Safety and Efficacy of a Novel, Variable-Sequenced, Long-Pulsed, 532-nm and 1,064-nm Laser With Cryogen Spray Cooling for Pigmented and Vascular Lesions.

BACKGROUND: Patients frequently seek treatment for vascular and pigmented lesions. More recently, a novel, variable-sequenced, long-pulsed, 532-nm and 1,064-nm laser with cryogen spray cooling was developed to offer greater flexibility in treatments. OBJECTIVE: A prospective clinical trial evaluated the safety and efficacy of a novel, variable-sequenced, long-pulsed, 532-nm and 1,064-nm laser with cryogen spray cooling (DermaV, Lutronic, South Korea). MATERIALS AND METHODS: Subjects with vascular and/or pigmented lesions were enrolled and underwent laser treatments. RESULTS: Twenty-three subjects were enrolled with vascular lesions (39.1%), pigmented lesions (17.4%), and both (43.5%). Mean age was 53.1 years, and 91.3% were women. Fitzpatrick skin types II-IV were included. All subjects were treated with 532 nm, and 4 were also treated with 1,064 nm. According to 4 blinded physician reviewers, correct before and after photographs were selected in 94.7%, 92.1%, 84.2%, and 76.3% of cases. Overall, 86.8% were responders, meaning that at least 3 of 4 reviewers agreed. For Global Aesthetic Improvement Scale, improvement occurred in 81.6%, 81.6%, 81.6%, and 76.3% of cases. No serious adverse events occurred. Overall, 87.0% of subjects reported being very satisfied or satisfied. CONCLUSION: A novel, variable-sequenced, long-pulsed, 532-nm and 1,064-nm laser with cryogen spray cooling can safely and effectively improve vascular and pigmented lesions.

Body contouring for fat and muscle in aesthetics: Review and debate.

The recent demand for noninvasive fat reduction and muscle toning has generated the need for a variety of noninvasive body contouring devices, including cryolipolysis, radiofrequency, focused ultrasound, laser energy, and high intensity focused electromagnetic energy. Many of the recent technologies are still relatively new, and clinical trials are limited. There is also a lack of comparison between modalities, which makes it difficult for practitioners to select the best treatment option for patients. We review the currently available treatment modalities and offer relevant insights.

Female genitourinary treatments in aesthetics.

Female genitourinary treatments in aesthetics utilize energy-based treatments and other noninvasive modalities. These include CO2 and Erbium YAG lasers, radiofrequency, high-intensity focused electromagnetic energy, hyaluronic acid injection, platelet-rich plasma, and silicone thread treatments with an objective to treat sexual dysfunction and symptoms of genitourinary syndrome associated with menopause, which include atrophic vaginitis, urinary incontinence, and vulvovaginal laxity that is characterized by vaginal dryness, thinning of the epithelium, laxity, prolapse, incontinence, dyspareunia, and increased bacterial infections. The body of evidence is growing for the use of these modalities to improve signs and symptoms of the genitourinary syndrome associated with menopause and sexual function, as well as for rejuvenating the appearance of the external female genitalia. We reviewed the currently available modalities in this rapidly advancing area of expertise.

National market analysis for body contouring providers: Medical spas and physician practices.

BACKGROUND: Non-invasive body contouring has experienced recent growth. To meet demand, medical spas and non-physician operators have grown. Insights into their practice can provide information on their impact. OBJECTIVE: Our study investigated the current market distribution of body contouring providers in the aesthetic field. MATERIALS AND METHODS: For the 30 most populous cities, data were collected for non-invasive body contouring providers in medical spas and physician practices. Descriptive ratios were calculated, and various local factors were examined. RESULTS: The cities with the greatest number of body contouring providers were New York (138), Los Angeles (106), and Houston (87). Population size had a significant relationship, while median household income did not. For number of body contouring providers per 100 000 persons, the top cities were Austin (4.87), Houston (3.74), and Las Vegas (3.41). The mean ratio of providers in medical spas to physician practices was 1.81. In total, 70.0% of cities had equal or more body contouring providers in medical spas than physician practices. CONCLUSION: Certain cities have experienced an unequal distribution of body contouring providers, and many cities are skewed in favor of medical spas over physician-based practices.

Understanding aesthetic interest in oral collagen peptides: A 5-year national assessment.

Oral supplementation with collagen peptides has recently grown in popularity. It has been marketed to offer skin rejuvenating properties, such as wrinkle reduction, skin plumping, and moisturizing effects. However, current data are limited regarding its effects on the skin. Despite the controversial status of oral collagen supplements, its popularity has continued to rise. Here, we examine the consumer interest in oral collagen peptides over a 5-year period in the United States.

Utility of platelet-rich plasma for treatment of striae distensae: A current exploration.

Platelet-rich plasma (PRP) has recently become a popular treatment for various skin conditions, including striae distensae, acne scars, traumatic scars, hair regrowth, and cutaneous rejuvenation. Although PRP has been utilized in orthopedics for many years, its recent entry into dermatology has been met with controversy. While the recent research has generally been limited and is often contradictory, this has differed from the persuasive marketing campaigns targeting patients and consumers. Aesthetic practitioners should be knowledgeable with the available evidence for PRP in the treatment of striae distensae. Here, we review the pertinent literature and offer additional insights.

Sterility and cost of gloves during Mohs micrographic surgery: Sterile or peril?

In recent years, the focus in the field of health care has shifted toward cost-saving strategies without the sacrifice of patient safety and clinical outcomes. Therefore, we decided to look into the use of nonsterile gloves and sterile gloves during Mohs micrographic surgery. This practice varies widely between Mohs surgeons. However, studies have shown no differences in infection rates. Here, we review the pertinent studies and also combine the data to offer readers an overall financial analysis.

Incidence of melanoma and keratinocytic carcinomas in patients evaluated by store-and-forward teledermatology vs. dermatology clinic.

BACKGROUND: It is unclear whether incidence of detected skin cancer in patients evaluated by store-and-forward teledermatology (SAF) vs. face-to-face consultation (F2F) significantly differs, and whether such differences are because of variations in patient demographics, diagnostic accuracy, or both. METHODS: This retrospective cohort study compares patient skin cancer risk profile, pre-post biopsy diagnostic accuracy, and detection rates of any skin cancer, melanoma, and keratinocytic carcinoma between all SAF teledermatology patients and a subset of randomly selected F2F consultations at VA-Boston Healthcare System in 2014. RESULTS: Patients in the teledermatology (n = 434) and F2F visit cohorts (n = 587) had similar baseline demographics except a higher proportion of F2F patients had prior history of skin cancer, 22% (131/587) vs. 10% (45/434), P < 0.001, and received biopsies, 27.2% (160/587) vs. 11.5% (50/434), P < 0.001. When adjusted for age, immunosuppression, and personal and family history of skin cancer, there were no significant differences between the two cohorts in detection rates for any skin cancer (9.5% vs. 5.8%, P = 0.3), melanoma (0.6% vs. 0%, P = N/A), or keratinocytic carcinoma (8.5% vs. 5.5%, P = 0.7). The two cohorts also had similar pre-post biopsy perfect diagnostic concordance, time from initial consult request to biopsy (45.5 d vs. 47.3 d, P = 0.8), and time from biopsy to definitive treatment (67.5 d vs. 65.4 d, P = 0.8). CONCLUSION: F2F patients were more likely to have prior history of skin cancer and receive biopsies. When adjusted for presence of skin cancer risk factors, incidence of detected melanoma, keratinocytic carcinoma, and any skin cancer was similar between SAF teledermatology and F2F patients.