Journal of Cosmetic Dermatology最新文献_第6页

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

Journal of Cosmetic 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。

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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

Journal of Cosmetic 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。

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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

Journal of Cosmetic 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。

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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

Journal of Cosmetic 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。

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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

Journal of Cosmetic 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。

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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

Journal of Cosmetic 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 < 0.001；仅血清，p < 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 < 0.001）。平均穿透深度从7.36±1.99 μm增加到17.00±5.16 μm （p < 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。

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引用次数: 0

Impact of Fatigue on the Skin: Pilot Study on “996” Work-Life Pattern in China and the Influence of Their Lifestyle on the Skin 疲劳对皮肤的影响：中国“996”工作生活模式及其生活方式对皮肤影响的初步研究

IF 2.5 4区医学 Q2 DERMATOLOGY

Journal of Cosmetic Dermatology

Pub Date : 2026-01-21 DOI: 10.1111/jocd.70679

Xiaoyu Ma, Li Ma, Yimei Tan, Wencai Jiang, Pujos Muriel, Florante Ricarte, Doucet Olivier

Background

Modern living encouraged longer working hours and an increased sense of fatigue. In China, a rising trend called “996”, meaning working from 9 a.m. to 9 p.m., 6 days per week in succession, has raised concerns about the impact of fatigue on health, specifically on skin aging.

Methods

A one-week, single center, self-controlled clinical study was conducted to evaluate the impact of fatigue on skin phenotypes, through the enrollment of 31 Chinese women with a 996 work-life pattern based on Life Style questionnaires and Chalder fatigue scale. Clinical grading and instrumental measurements were conducted before the working week, after 1, 3, and 5 working days.

Results

The fatigue score of the participants accumulated during the working week. From clinical grading, periocular fine lines, fine lines of the cheeks, and forehead wrinkles were significantly worsened in the working week compared to the weekend. Skin elasticity parameters R0, R5, and R7 were also significantly worse compared to the weekend. Significantly increased porphyrin, yellowness, and decrease of redness of skin during working times were also observed. Additionally, the clinical evaluations were well recorded with self-perceptions from the questionnaire.

Conclusion

Fatigue is an inescapable stressor in modern life that impacts skin's health and appearance by accelerating signs of aging, altering skin color, and increasing risk of acne. This is a pilot study analyzing the population with intensive work-life patterns, serving as a reference to comprehensively assess the impact of modern living on skin.

背景：现代生活促使人们工作时间更长，疲劳感更强。在中国，一种名为“996”的新兴趋势，即从早上9点开始工作。到晚上9点。人们开始关注疲劳对健康的影响，特别是对皮肤衰老的影响。方法：采用基于生活方式问卷和Chalder疲劳量表的996种工作-生活模式，对31名中国女性进行为期一周的单中心自我对照临床研究，以评估疲劳对皮肤表型的影响。临床分级和仪器测量分别在工作周前、1、3和5个工作日后进行。结果：被试的疲劳评分在工作周内累积。从临床分级来看，与周末相比，工作日的眼周细纹、脸颊细纹和前额皱纹明显恶化。与周末相比，皮肤弹性参数R0、R5和R7也明显变差。在工作期间，还观察到卟啉明显增加，皮肤发黄，皮肤发红减少。此外，临床评估与问卷中的自我认知被很好地记录下来。结论：疲劳是现代生活中不可避免的压力源，它通过加速衰老、改变肤色和增加痤疮的风险来影响皮肤的健康和外观。这是一项针对工作生活密集人群的初步研究，为全面评估现代生活对皮肤的影响提供参考。

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引用次数: 0

Topical Volumizing Cream Improves Facial Volume and Skin Health in Adults With Rapid Weight Loss From Pharmacologic (GLP-1/GIP Agonists), Surgical, or Behavioral Interventions 局部增容乳膏可改善因药物（GLP-1/GIP激动剂）、手术或行为干预而体重迅速减轻的成人面部体积和皮肤健康。

IF 2.5 4区医学 Q2 DERMATOLOGY

Journal of Cosmetic Dermatology

Pub Date : 2026-01-20 DOI: 10.1111/jocd.70681

Nhi Nguyen, Alejandra Aguilar, Nasima Afzal, Andy Lee, Wardah Akram, Minh N. Duong, Raja K. Sivamani

Background

GLP-1 receptor agonists (GLP-1) and dual GLP-1/gastric inhibitory polypeptide (GIP) agonists emerged in recent years to promote weight loss. By reducing subcutaneous fat, collagen, and overall structural support of the skin, rapid weight loss can lead to visual face aging.

Aims

This study investigates the synergistic effect of a multi-ingredient topical that acts on different skin levels to treat facial aging in individuals experiencing rapid weight loss from GLP-1 and GIP/GLP-1 agonist use.

Patients/Methods

In this 12-week study, 33 participants from the Sacramento region were given the same topical volumizing cream (Vol.U.Lift, Image Skincare). Participants had 6 visits: screening, baseline, weeks 2, 4, 8, and 12. Tolerability assessments, facial photography, and measurements of hydration, elasticity, and wrinkles were acquired.

Results

29 subjects completed all study related procedures. Wrinkle severity appearance decreased at week 4 (14.5%, p < 0.001) and 12 (20.7%, p < 0.001). The ultrasound based skin and subcutaneous thickness increased at week 4 (17.3%, p = 0.04) and 12 (20.1%, p = 0.015); TEWL decreased at week 4 (10.39%, p ≤ 0.02) and 12 (12.7%, p ≤ 0.02); Skin hydration increased at week 2 (21.29%, p ≤ 0.01), 4 (19.50%, p ≤ 0.02), and week 12 (21.8%, p ≤ 0.02); Firmness (22.5%, p ≤ 0.002), viscoelasticity (13.1%, p ≤ 0.02) and net elasticity (23.2%, p ≤ 0.0002) increased at week 12.

Conclusions

The use of a topical volumizing cream improved the appearance of facial volume, wrinkles, and biophysical characteristics in participants who had undergone rapid weight loss primarily due to GLP-1/GIP agonist use.

背景：近年来出现了GLP-1受体激动剂（GLP-1）和GLP-1/胃抑制多肽（GIP）双激动剂来促进减肥。通过减少皮下脂肪、胶原蛋白和皮肤的整体结构支持，快速减肥会导致视觉面部老化。目的：本研究探讨了一种多成分局部作用于不同皮肤水平的治疗面部衰老的协同效应，这些患者因使用GLP-1和GIP/GLP-1激动剂而体重迅速减轻。患者/方法：在这项为期12周的研究中，来自萨克拉门托地区的33名参与者被给予相同的局部丰胸霜（Vol.U. 2）。Lift， Image护肤)。参与者有6次就诊：筛查、基线、第2周、第4周、第8周和第12周。获得耐受性评估、面部摄影、水合作用、弹性和皱纹测量。结果：29名受试者完成了所有研究相关程序。皱纹严重程度在第4周减少（14.5%,p）。结论：局部增容霜的使用改善了主要由于使用GLP-1/GIP激动剂而经历快速减肥的参与者的面部体积、皱纹和生物物理特征。

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引用次数: 0

A Novel Application of Injectable PRF for Superior Sulcus Hollowing 可注射PRF在上沟成形术中的新应用。

IF 2.5 4区医学 Q2 DERMATOLOGY

Journal of Cosmetic Dermatology

Pub Date : 2026-01-20 DOI: 10.1111/jocd.70666

Nese Arslan, Alperen Bahar, Ahmet Alp Bilgic, Şule Barman Kakil

Background

Superior sulcus hollowing is a frequent esthetic concern, commonly managed with synthetic fillers or fat grafts; however, these approaches carry potential risks and costs. Injectable platelet-rich fibrin (i-PRF), an autologous regenerative biomaterial, has shown promise in dermatologic and dental applications, but its use for periocular volume restoration remains unexplored.

Aims

To evaluate the efficacy, safety, and patient satisfaction of i-PRF injections for the correction of superior sulcus hollowing.

Patients/Methods

This single-center retrospective study included 24 eyes of 12 patients treated with i-PRF between 2021 and 2024. Sulcus depth was measured at baseline and at 3 and 6 months posttreatment. Subjective satisfaction was assessed using a binary scale. i-PRF was prepared using a low-speed centrifugation protocol and injected suborbicularis in three sessions spaced 1 week apart.

Results

A significant reduction in superior sulcus depth was observed from baseline to 3 months (13.3 ± 2.8 mm to 9.2 ± 3.7 mm; p = 0.002), followed by mild regression at 6 months (10.5 ± 3.3 mm). Patient satisfaction was high, with 18 out of 24 eyes (75%) reporting favorable outcomes at 3 months. No adverse effects were recorded.

Conclusions

This first clinical report of i-PRF for upper eyelid hollowing suggests that it may serve as a safe, autologous, and minimally invasive alternative for superior sulcus volume restoration. Further prospective studies with standardized outcome measures are warranted to validate these findings.

背景：上沟空心化是一个常见的美学问题，通常通过人工填充物或脂肪移植来处理；然而，这些方法有潜在的风险和成本。可注射的富血小板纤维蛋白（i-PRF）是一种自体再生生物材料，在皮肤科和牙科方面的应用前景广阔，但其在眼周体积修复方面的应用仍未探索。目的：评价注射i-PRF矫正上沟凹陷的疗效、安全性及患者满意度。患者/方法：这项单中心回顾性研究包括在2021年至2024年间接受i-PRF治疗的12例患者的24只眼睛。在基线和治疗后3个月和6个月测量沟深度。主观满意度采用二值量表进行评估。采用低速离心工艺制备i-PRF，每隔1周注射3次轮匝肌下。结果：从基线到3个月（13.3±2.8 mm至9.2±3.7 mm; p = 0.002），观察到上沟深度显着减少，随后在6个月（10.5±3.3 mm）轻度消退。患者满意度很高，24只眼睛中有18只（75%）在3个月时报告了良好的结果。无不良反应记录。结论：这是i-PRF治疗上睑凹陷的第一份临床报告，表明它可以作为一种安全、自体、微创的上睑沟体积修复方法。需要进一步采用标准化结果测量的前瞻性研究来验证这些发现。

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引用次数: 0

Managing Aesthetic Needs in Prescription Medication-Driven Rapid Weight Loss Patients: Results of an International Consensus. The Clinician Perspective 管理处方药物驱动的快速减肥患者的审美需求：国际共识的结果。临床医生的观点。

IF 2.5 4区医学 Q2 DERMATOLOGY

Journal of Cosmetic Dermatology

Pub Date : 2026-01-20 DOI: 10.1111/jocd.70644

Andreas Nikolis, Michael T. Somenek, Steven Dayan, Hugues Cartier, Sabrina G. Fabi, Luiz Avelar, Johnny Franco, Konstantin Frank, Alessandra Haddad, Mohammed A. Alsufyani, Jeff Huang, Inna Prygova, Tyler Safran

Introduction

The global prevalence of obesity has continued to increase at alarming rates. More recently, there has been an exponential increase in the usage of GLP1 agonists in both clinically obese patients and those seeking weight loss. As a result, there has been an influx of patients who are noticing substantial weight loss and changes to their bodies. Given this surge, it is of utmost importance to have homogeneity in clinical guidelines. A consensus panel was created to discuss clinical scenarios, definitions, and set the stage for the appropriate treatment of patients who have undergone massive weight loss.

Methods

To set standards for nonsurgical rejuvenation of patients at different ages, weight loss patterns, and genders, a consensus panel of 10 panelists was created with advanced expertise and knowledge on this patient population. Each panelist filled out a survey that addressed panelist demographics, including practice patterns and patient demographics, as well as treatment guidelines in both male and female patients. Following the survey, the panelists met to discuss preliminary results and obtain qualitative data to support their conclusions on the criteria.

Results

All 10 respondents (100%) were able to complete the survey in its entirety. The panel demonstrates the need to assess and address each treatment region individually in these patients. It also emphasizes the need to consider the appropriate range of volumization based on factors such as age, gender, and the degree of weight loss. While the consensus suggests initiating biostimulator treatment concurrently with weight loss to mitigate fat pad deflation and skin laxity, uncertainties remain regarding the optimal timing and dosing.

Conclusion

In conclusion, this consensus panel represents the first international effort to provide clinical guidance specifically for patients experiencing medication-derived weight loss (MDWL). When creating a treatment plan for the MDWL patient, following them throughout the weight loss journey is essential to understand the more global volume changes that they may be observing.

导言：全球肥胖患病率继续以惊人的速度增长。最近，GLP1激动剂在临床肥胖患者和寻求减肥的患者中的使用呈指数增长。结果，大量患者注意到他们的体重明显减轻，身体也发生了变化。鉴于这种激增，在临床指南中保持一致性是至关重要的。成立了一个共识小组，讨论临床情景、定义，并为大规模减肥患者的适当治疗奠定基础。方法：为制定不同年龄、减肥模式和性别患者的非手术年轻化标准，我们建立了一个由10名专家组成的共识小组，他们对这一患者群体具有先进的专业知识和知识。每位小组成员都填写了一份调查问卷，内容涉及小组成员的人口统计数据，包括实践模式和患者人口统计数据，以及男性和女性患者的治疗指南。调查结束后，小组成员开会讨论初步结果，并获得定性数据，以支持他们关于标准的结论。结果：10名被调查者（100%）均能完整完成调查。该小组表明，有必要对这些患者的每个治疗区域进行单独评估和处理。它还强调需要根据年龄、性别和体重减轻程度等因素考虑适当的体积范围。虽然普遍建议在减肥的同时开始生物刺激治疗，以减轻脂肪垫收缩和皮肤松弛，但关于最佳时间和剂量的不确定性仍然存在。结论：总而言之，这个共识小组代表了第一个国际努力，专门为经历药物源性减肥（MDWL）的患者提供临床指导。在为MDWL患者制定治疗计划时，在整个减肥过程中跟踪他们，对于了解他们可能观察到的更全面的体积变化至关重要。

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引用次数: 0