Background and objectives Acne scars are one of the most distressing and long-term consequences of acne vulgaris, with damaging effect on a person's physical, mental, and social well-being. Numerous treatment options are available including surgical and nonsurgical techniques, depending on the clinical presentation. Although considerable advances in the development of new treatment technologies and applications have been made in the last decade, international treatment guidelines and reimbursement schemes have not yet caught up with current knowledge and practice in many centers. The authors intend to highlight the potential utility of energy-based devices (EBDs) for acne scarring, offer recommendations for safe and efficacious treatment, and provide consensus-based EBD treatment options based on varying presentations demonstrated in a series of real-life clinical photographs. Study design/materials and methods An international panel of 24 dermatologists and plastic surgeons from 12 different countries and a variety of practice backgrounds was self-assembled to develop updated consensus recommendations for the treatment of acne scars. A two-step modified Delphi method took place between March 2020 and February 2021 consisting of two rounds of emailed questionnaires. The panel members approved the final manuscript via email correspondence. Results The manuscript includes a comprehensive discussion and panel recommendations regarding the following topics: 1. the role of EBD in mitigating and treating acne scars in a patient with active acne, 2. the use of various EBDs for the treatment of different acne scar types with special focus on commonly used laser platform such as vascular lasers, ablative fractional lasers (AFLs) and non-AFLs (NAFLs), 3. treatment combinations, and 4. acne scar treatments in skin of color. The last part comprised of 10 photos of real-life clinical cases with the panel recommendation treatment plan to achieve best aesthetic outcome. Conclusion Panel members were unanimous in their view that EBDs have a role in the management of acne scars, with AFLs, NAFLs, vascular lasers, and RF devices preferentially selected by most of the panel experts. EBDs are considered a first-line treatment for a variety of acne scar types and patients without access to these treatments may not be receiving the best available care for optimal cosmetic results. Future high-quality research and updated international treatment guidelines and reimbursement schemes should reflect this status.

Energy-based devices for the treatment of acne scars: 2021 international consensus recommendations.

Phyllanthus emblica L. (amla) branch: A safe and effective ingredient against skin aging.

Acne vulgaris is a disease of the pilosebaceous unit and the most common inflammatory dermatosis worldwide. It is also associated with significant economic burden. Limitations of conventional topical and systemic treatments include long treatment course, intolerable adverse effects, antibiotic resistance, and patient compliance. Therefore, laser and light-based interventions present as alternative options over the past decade and have been used in combination with conventional pharmacological therapies and other physical modalities. An updated overview on the use of lasers and light-based devices in acne management is presented to help clinicians understand the safety and efficacy of these treatment options. The effectiveness of neodymium:yttrium aluminum garnet (Nd:YAG) for treating acne is supported by more high-level studies compared with other laser devices. There is limited evidence to support the use of CO2 lasers, potassium titanyl phosphate lasers, and 1565-nm non-ablative fractional lasers for treating acne. Among light devices, photodynamic therapy is the most studied, showing higher efficacies than some of the conventional topical and oral acne therapies. Intense-pulsed light and blue light therapies also show favorable outcomes. A limitation is that most studies are non-randomized and lack a control group, and report on a variety of device settings, treatment regimens, and outcome measures, making it challenging to summarize and generalize findings. Although the use of laser and light devices to treat acne is promising, further work with randomized controlled study designs and larger sample sizes will provide improved guidance on the application of these modalities.

The Use of Lasers and Light Devices in Acne Management: An Update

Excised animal and human skins are frequently used in permeability testing in pharmaceutical research. Several factors exist that may have influence on the results. In the current study some of the skin parameters that may affect drug permeability were analysed for human, mouse, rat and pig skin.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/srt.13165

Characterization and ex vivo evaluation of excised skin samples as substitutes for human dermal barrier in pharmaceutical and dermatological studies

Skin pores are enlarged openings of the pilosebaceous follicles that can be affected by age, gender, genetics, exposure to UV light, ethnicity, and sebum secretion. Many treatment modalities reduce facial pores’ count and area, including oral and topical medications as well as different wavelengths of lasers. Finding a safe and cost‐effective treatment protocol is necessary since facial pores are one of the main reasons for cosmetic complaints.

“The efficacy and adverse effects of treatment options for facial pores: A review article”

Objective: We aimed to evaluate the efficacy and safety of the 1,565 nm non-ablative fractional laser (NAFL) in combination with isotretinoin and pricking blood therapy (PBT) for treatment of AV.Me...

Treatment of acne vulgaris using 1,565 nm non-ablative fractional laser in combination with isotretinoin and pricking blood therapy.

Background: Vaginal laxity (VL) is characterized by the relaxing of the vaginal wall that affects the quality of life and sexual function of patients. The current management of VL such as Kegel exercises and topical or systemic hormonal replacement results in unsatisfactory outcomes; thus, novel modalities are needed to improve the efficacy. Vaginal fractional carbon dioxide (CO2) laser treatment has shown growing applications for the treatment of VL, but results show nonconformities due to the lack of objective evaluations. In this study, we aimed to validate the clinical efficacy and biophysical benefits of fractional CO2 laser treatment for VL patients with the incorporation of objective approaches. Methods: This is a descriptive study without controls. A total of 29 patients were enrolled and treated with two sessions of FemTouch vaginal fractional CO2 laser, with a one-month interval between sessions. Both subjective and objective measurements, including female sexual function index (FSFI), vaginal health index score (VHIS), vaginal tactile imaging (VTI), and histology were used to validate the clinical efficacy and biophysical benefits after treatment. Results: The overall FSFI scores and VHIS scores after the first and second treatment sessions were significantly higher than the baseline scores (p < 0.01, n = 29). VTI measurements showed a significant increase in maximal pressure resistance (kPa) of both the anterior and posterior vaginal walls at a 10–12-month post-treatment visit compared with pre-treatment controls (p < 0.001; n = 16). Histological examination showed that laser treatment led to increases in the thickness of the stratified squamous epithelium layer and density of connective tissues in the lamina propria. Conclusions: Fractional CO2 vaginal laser treatment can improve both vaginal health and sexual function and restore vaginal biomechanical properties by increasing vaginal tissue tightening and improving vaginal tissue integrity in Asian women. Our data support that fractional CO2 vaginal laser is a valid treatment modality for VL.

/pdf/fractional-carbon-dioxide-laser-improves-vaginal-laxity-via-1rocij5n.pdf

Fractional Carbon Dioxide Laser Improves Vaginal Laxity via Remodeling of Vaginal Tissues in Asian Women

BACKGROUND: The early signs of skin aging usually occur in the periocular region. OBJECTIVES: This retrospective analysis evaluated the efficacy and safety profile of a multisource 3DEEP radiofrequency (RF) technology (EndyMed, Caesarea, Israel) in combination with fractional skin resurfacing (FSR) for the treatment of periocular skin aging. METHODS: A total of 15 patients with periocular aging underwent monthly treatment sessions of 3DEEP and FSR for three months. Sessions were administered at the Department of Dermatology at Xijing Hospital in Xi'an, China. Indices of skin moisture level, transepidermal water loss (TEWL), skin elasticity, wrinkles, pore size, and skin texture were determined before and after treatment using the Visia® (Canfield Imaging Systems, New Jersey), Multiprobe Adapter (CK, Cologne, Germany) and Antera3D® (Miravex, Dublin, Ireland) systems. RESULTS: Skin moisture level, elasticity, wrinkles, pore size, and texture improved relative to baseline (p 0.05). Patient satisfaction was 86.67 percent. Patients experienced varying degrees of transient edema, erythema, scabbing, and occasional hyperpigmentation; all adverse effects resolved within 2 to 10 days post-treatment. CONCLUSION: ENDYMED 3DEEP in combination with FSR appears to be safe and effective in treating periocular skin aging. Randomized controlled trials with a larger patient group are needed to confirm our findings.

Clinical Efficacy and Safety of 3DEEP Multisource Radiofrequency Therapy Combined with Fractional Skin Resurfacing for Periocular Skin Aging.

To demonstrate remodeling of vaginal biomechanical and physiological properties using vaginal fractional carbon dioxide (CO2) laser treatment of stress urinary incontinence (SUI).

Meiheng Lu

Papers

Treatment of acne vulgaris using 1,565 nm non-ablative fractional laser in combination with isotretinoin and pricking blood therapy.

Fractional Carbon Dioxide Laser Improves Vaginal Laxity via Remodeling of Vaginal Tissues in Asian Women

Clinical Efficacy and Safety of 3DEEP Multisource Radiofrequency Therapy Combined with Fractional Skin Resurfacing for Periocular Skin Aging.

Fractional carbon dioxide vaginal laser treatment of stress urinary incontinence: Remodeling of vaginal tissues and improving pelvic floor structures