on effective translation of findings to real-world clinical practice and how to best approach patients who may already be on medications is needed.</p><p>Here, an expert consensus group of five dermatologists presents best-practice recommendations for patient selection, treatment optimization, adjunctive therapies, and management strategies. Panelists were selected based on having performed the highest number of contact-cooled 1726 nm treatments, to date, as well as recognized expertise in managing acne. A nominal group technique was used: individual participant best practices were first collected individually via 1-h phone interview and clarified via follow-up e-mail communications. Next, a series of two 1-h virtual discussions were held, where panelist approaches were shared and discussed and a consensus was developed on the guidance for clinical practice presented here. The recommendations presented herein have been approved by all panelists/authors. Agreement was discussion based and there was no formal voting or Delphi process. Recommendations are based on clinical experience in treating over 1600 patients, collectively.</p><p>Contact-cooled 1726 nm laser therapy represents an innovative and effective addition to the acne treatment armamentarium. Its targeted selectivity for sebaceous glands and sustained clinical results set it apart from earlier laser-based modalities. Achieving optimal outcomes requires careful patient selection, clear expectation-setting, thorough counseling regarding the potential for transient acne flares, and the judicious use of adjunctive medications and supportive therapies. As clinical experience and evidence continue to accumulate, treatment protocols will likely become increasingly individualized, further refining and enhancing the role of contact-cooled 1726 nm laser therapy in comprehensive acne management.</p><p>All of the Authors Listed Participated in the Development of Recommendations and Each Aided in the Development and Review of This Commentary.</p><p>The authors have nothing to report.</p><p>The patient featured provided written consent for use of their image.</p><p>All authors serve as consultants for Cutera Inc.</p><p>Data sharing not applicable to this article as no datasets were generate
接触冷却的1726 nm激光器(Aviclear, Cutera Inc., Brisbane, CA)通过选择性热解皮脂腺来治疗寻常性痤疮。在临床试验中,该设备已在广泛的轻度至重度炎性痤疮患者中证明了其有效性和安全性[2,3]。在获得FDA批准的关键试验中,104名受试者(103/104在基线时被分级为中度或重度)以2-5周的间隔接受三种治疗。该试验的按方案分析(表1)显示炎症病变计数(ILC)和研究者总体评估(IGA)均有显著改善[3,4]。虽然研究结果很有希望,但需要指导将研究结果有效地转化为现实世界的临床实践,以及如何最好地接近可能已经在服药的患者。在这里,一个由五位皮肤科医生组成的专家共识小组就患者选择、治疗优化、辅助治疗和管理策略提出了最佳实践建议。小组成员的选择是基于迄今为止进行接触冷却1726纳米治疗的最高次数,以及在管理痤疮方面公认的专业知识。采用了一种名义上的小组技术:首先通过1小时的电话访谈收集个人参与者的最佳实践,并通过后续的电子邮件沟通进行澄清。接下来,举行了一系列的两次1-h虚拟讨论,小组成员分享和讨论了方法,并就临床实践指南达成了共识。此处提出的建议已得到所有小组成员/作者的批准。协议是基于讨论的,没有正式的投票或德尔菲程序。这些建议是根据总共治疗1600多名患者的临床经验提出的。接触冷却1726纳米激光治疗代表了一个创新和有效的补充,痤疮治疗设备。其针对皮脂腺的选择性和持续的临床结果使其有别于早期的基于激光的治疗方式。达到最佳结果需要仔细的患者选择,明确的期望设置,关于短暂痤疮爆发的可能性的彻底咨询,以及明智地使用辅助药物和支持疗法。随着临床经验和证据的不断积累,治疗方案可能会越来越个性化,进一步完善和增强接触冷却1726纳米激光治疗在痤疮综合治疗中的作用。列出的所有作者都参与了建议的制定,并在本评注的制定和审查中提供了帮助。作者没有什么可报告的。患者提供了使用其图像的书面同意。所有作者均为Cutera公司的顾问。数据共享不适用于本文,因为在当前研究中没有生成或分析数据集。
{"title":"Consensus Panel Recommendations for Optimizing Use of a Contact-Cooled 1726 nm Laser for the Treatment of Acne","authors":"Andrei Metelitsa,&nbsp;R. Sonia Batra,&nbsp;Anne Chapas,&nbsp;Jeffrey Fromowitz,&nbsp;Emmy Graber","doi":"10.1111/jocd.70699","DOIUrl":"10.1111/jocd.70699","url":null,"abstract":"&lt;p&gt;The contact-cooled 1726 nm laser (Aviclear, Cutera Inc., Brisbane, CA) treats acne vulgaris by selective thermolysis of sebaceous glands [&lt;span&gt;1&lt;/span&gt;]. The device has demonstrated efficacy and safety across a broad range of patients with mild to severe inflammatory acne in clinical trials [&lt;span&gt;2, 3&lt;/span&gt;]. In the pivotal trial leading to FDA clearance, 104 subjects (103/104 were graded as moderate or severe at baseline) received three treatments at 2–5 week intervals [&lt;span&gt;3&lt;/span&gt;]. A per-protocol analysis of the trial (Table 1) showed significant improvements in both inflammatory lesion count (ILC) and investigator global assessment (IGA) [&lt;span&gt;3, 4&lt;/span&gt;]. While study findings are promising, guidance on effective translation of findings to real-world clinical practice and how to best approach patients who may already be on medications is needed.&lt;/p&gt;&lt;p&gt;Here, an expert consensus group of five dermatologists presents best-practice recommendations for patient selection, treatment optimization, adjunctive therapies, and management strategies. Panelists were selected based on having performed the highest number of contact-cooled 1726 nm treatments, to date, as well as recognized expertise in managing acne. A nominal group technique was used: individual participant best practices were first collected individually via 1-h phone interview and clarified via follow-up e-mail communications. Next, a series of two 1-h virtual discussions were held, where panelist approaches were shared and discussed and a consensus was developed on the guidance for clinical practice presented here. The recommendations presented herein have been approved by all panelists/authors. Agreement was discussion based and there was no formal voting or Delphi process. Recommendations are based on clinical experience in treating over 1600 patients, collectively.&lt;/p&gt;&lt;p&gt;Contact-cooled 1726 nm laser therapy represents an innovative and effective addition to the acne treatment armamentarium. Its targeted selectivity for sebaceous glands and sustained clinical results set it apart from earlier laser-based modalities. Achieving optimal outcomes requires careful patient selection, clear expectation-setting, thorough counseling regarding the potential for transient acne flares, and the judicious use of adjunctive medications and supportive therapies. As clinical experience and evidence continue to accumulate, treatment protocols will likely become increasingly individualized, further refining and enhancing the role of contact-cooled 1726 nm laser therapy in comprehensive acne management.&lt;/p&gt;&lt;p&gt;All of the Authors Listed Participated in the Development of Recommendations and Each Aided in the Development and Review of This Commentary.&lt;/p&gt;&lt;p&gt;The authors have nothing to report.&lt;/p&gt;&lt;p&gt;The patient featured provided written consent for use of their image.&lt;/p&gt;&lt;p&gt;All authors serve as consultants for Cutera Inc.&lt;/p&gt;&lt;p&gt;Data sharing not applicable to this article as no datasets were generate","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12856072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146085728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Unveiling the Therapeutic Potential of “Taikong Blue” Lavender Essential Oil and Its Key Compounds in Skin Problems via Network Pharmacology and In Vitro Validation 通过网络药理学和体外验证揭示“太空蓝”薰衣草精油及其关键化合物对皮肤问题的治疗潜力。
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2026-01-28 DOI: 10.1111/jocd.70640
Fei Liu, Yingyu Zhang, Minhazul Abedin, Jingyi Song, Suzhen Yang, Hongxiang Lou, Xixi Dou, Junsong Xiao, Hua Wu

Background

Taikong Blue Lavender Essential Oil (TLEO) is derived from a proprietary space-bred cultivar of Lavandula angustifolia and cultivated under pristine conditions in Xinjiang, China. TLEO has long been used by regional people to treat various skin disorders such as hyperpigmentation, trans-epidermal water loss, collagen degradation, and poor wound healing. Despite the ethnopharmacological applications of TLEO, the molecular basis of its dermatological efficacy remains poorly defined.

Method

This study integrated network pharmacology, molecular docking, and in vitro assays to systematically investigate how TLEO works against inflammatory skin conditions, focusing on its key compounds and biological targets.

Results

A total of 66 skin disorder-related genes were identified through network pharmacology, with gene enrichment analyses highlighting the TNF signaling pathway as a critical mediator. Protein–protein interaction analysis revealed MMP9, EGFR, and PTGS2 as core targets. Molecular docking confirmed that linalool and linalyl acetate, the primary constituents of TLEO, exhibited moderate binding affinities with these targets. In vitro experiments using TNF-α-stimulated HaCaT cells demonstrated that treatment with 0.01% TLEO significantly (p < 0.05) reduced oxidative stress markers (NO, ROS, MDA), restored antioxidant enzymes (SOD, CAT), and downregulated inflammatory cytokines (IL-6, IL-1β, IL-8). TLEO also inhibited the phosphorylation of p38 MAPK and NF-κB p65, suppressed PTGS2 and MMP9 expression, and restored EGFR levels, indicating anti-inflammatory and barrier-restorative functions.

Conclusions

The study establishes a scientific foundation for the use of TLEO as a multifunctional ingredient in dermatological applications and highlights its value as a sustainable crop for regional economic development in Xinjiang.

背景:泰康蓝薰衣草精油(Taikong Blue Lavender精油,TLEO)是在中国新疆的原始条件下,由一种太空栽培的薰衣草(Lavandula angustifolia)衍生而成。TLEO长期以来被地区人民用于治疗各种皮肤疾病,如色素沉着、经表皮失水、胶原蛋白降解、伤口愈合不良等。尽管TLEO的民族药理学应用,其皮肤功效的分子基础仍然不明确。方法:本研究结合网络药理学、分子对接、体外实验等方法,系统研究TLEO抗炎性皮肤的作用机制,重点研究其关键化合物和生物学靶点。结果:通过网络药理学共鉴定了66个皮肤疾病相关基因,基因富集分析突出了TNF信号通路是一个关键的中介。蛋白-蛋白相互作用分析显示MMP9、EGFR和PTGS2是核心靶点。分子对接证实,TLEO的主要成分芳樟醇和乙酸芳樟醇与这些靶标具有中等的结合亲和力。结论:本研究为TLEO作为一种多功能成分在皮肤科的应用奠定了科学基础,突出了其作为新疆区域经济发展的可持续作物的价值。
{"title":"Unveiling the Therapeutic Potential of “Taikong Blue” Lavender Essential Oil and Its Key Compounds in Skin Problems via Network Pharmacology and In Vitro Validation","authors":"Fei Liu,&nbsp;Yingyu Zhang,&nbsp;Minhazul Abedin,&nbsp;Jingyi Song,&nbsp;Suzhen Yang,&nbsp;Hongxiang Lou,&nbsp;Xixi Dou,&nbsp;Junsong Xiao,&nbsp;Hua Wu","doi":"10.1111/jocd.70640","DOIUrl":"10.1111/jocd.70640","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Taikong Blue Lavender Essential Oil (TLEO) is derived from a proprietary space-bred cultivar of <i>Lavandula angustifolia</i> and cultivated under pristine conditions in Xinjiang, China. TLEO has long been used by regional people to treat various skin disorders such as hyperpigmentation, trans-epidermal water loss, collagen degradation, and poor wound healing. Despite the ethnopharmacological applications of TLEO, the molecular basis of its dermatological efficacy remains poorly defined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This study integrated network pharmacology, molecular docking, and in vitro assays to systematically investigate how TLEO works against inflammatory skin conditions, focusing on its key compounds and biological targets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 66 skin disorder-related genes were identified through network pharmacology, with gene enrichment analyses highlighting the TNF signaling pathway as a critical mediator. Protein–protein interaction analysis revealed MMP9, EGFR, and PTGS2 as core targets. Molecular docking confirmed that linalool and linalyl acetate, the primary constituents of TLEO, exhibited moderate binding affinities with these targets. In vitro experiments using TNF-<i>α</i>-stimulated HaCaT cells demonstrated that treatment with 0.01% TLEO significantly (<i>p &lt;</i> 0.05) reduced oxidative stress markers (NO, ROS, MDA), restored antioxidant enzymes (SOD, CAT), and downregulated inflammatory cytokines (IL-6, IL-1<i>β</i>, IL-8). TLEO also inhibited the phosphorylation of p38 MAPK and NF-<i>κ</i>B p65, suppressed PTGS2 and MMP9 expression, and restored EGFR levels, indicating anti-inflammatory and barrier-restorative functions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study establishes a scientific foundation for the use of TLEO as a multifunctional ingredient in dermatological applications and highlights its value as a sustainable crop for regional economic development in Xinjiang.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12848645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146063746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tranexamic Acid for Hyperpigmentation Disorders: A Literature Review on Efficacy and Safety in Melasma and PIH 氨甲环酸治疗色素沉着症:黄褐斑和PIH疗效和安全性的文献综述。
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2026-01-28 DOI: 10.1111/jocd.70692
Ahmed AlJabr, Aseel Muhana I. AlAnazi, Rakan Abdulkarim A. AlEtebi

Background

Hyperpigmentation disorders, including melasma and post-inflammatory hyperpigmentation (PIH), are common dermatologic conditions associated with significant cosmetic and psychological burden. Tranexamic acid (TXA), an antifibrinolytic agent, has gained increasing attention due to its anti-inflammatory and antimelanogenic properties.

Objective

To review the current evidence on the efficacy and safety of tranexamic acid in the management of hyperpigmentation disorders, particularly melasma and PIH.

Methods

A narrative literature review was conducted using PubMed, Scopus, and Google Scholar to identify clinical and observational studies evaluating the efficacy, safety, and comparative outcomes of oral, topical, and intradermal tranexamic acid in hyperpigmentation disorders. Data were descriptively analyzed with comparison to standard treatments such as hydroquinone and laser therapies.

Results

Evidence from randomized and comparative studies demonstrates that oral, topical, and intradermal TXA significantly reduce pigmentation indices and improve quality-of-life scores in patients with melasma and PIH. Oral TXA at doses of 250–500 mg twice daily showed sustained clinical improvement with minimal adverse effects, most commonly mild gastrointestinal symptoms and menstrual irregularities. Topical and intradermal formulations demonstrated comparable or superior efficacy to hydroquinone with fewer irritant reactions. Combination therapies (e.g., TXA with hydroquinone or laser) yielded enhanced and longer-lasting outcomes.

Conclusion

Tranexamic acid represents a promising and well-tolerated therapeutic option for hyperpigmentation disorders. Its efficacy across multiple administration routes, favorable safety profile, and synergistic potential with existing therapies support its expanding role as both a primary and adjunctive treatment in dermatologic pigment management.

背景:色素沉着障碍,包括黄褐斑和炎症后色素沉着(PIH),是一种常见的皮肤病,与显著的美容和心理负担相关。氨甲环酸(TXA)是一种抗纤溶药物,由于其抗炎和抗黑色素的特性而受到越来越多的关注。目的:回顾氨甲环酸治疗色素沉着症(尤其是黄褐斑和PIH)的有效性和安全性。方法:使用PubMed、Scopus和谷歌Scholar进行叙述性文献综述,以确定评估口服、局部和皮内氨甲环酸治疗色素沉着症的有效性、安全性和比较结果的临床和观察性研究。对数据进行描述性分析,并与对苯二酚和激光治疗等标准治疗进行比较。结果:来自随机和比较研究的证据表明,口服、局部和皮内TXA可显著降低黄褐斑和PIH患者的色素沉着指数,提高生活质量评分。每日两次口服250-500毫克的TXA显示出持续的临床改善,副作用最小,最常见的是轻微的胃肠道症状和月经不规律。局部和皮内制剂显示出与对苯二酚相当或更好的疗效,刺激反应更少。联合治疗(例如,TXA与对苯二酚或激光)产生了增强和更持久的结果。结论:氨甲环酸是一种有前景且耐受性良好的治疗色素沉着症的选择。其跨多种给药途径的有效性、良好的安全性以及与现有疗法的协同潜力支持其作为皮肤色素管理的主要和辅助治疗的作用不断扩大。
{"title":"Tranexamic Acid for Hyperpigmentation Disorders: A Literature Review on Efficacy and Safety in Melasma and PIH","authors":"Ahmed AlJabr,&nbsp;Aseel Muhana I. AlAnazi,&nbsp;Rakan Abdulkarim A. AlEtebi","doi":"10.1111/jocd.70692","DOIUrl":"10.1111/jocd.70692","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hyperpigmentation disorders, including melasma and post-inflammatory hyperpigmentation (PIH), are common dermatologic conditions associated with significant cosmetic and psychological burden. Tranexamic acid (TXA), an antifibrinolytic agent, has gained increasing attention due to its anti-inflammatory and antimelanogenic properties.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To review the current evidence on the efficacy and safety of tranexamic acid in the management of hyperpigmentation disorders, particularly melasma and PIH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A narrative literature review was conducted using PubMed, Scopus, and Google Scholar to identify clinical and observational studies evaluating the efficacy, safety, and comparative outcomes of oral, topical, and intradermal tranexamic acid in hyperpigmentation disorders. Data were descriptively analyzed with comparison to standard treatments such as hydroquinone and laser therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Evidence from randomized and comparative studies demonstrates that oral, topical, and intradermal TXA significantly reduce pigmentation indices and improve quality-of-life scores in patients with melasma and PIH. Oral TXA at doses of 250–500 mg twice daily showed sustained clinical improvement with minimal adverse effects, most commonly mild gastrointestinal symptoms and menstrual irregularities. Topical and intradermal formulations demonstrated comparable or superior efficacy to hydroquinone with fewer irritant reactions. Combination therapies (e.g., TXA with hydroquinone or laser) yielded enhanced and longer-lasting outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tranexamic acid represents a promising and well-tolerated therapeutic option for hyperpigmentation disorders. Its efficacy across multiple administration routes, favorable safety profile, and synergistic potential with existing therapies support its expanding role as both a primary and adjunctive treatment in dermatologic pigment management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12848551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146063819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predictive Factors of Better Patient Satisfaction After Phenol-Croton Peel: A Retrospective Study of 102 Patients 苯酚-巴豆剥后患者满意度提高的预测因素:对102例患者的回顾性研究。
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2026-01-25 DOI: 10.1111/jocd.70609
Gustavo Carneiro Nogueira, Raquel Iracema de Freitas Macedo Oliveira, Mariana Rocha Andrade, Bárbara Arze Rocha, Naides Carneiro Nogueira, Márcio Roberto Silva, Ana Carolina Tardin Rodrigues de Medeiros, Marina Vieira Rodrigues de Queiroz, Felipe Xavier Clo, Ticiano Teixeira Cesar Clo, Carlos Gustavo Wambier, Gisele Viana de Oliveira

Background

Phenol-croton peels are the gold standard for treating sun-damaged skin and static wrinkles; their long-term outcomes and patient satisfaction rates have yet to be thoroughly investigated.

Aims

To evaluate patient satisfaction and both short- and long-term cutaneous side effects in individuals undergoing phenol-croton peels.

Materials and Methods

This retrospective cohort study analyzed 102 female patients who underwent phenol-croton peels and were followed up until 3 months after the procedure to assess short-term side effects and to identify any long-term side effects that persisted beyond this period. Univariate and multivariate analyses were performed to assess patient satisfaction and long-term cutaneous side effects.

Results

Ninety-two percent of patients rated their satisfaction as 4 or 5. Persistent cutaneous side effects were observed in 12% of cases (hypopigmentation: 6, hyperpigmentation: 5, dryness: 1). Despite mild hypopigmentation, five patients expressed willingness to undergo the procedure again. In the univariate analyses, full-face treatment, increasing age, and the absence of cutaneous side effects were significantly associated with higher satisfaction scores (p < 0.05). In the multivariate model, age and the absence of cutaneous side effects remained independently and significantly associated with the outcome. Full-face treatment, although not statistically significant in the final model, showed a trend toward association and contributed to the overall adjustment. Notably, cutaneous side effects decreased at follow-up performed at least 15 months after the procedure compared to follow-up conducted within 3 months post-procedure (p = 0.039).

Conclusions

Phenol-croton peels demonstrated high satisfaction rates despite occasional prolonged cutaneous side effects. However, these side effects significantly decreased at ≥ 15 months post-procedure compared to ≤ 3 months post-procedure. Careful patient selection and expertise in performing this procedure remain crucial for optimizing outcomes.

背景:酚巴豆皮是治疗晒伤皮肤和静态皱纹的金标准;它们的长期效果和患者满意度尚未得到彻底调查。目的:评估接受酚-巴豆换肤的患者满意度和短期和长期的皮肤副作用。材料和方法:本回顾性队列研究分析了102例接受酚-巴豆去皮术的女性患者,并随访至手术后3个月,以评估短期副作用,并确定任何长期副作用持续超过这一时期。进行单因素和多因素分析以评估患者满意度和长期皮肤副作用。结果:92%的患者满意度为4分或5分。在12%的病例中观察到持续的皮肤副作用(色素沉着:6,色素沉着:5,干燥:1)。尽管轻度色素沉着,5名患者表示愿意再次接受手术。在单变量分析中,全脸治疗、年龄增长和无皮肤副作用与更高的满意度评分显著相关(p)。结论:酚巴豆换肤术尽管偶尔会出现持续的皮肤副作用,但仍表现出较高的满意度。然而,与术后≤3个月相比,这些副作用在术后≥15个月显著减少。谨慎的患者选择和专业知识的实施仍然是优化结果的关键。
{"title":"Predictive Factors of Better Patient Satisfaction After Phenol-Croton Peel: A Retrospective Study of 102 Patients","authors":"Gustavo Carneiro Nogueira,&nbsp;Raquel Iracema de Freitas Macedo Oliveira,&nbsp;Mariana Rocha Andrade,&nbsp;Bárbara Arze Rocha,&nbsp;Naides Carneiro Nogueira,&nbsp;Márcio Roberto Silva,&nbsp;Ana Carolina Tardin Rodrigues de Medeiros,&nbsp;Marina Vieira Rodrigues de Queiroz,&nbsp;Felipe Xavier Clo,&nbsp;Ticiano Teixeira Cesar Clo,&nbsp;Carlos Gustavo Wambier,&nbsp;Gisele Viana de Oliveira","doi":"10.1111/jocd.70609","DOIUrl":"10.1111/jocd.70609","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Phenol-croton peels are the gold standard for treating sun-damaged skin and static wrinkles; their long-term outcomes and patient satisfaction rates have yet to be thoroughly investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To evaluate patient satisfaction and both short- and long-term cutaneous side effects in individuals undergoing phenol-croton peels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This retrospective cohort study analyzed 102 female patients who underwent phenol-croton peels and were followed up until 3 months after the procedure to assess short-term side effects and to identify any long-term side effects that persisted beyond this period. Univariate and multivariate analyses were performed to assess patient satisfaction and long-term cutaneous side effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-two percent of patients rated their satisfaction as 4 or 5. Persistent cutaneous side effects were observed in 12% of cases (hypopigmentation: 6, hyperpigmentation: 5, dryness: 1). Despite mild hypopigmentation, five patients expressed willingness to undergo the procedure again. In the univariate analyses, full-face treatment, increasing age, and the absence of cutaneous side effects were significantly associated with higher satisfaction scores (<i>p</i> &lt; 0.05). In the multivariate model, age and the absence of cutaneous side effects remained independently and significantly associated with the outcome. Full-face treatment, although not statistically significant in the final model, showed a trend toward association and contributed to the overall adjustment. Notably, cutaneous side effects decreased at follow-up performed at least 15 months after the procedure compared to follow-up conducted within 3 months post-procedure (<i>p</i> = 0.039).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Phenol-croton peels demonstrated high satisfaction rates despite occasional prolonged cutaneous side effects. However, these side effects significantly decreased at ≥ 15 months post-procedure compared to ≤ 3 months post-procedure. Careful patient selection and expertise in performing this procedure remain crucial for optimizing outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12833551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comprehensive Facial Skin Rejuvenation With Long-Term Regular Intense Pulsed Light Therapy: A Real-World Study 长期定期强脉冲光治疗全面面部皮肤年轻化:一项真实世界的研究。
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2026-01-25 DOI: 10.1111/jocd.70691
Birao Fan, Ruixing Yu

Background

Intense pulsed light (IPL) therapy is widely used for facial rejuvenation, targeting vascular, pigmentary, and textural changes. However, comprehensive, real-world evidence evaluating long-term, regular IPL treatment across multiple dimensions of skin improvement remains limited.

Objectives

This study aimed to assess the efficacy and safety of long-term, regular IPL therapy in improving facial erythema, pigmentation, and wrinkles, and to identify predictors of favorable response.

Methods

This retrospective real-world study included 236 patients who underwent six or more IPL sessions between 2020 and 2025. Patients were categorized as acne, rosacea, or cosmetic subjects. VISIA imaging quantified erythema, pigmentation, and wrinkle indices, while the Global Aesthetic Improvement Scale (GAIS) was used to assess aesthetic outcomes. Logistic regression identified predictors of good response.

Results

Significant improvements were observed in erythema, pigmentation, and wrinkle indices after treatment (all p < 0.05). Regular treatment intervals and total number of sessions were independently associated with better outcomes (OR = 13.62 and 3.80, respectively, both p < 0.05). Patients with Fitzpatrick Type IV skin showed lower response rates (OR = 0.12, p = 0.001). VISIA analyses demonstrated quantifiable reductions in erythema and pigmentation areas, while wrinkles showed notable textural improvement. No severe adverse events occurred.

Conclusions

Long-term, regular IPL therapy effectively improves facial erythema, pigmentation, and wrinkles, confirming its value as a comprehensive rejuvenation strategy. Regular treatment intervals optimize cumulative effects, while objective imaging enhances precision in outcome evaluation. These findings support IPL as a safe, evidence-based, and multidimensional approach to long-term facial rejuvenation.

背景:强脉冲光(IPL)疗法广泛应用于面部年轻化,针对血管、色素和肌理的改变。然而,全面的、真实的证据评估长期、定期IPL治疗在多个维度上的皮肤改善仍然有限。目的:本研究旨在评估长期、常规IPL治疗在改善面部红斑、色素沉着和皱纹方面的有效性和安全性,并确定良好反应的预测因素。方法:这项回顾性现实世界研究包括236名患者,他们在2020年至2025年间接受了6次或更多的IPL治疗。患者分为痤疮、酒糟鼻和美容组。VISIA成像量化红斑、色素沉着和皱纹指数,而全球美学改善量表(GAIS)用于评估美学结果。逻辑回归确定了良好反应的预测因子。结果:治疗后患者的红斑、色素沉着和皱纹指标均有显著改善(p)。结论:长期、定期的IPL治疗可有效改善面部红斑、色素沉着和皱纹,证实其作为一种综合年轻化策略的价值。定期的治疗间隔优化累积效应,而客观成像提高了结果评估的准确性。这些发现支持IPL是一种安全的、基于证据的、多维的长期面部年轻化方法。
{"title":"Comprehensive Facial Skin Rejuvenation With Long-Term Regular Intense Pulsed Light Therapy: A Real-World Study","authors":"Birao Fan,&nbsp;Ruixing Yu","doi":"10.1111/jocd.70691","DOIUrl":"10.1111/jocd.70691","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Intense pulsed light (IPL) therapy is widely used for facial rejuvenation, targeting vascular, pigmentary, and textural changes. However, comprehensive, real-world evidence evaluating long-term, regular IPL treatment across multiple dimensions of skin improvement remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to assess the efficacy and safety of long-term, regular IPL therapy in improving facial erythema, pigmentation, and wrinkles, and to identify predictors of favorable response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective real-world study included 236 patients who underwent six or more IPL sessions between 2020 and 2025. Patients were categorized as acne, rosacea, or cosmetic subjects. VISIA imaging quantified erythema, pigmentation, and wrinkle indices, while the Global Aesthetic Improvement Scale (GAIS) was used to assess aesthetic outcomes. Logistic regression identified predictors of good response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant improvements were observed in erythema, pigmentation, and wrinkle indices after treatment (all <i>p</i> &lt; 0.05). Regular treatment intervals and total number of sessions were independently associated with better outcomes (OR = 13.62 and 3.80, respectively, both <i>p</i> &lt; 0.05). Patients with Fitzpatrick Type IV skin showed lower response rates (OR = 0.12, <i>p</i> = 0.001). VISIA analyses demonstrated quantifiable reductions in erythema and pigmentation areas, while wrinkles showed notable textural improvement. No severe adverse events occurred.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Long-term, regular IPL therapy effectively improves facial erythema, pigmentation, and wrinkles, confirming its value as a comprehensive rejuvenation strategy. Regular treatment intervals optimize cumulative effects, while objective imaging enhances precision in outcome evaluation. These findings support IPL as a safe, evidence-based, and multidimensional approach to long-term facial rejuvenation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12833585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Regeneration in Aesthetic Medicine: Mechanisms, Evidence, and Clinical Boundaries 美容医学中的再生:机制、证据和临床界限。
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2026-01-23 DOI: 10.1111/jocd.70669
Antony de Paula Barbosa
<div> <section> <h3> Background</h3> <p>Regeneration has emerged as a key concept in aesthetic medicine as the field evolves from predominantly volumetric correction toward biologically oriented strategies aimed at improving tissue quality, function, and long-term structural integrity. However, the widespread use of the term “regenerative” has often been used without biological precision, leading to conceptual overlap with repair, remodeling, and biostimulation. A critical evaluation of the biological basis and clinical evidence supporting regenerative claims is needed.</p> </section> <section> <h3> Objective</h3> <p>To critically synthesize current biological, translational, and clinical evidence related to skin regeneration in aesthetic medicine, with emphasis on extracellular matrix remodeling, immune modulation, mechanotransduction, and dermal–hypodermal integration, and to contextualize the regenerative potential and limitations of commonly used biomaterials.</p> </section> <section> <h3> Methods</h3> <p>A narrative review was conducted based on experimental studies, translational research, narrative and systematic reviews, and clinical investigations cited in the reference set. Evidence was qualitatively analyzed focusing on mechanisms of action, tissue-level interactions, immune responses, extracellular matrix dynamics, involvement of subcutaneous adipose compartments, and durability of clinical outcomes.</p> </section> <section> <h3> Results</h3> <p>Cutaneous regeneration is a multilevel functional process driven by coordinated extracellular matrix reorganization, controlled inflammation, mechanotransduction, angiogenesis, and dermal–hypodermal crosstalk. Particulate collagen biostimulators (poly-<span>l</span>-lactic acid, poly-<span>d</span>,<span>l</span>-lactic acid, calcium hydroxyapatite, and polycaprolactone) demonstrate the most consistent evidence for sustained functional remodeling, with poly-<span>l</span>-lactic acid showing the strongest longitudinal and histological support. Hyaluronic acid–based fillers and skinboosters primarily act as microenvironmental modulators with limited regenerative depth. Polydioxanone threads induce localized mechanobiological remodeling that is highly technique dependent. Biological bioregenerators, including polynucleotides, polydeoxyribonucleotides, and extracellular vesicles, show strong mechanistic plausibility but limited and heterogeneous clinical evidence.</p> </section> <section> <h3> Conclusion</h3>
背景:随着美容医学领域从主要的体积校正向旨在改善组织质量、功能和长期结构完整性的生物学导向策略的发展,再生已经成为一个关键概念。然而,“再生”一词的广泛使用往往缺乏生物学上的精确性,导致与修复、重塑和生物刺激的概念重叠。需要对支持再生声称的生物学基础和临床证据进行批判性评估。目的:批判性地综合当前美容医学中与皮肤再生有关的生物学、翻译和临床证据,重点是细胞外基质重塑、免疫调节、机械转导和真皮-皮下整合,并介绍常用生物材料的再生潜力和局限性。方法:以文献集中引用的实验研究、转化研究、叙述性综述和系统综述以及临床调查为基础,进行叙述性综述。对证据进行定性分析,重点关注作用机制、组织水平的相互作用、免疫反应、细胞外基质动力学、皮下脂肪室的参与以及临床结果的持久性。结果:皮肤再生是一个多层次的功能过程,由协调的细胞外基质重组、炎症控制、机械转导、血管生成和真皮-皮下相互作用驱动。颗粒型胶原生物刺激剂(聚l-乳酸、聚d、l-乳酸、羟基磷灰石钙和聚己内酯)显示出最一致的持续功能重塑证据,其中聚l-乳酸显示出最强的纵向和组织学支持。基于透明质酸的填充剂和皮肤促进剂主要作为微环境调节剂,具有有限的再生深度。聚二恶酮线诱导高度依赖技术的局部机械生物学重塑。包括多核苷酸、多脱氧核糖核苷酸和细胞外囊泡在内的生物再生源显示出强大的机制合理性,但临床证据有限且不一致。结论:美容医学的再生应以生物机制、功能整合和持久性来定义,而不是以短暂的形态改变来定义。生物学上可问责和基于证据的框架对于负责任的临床应用至关重要。
{"title":"Regeneration in Aesthetic Medicine: Mechanisms, Evidence, and Clinical Boundaries","authors":"Antony de Paula Barbosa","doi":"10.1111/jocd.70669","DOIUrl":"10.1111/jocd.70669","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Regeneration has emerged as a key concept in aesthetic medicine as the field evolves from predominantly volumetric correction toward biologically oriented strategies aimed at improving tissue quality, function, and long-term structural integrity. However, the widespread use of the term “regenerative” has often been used without biological precision, leading to conceptual overlap with repair, remodeling, and biostimulation. A critical evaluation of the biological basis and clinical evidence supporting regenerative claims is needed.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To critically synthesize current biological, translational, and clinical evidence related to skin regeneration in aesthetic medicine, with emphasis on extracellular matrix remodeling, immune modulation, mechanotransduction, and dermal–hypodermal integration, and to contextualize the regenerative potential and limitations of commonly used biomaterials.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A narrative review was conducted based on experimental studies, translational research, narrative and systematic reviews, and clinical investigations cited in the reference set. Evidence was qualitatively analyzed focusing on mechanisms of action, tissue-level interactions, immune responses, extracellular matrix dynamics, involvement of subcutaneous adipose compartments, and durability of clinical outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Cutaneous regeneration is a multilevel functional process driven by coordinated extracellular matrix reorganization, controlled inflammation, mechanotransduction, angiogenesis, and dermal–hypodermal crosstalk. Particulate collagen biostimulators (poly-&lt;span&gt;l&lt;/span&gt;-lactic acid, poly-&lt;span&gt;d&lt;/span&gt;,&lt;span&gt;l&lt;/span&gt;-lactic acid, calcium hydroxyapatite, and polycaprolactone) demonstrate the most consistent evidence for sustained functional remodeling, with poly-&lt;span&gt;l&lt;/span&gt;-lactic acid showing the strongest longitudinal and histological support. Hyaluronic acid–based fillers and skinboosters primarily act as microenvironmental modulators with limited regenerative depth. Polydioxanone threads induce localized mechanobiological remodeling that is highly technique dependent. Biological bioregenerators, including polynucleotides, polydeoxyribonucleotides, and extracellular vesicles, show strong mechanistic plausibility but limited and heterogeneous clinical evidence.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 ","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Where Should We Inject Botulinum Toxin for the Bunny Lines? 我们应该在哪里注射肉毒杆菌毒素?
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2026-01-22 DOI: 10.1111/jocd.70673
Kyu-Ho Yi, Soo-Bin Kim
<p>In aesthetic clinical practice, the treatment of “bunny lines”—the fine diagonal or vertical wrinkles that appear on the nasal sidewall during facial expressions such as smiling or laughing—has conventionally involved direct botulinum toxin (BoNT) injection into the crease itself (Figure 1). This approach assumes the presence of a hyperactive muscle immediately beneath the visible wrinkle. However, emerging evidence from detailed cadaveric dissections and ultrasonographic (US) analyses challenges this long-standing assumption and may explain the inconsistent and sometimes suboptimal outcomes associated with the “in-the-line” injection approach [<span>1</span>].</p><p>Recent anatomical and imaging data demonstrate that the region between the medial canthus and nasal dorsum—where bunny lines manifest—is not underlain by a discrete muscle but rather represents a non-muscular interval termed the bunny triangle. In their multimodal study involving 39 cadaveric dissections and dynamic US examinations of 13 volunteers, Ahn et al. [<span>1</span>] delineated this muscle-free triangle bordered by the procerus (superior-medial margin), transverse nasalis (superior-lateral margin), levator labii superioris alaeque nasi (LLSAN, inferomedial margin), and medial fibers of the orbicularis oculi (OOc, lateral margin). During active nose scrunching, US confirmed that the visible wrinkles correspond to skin folding over this non-muscular region, while adjacent muscles contract peripherally. The nasalis thickened dynamically in most participants, confirming its primary mechanical role in bunny line formation. Thus, the wrinkle is not generated by a localized underlying muscle but by convergent traction from neighboring muscles. Injecting BoNT directly into the crease therefore targets connective tissue and relies on passive diffusion, resulting in unpredictable efficacy and a higher likelihood of over- or under-treatment depending on the diffusion pattern [<span>2, 3</span>].</p><p>The clinical implication of these findings is that the traditional “in-the-line” injection paradigm may be anatomically unsound. Instead, practitioners should adopt a border-targeted chemodenervation strategy focusing on the muscles actually responsible for wrinkle formation. This concept aligns with modern principles of functional anatomy, emphasizing selective modulation of active muscle borders rather than superficial crease injection.</p><p>Before injection, dynamic facial assessment should be performed. The patient is asked to smile, scrunch the nose, or express disgust to identify which borders contract most prominently—procerus, nasalis, LLSAN, or medial OOc. This individualized mapping acknowledges inter-patient variability in perinasal muscle dominance (Figure 2).</p><p>(Figure 3) Transverse nasalis (primary driver): Small intramuscular injections (1–2 U of BoNT-A) along its superior border on the upper nasal sidewall effectively attenuate line formation [<span>4</span>].</p>
在美学临床实践中,治疗“兔纹”——在微笑或大笑等面部表情时出现在鼻侧壁上的细小对角线或垂直皱纹——通常涉及直接向皱纹本身注射肉毒杆菌毒素(BoNT)(图1)。这种方法假定在可见的皱纹下面有一块过度活跃的肌肉。然而,来自详细尸体解剖和超声(US)分析的新证据挑战了这一长期存在的假设,并可能解释与“在线”注射方法相关的不一致和有时不理想的结果[1]。最近的解剖学和影像学数据表明,在内眦和鼻背之间的区域——兔纹显示的地方——并不是由一个离散的肌肉所覆盖,而是代表了一个被称为兔三角的非肌肉间隔。在他们的多模式研究中,Ahn等人对13名志愿者进行了39例尸体解剖和动态超声检查,描绘了这个无肌肉的三角形,其边界是前肌(上内侧缘)、鼻横肌(上外侧缘)、鼻上唇提肌(内内侧缘)和眼轮匝肌内侧纤维(外侧缘)。在主动揉鼻子的过程中,美国证实,可见的皱纹对应于这个非肌肉区域的皮肤折叠,而邻近的肌肉在周围收缩。鼻肌在大多数参与者中动态增厚,证实了其在兔线形成中的主要机械作用。因此,皱纹不是由局部的下层肌肉产生的,而是由邻近肌肉的收敛牵引力产生的。因此,将BoNT直接注射到皱褶中针对结缔组织,并依赖于被动扩散,导致不可预测的疗效,并且根据扩散模式,治疗过度或治疗不足的可能性更高[2,3]。这些发现的临床意义是,传统的“在线”注射模式可能在解剖学上是不合理的。相反,从业者应该采用一种针对边缘的化学神经支配策略,专注于实际负责皱纹形成的肌肉。这个概念与现代功能解剖学原理一致,强调活动肌肉边界的选择性调节,而不是表面折痕注射。注射前应进行动态面部评估。病人被要求微笑,皱鼻子,或表示厌恶,以确定哪个边界收缩最突出- - -前肌,鼻肌,LLSAN,或内侧OOc。这种个体化的定位确认了鼻周肌优势在患者间的可变性(图2)。(图3)鼻横肌(主要驱动因素):沿着鼻上侧壁的上边界进行少量肌肉注射(1-2 U BoNT-A),有效地减弱了线形成[4]。LLSAN(次要贡献者):在其上内侧边界的微等分(0.5-1 U)可以抑制鼻翼的过度升高,但必须谨慎放置,以避免鼻翼下垂或上唇提升无力。内眼轮匝肌:当强烈的外侧牵引使皱褶加重时,应在内侧眦缘处保守注射。前肌:如果眉间窝收缩延伸到鼻根,在其内外侧缘注射低剂量(1u)可以补充治疗。高精度、小容量注射可最大限度地减少毒素扩散。扩散研究表明,大体积和低浓度会增加邻近肌肉的非预期失神经支配[5,6]。因此,限制在活跃边界内的微配额提高了安全性和可预测性。b模式美国成像允许实时可视化兔子三角形和收缩边界。超声引导下注射提高了准确性,确保了正确的深度(通常在皮下平面1.5-2.0 mm),并避免了附近的血管,如角状动脉。该技术还降低了不对称和扩散相关并发症的风险。在功能上,兔子三角形充当被动变形区,当周围肌肉的张力汇聚时折叠。前肌提供上内侧牵拉,鼻横肌向外侧压迫,LLSAN和内侧OOc分别施加垂直和斜向牵拉。这种协同复合物的重复招募会引起动态皱纹,后来由于真皮变薄和重复牵引[8]而成为静态皱纹。因此,针对皱褶本身并不能有效地抑制产生皱褶的肌肉力量。相反,外围的注射会中断直接导致褶皱的收缩力。这一精细化的理解也解释了为什么过量注射BoNT会不可预测地扩散到附近的电梯,导致功能和美学并发症,如嘴唇不对称、鼻翼下降或下眼睑无力。
{"title":"Where Should We Inject Botulinum Toxin for the Bunny Lines?","authors":"Kyu-Ho Yi,&nbsp;Soo-Bin Kim","doi":"10.1111/jocd.70673","DOIUrl":"10.1111/jocd.70673","url":null,"abstract":"&lt;p&gt;In aesthetic clinical practice, the treatment of “bunny lines”—the fine diagonal or vertical wrinkles that appear on the nasal sidewall during facial expressions such as smiling or laughing—has conventionally involved direct botulinum toxin (BoNT) injection into the crease itself (Figure 1). This approach assumes the presence of a hyperactive muscle immediately beneath the visible wrinkle. However, emerging evidence from detailed cadaveric dissections and ultrasonographic (US) analyses challenges this long-standing assumption and may explain the inconsistent and sometimes suboptimal outcomes associated with the “in-the-line” injection approach [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Recent anatomical and imaging data demonstrate that the region between the medial canthus and nasal dorsum—where bunny lines manifest—is not underlain by a discrete muscle but rather represents a non-muscular interval termed the bunny triangle. In their multimodal study involving 39 cadaveric dissections and dynamic US examinations of 13 volunteers, Ahn et al. [&lt;span&gt;1&lt;/span&gt;] delineated this muscle-free triangle bordered by the procerus (superior-medial margin), transverse nasalis (superior-lateral margin), levator labii superioris alaeque nasi (LLSAN, inferomedial margin), and medial fibers of the orbicularis oculi (OOc, lateral margin). During active nose scrunching, US confirmed that the visible wrinkles correspond to skin folding over this non-muscular region, while adjacent muscles contract peripherally. The nasalis thickened dynamically in most participants, confirming its primary mechanical role in bunny line formation. Thus, the wrinkle is not generated by a localized underlying muscle but by convergent traction from neighboring muscles. Injecting BoNT directly into the crease therefore targets connective tissue and relies on passive diffusion, resulting in unpredictable efficacy and a higher likelihood of over- or under-treatment depending on the diffusion pattern [&lt;span&gt;2, 3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The clinical implication of these findings is that the traditional “in-the-line” injection paradigm may be anatomically unsound. Instead, practitioners should adopt a border-targeted chemodenervation strategy focusing on the muscles actually responsible for wrinkle formation. This concept aligns with modern principles of functional anatomy, emphasizing selective modulation of active muscle borders rather than superficial crease injection.&lt;/p&gt;&lt;p&gt;Before injection, dynamic facial assessment should be performed. The patient is asked to smile, scrunch the nose, or express disgust to identify which borders contract most prominently—procerus, nasalis, LLSAN, or medial OOc. This individualized mapping acknowledges inter-patient variability in perinasal muscle dominance (Figure 2).&lt;/p&gt;&lt;p&gt;(Figure 3) Transverse nasalis (primary driver): Small intramuscular injections (1–2 U of BoNT-A) along its superior border on the upper nasal sidewall effectively attenuate line formation [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Global Recommendations for Facial Rejuvenation Using a Hyaluronic Acid and Calcium Hydroxyapatite Hybrid Injectable 使用透明质酸和羟基磷灰石钙混合注射剂的面部年轻化的全球建议。
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2026-01-21 DOI: 10.1111/jocd.70608
Maurizio Cavallini, Andre Braz, Daniela Greiner-Krüger, Sylwia Lipko-Godlewska, Tapan Patel, Marva Safa, Sophie Shotter, Fernando Urdiales Gálvez, Graeme Kerson

Background

The hybrid injectable HA-CaHA contains a formulated matrix of crosslinked hyaluronic acid (HA) gel with embedded calcium hydroxyapatite (CaHA) microspheres to increase skin elasticity and hydration as well as promote neocollagenesis, respectively. Clinical practice recommendations for use of HA-CaHA are limited.

Aims

The objective of this article was to provide global recommendations on safe and effective practices for injecting HA-CaHA.

Patient/Methods

An expert panel consisting of eight international consultants was invited to discuss and provide best-practice recommendations on HA-CaHA patient selection, skin laxity assessment, injection techniques, touch-up/retreatment practices, combination treatment protocols, and safety considerations.

Results

The expert panel recommended using HA-CaHA for structural support and soft tissue repositioning in patients with skin laxity, sagginess, and mild to moderate loss of volume and contour. They also recommended defining injection entry points by referring to the line of ligaments and the zygomatic arch and keeping injections in the lateral and thus less mobile areas of the face. Experts advised using a cannula instead of a needle, retreating only if mild to moderate skin laxity recurs, and injecting in small volumes. Measures to minimize potential side effects, including injection site responses, were discussed.

Conclusions

Expert clinical recommendations affirm the safe and effective use of HA-CaHA to improve soft tissue quality over time.

背景:混合可注射HA-CaHA含有交联透明质酸(HA)凝胶的配方基质,内含羟基磷灰石钙(CaHA)微球,分别增加皮肤弹性和水合作用,并促进新胶原形成。临床实践推荐使用HA-CaHA是有限的。目的:这篇文章的目的是提供安全有效的注射HA-CaHA的全球建议。患者/方法:一个由8名国际顾问组成的专家小组被邀请讨论并提供关于HA-CaHA患者选择、皮肤松弛评估、注射技术、补药/再治疗实践、联合治疗方案和安全考虑的最佳实践建议。结果:专家组建议在皮肤松弛、松弛、轻度至中度体积和轮廓丢失的患者中使用HA-CaHA进行结构支撑和软组织复位。他们还建议通过参考韧带线和颧弓来确定注射进入点,并将注射保持在面部外侧,从而减少活动区域。专家建议使用套管而不是针头,只有在轻度至中度皮肤松弛复发时才撤退,并注射小剂量。讨论了减少潜在副作用的措施,包括注射部位反应。结论:专家的临床建议肯定了HA-CaHA安全有效的使用,随着时间的推移可以改善软组织质量。
{"title":"Global Recommendations for Facial Rejuvenation Using a Hyaluronic Acid and Calcium Hydroxyapatite Hybrid Injectable","authors":"Maurizio Cavallini,&nbsp;Andre Braz,&nbsp;Daniela Greiner-Krüger,&nbsp;Sylwia Lipko-Godlewska,&nbsp;Tapan Patel,&nbsp;Marva Safa,&nbsp;Sophie Shotter,&nbsp;Fernando Urdiales Gálvez,&nbsp;Graeme Kerson","doi":"10.1111/jocd.70608","DOIUrl":"10.1111/jocd.70608","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The hybrid injectable HA-CaHA contains a formulated matrix of crosslinked hyaluronic acid (HA) gel with embedded calcium hydroxyapatite (CaHA) microspheres to increase skin elasticity and hydration as well as promote neocollagenesis, respectively. Clinical practice recommendations for use of HA-CaHA are limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The objective of this article was to provide global recommendations on safe and effective practices for injecting HA-CaHA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient/Methods</h3>\u0000 \u0000 <p>An expert panel consisting of eight international consultants was invited to discuss and provide best-practice recommendations on HA-CaHA patient selection, skin laxity assessment, injection techniques, touch-up/retreatment practices, combination treatment protocols, and safety considerations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The expert panel recommended using HA-CaHA for structural support and soft tissue repositioning in patients with skin laxity, sagginess, and mild to moderate loss of volume and contour. They also recommended defining injection entry points by referring to the line of ligaments and the zygomatic arch and keeping injections in the lateral and thus less mobile areas of the face. Experts advised using a cannula instead of a needle, retreating only if mild to moderate skin laxity recurs, and injecting in small volumes. Measures to minimize potential side effects, including injection site responses, were discussed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Expert clinical recommendations affirm the safe and effective use of HA-CaHA to improve soft tissue quality over time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12824049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Radiofrequency Microneedling With 1927 nm Thulium Laser Versus Radiofrequency Microneedling Monotherapy for Rejuvenation of Photoaged Skin 277nm铥激光射频微针与射频微针单药治疗光老化皮肤的对比研究。
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2026-01-21 DOI: 10.1111/jocd.70685
Lynhda Nguyen, Marco Blessmann, Stefan W. Schneider, Katharina Herberger
<div> <section> <h3> Background</h3> <p>The combination of radiofrequency microneedling (RFMN) with fractional 1927 nm thulium (Tm) laser has gained popularity in clinical practice. However, comparative studies remain limited.</p> </section> <section> <h3> Objectives</h3> <p>To evaluate the efficacy and safety of combined RFMN/Tm laser treatment versus RFMN alone for rejuvenation of photoaged skin of the lower face and neck area.</p> </section> <section> <h3> Material and Methods</h3> <p>A prospective, evaluator-blinded, clinical study. Patients were assigned to a combined protocol consisting of 1–3 RFMN treatment sessions immediately followed by Tm laser, supplemented by three additional Tm laser sessions at 6–8-week intervals. Study endpoints were compared with data from our previously published RFMN monotherapy cohort. Outcomes were assessed using validated clinical grading scales, computer-assisted analysis of submental volume, and a standardized color space system to quantify skin tone evening. Pain was assessed using a numeric rating scale. Adverse events (AEs) were monitored throughout the study period.</p> </section> <section> <h3> Results</h3> <p>26 received the combined treatment, and 27 patients were treated with RFMN alone. Mean ages were 50.7 ± 7.4 and 55.6 ± 8.9 years, respectively. Both groups showed significant reductions in submental volume without significant differences between them. However, only the combination group demonstrated a distinct improvement in hyperpigmented lesions, as quantified by the color analysis. Blinded evaluations noted improvements in the melomental area, jawline, and neck in both groups, while greater improvements in skin tone evening and therefore overall appearance were seen only in the combination group. No serious AEs were reported.</p> </section> <section> <h3> Conclusion</h3> <p>Both treatment modalities effectively addressed lower facial and neck laxity. The addition of Tm laser to RFMN provided additional benefits in treating pigmentary irregularities and improving overall clinical outcome without notably compromising downtime. Larger studies are warranted to validate these findings and assess long-term outcomes.</p> </section> <section> <h3> Trial Registration</h3> <p>This study was preregistered in clinicaltrials.gov (NCT06029725) on 23 August 2023</p> </section> </div
背景:射频微针(RFMN)与分数级277nm铥(Tm)激光相结合已在临床实践中得到广泛应用。然而,比较研究仍然有限。目的:评价RFMN/Tm激光联合治疗与单独RFMN治疗下面部及颈部光老化皮肤的疗效和安全性。材料和方法:一项前瞻性、评价者盲法临床研究。患者被分配到一个联合方案,包括1-3次RFMN治疗,紧接着是Tm激光治疗,每隔6-8周补充3次Tm激光治疗。研究终点比较了我们先前发表的RFMN单药治疗队列的数据。使用经过验证的临床分级量表、计算机辅助的脑下体积分析和标准化的色彩空间系统来量化肤色。疼痛采用数字评定量表进行评估。在整个研究期间监测不良事件(ae)。结果:联合治疗26例,单用RFMN治疗27例。平均年龄分别为50.7±7.4岁和55.6±8.9岁。两组均表现出显著的脑下体积减少,但两者之间无显著差异。然而,只有联合用药组在色素沉着病变方面表现出明显的改善,这是通过颜色分析来量化的。盲法评估发现,两组患者的黑色素区域、下颌线和颈部均有改善,而只有联合用药组患者的晚间肤色和整体外观均有较大改善。没有严重的ae报告。结论:两种治疗方式均能有效解决下面部及颈部松弛。在RFMN中加入Tm激光在治疗色素不规则和改善整体临床结果方面提供了额外的好处,而不会明显影响停机时间。需要更大规模的研究来验证这些发现并评估长期结果。试验注册:该研究已于2023年8月23日在clinicaltrials.gov (NCT06029725)上进行预注册。
{"title":"Radiofrequency Microneedling With 1927 nm Thulium Laser Versus Radiofrequency Microneedling Monotherapy for Rejuvenation of Photoaged Skin","authors":"Lynhda Nguyen,&nbsp;Marco Blessmann,&nbsp;Stefan W. Schneider,&nbsp;Katharina Herberger","doi":"10.1111/jocd.70685","DOIUrl":"10.1111/jocd.70685","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The combination of radiofrequency microneedling (RFMN) with fractional 1927 nm thulium (Tm) laser has gained popularity in clinical practice. However, comparative studies remain limited.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To evaluate the efficacy and safety of combined RFMN/Tm laser treatment versus RFMN alone for rejuvenation of photoaged skin of the lower face and neck area.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Material and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A prospective, evaluator-blinded, clinical study. Patients were assigned to a combined protocol consisting of 1–3 RFMN treatment sessions immediately followed by Tm laser, supplemented by three additional Tm laser sessions at 6–8-week intervals. Study endpoints were compared with data from our previously published RFMN monotherapy cohort. Outcomes were assessed using validated clinical grading scales, computer-assisted analysis of submental volume, and a standardized color space system to quantify skin tone evening. Pain was assessed using a numeric rating scale. Adverse events (AEs) were monitored throughout the study period.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;26 received the combined treatment, and 27 patients were treated with RFMN alone. Mean ages were 50.7 ± 7.4 and 55.6 ± 8.9 years, respectively. Both groups showed significant reductions in submental volume without significant differences between them. However, only the combination group demonstrated a distinct improvement in hyperpigmented lesions, as quantified by the color analysis. Blinded evaluations noted improvements in the melomental area, jawline, and neck in both groups, while greater improvements in skin tone evening and therefore overall appearance were seen only in the combination group. No serious AEs were reported.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Both treatment modalities effectively addressed lower facial and neck laxity. The addition of Tm laser to RFMN provided additional benefits in treating pigmentary irregularities and improving overall clinical outcome without notably compromising downtime. Larger studies are warranted to validate these findings and assess long-term outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Trial Registration&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study was preregistered in clinicaltrials.gov (NCT06029725) on 23 August 2023&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 &lt;/div","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12824051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical Evaluation of an Integrated Tri-Modal Transdermal Device for Enhanced Serum Absorption 提高血清吸收的集成三模态透皮装置的临床评价。
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2026-01-21 DOI: 10.1111/jocd.70674
Youjin Kim, Seongwon Hong, Kiyoung Chang, Seoyeon Han, Huijun Leung, Jee Sun Lee, Soha Jeon, Hae Jo
<p>Physical transdermal delivery systems such as electroporation, sonophoresis, and iontophoresis have been studied for their potential to enhance cutaneous absorption of active ingredients, improving penetration and bioavailability in cosmetic and therapeutic applications [<span>1</span>]. Electroporation delivers short high-voltage pulses that transiently disrupt the stratum corneum, forming micropores that allow passage of otherwise impermeable molecules [<span>2, 3</span>]. Sonophoresis employs ultrasound waves (~1 MHz) to disorder intercellular lipid bilayers, widening diffusion pathways [<span>4</span>]. Iontophoresis applies a low-level electrical current to drive charged actives via electro-repulsion and promote nonionic transport through electroosmosis [<span>5</span>].</p><p>Combining physical enhancers is suggested to lead to additive or potentially synergistic improvements in transdermal flux [<span>6</span>]. Previous studies have shown that combining two modalities enhances penetration more than either alone—for example, sonophoresis can lower the electroporation threshold and increase skin permeability, allowing iontophoresis to subsequently provide a sustained electrical driving force that maintains or augments flux [<span>1, 3, 6</span>]. Although such dual-modality combinations have been explored, no clinical study has evaluated the integrated use of all three modalities or quantified tri-modal delivery using depth-resolved confocal Raman spectroscopy, particularly in consumer-grade devices.</p><p>This study used depth-resolved confocal Raman spectroscopy to assess penetration depth and concentration of a tri-modal delivery system compared with manual application. In this open-label crossover study (IRB approval: Ellead No. 240912T005), 22 healthy Korean women aged 23–60 years (mean ± standard deviation: 47.6 ± 9.4) without history of skin diseases were enrolled. Following a 30-min acclimatization (20°C–22°C; 40%–60% humidity), each participant received a 90-s serum application on one forearm. On the contralateral forearm, the same serum was applied followed by a single device application (electroporation + sonophoresis + iontophoresis). Device parameters were 9.2 V and 1 kHz for electroporation, 5 V and 1 kHz for iontophoresis, and 1 MHz ultrasound for sonophoresis, selected based on preclinical optimization and established safety-validated ranges in cosmetic skin-delivery applications. The serum contained plant-based collagen, cranberry biopeptides, fermented oligopeptides, and white chia peptides in a liposomal carrier. Raman spectroscopy (gen2 Skin Composition Analyzer; River Diagnostics, Rotterdam, Netherlands) was performed at baseline and 30 min after application, with 2 μm steps to 30 μm. Penetration quantity was expressed as Raman intensity relative to keratin (A.U./cm<sup>2</sup>), and depth (μm) defined as the deepest point exceeding baseline. Statistical analyses were performed in SPSS version 27 (IBM, Armonk, NY, US
物理透皮输送系统,如电穿孔、声透和离子透等,已被研究用于增强活性成分的皮肤吸收,改善化妆品和治疗应用中的渗透和生物利用度[10]。电穿孔提供短的高压脉冲,瞬时破坏角质层,形成微孔,允许不渗透的分子通过[2,3]。超声电泳利用超声波(~ 1mhz)扰乱细胞间脂质双层,扩大扩散途径[4]。离子电泳通过电斥力施加低电流来驱动带电活性物质,并通过电渗透促进非离子传输。建议结合物理增强剂可导致透皮通量的附加或潜在协同改善。先前的研究表明,结合两种方式比单独使用一种方式更能增强渗透,例如,声透可以降低电穿孔阈值并增加皮肤渗透性,从而使离子透随后提供持续的电驱动力,维持或增加通量[1,3,6]。虽然已经探索了这种双模态组合,但没有临床研究评估所有三种模式的综合使用或使用深度分辨共聚焦拉曼光谱定量的三模态递送,特别是在消费级设备中。本研究使用深度分辨共聚焦拉曼光谱来评估与手动应用相比,三模态输送系统的渗透深度和浓度。在这项开放标签交叉研究(IRB批准:Ellead No. 240912T005)中,22名年龄在23-60岁(平均±标准差:47.6±9.4)、无皮肤病史的韩国健康女性入组。经过30分钟的环境适应(20°C - 22°C;湿度40%-60%),每位参与者在一只前臂上接受90秒的血清应用。在对侧前臂,应用相同的血清,然后使用单一装置(电穿孔+超声电泳+离子电泳)。设备参数为9.2 V和1 kHz电穿孔,5 V和1 kHz离子透入,1 MHz超声透入,根据临床前优化和化妆品皮肤输送应用中建立的安全验证范围选择。该血清在脂质体载体中含有植物胶原蛋白、蔓越莓生物肽、发酵寡肽和白奇异肽。拉曼光谱(gen2皮肤成分分析仪;River Diagnostics,鹿特丹,荷兰)在基线和敷药后30分钟进行,步骤2 μm至30 μm。穿透量表示为相对于角蛋白的拉曼强度(A.U./cm2),深度(μm)定义为超过基线的最深点。统计分析采用SPSS version 27 (IBM, Armonk, NY, USA)。使用配对t检验分析受试者内(应用前与应用后)比较,使用Wilcoxon符号秩检验评估个体内对侧比较(仅使用血清与器械辅助使用血清),显著性设置为p &lt; 0.05。两种情况均显示受试者体内渗透指标显著增加(器械辅助血清应用,p &lt; 0.001;仅血清,p &lt; 0.001;数据未显示)。对侧比较证实,器械辅助血清应用显著增加了释药量,平均吸收量从单纯血清部位的0.080±0.019 A.U./cm2增加到器械辅助部位的0.207±0.145 A.U./cm2 (p &lt; 0.001)。平均穿透深度从7.36±1.99 μm增加到17.00±5.16 μm (p &lt; 0.001;图1)。Raman图(图2)证实了这些发现:仅血清应用在角质层的6-10 μm范围内显示狭窄的信号,而器械辅助应用显示更宽的波段,延伸至12-26 μm,到达上层活表皮。研究结果在参与者中是一致的,通过皮肤科医生评估的视觉检查(如红斑、瘙痒、刺痛)和参与者报告的感觉进行安全监测,没有发现不良反应或不适。器械辅助透皮给药系统的直接交叉研究比较本质上是有限的,因为增强结果受到器械设置、应用协议、解剖部位、研究设计和终点测量方法的差异的高度影响[b]。因此,我们将研究内比较应用于仅血清对照,其中三模式装置的穿透量增加2.6倍,深度增加2.3倍。虽然一项使用双模式方法(电穿孔+声泳)的临床研究表明,与被动应用[8]相比,大约有2 - 3倍的改善,但本研究中观察到的增强被认为具有临床意义。 这种程度的增强是在单次90秒的治疗后达到的,没有不良反应,这表明通过有效的皮内给药,可以改善代谢活跃的角质形成细胞的获取途径,并有可能获得更大的美容效果。电穿孔、声电泳和离子电泳——通过瞬时孔隙形成、脂质双层扰动和电泳运输起作用——在促进活性成分的深层吸收方面似乎是互补的,潜在的协同作用,尽管需要使用单模和双模比较器进行确证性研究。这一临床发现为支持低能量三模式给药技术的安全性和有效性提供了定量证据,并强调了其提高家庭美容性能的潜力。h。j。对研究进行了概念化。S.H.负责项目管理。k.c.、s.h.、H.L.和J.S.L.贡献了必要的材料或工具。S.H.和Y.K.对数据进行了解释。这篇论文是Y.K.写的。该研究于2024年10月4日由Ellead伦理委员会(IRB No. 240912T005)审查并批准。此次研究是根据韩国食品医药品安全处的化妆品临床及功效检验指南和Ellead的标准操作程序(EL-P-7400)进行的。所有患者都签署了知情同意书。所有作者都是Access Business Group北亚区的全职员工。这项研究是由雇主资助的。除了他们的正常工资,作者没有收到额外的报酬,股票,或版税相关的工作。赞助者在研究设计中没有作用;数据收集、分析和解释;手稿准备;或者决定屈服。作者保留了对稿件准备和提交的完全控制权。研究数据不共享。
{"title":"Clinical Evaluation of an Integrated Tri-Modal Transdermal Device for Enhanced Serum Absorption","authors":"Youjin Kim,&nbsp;Seongwon Hong,&nbsp;Kiyoung Chang,&nbsp;Seoyeon Han,&nbsp;Huijun Leung,&nbsp;Jee Sun Lee,&nbsp;Soha Jeon,&nbsp;Hae Jo","doi":"10.1111/jocd.70674","DOIUrl":"10.1111/jocd.70674","url":null,"abstract":"&lt;p&gt;Physical transdermal delivery systems such as electroporation, sonophoresis, and iontophoresis have been studied for their potential to enhance cutaneous absorption of active ingredients, improving penetration and bioavailability in cosmetic and therapeutic applications [&lt;span&gt;1&lt;/span&gt;]. Electroporation delivers short high-voltage pulses that transiently disrupt the stratum corneum, forming micropores that allow passage of otherwise impermeable molecules [&lt;span&gt;2, 3&lt;/span&gt;]. Sonophoresis employs ultrasound waves (~1 MHz) to disorder intercellular lipid bilayers, widening diffusion pathways [&lt;span&gt;4&lt;/span&gt;]. Iontophoresis applies a low-level electrical current to drive charged actives via electro-repulsion and promote nonionic transport through electroosmosis [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Combining physical enhancers is suggested to lead to additive or potentially synergistic improvements in transdermal flux [&lt;span&gt;6&lt;/span&gt;]. Previous studies have shown that combining two modalities enhances penetration more than either alone—for example, sonophoresis can lower the electroporation threshold and increase skin permeability, allowing iontophoresis to subsequently provide a sustained electrical driving force that maintains or augments flux [&lt;span&gt;1, 3, 6&lt;/span&gt;]. Although such dual-modality combinations have been explored, no clinical study has evaluated the integrated use of all three modalities or quantified tri-modal delivery using depth-resolved confocal Raman spectroscopy, particularly in consumer-grade devices.&lt;/p&gt;&lt;p&gt;This study used depth-resolved confocal Raman spectroscopy to assess penetration depth and concentration of a tri-modal delivery system compared with manual application. In this open-label crossover study (IRB approval: Ellead No. 240912T005), 22 healthy Korean women aged 23–60 years (mean ± standard deviation: 47.6 ± 9.4) without history of skin diseases were enrolled. Following a 30-min acclimatization (20°C–22°C; 40%–60% humidity), each participant received a 90-s serum application on one forearm. On the contralateral forearm, the same serum was applied followed by a single device application (electroporation + sonophoresis + iontophoresis). Device parameters were 9.2 V and 1 kHz for electroporation, 5 V and 1 kHz for iontophoresis, and 1 MHz ultrasound for sonophoresis, selected based on preclinical optimization and established safety-validated ranges in cosmetic skin-delivery applications. The serum contained plant-based collagen, cranberry biopeptides, fermented oligopeptides, and white chia peptides in a liposomal carrier. Raman spectroscopy (gen2 Skin Composition Analyzer; River Diagnostics, Rotterdam, Netherlands) was performed at baseline and 30 min after application, with 2 μm steps to 30 μm. Penetration quantity was expressed as Raman intensity relative to keratin (A.U./cm&lt;sup&gt;2&lt;/sup&gt;), and depth (μm) defined as the deepest point exceeding baseline. Statistical analyses were performed in SPSS version 27 (IBM, Armonk, NY, US","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12821079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Cosmetic Dermatology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1