Effective treatment of corticosteroid-induced facial erythema using fractional radiofrequency microneedling.

OBJECTIVES: To investigate the efficacy of Fractional Radiofrequency Microneedling (FRM) in treating corticosteroid-induced facial erythema. METHODS: A retrospective study was conducted involving eight patients diagnosed as corticosteroid-induced facial erythema. Each patient underwent a single session of FRM. Evaluative measures included Clinician's Erythema Assessment (CEA), Patient's Self-Assessment (PSA), assessment of telangiectasia severity, procedure-associated pain (10-point scale), patient satisfaction (3-point scale) and secondary outcomes. RESULTS: The study found a 75% success rate and 100% effectiveness rate in alleviating erythema symptoms. CEA and PSA scores decreased by 67.7% and 78.1%, respectively. No cases of erythema rebound were recorded during the 3-month follow-up period. CONCLUSIONS: FRM demonstrated effectiveness and safety in treating facial erythema, offering promising advancement in dermatologic therapeutics.

Occupational dermatitis to facial personal protective equipment in health care workers: A systematic review.

BACKGROUND: Prolonged wear of facial protective equipment can lead to occupational dermatoses. OBJECTIVE: To identify important causes of occupational dermatoses from facial protective equipment. METHODS: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed using PubMed and Embase databases. Articles were included if they reported occupational dermatoses caused by surgical/procedure masks or N95 respirators, or both. RESULTS: We identified 344 articles, and 16 were suitable for inclusion in this review. Selected articles focused on facial occupational dermatoses in health care workers. Allergic contact dermatitis to the elastic straps, glue, and formaldehyde released from the mask fabric was reported. Irritant contact dermatitis was common on the cheeks and nasal bridge due to pressure and friction. Irritant dermatitis was associated with personal history of atopic dermatitis and prolonged mask wear (>6 hours). Acneiform eruption was reported due to prolonged wear and occlusion. Contact urticaria was rare. LIMITATIONS: Only publications listed in PubMed or Embase were included. Most publications were case reports and retrospective studies. CONCLUSION: This systematic review from members of the American Contact Dermatitis Society highlights cases of occupational dermatitis to facial protective equipment, including potential offending allergens. This work may help in the diagnosis and treatment of health care workers with facial occupational dermatitis.

Novel Facial Treatment Regimen Improves Aging Skin Appearance.

BACKGROUND: Skin care regimens with multiple active ingredients offer a multimodal approach to anti-aging treatments. OBJECTIVE: The objective of this research was to investigate the efficacy of a multimodal skincare regimen on facial skin appearance after 12 weeks of twice daily use as compared to baseline. METHOD: 35 healthy female subjects 35–65 years of age of Fitzpatrick skin types I–III with mild to moderate facial photoaging characterized by hyperpigmentation were enrolled. Subjects were seen at baseline, week 6, and week 12, and underwent subject and investigator assessments along with noninvasive evaluations (elasticity, corneometry, dermaspectrophotometer) and photography. RESULTS: Most notable at week 12 was a 60% improvement in smoothness, 82% improvement in dryness, 30% improvement in fine lines, and 24% improvement in crow’s feet. There was an 8% reduction in macule hyperpigmentation (P<0.001) at week 12, supporting excellent pigment lightening qualities for the regimen. There was a statistically significant increase in skin firmness (decrease in elasticity) as early as week 6 of 6% with further improvement observed at week 12 of 16% (P=0.002). SUMMARY: A multimodal skincare regimen with antioxidants, retinol, hydrolyzed pearl, caviar extract, peptides, and growth factors including EGF and TGF-β results in an improvement in the appearance of photoaged skin after 12 weeks of twice daily use. J Drugs Dermatol. 2021;20(3):274-278. doi:10.36849/JDD.5791.

Evaluation of skin problems and dermatology life quality index in health care workers who use personal protection measures during COVID-19 pandemic.

The aim of this study was to evaluate the skin problems and dermatological life quality of the health care workers (HCWs) due to personal protection equipment (PPE) use, who are at high risk for COVID-19 infection. A questionnaire about HCWs' PPE use, their skin symptoms, and prevention, management methods and Dermatology Life Quality Index (DLQI) was fulfilled. The median age of 440 participants was 33.5 (21.0-65.0) years old. Skin problems were found to be 90.2%, the most common were dryness, itching, cracking, burning, flaking, peeling and lichenification. The presence of skin problems (P < .001) was higher in those who did not use moisturizers. Of all, 22.3% (n = 98) stated that the use of PPE increased the severity of their previously diagnosed skin diseases and allergies (P < .01). Only 28.0% (n = 123) stated that they know the skin symptoms that may develop by using PPE. The proper hand washing rate was higher as education level increased (P < .001). Skin problems were higher in those using mask with metal nose bridge (P: .02 and P: .003, respectively). As the mask using period prolonged, acne was more common (P: .02). DLQI was significantly affected in women (P = .003), and with increased skin problems related to PPE (P < .001). It is important to organize trainings on prevention and management of possible skin symptoms due to PPE use according to guidelines.

Combination of Calcium Hydroxylapatite Diluted With Normal Saline and Microfocused Ultrasound With Visualization for Skin Tightening.

Background/Objectives: Treatment options for the correction of age-related changes in skin include the use of energy-based devices and dermal fillers. In this study, we evaluate the clinical efficacy and tolerability of microfocused ultrasound with visualization (MFU-V) and injectable calcium hydroxylapatite (CaHA) filler diluted with normal saline, for the correction of age-related changes and to assess patients' satisfaction with this combination therapy. Methods: This was a randomized, split-face, comparative clinical study and immunohistochemical analysis in 20 subjects with indications for lower face, neck and décolleté lifting. Over five visits, CaHA diluted with normal saline (1:2) was injected subdermally in the lower third of the face, neck and décolleté, and lower abdominal quadrant. MFU-V was performed on the lower third of the face, neck, and décolleté, and the right lower abdominal quadrant. Results: Upon baseline examination, the age-related changes were quantified as follows: marionette lines score 2.47 ± 0.8, jawline contour score 2.2 ± 0.7 and neck score 2.1 ± 0.7 points; and after 15 months, they changed to 1.8 ± 0.7 (P≤0.00003), 1.89 ± 0.56 (P≤0.005), and 1.7 ± 0.6 (P≤0.005) points, respectively. The procedures were well tolerated, and subject satisfaction was high. Conclusions: The injections of CaHA in combination with MFU-V treatment stimulated neoangiogenesis, led to the increased synthetic activity of cells, a marked increase in collagen and elastin fibers, and remodeling of both the superficial and deep layers of the dermis. An improvement in the severity of age-related changes was observed in all areas studied. J Drugs Dermatol. 2020;19(4):405-411. doi:10.36849/JDD.2020.4625.

Efficacy and Safety of Intense Pulsed Light With a KTP/PDLlike Filter for the Treatment of Facial Telangiectasias.

BACKGROUND: An intense pulsed light (IPL) narrowband "KTP/PDL-like" filter (525–585 nm) may combine the tolerability of the IPL with the precision of KTP and PDL lasers. This study evaluated the impact of IPL with a KTP/PDL-like filter on telangiectasias. METHODS: This was a single-center, prospective study of 17 subjects with facial telangiectasias and skin types I–III. Three monthly treatments were performed using this specific filter, with follow-up visits at 1, 3, and 6 months. Telangiectasia improvement was assessed by the investigator and subjects using a 5-point scale. Facial photographs and safety assessments were obtained at each visit. Subject discomfort was evaluated using a visual analog scale (VAS) immediately posttreatment, and subject downtime was recorded at each subsequent visit. RESULTS: All facial telangiectasias significantly improved. At 1-month follow-up, >50% lesion clearance was noted in 97.1% of facial (n=36) and 85.7% of non-facial (n=7) lesions, with 73% of subjects satisfied or very satisfied. An increase in mean social downtime (0, 2.3, and 3 days) and VAS scores (3.5, 4.5, and 4.8) with treatments 1, 2, and 3, respectively, mirrored a stepwise increase in fluence with subsequent sessions. CONCLUSIONS: The use of a novel IPL narrowband KTP/PDL-like filter can significantly improve facial and non-facial telangiectasias with minimal downtime. J Drugs Dermatol. 2020;19(9):844-850. doi:10.36849/JDD.2020.4834.

Interventions for rosacea based on the phenotype approach: an updated systematic review including GRADE assessments.

BACKGROUND: Rosacea is a common chronic facial dermatosis. Classification of rosacea has evolved from subtyping to phenotyping. OBJECTIVES: To update our systematic review on interventions for rosacea. METHODS: We searched CENTRAL, MEDLINE, Embase, LILACS, Science Citation Index and ongoing trials registers (March 2018) for randomized controlled trials. Study selection, data extraction, risk-of-bias assessment and analyses were carried out independently by two authors. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to assess certainty of evidence. RESULTS: We included 152 studies (46 were new), comprising 20 944 participants. Topical interventions included brimonidine, oxymetazoline, metronidazole, azelaic acid, ivermectin and other topical treatments. Systemic interventions included oral antibiotics, combinations with topical treatments or other systemic treatments. Several studies evaluated laser or light-based treatment. We present the most current evidence for rosacea management based on a phenotype-led approach. CONCLUSIONS: For reducing temporarily persistent erythema there was high-certainty evidence for topical brimonidine and moderate certainty for topical oxymetazoline; for erythema and mainly telangiectasia there was low-to-moderate-certainty evidence for laser and intense pulsed light therapy. For reducing papules/pustules there was high-certainty evidence for topical azelaic acid and topical ivermectin; moderate-to-high-certainty evidence for doxycycline 40 mg modified release (MR) and isotretinoin; and moderate-certainty evidence for topical metronidazole, and topical minocycline and oral minocycline being equally effective as doxycycline 40 mg MR. There was low-certainty evidence for tetracycline and low-dose minocycline. For ocular rosacea, there was moderate-certainty evidence that oral omega-3 fatty acids were effective and low-certainty evidence for ciclosporin ophthalmic emulsion and doxycycline.

Ten-Year and Beyond Follow-up After Treatment With Highly Purified Liquid-Injectable Silicone for HIV-Associated Facial Lipoatrophy: A Report of 164 Patients.

BACKGROUND: Highly purified liquid-injectable silicone (LIS) has been established as a permanent agent for off-label correction of HIV-associated facial lipoatrophy (HIV-FLA). However, controversy exists about long-term safety. OBJECTIVE: To establish the safety and efficacy at 10 years or greater of LIS for HIV-FLA. METHODS: Patients from 3 practices with 10-year or greater in-person office follow-up were analyzed to determine the number of LIS treatments and total volume required to achieve optimal correction. The nature of any treated adverse events was noted. RESULTS: One hundred sixty-four patients had 10-year or greater in-office follow-up. All subjects maintained long-term correction with an average of 9 treatments, average of 1.56 mL per treatment, and an average total of 14.1 mL. Two patients had severe adverse events manifesting as temporary facial edema. Four patients experienced mild-to-moderate excess fibroplasia presenting as perceived overcorrection, and 6 patients had nondisfiguring subcutaneous firmness. All adverse events were successfully treatable, mostly with intralesional 5-fluorouracil and triamcinolone. CONCLUSION: Liquid-injectable silicone is an effective long-term treatment option for HIV-FLA. When injected in small quantities with the microdroplet serial puncture technique at monthly or greater intervals, optimal correction appears durable for more than 10 years. Adverse events consisted mostly of excess fibroplasia and were treatable.

Treatment of Facial Telangiectases With Glycerin Sclerotherapy.

BACKGROUND: Sclerotherapy is used to treat varicosities and telangiectases. Glycerin is a sclerosing agent that has been used off-label for years with a favorable adverse effect profile. However, the treatment of facial telangiectases with sclerotherapy is controversial given the potential for necrosis and embolization in relation to the complex vascular anatomy of the face. OBJECTIVE: To determine the safety and efficacy of glycerin sclerotherapy for the treatment of facial telangiectases. MATERIALS AND METHODS: The authors report a series of 8 patients with facial telangiectases treated with glycerin sclerotherapy. Glycerin mixed with lidocaine and epinephrine was used. The telangiectases were measured and identified as targets for treatment. RESULTS: The patients ranged in age from 45 to 88 years. Between 0.5 and 1 mL was used to treat telangiectases of the nose and malar cheek area per session. Five of the patients achieved satisfactory results after 1 treatment, whereas patients with more extensive telangiectases required up to 3 sessions with 4-week intervals between each session. Injection site pain was the only reported adverse effect, and no evidence of necrosis or blindness was observed. CONCLUSION: Glycerin sclerotherapy seems to be a safe and effective modality for the treatment of facial telangiectases.

Favre-Racouchot disease: systematic review and possible therapeutic strategies.

Favre-Racouchot disease (FRD) is a relatively common dermatosis induced by chronic sun exposure. FRD is clinically and histologically characterized by the presence of both comedones and cysts in the context of an elastotic degeneration of the dermis. Those lesions are mainly located in the face, especially in the malar and periorbital areas. Smoking and radiotherapy seem to play a role in the pathogenesis together with UV exposure. The disease affects predominantly the aged population and seems to be a problem of mainly aesthetic concern. No official guidelines are available for the treatment of FRD; most common therapeutic strategies are represented by topical retinoids and laser treatments. The goal of our review was to identify the principal clinical and epidemiological characteristics of FRD and to analyse all the therapeutic strategies available. We also focused our attention on the follow-up of this particular dermatosis. Our aim was therefore to suggest alternative possible strategies for both the treatment and the follow-up of these patients. Our data support the efficacy of carbon dioxide laser and topical retinoids in the setting of FRD, but we also suggest considering alternative treatments, such as plasma exeresis. We also recommend planning both a short-term and a long-term follow-up visit, as the majority of relapses is observed after 10-12 months.

Managing the Aesthetic Patient

wide variety of therapeutic options, some challenges have arisen: designing an adequate treatment plan, electing the most suitable procedures for the patient, taking into consideration the rheological characteristics of the products, considering the amount needed to achieve a natural look, but also defining the safest way to deliver the treatment. Aging of the facial structural tissue layers occurs at a different pace and the requirements for the aesthetic approach of a 30-year-old patient are different from a 60-year-old patient. A group of twelve experts in minimally invasive injectable procedures sought to identify common changes observed in different age groups in order to help in establishing a plan of treatment for patients of different ages. The individualized aesthetic plan should consider the main pillars of the aesthetic treatment -- aging process, facial assessment, and facial anatomy, to identify and systematize common changes observed in different age groups, as well as the safest and most reproducible techniques, especially for new injectors. J Drugs Dermatol. 2019;18(1):92-102.

A Cohort Study Using a Facial Cleansing Brush With Acne Cleansing Brush Head and a Gel Cleanser in Subjects With Mild-to-Moderate Acne and Acne-Prone Skin

Introduction: Acne vulgaris is a highly prevalent skin condition that can adversely affect the quality of life. Acne-predisposed skin is in a state of subclinical inflammation leading to skin barrier dysfunction. A multi-center cohort study was designed to evaluate clinical efficacy and safety of twice daily facial cleansing using an oscillatory sonic brush, acne brush head, and cleansing gel for 4 weeks. Methods: Subjects with mild-to-moderate acne and acne-prone skin used the cleansing regime after which they applied the skin care products they routinely used. Physician-assessed skin condition comparing baseline versus week 4 using the FDA/IGA scale and subject satisfaction with cleansing efficacy and handling properties of the regime were scored during the last visit. Results: Forty-six subjects completed the study. Physician-scored skin condition showed a statistically significant improvement in FDA/IGA scores and a significant reduction of inflammatory and non-inflammatory lesions comparing baseline versus 4 weeks. Thirty-five (76.0%) subjects had cleared or almost cleared. Subjects similarly assessed their skin to be improved. Conclusion: Both the physician and subject scores revealed the gentle cleansing routine using the sonic brush to be effective reducing the number of acne lesions, improving skin condition. No adverse events were reported during the study period. The cleansing regime may offer an attractive, safe option for maintenance and treatment of subjects with mild-to-moderate acne and acne-prone skin. J Drugs Dermatol. 2019;18(11):1140-1145.

Facial Skin Tightening With Microfocused Ultrasound and Dermal Fillers: Considerations for Patient Selection and Outcomes

Introduction: Microfocused ultrasound (MFU) is a heat technology that is developed from focused ultrasound (FU) used in a high intense mode to generate heat (HIFU). Patient assessment is very complex and involves more than just addressing complaints. It is a challenge to evaluate, decide on options, and give treatments that guarantee the best outcomes. In order to facilitate the process, the authors divided the protocol into five steps: Assess (expectations, features); Decide (which depth to customize); Select (choose a number of lines to achieve the objective); Plan (combination, if needed); Treat (documentation, safety, and comfort). Methods: The PubMed search engine was used to search all publications from 1900­2019 that mention HIFU. The information collected was then grouped into the five protocol steps. Discussion: MFU is a focused ultrasound device that, at certain energy levels, produces heat over 55ºC at the focal point, which leads to thermal coagulation points (TCPs) in the target tissue. The creation of TCPs leads to a healing cascade, ending with neocollagenesis and neoelastogenesis. At different levels, this can bring about either a lifting effect or skin tightening, depending on the structure targeted. Therefore, the two most important tools for precision and efficacy of treatment are visualization with ultrasound and real-time evaluation of severity and structural changes (such as bone or fat loss). Conclusion: MFU-V is a well-known and, based on the evidence, an effective tool for non-invasive lifting and skin tightening. The secret to successful use of the device is to assess adequately patient needs and expectations and plan ahead for the combination of other treatment if necessary to achieve the desired outcome. J Drugs Dermatol. 2019;18(11):1075-1082.

Patient Satisfaction Following Treatment With Microfocused Ultrasound With Visualization: Results of a Retrospective Cross-Sectional Survey

Background: A device that uses microfocused ultrasound with visualization (MFU-V) is cleared in the United States and European Union as a noninvasive procedure that lifts and tightens the skin (Ultherapy® System; Merz North America, Raleigh, NC, USA). The objective of this patient survey was to obtain more in-depth information on patient satisfaction during the MFU-V treatment procedure and satisfaction with their aesthetic results. Methods: Survey participants had received MFU-V treatment and completed at least 6 months of follow-up. A hyperlink to an online survey was distributed via email and respondents completed the survey anonymously. The satisfaction survey consisted of 13 questions related to the treatment process and post-treatment outcomes. A validated Age Appraisal Visual Analog Scale was also included to evaluate patient pre- and post-treatment self-assessments of their age. Results: The survey was completed by 52 patients, and the majority of surveyed patients received treatment on the lower face (100%) and submentum (92.3%). Many patients (41%) reported their treatment outcome met or exceeded their expectation. About one-half of patients (n=27; 52%) needed a follow-up appointment with photos to be able see post-treatment changes. Following MFU-V treatment, 50% believed they looked 1 to 15 years younger. Most (73%) would recommend MFU-V to others. Conclusion: About half of patients undergoing MFU-V were Very Satisfied or Satisfied with their results and a large number reported their treatment outcome met or exceeded their expectations. The number of follow-up appointments appeared to be related to patient satisfaction. Treatment with MFU-V is very well tolerated. J Drugs Dermatol. 2019;18(1):75-79.

Combined 400-600nm and 800-1200nm Intense Pulsed Phototherapy of Facial Acne Vulgaris

Background and Objective: Laser and light-based therapies are relatively new treatment options for acne vulgaris patients. Intense pulsed light (IPL) is believed to exploit the photosensitivity of P. acnes residing in the pilosebaceous units at lower wavelengths and induce anti-inflammatory effects by influencing cytokine release at higher wavelengths. Our study aimed to assess the clinical safety and efficacy of a novel dual-band "notch" acne filter (400-600nm and 800-1200nm) in improving inflammatory and non-inflammatory lesions in patients presenting with mild-to-moderate acne. Materials and Methods: The study was designed as a single-site, prospective study of 10 patients with Fitzpatrick skin types II-V presenting with mild to moderate inflammatory facial acne vulgaris. A total of five whole-face light treatments were conducted at 1-2-week intervals with an IPL system (Lumenis M22 System, Lumenis Ltd.) equipped with a dual-band "notch" acne filter (400-600nm and 800-1200nm). Follow-up visits were performed at 1 and 4 weeks following the last treatment session. Acne mean change from baseline was assessed using the 4-point Investigator Global Assessment (IGA) scale. Comprehensive facial photographs were taken, and lesions were counted at screening, treatment 4, and both 1- and 4-week follow-up visits. The investigator and the patients assessed overall improvements in appearance, using the 5-point Likert scale. Subjects also completed the Cardiff Acne Disability Index (CADI) questionnaire and rated their satisfaction from treatment. Subject-reported pain, using the visual analog scale (VAS), and downtime were also recorded. Results: Treatment impact on overall lesion clearance was most substantial at 4 weeks follow-up, at which 50% of patients showed at least a 50% reduction from baseline of lesion counts (P<0.0001). IGA scores improved throughout the course of the study, and significant improvements in the overall skin condition was noted, with mean 1.63-point and 1.50-point increases from baseline in the acne improvement ratings, at 1- and 4-weeks follow-up, respectively (P=0.0074, 0.0063). Patient-assessed CADI improved throughout the treatment and follow-up visits, peaking at a 3.22-point and 4.9-point average reductions from baseline at 1-week follow-up (P=0.0001) and 1-month follow-up (P<0.0001), respectively. The majority of the patients (80%) rated their acne lesions as improved, much improved, or very much improved at 4-weeks follow-up (P=0.0004). Significant enhancements were also noted for skin texture. Eighty percent of the patients reported overall satisfaction with treatment outcomes, while 60% rated their satisfaction as "good" or "very good" at 4-weeks follow-up (P<0.0001). Treatments were well tolerated, with mean per-session VAS scores being ≤3.77, while the mean downtime was negligible (a few hours). Conclusion: The use of an IPL device equipped with a proprietary "notch" acne filter elicited a significant effect on acne vulgaris. No severe pain, erythema, edema, folliculitis, crusting or exfoliation was noted, emphasizing the safety of our technique. J Drugs Dermatol. 2019;18(11):1116-1122.

A case series of demodicosis in children.

Demodex mites are commensal inhabitants of the pilosebaceous unit that are typically absent or at low numbers in childhood. When they are present, they can cause a primary eruption or exacerbate an underlying facial dermatosis. Here we report five cases of demodicosis occurring in childhood, the clinical presentations, and responses to treatment. Papulopustular lesions predominate, prompting the advice "pustules on noses, think demodicosis!"

Underdiagnosed and undertreated psoriasis: Nuances of treating psoriasis affecting the scalp, face, intertriginous areas, genitals, hands, feet, and nails.

Psoriasis of the scalp, face, intertriginous areas, genitals, hands, feet, and nails is often underdiagnosed, and disease management can be challenging. Despite the small surface area commonly affected by psoriasis in these locations, patients have disproportionate levels of physical impairment and emotional distress. Limitations in current disease severity indices do not fully capture the impact of disease on a patient's quality of life, and, combined with limitations in current therapies, many patients do not receive proper or adequate care. In this review, we discuss the clinical manifestations of psoriasis in these less commonly diagnosed areas and its impact on patient quality of life. We also examine clinical studies evaluating the effectiveness of therapies on psoriasis in these regions. This article highlights the need to individualize treatment strategies for psoriasis based on the area of the body that is affected and the emerging role of biologic therapy in this regard.

Granuloma Faciale Treatment: A Systematic Review.

Granuloma faciale is an uncommon benign chronic dermatosis characterized by reddish-brown to violaceous asymptomatic plaques appearing predominantly on the face. The pathogenesis of granuloma faciale remains unclear, and it is frequently unresponsive to therapy. This systematic review aims to summarize all recent publications on the management of granuloma faciale. The publications are mainly individual case reports, small case series and a few retrospective studies. Treatment options included topical, intralesional and systemic corticosteroids, topical pimecrolimus and tacrolimus, topical and systemic dapsone, systemic hydroxychloroquine, clofazimine, and tumour necrosis factor-alpha inhibitors. More invasive therapies using lasers as well as cryosurgery and surgery were also reported. Topical glucocorticosteroids and tacrolimus remain treatments of first choice, possibly supplemented by topical dapsone.

Combination of platelet rich plasma in fractional carbon dioxide laser treatment increased clinical efficacy of for acne scar by enhancement of collagen production and modulation of laser-induced inflammation.

BACKGROUND: Platelet-rich plasma (PRP) which contains large amounts of growth factors has been tried to enhance therapeutic efficacy of laser treatment for acne scar with unknown underlying mechanism. OBJECTIVES: The present study was conducted to investigate the molecular mechanism of increased clinical efficacy of PRP when combined with fractional laser treatment for treating acne scars. METHODS: Subjects with mild to moderate acne scars were treated with two sessions of fractional CO2 laser therapy given with and without co-administration of PRP. Skin biopsy specimens were obtained at baseline, 1, 3, 7, and 28 days for investigation of molecular profiles associated with skin changes produced by laser plus PRP treatment. RESULTS: The PRP treatment increased clinical efficacy with decreased severity of adverse effects such as erythema, swelling and oozing. Productions of TGFß1 and TGFß3 proteins were more highly elevated on the PRP-treated side of the face compared to the control side at day 28. Furthermore, PRP-treated side showed significant increase of c-myc, TIMP, and HGF expression. Experimental fibroblast culture model was also used. PRP administration after laser irradiation increased expressions of p-Akt, TGFß1, TGFß3, ß-catenin, collagen 1, and collagen 3 in both dose-dependent and time dependent manners in fibroblast. Moreover, we acquired clinical and histological data through randomized control clinical trial. CONCLUSION: Taken together with human study results combined with the data from cell experiments we suggest that PRP treatment increased fibrogenetic molecules induced by fractional CO2 laser, which have association with clinical effect. Lasers Surg. Med. 50:302-310, 2018. © 2017 Wiley Periodicals, Inc.

Acne and Scarring: Facing the Issue to Optimize Outcomes

This supplement summarize recent advances in the scientific understanding of acne pathogenesis as it relates to effective treatment acne in patients of all skin types and describes the role of retinoids in the management of acne and effective treatment and prevention strategies for hypertrophic and atrophic acne scarring in all skin types.