Effectiveness of fractional erbium-YAG laser, microneedling, platelet-rich plasma in localized stable vitiligo patients: randomized clinical trial.

Vitiligo is considered an autoimmune disease, and its treatment is challenging. We assessed and compared the effect of fractional erbium:yttrium-aluminum-garnet (Er:YAG) laser-assisted delivery of platelet-rich plasma versus microneedling (Mn) with platelet-rich plasma (PRP) in enhancing skin repigmentation in localized stable vitiligo patients. In total, 40 patients with localized stable vitiligo were selected in a random manner into two similar groups (20 each). Group (A) was subjected to fractional Er:YAG laser combined with platelet-rich plasma and Group (B) was subjected to microneedling combined with platelet-rich plasma. The procedure was repeated every 2 weeks for up to 6 months. Each individual was assessed clinically utilizing Vitiligo Area Scoring Index (VASI). Fractional Er:YAG + PRP group achieved better pigmentation100% (excellent 30%, very good 15%, good 30% and satisfactory 25%) which is comparable to Mn + PRP where 80% of cases demonstrate repigmentation (20% very good, 10% good and 50% mild). When comparing the VASI scores for both groups after therapy to the baseline VASI, there was a statistically significant decrease [p = 0.001 for group(A) and 0.003 for group(B)]. Regarding the treatment side effects, there was significantly (p = 0.048) side effects among cases treated with microneedling group(B) (25%) than those fractional Er:Yag laser therapy group(A) (5%). Both forms of therapy demonstrated induction of repigmentation of vitiligo, but fractional Er:YAG laser efficacy is greater when combined with platelet-rich plasma.Clinical trials.gov identifier: NCT05511493.

Treatment of Acne Scars with Microneedling and Chemical Reconstruction of Scarred Skin Therapy (CROSS) Using Penol/Croton Oil Combination.

BACKGROUND: Microneedling has been shown to release growth factors, which improves the appearance of acne scars by itself and in combination with different therapy modalities. Combining microneedling with Chemical Reconstruction of Scarred Skin (CROSS) therapy using a 60% phenol and 0.2% croton oil combination results in a significant improvement of acne scarring. OBJECTIVE: To assess the safety and efficacy of combination treatments using microneedling in combination with CROSS therapy that contains 60% phenol and 0.2% croton preparation in patients with Fitzpatrick skin types III to V.  Materials and Methods: Patients were treated over a 5-year period for atrophic acne scars using microneedling combined with CROSS. Most of the patients had combination atrophic scarring. High-quality before and after photographs were taken of the patients to assess the improvement in the scars.  Results: Most of the patients (89.5%) had Fitzpatrick skin types IV through V.  Analysis was done on a maximum of 3 microneedling sessions with 1 to 3 CROSS sessions. Photographic evaluation using the Global Aesthetic Improvement Scale showed an 18% grade-1 improvement and 81% grade-2 improvement. The Goodman and Baron Qualitative scar grading system showed a 62% grade-1 improvement and 38% grade-2 improvement. CONCLUSION: Combination treatments work best for atrophic scars. This is the first published report of using microneedling with a 60% phenol/0.2% croton oil combination. It proved to be very effective and safe in treating atrophic acne scars in Fitzpatrick skin types III to V, with minimal side effects and a quick recovery. J Drugs Dermatol. 2024;23(6):418-422.     doi:10.36849/JDD.7657.

Comparing Myofascial Pain Syndrome Treatment with Dry Needling Versus Extracorporeal Shock Wave Therapy for Plantar Fasciitis on Pain and Function of the Heel.

The aim of this study was to compare the effects of dry needling (DN) and extracorporeal shock wave therapy (ESWT) in the treatment of plantar fasciitis (PF). The study included 55 patients with PF. The patients were randomly divided into 2 groups. The DN group applied 3 sessions of DN to the myofascial trigger points in the lower limb muscles. The ESWT group applied 3 sessions of ESWT to the plantar fascia. For clinical evaluation, we used a visual analog scale (VAS) (first step, rest, activity) and Foot Function Index (FFI) (pain, disability, activity). Assessments were done baseline, post-treatment first week, and fourth week. Maximum pain-free standing time (Max PfST) and maximum pain-free walking distance (Max PfWD) were recorded at baseline and post-treatment fourth week. In this study, we found significant improvement in VAS, FFI, Max PfST, and Max PfWD in both groups (p < .01). VAS-activity baseline-forth week change was significantly superior in the DN group compared to the ESWT group (p = .023). FFI-disability baseline-fourth week change was significantly superior in the DN group compared to the ESWT group (p = .048). There was no significant difference in other treatment-related changes between the groups (p > .05). However, VAS-rest baseline-fourth week change and FFI-pain baseline-fourth week change trended towards statistical significance between groups ((p = .056), (p = .052) respectively). This study showed that DN may be a good alternative treatment for patients with PF, with effects similar to or even superior to ESWT.

Evaluation of efficacy and safety of vitiligo treatment with micro-needling combined with N-Acetylcysteine and micro-needling alone: A double-blinded randomized controlled clinical trial.

INTRODUCTION: Vitiligo is a skin pigmentation disorder caused by the selective degradation of melanocytes. This study investigates the therapeutic effects of microneedling with and without N-acetylcysteine (NAC) in patients with persistent and limited vitiligo. METHOD: This research employed a clinical trial design with double-blind randomization. Individuals affected by vitiligo and seeking treatment at Rasool Akram Medical Complex were divided into two separate treatment groups. In the intervention group, 24 affected areas underwent meso-microneedling using 5% NAC ampoules over six sessions, in addition to the application of 4.7% NAC cream once daily on the specified area. Conversely, the control group, consisting of 22 lesions, underwent microneedling using distilled water during six sessions. The severity of lesions and the extent of repigmentation were gauged using the Modified VETI Score. Assessment of treatment efficacy was determined through both physician evaluations and patient feedback. RESULTS: Twenty patients with a mean age of 36.4 years were recruited. The mean percentage of lesions and their intensity were significantly improved 2 weeks after the third session and 1 month after the end of the treatment (p < 0.01). There was no statistically significant difference between the intervention and control groups. Gender, age, family history, duration of disease, duration of disease stability, and history of hypothyroidism had no statistically significant relationship with patients' treatment outcomes (p > 0.05). CONCLUSION: Microneedling with or without the application of NAC appears to be an effective treatment option for persistent vitiligo lesions. However, despite the higher improvement rate with the application of NAC, the difference was not significant.

COMPARISON THE EFFICACY OF DRY NEEDLING AND ISCHEMIC COMPRESSION METHODS IN MIYOFASCIAL PAIN SYNDROME: A RANDOMIZED TRIAL.

Myofascial pain syndrome (MPS) is the most common in the musculoskeletal disease. Dry needling techniques and ischemic compression are the most common applications. We aimed to compare the efficacy of dry needling and ischemic compression methods on pain, cervical range of motion and disability in myofascial pain syndrome. This is a randomized, controlled study. 98 patients with MPS were randomly assigned into three groups. Group1 received dry needling (n=33), group 2 (n=33) received ischemic compression and group 3 (n=32) received combined with dry needling and ischemic compression inventions. Additionally, all patients were given neck exercise programs including isotonic, isometric, and stretching. The severity of the pain was measured by visual analog scale (VAS). The pressure pain threshold (PPT) and cervical range of motion (ROM) were also recorded. Disability was assessed by the Neck Pain Disability Scale. All assessments were performed before the treatment and one month and three months after the treatment. There were statistically significant improvements in VAS, PPT, cervical ROM, and disability scores after one and three months in all groups compared to pre-treatment results (p<0.05). After three months of follow-up, statistically significant differences were observed in all parameters between the groups (p<0.05) except cervical ROM (p>0.05). Myofascial pain syndrome in patients with ischemic compression and dry needling effective treatment methods are shown separately in our study to be more effective when used together.

Análise da eficácia do agulhamento seco e da massagem facial no tratamento de disfunções temporomandibulares com base em relato de caso clínico / Analysis of the effectiveness of dry needing and facial massage in the treatment of temporomandibular disorders based on a clinical case report

O objetivo do presente trabalho é apresentar um relato de caso de Disfunção Temporomandibular (DTM) dolorosa de origem muscular, tratado por meio de Agulhamento Seco (AS) e Massagem Facial (MF). Paciente do sexo feminino, M.R.B.A., de 47 anos, com diagnóstico de dor miofascial com referência do lado esquerdo e deslocamento de disco com redução do lado esquerdo, de acordo com os Critérios de Diagnóstico e Tratamento das Disfunções Temporomandibulares (DC/TMD). A paciente foi submetida a cinco sessões de AS e MF, executadas por fisioterapeuta experiente. Na primeira consulta, foi realizada a anamnese e exame físico para a obtenção de informações sobre qualidade, frequência, duração e intensidade da dor, bem como fatores de melhora, fatores de piora, fatores acompanhantes, fatores desencadeantes e tratamentos prévios. A intensidade da dor foi avaliada através de escala visual analógica e as intervenções com agulhamento seco foram iniciadas a partir da segunda consulta. Ao final das sessões, a paciente foi orientada quanto à continuidade de exercícios de relaxamento muscular e ao uso de placa interoclusal. Com base na escala adotada, o quadro doloroso geral da paciente teve evolução positiva de 6 a 0 após o tratamento, com destaque observado em seus pontos gatilhos de 10 e 8 para 6 e 3, para os lados esquerdo e direito respectivamente. Concluise que, após a aplicação da terapia proposta, a paciente obteve melhora com redução significativa em sua sintomatologia dolorosa em ambos os lados(AU)

The objective of this work is to present a case report of Dysfunction Painful temporomandibular joint (DTM) of muscular origin, treated with needling Dry (AS) and Facial Massage (MF). Female patient, M.R.B.A., 47 years old, with a diagnosis of myofascial pain with reference on the left side and displacement of disc with reduction on the left side, according to the Diagnostic and Treatment of Temporomandibular Disorders (DC/TMD). The patient underwent five sessions of AS and MF, performed by an experienced physiotherapist. At the first consultation, anamnesis and physical examination were carried out to obtain information on quality, frequency, duration and intensity of pain, as well as improvement factors, worsening factors, accompanying factors, triggering factors and previous treatments. The intensity of pain was assessed using a visual analogue scale and interventions with needling dry were started from the second consultation. At the end of the sessions, the patient was guided regarding the continuation of muscle relaxation exercises and the use of interocclusal splint. Based on the adopted scale, the patient's general painful condition was positive evolution of 6 to 0 after treatment, with emphasis on its points triggers from 10 and 8 to 6 and 3, for the left and right sides respectively. It is concluded that, after applying the proposed therapy, the patient improved with reduction significant in its painful symptoms on both sides

Intervención fisioterapéutica en fibromialgia / Physiotherapeutic intervention in fibromyalgia

Introducción: La fibromialgia afecta el movimiento corporal. Provoca dolor en puntos claves, causa molestias musculoesqueléticas y limita la actividad de las personas. Se ha descrito que la fisioterapia mejora de calidad de vida de estos pacientes. Objetivo: Identificar los test de evaluación y los procesos de intervención fisioterapéutica utilizados en la fibromialgia. Métodos: Se realizó una revisión de literatura en PubMed, ScientsDirect, SciELO y LILLACS, con la terminología MeSH y DeCS, entre 2017 y 2022. Resultados: La escala visual análoga y la algometría por presión son los test utilizados para el dolor. La hidroterapia, el cupping, la punción seca, el masaje sueco, los ejercicios respiratorios y los aeróbicos resultan los métodos de intervención con más uso. Conclusiones: Los procesos de intervención se deben plantear según las evaluaciones del dolor y la funcionalidad en la persona. El tratamiento fisioterapéutico de la fibromialgia debe tener un componente de ejercicio físico aérobico y fuerza para disminuir la fatiga; devolverle al músculo su funcionalidad y aumentar la capacidad aeróbica(AU)

Introduction: Fibromyalgia affects body movement. It causes pain in key points, it causes musculoskeletal discomfort and it limits the persons's activity. It has been described that physiotherapy improves the quality of life of these patients. Objective: To identify the evaluation tests and physiotherapy intervention processes used in fibromyalgia. Methods: A literature review was carried out in PubMed, ScientsDirect, Scielo and LILLACS, with the terminology MeSH and DeCS, from 2017 to 2022. Results: The visual analogue scale and pressure algometry are the tests used for pain. Hydrotherapy, cupping, dry needling, Swedish massage, breathing exercises and aerobics are the most commonly used intervention methods. Conclusions: Intervention processes should be planned according to the evaluations of pain and functionality in the person. The physiotherapy treatment of fibromyalgia must have a component of aerobic physical exercise and strength to reduce fatigue, to return the muscle to its functionality and increase aerobic capacity(AU)

Manejo das disfunções temporomandibulares. Parte I: tratamento conservador / Management of temporomandibular joint disorders. Part I: conservative treatment

Objetivo: Apresentar as modalidades de tratamentos conservadoras e minimamente invasivas mais usadas disponíveis no arsenal terapêutico das desordens temporomandibulares (DTM). Revisão da literatura: Os objetivos do tratamento invariavelmente incluem redução da dor, diminuição das atividades parafuncionais e restauração da função. Dentre as alternativas conservadoras e minimamente invasivas, podemos citar os dispositivos interoclusais, exercícios terapêuticos, eletrofototermoterapia, agulhamento seco e infiltração de anestésicos locais em pontos gatilho, injeção de sangue autógeno para controle da luxação mandibular, terapia cognitivo comportamental, toxina botulínica, viscossuplementação, controle farmacológico da dor aguda e crônica. As DTMs afetam uma proporção significativa da população. Somente após o fracasso das opções não invasivas é que devem ser iniciados tratamentos mais invasivos e irreversíveis. No entanto, algumas condições, como a anquilose e neoplasias, por exemplo, são essencialmente tratadas cirurgicamente e tentativas de tratamentos conservadores podem trazer piora na qualidade de vida ou risco de morte. Considerações finais: Uma abordagem de equipe multidisciplinar para o manejo é essencial no cuidado fundamental de todos os pacientes com DTM, para que o tratamento possa ser especificamente adaptado às necessidades individuais do paciente.

Aim: To present the most widely used conservative and minimally invasive treatment modalities available in the therapeutic arsenal for temporomandibular disorders (TMD). Literature review: Treatment goals invariably include pain reduction, reduction of parafunctional activities and restoration of function. Among the conservative and minimally invasive alternatives, we can mention interocclusal devices, therapeutic exercises, electrophototherapy, dry needling and infiltration of local anesthetics in trigger points, autogenous blood injection to control mandibular dislocation, cognitive behavioral therapy, botulinum toxin, viscosupplementation, pharmacological control of acute and chronic pain. TMD affects a considerable proportion of the population. Only after non-invasive options have failed should more invasive and irreversible treatments be initiated. However, some conditions, such as ankylosis and neoplasms, for example, are treated surgically and attempts at conservative treatments can lead to worsening quality of life or risk of death. Conclusions: A multidisciplinary team approach to management is essential in the fundamental care of all TMD patients, so that treatment can be specifically tailored to the patient's individual needs.

Ultrasound-guided pulsed radiofrequency versus dry needling for pain management in chronic neck and shoulder myofascial pain syndrome patients at a tertiary hospital in China: a randomised controlled trial protocol.

INTRODUCTION: Myofascial pain syndrome (MPS), especially in the neck and shoulder region, is one of the most common chronic pain disorders worldwide. Dry needling (DN) and pulsed radiofrequency (PRF) are the two effective methods for treating MPS. We aimed to compare the effects of DN and PRF in chronic neck and shoulder MPS patients. METHODS AND ANALYSIS: This is a prospective, single-centre, randomised, controlled trial in a tertiary hospital. We plan to recruit 108 patients aged 18-70 years who are diagnosed with chronic MPS in the neck, shoulder and upper back regions and randomly allocate them to either the DN or PRF group at a 1:1 ratio. The DN group will receive ultrasound-guided intramuscular and interfascial DN 8-10 times per pain point or until local twitch responses are no longer elicited and 30 min of indwelling. The PRF group will receive ultrasound-guided intramuscular (0.9% saline 2 mL, 42℃, 2 Hz, 2 min) and interfascial (0.9% saline 5 mL, 42℃, 2 Hz, 2 min) PRF. Follow-up will be performed by the research assistant at 0, 1, 3 and 6 months postoperatively. The primary outcome is the postoperative 6-month pain visual analogue score (0-100 mm). Secondary outcomes include pressure pain threshold measured by an algometer, Neck Disability Index, depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7), sleep status (Likert scale) and overall quality of life (36-Item Short Form Survey). Between-group comparisons will be analysed using either a non-parametric test or a mixed effects linear model. ETHICS AND DISSEMINATION: This study was approved by the medical ethics committee of Peking Union Medical College Hospital (JS-3399). All participants will give written informed consent before participation. The results from this study will be shared at conferences and disseminated in international journals. TRIAL REGISTRATION NUMBER: NCT05637047, Pre-results.

Plum-blossom needle tapping enhances the efficacy of ALA photodynamic therapy for facial actinic keratosis in Chinese population: a randomized, multicenter, prospective, and observer-blind study.

BACKGROUND: Photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) is a reliable treatment for actinic keratosis (AK), but its effect needs to be enhanced in thick lesions. Plum-blossom needle is a traditional Chinese cost-effective instrument for enhancing the transdermal delivery of ALA. However, whether it could improve the efficacy of AK treatment has not yet been investigated. OBJECTIVE: To compare the efficacy and safety of plum-blossom needle-assisted PDT in facial AK in the Chinese population. METHODS: In this multicenter, prospective study, a total of 142 patients with AKs (grades I-III) were randomized into the plum-blossom needle-assisted PDT group (P-PDT) and control PDT group (C-PDT). In the P-PDT group, each AK lesion was tapped vertically by a plum-blossom needle before the application of 10% ALA cream. In the C-PDT group, each lesion was only wiped with regular saline before ALA cream incubation. Then, 3 hours later, all the lesions were irradiated with light-emitting diode (LED) at a wavelength of 630 nm. PDT was performed once every 2 weeks until all lesion patients achieved complete remission or completed six sessions. The efficacy (lesion response) and safety (pain scale and adverse events) in both groups were evaluated before each treatment and at every follow-up visit at 3-month intervals until 12 months. RESULTS: In the P-PDT and C-PDT groups, the clearance rates for all AK lesions after the first treatment were 57.9% and 48.0%, respectively (P < 0.05). For grade I AK lesions, the clearance rates were 56.5% and 50.4%, respectively (P = 0.34). For grade II AK lesions, the clearance rates were 58.0% and 48.9%, respectively (P = 0.1). For grade III AK lesions, the clearance rates were 59.0% and 44.2%, respectively (P < 0.05). Moreover, grade III AK lesions in the P-PDT group required fewer treatment sessions (P < 0.05). There was no significant difference in the pain score between the two groups (P = 0.752). CONCLUSION: Plum-blossom needle tapping may enhance the efficacy of ALA-PDT by facilitating ALA delivery in the treatment of AK.

Dry needling in a multimodal rehabilitation protocol following rotator cuff repair surgery: study protocol for a double-blinded randomized sham-controlled trial.

BACKGROUND: Rotator cuff tear (RCT) is one of the main causes of shoulder pain and dysfunction. Rotator cuff repair (RCR) is a common surgical procedure for the management of RCTs. Presence of myofascial trigger points (MTrP) as a result of surgical procedure can aggravate postoperative shoulder pain. The purpose of this protocol is to describe a randomized controlled trial design to evaluate the effect of implementing 4 sessions of myofascial trigger point dry needling (MTrP-DN) within a multimodal rehabilitation protocol following RCR surgery. METHODS: Forty-six participants aged 40-75 will be recruited having postoperative shoulder pain after RCR and meeting the inclusion criteria. Participants will be randomly divided into 2 groups: One group will undergo MTrP-DN, manual therapy, exercise therapy and electrotherapy and the other will receive sham dry needling (S-DN), manual therapy, exercise therapy and electrotherapy. This protocol will cover 4 weeks of intervention. The primary outcome measure will be the Numeric Pain Rating Scale (NPRS) for pain. Secondary outcome measures will be Shoulder Pain and Disability Index (SPDI), range of motion (ROM), strength and adverse events. DISCUSSION: This is the first study to investigate the use of 4 sessions of MTrP-DN in combination with a multimodal rehabilitation protocol for postoperative shoulder pain, restriction, weakness and dysfunction following RCR. The results of this study may help to determine the effect of MTrP-DN on various outcomes after RCR surgery. TRIAL REGISTRATION: This trial was registered at the ( https://www.irct.ir ), (IRCT20211005052677N1) on 19/2/2022.

Treatment of postsurgical trigeminal neuralgia with Fu's subcutaneous needling therapy resulted in prompt complete relief: Two case reports.

RATIONALE: Trigeminal neuralgia is a recurrent unilateral transient electroshock-like pain. Fu's subcutaneous needling (FSN), used to treat the musculoskeletal problems, has not been reported in this field. PATIENT CONCERNS: The pain extent of case 1 had no reduction after the previous microvascular decompression, the pain of case 2 relapsed 4 years after the microvascular decompression. DIAGNOSES: Postsurgical trigeminal neuralgia. INTERVENTIONS: FSN therapy was applied on the muscles around the neck and face area, which the myofascial trigger points were palpated in these muscles. The FSN needle was inserted into the subcutaneous layer and the needle tip was pointed toward the myofascial trigger point. OUTCOMES: The following outcome measurements were observed before and after treatment, including numerical rating scale, Barrow Neurology Institute Pain Scale scores, Constant Face Pain Questionnaire scores, Brief Pain Inventory-Facial scores, Patient Global Impression of Change scores, and medication dosage. The follow-up surveys were made after 2 and 4 months respectively. The pain of Case 1 was significantly reduced after 7 times FSN treatments and the pain of Case 2 was even disappeared after 6 times FSN treatments. LESSONS: This case report suggested that FSN can relieve postsurgical trigeminal neuralgia safely and effectively. Clinical randomized controlled studies are needed to be further conducted.

Procedimentos estéticos com ênfase na queda capilar / Aesthetic procedures with emphasis on hair loss / Procedimientos estéticos con énfasis en la caída del cabello

A beleza está diretamente ligada ao aspecto dos cabelos, em todos os tempos e todas as culturas. O cabelo ao longo da vida é sujeito a vários tipos de mudanças, sejam elas naturais ou artificiais, conduzidas por uma vontade de mudar, muitas vezes, seja por representar uma nova fase, como também é símbolo de autocuidado, vaidade, sucesso, possuem significativa importância na aparência e autoestima das pessoas e, por isso, a queda capilar pode atingir a qualidade de vida do indivíduo. Neste sentido, o objetivo deste estudo foi avaliar procedimentos estéticos minimamente invasivos e não cirúrgicos com ênfase na queda capilar. Para tanto, foi realizada uma revisão bibliográfica integrativa, de caráter descritivo nas principais bases de dados em saúde: SciELO, Google Acadêmico, PubMed e livros de medicina, nos idiomas português, inglês e espanhol, considerando o período de 2007 a 2022. De acordo com o último censo da Sociedade Brasileira de Dermatologia, a queixa de alopecia está entre as dez mais frequentes nos consultórios dermatológicos. As doenças capilares mais importantes estão divididas em dois grupos, as cicatriciais quando a perda de cabelo é acompanhada por cicatrizes resultando em calvície permanente, e as não cicatriciais onde a calvície não é permanente levando a diminuição e o afinamento gradual do cabelo. A alopecia não cicatricial é a mais frequente e as mais comuns entre elas são a alopecia androgenética e o eflúvio telógeno. Muitos pacientes procuram tratamento para melhorar a aparência e a autoestima, que podem estar relacionados a quadros de ansiedade e depressão. Esses tratamentos devem ser individualizados, onde se deve avaliar as características individuais de cada paciente. Os tratamentos capilares estéticos podem contribuir de forma significativa para a redução da baixa autoestima, contribuindo para recuperação da autoconfiança através do crescimento capilar proporcionado pela estética. Sendo assim, conclui-se que os resultados coletados na revisão de literatura foram satisfatórios, de forma onde mostra que os medicamentos, suplementos e tratamentos estéticos na queda capilar vem evoluindo cada vez mais. Contudo, mais estudos acerca do assunto são necessários.

Beauty is directly linked to the appearance of hair, in all times and all cultures. Hair throughout life is subject to various types of changes, whether natural or artificial, driven by a desire to change, often because it represents a new phase, as it is also a symbol of self-care, vanity, success, they have significant importance in people's appearance and self-esteem and, therefore, hair loss can affect the individual's quality of life. In this sense, the objective of this study was to evaluate minimally invasive and non- surgical aesthetic procedures with an emphasis on hair loss. To this end, an integrative bibliographic review was carried out, of a descriptive nature, in the main health databases: SciELO, Google Scholar, PubMed and medical books, in Portuguese, English and Spanish, considering the period from 2007 to 2022. According to the latest census by the Brazilian Society of Dermatology, the complaint of alopecia is among the ten most frequent complaints in dermatological offices. The most important hair diseases are divided into two groups, scarring when hair loss is accompanied by scars resulting in permanent baldness, and non-scarring where baldness is not permanent leading to gradual thinning and thinning of the hair. Non-scarring alopecia is the most frequent and the most common among them are androgenetic alopecia and telogen effluvium. Many patients seek treatment to improve their appearance and self-esteem, which may be related to anxiety and depression. These treatments must be individualized, where the individual characteristics of each patient must be evaluated. Aesthetic hair treatments can contribute significantly to reducing low self-esteem, contributing to the recovery of self-confidence through hair growth provided by aesthetics. Therefore, it is concluded that the results collected in the literature review were satisfactory, in a way that shows that medicines, supplements and aesthetic treatments in hair loss have been evolving more and more. However, more studies on the subject are needed.

La belleza está directamente ligada al aspecto del cabello, en todos los tiempos y en todas las culturas. El cabello a lo largo de la vida está sujeto a diversos tipos de cambios, ya sean naturales o artificiales, impulsados por un deseo de cambio, a menudo, ya sea para representar una nueva etapa, como también es un símbolo de auto- cuidado, la vanidad, el éxito, tienen una importancia significativa en la apariencia y la autoestima de las personas y, por lo tanto, la pérdida del cabello puede afectar la calidad de vida del individuo. En este sentido, el objetivo de este estudio fue evaluar los procedimientos estéticos mínimamente invasivos y no quirúrgicos con énfasis en la pérdida de cabello. Para ello, se realizó una revisión bibliográfica descriptiva integradora en las principales bases de datos de salud: SciELO, Google Scholar, PubMed y libros de medicina, en portugués, inglés y español, considerando el período de 2007 a 2022. Según el último censo de la Sociedad Brasileña de Dermatología, la queja de alopecia está entre las diez más frecuentes en las consultas de dermatología. Las enfermedades capilares más importantes se dividen en dos grupos, las cicatriciales, cuando la caída del cabello va acompañada de cicatrices que dan lugar a una calvicie permanente, y las no cicatriciales, cuando la calvicie no es permanente, dando lugar a un adelgazamiento y reducción gradual del cabello. Las alopecias no cicatriciales son las más frecuentes y entre ellas destacan la alopecia androgenética y el efluvio telógeno. Muchos pacientes buscan tratamiento para mejorar su aspecto y autoestima, que pueden estar relacionados con la ansiedad y la depresión. Estos tratamientos deben ser individualizados, donde se deben evaluar las características individuales de cada paciente. Los tratamientos capilares estéticos pueden contribuir significativamente a la reducción de la baja autoestima, contribuyendo a la recuperación de la confianza en uno mismo gracias al crecimiento del cabello que proporciona la estética. Por lo tanto, se concluye que los resultados recogidos en la revisión bibliográfica fueron satisfactorios, mostrando que los medicamentos, suplementos y tratamientos estéticos para la caída del cabello están evolucionando cada vez más. Sin embargo, son necesarios más estudios sobre el tema.

Comparison of the effectiveness of dry needling and high-intensity laser therapy in the treatment of myofascial pain syndrome: a randomized single-blind controlled study.

Myofascial pain syndrome (MPS) is a very common disease in the population that seriously affects quality of life. Although many treatment modalities are used, there is still no common protocol. The aim of this study was to compare the effectiveness of high-intensity laser therapy (HILT) and dry needling options. This prospective study included 108 patients with neck and/or upper back pain, diagnosed with MPS, who were randomly separated into 3 groups: the exercise group, the exercise + HILT group (HILT group), and the exercise + dry needling group (needling group). The visual analog scale (VAS), neck disability index (NDI), short form-36 (SF-36) scores, and neck range of motion (ROM) values of the patients before and after treatment were recorded and compared between the groups. In all 3 groups, the VAS and NDI scores decreased and ROM levels increased after treatment. The results in the HILT and needling groups were statistically significantly better than those of the exercise group (p < 0.05).The addition of HILT and dry needling to exercises is seen as a more successful treatment option to reduce pain in MPS. Clinical trial registration number: NCT05078333.

Dry needling for the treatment of acute myofascial pain syndrome in general practitioners' clinics: a cohort study.

BACKGROUND: Musculoskeletal pain is one of the leading complaints in the ambulatory setting. There are many ways to treat it, including pharmacologic and non-pharmacologic approaches. Dry needling (DN) is an option that is easy to learn, cheap and has a good safety profile. The aim of this study was to assess the association between DN performed by GPs for acute myofascial pain syndrome (MPS) and pain relief and to evaluate factors associated with treatment success. METHODS: In this prospective cohort study, two GPs performed DN in their clinics. Patients were asked to rank their pain using the Short-Form McGill Pain Questionnaire (SF-MPQ) before, 10-min and 1-week after the procedure. The SF-MPQ index consists of 3 parts; visual analog scale (VAS), pain rating index (PRI) and present pain intensity (PPI). Logistic regressions were performed to assess the variables associated with short- and medium- term success. RESULTS: Fifty two patients were recruited from September 2019 until August 2020. VAS was 6.0 ± 2.3 (before), 4.1 ± 2.5 (10-min after) and 2.6 ± 2.71 (1-week after), P < 0.05. PRI was 17 ± 9.1 (before), 10.8 ± 8.5 (10-min after) and 5.1 ± 6.5 (1-week after), P < 0.05. PPI was 2.6 ± 1.0 (before), 1.7 ± 1.0 (10-min after) and 1.1 ± 1.2 (1-week after), P < 0.05. Short-term success was associated with the physician who performed the procedure (OR 10.08, 95% CI 1.15,88.4) and with the use of a single needle (vs. multiple needles inserted) (OR 4.55, 95% CI 1.03,20.11). Medium-term success was associated with being a native born (non-immigrant), OR 8.59, 95% CI 1.11,66.28 and with high level of initial pain, OR 11.22, 95% CI 1.82,69.27. CONCLUSION: Our study demonstrated improvement in acute pain 10-min and 1-week after DN performed by a GP, in all parts of the SF-MPQ. Therefore, we believe DN is a good therapeutic option for GPs to aid patients suffering from MPS.

Ultrasound-Guided Dry Needling for Trigger Point Inactivation in the Treatment of Postherpetic Neuralgia Mixed with Myofascial Pain Syndrome: A Prospective and Controlled Clinical Study.

Objective: To evaluate the safety and effectiveness of ultrasound-guided dry needling for trigger point inactivation in the treatment of postherpetic neuralgia (PHN) mixed with myofascial pain syndrome (MPS). Methods: A prospective and controlled clinical study was conducted. From January 2020 to December 2020, among the 100 patients who received PHN treatment in the pain department, 54 patients complicated with MPS were randomly divided into the dry needling group D (n = 28) and pharmacotherapeutic group P (n = 26). Visual analogue score (VAS) and McGill Pain Questionnaire (MPQ) were taken as primary indicators. Ultrasound-guided inactivation of myofascial trigger points (MTrPs) with dry needling and intradermal needling combined with press needling were applied on group D and pharmacotherapeutic only treatment on group P respectively. The VAS score <3 and/or the MPQ score <2 represents effective treatment. The VAS score >3 and/or the MPQ score >2 represents recurrent in follow-up study three months after the treatment. Results: After four weeks treatment, the effective rate of one month later of the group D was 92.9% and the effective rate of group P was 38.5%, respectively. The recurrent rate of group D was 7.1% and 34.6% for group P, respectively, for follow-up three months later. The satisfactory rate of group D was higher than that of group P. Conclusion: Ultrasound-guided dry needling and intradermal needling combined with press needling were more effective than only pharmacotherapeutic treatment for PHN mixed with MPS, with lower recurrent rate and higher patient's satisfactory rate.

Long-acting microneedle patch loaded with adipose collagen fragment for preventing the skin photoaging in mice.

Skin photoaging is one of the most serious public health problems in the 21st century that may lead to thin, saggy, and structurally weakened skin. Adipokine therapy toward skin photoaging is always associated with poor permeability, biologic stability and the short in vivo release duration. Our laboratory previously extracted an extracellular matrix component of adipose tissue by purely physical methods, namely "adipose collagen fragment (ACF)", which holds promise for preventing skin photoaging. However, the injection treatment of ACF requires repeated preparation processes and injection procedures, which may be time-consuming and painful. Therefore, we describe the fabrication and assessment of a detachable ACF-microneedle (ACF-MN) patch that creates minimally invasive dermal microtrauma upon application. And we evaluated the morphology characterization, mechanical properties and puncture performance in vitro. The delivery efficiency of ACF from the patches was estimated in vitro and vivo. Then, the therapeutic efficacy was identified through applying ACF-MN patches into the dermis of UVA-induced photoaging mice and the related detection of skin photoaging was estimated. Our results demonstrated that ACF-MN exhibited well skin puncture performance and could release ACF component slowly. Meanwhile, this microneedle device loaded with ACF exhibited the treatment efficiency on skin photoaging in a mouse model. Therefore, implantation of the microtrauma-mediated, long-acting ACF-MN system can be utilized as a potential candidate for preventing skin photoaging in the clinic.

Efficacy of Dry Needling and Acupuncture in Patients with Fibromyalgia: A Systematic Review and Meta-Analysis.

Fibromyalgia (FM) is a syndrome that involves chronic pain, fatigue, sleep disturbance and impaired quality of life and daily functioning. In addition to medical and psychological therapies, other therapies including acupuncture and dry needling aim to reduce pain and disability in patients with FM. The aim of this study was to investigate the efficacy of dry needling and acupuncture in patients with FM regarding pain, function and disability in both the short and the long term. MEDLINE, PubMed, SCOPUS and Web of Science databases were systematically searched for randomized controlled trial studies evaluating efficacy data of dry needling or/and acupuncture treatments to improve pain, fatigue, sleep disturbance and impaired quality of life and/or daily function. A qualitative analysis including the methodological quality and a systematic data synthesis was performed. A total of 25 studies addressed the selection criteria. Most studies had an acceptable methodological quality. Four studies assessed the effect of dry needling, and twenty-one studies assessed the effect of acupuncture. In general, both interventions improved pain, anxiety, depression, fatigue, stiffness, quality of sleep and quality of life. However, both techniques were not compared in any study. Acupuncture and dry needling therapies seems to be effective in patients with FM, since both reduced pain pressure thresholds, anxiety, depression, fatigue, sleep disturbances and disability in the short term. It is still required to compare both techniques and their application in the long term.