Journal of Cosmetic and Laser Therapy最新文献

This systematic review evaluates treatment options for postoperative scars using evidence from randomized controlled trials. A total of 214 studies encompassing 11,132 treated scars and 49 unique interventions were identified. Multiple treatments demonstrated efficacy, including topical agents (e.g. silicone), injectables (e.g. botulinum toxin, PRP, corticosteroids, 5-FU), mechanical interventions (e.g. dermabrasion, tension offloading devices), vascular lasers (e.g. PDL, KTP), non-ablative lasers (e.g. NAFL, Nd:YAG), and ablative lasers (e.g. CO₂, Er:YAG). Wide variability in treatment protocols, follow-up duration, and outcome measures limits direct comparisons across studies. Current evidence supports a tailored, multimodal approach to postoperative scar management, guided by individual scar characteristics.

Introduction: Poly-D, L-lactic acid (PDLLA), a new dermal filler, has gained popularity in cosmetic surgery due to its biodegradability, safety, and rejuvenating effects. While the literature has primarily focused on dermal reactions as side effects of PDLLA injections, ophthalmic complications are rarely mentioned.

Case description: We describe a presentation of severe visual loss and ophthalmalgia in a patient after injection with PDLLA subcutaneous filler at the nasal region who had been diagnosed with right eye iatrogenic ocular ischemic syndrome combined with central retinal artery occlusion. Despite treatment with ocular massage, intravitreal Aflibercept injection, and Hyperbaric Oxygen Therapy, her vision remained persistently impaired.

Discussion and conclusion: This appears to be the first reported case of iatrogenic ocular ischemic syndrome combined with central retinal artery occlusion following PDLLA subcutaneous filler treatment. We emphasize the importance of understanding facial arterial anatomy and raise awareness of this rare visual complication associated with PDLLA.

Objective: This study compared the clinical effectiveness of two methods of platelet-rich plasma (PRP) administration for treating androgenetic alopecia (AGA): microneedle delivery and intradermal injection. The study also evaluated adverse reactions associated with both methods.

Patients and methods: Twenty patients with AGA were selected according to specific inclusion and exclusion criteria. The scalp of each patient was divided into two treatment areas along the midline, each randomly assigned to receive PRP either via intradermal injection (n = 20) or microneedle delivery (n = 20). The treatment comprised three sessions spaced 1 month apart. Scalp photographs and trichoscopic measurements were obtained before the first session and 6 month after the final session. Patient outcomes were assessed 6 month after the last treatment using the Global Aesthetic Improvement Scale and a self-satisfaction questionnaire. Pain levels during the first session were measured using a Numerical Rating Scale, and adverse reactions were recorded throughout the study.

Results: Six month after completing all treatments, no significant differences were observed between the microneedle delivery and intradermal injection groups for hair density, hair diameter, single hair follicle ratio, or trichoscopic findings (p > .05). However, the microneedle group reported significantly lower pain levels than the intradermal injection group (p < .001). No adverse events were observed during the treatment period.

Conclusion: The clinical efficacy of microneedle delivery of PRP was comparable to that of intradermal injection for AGA treatment, with the added benefit of significantly lower pain levels. This suggests that microneedle delivery may be a promising alternative for AGA management.

Advances in aesthetics and dermatology bring alternatives for the treatment of pigmentary dysfunctions and photoaging. The thulium laser combines characteristics of ablative and non-ablative lasers, standing out for its high precision in epidermal penetration, promoting cell renewal, pigment removal and stimulation of collagen production, with good tolerability. This study conducted an integrative review on the safety and efficacy of the 1927 nm fractional Thulium laser in the treatment of aesthetic dysfunctions. Searches were conducted in the databases MEDLINE/PubMed, Science Direct, Scopus, Google Scholar and Capes Journals between 2014 and 2024, to select studies that demonstrate the results of the application of this treatment. The studies carried out showed its efficacy in conditions such as melasma, scars and skin rejuvenation, with low adverse effects and high patient satisfaction. Although comparisons with other technologies, such as Er:YAG and Alexandrite lasers indicate some differences in results, the thulium laser offers advantages such as shorter recovery time and lower incidence of adverse effects. However, methodological and sampling limitations suggest the need for more robust clinical trials to consolidate their results and applications. It is concluded that the 1927 nm thulium laser represents a promising tool in aesthetic health, offering effective and safe treatment.

Objects: The study aimed to assess the effectiveness and safety of fractional CO₂ laser and 308 nm excimer laser in non-segmental vitiligo.

Materials and methods: We carried out a systematic literature search in databases: Embase, Web of Science, PubMed, Wanfang and CNKI. Randomized controlled trials (RCTs) comparing the combined treatment of fractional CO₂ and 308 nm excimer lasers with other treatments for non-segmental vitiligo were included. The primary outcomes were re-pigmentation rate and side effects.

Results: Twelve RCTs involving a total of 1,064 patients were included. Our results showed significantly higher rates of excellent response (≥75% re-pigmentation) (RR = 1.53, 95%CI: 1.31, 1.78; p < .001) and good response (50-75% re-pigmentation) (RR = 1.14, 95%CI: 1.03, 1.26; p = .015) in combined treatment group than the control group. A subgroup analysis considering control treatment suggested that, the combination treatment yielded a superior rate of excellent response when compared to either fractional CO₂ laser or 308 nm excimer laser. It also demonstrated a superior rate of good response compared to the fractional CO₂ laser, while showing a comparable effect to 308 nm excimer laser alone. Regarding safety, the adverse event rates were comparable between the two groups (RR = 0.67, 95%CI: 0.43, 1.07; p = .093). Meta-regression analysis indicated that none of these potential factors (mean age, gender, disease onset and vitiligo subtype) had any significant effect on excellent response rate. Results of trial sequential analysis (TSA) for excellent response rate suggested that current conclusions regarding combination treatment are adequate, and additional explorations are unlikely to alter the conclusion.

Conclusion: Our results suggested that, the combined treatment of fractional CO₂ and 308 nm excimer lasers seems to be an effective and well-tolerated modality for non-segmental vitiligo. It significantly improves the re-pigmentation rate without posing serious side effects. More high-quality, large-scale RCTs are warranted to further validate these results and explore the long-term efficacy and safety of this treatment approach.

Laser-based procedures for tattoo removals are popular due to their high efficacy. However, multiple sessions are required to remove the tattoo satisfactorily. Various methods have been proposed to remove tattoos quickly. The objective of this study was to report nine patients who underwent tattoo removal using four different ways with a picosecond laser. The target site was divided into four areas, each of which received different tattoo removal protocols: picosecond laser alone, a modified R20 method, picosecond laser with MLA (microlens array) handpiece followed by picosecond laser, and picosecond laser after gel application. Clinical evaluations were conducted for all nine patients, focusing on clinical improvements such as tattoo fading and skin texture. The R20 method picosecond laser showed the most significant improvement in clinical evaluation. Histopathologic examination showed that the picosecond R20 treatment site had the least intradermal pigmentation. These case series provide further evidence to support the effectiveness of the R20 method of picosecond laser in histopathological examination and clinical improvement.

Androgenetic alopecia significantly affects individuals' quality of life, creating a need for better therapeutic strategies. Hair transplant surgery plays a key role in treating hair loss, with adjuncts like PRP and meso-cocktails explored to enhance results and procedure longevity. A prospective, single-blind study involved 112 males aged 25-50 years with Norwood-Hamilton grade IV-VI alopecia. Patients were randomly divided into two groups receiving different transplant methods. In Stage I, hair condition was evaluated, and QR678 Neo® was administered intradermally in Group A. Stage II involved hair transplantation surgery with diluted QR678 Neo® for graft preservation. Post-transplantation (Stage III) included additional QR678 Neo® administration in Group A. Evaluation methods consisted of global photographic assessment and videomicroscopy to measure hair growth and density. Group A (QR678 Neo®) demonstrated significant improvements in regrowth, density, and shaft diameter compared to Group B (conventional transplant). By Stage III, Group A had higher Global Photographic Assessment scores (8.87) and terminal hair count (181.02), with statistically significant differences (p < .001). The study suggests that QR678 Neo® improves outcomes and offers a promising treatment option for androgenetic alopecia.

A uniform model for the treatment of aging signs of the face using Poly-L-lactic acid is presented. The causes of aging effects on the levels of the bone, the connective tissue, fat pads and the skin are addressed in a single procedure by use of needle or canula. For the treatment of the skin, a facial grid is introduced in order to spread the product evenly and avoid the formation of nodules. This standardized procedure provides a safer treatment protocol in order to avoid adverse events such as nodules or irregularities.

Objective: The purpose of this study was to evaluate the effectiveness of 1565 nm NAFL treatment for atrophic acne scars using 22-MHz digital ultrasonography.

Methods: A total of 29 patients with acne atrophic scars were sequentially enrolled in this study. Digital clinical images of each patient's face were collected. The Quantitative Global Acne Scarring Grading System developed was employed to assess the outcomes of acne atrophic scars treated by 1565 nm NAFL. Two independent dermatologists performed an ultrasound examination of the acne atrophic scars using 22-MHz ultrasonography.

Results: Of all the patients received 1565 nm NAFL treatment, no adverse side effect was detected. The mean scores of Assessments Quantitative Global Acne Scarring Grading System in all the patients were no significant difference between the baseline and after 1-, 2-, and 3-month treatment. The means of epidermal thickness, dermal thickness, and epidermal echo intensity at the baseline and 1-, 2-, and 3-months were of no significant difference (P>0.05). The differences in the means of dermal echo intensity between the baseline and 1-, 2-, and 3- months were statistically significant (P<0.05).

Conclusion: 1565 nm NAFL was effective in improving the acne atrophic scars due to increased collagen fiber synthesis detected by 22 MHz frequency ultrasound system.