Carboxytherapy Mask as Post Nanofractional Radiofrequency Treatment for Improvement of Facial Skin Quality and Photoaging.

BACKGROUND: Skin rejuvenation can be achieved with minimally invasive treatments using energy-based devices that feature reduced side effects and downtime. Post-treatment care is key to minimize any potential side effects and skin reactions such as erythema, dryness, or dyschromia. OBJECTIVE: The objective of this study was to evaluate the efficacy and patient satisfaction of a novel carboxytherapy gel mask compared with petroleum-based lanolin-containing ointment to accelerate wound healing facial post-nanofractional radiofrequency treatment. METHODS AND MATERIALS: Ten subjects were enrolled in this pilot, prospective, randomized, single-blind study and randomized into two arms. One arm received one nanofractional radiofrequency treatment with ointment right after and four consecutive days of ointment applications twice a day, while the second arm followed this regimen with a carboxytherapy gel mask application right after and four consecutive days after treatment. Investigator, safety, and patient assessments were conducted at 24 hours and one-week post treatment. Safety was monitored throughout. The primary endpoint was defined as the degree of investigator global assessment (IGA) in photodamage, pigmentation, and wrinkles using standardized photographs. Secondary endpoints included investigator-rated degree of erythema, edema, crusting, exudation, percentage healing, improvement of skin quality, and patient satisfaction. RESULTS: Nine patients completed the study. There was improvement of one degree in IGA for photodamage, pigmentation and wrinkles in all patients using the carboxytherapy gel mask at the one-week follow up. Blinded investigator ratings showed significant improvement of dryness, erythema, edema, crusting, and percentage healing at the 24-hour follow up, with all patients remaining the same a week post treatment. All patients in the carboxytherapy group were satisfied with the treatment and had no adverse effects. Three patients in the petroleum-based lanolin-containing group experienced mild edema and acne breakout that resolved two weeks after treatment. CONCLUSION: Carboxytherapy delivered via a gel mask after skin rejuvenation procedures is a safe and effective strategy to improve clinical outcomes and reduce post-treatment side effects. J Drugs Dermatol. 20(4):461-465. doi:10.36849/JDD.5856.

The Low Prevalence of Allergic Contact Dermatitis Using a Petrolatum Ointment Containing Lanolin Alcohol

Lanolin alcohol is a high cholesterol containing naturally derived material used as a skin protectant in wound healing petrolatum-based ointments. It is a highly purified fraction of lanolin wool wax that has been identified as a possible cause of allergic contact dermatitis. This 3-center study enrolled 499 subjects who underwent a variety of in-office surgical procedures followed by application of a wound healing ointment containing lanolin alcohol without antibiotics. No allergic contact dermatitis was identified in the 499 subjects who completed the study. The lack of allergic contact dermatitis observed may be due to the proprietary highly purified lanolin alcohol utilized in the study formulation. This is not the lanolin alcohol preparation found on the standard dermatology patch test tray. Not all lanolin alcohols are equal. This is an important consideration when examining the reported incidence of allergic contact dermatitis to lanolin alcohol and the absence of allergic contact dermatitis demonstrated in this research. J Drugs Dermatol. 2019;18(10):1002-1004.

Lanolin-based organogel of salicylic acid: evidences of better dermatokinetic profile in imiquimod-induced keratolytic therapy in BALB/c mice model.

The primary aim of the present study was to develop lanolin-based organogel with enhanced delivery potential and reduced skin irritation for the treatment of hyperkeratotic lesions and scaling. The drug was encapsulated in the lipidic bilayers of organogel. The values of particle size, polydispersity index (PDI), and zeta potential of the developed carrier system was found to be 257.5 nm, 0.272, and -24.9 mV, respectively. The system was pseudoplastic in nature with the yield value of 2.3078 Pa. The skin permeation studies exhibited superiority of the prepared lanolin-based organogel formulation over the conventional gel formulation (CGF). Further, the dermatokinetic studies also confirmed better permeation and enhanced skin bioavailability of SA to epidermis as well as dermis vis-à-vis the CGF. In conclusion, the developed organogel system not only improved the delivery profile of SA but also reduced the skin irritant potential. The current findings can provide a suitable alternative for the development of an effective topical formulation of SA for the treatment of hyperkeratotic lesions.

A novel nanoscale-dispersed eye ointment for the treatment of dry eye disease.

A novel nanoscale-dispersed eye ointment (NDEO) for the treatment of severe evaporative dry eye has been successfully developed. The excipients used as semisolid lipids were petrolatum and lanolin, as used in conventional eye ointment, which were coupled with medium-chain triglycerides (MCT) as a liquid lipid; both phases were then dispersed in polyvinyl pyrrolidone solution to form a nanodispersion. Single-factor experiments were conducted to optimize the formulations. A transmission electron micrograph showed that the ointment matrix was entrapped in the nanoemulsion of MCT, with a mean particle size of about 100 nm. The optimized formulation of NDEO was stable when stored for six months at 4 °C, and demonstrated no cytotoxicity to human corneal epithelial cells when compared with commercial polymer-based artificial tears (Tears Natural Forte). The therapeutic effects of NDEO were evaluated on a mouse model with 'dry eye'. Both the tear break-up time and fluorescein staining demonstrated therapeutic improvement, displaying a trend of positive correlation with higher concentrations of ointment matrix in the NDEO formulations compared to a marketed product. Histological evaluation demonstrated that the NDEO restored the normal corneal and conjunctival morphology and is safe for ophthalmic application.

Positive effect of HPA lanolin versus expressed breastmilk on painful and damaged nipples during lactation.

Painful and/or damaged nipples associated with breastfeeding are common and represent a challenge for both the persons experiencing nipple pain and/or trauma and for those providing treatment. However, evidence-based data has been insufficient to demonstrably minimize these common reasons for failure to initiate or continue successful breastfeeding. The aim of this study was to evaluate the efficacy of specific-grade highly purified anhydrous (HPA) lanolin versus expressed breastmilk (EBM) for the treatment of painful and damaged nipples associated with breastfeeding in a prospective controlled clinical trial evaluating 84 lactating mothers. Nipple trauma and healing rates were rated by the Nipple Trauma Score. Nipple pain intensity was assessed on a visual analog scale. Outcome parameters were in favor of the HPA lanolin group, reaching statistical significance for healing rates, nipple trauma and nipple pain. In our study, we found HPA lanolin more effective than EBM, inducing faster healing of nipple trauma (absolute risk reduction of 0.43) and reducing nipple pain (absolute risk reduction of 0.61 on day 3). We concluded that HPA lanolin, combined with breastfeeding education, was more effective than EBM, combined with breastfeeding education, in reducing nipple pain and promoting healing of nipple trauma.

The effect of daily treatment with an olive oil/lanolin emollient on skin integrity in preterm infants: a randomized controlled trial.

To date, appropriate skin therapy for premature infants has not been clearly defined. Emollient creams are often used without solid evidence for a benefit to the neonate. The aim of the current study was to investigate the cutaneous effects of two different topical ointment therapies. Between October 2004 and November 2006 we prospectively enrolled 173 infants between 25 and 36 weeks of gestation admitted to a neonatal intensive care unit. Infants were randomly assigned to daily topical treatment with water-in-oil emollient cream (Bepanthen), olive oil cream (70% lanolin, 30% olive oil), or to a control group. Each neonate was continuously treated for a maximum of 4 weeks. Skin condition (skin score reflecting degree of dermatitis) in these groups was compared at weeks 1, 2, 3, and 4. Neonates treated with olive oil cream showed statistically less dermatitis than did neonates treated with emollient cream, and both had a better outcome than those in the control group (p < 0.001 in weeks 2-4). Treatment effects persisted throughout the study period and applied to infants of all gestational ages. This study demonstrates that topical skin therapy lowers the risk of dermatitis. Olive oil cream was superior to water-in-oil emollient cream.

Equilibrium solubilization of lipophilic therapeutic agents by aqueous solutions of products of catalytic oxyethylation of Croda-type lanolin as model excipients of the class of non-ionic surface active agents.

Research was conducted into the properties and identity of the products of Croda-type hypoallergenic lanolin, which were obtained with the use of a selective catalyst (K-4) and a standard alkaline catalyst (Na/NaOH). The 1HNMR method was employed to assess the content of oxyethylated segments and the analytic level of hydrophilic-lipophilic balance (HLB). Surface activity of products soluble in water with n(TE) > or = 40 was examined and the thermodynamic potential for micelle formation deltaGm(o) was calculated. Basic viscosity and hydrodynamic values were determined for the solubilizers and their micellar adduct with ibuprofen, ketoprofen and naproxen. In addition, the amount of solubilized therapeutic agents c/s/ was examined by means of the spectroscopic method and the micellar partition coefficient--Kw(m) was estimated. The results obtained in the course of research served as a basis for determining the solubilization mechanism and the stability of the micellar adduct for the purpose of application. This enabled the commencement of technological work on the design and manufacture of a model dosage form administered to the skin and containing the products of lanolin oxyethylation.

A randomized trial of peppermint gel, lanolin ointment, and placebo gel to prevent nipple crack in primiparous breastfeeding women.

BACKGROUND: Sore nipples are common during lactation and remain the major reason for failing to establish successful breastfeeding. To formulate a peppermint gel and to evaluate its effect on the prevention of nipple crack associated with breast-feeding, a randomized double-blinded clinical trial comparing the above formulation with modified lanolin and a neutral ointment was carried out. MATERIAL/METHODS: Two hundred and sixteen primiparous participants were assigned randomly to three groups. Each group applied only one of the above three preparations on both breasts for 14 days. Each group consisted of 72 primiparous mothers and was seen for a maximum of four follow-up visits within 14 days and a final visit at week 6. The rate of nipple and areola crack and pain was evaluated. RESULTS: The study groups were comparable in mean age and route of delivery. Nipple crack were less in mothers who received peppermint gel than in those who received lanolin ointment or placebo (chi(2)=16.8, df=6, P=0.01). Relative risk of nipple crack in the lanolin group (RR: 2.41, 95%CI: 1.20-3.01) was higher than in the peppermint group (RR: 1.85, 95%CI: 1.64-3.10). CONCLUSIONS: Prophylactic peppermint gel in breastfeeding lactating women is associated with fewer nipple cracks and is more effective than lanolin and placebo. It could be recommended for preventing of nipple crack along with teaching better breastfeeding technique at the initiation of breastfeeding.

Contact allergy to topical medicaments becomes more common with advancing age: an age-stratified study.

Eczema is common in the elderly people who often use topical medicaments. Previous studies in the elderly people have noted allergic positive patch tests in between 43% and 64% of those tested. We set out to assess whether medicament contact allergies are more common in elderly patients. We undertook a retrospective age-stratified study of all patients patch tested at the Royal Hallamshire Hospital, Sheffield, between January 1994 and July 2005. We confirmed that contact allergy to topical medicaments is more common in those aged more than 70 years compared with the younger age groups. There was no sex difference. The commonest problematic allergen types found in medicaments were fragrances and preservatives. The most frequent individual allergens were fragrance mix, Myroxylon pereirae, lanolins, local anaesthetic agents, neomycin and gentamicin, and tixocortol pivolate. The pattern of medicament contact allergens was similar to that of the younger age groups except that multiple allergic positives were more frequent and sensitivities to local anaesthetics and Myroxylon pereirae were proportionally more common. Elderly patients were more likely to have multiple contact allergies than the younger ones. Care needs to be taken when prescribing topical medicaments to elderly patients with eczema, especially for preparations that contain perfumes, lanolins, and local anaesthetics.

Short communication: disinfectant containing a complex of skin conditioners.

The efficacies of 2 new teat dip formulations were tested against experimental challenge by contagious mastitis pathogens Staphylococcus aureus and Streptococcus agalactiae over a 12-wk period. Formulations contained an iodine complex (0.5 or 1.0% iodine) and skin conditioning agents (propylene glycol, polyvinylpyrridone, glycerine, lanolin, allantoin, and aloe). Percentage reduction (dipped vs. control mammary quarters) in new contagious mastitis pathogen intramammary infections for the 0.5 and 1.0% iodine dips was 65.4 and 84.5, respectively. Both dips were significantly effective in reducing new contagious intramammary infections. Teat skin scores and teat end scores varied over time but were virtually identical for both treated and control teats, for both treatments. Thus, both dips were effective in reducing new contagious mastitis infections without untoward effects on teat skin condition.

[Lansinoh in the treatment of sore nipples in breastfeeding women]. / Prilozhenie na lansinoh pri vuzpalenie na grudnite zurna u kurmachki.

UNLABELLED: The aim of the study was to assess the efficacy and side effects of purified lanolin (Lansinoh) in the prophylactics and treatment of sore nipples. Fifty-seven women aged 20-35 years have been treated - 41 (72%) with phototype III-IV and 16 (28%) with phototype I-II. Thirty-seven (65%) of them were primiparous and 20 (35%) were multiparous. Pre-delivery preparation of the breast has been performed in 16 (28%) of the women. Two groups of patients were formed: I gr. - 10 women (17,5%) with no complaints applying the preparation with preventive aim and II gr. - 47 (82,5%) women with sore nipples of different severity. Therapeutic efficacy was assessed according to the nipple attribute score. In the first group of patients due to the application of Lansinoh the skin remained smooth and elastic and breast-feeding was not disturbed. In the II group Lansinoh lead to a statistically significant difference in the nipple attribute score before and after treatment. The improvement was most pronounced in patients with light and moderate forms of inflammation, in women with phototype III-IV, in multipara and in patients with pre-delivery preparation of the breast. CONCLUSION: Lansinoh is purified lanolin suitable for prophylactics and treatment of sore nipples.

A double-blind clinical trial comparing the efficacy and safety of pure lanolin versus ammonium lactate 12% cream for the treatment of moderate to severe foot xerosis.

Xerotic skin is a pattern of reaction to a variety of disorders (eg, winter xerosis, hereditary ichthyosis) with abnormalities of desquamation in common. The trial described in this article was a double-blind randomized-comparison clinical trial investigating the effect of pure lanolin versus ammonium lactate 12% cream in treating moderate to severe foot xerosis. Xerosis was clinically assessed at baseline visit, and designated sites were reevaluated after 1, 2, and 4 weeks of therapy. Ninety-two patients were enrolled; 41 of these were excluded from analysis (25 were lost to follow-up, 8 were noncompliant, 1 was discharged from study because of an adverse event after visit 1, and 7 were noncompliant after visit 2). Although there was significant improvement in xerosis scores for both treatment groups after 2 and 4 weeks of treatment, no differences were statistically significant. Used twice daily for 4 weeks, pure lanolin and ammonium lactate cream were both effective in treating moderate to severe xerosis.

[Efficacy of barrier creams in comparison to skin care products in dental laboratory technicians--a controlled trial]. / Wirksamkeit von Hautschutzprodukten im Vergleich zu Hautpflegeprodukten bei Zahntechnikern--eine kontrollierte Feldstudie.

BACKGROUND: Irritant contact dermatitis of the hands is very common in dental laboratory technicians due to frequent contact with various irritants. Barrier creams (HS) are often avoided because a tight grip of tools and small objects is necessary; furthermore dental objects must not be contaminated by HS. In this study the efficacy of HS applied during working hours was compared to skin care products (HP) applied only after work. METHOD: 2 popular commercial HS (HS-1, HS-2) and 2 moisturizers containing urea and beeswax respectively (HP-1, HP-2) were evaluated in 5 laboratories by a total of 192 technicians. Every technician used one HS (several applications during working hours) and one HP applied at home at least once daily for 4 weeks each with a wash-out period of 2 weeks in between. The sequence HS-HP, HP-HS was randomized for every laboratory in two single blind cross over designs for both combinations (HS-1 with HP-1, HS-2 with HP-2). The technicians scored the products on a scale of efficacy (worse, none, good, very good). The skin condition was evaluated by a dermatologist at the beginning of the study, after 4, 6 and 10 weeks on a scale for erythema, infiltration, vesicles, fissures and scaling to produce a sum score. Furthermore, transepidermal water loss (TEWL) was measured on the back of the hand and on the ventral aspect of the forearm at the beginnung and the end of the 4 weeks application period. The quotient of these two parameters was used for statistical evaluation (covariance analysis). RESULTS: The assessment of either "good" or "very good" was as follows: HS-1 58%; HS-2 67%; HP-1 77%; HP-2 98%. Both HP, particularly HP-2, were judged superior to either HS. This was confirmed by the improvement of the skin condition (HS-1 35%; HS-2 44%; HP-1 55%; HP-2 56%). Statistical significance of the differences in TEWL data was clearly demonstrated: HP-1 better than HS-1 (p = 0.007); HP-2 better than HS-2 (p = 0.03). The acceptance of the products was high. The majority was willing to continue its usage after the study (68 %-89 %). CONCLUSIONS: The results demonstrate that the use of after work moisturizers is highly beneficial and under the chosen study conditions even superior to barrier creams applied at work. This approach is more practical for many professions and may effectively reduce the frequency of irritant contact dermatitis.

Use of EMLA cream with vasectomy.

OBJECTIVES: To determine whether the application of a eutectic mixture of anesthetic cream (EMLA cream) can decrease the pain of lidocaine injection during vasectomy. METHODS: A double-blind, prospective study was performed in which each patient acted as his own control. One hour before a double-incision vasectomy, EMLA cream was applied to one side of the scrotum and a white lanolin hand cream to the other side. A double-incision vasectomy was performed, and each patient was asked to rate the pain associated with each side of the procedure. RESULTS: Eighty-nine patients agreed to the study; 61 patients thought the EMLA cream decreased the pain of the vasectomy, 16 preferred the lanolin hand cream, and 3 said there was no difference. These results were significant at the 0.0001 level using the Student t test. CONCLUSIONS: EMLA cream significantly decreases the pain associated with lidocaine injections given as local anesthesia for vasectomy.

Treatment of toxicodendron dermatitis (poison ivy and poison oak).

Toxicodendron dermatitis results from a reaction to an oil soluble oleoresin that is present in many parts of the poison ivy and poison oak plants. Prophylactic measures include avoidance, protective clothing, barrier creams and hyposensitization. Treatments include washing the area immediately with a solvent suitable for lipids and the use of anti-inflammatory agents, especially corticosteroids.

Sore nipples in breast-feeding women: a clinical trial of wound dressings vs conventional care.

BACKGROUND: Sore nipples in breast-feeding mothers are a common cause of premature weaning, and are difficult to treat owing to recurrent trauma and exposure to the infant's oral flora. OBJECTIVE: To compare the safety and efficacy of a hydrogel moist wound dressing (Elasto-gel, Southwest Technologies Inc, Baltimore, Md) with the use of breast shells and lanolin cream in the treatment of maternal sore nipples associated with breast-feeding. DESIGN: Randomized controlled trial comparing the above treatments for sore nipples. Patients were seen for a maximum of 3 follow-up visits within 10 days, or until the resolution of symptoms. SETTING: The Maternal-Infant Lactation Center at the Mercy Hospital of Pittsburgh, Pittsburgh, Pa, a tertiary care teaching hospital in inner-city Pittsburgh. PATIENTS: A referred sample of 42 breast-feeding women who presented to the Maternal-Infant Lactation Center for the treatment of sore nipples. All patients with breast infection or chronic unrelated pain conditions were excluded from the study. INTERVENTION: After informed consent, patients were randomized to receive either a hydrogel wound dressing or breast shells and lanolin. All patients underwent a history, physical examination of the infant and the mother's breasts, assessment of breast-feeding technique, and breast-feeding instruction. MAIN OUTCOME MEASURES: The degree of pain on self-report questionnaires and the change in scores for physical examination, breast-feeding technique, and pain behaviors during breast-feeding. RESULTS: Although both treatments, in association with instruction in breast-feeding technique, were effective, greater improvement was seen in the group using breast shells and lanolin. This reached statistical significance for physician-rated healing (P<.01) and self-reported pain (P<.05). There were significantly more infections in the dressing group (P<.05), which resulted in early discontinuation of the study. CONCLUSIONS: Prevention of sore nipples by teaching proper technique on the initiation of breast-feeding should be instituted. For those cases in which sore nipples do develop, breast shells and lanolin in association with instruction in breast-feeding technique are more effective than moist wound dressings. Lanolin and shells should remain first-line therapy.