Long-term effect of azelaic acid peel on sebum production in acne.

Seborrhea and the associated oily skin are undoubtedly the problem of women and men around the world. The pathogenesis of acne vulgaris involves excessive activity of sebaceous glands, as well as disturbances in the composition of sebum. The aim of the study was to assess the severity of seborrhea in a group of acne vulgaris patients and to determine the effect of a 20% azelaic acid solution on the activity of sebaceous glands. Twenty seven women, aged 19-25 years, underwent a series of six treatments with the application of a 20% solution of azelaic acid to the face. The mean values of sebum level showed a decreasing tendency. On the forehead, the results were as follows-195.5 before the treatment and 162.7 2 weeks after the last treatment. Measurements of the right cheek decreased from 175.3 to 141.3 The measurements taken 3 months after the study were 151.3 on the forehead and 138.9 on the cheek. Similarly, the values determining the total number of acne lesions and the severity of the disease according to the IGA scale also changed significantly. Chemical peel with 20% azelaic acid shows long-term sebostatic action, which inhibits the formation of new acne lesions.

A blinded study assessment of the efficacy of an original formula with retinol in combination with sonophoresis.

An appropriately designed cosmetic product and regimen of treatment can improve facial skin appearance and provide good tolerability. The aim of the study was to evaluate the effect of 0.3 and 0.5% retinol in liquid crystal formula, applied with sonophoresis, on mature skin. Serum with various concentrations of retinol was applied to the left and right sides of the face and treated with ultrasound. The treatments were performed once a week for a period of 7 weeks. The skin condition before and after treatment was compared using the Fotomedicus system. The Visual Analogue Scale method enabled the results to be assessed by three independent specialists. The Multi Probe Adapter system was used to evaluate the efficacy of a series of treatments. Subjective assessment of volunteers identified perceived improvement of skin conditions. In addition, treatment was associated with greater skin moisture level, reduced wrinkling and decreased skin discoloration. Mild side effects appeared mainly after the first treatment and on the left side of the face with 0.5% retinol. More significant results may be obtained by extending the treatment duration in longer-term studies. Nonetheless, the findings confirmed the effectiveness of the procedures.

A Clinical Anti-Ageing Comparative Study of 0.3 and 0.5% Retinol Serums: A Clinically Controlled Trial.

BACKGROUND: Retinol influences the process of keratinization of the epidermis, which improves stratum corneum structure and reduces transepidermal water loss. It also significantly enhances mature skin by brightening hyperpigmentation and reducing the signs of photoageing. Cosmeceuticals are intended to both provide aesthetic effects for the skin and allow dermatological treatment. The aim of the study was to assess the rejuvenating effect of retinol serum on facial skin at concentrations of 0.3 and 0.5%, as well as any improvements in skin brightening and elasticity. MATERIALS AND METHODS: Thirty-seven volunteers were included in the study, after confirming tolerance. The novel formula was applied once daily to the face for a period of 12 weeks: one retinol concentration on the left side and the other on the right. The initial study with liquid crystal formula (study vehicle) was carried out for 8 weeks on 28 volunteers. Treatment efficiency was evaluated at baseline, and 56 and 84 days following treatment using the multi probe adapter and Fotomedicus imaging system. PRIMOS was used to measure skin surface roughness. The visual analogue scale method enabled the results to be determined by 3 independent specialists. RESULTS: Skin hyperpigmentation, unevenness, and wrinkles gradually decreased over the course of treatment, both on the left and right parts of the face. Adverse events were predominantly mild or moderate skin irritation. More frequent and more intense symptoms were observed on the left side (0.5%). CONCLUSION: Retinol in liquid crystal formulation is safe and provides significant clinical benefits associated with unification of skin colour, overall skin tone, skin elasticity, and moisture. Regular use of retinol typically results in brightening of the skin and reduced signs of ageing. The objective findings confirmed the effectiveness of the procedures.

Light-emitting diodes in photodynamic therapy in non-melanoma skin cancers--own observations and literature review.

Photodynamic therapy (PDT) employs light activation of tissue-localized photosensitizer in an oxygen-dependent process which initiates oxidative stress, inflammation, and cell death. There are many indications for PDT, although the main ones are still non-melanoma skin cancers. The light sources used include coherent and non-coherent ones, but we would like to focus on the use of light-emitting diodes (LED) in PDT. We present four patients with skin lesions successfully treated with LED-based photodynamic therapy. The main advantage of that source is narrow emission spectrum that can correspond well with maximum absorption photosensitizers. Also, using LED source seems to be cheaper and simpler, and the field of irradiation is larger. The data showed good clinical and cosmetic outcome of LED-based PDT in actinic keratosis, basal cell carcinoma, and Bowen's disease. Since these diseases often appear on sun-exposed skin, aesthetic results are very important. The effect of LED treatment is as good or in some data even better than those in older types of PDT.

Variable pulsed light treatment of melasma and post-inflammatory hyperpigmentation - a pilot study.

Hyperpigmentation disorders are a serious aesthetic problem. Various therapies are applied to remove these lesions. The variable pulsed light (VPL) is similar to intense pulsed light (IPL), but instead of one flash of light, energy is provided in a few small and rapid micro-flashes. The aim of the study is a mexametric evaluation of results of the treatment of hyperpigmentation with the application of the VPL device as well as the patient's opinion on this kind of treatment. The therapy with the VPL was administered twice within a period of three weeks. In order to evaluate the effectiveness of the treatment procedure, we carried out the mexametric measurements three times. Eighteen women with hyperpigmentation disorders were included in the study. The lesions were lightened in thirteen patients. Three patients demonstrated more intensive hyperpigmentation. Twelve patients assessed the effects of the therapy as good and excellent. In the patients, in whom the initial mexametric results confirmed the strongest changes, the effect of the VPL therapy appeared to be the greatest. The obtained results allow claiming that the VPL method is effective for treating hyperpigmentation. The level of the patients' satisfaction after the therapy is equally important.

Ascorbic Acid Treatments as Effective and Safe Anti-Aging Therapies for Sensitive Skin.

The most common signs of aging skin include a decrease in firmness and density, uneven skin tone, and a tendency to erythema. There is an ever-increasing interest in aesthetic treatments that maintain the skin's favorable appearance. However, such therapies are difficult in the case of sensitive skin, defined as a set of stimuli-triggered symptoms (stinging, erythema, burning, and itching) that would not appear in healthy skin. Sensitive skin is common and affects, to varying degrees, about half of the European population. This study was aimed at evaluating the effects of ascorbic acid-a known antioxidant-applied with sonophoresis and microneedling on the signs of photoaging in reactive and erythematous skin. A significant improvement in skin elasticity was observed after a series of tests. A significant reduction in erythema was observed after both therapies. The greatest reduction was observed on the cheeks after applying vitamin C combined with microneedling. At the same time, the results showed an excellent tolerance of both treatments, which proved them to be safe and effective.

A Subjective and Objective Assessment of Combined Methods of Applying Chemical Peels and Microneedling in Antiaging Treatments.

Combined methods of applying chemical peels and antioxidants could be an option for skin rejuvenation with no down-time. The penetration of active substances can be enhanced by microneedle mesotherapy. The study was conducted on a group of 20 female volunteers, aged 40-65 years. All volunteers received a series of eight treatments performed every seven days. The whole face was first treated with azelaic acid; following this, the right side received a 40% solution of vitamin C and the left side 10% vitamin C with microneedling. Hydration and skin elasticity were markedly improved, with better results observed on the microneedling side. Melanin and erythema index decreased. No significant side effects were seen. The combination of active ingredients and delivery techniques have great potential to enhance the effectiveness of cosmetic preparations, probably by multidirectional ways of action. In our study, we demonstrated that both 20% azelaic acid + 40% vitamin C treatment and 20% azelaic acid + 10% vitamin C + microneedle mesotherapy efficiently improved the assessed parameters of aging skin. However, the use of microneedling mesotherapy as a means of direct delivery of active compound to the dermis enhanced the effectiveness of the studied preparation.

Expression of selected neuropeptides in pathogenesis of bullous pemphigoid and dermatitis herpetiformis.

Bullous pemphigoid (BP) and dermatitis herpetiformis (DH) are chronic subepidermal bullous diseases, which progress together with an itch and an inflammatory reaction. These symptoms may be the cause of a phenomenon described in the literature as a neurogenic skin inflammation. Neuropeptides are one of the mediators which take part in this process. The aim of our study was to indicate the expression of selected neuropeptides - CRF (corticotropin releasing factor), CGRP (calcitonin gene-related peptide), NKB (neurokinin B), SP (substance P) and the receptor for endothelin B (ETRB) - in the skin of patients suffering from BP or DH. A significantly increased expression of CRF was found in the specimen collected from the skin lesions of patients with BP and DH as well as a significantly increased expression of receptor for endothelin B in the patients with DH by the immunohistochemical method. The results obtained give evidence of a possible participation of CRF and receptor for endothelin B in the pathogenesis of the itch in the dermatitis herpetiformis as well as CRF in bullous pemphigoid.

Clinical evaluation of anti-aging effects of combined therapy-Azelaic acid, phytic acid, and vitamin C applied layer by layer in females with Fitzpatrick skin types II and III.

INTRODUCTION: Vitamins C, E, and A and substances of plant origin, including azelaic acid and phytic acid are frequently used in cosmetic preparations to counteract oxidative stress and negative effects of free radicals. The aim of the study was to evaluate a novel combined therapy consisting of azelaic acid, ascorbic acid, and phytic acid applied layer on layer. METHODS: Twenty study participants received a series of eight treatments performed every 7 days. Twenty percent azelaic acid and then 30% phytic acid were applied to the entire face, while 40% l-ascorbic acid only on the left side. The preparations were applied layer by layer. Skin parameters were measured before the series of treatments (T0), after the series of eight treatments (T1-8 weeks), and 1 month after the end of the treatment (T2-12 weeks). RESULTS: The application of two and three active compounds resulted in a significant improvement in erythema and hyperpigmentation both on the forehead and the cheeks, however, more pronounced effects were observed when all the three active compounds were used. Both applied types of treatment considerably increased skin moisture. All the participants (100%) were satisfied with the effects of the treatment. A majority of them reported an improvement in skin hydration, firmness, and elasticity, more uniform skin tone and a reduction of skin redness and wrinkles. CONCLUSIONS: Topical application of these active compounds resulted in improvement of skin elasticity and flexibility, reduction of wrinkles, hyperpigmentation, erythema, and telangiectasia as well as amelioration of skin tone.

[Vestibular system in patients with systemic sclerosis]. / Stan ukladu przedsionkowego u pacjentów z twardzina ukladowa.

OBJECTIVES: In systemic sclerosis (SSc) there may occur hearing and balance disorders as a result of the immune-mediated inner ear damage, the etiology being vasculitis and fibrosis. The objective is the vestibular organ evaluation in patients with SSc regarding their prevalence and relationship to duration of the disease and Raynaud phenomenon and also to type and severity of SSc. MATERIAL: Twenty unselected, consecutive patients with diagnosed SSc, complying with international diagnostic criteria of the American Rheumatism Association (1982), were enrolled into the study. The control group consisted of 26 otologically healthy persons matched to the SSc group for age and sex. METHODS: In all patients the questionnaire about audiovestibular history, otolaryngological examination, static and dynamic vestibular tests and the electronystsgmography (ENG) were performed. The patients were investigated with the electronystsgmography (ENG) for spontaneous, positional and caloric-induced nystagmus. Also visual ocular-motor tests were performer. RESULTS: In the anamnesis 65% of patients reported vertigo, 55% - headaches, 50% - tinnitus, 40% - hyperacusis, 40% - hearing loss and 30% - ear fullness. Vertigo, dizziness balance disturbance and uncorrect results of Romberg and Utenberger tests were more frequent in patients with vestibular organ lesion. Abnormalities in vestibular organ in SSc patients were fund in 14 (70%) persons - the central type of lesion - 8 (40%), mixed type in 3 (15%) and peripheral in 3 (15%). CONCLUSIONS: Ear involvement is frequent in systemic sclerosis and should be taken into consideration during diagnostic and therapeutic procedures.

The Anti-Acne Effect of Near-Infrared Low-Level Laser Therapy.

BACKGROUND: Acne vulgaris is a skin problem affecting many people of different ages. Phototherapy is one of the acne treatment options. The aim of the study was to assess the effect of near-infrared low-level laser therapy on acne lesions. MATERIALS AND METHODS: The prospective study involved a total number of 27 women, aged 18 to 45 years, with mild to severe acne. All the participants underwent a series of six treatments with the use of a 785 nm low-level laser with the power density 80mW/cm2, performed every two weeks. The analysis of the effectiveness of the performed procedures was based on sebumetric examination, photographic documentation and assessment of the change in the number of acne lesions. RESULTS: Significant improvements in acne lesions (assessed as non-inflammatory and inflammatory lesion counts) and a significant decrease in skin sebum excretion were observed after the treatment. No adverse effects were reported. CONCLUSION: A series of six treatments using a near-infrared low-level laser represents a safe and effective non-invasive therapy option for acne vulgaris.

Efficacy of 30% azelaic acid peel in the nonpharmacological treatment of facial acne.

BACKGROUND: Acne is a common, chronic, inflammatory disease of the pilosebaceous unit. It has a significant impact on patient quality of life, especially when lesions occur on cosmetically sensitive areas. Chemical peeling is a well-known option in the treatment of acne vulgaris, but little is known about azelaic acid (AZA) peels. OBJECTIVES: To determine the efficacy of 30% AZA peel, in decreasing the amount of secreted sebum, and reducing acne lesions. METHODS: The study involved 35 women, with acne lesions on face skin. All the subjects underwent a series of six treatments, performed every 2 weeks. RESULTS: A series of treatments contributed to a statistically significant reduction in the amount of secreted sebum. Similarly, highly significant values determining the overall number of acne lesions and the severity of the disease according to the IGA scale were also changed. The procedure was well tolerated by all participants. CONCLUSIONS: Peels with 30% AZA reduced acne lesions and normalized the activity of the sebaceous glands. The reduction of sebum allows us to believe that obtained good results in patients will be stable and long-lasting.

How has the pandemic lockdown changed our daily facial skincare habits?

BACKGROUND: During the COVID-19 pandemic, Poland implemented widespread closure of beauty and cosmetic services to control the virus spread. AIMS: The aim of this study was to investigate the impact of the SARS-CoV-2 pandemic on home face care of women and to analyze changes that have occurred in their daily habits. PATIENTS/METHODS: An online survey was completed by 412 women living in Poland during the spring lockdown. Questions addressed changes in face care during the COVID-19 pandemic. RESULTS AND CONCLUSIONS: Our questionnaire showed that during the lockdown, women were more interested in face skincare, more often followed the procedure of full home skincare. And after implementing the changes in skincare, they saw a good impact on their skin. The significance of the Internet also increased considerably, not only as a source of knowledge in the field of cosmetology but also as a thriving market selling cosmetic products.

Comparison of hair reduction by intensive pulsed light device and combined intense pulsed light with a bipolar radiofrequency.

BACKGROUND: Photoepilation has become a very popular epilation procedure in esthetic and cosmetic practice. There are some types of lasers and other light sources used for epilation. AIMS: The purpose of our study was to compare an IPL device with an IPL plus RF in one device, using a within-patient, right-left controlled study design. PATIENTS/METHODS: Thirty-three patients completed four treatment sessions and the follow-up period of the study. RESULTS: Hair reduction was effective after the first treatment, but similar results were achieved using the IPL system alone, and with IPL combined with RF. The degree of hair reduction increased after the following treatments, but the two methods yielded similar effects. Three months after the last treatment, some hair had regrown in both treatments, the combined IPL with RF treatment gave significantly better results than the IPL treatment alone. CONCLUSIONS: In conclusion, IPL and IPL-RF are effective hair reduction therapies, yielding similar effects in patients with skin phototypes II or III. However, IPL-RF can be more effective in long-term observations. These therapies are also safe and regarded be quite comfortable in this population.

Expression of selected adhesion molecules in dermatitis herpetiformis and bullous pemphigoid.

Dermatitis herpetiformis (DH) and bullous pemphigoid (BP) are autoimmune diseases characterized by destruction of the basement membrane zone (BMZ) and anchoring fibres by autoantibodies and infiltration. Adhesion molecules can take part in these phenomena. Skin biopsies were taken from 13 patients with DH, 21 with BP, and from 10 healthy subjects. The localization and expression of E and L selectins and beta1, beta3, beta4 integrins were studied by immunohistochemistry. Expression of selectins was detected mainly in the skin leukocytes in all samples. Expression of beta1, beta3 integrins was detected mainly in basal keratinocytes. Expression of beta 4 integrin was irregular and detected mainly in the blister. Our results suggest that integrins and selectins may play an important role in the destruction of BMZ in DH and BP. The elucidation of the role of adhesion molecules in the pathogenesis of bullous diseases may be helpful in the development of new targeted therapies.

An evaluation of the antiaging properties of strawberry hydrolysate treatment enriched with L-ascorbic acid applied with microneedle mesotherapy.

BACKGROUND: Mature skin is characterized by a loss of elasticity, hyperpigmentation, and dehydration. L-ascorbic acid stimulates the synthesis of collagen type I, inhibits melanogenesis, and helps to maintain correct skin hydration. Combining microneedle mesotherapy with the application of preparations rich in vitamin C results in better therapeutic effects due to the improved absorption of active substances. The study evaluates the effectiveness of the application of strawberry hydrolysate enriched with L-ascorbic acid using microneedle mesotherapy. MATERIALS AND METHODS: Seventeen volunteers aged 45-70 years underwent a series of four microneedle mesotherapy treatments with vitamin C serum, performed every 10 days. The 20% L-ascorbic acid solution (pH = 3.5) was prepared immediately before application. After the treatment, the participants gave a subjective assessment of the effectiveness. Cutometer® was used to measure skin elasticity and firmness, Corneometer® to measure skin hydration, and Mexameter® skin tone. RESULTS: The results of the survey showed improvements in skin hydration and elasticity. In vivo studies confirmed the effectiveness of serum and the impact of the active substance on skin firmness and elasticity, the degree of hydration and skin tone. CONCLUSION: Microneedling with vitamin C improves skin tone, hydratation and firmness, and decreases the visibility of hyperpigmentation.

Preliminary randomized controlled trial of antiaging effects of l-ascorbic acid applied in combination with no-needle and microneedle mesotherapy.

BACKGROUND: The epidermis is keratinized stratified squamous epithelium covered by hydro-lipid barrier. Vitamin C is a water-soluble antioxidant which protects skin from oxidative damage and rejuvenates photo-aged skin. There are different options of improving active substance penetration through the stratum corneum of the epidermis. One of them is noneedle mesotherapy which is a non-invasive rejuvenation technique involving electric pulses, electroporation, and ultrasounds. The use of these physicals factors results in deeper penetration of active ingredients. The other one is micro-needle mesotherapy which is nonsurgical therapy, which could cause the controlled inflammation. Micro channels are formed by needles during the skin puncture, that facilitate penetration of the active ingredients. AIMS: The aim of the study was to assess the efficacy of L-ascorbic acid applied in combination with no-needle and micro-needle mesotherapy in anti-aging therapy. MATERIALS AND METHODS: This study involved 17 healthy volunteers, 2.5 ml of serum containing 20% L-ascorbic acid with hydrate from strawberries was used topically in every of 4 treatments. No-needle mesotherapy was applied on the left half of the face while microneedle mesotherapy in combination with the same serum was performed on the right half of face. RESULTS: In vivo studies confirmed the effectiveness of both methods. CONCLUSION: The impact of active substance on skin firmness and elasticity as well as the degree of hydration and skin tone was more efficient after micro-needle mesotherapy.

The evaluation of elasticity after nonablative radiofrequency rejuvenation.

BACKGROUND: Laxity and rhytides are manifestations of photodamage on the face and chest. Nonablative radiofrequency (RF) is one of the most common procedures used for skin rejuvenation. AIM: The aim of this study was to assess the elasticity of face and chest skin after multipolar radiofrequency. PATIENTS/METHODS: Thirty women, aged 43-68, were included in the study. Twenty women were postmenopausal and 10 were premenopausal. They received 4 treatment sessions with an application of nonablative radiofrequency in 2-week intervals. Biomechanical properties of the skin were measured with the use of a Cutometer. RESULTS: The objective evaluation in a cutometric analysis showed a statistically significant improvement between measurements taken in the pretreatment period and 3 months after the treatment. CONCLUSIONS: The study is an objective confirmation that RF treatment improves skin elasticity. The method may appear to be beneficial for women of any age and skin types. It is a noninvasive treatment with a low risk of complications.

Expression of selected integrins and selectins in bullous pemphigoid.

Blister development in bullous pemphigoid (BP) results from destruction of hemidesmosomes and basement membrane components within the dermoepidermal junction by autoantibodies. Adhesion molecules can take part in pathogenesis of this disease. The aim of the study was to determine the localization and expression of L- and E-selectins and beta1, beta3, and beta4 integrins by immunohistochemistry in skin lesions of 21 patients with BP, compared with 10 healthy subjects. Expression of L and E selectins and beta1, beta3 integrins was detected mainly in basal keratinocytes and in inflammatory infiltrates in the dermis, expression of beta4 integrin was irregular and was detected mainly in dermal part of the blister, while in the control group only weak and single expression of the examined molecules was detected in basal keratinocytes and endothelium cells. The obtained results reveal the important role of selected selectins and integrins in development of skin lesions in BP.

Auditory function in patients with systemic lupus erythematosus.

OBJECTIVE: Patients with systemic lupus erythematosus (SLE) may develop hearing and balance disorders as a result of the immune-mediated inner ear damage due to vasculitis or ototoxicity of drugs used in SLE treatment. The aim of the study was evaluation of the hearing organ disorders in patients with SLE with particular regard to their prevalence and relationship to duration and severity of disease. The severity was assessed from involvement of organs that resulted in poorer SLE outcome, i.e. kidneys and central nervous system (CNS), and from the presence of antibodies associated with unfavourable SLE prognosis. METHODS: Thirty-five unselected, consecutive patients (33 women, two men, mean age 47.8 years) with SLE diagnosed in compliance to the international diagnostic criteria of the American Rheumatism Association (1982) were enrolled into the study. The control group consisted of 30 otologically healthy persons matched to the SLE group for age and sex. Case history was recorded for all patients from questionnaire data and laryngological examinations were performed, followed by pure-tone, speech and impedance audiometry and auditory brainstem response audiometry (ABR). RESULTS: In the anamnesis 71.4% of patients reported vertigo, 62.9% headaches, 40% tinnitus, 25.7% hyperacusis, 17.1% hearing loss and 2.9% ear fullness. It was found that SLE patients had a significantly poorer mean hearing thresholds than the control group for all frequencies, except for 500; 2000 and 4000 Hz. Longer ABR latency averages were observed in the group of SLE patients compared to control. Ten patients (28.6%) developed high-frequency and symmetric sensorineural hearing loss (SNHL). Significant positive correlation between mean air-conduction hearing thresholds and SLE duration (r = 0.46, p < 0.001) was found. After taking age into consideration, hearing acuity in SLE was related to duration of disease in younger patients. Furthermore, no relation was seen between hearing level and severity of disease. CONCLUSIONS: Auditory system involvement ought to be considered as one of elements of the clinical picture of systemic lupus erythematosus while determination of its character, original or secondary, requires further research.