Carboxytherapy for striae distensae: A promising modality.

BACKGROUND: Striae distensae (SD) is a very common skin problem. Although a lot of treatment modalities have been proposed, few of them are effective. Recently, carbon dioxide therapy (CDT) or carboxytherapy was used in many indications of cosmetic dermatology such as SD. OBJECTIVES: To objectively evaluate the use and effectiveness of CDT for treatment of SD. PATIENTS AND METHODS: Twenty patients were subjected to 8 sessions of CDT injection at 2-week intervals using carboxy-gun. Patients were photographed, and skin specimens were obtained from the treated area before and after 4 months of treatment. Using a computerized 3D camera, skin topography was objectively analyzed before and after treatment. Evaluation of collagen and elastic fibers by special histopathological staining, in addition to histometric analysis, was also done to evaluate treatment efficacy. RESULTS: Clinically, SD was statistically significantly improved after CDT injection compared with baseline (mean percentage of improvement of length and width, 59.8 ± 15.9; P < .05). Meanwhile, the improvement observed by the 3D camera correlated with the clinical improvement. Histometric analysis showed an increase in epidermal thickness (P < .0001) in association with re-appearance of rete ridges following treatment. Histochemical evaluation of changes in elastic and collagen fibers after treatment showed better organization of curled and fragmented elastic fibers, which was accompanied by an increase in collagen content that became denser, arranged in bundles and parallel to the epidermis. CONCLUSIONS: CDT is an effective, promising, and simple minimally invasive procedure for improving SD with few side effects and low downtime.

The use of Carboxytherapy alone or in combination with fractional CO2 laser for facial rejuvenation: A split-face comparative study.

BACKGROUND: A wide variety of minimally invasive treatments are available for skin aging. Recently, carbon dioxide therapy (CDT) or carboxytherapy was used in many cosmetic indications including facial rejuvenation. OBJECTIVE: To compare the efficacy of CDT alone versus combined CDT and fractional CO2 laser in management of facial aging. METHODS: Twenty-Five female patients with bilateral and symmetrical facial aging were included in the study. The right (Rt) hemiface received 8 sessions of CDT whereas the left (Lt) side was treated with combined technique (6 sessions of CDT and 2 sessions of fractional CO2 in between. Clinical and objective evaluation using 3D skin analysis, histological, and morphometric analysis were performed. RESULTS: Clinical evaluation demonstrated that all patients (100%) were satisfied with no significant difference between both sides of the face (P > .05). Regarding texture and pigmentation improvement, the Lt side (combined) showed significant improvement compared to the Rt side (P < .05). Using Antera 3D camera, there was a significant difference (P < .05) in 3D improvement percent in textural changes while there was no significant difference (P > .05) in the 3D percent of wrinkles improvement between both sides. The Lt side showed more significant increase in epidermal thickness after treatment when compared to the Rt side (P < .05) with evident neocollagen formation. CONCLUSION: Carboxytherapy is an easy, safe, simple, and a relatively effective method for facial rejuvenation with minimal downtime. Better results were achieved when used in combination with fractional CO2 laser.

Epithelial grafting for vitiligo requires ultraviolet A phototherapy to increase success rate.

BACKGROUND: Phototherapeutic techniques were introduced into medical practice by the ancient Egyptians. It is considered a cornerstone in the management of resistant vitiligo; yet, failures are very well known. Recently, the introduction of surgical techniques provided a major development in the management of vitiligo and replaced other conventional unsuccessful therapies. OBJECTIVES: The aim of this work is to find out if phototherapy, which failed to resolve the vitiligo problem in patients, is still required in the treatment strategy after epithelial grafting of the same cases. METHODS: Twenty-five vitiligo patients, nonresponding to classic phototherapy, were treated surgically. Ultrathin Thiersch grafts and suction blister grafts were used. Phototherapy using ultraviolet A (UVA) bulbs in combination with psoralen or khellin was used postoperatively immediately after take of grafts onto recipient sites. RESULTS: In spite of reactivation of depigmentary effects at grafted areas, phototherapy acted as a stimulator for melanocytic proliferation and function and as an immunosuppressant, halting the melanocytic destructive process. The application of UVA phototherapy resulted in successful treatment in the patients receiving it. CONCLUSION: The success of epithelial grafting in patients with vitiligo can be increased by UVA phototherapy.