Expert consensus on perioperative integrated skincare for noninvasive energy-based device aesthetic procedures in clinical practice in China.

BACKGROUND: Noninvasive energy-based device (NI-EBD) aesthetic procedures has recently gained widespread usage for treating various skin conditions, enhancing skin texture and performing rejuvenation-related procedures. However, practically all NI-EBD procedures result in variable degrees of damage to the skin barrier, inducing pathological and physiological processes such as oxidative stress and inflammation, and only a small percentage of individuals possess the innate ability to restore it. OBJECTIVE: To introduce the concept of integrated skincare and establish standardized operational procedures for perioperative integrated skincare, and furnish a theoretical basis for clinical diagnosis and treatment performed by professional medical aestheticians. METHODS: The author leveraged domestic and international guidelines, clinical practice expertise and evidence-based research, adapting them to suit the specific circumstances in China. RESULTS: The consensus were provided four parts, including concept and essence of integrated skincare, integrated skincare significance during the perioperative phase of NI-EBD procedures, active ingredients and functions of effective skincare products, standardized perioperative skincare procedure for NI-EBD procedures and precautions. For the standardized perioperative skincare procedure, four recommendations were listed according to different stages during NI-EBD procedures. CONCLUSION: These recommendations create the 'Expert Consensus on Perioperative Integrated Skincare for Noninvasive Energy-Based Device Aesthetic Procedures in Clinical Practice in China'.

Intense pulsed light, near infrared pulsed light, and fractional laser combination therapy for skin rejuvenation in Asian subjects: a prospective multi-center study in China.

Ablative skin rejuvenation therapies have limitations for Asian people, including post-inflammatory hyperpigmentation and long down time. Non-ablative lasers are safer but have limited efficacy. This study is to investigate the safety and efficacy of a combination therapy consisting of intense pulsed light (IPL), near infrared (NIR) light, and fractional erbium YAG (Er:YAG) laser for skin rejuvenation in Asian people. This study recruited 113 subjects from six sites in China. Subjects were randomly assigned to a full-face group, who received combination therapy, and split-face groups, in which one half of the face received combination therapy and the other half received IPL monotherapy. Each subject received five treatment sessions during a period of 90 days. Subjects were followed up at 1 and 3 months post last treatment. Three months after last treatment, the full-face group (n = 57) had a global improvement rate of 29 % and 29 % for wrinkles, 32 % for skin texture, 33 % for pigment spots, 28 % for pore size, respectively. For patients in the split-face groups (n = 54), monotherapy side had a global improvement rate of 23 % and 20 % for wrinkles, 27 % for skin texture, 25 % for pigment spots, 25 % for pore size, respectively. Both combination therapy and monotherapy resulted in significant improvements at the follow-up visits compared to baseline (P < 0.001). Combination therapy showed significantly greater improvements compared to monotherapy at two follow-up visits (P < 0.05). Combination therapy is a safe and more effective strategy than IPL monotherapy for skin rejuvenation in Asian people.

Effects of intense pulsed light and ultraviolet A on metalloproteinases and extracellular matrix expression in human skin.

OBJECTIVE: The aim of this study was to evaluate the effects of intense pulsed light (IPL) and ultraviolet A (UVA) irradiation on the expression of matrix metalloproteases (MMPs), tissue inhibitor of metalloproteinase 1 (TIMP-1), and extracellular matrix (ECM) in human skin, and to confirm the relative mechanism. BACKGROUND DATA: IPL has been widely used to treat photoaged skin but the underlying mechanism remains unknown. METHODS: Human buttock skin was irradiated by repetitive suberythemal doses of UVA and therapeutic doses of IPL. Skin biopsies were taken and the protein/mRNA expression of MMP-1, -3, -9, and -12 and TIMP-1 was examined by immunohistochemistry, image analysis, and real-time quantitative polymerase chain reaction (qRT-PCR). RESULTS: Compared with normal control skin, both IPL and UVA irradiation induced a general elevation of MMP-1, -3, -9, and -12 and TIMP-1 at protein/mRNA levels, with some differences in the MMP expression patterns, e.g., a remarkable increase of MMP-1, -3, and -12 in UVA-exposed skin, while lower MMP-1, -3, and -12 (p < 0.01, p < 0.01, p < 0.01) but higher MMP-9 (p < 0.05) levels in IPL-irradiated skin. Meanwhile, increased collagen I fibers (p < 0.05) were observed in IPL-irradiated skin, whereas fragments of elastic fibers were found in UVA-exposed skin. CONCLUSION: These findings demonstrated that IPL has similar effects on the expression of MMPs/TIMP-1 in human skin to UVA, but the expression pattern differed from that in UVA-exposed skin, which may account for IPL's photorejuvenation effects.