Showing papers in "Journal of Cosmetic Dermatology in 2021"
TL;DR: In this article, the authors present two cases of delayed reaction after hyaluronic acid soft tissue filler treatment of the tear trough area and following mRNA vaccination against SARS-Cov-2, also known as COVID-19, months later.
Abstract: Background The use of hyaluronic acid soft tissue fillers in aesthetic medicine exploded in recent years for many reasons, including being relatively safe. Incidence of delayed inflammatory reactions (DIRs) to hyaluronic acid soft tissue fillers range between 0.3% and 4.25%. These reactions are mediated by T-lymphocytes and can be triggered by flu-like illnesses, including SARS-CoV-2 infection. Vaccination may also induce hypersensitivity. Aim In this case report, we present two cases of delayed reaction after hyaluronic acid soft tissue filler treatment of the tear trough area and following mRNA vaccination against SARS-Cov-2, also known as COVID-19, months later. Patients A 39-year old female who previously had her tear trough area treated with hyaluronic acid soft tissue filler developed swelling days after getting the mRNA Pfizer-BioNTech COVID-19 vaccine. Another patient, a 61-year-olf female, developed intermittent facial swelling in areas previously treated with hyaluronic acid soft tissue fillers days after receiving her first dose of the mRNA Pfizer-BioNTech COVID-19 vaccine. Results As demonstrated in our case report, vaccination against COVID-19 may induce DIRs in patients who previously had hyaluronic soft tissue fillers. Conclusion Delayed inflammatory reactions to hyaluronic acid soft tissue fillers are uncommon and usually self-limited, with frequent spontaneous resolution. However, considering the ongoing pandemic and the worldwide demand for vaccines against COVID-19, the aesthetic providers should be conscious of the risks posed by the interaction of such vaccines in patients who previously had or seeking hyaluronic acid soft tissue filler injections.
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TL;DR: It is aimed to report according to the CARE guidelines, three COVID-19 cases who sought teleconsultations from the authors' private practice from July to September 2020 and perform a literature search in Ovid MEDLINE®, EMBASE, Cochrane Library, and Epistemonikos with a combination of keywords (CO VID-19 OR SARS-CoV-2) AND oral candidiasis.
Abstract: The immune dysregulation triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been hypothesised as a causal pathway for the increasingly reported oral manifestations associated with coronavirus diseases (COVID-19) especially the ones of fungal origin.1–3 As a result of this, we aim to report according to the CARE guidelines, three COVID-19 cases who sought teleconsultations from our private practice (Cairo, Egypt) from July to September 2020. In addition, we have performed a literature search in Ovid MEDLINE®, EMBASE, Cochrane Library, and Epistemonikos from inception until November 30th, 2020 with a combination of keywords (COVID-19 OR SARS-CoV-2) AND oral candidiasis.
39 citations
TL;DR: In this article, a delayed-type hypersensitivity after hyaluronic acid dermal filler treatment of the nose and subsequent infection with SARS-CoV-2 was reported.
Abstract: The incidence of hypersensitivity reactions to hyaluronic acid dermal fillers is between 0.3 and 4.25%, mediated by T-lymphocytes. Flu-like illness can trigger immunogenic reactions at the site of filler placement. Cases of SARS-CoV-2 are significant and pose a possible risk of inducing hypersensitivity. This case report is of a delayed-type hypersensitivity after hyaluronic acid dermal filler treatment of the nose and subsequent infection with SARS-CoV-2. Risk factors for the development of such symptoms were identified as the presence of hyaluronic acid combined with flu-like illness and repeated treatment of one area. The case resolved without intervention. Clinicians should be mindful of the risk posed by the interaction of hyaluronic acid dermal filler with SARS-CoV-2 in light of the pandemic.
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TL;DR: Wang et al. as discussed by the authors reported three cases of recurrence of alopecia areata (AA) occurred after the first dose of COVID-19 vaccine, with widespread hair loss in two cases and a single patch of the vertex in one case, with typical trichoscopic features of AA.
Abstract: BACKGROUND: Common COVID-19 vaccines side effects are pain at the injection site, muscle pain, fever, headaches, fatigue. Possible immune-related side effects in predisposed individuals have not been established so far. MATERIALS AND METHODS: We report three cases of recurrence of alopecia areata (AA) occurred after the first dose of COVID-19 vaccine. RESULTS: All patients had previous episodes of AA with total hair regrowth and stable remission during the months preceding the vaccination. Rapid hair loss occurred 2-3 weeks after BNT162b2 mRNA (patient 1) and AZD1222/ChAdOx1 vaccine (patient 2 and 3), with widespread hair loss in two cases and a single patch of the vertex in one case, with typical trichoscopic features of AA. DISCUSSION: Both BNT162b2 mRNA and AZD1222/ChAdOx1 vaccines share the same goal of inducing the immune system, with antibodies production and Th1 cells activation with release of pro-inflammatory cytokines. Thus, in patients with pre-existing inflammatory dysregulated pathways, the interaction between the immune system and vaccines may enhance other autoimmune mechanisms. In our cases, we speculate that vaccine may have induced the hair loss focusing on components having a key role in both COVID-19 vaccination and AA pathogenesis. CONCLUSION: This report may help to collect new data concerning possible immune-related effects of vaccines. Certainly, only three cases are not sufficient to draw conclusion, thus a large-scale study is necessary. Immune-mediated side effects remain a rare event, thus the benefits of COVID-19 vaccines outweigh the risk of disease flares and we strongly recommend it in all eligible patients with AA.
33 citations
TL;DR: A review of the literature focused on in vitro studies explaining the mechanisms of photoaging is presented in this paper, which will help to better understand the complex and multidirectional mechanism of skin photoaging, which will contribute to the development of potential cosmetic products that provide effective and safe sun protection or repair damage caused by UV radiation.
Abstract: Background Photoaging, ultra violet (UV) induced skin aging is a gradual process that depends on the time and intensity of solar radiation. Aim The aim of this paper was to review of the literature focused on in vitro studies explaining the mechanisms of photoaging. Methods Electronic databases, including PubMed and MEDLINE, were searched for in vitro studies on the importance of UV radiation in the skin photoaging process of peer-reviewed scientific journals. Only articles available in English and full version publications were considered for this review. Results Three main modes of UV radiation action on skin cells which lead to photoaging, there are changes in cell metabolism, induction of oxidative stress due to the change in enzyme activity. Conclusion The information gathered in this publication will help to better understand the complex and multidirectional mechanism of skin photoaging, which will contribute to the development of research on potential cosmetic products that provide effective and safe sun protection or repair damage caused by UV radiation.
33 citations
TL;DR: In this article, a search of literature included peer-reviewed articles including clinical trials and scientific reviews, and references of respective articles and only the articles published in English language were included.
Abstract: Numerous therapeutic strategies have been described for prevention and reduction of hypertrophic scars and keloids, but none of the treatments is effective in all patients. No universal consensus in treatment regimen has been established, and there is limited evidence-based literature to guide the correct management. The process of scar development is complex and requires deeper understanding of the molecular mechanisms that cause their development and recurrences. Despite many available modes of targeting keloid and hypertrophic scars, yet they remain an ongoing challenge to patients and clinicians. To date, no one therapy has been universally accepted as the gold standard for the treatment of all excessive scars nor has the capability of complete scar resolution The search of literature included peer-reviewed articles including clinical trials and scientific reviews. Literature was identified from electronic databases (MEDLINE/PubMed) through May 2021 and references of respective articles and only the articles published in English language were included.
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TL;DR: There has been a growing interest in using compounds from natural sources to develop new multifunctional products that protect human skin from the consequences of UV exposition, and in vitro methods to determine anti‐UV efficacy are still required.
Abstract: Background The use of sunscreens is mandatory, especially in countries with high ultraviolet (UV) incidence. In consequence, there has been a growing interest in using compounds from natural sources to develop new multifunctional products that protect human skin from the consequences of UV exposition. Even though there are in vitro methods to determine anti-UV efficacy, it is still required to test photoprotection activity on human skin to validate product performance. Aim and methods In this review, we summarized all reported clinical studies about sun protection factor (SPF) measurements of sunscreens with natural compounds. We also discussed the probable action mechanism of those actives. Results Herein, we provided an overview on recent studies concerning photoprotection activity of compounds from natural sources, for example, rutin, ferulic acid, caffeine, shea butter, and plant extracts, mainly presented in sunscreen systems with efficacy clinically established by SPF. Conclusion Our review suggested that even when the in vivo SPF evaluation has inherent difficulties, it is essential to assure the real efficacy of sunscreens. Furthermore, the incorporation of natural compounds could enhance the in vivo SPF values of such sunscreens by different mechanisms. Finally, some compounds derived from natural resources with skin benefits could be used as "green"/natural UV filters that provide broad-spectrum sunscreens with further upgrading of the multifunctional dermocosmetic formulation to enhance aesthetics and even skin health.
TL;DR: In recent years, skin microbiota has been shown to play an important role in inflammatory skin diseases, and heredity, environment, immunity, epidermal barrier, mental disorders, infection and so on.
Abstract: Background Inflammatory skin diseases include a variety of skin diseases, such as seborrheic dermatitis, acne, atopic dermatitis, psoriasis and so on, which are more common and tend to have a significant impact on patients' quality of life Inflammatory skin diseases often result in physical or psychological distress; however, the pathogenesis of these diseases have not been clearly elucidated Many factors are involved in the pathogenesis of inflammatory skin diseases, including heredity, environment, immunity, epidermal barrier, mental disorders, infection and so on In recent years, skin microbiota has been shown to play an important role in inflammatory skin diseases Aims To elaborate on the specific mechanisms of inflammatory skin diseases induced by microbiota dysbiosis Methods We introduce the function and influence of skin microbiota in inflammatory skin diseases from the following aspects: Immunity, epigenetics, epidermal barrier and treatment Results Skin microbiota can affect many aspects of the host, such as Immunity, epigenetics, epidermal barrier, and it plays an important role in the pathogenesis of inflammatory skin diseases Conclusion Skin microbiota is extremely important for maintaining the health of skin and the dysbiosis of skin microbiota is an important pathogenesis of inflammatory skin diseases
TL;DR: In this article, the authors highlight treatment options for androgenetic alopecia taking into consideration the efficacy, side effect profiles, practicality of treatment (compliance), and costs to help clinicians offer ethically appropriate treatment regimens to their patients.
Abstract: Background Androgenetic alopecia (AGA) is the most common form of hair loss consisting of a characteristic receding frontal hairline in men and diffuse hair thinning in women, with frontal hairline retention, and can impact an individual's quality of life. The condition is primarily mediated by 5-alpha-reductase and dihydrotestosterone (DHT) which causes hair follicles to undergo miniaturization and shortening of successive anagen cycles. Although a variety of medical, surgical, light-based and nutraceutical treatment options are available to slow or reverse the progression of AGA, it can be challenging to select appropriate therapies for this chronic condition. Aims To highlight treatment options for androgenetic alopecia taking into consideration the efficacy, side effect profiles, practicality of treatment (compliance), and costs to help clinicians offer ethically appropriate treatment regimens to their patients. Materials and methods A literature search was conducted using electronic databases (Medline, PubMed, Embase, CINAHL, EBSCO) and textbooks, in addition to the authors' and other practitioners' clinical experiences in treating androgenetic alopecia, and the findings are presented here. Results Although topical minoxidil, oral finasteride, and low-level light therapy are the only FDA-approved therapies to treat AGA, they are just a fraction of the treatment options available, including other oral and topical modalities, hormonal therapies, nutraceuticals, PRP and exosome treatments, and hair transplantation. Discussion Androgenetic alopecia therapy remains challenging as treatment selection involves ethical, evidence-based decision-making and consideration of each individual patient's needs, compliance, budget, extent of hair loss, and aesthetic goals, independent of potential financial benefits to the practitioners.
TL;DR: Despite being a frequent and nonthreatening life condition, acne has a significant psychological impact and comorbidity.
Abstract: Introduction Acne is a chronic inflammatory skin condition seen commonly in adolescence and young adulthood. Despite being a frequent and nonthreatening life condition, acne has a significant psychological impact and comorbidity. Aims This review will describe prevalence, common clinical features, different clinical presentations, differential diagnoses, and treatment recommendation. Special focus has been put on psychological aspects. Methods We conducted a literature search on PubMed from January 2001 to June 2020 with the search terms of Acne vulgaris, psychological, adolescents, anxiety, suicide, mood disorders. Reference lists of identified articles were examined for further relevant studies. The search was limited to English language articles. No specified quality criteria were used for study inclusion. Results The clinical manifestations of acne are very important in the differential diagnosis and its psychological implications. Conclusion Through this article, we conclude that despite being a frequent and nonthreatening life condition, acne has a significant psychological impact which requires effective treatment to improve the patient's skin and self-esteem.
TL;DR: Concerns about the negative effects of blue light on the skin have rapidly increased over the past 15 years, and consequently, the urge to learn more about this topic is increasing as well.
Abstract: Background Blue light is emitted visible light between the wavelengths of 400 to 500 nm. The main source of blue light is sunlight, but digital screens, light-emitting diodes (LEDs), and fluorescent lighting serve as additional sources. Concerns about the negative effects of blue light on the skin have rapidly increased over the past 15 years, and consequently, the urge to learn more about this topic is increasing as well. Aims Part I of this article provides up-to-date information on the definition of blue light and the negative and positive effects of blue light on the skin. Methods An Internet search was completed using the Google scholar database for relevant literature. Results Blue light can be both harmful and beneficial to the skin, depending on intensity and wavelength. Short-term safety information is more readily available from clinical studies; however, the biological effects of repeated and/or longer-term exposure are not fully understood yet. Conclusions Low-energy and low exposure times to high-energy blue light can help prevent skin diseases, while studies have revealed that longer exposure to high-energy blue light can increase the amount of DNA damage, cell and tissue death, and injury, eye damage, skin barrier damage, and photoaging.
TL;DR: A clinical and histological evaluation of the effect of low‐molecular‐weight hyaluronic acid fragments mixed with amino acid (HAAM) on the rejuvenation the face skin treated with intradermal microinjections is evaluated.
Abstract: Background In esthetic medicine, different techniques have been used against the aging of the human skin especially in the facial area. Hyaluronic acid is used for improving the quantity of water and extracellular matrix molecule. The aim of this study is a clinical and histological evaluation of the effect of low-molecular-weight hyaluronic acid fragments mixed with amino acid (HAAM) on the rejuvenation the face skin treated with intradermal microinjections. Methods Twenty women with mean age 45 range from 35 to 64 were studied, thereof 8 in menopause and 12 of childbearing age. The patients were treated with the HAAM products by mesotherapy technique; before and after 3 months of the therapeutic procedure, each patient underwent small biopsies with a circular punch biopsy. Results The clinical results of the present study showed that the administration of the dermal filler containing fragments of hyaluronic acid between 20 and 38 monomers and amino acid via dermis injection technique produces an esthetic improvement in the faces of the treated patients, while the histological evaluation shows an increased fibroblast activity with the production of type III reticular collagen and increased number of vessels and epidermis thickness. Conclusions The clinical and histological assessment showed that subcutaneous HAAM infiltration has a significant impact on the dermis and clinical aspects of the face.
TL;DR: This study highlights the importance of knowing the carrier and removal of canine coronavirus, as a source of infection for other animals, not necessarily belonging to the same breeds.
Abstract: Background Collagen is the primary component in human skin. With age, there is loss of skin elasticity and collagen, resulting in wrinkle formation and reduction in skin appearance. Aims The objective of this randomized, triple-blind, placebo-controlled study was to evaluate the safety and efficacy of a hydrolyzed marine collagen (Vinh Wellness Collagen, VWC) on aspects of skin health and quality in women between 45 and 60 years of age. Patients/methods Assessments of skin wrinkles, elasticity, and self-reported appearance were conducted using the VISIA skin analysis system, Cutometer® , and Skin Quality Visual Analogue Scale. Outcomes were assessed at weeks 0 (baseline), 6, and 12. Results After 12 weeks, participants supplemented with VWC had a significant 35% reduction in wrinkle score (P = .035) from baseline. Participants in the VWC group showed a 24% greater reduction in wrinkles on the right side of the face than those on placebo. A planned subgroup analysis based on age showed women 45-54 years had a significant 20% and 10% improvement in cheek skin elasticity from baseline to week 6 (P = .016) and 12 (P = .022), respectively. At week 12, participants in the VWC group reported greater percentage improvements in overall skin score (9%) and wrinkle (15%), elasticity (23%), hydration (14%), radiance (22%), and firmness (25%) scores vs placebo. Conclusion Supplementation with VWC was found to be safe and well-tolerated. The results of this study support the use of fish-derived hydrolyzed collagen for the improvement of skin health in an aging population.
TL;DR: Hyaluronic acid filler injection is a rapid, nonsurgical technique that gives good long‐lasting, but not permanent, results, however, to achieve optimal results, the attending physician must have good anatomical knowledge of the area and involvement of the structures in the tear trough.
Abstract: Background Recent years have seen a growing interest in the appearance of the eyes among the concerns expressed by patients in cosmetic clinics. This has led to an increase in the frequency of diagnosis of tear trough deformity, and, as a result, the number of treatments performed by specialized professionals has also risen. Hyaluronic acid filler injection is a rapid, nonsurgical technique that gives good long-lasting, but not permanent, results. However, to achieve optimal results, the attending physician must have good anatomical knowledge of the area and involvement of the structures in the tear trough, carry out proper clinical assessment of the patient, and use an appropriate injection technique with the right product. Aims To support good practice among the professionals who carry out these procedures, this interdisciplinary consensus document describes the relevant issues and recommendations, in order to improve safety standards and to help successfully resolve this aesthetic problem.
TL;DR: Eucheuma Cottonii is a type of red algae obtained from Sabah with main active component, sulfated polysaccharide or k‐carrageenan.
Abstract: BACKGROUND Eucheuma Cottonii is a type of red algae obtained from Sabah with main active component, sulfated polysaccharide or k-carrageenan. AIMS The objective of this research was to evaluate the antioxidant, antibacterial and potential wound-healing properties in aqueous extraction of E cottonii in order to meet the increasing demand for halal and natural cosmeceutical products. METHODS AND RESULTS Aqueous extract of E cottonii was investigated for active compounds by phytochemical screening and IR spectroscopy. Antioxidant activity was carried out using DPPH method, and the IC50 value was 1.99 mg/mL. Antibacterial activity was examined against Staphylococcus Aureus using Kirby-Bauer disk diffusion method and showed 10.03 ± 0.06 mm zone of inhibition, achieved by 200 mg/mL of extracts. A wound was made by skin excision of area around 100 mm2 on each mouse. Test group was treated with aqueous extract gel (10% w/w); meanwhile, the mice that were treated with honey acted as the positive control group and the untreated mice as negative control group. Results showed that the wound contraction rate inclined to aqueous extracts as compared to untreated group (P < .05). Percentage of wound healing for aqueous extracts and untreated group were 87.7% ± 2.0% and 57.6% ± 5.3%, respectively. CONCLUSION Aqueous extract was found to be comparable to the honey in wound healing.
TL;DR: In this paper, a systemic review of articles from PubMed and Embase using MeSH and keywords like "Shingles," "Herpes zoster," "Varicella zoster", "COVID-19," "Vaccine," "SARS-CoV-2" was performed.
Abstract: Introduction Although the COVID-19 vaccination is deemed safe, exact incidence and nature if adverse effects, particularly dermatological ones, are still unknown. Objective To describe the demographic, clinical, morphological characteristics, outcomes, and timing of development of herpes zoster to the various COVID-19 vaccines. And to identify on whether COVID-19 vaccine has temporal relationship between development of herpes zoster (HZ). Methods We have performed a systemic review of articles from PubMed and Embase using MeSH and keywords like "Shingles," "Herpes zoster," "Varicella zoster," "COVID-19," "Vaccine," "SARS-CoV-2." No filters including country of publication, language, type of articles were applied. Individual case report references were filtered for any pertinent cases. Results A total of 54 cases consisting of 27 male and 27 female patients have been reported. There were cases with known risk factors for herpes zoster, which included age more than 50 years (n = 36), immunological disorders (n = 10), chronic disease (n = 25), metabolic disorder (n = 13), malignancy (n = 4), and psychiatric disorder (n = 2). The mean (SD) period between development of herpes zoster and COVID-19 vaccination was 7.64 (6.92) days. Majority of the cases were from the high-income and/or middle-income countries. 86.27% of the cases of HZ were reported due to mRNA vaccine. Thirty-six patients 36/45 (80%) developed herpes zoster following the priming dose of COVID-19 vaccine among those who received mRNA vaccine. Conclusion We could not establish definite link but there may be possible association between COVID-19 vaccine and shingles. Large-scale studies may help to understand the cause-effect relationship.
TL;DR: Sunscreen has been gradually evolving, and new photoprotective ingredients are continuing to be produced in response to growing scientific evidence on the effect of solar radiation on the skin this paper.
Abstract: Background With the global sunscreen market expected to reach $24.4 billion worldwide by 2029, this demonstrates the increasing awareness of the damaging effects of sunlight. Sunscreen has been gradually evolving, and new photoprotective ingredients are continuing to be produced in response to growing scientific evidence on the effect of solar radiation on the skin. Aims This literature review aims to provide an updated view of the history of sunscreens. Methods A literature search was conducted with the keywords "Sunscreen, history, regulation, ultraviolet A, ultraviolet B, visible light" from PubMed, Medline, and online search engines. Results Humankind has always found ways to provide photoprotection since 4000BC. Only in the last century, evidence-based sunscreens have existed. The first ultraviolet B filters were produced in 1928, its evidence of efficacy and safety discovered in 1956 and development of sun protection factor in 1974. Similarly, sunscreen containing ultraviolet A filters was released in 1980 and the ultraviolet A star rating system developed in 1992. Regulatory bodies for sunscreen were introduced in the 1970s and have sought to review the safety and efficacy of ingredients. With the rising number of researches on the effects of visible light on hyperpigmentation over the past decade, the need for photoprotection beyond ultraviolet has been increasing. Conclusion To provide consumers with evidence-based sunscreen, challenges remain in acquiring further evidence, regulation, and rating systems.
TL;DR: Although the etiopathogenesis of alopecia areata (AA) is still unclear, inflammation, oxidative stress, and subsequent DNA damage might be considered role players in disease development.
Abstract: BACKGROUND Although the etiopathogenesis of alopecia areata (AA) is still unclear, inflammation, oxidative stress, and subsequent DNA damage might be considered role players in disease development. AIM We aimed at exploring the potential link between oxidative DNA damage and inflammation in AA patients through measuring 8-hydroxy deoxyguanosine (8-OHdG), high mobility group box 1 protein (HMGB1), and one of the inflammatory mediators, C-reactive protein (CRP). METHODS A total of 79 subjects (49 AA patients in addition to 30 apparently healthy control subjects) were tested for serum levels of 8-OHdG, HMBG1, and CRP. RESULTS Compared with the control group, serum 8-OHdG, HMBG1, and CRP levels were significantly elevated in the studied patients group (0.031, <0.001, and <0.001, respectively). Moreover, logistic regression analysis revealed that disease course, serum levels of 8-OHdG, and HMBG1 were considered independent predictors for AA severity in both uni- and multivariable analyses. CONCLUSION Our results suggest a possible role of oxidative stress together with proinflammatory biomarkers in development of AA and their benefit in predicting a severe form of the disease.
TL;DR: The investigation of tranexamic acid for treating melasma, since it possesses anti‐plasmin properties, and the use of laser‐assisted drug delivery can also increase the uptake of topical medications.
Abstract: Background Melasma can be associated with immense psychosocial stress, which can impact quality of life. One theory suggests that ultraviolet light can increase plasmin activity in keratinocytes, which has led to the investigation of tranexamic acid for treating melasma, since it possesses anti-plasmin properties. The use of laser-assisted drug delivery can also increase the uptake of topical medications. Aims A prospective pilot study was performed to assess the utility of combination treatment with low-energy, low-density 1927 nm fractional thulium fiber laser and topical tranexamic acid for melasma. Patients/methods A total of 10 subjects were enrolled. Each received 5 treatments to the full face with a low-energy, low-density 1927 nm fractional thulium fiber laser. Immediately following treatment, topical tranexamic acid was applied, and subjects were instructed to apply it twice daily for 7 days. Clinical measures, quality of life, and patient satisfaction were assessed. Results Mean improvements in Melasma Area and Severity Index (MASI) scores were 1.1 (P = .0899), 3.5 (P = .0395), and 2.5 (P = .2429) at 30-, 90-, and 180-day follow-up, respectively. Maximum improvement occurred at 90-day follow-up. The mean improvement of Melasma Quality of Life Scale (MELASQOL) score was 9.6 (P = .0024) at 30-day follow-up. In addition to changes in pigmentation, subjects also believed their skin felt better, looked more radiant, and had improvements in skin texture and tone. Conclusion Combination of low-energy, low-density 1927 nm fractional thulium fiber laser and topical tranexamic acid improved clinical outcomes and quality of life associated with melasma. This combination treatment was safe, well-tolerated, and well-liked by subjects.
TL;DR: In this article, a systematic PubMed search was performed using the search term "((melasma[Text Word]) OR facial melanosis[text Word]) AND (pathogenesis OR causality[MeSH Terms])" for articles published between 1990 and 2020.
Abstract: BACKGROUND Melasma is a complex and poorly understood disorder, with high rates of treatment failure and recurrences. OBJECTIVES We aimed to review the current knowledge of the pathogenesis of melasma and apply this knowledge to clinical implications on relevant therapeutic interventions. METHODS A systematic PubMed search was performed using the search term "((melasma[Text Word]) OR facial melanosis[Text Word]) AND (pathogenesis OR causality[MeSH Terms])" for articles published between 1990 and 2020. Included articles were then evaluated by two authors and assessed for relevant pathomechanistic pathways, after which they were divided into groups with minimal overlap. We then reviewed current treatment modalities for melasma and divided them according to the involved pathomechanistic pathway. RESULTS A total of 309 search results were retrieved among which 76 relevant articles were identified and reviewed. Five main pathomechanisms observed in melasma were identified: (1) melanocyte inappropriate activation; (2) aggregation of melanin and melanosomes in dermis and epidermis; (3a) increased mast cell count and (3b) solar elastosis; (4) altered basement membrane; and (5) increased vascularization. Treatment modalities were then divided based on these five pathways and detailed in 6 relevant tables. CONCLUSION The pathophysiology of melasma is multifactorial, resulting in treatment resistance and high recurrence rates. This wide variety of pathomechanisms should ideally be addressed separately in the treatment regimen in order to maximize results.
TL;DR: Skin‐whitening products are in the high trend of demand for skin beautifying and lightening and sources of ingredients could be natural, semi‐synthetic, and synthetic that may affect the halal status of a product.
Abstract: Background Skin-whitening products are in the high trend of demand for skin beautifying and lightening. Sources of ingredients for cosmetics could be natural, semi-synthetic, and synthetic that may affect the halal status of a product. The lack of scientific evidence on the safety and risks of such ingredients is a major concern to many consumers. Objective This review paper aimed to shed light on the skin-whitening ingredients and their issues related to safety, health risk, and halal status. Methodology Based on the reviews scientific publications published from January 2015 to July 2020 using Web of Science and Scopus engines. Findings Based on the review, most of the common ingredients in the skin-whitening products are originated from plants, animals, microbes, and heavy metals. Health risk of the ingredients was evaluated based on the usage, chronic or acute adverse effect, frequency of incidence, and the hazardous chemical contents of a halal cosmetics. The halal status of the ingredients was investigated based on the sources of origin, safety evaluation, and associated health risk of the ingredients. Originality This review shows that ingredients play a vital role in the halal status decision-making of a cosmetic product. Therefore, the categories of Halal-Safe, Haram-Prohibited, and Critical-Need further evaluation were suggested to integrate the sources of ingredients with safety.
TL;DR: Microneedling has shown to have positive therapeutic effects in treatment of androgenetic alopecia (AGA); however, the best microneedled protocol is still controversial.
Abstract: BACKGROUND Microneedling has shown to have positive therapeutic effects in treatment of androgenetic alopecia (AGA); however, the best microneedling protocol is still controversial. AIMS Investigating effect of microneedling with 2 different depths of penetration on promoting hair growth in patients with AGA. METHODS Sixty patients, in the age of 18-45 years old with moderate and severe AGA, were allocated into 3 groups of control: treatment with minoxidil 5% lotion; group A: treatment with minoxidil 5% lotion and biweekly microneedling with a depth of 1.2 mm and group B: treatment with minoxidil 5% lotion and biweekly microneedling with a depth of 0.6 mm during 12 weeks. Efficacy parameters including change of hair count and hair thickness from baseline and assessment of hair growth by patient and investigator were evaluated. RESULTS Compared with the baseline, a significant increase in hair count and hair thickness was observed in all three groups after completion of the treatment course (P < .05). The mean rise in hair count (P = .017) and hair thickness (P = .007) was significantly greater in group B compared with control group. Investigator's evaluation of hair regrowth was significantly greater in group A (P = .04) and group B (P = .007) compared with control group. CONCLUSION Microneedling with a depth of 0.6 mm in combination with minoxidil is more effective than minoxidil monotherapy in patients with AGA in terms of hair count and hair thickness. This depth of penetration tended to be more beneficial than depth of 1.2 mm.
TL;DR: A significant improvement in the skin pores, spots, skin lightness and melanin content of the skin, skin elasticity and TEWL after 6 months of treatment is observed.
Abstract: BACKGROUND Scarring is an unfortunate result of acne because it causes the psychological and cosmetic problems for the patients. Unfortunately, no single treatment is suitable, and using multiple methods may have a better result. The autologous fat and stromal vascular fraction (SVF) cells and their secretory factors can enhance the angiogenesis, collagen synthesis, and migration of fibroblasts, therefore regenerate hurt tissues. Moreover, other treatments for acne scarring, such as platelet-rich plasma (PRP), induce the increase in scare. AIMS This study aimed to verify the effectiveness of transplantation of autologous fat, SVF cells, and PRP as cell therapy techniques on atrophic acne scars. PATIENTS/METHODS This study included 9 adult patients with atrophic acne scars on face. All patients received the transplantation of autologous fat, stromal vascular fraction (SVF) cells, and PRP. The treatment outcome was measured by biometric assessment (VisioFace 1000 D, Colorimeter, multi-probe adapter Cutometer, Tewameter, Mexameter, and skin ultrasound imaging system), and also, the satisfaction of patients was evaluated. The patients were followed 6 months after the treatment. RESULTS There was a significant improvement in the skin pores, spots, skin lightness and melanin content of skin, skin elasticity, and TEWL (transepidermal water loss) after 6 months of the treatment. Furthermore, denser skin layers were observed both in the epidermis and in the dermis. Moreover, 66.6% of patients showed good satisfaction after the treatment. CONCLUSION In brief, the transplantation of autologous fat, SVF cells, and PRP is an effective cell therapy for atrophic acne scars.