Journal of Cosmetic Dermatology最新文献

Background: Melasma is a chronic condition characterized by dark patches on the facial skin. It has a known female gender dominancy, and women usually think of melasma as being a serious cosmetic problem. Treatment of melasma can be seriously challenging, thus, dermatologists may employ different approaches for melasma. This study aimed to investigate how dermatologists diagnose and treat patients with melasma and to present the general characteristics of patients with melasma.

Methods: A survey was conducted using Google Forms targeting dermatologists in Turkiye. A total of 199 dermatologists (142 females/57 males) participated in the study.

Results: Most of the participants (52.3%) were residents. Majority gender of the patients was female and most common age range of patients with melasma was 30-40 years. Mixed melasma was the most common type (57.4%). Malar region was the most frequent location (58.6%). Wood's lamp examination was used by 25.6% of the participants. Topical treatment was the first-line choice for melasma therapy (95%), with Kligman's formula being the most used topical agent (69.8%). Oral therapy was not used by 70.8% of the participants. Tranexamic acid was the first choice for oral treatment (23.4%). Only 24.9% of the dermatologists used laser/light therapy, and Q-switched Nd-YAG laser was the most preferred device (58%). The most common recurrence rate was 41%-60% (45.9%).

Conclusions: The findings of the current study investigating the melasma management in Turkiye revealed a female predominance and peak prevalence in the 30-40 years age group. Kligman's formula is the preferred topical treatment, whereas oral tranexamic acid remains underutilized. Recurrence rates are high, highlighting the need for preventative strategies. This study emphasizes the importance of personalized approaches and ongoing research for effective melasma management.

Background: Aesthetic neuromodulator injections of the upper face are frequently performed to temporarily block muscular actions of the periorbital muscles to ultimately reduce skin rhytids. However, the adverse event rate in the literature for toxin-induced blepharoptosis ranges from 0.51% to 5.4%.

Objective: To identify access pathways by which injected neuromodulator product can travel from extra- to intra-orbital and therefore affect the levator palpebrae superioris muscle.

Methods: Nine non-embalmed human body donors were investigated in this study with a mean age at death of 72.8 (16.1) years. The 18 supraorbital regions were injected in 28 times (14 for supratrochlear and 14 for supraorbital) with 0.5 cc, whereas eight cases (four for supratrochlear and four supraorbital) were injected with 0.1 cc of colored product. Anatomic dissections were conducted to identify structures stained by the injected color.

Results: The results of this injection- and dissection-based study revealed that both the supratrochlear and the supraorbital neurovascular bundles are access pathways for injected neuromodulator products to reach the intra-orbital space and affect the levator palpebrea superioris muscle. Out of 36 conducted injection passes, seven (19.44%) resulted in affection of the sole elevator of the eyelid of which 100% occurred only at an injection volume of 0.5 cc and not at 0.1 cc.

Conclusion: Clinically, the results indicate that a low injection volume, a superficial injection for the supraorbital location, and angling the needle tip away from the supratrochlear foramen (toward the contralateral temple) when targeting the corrugator supercilii muscles, can increase the safety profile of an aesthetic toxin glabellar treatment.

Background: Many people are interested in addressing visible signs of aging with non-invasive cosmetic treatments. Development of effective topical products will provide options to delay or support cosmetic procedures.

Aims: This study assessed and compared the efficacy and tolerance of a topical product used over the course of 16 weeks to a single ablative laser treatment on women with moderate global photodamage on the face.

Methods: Subjects in Cell 1 (Laser Cell) were treated over the entire face with a fractional CO₂ laser system. Subjects in Cell 2 (Topical Serum Cell) were treated with a topical serum containing hydroxypinacolone retinoate and peptides over the entire face, twice per day for 16 weeks. The study was composed of 71 women, with 29 in the Laser Cell (mean age 56.2) and 42 in the Topical Serum Cell (mean age 55.0), between 40 and 65 years old. Expert grading was used to determine efficacy parameters.

Results: Participants in the Topical Serum Cell achieved more significant improvement (p < 0.05) in Marionette lines, fine lines (global face), wrinkles (global face), wrinkles (crow's feet), nasolabial folds, texture, smoothness (tactile), global hyperpigmentation, lift, and photodamage compared to participants in the Laser Cell. Participants in the Topical Serum Cell achieved parity in the look of fine lines (crow's feet), forehead lines, glabella, firmness/bounce (tactile), skin tone evenness, radiance.

Conclusions: While no statistically significant differences in tolerability were observed, treatment with the topical cosmetic product achieved parity or statistically better improvement in parameters compared to laser treatment at 16 weeks.

Background: Radiofrequency (RF) microneedling produces patient discomfort which deters patients from completing the recommended treatment series.

Objective: The primary objective was to determine the tolerability, safety, and efficacy of a neurocosmetic postprocedure cream post-RF microneedling in reducing patient discomfort and enhancing recovery across the length of the study and, secondarily, to evaluate against a leading comparator. The third objective was to evaluate the efficacy of the neurocosmetic on self-perceived improvement and objective grading.

Materials and methods: An Institutional Review Board (IRB) approved, fourteen-day, randomized, single-center, double-blind, controlled clinical case study was conducted with 11 healthy female subjects, 6 randomized to the neurocosmetic and 5 to the comparator cell. Following a 7-day washout period, subjects received RF microneedling (face and neck) and applied the postprocedure cream twice daily for 7 days. Objective and subjective tolerability, self-assessments, and clinical photography were performed immediately postprocedure, 24 h, three and seven days following the procedure.

Results: The neurocosmetic was tolerable and safe. Erythema and stinging immediately decreased postprocedure, postneurocosmetic application. After 24 h, 83% favorably agreed the neurocosmetic "reduced irritation on the skin post-procedure," and after 7 days, 100% favorably agreed "experience with the product was positive and I would be interested in returning for a second treatment." The neurocosmetic reduced skin tone redness in the face and neck faster and to a greater degree when measured against a comparator.

Conclusion: The neurocosmetic postprocedure cream improved patient discomfort and enhanced recovery when used immediately post-RF microneedling and after 7 days.

Irb protocol number: Pro00064211.

Background: Radiant skin is a common patient request and the result of multiple contributing factors. Currently, there is no standardized methodological approach that facilitates assessment of skin quality from a holistic perspective.

Aim: To develop a holistic methodological process to assess skin quality using a scale that helps identify treatment priorities, facilitates conversation with the subject, and helps manage expectations, supports long-term treatment plans, and tracks treatment progress over time.

Methods: Ten global experts (dermatologists and esthetic physicians) identified the main measurable aspects that contribute to skin quality, and these were combined to form the Skin Quality Assessment Scale (SQS). The scale comprises four overarching skin quality domains containing nine measurable aspects: texture (pores, lines, scars); discoloration (redness, pigmentation, dullness); firmness (laxity); and hydro-lipid balance (oiliness, dryness). Each aspect is graded on a 4-point severity scale (0 = none to 3 = severe). The SQS was validated by a large group of practicing clinicians.

Results: Practicing clinicians (> 40, 78% dermatologists) were surveyed; prior to reviewing the scale, 67% did not use any scale but 81% believed a holistic SQS was needed. After reviewing the scale, 100% agreed the scale provides a holistic assessment of skin quality. In addition, 95% agreed the scale helps assess all key aspects of skin quality with subjects and 98% deemed it valuable for their clinic.

Conclusions: The SQS represents a holistic assessment tool that engages with and manages subjects' expectations, identifies treatment priorities, creates a long-term treatment plan, and visualizes the skin quality improvement over time.

Background: Graying is an inherent and unavoidable consequence of the aging process, impacting individuals of all genders. There are limited studies in Saudi Arabia that have examined the prevalence and predictors of premature graying of hair (PGH).

Objectives: This study aims to explore the prevalence and predictors of PGH before the age of 30 among the population of Saudi Arabia.

Methods: This is a cross-sectional online survey that was conducted between July 2023 and February 2024 in Saudi Arabia. Binary logistic regression analysis was used to identify risk factors of having gray hair before the age of 30.

Results: A total of 1193 participants were involved in this study. A significant portion of respondents reported having gray hair before the age of 30 (55.9%). The younger population (younger than 44 years), smokers, and those who have comorbidities, have anxiety, have depression, have a family history of gray hair before the age of 30 years, have a dry scalp, suffer from vitamin or mineral deficiencies, have hair loss due to immune diseases (such as alopecia), and use minoxidil or rosemary for hair loss were more likely to have gray hair before the age of 30 years (p < 0.05).

Conclusion: This study highlighted the high prevalence rate and associated predictors of PGH in Saudi Arabia. Identified predictors include genetic, health, and lifestyle factors. Healthcare professionals and decision makers are advised to promote the awareness of the general public on its risk factors to enhance the prevention of PGH. Public health initiatives include campaigns on smoking cessation, healthy nutrition, and mental health.

Background: Sensitive skin is a worldwide skin problem, and its assessment of therapeutic efficacy traditionally relies on the facial stinging test. However, this test possesses certain limitations due to its restrictive application site, intense pain sensation, and adverse effects on physical appearance.

Objective: This study aimed to develop and evaluate a highly efficient and user-friendly sensitive skin simulation model, which combines tape stripping and capsaicin testing on the forearm (FA-TS-CAT), as an alternative to the facial stinging test.

Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted involving 74 subjects. Skin redness (a* value), transepidermal water loss (TEWL), and self-assessment questionnaires were collected at different time points for analysis.

Results: Tape stripping 5 times and 10 min application of capsaicin test were identified as the optimal conditions for the FA-TS-CAT model. Consistent stimulation and natural recovery trends of a* value and TEWL were observed on both the FA-TS-CAT and facial capsaicin test (F-CAT) models within 50 min. After the 4-t-butylcyclohexanol complex emulsion was applied, the a* value in the FA-TS-CAT model exhibited a soothing trend similar to the F-CAT model, with a significantly reduced by 3.99-fold and 3.28-fold at T3 and T4 (p < 0.001), compared to the placebo. Notably, the test efficiency of the FA-TS-CAT model was threefold higher than that of the F-CAT model, and subjects showed more willingness to participate in the FA-TS-CAT test (95.95% vs. 4.05%).

Conclusions: These results indicated the FA-TS-CAT is a highly efficient and user-friendly model for sensitive skin, providing a reliable and valid method for clinical research in sensitive skin treatment.

Background: Thread lifting is a minimally invasive procedure that enhances facial aesthetics by repositioning sagging tissues with absorbable threads. It requires a comprehensive understanding of facial anatomy for safe and effective results.

Aims: This study aims to highlight the critical anatomical considerations in thread lifting, including the navigation of facial vascular structures, the protection of facial nerves, manipulation of fat compartments, and engagement of retaining ligaments. These factors are essential for minimizing complications and achieving optimal outcomes.

Patients/methods: A review was conducted focusing on the anatomical elements critical to thread lifting. The study analyzed clinical outcomes related to vascular structures, nerve pathways, fat compartments, and ligaments in patients undergoing the procedure.

Results: The review revealed that careful navigation of facial blood vessels is crucial to avoid complications such as bleeding and bruising. Knowledge of facial nerve pathways is essential to prevent nerve damage, which could result in facial weakness or paralysis. Proper manipulation of facial fat compartments helps address aging-related changes, and engaging retaining ligaments is vital for a sustainable lift without tissue distortion.

Conclusions: Thread lifting demands not only technical skill but also a deep understanding of facial anatomy to ensure patient safety and desired aesthetic results. Expertise in these anatomical considerations is essential for minimizing complications and preserving the natural function of facial structures.