The Role of Medical Nutrition Therapy in Dermatology and Skin Aesthetics: A Review

The field of nutritional sciences has advanced beyond research of the role of individual nutrients, supplements, and diet in disease to the multi-disciplinary practice of adjuvant medical nutrition therapy (MNT). Nutrition research is often that of association rather than cause and effect, yet there are compellingly strong relationships between diet and disease severity and incidence of a number of dermatological conditions. MNT is a tailored, evidence-based, comprehensive nutrition intervention strategy delivered by a physician and registered dietitian to a subset of dermatology patients who may benefit from nutrition intervention. With shorter clinical interaction times and patients requesting nutrition information, a collaborative approach may spur clinically meaningful nutritional changes with advice beyond the often quoted "eat better, lose weight, and exercise." This review provides a comprehensive overview of the latest Dermatology Medical Nutrition Therapy (D-MNT) recommendations and advocates an evidence-based, collaborative approach to dermatological patient care. J Drugs Dermatol. 2020;19(1):12-18. doi:10.36849/JDD.2020.4745

A review of hand-held, home-use cosmetic laser and light devices.

BACKGROUND: As the market for home-use light-based and laser-based devices grows, consumers will increasingly seek advice from dermatologists regarding their safety and efficacy profiles. OBJECTIVE: To review the literature on home-use hand-held devices for various dermatologic conditions. To educate dermatologists about commercially available products their patients may be using. MATERIALS AND METHODS: A comprehensive literature search was conducted to determine the safety and efficacy of home-use laser and light devices for the treatment of the following: hair removal, acne, photoaging, scars, psoriasis, and hair regrowth. In addition, a thorough search of the Food and Drug Administration's (FDA) radiation-emitting electronic products' database was performed; by searching specific product codes, all hand-held devices that are FDA-approved for marketing in the United States were identified. RESULTS: Of the various home-use devices reviewed, intense pulsed light (IPL) for hair removal and light-emitting diode (LED) for treatment of acne have the most published data. Although the literature shows modest results for home-use IPL and LED, small sample sizes and short follow-up periods limit interpretation. CONCLUSION: There is a paucity of randomized, double-blind controlled trials to support the use of home-use laser and light devices; smaller, uncontrolled industry-sponsored single-center studies suggest that some of these devices may have modest results.

Side effects and complications of fractional laser photothermolysis: experience with 961 treatments.

BACKGROUND: A novel 1,550-nm erbium-doped laser (Fraxel, Reliant Technologies Inc.) has been shown to be effective in the treatment of photodamaged skin and scars with minimal postoperative recovery; however, studies evaluating its side effects and complication rates have been limited. PURPOSE: The purpose was to determine the frequency and range of side effects and complications associated with fractional photothermolysis treatment. METHODS: A retrospective evaluation of 961 successive 1,550-nm erbium-doped laser treatments in patients of various skin phototypes (I-V) was conducted in a single center. Side effects and complications of treatment, including time of onset and duration, were identified and tabulated. Patient demographics and laser parameters were also assessed. RESULTS: Seventy-three treatments (7.6%) resulted in development of complications. The most frequent complications were acneiform eruptions (1.87%) and herpes simplex virus outbreaks (1.77%). Side effects and complications were equally distributed across different ages, skin types, body locations, laser parameters, and underlying skin conditions, except for postinflammatory hyperpigmentation, which occurred with increased frequency in patients with darker skin phototypes. CONCLUSIONS: Fractional laser skin treatment is associated with a relatively low complication rate. Side effects and complications observed in this study were temporary and did not result in long-term or significantly severe sequelae (e.g., scarring).