|
1
|
Qin X, Zhai J, Zhou C, Wang Y, Chen M, Zhu L, Shi Q, Chen W, Zhang L, Luo X, Li K. A Randomized, Investigator-Blinded, Split-Face, Controlled Trial Assessing Efficacy and Satisfaction of CE Ferulic Serum Following Nonablative Fractional Fraxel Laser Treatment for Photoaging Skin in Chinese Population. J Cosmet Dermatol 2025; 24:e70251. [PMID: 40414817 DOI: 10.1111/jocd.70251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2024] [Revised: 04/07/2025] [Accepted: 05/11/2025] [Indexed: 05/27/2025]
Abstract
BACKGROUND Following Nonablative fractional Fraxel laser (NAFL), a well-established treatment for skin rejuvenation, immediate post-procedural care is essential to address any potential complications and accelerate the healing process. AIMS To evaluate the efficacy and patient satisfaction of a topical skincare regimen containing vitamin C, vitamin E, and ferulic acid-CE Ferulic serum (CEF) following NAFL treatment in the Chinese population. METHODS In this randomized, investigator-blinded, split-face, controlled trial, patients with mild-to-moderate facial photodamage were randomized to receive CEF treatment on one side of the face and normal saline (NS) on the other side immediately after the NAFL procedure and daily during the 7-day follow-up. The primary endpoint was the change from baseline in erythema score on Day 7, with key secondary endpoints including changes from baseline in erythema index (EI), melanin index (MI), transepidermal water loss, skin hydration, skin sebum content, scabbing, edema, overall patient satisfaction, and post-procedure pain. RESULTS In total, 50 patients (female 45/50) were enrolled in this study, with a mean age of 31.6 years. The mean change from baseline in erythema score was significantly lower on the CEF side than on the NS side on Day 7 post-NAFL treatment (0.04 ± 0.40 vs. 0.18 ± 0.48, p = 0.011). The CEF side also exhibited improved changes in EI, MI, and skin hydration, as well as higher overall satisfaction and less pain compared with the NS side. CONCLUSIONS Applying CEF after NAFL treatment reduced erythema progression, maintained skin hydration, and promoted the healing process compared with NS. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR2300069246.
Collapse
Affiliation(s)
| | | | - Chenxi Zhou
- Dexi Cosmetic Clinic, Deyi Skin Institution, Xi'an, China
| | | | | | - Lin Zhu
- Deyue Clinic, Shenzhen, China
| | - Qi Shi
- Deyue Clinic, Shenzhen, China
| | - Weiliang Chen
- Dexi Cosmetic Clinic, Deyi Skin Institution, Xi'an, China
| | - Liyuan Zhang
- Dexi Cosmetic Clinic, Deyi Skin Institution, Xi'an, China
| | - Xiao Luo
- Dexi Cosmetic Clinic, Deyi Skin Institution, Xi'an, China
| | - Kai Li
- Dexi Cosmetic Clinic, Deyi Skin Institution, Xi'an, China
| |
Collapse
|
|
2
|
Mar K, Maazi M, Khalid B, Ahmed R, Wang OJ(E, Khosravi‐Hafshejani T. Prevention of Post-Inflammatory Hyperpigmentation in Skin of Colour: A Systematic Review. Australas J Dermatol 2025; 66:119-126. [PMID: 39953770 PMCID: PMC12062726 DOI: 10.1111/ajd.14432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 01/23/2025] [Accepted: 01/30/2025] [Indexed: 02/17/2025]
Abstract
BACKGROUND/OBJECTIVES Post-inflammatory hyperpigmentation (PIH) impacts all skin tones with a heightened predilection for Fitzpatrick skin types (FST) III-VI. Preventative measures include pre- and post-intervention approaches, such as sunscreen and corticosteroids. This systematic review aims to summarise the preventative measure outcomes for skin of colour individuals. METHODS A literature search was conducted using MEDLINE (from 1946) and Embase (from 1974) in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. RESULTS Of 14 studies, 369 cases were included. The mean age was 38 years (n = 293) and 72% were female (n = 265). All patients were of Asian ethnicity, and 42% were of FST III, 54% FST IV, and 4% FST V. Nearly all cases were precipitated by laser therapy (> 95%), and the face was the most reported location (85%). The most successful preventative measure was sunscreen alone or combined with other ingredients. Less successful outcomes were seen with topical corticosteroids and systemic tranexamic acid, while cooling air devices exacerbated the development of PIH. CONCLUSION Overall, only sunscreen consistently prevented the incidence of PIH; however, the severity of the ensuing PIH may be diminished with other measures. There is considerable room for improved preventative strategies for at-risk populations.
Collapse
Affiliation(s)
- Kristie Mar
- Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Mahan Maazi
- Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Bushra Khalid
- Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Rayan Ahmed
- Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Ou Jia (Emilie) Wang
- Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | | |
Collapse
|
|
3
|
Almansory AS, Alhamdany ZS. Multimodality Management of Skin Hyperpigmentation. Aesthetic Plast Surg 2025:10.1007/s00266-025-04866-0. [PMID: 40301200 DOI: 10.1007/s00266-025-04866-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2025] [Accepted: 03/22/2025] [Indexed: 05/01/2025]
Abstract
BACKGROUND Skin hyperpigmentation, caused by excessive melanin production, presents both aesthetic and psychological concerns. The Q-switched Nd:YAG laser is a key treatment modality, with effectiveness influenced by factors such as skin type, laser fluence, and treatment frequency. A multimodal approach combining laser therapy and medical treatment may enhance outcomes. OBJECTIVES This study evaluates the efficacy and safety of Q-switched Nd:YAG laser combined with medical therapy for hyperpigmentation, focusing on clinical outcomes and patient satisfaction. METHODS A randomized cross-sectional study was conducted on 300 patients in private clinics from January 2022 to September 2023. Treatment response was assessed through clinical evaluations and patient-reported satisfaction using the Likert scale. The impact of factors such as gender, sun exposure, pregnancy, and hormonal influences was analyzed. RESULTS The majority of participants were female (92.6%). Clinical evaluation and patient satisfaction improved significantly over successive sessions, with "Good" satisfaction ratings increasing from 80.6% initially to 98.3% at study completion. Male patients demonstrated a stronger response to treatment than females. No significant impact of the studied factors on outcomes was identified. CONCLUSIONS A comprehensive assessment of hyperpigmentation is crucial for optimal treatment selection. A multimodal approach combining Q-switched Nd:YAG laser and medical therapy yields superior results compared to single-modality treatments, with outcomes improving progressively across sessions. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Collapse
|
|
4
|
Zhao H, Wang X, Ye J, Zou P, Yang K, Zeng W, Qiao Z, Ju Y. The application of external incision in correcting bulbous nasal tip caused by skin thickness in East Asian patients. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2025:102327. [PMID: 40216087 DOI: 10.1016/j.jormas.2025.102327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2025] [Revised: 04/01/2025] [Accepted: 04/02/2025] [Indexed: 04/21/2025]
Abstract
BACKGROUND Bulbous nasal tips in East Asian patients are often caused by thick skin and soft tissue hypertrophy, presenting challenges in rhinoplasty. This study evaluates the efficacy and safety of supratip excision combined with cartilage reshaping to address nasal tip hypertrophy and minimize scarring. METHODS A retrospective analysis was performed on patients who underwent bulbous nasal tip correction from January 2021 to October 2023. The surgical approach involved midline elliptical supratip excision, cartilage grafting (from septum, rib, or ear), and lateral crural adjustments. Outcomes were assessed using anthropometric measurements (nasal length, tip projection [NTP], nasolabial angle [NLA]), the Rhinoplasty Outcome Evaluation (ROE) score, and the Patient and Observer Scar Assessment Scale (POSAS). RESULTS Thirteen East Asian patients (mean age: 29.23 years) met the inclusion criteria. Postoperative results showed a 20 % reduction in nasal length (7.29 cm to 5.83 cm, p < 0.001), 8.3 % increase in NTP (18.98 mm to 20.56 mm, p < 0.001), and 7.2° improvement in NLA (82.59° to 88.64°, p < 0.001). ROE scores improved significantly (p < 0.001). Scar satisfaction was 96.16 %, with minimal irregularities noted in 15.38 % of cases. CONCLUSION Supratip excision effectively corrects bulbous nasal tips in East Asian patients, resulting in refined nasal contours and high patient satisfaction. Careful patient selection and scar management are paramount to ensure the success of the procedure. Further studies with larger cohorts are needed to confirm long-term outcomes.
Collapse
Affiliation(s)
- Hongli Zhao
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011 China.
| | - Xiancheng Wang
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011 China.
| | - Jiandong Ye
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011 China.
| | - Pei Zou
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011 China.
| | - Kai Yang
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011 China.
| | - Weiliang Zeng
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011 China.
| | - Zhihua Qiao
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011 China.
| | - Yikun Ju
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011 China.
| |
Collapse
|
|
5
|
Nasseri M, Jia JL, Croffoot J. Systemic Involvement of Leukocytoclastic Vasculitis in Skin of Color. Cureus 2025; 17:e82105. [PMID: 40351897 PMCID: PMC12066162 DOI: 10.7759/cureus.82105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2025] [Indexed: 05/14/2025] Open
Abstract
Leukocytoclastic vasculitis (LCV) is an immune-mediated small-vessel vasculitis with various underlying causes. We present a unique case of LCV in an elderly man with Fitzpatrick phototype V skin to highlight multi-organ signs associated with this rare pathology. Our patient presented with an evolving, diffusely spread rash following respiratory symptoms accompanied by muscle weakness, scant hemoptysis, and decreased visual acuity. A comprehensive diagnostic approach, including skin biopsy, revealed LCV with associated eosinophilia. Treatment through a multidisciplinary approach included systemic steroids, topical ointments, and empiric antibiotics. The patient showed gradual improvement and was discharged after nine days of hospitalization. Differential diagnoses for the rash included infections, inflammatory processes, and autoimmune vasculitides such as immunoglobulin A (IgA) vasculitis, urticarial vasculitis, cryoglobulinemic vasculitis, and anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides. While most instances of LCV are typically skin-limited and self-resolving, this case highlights diffuse systemic involvement requiring a broad diagnostic perspective.
Collapse
Affiliation(s)
- Mana Nasseri
- Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, D.C., USA
| | - Justin L Jia
- Department of Dermatology, George Washington University, Washington, D.C., USA
| | - James Croffoot
- Department of Internal Medicine, Veteran Affairs Medical Center, Washington, D.C., USA
- Department of Internal Medicine, George Washington University, Washington, D.C., USA
| |
Collapse
|
|
6
|
Lee H, Jeon YY, Eah KS, Park N, Lee YE, Han J, Lee CM, Kim C, Chung HS, Kim JY, Lee H. A Comparative Study of Intense Pulsed Light with Two Different Filters in Meibomian Gland Dysfunction: A Prospective Randomized Study. J Clin Med 2025; 14:199. [PMID: 39797282 PMCID: PMC11721273 DOI: 10.3390/jcm14010199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2024] [Revised: 12/26/2024] [Accepted: 12/28/2024] [Indexed: 01/13/2025] Open
Abstract
Objectives: To compare the long-term efficacy and safety of intense pulsed light (IPL) treatments using a 590-nm and an acne filter. Methods: In this prospective, randomized, paired-eye trial study, 30 patients with moderate and severe meibomian gland dysfunction (MGD) were followed up for at least one month after their last treatment. Group A received IPL treatment with an acne filter, a type of notch filter that blocks wavelengths between 600 and 800 nm, allowing IPL to emit wavelengths between 400-600 nm and 800-1200 nm. Group B received treatment with a 590 nm filter, a type of cut-off filter that blocks wavelengths below 590 nm. Clinical parameters, including tear osmolarity, matrix metalloproteinase (MMP)-9 expression, tear break-up time, ocular surface staining scores, Schirmer's test I, lid margin telangiectasia scores, MG expressibility/secretion scores, and Ocular Surface Disease Index scores, were measured at baseline, 1, 6, and 12 months after their last treatment. Results: In the linear mixed model, significant time effects on all clinical parameters, except for MMP-9 grades and Schirmer's test I results, were observed within each group. However, interactions between time points (baseline, 6 months, 12 months) and groups (Group A, B) were not significant. The generalized estimating equation model showed no significant interaction between time points and groups for MMP-9 positivity; however, a significant time effect on MMP-9 positivity was observed in Group A, with a decrease at 12 months after their last treatment when compared to baseline and 6 months. Conclusions: The IPL treatment modality for moderate to severe MGD demonstrated a significant therapeutic effect for one year under strictly controlled self-administration of other treatments. IPL treatment using acne filter is a promising treatment option for reducing MMP-9 positivity in MGD patients.
Collapse
Affiliation(s)
- Hayoung Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (H.L.); (Y.Y.J.); (K.S.E.); (N.P.); (Y.E.L.); (J.H.); (C.M.L.); (C.K.); (H.S.C.); (J.Y.K.)
- Department of Ophthalmology, Asan Medical Institute of Convergence Science and Technology (AMIST), University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Yoo Young Jeon
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (H.L.); (Y.Y.J.); (K.S.E.); (N.P.); (Y.E.L.); (J.H.); (C.M.L.); (C.K.); (H.S.C.); (J.Y.K.)
| | - Kyu Sang Eah
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (H.L.); (Y.Y.J.); (K.S.E.); (N.P.); (Y.E.L.); (J.H.); (C.M.L.); (C.K.); (H.S.C.); (J.Y.K.)
- Department of Ophthalmology, Asan Medical Institute of Convergence Science and Technology (AMIST), University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Nahyun Park
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (H.L.); (Y.Y.J.); (K.S.E.); (N.P.); (Y.E.L.); (J.H.); (C.M.L.); (C.K.); (H.S.C.); (J.Y.K.)
- Department of Ophthalmology, Asan Medical Institute of Convergence Science and Technology (AMIST), University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Yea Eun Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (H.L.); (Y.Y.J.); (K.S.E.); (N.P.); (Y.E.L.); (J.H.); (C.M.L.); (C.K.); (H.S.C.); (J.Y.K.)
| | - Jeewon Han
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (H.L.); (Y.Y.J.); (K.S.E.); (N.P.); (Y.E.L.); (J.H.); (C.M.L.); (C.K.); (H.S.C.); (J.Y.K.)
- Department of Ophthalmology, Asan Medical Institute of Convergence Science and Technology (AMIST), University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Chung Min Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (H.L.); (Y.Y.J.); (K.S.E.); (N.P.); (Y.E.L.); (J.H.); (C.M.L.); (C.K.); (H.S.C.); (J.Y.K.)
| | - Changmin Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (H.L.); (Y.Y.J.); (K.S.E.); (N.P.); (Y.E.L.); (J.H.); (C.M.L.); (C.K.); (H.S.C.); (J.Y.K.)
- Department of Ophthalmology, Asan Medical Institute of Convergence Science and Technology (AMIST), University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Ho Seok Chung
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (H.L.); (Y.Y.J.); (K.S.E.); (N.P.); (Y.E.L.); (J.H.); (C.M.L.); (C.K.); (H.S.C.); (J.Y.K.)
| | - Jae Yong Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (H.L.); (Y.Y.J.); (K.S.E.); (N.P.); (Y.E.L.); (J.H.); (C.M.L.); (C.K.); (H.S.C.); (J.Y.K.)
| | - Hun Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (H.L.); (Y.Y.J.); (K.S.E.); (N.P.); (Y.E.L.); (J.H.); (C.M.L.); (C.K.); (H.S.C.); (J.Y.K.)
- Department of Ophthalmology, Asan Medical Institute of Convergence Science and Technology (AMIST), University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
- Department of Ophthalmology, Brain Korea 21 Project, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
- Center for Cell Therapy, Asan Medical Center, Seoul 05505, Republic of Korea
| |
Collapse
|
|
7
|
Alexis AF, Andriessen A, Beach RA, Campos VB, Ginn LR, Bravo RG, Naidoo L, Li M. Periprocedural Skincare for Nonenergy and Nonablative Energy-Based Aesthetic Procedures in Patients With Skin of Color. J Cosmet Dermatol 2025; 24:e16712. [PMID: 39829119 PMCID: PMC11744056 DOI: 10.1111/jocd.16712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2024] [Revised: 11/03/2024] [Accepted: 11/19/2024] [Indexed: 01/22/2025]
Abstract
BACKGROUND Anti-aging facial procedures with nonenergy and nonablative energy devices are increasingly popular among patients with skin of color (SOC). Algorithms have addressed the measures to reduce the side effects related to aesthetic procedures, but few focus on SOC patients and periprocedural integrating skincare. METHODS Eight dermatologists from Brazil, Canada, South Africa, Mexico, and the USA participated in a meeting and an online follow-up to develop an algorithm for periprocedural skincare for nonenergy and nonablative energy-based facial aesthetic procedures in patients with SOC. A Delphi method was used to develop this algorithm and integrate information from the literature with panels' clinical experience and opinion, resulting in the current algorithm. RESULTS The algorithm has five sections, starting with a medical history and skin examination, followed by pretreatment measures beginning 2-4 weeks before the procedure, then measures on the day of the procedure, aftercare 1-7 days after the procedure, and follow-up care 1-4 weeks after the procedure and ongoing. CONCLUSIONS This algorithm provides guidelines for treatment optimization of non-energy, non-ablative energy-based devices for SOC patients. It also provides physicians with skincare recommendations pre-, peri-, and post-aesthetic procedures.
Collapse
Affiliation(s)
| | | | - Renée A. Beach
- DermAtelier, Faculty of MedicineUniversity of TorontoOntarioCanada
| | | | | | | | - Levashni Naidoo
- Private Practice, The Dermatology RoomJohannesburgSouth Africa
| | - Monica Li
- Department of Dermatology and Skin ScienceUniversity of British Columbia VancouverVancouverBritish ColumbiaCanada
| |
Collapse
|
|
8
|
Liu J, Xu T, Ding J, Wen H, Meng J, Liu Q, Liu X, Zhang W, Zhu GY, Jiang ZH, Gao J, Bai LP. Discovery of anti-melanogenic components in persimmon (Diospyros kaki) leaf using LC-MS/MS-MN, AlphaFold2-enabled virtual screening and biological validation. Food Chem 2024; 455:139814. [PMID: 38824735 DOI: 10.1016/j.foodchem.2024.139814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/29/2024] [Accepted: 05/22/2024] [Indexed: 06/04/2024]
Abstract
Persimmon (Diospyros kaki) leaf is widely used as a tea substitute in East Asia, offering potential health benefits. Although studies have highlighted their effects on hyperpigmentation disorders, the active components remain unidentified. This study introduces a novel approach combining LC-MS/MS-based molecular networking with AlphaFold2-enabled virtual screening to expedite the identification of bioactive components in persimmon leaf. A total of 105 compounds were identified by MS/MS analysis. Further, virtual screening identified five flavonoids with potential anti-melanogenic properties. Bioassays confirmed myricetin, quercetin, and kaempferol inhibited melanogenesis in human melanocytes in a dose-dependent manner. Biolayer interferometry assays revealed strong binding affinity between these flavonols and hsTYR, with KD values of 23.26 ± 11.77 for myricetin, 12.43 ± 0.37 for quercetin, and 14.99 ± 3.80 μM for kaempferol. Molecular dynamics simulations provided insights into the binding interactions of these flavonols with hsTYR, particularly highlighting the essential role of the 3-OH group on the C-ring. This study elucidates the bioactive components responsible for the anti-melanogenic effects of persimmon leaf, supporting their use in product development.
Collapse
Affiliation(s)
- Jiazheng Liu
- State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, Macau University of Science and Technology, Taipa, Macau, China
| | - Ting Xu
- State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, Macau University of Science and Technology, Taipa, Macau, China; Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, School of Pharmaceutical Science, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Jianjun Ding
- School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, China
| | - Haoyue Wen
- State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, Macau University of Science and Technology, Taipa, Macau, China
| | - Jieru Meng
- State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, Macau University of Science and Technology, Taipa, Macau, China
| | - Qing Liu
- State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, Macau University of Science and Technology, Taipa, Macau, China
| | - Xiaomei Liu
- State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, Macau University of Science and Technology, Taipa, Macau, China
| | - Wei Zhang
- State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, Macau University of Science and Technology, Taipa, Macau, China
| | - Guo-Yuan Zhu
- State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, Macau University of Science and Technology, Taipa, Macau, China
| | - Zhi-Hong Jiang
- State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, Macau University of Science and Technology, Taipa, Macau, China.
| | - Jin Gao
- Increasepharm (Hengqin) Institute Co., Ltd., Zhuhai, Guangdong, China.
| | - Li-Ping Bai
- State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, Macau University of Science and Technology, Taipa, Macau, China.
| |
Collapse
|
|
9
|
Haykal D, Cartier H, Goldberg D, Gold M. Advancements in laser technologies for skin rejuvenation: A comprehensive review of efficacy and safety. J Cosmet Dermatol 2024; 23:3078-3089. [PMID: 39158413 DOI: 10.1111/jocd.16514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 07/19/2024] [Accepted: 07/24/2024] [Indexed: 08/20/2024]
Abstract
INTRODUCTION Laser technology has fundamentally transformed the landscape of dermatology, offering nuanced solutions for skin rejuvenation and resurfacing. This paper aims to explore the spectrum of laser technologies, from ablative to non-ablative and fractional lasers, their mechanisms, benefits, and tailored applications for diverse skin conditions. As we delve into the intricacies of each technology, we also consider the scientific advancements that have made these treatments safer and more effective, promising a new horizon in skin rejuvenation. OBJECTIVE This comprehensive analysis seeks to evaluate recent advancements in laser technology for skin rejuvenation, focusing on efficacy, safety, and patient satisfaction. METHODS The selection criteria for studies in this publication focused on recent, peer-reviewed articles from the last 20 years, emphasizing advancements in laser technologies for skin rejuvenation. Our comprehensive review involved searches in PubMed, Cochrane, Scopus and Google Scholar using keywords like "skin rejuvenation," "laser technology," "efficacy," "safety," and "dermatology." This approach focused on inclusion of recent research and perspectives on the efficacy and safety of laser treatments in the field of dermatology. RESULTS Our literature review reveals advancements in laser skin resurfacing technologies, notably fractional lasers for minimal downtime rejuvenation, ablative lasers for precise tissue vaporization, and non-ablative lasers for coagulation effect promoting collagen with reduced recovery. Hybrid and picosecond lasers are highlighted for their versatility and effectiveness in addressing a wide array of skin concerns. The findings also emphasize the development of safer treatment protocols for ethnic skin, significantly reducing risks like hyperpigmentation and scarring, thus broadening the scope of effective dermatological solutions. CONCLUSION This extensive review of advancements in laser technologies for skin rejuvenation underscores a remarkable evolution in dermatological treatments, offering an expansive overview of the efficacy, safety, and patient satisfaction associated with these interventions. Furthermore, the exploration of combination treatments and laser-assisted drug delivery represents a frontier in dermatological practice, offering synergistic effects that could amplify the therapeutic benefits of laser treatments.
Collapse
Affiliation(s)
| | | | - David Goldberg
- Director of Cosmetic Dermatology and Clinical Research, Schweiger Dermatology Group, Clinical Professor of Dermatology, Icahn School of Medicine at Mt. Sinai, New York, New York, USA
| | - Michael Gold
- Gold Skin Care Center, Tennessee Clinical Research Center, Nashville, Tennessee, USA
| |
Collapse
|
|
10
|
de Bona Sartor AT, da Silva AJ, Silva LO, Sasso AF, Kuriki HU, das Neves LMS, Barbosa RI, Marcolino AM. Does the skin phototype influence the sensory perception of individuals during photobiomodulation irradiation? Arch Dermatol Res 2024; 316:427. [PMID: 38904801 DOI: 10.1007/s00403-024-03180-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 06/07/2024] [Accepted: 06/08/2024] [Indexed: 06/22/2024]
Affiliation(s)
- Adrian Thives de Bona Sartor
- Curso de Graduação em Fisioterapia da Federal University of Santa Catarina-UFSC, Araranguá, Santa Catarina, Brazil
| | - Ana Júlia da Silva
- Curso de Graduação em Fisioterapia da Federal University of Santa Catarina-UFSC, Araranguá, Santa Catarina, Brazil
| | - Larissa Oliveira Silva
- Curso de Graduação em Fisioterapia da Federal University of Santa Catarina-UFSC, Araranguá, Santa Catarina, Brazil
| | - Aline Fascin Sasso
- Postgraduate Program in Rehabilitation Sciences - PPGCR, Federal University of Santa Catarina- UFSC, Araranguá, Santa Catarina, Brazil
| | - Heloyse Uliam Kuriki
- Curso de Graduação em Fisioterapia da Federal University of Santa Catarina-UFSC, Araranguá, Santa Catarina, Brazil
- Postgraduate Program in Rehabilitation Sciences - PPGCR, Federal University of Santa Catarina- UFSC, Araranguá, Santa Catarina, Brazil
- Laboratório de Avaliação e Reabilitação do Aparelho Locomotor, Universidade Federal de Santa Catarina, Campus Araranguá - Campus Mato Alto Rua Pedro João Pereira, 150, Araranguá, SC, CEP: 88905-120, Brazil
| | | | - Rafael Inacio Barbosa
- Curso de Graduação em Fisioterapia da Federal University of Santa Catarina-UFSC, Araranguá, Santa Catarina, Brazil
- Postgraduate Program in Rehabilitation Sciences - PPGCR, Federal University of Santa Catarina- UFSC, Araranguá, Santa Catarina, Brazil
- Laboratório de Avaliação e Reabilitação do Aparelho Locomotor, Universidade Federal de Santa Catarina, Campus Araranguá - Campus Mato Alto Rua Pedro João Pereira, 150, Araranguá, SC, CEP: 88905-120, Brazil
| | - Alexandre Marcio Marcolino
- Curso de Graduação em Fisioterapia da Federal University of Santa Catarina-UFSC, Araranguá, Santa Catarina, Brazil.
- Laboratório de Avaliação e Reabilitação do Aparelho Locomotor, Universidade Federal de Santa Catarina, Campus Araranguá - Campus Mato Alto Rua Pedro João Pereira, 150, Araranguá, SC, CEP: 88905-120, Brazil.
| |
Collapse
|
|
11
|
Soares I, Amaral IP, Correia MP, Travassos R, Filipe P. Complications of dermatologic lasers in high Fitzpatrick phototypes and management: an updated narrative review. Lasers Med Sci 2024; 39:149. [PMID: 38834924 DOI: 10.1007/s10103-024-04100-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 05/27/2024] [Indexed: 06/06/2024]
Abstract
This article explores the intricacies of laser surgery, acknowledging inherent risks and complications. Patients with higher Fitzpatrick phototypes, characterized by unique biological traits, face heightened vulnerability during laser treatments. Limited experience with darker skin tones necessitates a higher level of laser expertise and a conservative approach. The study aims to comprehensively review laser therapy's side effects and complications, with a specific focus on Fitzpatrick phototypes IV through VI. We searched the MEDLINE database from 1972 to 2023 to consolidate knowledge. Results illuminate nuanced challenges associated with laser surgery in higher phototypes. In conclusion, this research emphasizes the need for enhanced expertise and caution in laser procedures for individuals with darker skin, offering valuable insights to optimize patient safety and outcomes.
Collapse
Affiliation(s)
- Ivânia Soares
- Departament of Dermatology, Hospital de Santa Maria, Lisbon, Portugal.
| | | | | | - Rita Travassos
- Departament of Dermatology, Hospital de Santa Maria, Lisbon, Portugal
- Universidade de Lisboa Faculdade de Medicina, Dermatology University Clinic, Lisbon, Portugal
| | - Paulo Filipe
- Departament of Dermatology, Hospital de Santa Maria, Lisbon, Portugal
- Universidade de Lisboa Faculdade de Medicina, Dermatology University Clinic, Lisbon, Portugal
| |
Collapse
|
|
12
|
Lupon E, Berkane Y, Bertheuil N, Cetrulo CL, Vaillant C, Chaput B, Camuzard O, Lellouch AG. Nonsurgical Treatment of Postburn Hypopigmentation: A Literature Review. J Burn Care Res 2024; 45:601-607. [PMID: 38401148 DOI: 10.1093/jbcr/irae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Indexed: 02/26/2024]
Abstract
The treatment of postburn hypopigmentation was primarily surgical before the advent of new technologies. Medical devices and therapies are emerging to manage scar sequelae that can be disfiguring and associated with severe psychosocial impact. These innovations have been poorly investigated for hypopigmentation, but they represent a real hope. We reviewed all articles published on Pubmed up to June 2022. Included studies had to specifically focus on treating postburn hypopigmented scars. All articles evaluating transient solutions such as make-up, and articles describing inflammation-linked hypopigmentation with no etiological details or no burn injury history were excluded. Through this review, we have highlighted 6 different types of nonsurgical treatments reported in postburn leukoderma potentially allowing definitive results. Electrophoto-biomodulation or E light (combining intensive pulsed light, radiofrequency, and cooling), topical daylight psoralen UVA therapy, and lasers (fractional lasers using pulse energies or CO2FL devices, lasers-assisted drug delivery as local bimatoprost and tretinoin or pimecrolimus) have been explored with encouraging results in hypopigmented burns. Finally, other promising medical strategies include using FK506, a nonsteroidal anti-inflammatory drug, to induce melanogenesis or using melanocyte-stimulating hormones with fractional laser-assisted drug deliveries, which are expected to emerge soon.
Collapse
Affiliation(s)
- Elise Lupon
- Department of Plastic and Reconstructive Surgery, Institut Universitaire Locomoteur et du Sport, Pasteur 2 Hospital, University Côte d'Azur, 06001 Nice, France
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, 02114 Boston, MA, USA
| | - Yanis Berkane
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, 02114 Boston, MA, USA
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, 35000 Rennes, France
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, 35000 Rennes, France
| | - Curtis L Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, 02114 Boston, MA, USA
- Department of Plastic Surgery, Massachusetts General Hospital, 02114 Boston, MA, USA
| | - Camille Vaillant
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, 35000 Rennes, France
| | - Benoît Chaput
- Department of Plastic Surgery, University Toulouse III Paul Sabatier, 31000 Toulouse, France
| | - Olivier Camuzard
- Department of Plastic and Reconstructive Surgery, Institut Universitaire Locomoteur et du Sport, Pasteur 2 Hospital, University Côte d'Azur, 06001 Nice, France
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, 02114 Boston, MA, USA
- Department of Plastic Surgery, Massachusetts General Hospital, 02114 Boston, MA, USA
| |
Collapse
|
|
13
|
Meghe SR, Khan A, Jangid SD, Sarda B, Vangala N, Saoji V. Shedding Light on Acne Scars: A Comprehensive Review of CO2 vs. Erbium-Doped Yttrium Aluminium Garnet (Er:YAG) Laser Therapy. Cureus 2024; 16:e57572. [PMID: 38707019 PMCID: PMC11069036 DOI: 10.7759/cureus.57572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 04/03/2024] [Indexed: 05/07/2024] Open
Abstract
Acne scars pose a significant cosmetic concern and can have a profound impact on individuals' self-esteem and quality of life. Laser therapy has emerged as a promising treatment modality for improving the appearance of acne scars by promoting collagen remodeling and tissue regeneration. This comprehensive review compares two commonly used laser modalities, CO2 and erbium-doped yttrium aluminum garnet (Er:YAG), focusing on their mechanisms of action, efficacy, safety profiles, and patient outcomes. While CO2 lasers offer deeper tissue penetration and the potential for more significant improvement in severe acne scars, Er:YAG lasers provide a gentler approach with a lower risk of post-inflammatory hyperpigmentation. Recommendations for clinical practice include tailoring treatment approaches to individual patient characteristics, educating patients about treatment expectations and post-treatment care, considering combination therapies for enhanced outcomes, and implementing regular follow-up care. Areas for further research include long-term outcome studies, investigation of laser therapy in ethnically diverse populations, exploration of combination therapies, and evaluation of emerging laser technologies. This review aims to provide clinicians and patients with valuable insights to inform treatment decisions and optimize outcomes in managing acne scars.
Collapse
Affiliation(s)
- Soham R Meghe
- Dermatology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Arshiya Khan
- Dermatology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shivani D Jangid
- Dermatology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Bhakti Sarda
- Dermatology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nitya Vangala
- Dermatology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vikrant Saoji
- Dermatology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
|
14
|
Veronese S, Aggarwal R, Giovanelli T, Sbarbati A. Hyper- and Hypopigmentation in a Subject with Fitzpatrick Skin Phototype VI: A New Treatment Option. J Clin Med 2024; 13:1036. [PMID: 38398349 PMCID: PMC10889290 DOI: 10.3390/jcm13041036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/28/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Laser therapies can cause hyper- and hypopigmentation of the skin. There is little evidence in the literature of effective treatments for these types of problems in Fitzpatrick skin phototypes IV-VI. The main aim of this retrospective study is to evaluate the effects of a new therapy that combines the application of electromagnetic fields and vacuum on a subject with Fitzpatrick skin phototype VI, who presented extensive, laser-induced facial dyschromia. The secondary aim is to test the effectiveness of a free imaging software for assessing skin pigmentation. Methods: The level of improvement after therapy was evaluated, with a 5-point Likert scale, one month after the end of the treatment by the subject and by the doctor who performed the treatment, and by two blinded dermatologists. With the free software, a three-dimensional reconstruction of the treated area and the evaluation of the color distribution were performed. Results: Both the subject and the doctors involved in the study positively evaluated the effects of the treatment. The image analysis highlighted the homogenization of the skin color in the treated area. Conclusions: The combination of electromagnetic fields and vacuum for dyschromia treatments appears promising. The new method of assessing melanin levels resulted particularly efficient.
Collapse
Affiliation(s)
- Sheila Veronese
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Rajeev Aggarwal
- Cardiff Cosmetic Clinic, Cardiff CF24 3WD, UK; (R.A.); (T.G.)
| | | | - Andrea Sbarbati
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| |
Collapse
|
|
15
|
Chen A, Choi J, Balazic E, Zhu TR, Kobets K. Review of laser and energy-based devices to treat rosacea in skin of color. J COSMET LASER THER 2024; 26:43-53. [PMID: 39171934 DOI: 10.1080/14764172.2024.2376701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/06/2023] [Accepted: 07/02/2024] [Indexed: 08/23/2024]
Abstract
The prevalence of rosacea in skin of color (SOC) populations is estimated to be as high as 10% in some countries. Traditionally, intense pulsed light (IPL) and pulsed dye laser (PDL) have been the laser and energy-based devices (EBDs) used to treat rosacea. However, not all laser and EBDs are safe for SOC (Fitzpatrick skin types IV-VI) due to increased absorption of energy in pigmented skin and increased risk of post-inflammatory hyperpigmentation and scarring. This review summarizes the use of the top seven laser and EBDs for treating rosacea in SOC.
Collapse
Affiliation(s)
- Anna Chen
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Janet Choi
- Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Tian Ran Zhu
- Albert Einstein College of Medicine, Bronx, NY, USA
- Montefiore Medical Center, Department of Medicine, Division of Dermatology, Bronx, NY, USA
| | - Kseniya Kobets
- Montefiore Medical Center, Department of Medicine, Division of Dermatology, Bronx, NY, USA
| |
Collapse
|
|
16
|
Elliott J, Liu K, Motan T. Directive clinique n° 444 : Hirsutisme : Évaluation et traitement. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2023; 45:102273. [PMID: 38049279 DOI: 10.1016/j.jogc.2023.102273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
|
|
17
|
Elliott J, Liu K, Motan T. Guideline No. 444: Hirsutism: Evaluation and Treatment. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2023; 45:102272. [PMID: 38049282 DOI: 10.1016/j.jogc.2023.102272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
OBJECTIVE This guideline reviews the etiology, diagnosis, evaluation, and treatment of hirsutism. TARGET POPULATION Women with hirsutism. OPTIONS Three approaches to management include: 1) mechanical hair removal; 2) suppression of androgen production; and 3) androgen receptor blockade. OUTCOMES The main limitations of the management options include the adverse effects, costs, and duration of treatment. BENEFITS, HARMS, AND COSTS Implementation of the recommendations in this guideline may improve the management of hirsutism in women with this condition. Adverse effects and a potential long duration of treatment are the main drawbacks to initiating treatment, as is the possibility of significant financial costs for certain treatments. EVIDENCE A comprehensive literature review was updated to April 2022, following the same methods as for the prior Society of Obstetricians and Gynaecologists of Canada (SOGC) Hirsutism guidelines. Results were restricted to systematic reviews, randomized controlled trials, controlled clinical trials, and observational studies. There were no date limits, but results were limited to English- or French-language materials. VALIDATION METHODS The authors rated the quality of evidence and strength of recommendations using the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, along with the option of designating a recommendation as a "good practice point." See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and conditional [weak] recommendations). INTENDED AUDIENCE Primary care providers, family medicine physicians, obstetricians and gynaecologists, reproductive endocrinologists and others who manage the care of patients with hirsutism. TWEETABLE ABSTRACT Management of hirsutism involves a 3-pronged approach of mechanical hair removal, suppression of androgen production, and androgen receptor blockade. SUMMARY STATEMENTS RECOMMENDATIONS.
Collapse
|
|
18
|
Garg SP, Williams T, Taritsa IC, Wan R, Goel C, Harris R, Huffman K, Galiano RD. Evaluating skin colour diversity in the validation of scar assessment tools. Wound Repair Regen 2023; 31:731-737. [PMID: 37768279 DOI: 10.1111/wrr.13120] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/23/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
Across scar studies, there is a lack of dark-skinned individuals, who have a predisposition for keloid formation, altered pigmentation and poorer quality of life (QOL). There is a need for patients of colour to be included in scar scale development and validation. In this study, we evaluate the racial diversity of patients included in the validation of scar assessment scales. A systematic review was conducted for articles reporting on the validation of a scar assessment tool. Racial, ethnic and Fitzpatrick skin type (FST) data were extracted. Fifteen scar scale validation studies were included. Nine of the studies did not mention FST, race or ethnicity of the patients. Two of the studies that reported FST or race information only included White patients or included no FST V/VI patients: mapping assessment of scars (MAPS) and University of North Carolina '4P'. Only four studies included non-White patients or dark-skinned patients in the validation of their scar scale: the modified Vancouver Scar Scale (VSS), modified Patient and Observer Scar Assessment Scale (POSAS), acne QOL and SCAR-Q scales. The patients included in the modified VSS validation were 7% and 13% FST V/VI, 14% African in the modified POSAS and 4.5% FST V/VI in the SCAR-Q. We highlight the severe lack of diversity in scar scale validation, with only 4 out of 15 studies including dark-skinned patients. Given the susceptibility of darker-skinned individuals to have poorer scarring outcomes, it is critical to include patients of colour in the very assessment tools that determine their scar prognosis. Inclusion of patients of colour in scar scale development will improve scar assessment and clinical decision-making.
Collapse
Affiliation(s)
- Stuti P Garg
- Division of Plastic & Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Tokoya Williams
- Division of Plastic & Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Iulianna C Taritsa
- Division of Plastic & Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Rou Wan
- Division of Plastic & Reconstructive Surgery, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Chirag Goel
- Division of Plastic & Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Raiven Harris
- Division of Plastic & Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kristin Huffman
- Division of Plastic & Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Robert D Galiano
- Division of Plastic & Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| |
Collapse
|
|
19
|
Lim SS, Mohammad TF, Kohli I, Hamzavi I, Rodrigues M. Optimisation of skin phototype classification. Pigment Cell Melanoma Res 2023; 36:468-471. [PMID: 37550876 DOI: 10.1111/pcmr.13110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 04/17/2023] [Accepted: 06/20/2023] [Indexed: 08/09/2023]
Abstract
Understanding individuals' skin pigmentation and photosensitivity is important in judging risk of skin cancer and response to certain treatment modalities. However, individuals with darkly pigmented skin are poorly represented in the widely used Fitzpatrick skin phototype (FST) system. Moreover, the FST system is prone to misuse, as it relies on subjective patient and clinician assessment of skin type, and does not clearly differentiate pigmentation from photosensitivity. By evaluating the key literature surrounding the FST system, its criticisms and proposed alternatives, this review serves to understand how skin phototype classification can be optimised.
Collapse
Affiliation(s)
| | - Tasneem F Mohammad
- The Henry W Lim, MD, Division of Photobiology and Photomedicine, Department of Dermatology, Henry Ford Health, Detroit, Michigan, USA
| | - Indermeet Kohli
- The Henry W Lim, MD, Division of Photobiology and Photomedicine, Department of Dermatology, Henry Ford Health, Detroit, Michigan, USA
- Chroma Dermatology, Pigment and Skin of Colour Centre, Melbourne, Victoria, Australia
| | - Iltefat Hamzavi
- The Henry W Lim, MD, Division of Photobiology and Photomedicine, Department of Dermatology, Henry Ford Health, Detroit, Michigan, USA
| | - Michelle Rodrigues
- Department of Dermatology, The Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Physics and Astronomy, Wayne State University, Detroit, Michigan, USA
| |
Collapse
|
|
20
|
Duplechain JK. Ablative Laser Therapy of Skin. Facial Plast Surg Clin North Am 2023; 31:463-473. [PMID: 37806680 DOI: 10.1016/j.fsc.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Laser skin rejuvenation was introduced in the mid-1990s. Early ablative laser devices relied on scanner technology that provided significant ablation and longer time on tissue treatments. These early treatments provided significant improvement in the appearance of the skin, but because of the longer treatment times and in some cases excessive treatment, complications such as scarring and hypopigmentation were significant. More recent advances in skin resurfacing technology have now minimized these risks providing certain key principles are observed. These parameters are reviewed in detail to improve the reader's ability to propose and execute proper skin resurfacing treatments.
Collapse
Affiliation(s)
- J Kevin Duplechain
- Division of Facial Plastic Surgery, Department of Otolaryngology, Tulane Medical School, 1103 Kaliste Saloom Road, Suite 300, Lafayette, 70508, LA, USA.
| |
Collapse
|
|
21
|
Chao JR, Porter JP, Hessler J. Cosmetic Treatments with Energy-Based Devices in Skin of Color. Facial Plast Surg 2023; 39:496-500. [PMID: 37557909 DOI: 10.1055/s-0043-1772197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Abstract
The use of energy-based devices in cosmetic treatments for patients with higher Fitzpatrick skin types is a topic of concern due to the increased risk of complications such as hyperpigmentation and scarring. Advancements in technology have enabled the development of safe and effective energy-based modalities for improving skin tone, texture, and signs of aging in patients with higher Fitzpatrick skin types. This article reviews various modalities that have shown positive outcomes in Fitzpatrick skin types 4 to 6.Radiofrequency (RF) skin tightening devices have emerged as a noninvasive method for improving skin laxity by stimulating collagen and elastin production without generating excessive heat, making them suitable for darker skin tones. Microfocused ultrasound (MFUS) is another noninvasive option for skin tightening and lifting. By producing thermal coagulation in the deeper layers of the skin, MFUS stimulates collagen production, resulting in improved skin tightness. Fractional laser resurfacing, both ablative and nonablative, offers effective treatment options for various concerns such as acne scars, skin texture, and dyspigmentation. Nonablative fractional lasers, which target water rather than melanin, are particularly safer for darker skin types. Broadband light devices that emit different wavelengths have shown success in skin rejuvenation, improving wrinkles, pore size, erythema, telangiectasias, and dyspigmentation. Additionally, RF microneedling combines the benefits of both modalities, delivering safe treatment for skin laxity and textural concerns. The short-pulse neodymium-doped yttrium aluminum garnet (Nd:YAG) laser has become a transformative tool for patients with Fitzpatrick skin types 4 to 6. This laser targets melanin, hemoglobin, and water, providing improvements in hyperpigmentation, acne, fine lines, and scar texture. Combining the short-pulse Nd:YAG laser with other treatments like chemical peels or microneedling has shown synergistic effects and enhanced outcomes. Understanding these modalities and tailoring treatments to specific concerns is crucial for safe and effective solutions in patients with higher Fitzpatrick skin types.
Collapse
Affiliation(s)
- Janet Ren Chao
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Jennifer Parker Porter
- Department of Otolaryngology-Head and Neck Surgery, Georgetown University Medical Center, Washington, District of Columbia
- Chevy Chase Facial Plastic Surgery, Bethesda, Maryland
| | | |
Collapse
|
|
22
|
Gan C, Mahil S, Pink A, Rodrigues M. Atopic dermatitis in skin of colour. Part 2: considerations in clinical presentation and treatment options. Clin Exp Dermatol 2023; 48:1091-1101. [PMID: 37119261 DOI: 10.1093/ced/llad162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 03/09/2023] [Accepted: 04/24/2023] [Indexed: 05/01/2023]
Abstract
Recent advances in atopic dermatitis (AD) present the condition as a heterogeneous disease of distinct endotypes across ethnic groups. AD in people with skin of colour may appear psoriasiform, lichenoid, scaly or papular, with a violaceous colour and there is a higher prevalence of post-inflammatory dyspigmentation compared with affected individuals of White ethnicity. These differences in clinical presentation may limit the use of AD assessment tools in people with skin of colour, leading to the potential for misdiagnosis and underestimation of severity, particularly in relation to assessment of erythema. Recent targeted therapies for AD have been studied in multiple ethnic groups; however, ethnicity-based subgroup analysis is often not performed. Further research is required to understand whether treatment responses or safety may differ among ethnic groups.
Collapse
Affiliation(s)
- Christian Gan
- Department of Dermatology, The Royal Children's Hospital, Melbourne, VIC, Australia
- Department of Dermatology, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Satveer Mahil
- St John's Institute of Dermatology, Guy's and St Thomas NHS Foundation Trust and King's College London, London, UK
| | - Andrew Pink
- St John's Institute of Dermatology, Guy's and St Thomas NHS Foundation Trust and King's College London, London, UK
| | - Michelle Rodrigues
- Department of Dermatology, The Royal Children's Hospital, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Chroma Dermatology, Pigment and Skin of Colour Centre, VIC, Australia
| |
Collapse
|
|
23
|
Asfour L, Ismail D, Madan V. The Role of Lasers in Connective Tissue and Inflammatory Dermatoses: A 10-Year Retrospective Review of 60 Patients in a UK Tertiary Laser Clinic. Indian Dermatol Online J 2023; 14:616-623. [PMID: 37727556 PMCID: PMC10506828 DOI: 10.4103/idoj.idoj_439_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/30/2022] [Accepted: 11/29/2022] [Indexed: 09/21/2023] Open
Abstract
Introduction The role of lasers in the treatment of standard therapy-resistant inflammatory dermatoses and connective tissue disorders has been controversial and evidence supporting the role of lasers in this setting is scarce. Objective To assess the efficacy of lasers in the management of inflammatory dermatoses and connective tissue disorders (CTD). Materials and Methods A retrospective case review of all inflammatory dermatoses/connective tissue diseases treated in a tertiary laser clinic between March 2010 and 2020 was undertaken. Results A total of 60 cases (48 = female) were included and the average age was 51 years (range 21 to 74). The following conditions were treated: scleroderma n = 22 (37%), granuloma faciale n = 10 (17%), sarcoidosis n = 8 (13%), discoid lupus erythematosus n = 7 (12%), and systemic lupus erythematosus n = 2 (3%). Other diagnoses included necrobiosis lipoidica, pyoderma vegetans, hypertrophic lichen planus, and dermatomyositis. The most common type of laser used was pulsed dye laser (PDL) in n = 41 (68%) cases. Eight (13%) patients received treatment with the carbon dioxide (CO2) laser. The most common site treated was the face. A good response with a marked reduction of signs was seen in 62% of patients while 10% of the patients did not respond to laser treatment. Self-limiting complications included purpura and hyperpigmentation. Limitations Lack of objective assessment and outcome measures. Conclusions This is the largest cohort of patients to have undergone laser treatment for inflammatory dermatoses/connective tissue disease. Based on this retrospective review, we conclude that lasers can be a useful adjunct in the management of otherwise difficult-to-treat selected inflammatory and connective tissue diseases.
Collapse
Affiliation(s)
- Leila Asfour
- Department of Dermatology, Laser Division, Salford Royal NHS Foundation Trust Hospital, Stott Lane, Salford, Manchester, United Kingdom
| | - Dina Ismail
- Department of Dermatology, Laser Division, Salford Royal NHS Foundation Trust Hospital, Stott Lane, Salford, Manchester, United Kingdom
| | - Vishal Madan
- Department of Dermatology, Laser Division, Salford Royal NHS Foundation Trust Hospital, Stott Lane, Salford, Manchester, United Kingdom
| |
Collapse
|
|
24
|
Mineroff J, Austin E, Jagdeo J. Cutaneous effects of photobiomodulation with 1072 nm light. Arch Dermatol Res 2023; 315:1481-1486. [PMID: 36495337 DOI: 10.1007/s00403-022-02480-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/08/2022] [Accepted: 11/16/2022] [Indexed: 12/14/2022]
Abstract
Photobiomodulation, also known as low-level light therapy, has gained popularity in treating a variety of dermatologic and non-dermatologic conditions. The near-infrared (NIR) portion ranging from 700 to 1440 nm has a broad spectrum but most current research focuses on relatively shorter wavelengths. To date, clinical research regarding the application of 1072 NIR is limited to treatments for infections and photorejuvenation treatment in females. However, 1072 NIR light therapy may benefit male patients. This theoretical application is based on the biological properties of this subgroup having increased cutaneous density and thickness and the physical properties of 1072 NIR allowing it to penetrate increased depth. 1072 NIR can reach more cells throughout the epidermis and dermis compared to other parts of the electromagnetic spectrum traditionally used in phototherapy to provide unique and targeted benefits. 1072 NIR light-emitting diodes are commercially available and therefore hold tremendous potential to become accessible, affordable treatment options. Given the increased demand and market size for aesthetics for men that remains untapped, there is opportunity for future research to elucidate the potential for this wavelength as a safe and effective treatment.
Collapse
Affiliation(s)
- Jessica Mineroff
- Department of Dermatology, State University of New York, Downstate Health Sciences University, SUNY Downstate Medical Center, 450 Clarkson Avenue, 8th Floor, Brooklyn, NY, 11203, USA
| | - Evan Austin
- Department of Dermatology, State University of New York, Downstate Health Sciences University, SUNY Downstate Medical Center, 450 Clarkson Avenue, 8th Floor, Brooklyn, NY, 11203, USA
| | - Jared Jagdeo
- Department of Dermatology, State University of New York, Downstate Health Sciences University, SUNY Downstate Medical Center, 450 Clarkson Avenue, 8th Floor, Brooklyn, NY, 11203, USA.
| |
Collapse
|
|
25
|
Abstract
This article reviews the evaluation and techniques for facial skin rejuvenation using the fractionated carbon dioxide laser. It includes a detailed overview of laser skin rejuvenation and discusses the potential complications associated with this procedure. A review of clinical outcomes in the literature is also included.
Collapse
Affiliation(s)
- Kasra Ziai
- Department of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Harry V Wright
- Wright Spellman Plastic Surgery, 5911 N. Honore Avenue, Suite 120, Sarasota, FL 34243, USA.
| |
Collapse
|
|
26
|
Nelson K, Nelson J, Bradley T, Burgess C. Cosmetic Enhancement Updates and Pitfalls in Patients of Color. Dermatol Clin 2023; 41:547-555. [DOI: 10.1016/j.det.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
|
|
27
|
Yan BY, Rambhia PH, Barilla S, Sharon VR. Racial and ethnic diversity in clinical trials examining post-surgical scar cosmesis: a concise review. Int J Dermatol 2023; 62:e215-e217. [PMID: 35094391 DOI: 10.1111/ijd.16087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/20/2021] [Accepted: 01/06/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Bernice Y Yan
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA
| | - Pooja H Rambhia
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA
| | - Steven Barilla
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA
| | - Victoria R Sharon
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA
| |
Collapse
|
|
28
|
Q-Switched Nd:YAG Laser to Manage Hyperpigmentation in Asians: A Multicenter Study. COSMETICS 2023. [DOI: 10.3390/cosmetics10020044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
(1) Introduction: In cosmetic dermatology, benign hyperpigmentation is a prevalent issue. Solar lentigo and other melanoses are bringing patients to the attention of physicians more and more often. The Q-switched 1064/532-nanometer (nm) laser is the gold standard device to treat these conditions. A new generation of these machines, able to shorten pulse duration to hundreds of picoseconds, has emerged showing better preliminary results. In order to treat hypermelanoses in Asians, we used a Q-switched laser with a picosecond pulse. (2) Methods: A retrospective recruitment of 31 Asian individuals requesting treatment for melanosis was conducted at Catanzaro’s Magna Graecia University, University of Rome Tor Vergata and Villa Bella Antiaging. Although they might have varied, the treatment settings were typically as follows: for dermic lesions, a pulse wavelength of 1064 nm with a duration of 450 picoseconds (ps) was used, and for epidermal lesions, a pulse wavelength of 532 nm with a duration of 370 ps was used. Up to four laser treatments were carried out, each at least 30 days apart. During a three-month follow-up after the final session, patient satisfaction was evaluated using a visual analogue scale (VAS). Images taken prior to laser treatments and thereafter were compared, and the aesthetic effect was scored on a five-point scale by two blinded specialists. (3) Results: Of the 31 patients recruited, 25 (80.6%) were female and 6 were male (19.4%). The average stated age was 48.96 ± 13.68. During the dermatological examination, all patients were found to have nearly completely removed melanosis, with a mean VAS score of 7.03 ± 1.35 and a five-point evaluation scale of 2.71 ± 0.78. Conclusions: The Q-switched 1064/532 nm laser can be seen as a safe and effective option to treat benign hypermelanosis in Asian patients. Compared to other technologies, the use of a picosecond pulse appears to promise superior outcomes. To validate the results of this investigation, however, a clinical trial comparing the many commercially accessible therapy options is required.
Collapse
|
|
29
|
Radiofrequency and Radiofrequency Microneedling in Skin of Color: A Review of Usage, Safety, and Efficacy. Dermatol Surg 2023; 49:489-493. [PMID: 36826381 DOI: 10.1097/dss.0000000000003733] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND Radiofrequency (RF) and radiofrequency microneedling (RFM) for rhytides, scarring, and skin rejuvenation are believed to have a lower risk of postprocedural dyspigmentation in darker skin types. OBJECTIVE To explore the safety and efficacy of RF and RFM in Fitzpatrick skin Types III to VI. METHODS AND MATERIALS A systematic review of PubMed/MEDLINE databases from 2000 to 2021 using combinations of the terms radiofrequency, microneedling, skin of color, and Fitzpatrick was performed. Exclusion criteria included non-Fitzpatrick skin Types III-VI patient population, nonprimary articles, nonskin radiofrequency, and nonhuman studies. RESULTS Thirty-five articles addressing the use of RF or RFM in skin of color were identified-22 for skin rejuvenation, 7 for acne scars, 4 for nonacne scars, 1 for hyperpigmentation, and 1 for acne treatment. Seven studies noted transient postinflammatory hyperpigmentation, 1 observed mild prolonged hyperpigmentation, and only 1 study reported permanent scarring. CONCLUSION Radiofrequency and RFM seem to have a low risk of scarring or hyperpigmentation in skin of color. This review demonstrates that these procedures have been successfully used primarily for rhytides, acne scarring, and skin rejuvenation. However, a large proportion of the studies lack strong quality evidence.
Collapse
|
|
30
|
Rambhia PH, Yan BY, Barilla S, Sharon VR. Racial and ethnic diversity in clinical trials of laser treatments for scars. J Am Acad Dermatol 2022; 87:1178-1179. [PMID: 35259452 DOI: 10.1016/j.jaad.2022.02.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/20/2022] [Accepted: 02/15/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Pooja H Rambhia
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York
| | - Bernice Y Yan
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York
| | - Steven Barilla
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York
| | - Victoria R Sharon
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York.
| |
Collapse
|
|
31
|
Investigation of Prognostic Factors for Intense Pulsed Light Treatment with a Vascular Filter in Patients with Moderate or Severe Meibomian Gland Dysfunction. J Clin Med 2022; 11:jcm11164724. [PMID: 36012963 PMCID: PMC9410466 DOI: 10.3390/jcm11164724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/31/2022] [Accepted: 08/10/2022] [Indexed: 11/22/2022] Open
Abstract
We aimed to investigate the prognostic factors for, and treatment efficacy of, intense pulsed light (IPL) treatment with a vascular filter in patients with moderate or severe meibomian gland dysfunction (MGD). In this retrospective observational study, 58 moderate or severe MGD patients who underwent IPL treatment with a vascular filter were enrolled. IPL treatment was administered to the upper and lower eyelids four times at two-week intervals. At baseline, and four weeks after IPL, we evaluated the matrix metalloproteinase (MMP)-9 expression levels, tear break-up times (TBUT), ocular surface staining scores, lid margin telangiectasias, and meibomian gland characteristics. The subjective symptoms and adverse effects were reviewed and recorded. Regression analyses were performed to explore the prognostic factors affecting clinical outcomes. IPL treatment using a vascular filter led to improvements in the TBUT, ocular surface staining score, meibomian gland grade, meibum quality and consistency, lid margin telangiectasia, and symptom score (all p < 0.001). Furthermore, the positivity rate (90.2% to 70.6%, p = 0.013) and expression levels (1.92 ± 1.18 to 1.24 ± 1.18, p < 0.001) of tear MMP-9 improved after the IPL treatment. In multivariate logistic regression analysis, a young age (odds ratio = 0.867, p = 0.007) and a toothpaste-like consistency in the upper lid (odds ratio = 8.449, p = 0.046) were associated with improvements in the meibomian gland grade. No adverse effects were detected. IPL with a vascular filter is a safe and effective treatment for moderate and severe MGD. Age and the meibum consistency in the upper lid are important prognostic factors.
Collapse
|
|
32
|
Facial Rejuvenation in Patients of Color. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-022-00407-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
|
|
33
|
Aim to prevent acne-induced post-inflammatory hyperpigmentation as treatment remains a challenge. DRUGS & THERAPY PERSPECTIVES 2022. [DOI: 10.1007/s40267-022-00932-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
|
34
|
Carbon Dioxide Laser Rejuvenation of the Facial Skin. Facial Plast Surg Clin North Am 2022; 30:331-346. [DOI: 10.1016/j.fsc.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
|
35
|
Wang JV, Friedman PM, Johnson J, Konda A, Keator L, Geronemus RG. Key Parameters of Non-ablative Fractional Laser Pretreatments for Enhanced Topical Uptake. J Cosmet Dermatol 2022; 21:3803-3808. [PMID: 35841215 DOI: 10.1111/jocd.15245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 07/11/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The uptake of topical formulations can be enhanced through laser pretreatments. Newer technologies, such as non-ablative fractional lasers (NAFLs), can target dermal tissues and spare the stratum corneum (SC), which can mitigate common side effects associated with ablative laser treatment. OBJECTIVE To discuss parameters of 2 NAFL pretreatment systems (1440-nm/1927-nm diode system or 1550-nm erbium-doped glass/1927-nm thulium system), which can be paired with topicals to improve their cutaneous uptake. METHODS & MATERIALS The parameters of the 1440-nm/1927-nm diode system and 1550-nm erbium-doped glass/1927-nm thulium system were reviewed, as well as in-vivo experiments using both laser systems. RESULTS Multiple parameters should be optimized to enhance the uptake of various topical formulations and minimize side effects, including wavelength, spot size, density, pulse duration, thermal properties, and topical formulation. Chosen therapeutic parameters must account for patient-specific factors, such as treatment indication, therapeutic area, and Fitzpatrick skin type. In-vivo experiments have demonstrated that both laser systems are effective in enhancing the uptake of various topical therapies relative to untreated controls. CONCLUSION Individualization of laser system parameters increases efficiency and minimizes risk.
Collapse
Affiliation(s)
- Jordan V Wang
- Laser & Skin Surgery Center of New York, New York, NY
| | - Paul M Friedman
- Laser & Skin Surgery Center of New York, New York, NY.,Dermatology and Laser Surgery Center, Houston, TX
| | | | - Adarsh Konda
- Bausch Health US, LLC, Bridgewater, NJ; 5Solta Medical, Bothell, WA
| | | | | |
Collapse
|
|
36
|
Kim M, Min J. Effect of Intense Pulsed-Light Treatment Using a Novel Dual-Band Filter in Patients with Meibomian Gland Dysfunction. J Clin Med 2022; 11:jcm11133607. [PMID: 35806889 PMCID: PMC9267678 DOI: 10.3390/jcm11133607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/16/2022] [Accepted: 06/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background: This study evaluates the effect of intense pulsed-light (IPL) treatment in patients with meibomian gland dysfunction (MGD) using a novel dual-band filter (vascular filter, 530–650 nm and 900–1200 nm) and compares it with the effect and discomfort during treatment using a conventional filter. Methods: The medical records of 89 patients (89 eyes) with MGD who underwent IPL treatment were reviewed. Patients treated with the vascular filter or conventional 590 nm filter were designated as Group A or Group B, respectively. Patients underwent IPL treatment four times every four weeks. Ocular surface disease index (OSDI) scores, dry eye (DE), and MGD parameters were determined before the first IPL treatment and after the fourth IPL treatment. Visual analog scale (VAS) scores were obtained at every IPL treatment. OSDI, DE and MGD parameters, and VAS were compared between the groups. Results: OSDI, DE, and MGD parameters improved after the four IPL treatments in both groups. There were no significant differences, between the groups, in OSDI, DE, and MGD parameters, before the first IPL treatment and after the fourth IPL treatment. VAS at each of the IPL treatments was lower in Group B than in Group A. Conclusion: IPL treatment using the novel vascular filter for patients with MGD is effective compared with conventional IPL treatment for MGD patients.
Collapse
Affiliation(s)
| | - Jisang Min
- Correspondence: ; Tel.: +82-10-8838-8275
| |
Collapse
|
|
37
|
Maliyar K, Abdulla SJ. Dermatology: how to manage rosacea in skin of colour. Drugs Context 2022; 11:2021-11-1. [PMID: 35720055 PMCID: PMC9165629 DOI: 10.7573/dic.2021-11-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 03/15/2022] [Indexed: 11/21/2022] Open
Abstract
Rosacea is a common inflammatory skin disorder affecting the face. Common cutaneous symptoms include papules, pustules, persistent centrofacial erythema, telangiectasias, recurrent flushing, phymatous changes and a variety of ocular manifestations. Previous epidemiological studies have demonstrated that the incidence of rosacea is much lower in people with darker Fitzpatrick phototypes compared to fair-skinned individuals. In patients with darker skin, the centrofacial erythema can be masked and difficult to appreciate, impacting the ability for providers to make diagnoses and leading to misdiagnoses. Thus, it is difficult to say with certainty that the disparities in prevalence in rosacea amongst fair-skinned and darker individuals are true. The primary aim of this article is to raise awareness that rosacea is a global disease and to provide healthcare professionals with strategies to identify and manage rosacea amongst individuals with skin of colour.
Collapse
Affiliation(s)
- Khalad Maliyar
- Division of Dermatology, University of Toronto, Toronto, Canada
| | - Sonya J Abdulla
- Division of Dermatology, University of Toronto, Toronto, Canada
- Dermatology on Bloor, Toronto, Canada
| |
Collapse
|
|
38
|
Wu X, Wang X, Wu X, Cen Q, Xi W, Shang Y, Zhang Z, Lin X. Intense Pulsed Light Therapy Improves Acne-Induced Post-inflammatory Erythema and Hyperpigmentation: A Retrospective Study in Chinese Patients. Dermatol Ther (Heidelb) 2022; 12:1147-1156. [PMID: 35415801 PMCID: PMC9110597 DOI: 10.1007/s13555-022-00719-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 03/29/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Post-inflammatory erythema (PIE) and post-inflammatory hyperpigmentation (PIH) are the most common acne-related sequelae with no effective treatments. By combining different cut-off filters, intense pulsed light (IPL) therapy can effectively treat these conditions with few side effects. While the safety and effectiveness of IPL for treating post-burn hyperpigmentation is well known, there is little evidence for its benefits for acne-related PIH. In this article, we evaluate the efficacy and safety of IPL for the treatment of acne-related PIE and PIH. Methods This retrospective study evaluated 60 patients with more than 6 months of PIE and PIH treated by the same IPL device and similar protocols. The treatment included three to seven sessions at 4–6-week intervals, and three cut-off filters (640 nm, 590 nm and 560 nm) were used sequentially in each session. Using the Global Aesthetic Improvement Scale (GAIS), Cardiff Acne Disability Index (CADI), and Erythema Assessment Scale (EAS), patients were evaluated on the basis of their facial photographs. The facial brown spots and red areas were visualised and analysed using the VISIA-CR system. Six months after the last treatment, the patients were assessed for acne relapse or any side effects.Please check and confirm that the authors and their respective affiliations have been correctly processed and amend if necessary.Checked and confirmed. No further corrections. Results On the basis of the GAIS, 49 of 60 patients (81.7%) showed complete or partial clearance of erythema and hyperpigmentation. The CADI and EAS scores showed significant improvement (p < 0.01) after IPL treatment compared with pre-treatment. A significant reduction (p < 0.01) in the facial brown spots and red areas was seen after IPL treatment. While no long-term side effects were reported, seven patients (11.7%) experienced acne relapse at follow-up. Conclusion IPL is an effective and safe treatment for acne-related PIE and PIH.
Collapse
Affiliation(s)
- Xianglei Wu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Xue Wang
- Department of Dermatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Xiujuan Wu
- Department of Dermatology, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, 200031, China
| | - Qingqing Cen
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Wenjing Xi
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ying Shang
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Zhen Zhang
- Department of Dermatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Xiaoxi Lin
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China. .,Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| |
Collapse
|
|
39
|
Quiñonez RL, Agbai ON, Burgess CM, Taylor SC. An update on cosmetic procedures in people of color. Part 2: Neuromodulators, soft tissue augmentation, chemexfoliating agents, and laser hair reduction. J Am Acad Dermatol 2022; 86:729-739. [PMID: 35189253 DOI: 10.1016/j.jaad.2021.07.080] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 10/19/2022]
Abstract
Recent years have brought forth the undeniable practice gap in dermatology concerning knowledge and experience of cosmetic procedures in people of color (POC). A paucity in the literature regarding evidence-based recommendations for the management of POC undergoing cosmetic procedures and the rise of cosmetic procedures in dermatology serves as a call to action to provide education regarding differences in skin of color that may impact the cosmetic outcomes. To mitigate the current practice gap on the safety, use, and benefits of cosmetic procedures in POC, part 2 will discuss the authors' recommendations and clinical pearls, as well as evidence-based management for neuromodulators, soft tissue augmentation, chemexfoliating agents, and laser hair reduction in POC undergoing cosmetic procedures.
Collapse
Affiliation(s)
- Rebecca L Quiñonez
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Oma N Agbai
- Department of Dermatology, University of California, Davis School of Medicine, Sacramento, California.
| | - Cheryl M Burgess
- Center for Dermatology and Dermatologic Surgery, Washington, District of Columbia
| | - Susan C Taylor
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
|
40
|
Treatment of Postburn Scar Erythema and Dyschromia With Pulsed Dye and Q-Switched KTP Laser. Dermatol Surg 2022; 48:700-702. [PMID: 35316250 DOI: 10.1097/dss.0000000000003429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
|
41
|
Min JS, Yoon SH, Kim KY, Jun I, Kim EK, Kim TI, Seo KY. Treatment Effect and Pain During Treatment With Intense Pulsed-Light Therapy According to the Light Guide in Patients With Meibomian Gland Dysfunction. Cornea 2022; 41:177-182. [PMID: 34469338 DOI: 10.1097/ico.0000000000002859] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 06/10/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE We investigated whether there is a difference in the treatment effect and pain during the treatment of meibomian gland dysfunction (MGD) with intense pulsed-light (IPL) between new light guide and conventional light guide. METHODS We retrospectively reviewed medical records of 85 patients (170 eyes) who underwent IPL treatment of the upper and lower eyelids 3 times, at 3-week intervals, for MGD. Patients treated with the 6-mm or 8 × 15-mm cylindrical light guide were designated as group A or group B, respectively. The ocular surface disease index (OSDI), dry eye (DE), and MGD parameters were obtained before the first and after the third IPL treatments. Visual analog scale (VAS) scores were obtained at every IPL treatment. OSDI, DE, and MGD parameters and VAS scores were compared between the groups. RESULTS VAS scores at the first, second, and third IPL treatments were lower in group A than in group B. OSDI, DE, and MGD parameters were improved after 3 IPL treatments in both groups. There were no significant differences in OSDI, DE symptoms, and MGD parameters between before the first IPL treatment and after the third IPL treatment between the groups. CONCLUSIONS Using the new 6-mm cylindrical light guide for IPL treatment in patients with MGD induced less pain during treatment and had similar treatment effects to the conventional 8 × 15-mm light guide. The new 6-mm cylindrical light guide can be useful when treating patients with dark or hyperpigmented skin and for pediatric patients with low compliance.
Collapse
Affiliation(s)
- Ji Sang Min
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea; and
| | - Sook Hyun Yoon
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea; and
| | - Kang Yoon Kim
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea; and
| | - Ikhyun Jun
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea; and
- Department of Ophthalmology, Cornea Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Eung Kweon Kim
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea; and
- Department of Ophthalmology, Cornea Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Tae-Im Kim
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea; and
- Department of Ophthalmology, Cornea Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyoung Yul Seo
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea; and
- Department of Ophthalmology, Cornea Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| |
Collapse
|
|
42
|
Sun Y, Yang TT, Chih PL, Chen YC, Lan CCE. Favorable Effect after Single Treatment Session of 755-nm Picosecond Laser with A Diffractive Optic Lens on Facial Wrinkles and Pore Size in Asians. J Cosmet Dermatol 2022; 21:2026-2030. [PMID: 35100450 DOI: 10.1111/jocd.14810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/11/2022] [Accepted: 01/25/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Laser therapy has become one of the mainstay treatments for improving signs of aging including wrinkles, large pores, and skin pigmentation. However, in patients with pigmented skin, an increase in complications including post-inflammatory hyperpigmentation (PIH) has been noted. The purpose of this study is to investigate not only the safety profile of 755 nm picosecond laser with diffractive lens array (DLA) at approximately 2250 pulses on the face in people with darker skin, but also to evaluate its efficacy in treating wrinkles and pore sizes after one treatment session among different age groups. METHODS This single-center, retrospective study enrolled patients between age 22 to 65 with both facial wrinkles and enlarged pore sizes. A total of 46 patients (7 male, 39 female, mean age 43) with Fitzpatrick skin types III and IV were enrolled. Two independent data-blinded dermatologists assessed and scored the improvements of patients' wrinkles and pore sizes using photographs. RESULTS After one treatment session, statistically significant improvements were observed in lateral canthal wrinkles (p<0.001) and facial wrinkles (p=0.014). In addition, greater percentage of the patients from the aged group (50-65 years-old) showed clinically significant improvement as compared to the younger group. CONCLUSIONS For patients with type III and IV skin, one session of DLA picosecond laser treatment at around 2250 pulses to the face is safe and effective for clinically meaningful improvement of the wrinkles and pore sizes, especially for the patients from 50- to 65-years of age.
Collapse
Affiliation(s)
- Yng Sun
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ting-Ting Yang
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Ling Chih
- Huang PH Dermatology and Aesthetic Clinic, Kaohsiung City, Taiwan
| | - Yin-Chun Chen
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Cheng-Chen Eric Lan
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
|
43
|
Han JY, Lee Y, Nam S, Moon SY, Lee H, Kim JY, Tchah H. Effect of intense pulsed light using acne filter on eyelid margin telangiectasia in moderate-to-severe meibomian gland dysfunction. Lasers Med Sci 2022; 37:2185-2192. [PMID: 35022869 DOI: 10.1007/s10103-021-03482-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/29/2021] [Indexed: 12/28/2022]
Abstract
Evaluate the improvement in clinical signs and symptoms in patients with moderate-to-severe meibomian gland dysfunction (MGD) treated with intense pulsed light (IPL) using an acne filter. A retrospective chart review of 70 eyes of 35 patients with moderate-to-severe MGD treated with IPL using the acne filter was performed. IPL treatment was administered using the acne filter four times at 2- to 3-week intervals to upper and lower eyelids. We evaluated tear break-up time (TBUT), matrix metalloproteinase (MMP)-9, Sjögren's International Clinical Collaborative Alliance (SICCA) staining score, and Oxford staining grade. We performed Schirmer's test I without topical anesthesia, slit-lamp microscopic examination of lid margin and meibomian gland, and patient's symptom score assessment and evaluated the incidence of adverse effects in the ocular and periocular areas at baseline and 30 days after the final treatment. Significant improvements (P < 0.001) were observed in TBUT, SICCA staining score, Oxford staining grade, quality of meibum, consistency of meibum, lid margin telangiectasia, MGD grade, and patient's symptom scores after acne filter IPL treatment. Furthermore, the positivity (100 to 71.43%, P = 0.002) and level (2.43 ± 0.98 to 1.14 ± 0.78, P < 0.001) of MMP-9 significantly decreased after treatment. However, there was no significant improvement in Schirmer's test I (P = 0.224). No systemic or regional adverse effects were observed in any patient. IPL treatment using the acne filter is an effective and safe therapeutic modality for treating moderate-to-severe MGD, especially for lid margin telangiectasia and MMP-9.
Collapse
Affiliation(s)
- Jung Yeob Han
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| | - Yunhan Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| | - Sanghyu Nam
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| | - Su Young Moon
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| | - Hun Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea.
| | - Jae Yong Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| | - Hungwon Tchah
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| |
Collapse
|
|
44
|
Vachiramon V, Namasondhi A, Anuntrangsee T, Jurairattanaporn N. A single-blinded, randomized, controlled trial comparing efficacy between low-fluence alexandrite 755-nm picosecond laser and low-fluence neodymium-doped yttrium aluminum garnet (Nd:YAG) 1064-nm picosecond laser for the treatment of ultraviolet B-induced hyperpigmentation. J Cosmet Dermatol 2021; 21:1036-1044. [PMID: 34773725 DOI: 10.1111/jocd.14591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/08/2021] [Accepted: 10/26/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hyperpigmentation is a common concern of patients in dermatology clinics. Although there are many treatment options, lasers are considered a promising therapy for various hyperpigmentary conditions. OBJECTIVES This study aims to evaluate the efficacy of alexandrite 755-nm picosecond and neodymium-doped yttrium aluminum garnet (Nd:YAG) 1064-nm picosecond lasers for the treatment of ultraviolet B (UVB)-induced hyperpigmentation in Asians. MATERIALS AND METHODS A randomized, single-blinded study was conducted. UVB-induced hyperpigmentation was performed in three spots by narrowband UVB. After 2 weeks, these three spots were allocated into 755-treated, 1064-treated, and control sites. Patients received weekly laser treatments for five sessions. Follow-ups were scheduled at 1 and 2 months after the last session. RESULTS Twenty patients attended the study. Overall, 755-nm and 1064-nm picosecond lasers showed a significant improvement in the mean lightness index (L*) compared to the control site, which started at Day 49 and Day 77, respectively. The mean L* of the 755-nm-treated site was also higher than that of the 1064-nm-treated site at Day 105 (p ≤ 0.001). Initially, the mean L*, physician's visual analog scale (VAS), and patient satisfaction with the 1064-nm picosecond laser were better than those with the 755-nm picosecond laser. Nevertheless, an inversion of the mean L* and VAS was noted at Day 49, whereas the mean patient satisfaction was noted at Day 77. In the subgroup analysis, a 755-nm picosecond laser effectively treated Fitzpatrick skin types (FPTs) III and IV. However, the mean L* of the 1064-nm picosecond laser was not significantly different from that of the control for FPT4. CONCLUSION The alexandrite 755-nm picosecond and Nd:YAG 1064-nm picosecond lasers appear to be effective and safe modalities for treating UVB-induced hyperpigmentation. With the setting employed in this study, the outcome after the 755-nm picosecond laser treatment seemed superior to that of the 1064-nm picosecond laser treatment, especially for FPT4.
Collapse
Affiliation(s)
- Vasanop Vachiramon
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Amornrut Namasondhi
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tanaporn Anuntrangsee
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | |
Collapse
|
|
45
|
Elbuluk N, Grimes P, Chien A, Hamzavi I, Alexis A, Taylor S, Gonzalez N, Weiss J, Desai SR, Kang S. The Pathogenesis and Management of Acne-Induced Post-inflammatory Hyperpigmentation. Am J Clin Dermatol 2021; 22:829-836. [PMID: 34468934 DOI: 10.1007/s40257-021-00633-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 12/11/2022]
Abstract
Acne vulgaris is a common inflammatory disease. Among patients with darker skin phototypes (Fitzpatrick III-VI), the inflammatory processes of acne stimulate excess melanogenesis and abnormal melanin deposition, leading to pigmentary sequelae known as post-inflammatory hyperpigmentation and post-inflammatory erythema in all skin tones, although post-inflammatory hyperpigmentation is more common in darker skin and post-inflammatory erythema in lighter skin. These pigmentary alterations can be long lasting and are often more distressing to patients than the active acne lesions. This article discusses what is known about acne-related pigmentation, much of which is extrapolated from general study of nonspecific pigment deposition. Because dyspigmentation poses both a significant clinical concern to patients and a therapeutic challenge to clinicians, we formed a working group consisting of pigmentary experts with the aim of increasing awareness and education of acne-related pigmentary sequelae.
Collapse
Affiliation(s)
- Nada Elbuluk
- Department of Dermatology, Keck School of Medicine, University of Southern California, 830 S Flower Street, Suite 100, Los Angeles, CA, 90017, USA.
| | - Pearl Grimes
- Department of Dermatology, David Geffen School of Medicine, University of California - Los Angeles, CA, Los Angeles, USA
| | - Anna Chien
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Iltefat Hamzavi
- Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA
| | - Andrew Alexis
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
| | - Susan Taylor
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Jonathan Weiss
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
- Georgia Dermatology Partners and Gwinnett Clinical Research Center, Snellville, GA, USA
| | - Seemal R Desai
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Innovative Dermatology, Plano, TX, USA
| | - Sewon Kang
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| |
Collapse
|
|
46
|
Maruthappu T, Taylor M. Acne and rosacea in skin of colour. Clin Exp Dermatol 2021; 47:259-263. [PMID: 34709676 DOI: 10.1111/ced.14994] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 01/19/2023]
Abstract
Acne and rosacea are common inflammatory skin conditions present in numerous racial and ethnic groups. There are distinct differences in clinical presentation, exacerbating factors, potential triggers and consequences of both conditions in individuals with skin of colour (SOC), classified as Fitzpatrick skin types III-VI. For example, acne can be complicated by the development of postinflammatory hyperpigmentation and keloid scarring in SOC, and this can influence treatment choice. Although rosacea is reported less frequently in SOC, this may be the result of delayed diagnosis or late presentation due to the difficulty in discerning the classic features of erythema in darker skin tones. In such cases, additional clues in the medical history and clinical examination may assist in making the diagnosis. This review aims to summarize nuances in both the diagnosis and management of these two common skin conditions in patients with SOC to support clinicians in providing an individualized treatment approach.
Collapse
Affiliation(s)
- T Maruthappu
- Department of Dermatology, Royal London Hospital, Royal London Hospital Barts Health NHS Trust, London, UK.,Blizard Institute, Queen Mary University of London, London, UK
| | - M Taylor
- Department of Dermatology, St Mary's Hospital, Imperial College NHS Trust, London, UK
| |
Collapse
|
|
47
|
Deshpande A. Efficacy & safety of intense pulsed light therapy for unwanted facial hair: a retrospective analysis in skin of color. J COSMET LASER THER 2021; 23:116-121. [PMID: 35038966 DOI: 10.1080/14764172.2021.2009875] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 09/01/2021] [Accepted: 11/19/2021] [Indexed: 10/19/2022]
Abstract
Unwanted facial hair growth is a common esthetic problem. Laser hair removal has emerged as a leading treatment option for long-term depilation. The theory of selective photothermolysis has revolutionized laser hair removal in that it is effective and safe, when operated by sufficiently trained and experienced professionals. Long-pulsed ruby (694 nm), long-pulsed alexandrite (755 nm), diode (800-980 nm), and long-pulsed Nd: YAG (1064) are commercially available laser devices for hair removal most widely studied. The authors wish to share the efficacy and safety of intense pulse light therapy for permanent facial hair reduction in Indian population.
Collapse
|
|
48
|
Adotama P, Papac N, Alexis A, Wysong A, Collins L. Common Dermatologic Procedures and the Associated Complications Unique to Skin of Color. Dermatol Surg 2021; 47:355-359. [PMID: 34328287 DOI: 10.1097/dss.0000000000002813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The skin of color (SOC) population in the United States continues to grow, and these patients are undergoing various cosmetic and surgical procedures at increasing rates. There is a paucity of data on the potential complications associated with surgical and cosmetic procedures in this patient population. OBJECTIVE We aim to educate dermatologic surgeons and clinicians on surgical and cosmetic procedures in patients of color and increase awareness of the potential complications unique to this patient population. MATERIALS AND METHODS A thorough PubMed literature search was performed to conduct this review. RESULTS There are a number of complications in SOC that require special attention, including keloids, postoperative infections, postinflammatory hyperpigmentation, and hypopigmentation. There are also various precautions to consider when performing cosmetic procedures, such as neurotoxin and filler injections, laser therapy, microneedling, and chemical peels. CONCLUSION Dermatologists should be aware of the potential cosmetic and surgical complications of this growing patient population to provide optimal evidence-based medical care.
Collapse
Affiliation(s)
- Prince Adotama
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Nicole Papac
- Department of Dermatology, University of Oklahoma Health Sciences Center, College of Medicine, Oklahoma City, Oklahoma
| | - Andrew Alexis
- Department of Dermatology, Icahn School of Medicine, New York, New York
| | - Ashley Wysong
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Lindsey Collins
- Department of Dermatology, University of Oklahoma Health Sciences Center, College of Medicine, Oklahoma City, Oklahoma
| |
Collapse
|
|
49
|
Manuskiatti W, Punyaratabandhu P, Tantrapornpong P, Yan C, Cembrano KAG. Objective and Long-Term Evaluation of the Efficacy and Safety of a 1064-nm Picosecond Laser With Fractionated Microlens Array for the Treatment of Atrophic Acne Scar in Asians. Lasers Surg Med 2020; 53:899-905. [PMID: 33326626 DOI: 10.1002/lsm.23368] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/12/2020] [Accepted: 11/29/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVE Fractional 1064-nm picosecond-domain laser has recently been utilized for the treatment of atrophic acne scars and showed promising results. However, data on the safety and efficacy of this procedure in dark-skinned patients are limited. This prospective, self-controlled study was conducted to objectively evaluate the safety and efficacy of a 1064-nm picosecond laser coupled with a microlens array (MLA) for the treatment of atrophic acne scars on Asian skin. STUDY DESIGN/MATERIALS AND METHODS Twenty-six subjects of Fitzpatrick skin types (FSTs) III and IV with atrophic acne scars were enrolled. All subjects were treated with a 1064-nm picosecond laser (spot size of 8 mm, fluence of 1.0 J/cm2 , a repetition rate of 10 Hz) in combination with the MLA handpiece for an average of three passes, for 6 monthly sessions. Objective (measurement of scar volume using three-dimensional (3D) photography and skin roughness analysis using ultraviolet A-light video camera) and subjective (clinical evaluation by two blinded dermatologists) assessments were obtained at baseline and at 1, 3, and 6 months after the final treatment. RESULTS Statistically significant reduction of the scar volume from baseline at 1, 3, and 6 months after the final treatment were observed by 3D photography and ultraviolet A-light video camera. At the 6-month follow-up, 50% (13 of 26) of the subjects were rated as having at least 50% improvement of the scars. The rate of improvement significantly increased from the 1-month follow-up to the 6-month follow-up (P = 0.013). Similarly, at the 6-month follow-up, the scar volume (P = 0.024) and skin roughness (P = 0.001) also significantly improved, in comparison with the baseline. Mild postinflammatory hyperpigmentation (PIH) was observed to develop in approximately 18% of all the treatment sessions. All cases of PIH were temporary and resolved within 4 weeks on average. CONCLUSIONS The 1064-nm picosecond laser with MLA is a safe therapeutic alternative for the treatment of atrophic acne scars in dark-skinned individuals. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
Collapse
Affiliation(s)
- Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Preawphan Punyaratabandhu
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Ploypailin Tantrapornpong
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Chadakan Yan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Kathryn Anne G Cembrano
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| |
Collapse
|
|
50
|
Alster TS, Li MK. Dermatologic Laser Side Effects and Complications: Prevention and Management. Am J Clin Dermatol 2020; 21:711-723. [PMID: 32529468 DOI: 10.1007/s40257-020-00530-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The evolution of modern laser and light-based systems has mirrored the demand for clinically effective treatments and the need for safer technologies with reduced postoperative recovery, side effects, and complications. With each new generation of lasers, more selective tissue destruction can be achieved with reduced unwanted sequelae. Patient selection and preparation, operator technique, and expeditious recognition and management of post-treatment side effects are paramount in avoiding complications and patient dissatisfaction. An overview of important variables to consider for dermatologic laser treatments are presented in order to provide a framework to reduce the severity and duration of possible post-treatment side effects and complications.
Collapse
Affiliation(s)
- Tina S Alster
- Washington Institute of Dermatologic Laser Surgery, Washington, DC, USA.
| | - Monica K Li
- City Medical Aesthetics Center, Vancouver, BC, Canada
| |
Collapse
|