Patterns and Motivations of Topical Steroid Use for Skin Whitening in Jazan, Saudi Arabia: A Cross-Sectional Survey.

Background The use of topical steroids for skin whitening is prevalent in many regions, including Saudi Arabia. This study aims to analyze the patterns, motivations, and demographic factors associated with the use of topical steroids for cosmetic purposes in Jazan, Saudi Arabia. Methods This cross-sectional survey was conducted online over three weeks. A structured questionnaire was distributed to adults residing in Jazan, collecting data on demographics, topical steroid use, motivations, and product sources. Descriptive statistics were used to analyze the data. Results Among the 340 participants, 173 (50.9%) reported using topical steroids for skin whitening. The majority of users were female (149, 43.8%) and aged between 20 and 30 years (78, 22.9%). Most participants had used topical steroids for less than a year (127, 73.4%), with usage predominantly in the evening (86, 49.7%). Topical steroids were primarily purchased from pharmacies (70, 40.5%), with significant monthly expenditure variability: 55 participants (31.8%) spent between 50 and 110 SAR, and 62 (35.7%) spent more than 150 SAR. Motivations for use included a preference for lighter skin (49, 28.4%) and treatment of melasma (42, 24.3%). Recommendations from friends (71, 41.0%) and TV advertisements (34, 19.8%) influenced product choice. Conclusion Topical steroid use for skin whitening is widespread among adults in Jazan, with a notable emphasis on cosmetic outcomes and substantial financial investment. There is a critical need for increased public education on the risks associated with topical steroids and enhanced professional guidance to promote safer usage practices.

Interplay Between Health-Promoting Lifestyle, and Cognitive Emotion Regulation with Risk of Cosmetic Surgery Seeking in Young Women.

OBJECTIVES: This study investigated the relationship between lifestyle and cognitive regulation of emotion and the risk of seeking cosmetic surgery in young women. METHODS: The current study was a cross-sectional study. The outcome variable in this research was cosmetic surgery seeking. The association between sociodemographic and health behaviors with risk of cosmetic surgery seeking investigated. The multinomial logistic regression was used to examine the association between health promotion lifestyle and cognitive emotion regulation with cosmetic surgery seeking. RESULTS: Underweight was associated with cosmetic surgery seeking [5.50; 95% CI 1.90-15.92; P<0.005]. Other risk factors were former smoking, alcohol use, and poor sleep quality. An increase in poor lifestyle is associated with an increased risk of cosmetic surgery seeking [30.41; 95% CI 4.87-189.84; P<0.001]. Adaptive cognitive emotion regulation protects against cosmetic surgery seeking [0.36; 95% CI 0.15-0.84; P<0.001]. DISCUSSION: Lifestyle and adaptive cognitive emotion regulation played a significant role in people who were looking for cosmetic surgery, and therefore, like in other areas of disease and health, lifestyle and adaptive cognitive emotion regulation are important in cosmetic surgery, and it is necessary to pay attention to the effects of each of them. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Invited Response on: "Letter to the Editor: Neuromodulators Raising Eyebrows: Having Is Not So Pleasing, After All, As Wanting".

This response letter emphasizes the relevance of adopting a psychosocial approach for cosmetic surgeons, particularly concerning the impact of social media on the acceptance of cosmetic surgery among both women and men. Special attention has been directed toward social phenomena that appear to contribute to the formation and maintenance of positive attitudes toward aesthetic surgery and its normalization, including Snapchat Dysmorphia, the Angelina Jolie Effect, and the Mirror Effect, the Exposure Bias. Furthermore, this response letter highlights the critical importance of comprehensive aesthetic education and appropriate training for professionals in the field of cosmetic procedures, especially regarding the topic of body image.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Social Media Influencers and Their Impact on Society in Performing Cosmetic Procedures Among Al-Ahsa Community.

INTRODUCTION: The popularity of cosmetic surgery has been increasing in recent years, and social media is playing a role in this trend. This study investigated the influence of following social media influencers on the decision to undergo cosmetic procedures in Al Ahsa, Saudi Arabia. METHODOLOGY: A descriptive cross-sectional study was conducted in Al Ahsa, Saudi Arabia. A self-administered questionnaire was used to collect data. Males and females over 18 years old in Al Ahsa were included, while people under 18 years old who did not complete the questionnaire and did not live in Al Ahsa were excluded. RESULT: The study found that social media influencers may be influencing the decision of some people to undergo cosmetic procedures. 90.4% of participants agreed that undergoing cosmetic procedures is a popular procedure among influencers on social media. 37.9% of participants said that pictures of cosmetic procedures before and after affect their desire to undergo a cosmetic procedure. There were significant differences in the views of male and female participants. CONCLUSION: This study found that social media influencers may influence the decision to undergo plastic surgery, especially among young women. Participants who followed influencers were more likely to believe that influencers had undergone plastic surgery and were more likely to be influenced by the changes shown in before-and-after pictures. These findings suggest that social media may be playing a role in increasing the demand for plastic surgery, especially among young people.

The Beauty Revolution of Nanotechnology: Unveiling the Impact of Cosmetic Nano Wonders.

The infusion of nanotechnology into cosmetic formulations marks a transformative shift in beauty science. Although Raymond Reed originally used the word "cosmeceutical," Dr. Albert Kligman popularised the idea in the late 1970s. Cosmetic Nano Wonders are redefining skincare by leveraging nanomaterials to enhance the stability, delivery, and efficacy of active ingredients. The paradigm shift holds promise for overcoming longstanding challenges in traditional cosmetic formulations. This article aims to explore and showcase the revolutionary impact of nanotechnology on the cosmetic industry. Focusing on key nanocarriers, such as liposomes and nanoparticles, our objective is to illuminate how nanotechnology elevates the performance of beauty products, providing advanced solutions for skincare concerns. This revolution promotes sustainability through green synthesis techniques and enables more accurate and effective therapies for a variety of skin issues, including acne and ageing that raises the bar for safety and innovation in the cosmetics business by enhancing product performance and environmental impact. Conducting a thorough literature review, we analyze recent scientific studies and industry reports to unveil the mechanisms and applications of nanotechnology in cosmetics. Special attention is given to the role of nanocarriers in stability enhancement, targeted delivery, and controlled release, unraveling the methods that drive the transformative potential of Cosmetic Nano Wonders. The database sources are Scopus, PubMed, Google Scholar, and Google Patents. The examination of recent research underscores the tangible benefits of nanotechnology in cosmetics. Cosmetic Nano Wonders demonstrate superior stability, enhanced penetration into skin layers, and controlled release mechanisms, showcasing their potential to revolutionize beauty science and address longstanding challenges in skincare. Cosmetic Nano Wonders represent a groundbreaking shift in beauty science, offering unprecedented possibilities for formulators and consumers. As nanotechnology continues to reshape cosmetic formulations, the future holds the promise of safer, more effective, and personalized skincare solutions, ushering in a new era in beauty science.

General dentists' treatment plans in response to cosmetic complains; a field study using unannounced-standardized-patient.

Background: This field study explored general dentists' treatment plans in response to the request for cosmetic services of an unannounced standardized patient (USP) in Mashhad, Iran. Methods: The researcher, as a USP, visited 24 and 23 offices in a high-income and a low-income area, respectively. The primary complaint was that, according to her friend's comments, a dental student, her smile was "crooked and yellow" due to the congenitally missing tooth number 10 and peg-shaped tooth number 8. The dentists' treatment plans for teeth color and form and the cosmetic services expenses were recorded. The treatment plans of the two areas were compared. Results: For dental form, most dentists' treatment plans were categorized as "No intervention" (privileged area: 37.5 %, less-privileged area: 56.53 %, and total: 46.80 %). The percentage of dentists in the privileged area who prescribed cosmetic services was twice that of the less-privileged area (33.33 % versus 17.39 %). The intervention for dental form varied from placing 1 unit of composite veneer to 10 units of ceramic laminates or orthodontics with a wide range of treatment costs ($42.09 to $1079.14). For tooth color, most dentists (privileged area: 62.50 %, less-privileged area: 30.43 %, and total: 46.80 %) were categorized as "Interventionists." For tooth color, the treatment plans varied from scaling and root planing, bleaching, and composite veneer with various costs ($7.19 to $197.84). Conclusion: Cosmetic treatment plans and expenses varied significantly for a single USP, with many not aligning with the standard treatment plan. Some dentists offered treatments even without a chief complaint from the patient. Dentists in privileged areas were twice as likely to prescribe cosmetic treatments compared to those in less privileged areas. Therefore, cosmetic services necessitate monitoring, establishing clear diagnostic criteria, and implementing educational interventions.

Outcome Evaluation of BAHA Attract System Implantations.

Bone Anchored Hearing Aids (BAHAs) are currently well-utilized for treatment of hearing-impaired patients with unilateral or bilateral mixed and conductive hearing loss as well as patients with single sided deafness. The objective of this study is to evaluate outcome of BAHA Attract system in terms of surgical, functional,audiological and cosmetic results This is a prospective observational study of 15 consecutive patients of single sided deafness (SSD) who qualified for and underwent BAHA Attract surgery at a tertiary care hospital over a duration of two years. Parameters analysed were: (1) Surgery and wound healing, (2) Post-operative functional results (Bern Benefit for Single sided deafness questionnaire (BBSSQ)), (3) audiological results (free field speech in noise audiometry in two situations: with signal from implanted side and from contralateral side), (4) Cosmetic results (introduction of novel Three Points Scoring System (TPSS). Clinico-radiological planning of surgical site for implant is also described.Mean surgical time was 39 minutes and healing was uneventful in 73 % of patients. All patients reported improvement in all ten hearing situations with maximum improvement for sound localization. Significant improvement of speech in noise was seen especially when signal was presented from implanted side. All patient had full score in TPSS for cosmesis except one patient. This was the same patient in whom clinico-radiologically planned site was discarded intraoperatively due to overpneumatised temporal bone.BAHA Attract system is safeand effective solution for single sided deafness with acceptable cosmesis.

Management of dermatosis papulosa nigra: a systematic review.

Dermatosis papulosa nigra (DPN) is a variant of seborrheic keratosis that typically presents as hyperpigmented pedunculated papules on the face, trunk, and/or back in those with skin of color. Although benign, the lesions can cause significant discomfort and distress. Management options are limited and often unaffordable, as treatment is elective in most cases. This study was undertaken to provide an updated summary of safe and efficacious treatments for DPN. Five databases were searched to identify full-text publications reporting on treatments and outcomes in adults with DPN. Seventeen publications met inclusion criteria and were included: six cohort studies, one randomized controlled trial, five case report studies, one case series, and four pilot studies. Treatment options included simple excision, curettage, electrodesiccation, cryotherapy, topicals, and laser therapies. These modalities varied in their documented outcomes and associated potential adverse effect profiles. Postinflammatory hyperpigmentation is a common adverse effect that often leads to patient dissatisfaction. It can be mitigated with topical treatments aimed at reducing local inflammation. Study limitations included small sample size in individual studies, lack of consistent reporting of Fitzpatrick skin type, and lack of comparison to the standard treatment of electrodesiccation or curettage. Ultimately, treatment should consider the patient's Fitzpatrick type, treatment area, associated costs, and potential adverse effects.

Current State of Scientific Knowledge on Curcumin Encapsulation and Applications.

The yellow pigment curcumin has long been used in traditional medicine for its anti-inflammatory, antibacterial and antioxidant activities. Over the past half-century, scien-tific investigations have shown that curcumin is endowed with additional health benefits be-cause it can modify key molecular targets associated with a number of pathologies, such as diabetes, cancer, and arthritis, in addition to cardiovascular, multiple sclerosis, Alzheimer's, and Crohn's diseases. However, this molecule has several disadvantages, such as low bioavail-ability and solubility, severe oxidative destruction, light sensitivity, fast systemic clearance and breakdown at alkaline pH levels. To address these drawbacks, several methods of micro-encapsulation employing a variety of shell materials have been investigated. These techniques contributed toward the increase of curcumin's solubility and stability against heat, light, oxy-gen, and an alkaline pH. The various shell materials and methods used to microencapsulate this chemical are the main topics of this review. The use of microencapsulated curcumin in food, medicine, and cosmetics is also discussed in more detail. Recent relevant research from the last few years has been given in this area, along with future difficulties.

Update on surgical cosmetic solutions in equine ophthalmology.

Following eye removal surgery, ocular cosmetic solutions exist for the equine patient. The objective of this review is to summarize the current best evidence on equine ophthalmic cosmetic solutions. A literature review of ophthalmic cosmetic solutions in horses was conducted. Four cosmetic solutions are described. Cosmetic outcome, return to work, owner satisfaction, complication rates, implant choice and future perspectives are discussed under the light of most recent publications. Seventeen peer-reviewed articles were selected: five retrospective studies, four case series, five case reports and three narrative reviews. Additionally, two congress proceedings were included. Recent publications identify intrascleral prosthesis and intraorbital implants adjoined to a corneoscleral shell as cosmetically superior. The orbital meshwork implant requires improvement to be cosmetically acceptable. Return to work is deemed feasible and standing sedation is an option for orbital implant placement beneath sutured eyelids. 3D printing creates new possibilities for implant development.

Pursuing beauty: socio-cultural and labor-economic determinants of cosmetic surgery consideration among female college students in China.

BACKGROUND: Cosmetic surgery has a profound impact on health and other aspects. As a means of enhancing physical attractiveness, it is increasingly being considered by female college students in China. However, current knowledge about the determinants of cosmetic surgery consideration among Chinese female college students still needs to be improved due to the lack of systematic perspectives and large-scale representative data sets. This study aimed to contribute to the literature in these two aspects. METHODS: We framed cosmetic surgery consideration as a function of two broad sets of determinants: socio-cultural and labor-economic. We used data from a large, nationally representative sample of female college students in China (N = 6658, mean age = 20.3 years). RESULTS: In terms of socio-cultural oriented factors, we found that family socioeconomic status, peers' cosmetic surgery practices, and media exposure were positively associated with the likelihood of considering cosmetic surgery. In terms of labor-economic oriented factors, we found that self-rated physical appearance, higher grades, and expected income after graduation were positively associated with a higher likelihood of considering cosmetic surgery. CONCLUSIONS: These findings suggest that the decision-making process for cosmetic surgery among Chinese female college students goes beyond personal factors and is significantly influenced by structural factors.

Impact of Public Health and Social Measures on Cosmetic Treatments in the COVID-19 Pandemic: A Retrospective Multi-Center Study Combined With a Questionnaire-Based Cross-Sectional Study.

BACKGROUND: Public health and social measures (PHSMs) are considered the most effective approaches for controlling epidemic diseases. This study aimed to explore variations in the time-dependent characteristics of and public preferences for cosmetic treatments during and after the implementation of PHSMs during the COVID-19 pandemic. METHOD: Medical records from six medical institutions were extracted retrospectively. Time-series analyses were conducted to reveal the variations in characteristics in volume and proportion of cosmetic treatments according to PHSMs. A cross-sectional study was conducted with online questionnaire designed for the general population during and after the implementation of PHSMs. RESULT: A total of 141 033 records were included in this retrospective study. The implementation of PHSMs led to extremely low treatment volumes; compared with the increases in private hospitals, the treatment volumes in public hospitals exhibited earlier and more significant increases, even higher than pre-PHSM levels (p < 0.05), which mainly contributed to the increase in plastic surgery volumes during and after the implementation of PHSMs. The differences in the anxiety state, self-perceived appearance, and cosmetic treatment intentions of the participants were illustrated during and after PHSMs. We further demonstrated the participants' decisions on cosmetic treatments after the implementation of PHSMs during the COVID-19 pandemic. CONCLUSION: The immediate effects and aftereffects of PHSMs on cosmetic treatments were different in public and private hospitals. Furthermore, as PHSMs guided the adjustment of cosmetic treatments in the post-COVID-19 era, the intention to undergo cosmetic treatment during PHSMs was associated with the anxiety states and preferences of the population.

Safety and effectiveness results of an innovative injectable poly-L-lactic acid-based collagen stimulator (Lanluma®)-Clinical outcomes at 9 months in a post-market study.

BACKGROUND: Injectable fillers for soft tissue augmentation stand out as one of the most favored procedures in the field of aesthetic medicine, especially in addressing the clinical signs of skin aging. Among soft tissue fillers, non-permanent fillers have been safely used in numerous medical applications for several decades. AIMS: The aim of this post-market observational, open-label, uncontrolled, multicentered, prospective study (PMS) was to evaluate the effects of an injectable poly-L-lactic acid-based collagen stimulator (Lanluma®, the study product). PARTICIPANTS/METHODS: This analysis is based on the clinical outcomes data (safety and effectiveness) collected from investigators and participants between the first injection (T0, September 2022) and 9 months thereafter (T3, June 2023) in the treatment of five body-contouring areas. RESULTS: Overall, 70 participants had 99 treatment sessions of the neck (31%), upper arm (20%), hand (17%), thigh (16%) and décolleté (15%). Lumps (neck, upper arm, hand) and nodules (neck, hand, thigh) were the most frequent adverse events (AEs) reported by investigators. All were treatment related. None were serious, severe or fatal. No AEs were reported following treatment of the décolleté. Both investigators and participants reported high levels of satisfaction during the nine-month follow-up period with the treatments in five body areas. CONCLUSIONS: These positive clinical outcomes can be attributed to a proper implementation of best practices and recommendations, and the rheological properties of the study product. This 9-month follow-up analysis should be reconsidered in light of the study's objectives for the final analysis at the 25-month follow-up.

Debulking surgery after muscular paraffin oil injections: Effects on calcium homeostasis and patient satisfaction.

OBJECTIVE: Cosmetic paraffin oil injections can lead to granuloma formation causing hypercalcemia and kidney failure. This study explores whether debulking surgery is an effective treatment for improving calcium homeostasis, inflammation and clinical symptoms. MATERIALS AND METHODS: In a retrospective study, we reviewed 33 patients undergoing debulking surgery. Changes in calcium, inflammatory markers, and renal function from baseline up to twelve months post-surgery were assessed. Patients were interviewed post-surgery. RESULTS: The patients were 34.6 years (SD 6.9) and had 1,104 grams (SD 591) of granuloma tissue removed following injection of 1,329 mL (SD 803) paraffin oil 7.9 years (SD 3.2) earlier. Seventeen patients had hypercalcemia and experienced a significant decline in ionized calcium from 1.48 mmol/L (SD 0.16) at baseline to 1.33 mmol/L (SD 0.03) at twelve months (p<0.002), although only four men (23.5%) became normocalcemic. Serum ferritin was reduced by 50% after twelve months (p=0.048). Sixteen patients were normocalcemic and had no change in calcium homeostasis but experienced a 20% drop in serum ferritin levels (p=0.025) after surgery. Fifteen patients completed all their planned surgeries within the study period and experienced a decline in serum ionized calcium (p=0.031), ferritin (p=0.011), and interleukin 2-receptor (p=0.037). A patient satisfaction survey showed that 55% of patients reported post-operative satisfaction scores of 10/10, and 59% of the patients reported reduced pain. CONCLUSION: Surgery improved calcium homeostasis in a fraction of patients, reduced inflammation and subjective symptoms such as pain and mental well-being in a patient group left with few treatment options except high-dose prednisolone.

U-SMAS: ultrasound findings of the superficial musculoaponeurotic system.

The superficial musculoaponeurotic system (SMAS) is a complex fibrous network connecting facial muscles to the dermis, with varying morphological characteristics across different facial regions. Recent studies have identified five distinct types of SMAS morphology, highlighting the need for region-specific interventions in facial rejuvenation. This pictorial essay explores ultrasound imaging of the SMAS using ultra-high frequency (24-33 MHz) probes, known as U-SMAS. Analysis of 186 full-face U-SMAS scans revealed consistent patterns in the facial and neck layers, with regional variations aligning with the Sandulescu classifications: type I (preparotideal); type II (chin and lip); type III (eyelid); type IV (temporal and parotideal); and type V (cervical). Understanding these morphological differences is crucial for accurate interpretation of ultrasound images and for optimizing pre-procedural assessments to ensure that aesthetic treatments are safe and effective. Knowledge of the SMAS architecture enhances the ability to visualize facial and neck anatomy accurately, particularly through U-SMAS imaging, ensuring comprehensive patient care in rejuvenation procedures.

O sistema musculoaponeurótico superficial (SMAS) é uma rede fibrosa complexa que conecta os músculos faciais à derme, com características morfológicas variadas em diferentes regiões faciais. Estudos recentes identificaram cinco tipos distintos de morfologia do SMAS, destacando a necessidade de intervenções específicas em cada região para a rejuvenescimento facial. Este ensaio iconográfico explora a imagem por ultrassom do SMAS usando transdutores de ultra-alta frequência (24-33 MHz), conhecidas como U-SMAS. A análise de 186 exames de ultrassom de rosto completo revelou padrões consistentes nas camadas faciais e do pescoço, com variações regionais alinhadas com as classificações de Sandulescu: tipo I (preparotideal), tipo II (queixo e lábio), tipo III (pálpebra), tipo IV (temporal e parotideal) e tipo V (cervical). Compreender essas diferenças morfológicas é crucial para uma interpretação precisa do ultrassom e para otimizar avaliações pré-procedimento para tratamentos estéticos seguros e eficazes. O conhecimento da arquitetura do SMAS melhora a capacidade de visualizar com precisão a anatomia facial e do pescoço, especialmente por meio de imagens de ultrassom, garantindo cuidados abrangentes ao paciente em procedimentos de rejuvenescimento.

The microbial etiology and resistance patterns of cosmetic tourism-related infections in Ireland.

BACKGROUND: Cosmetic tourism is an increasingly common phenomenon, both in Ireland and internationally. Complications associated with procedures performed abroad may manifest after the patient has traveled back to their home country with patients often presenting to local health services. Such complications can be infectious in nature requiring either antimicrobial therapy and/or source control in the form of wound debridement or radiologically guided interventional procedures. METHODS: Patients who had presented to a regional plastic surgery unit between September 2021 and December 2022 with complications related to aesthetic procedures performed outside Ireland were identified in this retrospective-prospective design. Medical records were reviewed to ascertain what procedures were performed, where the procedure had taken place, the nature of complications, and microbial culture and sensitivity results. RESULTS: Thirty patients were identified during the study timeframe, predominantly female (n = 28) with a mean age of 40.27 years (SD 10.6). Abdominoplasty was the most common procedure (n = 17), and Turkey was the most frequently cited destination (70%). Wound dehiscence accounted for the majority of complications (n = 18). Wound cultures were obtained in 80% (n = 24) of patients and a causative organism was isolated in 85% (n = 34) of cultures. Eighteen species of bacteria were identified and antimicrobial sensitivities were obtained for 16 of these. Antimicrobial resistance to commonly prescribed empiric antibiotics was noted in several isolates. CONCLUSION: Post-operative infections related to cosmetic tourism are a growing concern in plastic surgery. The bacterial etiology is varied, and antimicrobial resistance poses significant challenges, highlighting the need for early intervention and wound cultures to guide effective management.

Modulation of Melanocyte in Melasma Patients After Picosecond Laser Treatment.

BACKGROUND: Melasma is a therapeutically challenging hyperpigmented skin condition. Currently, there is a lack of in vivo observation regarding changes in melanin and dendritic melanocytes after laser treatment. OBJECTIVE: To investigate alterations in melanin and melanocytes in melasma before and after laser treatment using optical coherence tomography (OCT). METHODS: Eight female melasma patients were enrolled in Taiwan. Based on the baseline OCT scans, the patients were categorized into either epidermal-type or mixed-type melasma and were assigned different treatment protocols accordingly. Sequential OCT images were collected from melasma lesions and normal skin at baseline, Week 4 and Week 8. RESULTS: After 8 weeks of laser treatment, the mean Melasma Area Severity Index (MASI) score improved from 10.92 to 6.30. Results from OCT showed no significant changes in the normalized density, area, or intensity of melanin in both lesional and normal skin. At baseline, the mean length of dendritic melanocytes in the affected skin was 15% longer than those in normal skin; at Week 8, the mean length of lesional dendritic melanocytes became the same as those in normal skin. Additionally, the mean width of dendritic melanocytes decreased from being 4% wider to only 2% wider than those in normal skin. CONCLUSION: After 8 weeks of treatment, an improvement of MASI score was noted, mainly attributable to a reduction in lesional area. OCT showed no notable change regarding melanin, but a decrease in length and width of dendritic melanocytes was noted in the lesional skin of melasma patients.