A Single Site, Open Label Clinical Trial, Evaluating the Duration, Efficacy, and Safety of a Novel Lip Plumper.

INTRODUCTION: Lip plumpers are topical agents that offer immediate, but temporary, volumization of the lips. While these products are becoming increasingly popular and are available at multiple retailers, there is a lack of clinical studies to evaluate the efficacy, longevity, and safety of the lip plumping products. METHODS: This is a prospective, single center, clinical trial to evaluate the duration, efficacy, and safety of a lip plumping agent in two clinical visits. Lip volume and adverse event were assessed by two clinicians at various time points: 15 minutes, 1 hour, 2 hours, 3 hours, and 4 hours. RESULTS: Twenty-two subjects were enrolled in the study, and eighteen completed the study. Investigator assessments of global improvement 15 minutes after application of the lip plumping product demonstrated improvement in lip fullness in 100% of the subjects (18/18), and 1 hour post-application 67% (12/18) showed an improvement in lip fullness that was statistically significant compared to the 2-hour assessment (P less than 0.05). Subject evaluations noted improvement in lip fullness 15 minutes post-application in 94.4% (17/18) of subjects, and 1 hour post-application, 89% (16/18) of the subjects who completed the trial noted some improvement in the volume of their lips that was statistically significant compared to the 2-hour post-application time point (P less than 0.0001). Subjects noted that they did experience a tingling and heat sensation, but a majority noted that that this sensation lasted less than 15 minutes. DISCUSSION: Our study demonstrated that the lip plumping product increased lip volume in almost all patients 15 minutes post-application and showed a continued improvement in lip fullness per investigator assessments 1 hour after application. Adverse events of a tingling or heat sensation were expected and observed as the topical product contained capsaicin, cinnamon, and menthol, all of which can induce this sensation by the release of substance P. J Drugs Dermatol. 2018;17(9):999-1004.

A Comparison Study of the Nonablative Fractional 1565-nm Er: glass and the Picosecond Fractional 1064/532-nm Nd: YAG Lasers in the Treatment of Striae Alba: A Split Body Double-Blinded Trial.

BACKGROUND: Few effective treatments exist for striae alba, which are the mature stage of stretch marks. OBJECTIVE: To evaluate the efficacy of the nonablative fractional 1,565-nm Erbium-glass (Er:glass) and the picosecond fractional 1,064/532-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) lasers in the treatment of striae alba. MATERIALS AND METHODS: Twenty subjects with striae alba on the bilateral abdomen were treated with either the nonablative fractional 1565-nm Er:glass or the picosecond fractional 1,064/532-nm Nd:YAG laser, with a total of 3 treatments 3 weeks apart. RESULTS: A 31% (1.25/4) texture improvement was noted for both the fractional 1,565-nm Er:glass laser and the picosecond fractional 1,064/532-nm Nd:YAG laser. The degree of atrophy was improved by 30% (1.19/4) with the 1,565-nm Er:glass laser and 35% (1.38/4) with the picosecond 1,064/532-nm Nd:YAG laser. A 48% (1.9/4) subject overall assessment of improvement was noted with the fractional 1565-nm Er:glass laser and 45% (1.8/4) improvement with the picosecond fractional 1,064/532-nm Nd:YAG laser. There was no significant change in striae density with either laser. The picosecond laser was rated as less painful during all 3 sessions (p = .002) and had a shorter healing time (p = .035). The nonablative fractional 1,565-nm Er:glass and the picosecond fractional 1,064/532-nm Nd:YAG lasers were equally efficacious in improving striae alba.

A split-body study evaluating the efficacy of a conformable surface cryolipolysis applicator for the treatment of male pseudogynecomastia.

BACKGROUND: Cryolipolysis is a non-invasive method of body shaping that has been used for male pseudogynecomastia. However, traditional vacuum suction cryolipolysis requires a minimum pinchable fat layer which may not always be present in this area. OBJECTIVE: To evaluate the efficacy and safety of a conformable surface cryolipolysis applicator for the reduction of male pseudogynecomastia. MATERIALS AND METHODS: Ten male subjects with pseudogynecomastia received two cycles of cryolipolysis to the breast 6 weeks apart. Ultrasound was used to measure the thickness of adipose tissue. RESULTS: Seven of 10 patients completed the study. Compared to baseline, the mean ± SD change in adipose tissue thickness was 8.12 ± 6.94 mm for the treated versus 1.03 ± 6.03 mm for the control breast at week 6 (p = 0.014), and 8.71 ± 7.04 mm for the treated vs. 2.66 ± 7.04 mm for the control breast at week 12 (P = 0.16). Four (4) of seven (57%) patients were at least slightly satisfied with the treated breast, and although subject satisfaction was higher in the treated breast, this did not reach significance (0.085). Adverse events were mild and transient. CONCLUSION: A conformable surface cryolipolysis applicator was effective in reducing the mean adipose tissue thickness in subjects with male pseudogynecomastia. Lasers Surg. Med. © 2018 Wiley Periodicals, Inc.

Open-label study assessing the efficacy and tolerability of topical skincare and sun protection products following intense pulsed light treatment.

BACKGROUND: The visible signs of photodamage can be improved by intense pulsed light (IPL). Active ingredients in cosmeceuticals also have effects on skin quality and pigmentation, and can camouflage post-treatment side effects. Combination therapies utilizing different treatment modalities have been shown to optimize clinical outcomes for skin rejuvenation and patient satisfaction. AIM: To evaluate the efficacy of a combination of IPL with a daily topical skincare and sunscreen regimen for the treatment of facial photodamage and for the improvement of IPL treatment tolerability. PATIENTS/METHODS: Twenty female subjects with moderate-to-severe facial photodamage, with past history of IPL treatments, received one IPL treatment followed by the use of the topical skincare regimen for 8 weeks. An investigator assessed facial photodamage and hyperpigmentation at baseline, week 4, and week 8, and postprocedure erythema. Subject questionnaires were also administered at each visit. RESULTS: Compared to baseline, there was a significant improvement in photodamage and hyperpigmentation of bare facial skin. The application of the skincare regimen resulted in a significant reduction in post-IPL erythema, stinging/burning, and itching. The majority of patients were very satisfied or satisfied and felt the treatment regimen improved various aspects of skin quality and the tolerability of the procedure. CONCLUSIONS: The addition of a topical skincare regimen after IPL treatment to the face resulted in significant improvements in facial photodamage and pigmentation, decreased post-treatment side effects, and increased tolerability.

A Prospective Pilot Clinical Trial to Evaluate the Efficacy and Safety of Topical Therapy with Ingenol Mebutate Gel 0.015% for Actinic Keratosis on an Expanded Area of the Chest.

BACKGROUND: Ingenol mebutate gel 0.05% once daily for two consecutive days provides high clearance rates for actinic keratosis on a 25cm2 area of the chest. However, it may cause intense local skin responses. OBJECTIVE: The objective of this study was to determine whether a lower dose of ingenol mebutate gel 0.015% could clear actinic keratosis on the chest with acceptable tolerability and a possible beneficial effect on photodamage and cosmesis. DESIGN: This was a noncomparative, open-label study (NCT02446223). PARTICIPANTS: In total, 21 subjects were enrolled, and 20 completed the study. MEASUREMENTS: ingenol mebutate gel 0.015% was applied once daily for three consecutive days to a contiguous area of the chest less than 100cm2 containing four or more actinic keratoses. RESULTS: the actinic keratosis lesion count decreased by an average of 76 percent compared with baseline. signs of photoaging were reduced significantly at the end of the study, with greater than 60 percent of the subjects reporting moderate or complete satisfaction with skin improvement. Local skin responses generally resolved within two weeks of treatment. there were no adverse reactions. LIMITATIONS: this was a noncomparative, open-label study that evaluated a relatively small number of subjects. CONCLUSION: ingenol mebutate gel 0.015% applied to a less than 100cm2 area of the chest once daily for three consecutive days reduced the actinic keratosis count and significantly improved signs of photoaging with high patient satisfaction and good tolerability.

A Randomized Evaluator-Blinded Trial Comparing Subsurface Monopolar Radiofrequency With Microfocused Ultrasound for Lifting and Tightening of the Neck.

BACKGROUND: Both subsurface monopolar radiofrequency (SMRF) and microfocused ultrasound with visualization (MFU-V) have demonstrated the ability to lift and tighten the neck. No head-to-head comparison study exists of these 2 technologies. OBJECTIVE: To compare the efficacy and safety of SMRF and MFU-V for the lifting and tightening of neck. MATERIALS AND METHODS: Twenty subjects aged from 18 to 65 with moderate neck skin laxity were randomized to receive either one treatment of SMRF or MFU-V. RESULTS: At Days 0, 30, 90, and 180, the mean (SD) investigator-assessed Neck Laxity Grade was 2.7 (0.67), 2.1 (1.1), 1.6 (1.2), and 0.86 (0.7), respectively, for patients treated with SMRF, and 2.8 (0.63), 2.4 (1.07), 1.5 (0.53), and 1.4 (0.7), respectively, for those treated with MFU-V. Both SMRF and MFU-V led to a significant decrease in the mean investigator-assessed Neck Laxity Grade by Day 90 and persistent to Day 180. Subject assessment of firmness, texture, and laxity also significantly improved by Day 90 and persistent to Day 180. Adverse events were mild and transient. CONCLUSION: There were no were statistically significant differences between SMRF and MFU-V in investigator-assessed and patient-assessed measures of neck laxity, patient satisfaction, and adverse events. Microfocused ultrasound with visualization was associated with more procedural pain.

A Retrospective Study of Multiple Sequential Light and Laser Sources to Activate Aminolevulinic Acid in the Treatment of Acne Vulgaris.

Reports of the sequential use of multiple light and laser sources for topical 5-aminolevulinic acid (ALA) activation in photodynamic therapy (PDT) of inflammatory acne vulgaris are lacking. The authors sought to retrospectively compare field-directed ALA-PDT with blue light only, blue light + pulsed dye laser (PDL), blue light + intense pulsed light (IPL), blue light + PDL + IPL, or blue light + red light + PDL + IPL for inflammatory acne of the face or upper trunk. Results showed a trend toward greater patient-reported improvement with comparable tolerability using multiple, sequential light sources in ALA-PDT for acne vulgaris, albeit not statistically significant. The addition of red light, however, did not improve outcomes. The disparate numbers of patients between treatment arms and high potential for recall bias limit this single-center retrospective study.

Subdermal Radiofrequency for Skin Tightening of the Posterior Upper Arms.

BACKGROUND: Subsurface thermistor-controlled monopolar radiofrequency (SMRF) is an emerging technology designed to offer a minimally invasive option for tightening of lax skin. The versatility of this technique allows it to be applied to virtually any body site. OBJECTIVE: The purpose of this study is to evaluate the safety and efficacy of SMRF for tightening of posterior upper arm skin laxity. PATIENTS: This is a prospective, open-label clinical trial involving 12 subjects aged 18 to 65 with moderate-to-severe skin laxity in the posterior upper arms. METHODS/MATERIALS: Each subject received treatment to the bilateral arms resulting in a population of n = 24 arms in the analysis group. Treatment consisted of SMRF delivered at Day 0 of the trial. Follow-up evaluation was conducted at Day 7, 30, and 90 post-treatment. The primary end point was the assessment of skin laxity by a nontreating physician utilizing a standardized 5 point Skin Laxity Grading Scale at baseline, Days 30 and 90. Subject self-evaluation of firmness, laxity, texture, and satisfaction was also collected. Circumferential and vertical arm measurements were obtained via digital fractional caliper. An adverse event profile was categorized. RESULTS: Significant improvements in skin laxity were observed at both Day 30 and at Day 90 post-treatment as assessed by the nontreating investigator. Subjects also rated significant improvements in the firmness, texture, and laxity of their treated arms. The majority of subjects were "satisfied" to "extremely satisfied" with their results. Adverse events recorded at Day 7 post-treatment included erythema (4%), contour irregularity (4%), and bruising (13%). All adverse events resolved completely by Day 30 post-treatment. CONCLUSION: Thermistor-controlled SMRF is a safe and effective means to treating posterior upper arm skin laxity.

Multiple sequential light and laser sources to activate aminolevulinic acid for rosacea.

BACKGROUND AND AIMS: The use of multiple, sequential light and laser sources for topical ALA activation in photodynamic therapy (PDT) of rosacea has been largely absent from the literature. The aim of this study was to evaluate ALA-PDT for rosacea using blue light sequentially with red light, pulsed-dye laser (PDL), and/or intense pulsed light (IPL). PATIENTS/METHODS: Thirty patients (39 treatments) were enrolled in this retrospective, single-center study. Treatment groups included blue light + PDL, blue light + IPL, blue light + PDL + IPL, or blue light + red light + PDL + IPL. Patient-reported outcome measures (incidence of adverse events, improvement in rosacea, and improvement in overall skin quality) were obtained via a telephone questionnaire and graded on a 4-point scale. RESULTS: There was no statistically significant difference in patient-reported rosacea or overall skin quality improvement. Apart from decreased peeling following blue light + IPL compared to blue light + PDL (P = 0.041) and blue light + IPL + PDL (P = 0.005), there were no other statistically significant differences in postprocedure adverse events. CONCLUSIONS: The use of multiple, sequential light and laser sources with ALA-PDT for rosacea, while well tolerated, did not lead to statistically significant improvements in patient-reported efficacy. Although this retrospective study is limited by a small sample size with disparate patient numbers between groups and no physician-evaluated outcome criteria, it does demonstrate that multiple light sources with PDT can be safely used in a single session.

Evaluation of the safety and efficacy of the picosecond alexandrite laser with specialized lens array for treatment of the photoaging décolletage.

BACKGROUND: Fractionated lasers are routinely used to treat the characteristic cutaneous signs of photoaging. In this study, we evaluate the use of picosecond pulse duration combined with a diffractive lens array for treatment of photodamage of the décolletage. METHODS: Twenty subjects with Fitzpatrick skin types I-IV were enrolled in a prospective open-label trial evaluating the efficacy of the 755 nm picosecond pulsed alexandrite laser with diffractive lens array for treatment of photodamage to the décolletage. Each subject received a series of four laser treatments at 3 week intervals. Follow up evaluation was performed 1 and 3 months later by a masked investigator and consisted of assessment of dyspigmentation, erythema, keratosis, texture, and rhytides on a standardized 5 point scale; global aesthetic improvement 5 point scale; and investigator and subject satisfaction questionnaire. Adverse events and treatment discomfort was also assessed. RESULTS: Statistically significant improvement in dyspigmentation, keratosis, and skin texture were observed at both 1 and 3 month follow up intervals (P < 0.05). rhytides initially demonstrated significant improvement at the 1 month time point, but this significance was not maintained at 3 months (P = 0.08). There was no statistically significant improvement noted in erythema. The majority of subjects were satisfied, with a mean rating of 2.8/6 (one being extremely satisfied and six being extremely dissatisfied). Subject pain was 3.6/10. CONCLUSION: The 755 nm picosecond pulsed alexandrite laser with diffractive lens array can be an effective option for rejuvenation of the photodamaged décolletage.

Multiple sequential light and laser sources to activate aminolevulinic acid in the treatment of photodamage: A retrospective study.

INTRODUCTION: The aim of this study was to retrospectively evaluate photodynamic therapy (PDT) with aminolevulinic acid (ALA) for cutaneous photorejuvenation using blue light sequentially with red light, pulsed-dye laser (PDL), and/or intense pulsed light (IPL). MATERIALS AND METHODS: Ninety-six patients (121 treatments) had photodamage treated with field-directed ALA-PDT from 2001 to 2010 in this single-center study. Treatments were performed with blue light + PDL, blue light + IPL, blue light + PDL + IPL, or blue light + red light + PDL + IPL. Outcome measures were obtained via telephone questionnaire and graded on a four-point scale. RESULTS: There were no significant differences in patient-reported improvement in photodamage, overall skin quality, and postprocedure adverse events between treatment arms. However, number of patients in the blue light + red light + PDL + IPL group was markedly smaller (n = 2) than that in the other groups (n = 14-46). DISCUSSION: Although results showed a trend toward greater efficacy with similar tolerability using multiple, sequential light and laser sources with ALA-PDT for photorejuvenation, the potential for recall bias and widely disparate number of patients between treatment groups and follow-up times between patients severely limit this retrospective study. Nevertheless, despite these major statistical flaws, the results may provide valuable information regarding the safety of multiple modalities with PDT of photodamage in a single session.

The effect of multiple sequential light sources to activate aminolevulinic Acid in the treatment of actinic keratoses: a retrospective study.

There is a lack of research regarding the sequential use of multiple light sources for topical 5-aminolevulinic acid activation in photodynamic therapy for actinic keratosis. This study evaluated 5-aminolevulinic acid-photodynamic therapy for actinic keratosis using blue light combined with red light, pulsed dye laser, and/or intense pulsed light in a retrospective fashion. Field-directed 5-aminolevulinic acid-photodynamic therapy was performed with blue light only, blue light + pulsed dye laser, blue light + intense pulsed light, blue light + pulsed dye laser + intense pulsed light, or blue light + red light + pulsed dye laser + intense pulsed light for nonhyperkeratotic actinic keratoses of face, scalp, or upper trunk. Blue light + intense pulsed light + pulsed dye laser produced greater patient-reported improvement in actinic keratoses than blue light or blue light + intense pulsed light and greater subject-reported improvement in overall skin quality than blue light + intense pulsed light. The addition of red light led to no further benefit in either outcome measure. Photodynamic therapy with multiple, sequential laser and light sources led to greater patient-graded improvement in actinic keratoses than that with a single light source (blue light), without significant differences in post-treatment adverse events. However, the small, widely disparate number of patients between groups and follow-up times between patients, as well as retrospective assessments based on subjective patient recall, severely limit the significance of these findings. Nevertheless, the results raise interesting questions regarding the use of multiple light and laser sources for photodynamic therapy of actinic keratoses and warrant further research with a prospective, randomized, controlled study.

A two-center, open-label, randomized, split-face study to assess the efficacy and safety of one versus three intradermal injection sites of abobotulinumtoxinA in the treatment of lateral periocular rhytides.

BACKGROUND: Lateral canthal rhytides partly result from repetitive muscular actions of the orbicularis oculi. OBJECTIVE: To determine the efficacy of one versus three injection sites of AbobotulinumtoxinA (ABO) in the treatment of lateral canthal rhytides. METHODS: This was a two-center, evaluator-masked, 120 day study in which 40 patients with moderate to severe hyperdynamic lateral canthal rhytides at maximal contracture were randomized to receive one injection of 36 Units of ABO into the middle of the lateral orbital rhytides on one side, with the contralateral side treated with the same total dose of ABO, divided into three intradermal injections of 12 Units each, along the lateral canthal area. A blinded evaluator assessed lateral orbital rhytides at rest and maximal contraction at baseline, 7, 42, 90, and 120 days post treatment. Standardized digital photography and subject self- assessment were performed at each visit. RESULTS: No statistically significant difference was seen at any visit between sides treated with one injection and those treated with three injections in any evaluation category. There was no difference in adverse events between the two sides. CONCLUSION: Sites treated with three injections of ABO showed no statistically significant difference from those treated with one injection.

Prospective, randomized, open-label trial comparing the safety, efficacy, and tolerability of an acne treatment regimen with and without a probiotic supplement and minocycline in subjects with mild to moderate acne.

BACKGROUND: Systemic antibiotics are an effective treatment for acne vulgaris. However, intolerable side effects may invariably occur. OBJECTIVE: To determine whether probiotics reduce the side effects imparted by systemic antibiotics while working synergistically with the latter in treating inflammatory acne. METHODS: Forty-five 18- to 35-year-old females were randomly assigned to one of three arms in this prospective, open-label study. Group A received probiotic supplementation, whereas group B received only minocycline. Group C was treated with both probiotic and minocycline. Clinical and subjective assessments were completed at baseline and during the 2-, 4-, 8-, and 12-week follow-up visits. RESULTS: All patients demonstrated a significant improvement in total lesion count 4 weeks after treatment initiation (p < .001), with continued improvement seen with each subsequent follow-up visit (p < .01). At the 8- and 12-week follow-up visits, group C had a significant decrease in total lesion count versus groups A (p < .001) and B (p < .01). Two patients (13%) from group B failed to complete the study secondary to vaginal candidiasis. CONCLUSION: Probiotics may be considered a therapeutic option or adjunct for acne vulgaris by providing a synergistic antiinflammatory effect with systemic antibiotics while also reducing potential adverse events secondary to chronic antibiotic use.

Treatment of melasma with the 1,927-nm fractional thulium fiber laser: a retrospective analysis of 20 cases with long-term follow-up.

BACKGROUND: Melasma is a common acquired symmetrical hyperpigmentation that is often recurrent and refractory. OBJECTIVES: To investigate the efficacy and safety of a single administration of high-density fractional thulium fiber laser (1,927 nm) for the treatment of refractory melasma in 20 patients. MATERIALS AND METHODS: A retrospective chart and photographs review of 20 women (Fitzpatrick skin type II-IV) with clinical diagnosis of melasma treated with the 1,927-nm fractionated thulium laser at 10 or 20 mJ/cm(2) , with 60-70% surface area coverage. Four investigators independently evaluated Melasma Area Severity Index (MASI) scores before, 4 weeks, 3-6 months, and 6-12 months after treatment. RESULTS: Mean MASI scores decreased dramatically from 13.2 ± 5.4 before treatment to 8.5 ± 3.5 at 4 weeks after laser treatment (P = 0.004). Patient assessment revealed that 12 of the 20 subjects had more than 50% clearance of their melasma. Recurrence was reported by 7 out of 15 patients who were successfully followed-up (mean 10.2 months). Two patients developed postinflammatory hyperpigmentation that subsided with topical bleaching after 3 months. CONCLUSION: High-density coverage fractional 1,927-nm thulium laser proved to be safe and effective for melasma with long-term remission.

The Fabi-Bolton chest wrinkle scale: a pilot validation study.

Up until now, no objective scale has existed to evaluate chest wrinkles and assess the efficacy of treatment. This study was designed to validate a new photonumeric wrinkle assessment scale using standardized photographic methodology to obtain reference photographs. Multiple photographs from 28 volunteer subjects with varying degrees of chest wrinkles were evaluated by a study team of two independent physicians. Photographs of 16 subjects representing the full spectrum of chest wrinkle severity were selected and classified using the Fabi-Bolton (F-B) 5-point wrinkle scale (1 = wrinkles absent; 2 = shallow but visible wrinkles; 3 = moderately deep wrinkles; 4 = deep wrinkles, with well-defined edges; 5 = wrinkles very deep with redundant folds). One representative photograph was chosen by study team consensus for each of the five scale points. A second, independent group of evaluators rated the randomly arranged photographs using the F-B wrinkle scale. The numeric results were then tabulated and compared. The F-B wrinkle scale provided a reproducible and effective method for assessing chest wrinkles with very little interrater variability. The F-B wrinkle scale is a reliable tool for the classification of chest wrinkles and evaluation of therapeutic and cosmetic interventions.

Treatment of reticular and telangiectatic leg veins: double-blind, prospective comparative trial of polidocanol and hypertonic saline.

BACKGROUND: Sixty-three subjects' legs were randomized to receive treatment with polidocanol (POL) or hypertonic saline (HS) for telangiectasias and reticular leg veins. OBJECTIVE: To compare the safety and efficacy of two sclerosing agents in three dermatologic surgery practices. METHODS: After exclusion of saphenofemoral junction incompetence, each subject's veins were categorized (telangiectasias <1 mm and reticular veins 1-3 mm) and randomized. Telangiectasias were treated with POL 0.5% or 11.7% HS and reticular veins with POL 1% or 23.4% HS. An independent, blinded physician determined efficacy and adverse events. Subject satisfaction questionnaires were administered and global clinical improvement assessments performed. RESULTS: All patients completed four visits at 0, 1, 4, and 12 weeks. Patients reported significantly greater pain during treatment with HS (2.42) than POL (1.03) (p < .001). There were no significant differences in physician-assessed improvement of reticular leg veins or telangiectasias; subject- or physician-assessed overall improvement; or physician-assessed phlebitis, pigmentation, edema, or matting in either of the three practices or the entire cohort. Two subjects developed ulcerations with HS. No ulcerations or allergic reactions developed after POL injections. CONCLUSION: Both agents provided effective treatment, but HS caused 2.35 times as much pain during injections and resulted in two episodes of tissue necrosis.

An investigation of coagulation cascade activation and induction of fibrinolysis using foam sclerotherapy of reticular veins.

BACKGROUND: Coagulation parameters have not been investigated when foam sclerotherapy is used to treat reticular leg veins. OBJECTIVE: To evaluate the effect of foam bubbles on coagulation and fibrinolysis by measuring platelet count and concentrations of clotting factors and fibrinogen after foam sclerotherapy with sodium tetradecyl sulfate (STS) mixed with room air. MATERIALS AND METHODS: Patients with reticular veins received treatment with up to 30 mL of foam sclerotherapy prepared with STS and room air in a 1:4 ratio (1 mL STS, 4 mL room air) using the double-syringe technique. Venous blood was drawn immediately beforesclerotherapy and 15 minutes after the procedure. Pre- and post-treatment laboratory values were compared. RESULTS: Subjects treated with up to 30 mL of foam (30 mL foam = 6 mL sclerosing solution and 24 mL air) showed no statistically significant difference in coagulation or fibrinolysis, as measured according to platelet count and concentrations of clotting factors and fibrinogen, after foam sclerotherapy with STS mixed with room air. CONCLUSION: STS foam made with room air, up to 30 mL, when injected into reticular veins does not affect coagulation parameters.

Evaluation of the effect of fractional laser with radiofrequency and fractionated radiofrequency on the improvement of acne scars.

BACKGROUND: Options for acne scar reduction include peels, subcision, fillers, lasers, dermabrasion, and surgical excision, although not all are applicable in darker skin types. A novel device with a handpiece combining optical and radiofrequency (RF) energies along with a fractionated RF handpiece is available for nonablative resurfacing. OBJECTIVES: Our primary objective was to evaluate the improvement in acne scars and skin texture. Secondary objectives were determination of patient satisfaction and comfort and evaluation of scar pigmentation improvement. Patients received five treatments at 30-day intervals. Post-treatment follow-up visits were performed 30 and 90 days after the last treatment. RESULTS: A 72.3% decrease (p<.001) was observed on the acne scar scale from day 1 to 210. From day 30 to 210, investigator-rated changes in scarring, texture, and pigmentation improved 68.2% (p<.001), 66.7% (p<.001), and 13.3% (p=.05), respectively. Patient satisfaction scores showed no significant change over time, although patient-evaluated overall improved scores increased 60% over baseline (p=.02). CONCLUSION: This technology may be a useful, nonablative resurfacing treatment for acne scarring. Scarring, texture, and pigmentation improved significantly according to investigator-rated assessment parameters. Although patient satisfaction scores did not improve, overall improvement scores did.