An evaluation of electrocoagulation and thermal diffusion following radiofrequency microneedling using an in vivo porcine skin model.

BACKGROUND: Few studies exist that examined the role of radiofrequency microneedling (RFMN) in skin electrocoagulation. This research utilized a porcine model to understand bipolar dermal delivery from an RFMN device. AIMS: The objective of this study was to elucidate and compare the dermal thermal effects of a RFMN device producing 1 and 2 MHz signal amplitudes, with respective voltage and current gradients, utilizing noninsulated and insulated needles by examining the histologic effects on porcine skin. METHODS: Two separate animal studies were conducted to evaluate the electrocoagulation and thermal diffusion effects using the RFMN device. The electrocoagulation effects were assessed histologically using hematoxylin and eosin (H&E) staining, and heating effects were assessed through thermal imaging. RESULTS: Histology results of the thermal injury induced by insulated needles demonstrated that 2 MHz resulted in a narrow and concentrated coagulation zone as compared to 1 MHz. Further, the 1 MHz insulated needle resulted in ovular shaped tissue coagulation as compared to 2 MHz tissue coagulation that was columnar. Finally, full thermal diffusion occurs seconds after the set RF conduction time. CONCLUSION: The findings showed that 1 MHz insulated needle produces larger coagulations with an increase in power level, the 1 MHz noninsulated array was comparable to the 2 MHz insulated array with similar histologic features, and heat dissipates seconds after the set conduction time.

The Role of Platelet Homeostasis in a Novel Topical PRP Formulation.

BACKGROUND: Topical platelet-rich plasma (PRP) must demonstrate stability to insure biologic activity in aesthetic medicine. OBJECTIVE: The objective of this research was to evaluate the role of platelet homeostasis in a novel PRP topical cosmetic formulation to provide facial appearance improvement. METHODS: The stability of the topical PRP formulation was evaluated in vitro followed by clinical in vivo testing. The in vitro evaluation examined platelet stability and morphology over a 90-day period within the preservative cosmetic base utilizing ELISA and light microscopy (LM)/scanning electron microscopy (SEM). The in vivo clinical study enrolled 20 subjects in a 120-day double blind split face study to evaluate the effect of 5–7x concentrated PRP compared to 2–3x concentrated PRP on facial photoaging. Cosmetic effect was evaluated by the subject and the dermatologist investigator on a 5-point ordinal scale at baseline, week 8, and week 16. RESULTS: 90-day stability for the topical PRP formulation was verified via ELISA and LM/SEM. ELISA showed the PRP was more inactive than control conditions via analyte concentration curves (PDGF-AB, EGF, and P-Selectin). LM/SEM demonstrated the PRP had less aggregation/activation over time within the cosmetic base and that refrigeration is superior to room-temperature storage thus delaying full platelet degranulation. The in vivo clinical study demonstrated parity between 20ml and 60ml PRP in terms of clinical efficacy. CONCLUSION: Platelets remain viable for up to 90 days in a refrigerated cosmetic vehicle with demonstrated topical clinical PRP facial benefits. PRP kits of 20ml and 60ml volumes for topical PRP are equally efficacious. J Drugs Dermatol. 2020;19(12): doi:10.36849/JDD.2020.5495.

Pilot study: Autologous platelet-rich plasma used in a topical cream for facial rejuvenation.

BACKGROUND: Platelet rich plasma (PRP) is traditionally used as an injectable material for enhanced healing, hair growth, and facial rejuvenation. AIMS: This research examined the novel use of topical autologously sourced PRP added to a preservative cosmetic base and applied twice daily to the face following electroporation for 8 weeks. METHODS: 20 healthy female and male subjects 30-60 years of age were enrolled in this single-site, investigator blinded, vehicle controlled split-face study to evaluate the effect of a PRP-containing serum versus the serum alone on facial photoaging. RESULTS: 90 day stability for the PRP in a preservative serum was achieved with refrigeration at 4 degrees Celsius. Facial skin biopsy histologic findings included improved rete peg architecture. Immunohistochemical analysis showed upregulation for collagen type I with qPCR data demonstrating concomitant upregulation of mRNA for collagen after 8 weeks of topical PRP use. CONCLUSION: These pilot study findings may indicate value for topical PRP in facial rejuvenation.

Topically delivered dissolved oxygen reduces inflammation and positively influences structural proteins in healthy intact human skin.

BACKGROUND: As oxygen is essential for wound healing and there is limited diffusion across the stratum corneum into the epidermis, we wanted to evaluate whether the topical delivery of a total dissolved oxygen in dressing form on intact human subject skin would improve clinical and histologic skin functioning. AIMS: Fifty normal, healthy subjects completed a pilot clinical evaluation to assess the efficacy and tolerability of a dissolved oxygen dressing (OxygeneSys™-Continuous) to improve the health and appearance of intact skin. METHODS: Clinical analysis was performed on 50 subjects; histological and gene expression analysis was performed on 12 of the 50 subjects to assess the effect of the dissolved oxygen dressing. RESULTS: Clinical data demonstrate that the dressing is well tolerated, and several measures of skin health and integrity showed improvements compared with a control dressing site. Skin hydration measurements showed a statistically significant increase in skin hydration at 0-4, 4-8, and 0-8 weeks (P < 0.05 at each time point). The blinded clinical investigator's grading of desquamation, roughness, and skin texture show significant decreases from baseline to the 8-week time point (P < 0.05). The dressings were removed prior to the blinded clinical investigator's grading. These data were supported by the histological and gene expression studies, which showed a general reduction in inflammatory response markers and transcription products (IL-6, IL-8, TNF-alpha, MMP-1, and MMP-12), while facilitating a general increase in structural skin proteins (collagen I, elastin, and filaggrin). Additionally, p53 signals from biopsy samples support the clinical investigator's observations of no safety concerns. CONCLUSION: The data from this study demonstrate that the dressing has no deleterious effects and stimulates beneficial effects on intact, nonwounded skin.

Hypoxic conditioned culture medium from fibroblasts grown under embryonic-like conditions supports healing following post-laser resurfacing.

OBJECTIVES: Treatment of facial skin perturbed by laser resurfacing with a novel, topical hypoxic conditioned culture medium (HCCM) product results in apparent, accelerated wound recovery time. The HCCM product is conditioned by neonatal fibroblasts under hypoxic conditions and used as the active ingredient in a formulated topical lotion. The HCCM contains significant quantities of growth factors such as vascular endothelial growth factor, keratinocyte growth factor, and interleukin-8. As these molecules are known to play an important role in normal wound healing in vivo, we conducted a pilot clinical evaluation "Proof of Concept" in which individuals, after receiving laser resurfacing, were instructed to use either active or placebo lotion on their abraded skin. METHODS: The end points used were clinical assessment of the time to complete healing, clinical and bioinstrumental mexameter measurements of erythema, and the number of days of rescue petrolatum use by patients, post-laser. RESULTS: Day 7, post-laser treatment, resulted in a greater improvement in erythema, and re-epithelization of the peri-oral and peri-ocular regions in subjects using the active lotion vs. placebo control as determined by blinded, clinical evaluation of gross photographs and bioinstrumental mexameter measurements. A statistically significant reduction in rescue petrolatum use in active lotion-treated subjects was reported. Finally, no attendant cutaneous safety concerns (e.g., irritant/allergic dermatitis) were reported with either active or placebo lotion. CONCLUSIONS: This HCCM product may have broad applications within the field of skin wound repair.

Evaluation of additive effects of hydrolyzed jojoba (Simmondsia chinensis) esters and glycerol: a preliminary study.

BACKGROUND: Glycerol has long served the topical prescriptive and personal care industry as a versatile and functional active and inactive ingredient. In skin care products, it acts primarily as an emollient, softening the skin through robust humectant hydration action. Hydrolyzed Jojoba Esters K-20W (K-20W) have been shown to increase skin hydration and improve sensory skin "feel" when included in a variety of skin, hair, and nail care cosmetic/personal care formulations. The addition of glycerol and hydrolyzed jojoba esters provides a substantial long-acting 24 h (moisturizing) skin hydration effect for topical products. AIM: A small pilot study was conducted to support the "proof of concept" that an enhanced, additive role exists between these two ingredients resulting in a long-term (24 h) skin moisturization effect. METHOD: Topical treatments were applied to the skin (lower leg) of subjects, and evaluations were made at baseline and 8- to 24-h post-application. Skin hydration data were obtained via bio-instrumental transepidermal water loss (TEWL) measurements and expert clinical skin grading, including standardized digital clinical photography. RESULTS: Clinical skin grading evaluations and TEWL measurements found that significantly lower evaporative (P < 0.05) TEWL values occurred in the topical formulations containing 3.75% glycerol and 1.25% K-20W (hydrolyzed jojoba esters) than with glycerol alone in a standard base skin care lotion at 8 and 24 h posttreatment. CONCLUSION: This preliminary data "proof of concept" supports the position that glycerol and hydrolyzed jojoba esters work in tandem to enhance skin moisturization for at least 24 h. This unique moisturizing potential may prove valuable in the future development of cosmetic and over-the-counter/prescriptive topical products, including new medicaments containing botanicals. This fact is further reinforced with the recent greater commercial use and demand for defined safe botanicals in cosmetic as well as pharmaceutical topical formulations. Additional mechanistic studies are underway.