Efficacy and safety of innovative acne scar serum in Indian patients (ESTEEM India study).

BACKGROUND: Scarring is a common and undesirable outcome of acne vulgaris. There are limited effective topical formulations for acne scar treatment. The investigational product, acne scar serum (HEXILAK® Acne Scar Serum) is latest topical formulation developed for treatment of acne scar with unique ingredients, Kollaren and Exo-T. OBJECTIVE: Evaluate safety and efficacy of latest acne scar serum on the reduction of acne scars in Indian population. MATERIALS AND METHODS: Subjects, diagnosed clinically with acne scars with or without hyperpigmentation, of either gender in the age group of 15 to 45 years were enrolled in the study. The investigational acne scar serum was applied twice daily for 3 months with monthly follow for outcome evaluation. RESULTS: Out of 72 subjects enrolled, 67 completed the study. Most of the subjects, 79.1% showed improvement in acne scar at Day 90. Significant reduction of mean total post-acne hyperpigmentation index (PAHI) was seen at all follow up visits compared with baseline. Significant improvement in mean acne scar depth, mean acne scar volume, and mean L value using 3D imaging were observed at all visits compared with baseline. All side effects reported were mild and overall, it was well tolerated by all subjects. CONCLUSION: We found that there was a significant reduction in acne scar and post-acne pigmentation with new acne scar serum as a monotherapy, this needs further confirmation in larger randomized controlled studies. Therefore, topical acne scar serum with unique ingredients Kollaren and Exo-T can be a safe, effective, and new option in the armamentarium of acne scar management.

Use of nanofractional radiofrequency for the treatment of acne scars in Indian skin.

BACKGROUND: Pitted acne scars of all types remain notoriously challenging to treat with no satisfactory treatment modality, particularly true for darker Fitzpatrick skin types such as Indian skin. AIM: Nanofractional radiofrequency has been shown to be an effective treatment modality for the cosmetic improvement of acne scars. METHODS: Twenty healthy male and female Indian patients aged 16-60 years with Fitzpatrick skin types IV-V and moderate-to-severe acne scar lesions received 1-3 treatments with a nanofractional radiofrequency device (Venus Viva) at baseline and at 3- to 6 week intervals and were evaluated with photographs at each treatment visit and up to 6 months after the final treatment session. Patients reported on their satisfaction with the treatment. The safety of treatments was evaluated by the frequency, severity, and type of adverse events. RESULTS: The majority of study patients achieved improvement in the appearance of their acne scar lesions. There was less improvement on ice pick scar compared to box and rolling type scars, with less impact on ice pick scar type. Overall patient satisfaction from treatment at the 6-month follow-up visit was very high. Adverse events were mild but transient in nature. CONCLUSION: The data and results presented here support the efficacy of nanofractional radiofrequency used for the cosmetic improvement of acne scar lesions in facial skin. Moreover, the favorable adverse event profile witnessed in this trial underscores the safety of this technology for cosmetic facial treatments such as facial acne scar lesion therapy in darker Fitzpatrick skin types.

Fractional lasers in dermatology--current status and recommendations.

INTRODUCTION: Fractional laser technology is a new emerging technology to improve scars, fine lines, dyspigmentation, striae and wrinkles. The technique is easy, safe to use and has been used effectively for several clinical and cosmetic indications in Indian skin. DEVICES: Different fractional laser machines, with different wavelengths, both ablative and non-ablative, are now available in India. A detailed understanding of the device being used is recommended. INDICATIONS: Common indications include resurfacing for acne, chickenpox and surgical scars, periorbital and perioral wrinkles, photoageing changes, facial dyschromias. The use of fractional lasers in stretch marks, melasma and other pigmentary conditions, dermatological conditions such as granuloma annulare has been reported. But further data are needed before adopting them for routine use in such conditions. PHYSICIAN QUALIFICATION: Any qualified dermatologist may administer fractional laser treatment. He/ she should possess a Master's degree or diploma in dermatology and should have had specific hands-on training in lasers, either during postgraduation or later at a facility which routinely performs laser procedures under a competent dermatologist or plastic surgeon with experience and training in using lasers. Since parameters may vary with different systems, specific training tailored towards the concerned device at either the manufacturer's facility or at another center using the machine is recommended. FACILITY: Fractional lasers can be used in the dermatologist's minor procedure room for the above indications. PREOPERATIVE COUNSELING AND INFORMED CONSENT: Detailed counseling with respect to the treatment, desired effects and possible postoperative complications should be provided to the patient. The patient should be provided brochures to study and also adequate opportunity to seek information. A detailed consent form needs to be completed by the patient. Consent form should include information on the machine, possible postoperative course expected and postoperative complications. Preoperative photography should be carried out in all cases of resurfacing. A close-up front and 45-degree lateral photographs of both sides must be taken. LASER PARAMETERS: There are different machines based on different technologies available. Choice parameters depend on the type of machine, location and type of lesion, and skin color. Physician needs to be familiar with these requirements before using the machine. ANESTHESIA: Fractional laser treatment can be carried out under topical anesthesia with eutectic mixture of lidocaine and prilocaine. Some machines can be used without any anesthesia or only with topical cooling or cryospray. But for maximal patient comfort, a topical anesthetic prior to the procedure is recommended. POSTOPERATIVE CARE: Proper postoperative care is important in avoiding complications. Post-treatment edema and redness settle in a few hours to a few days. A sunscreen is mandatory, and emollients may be prescribed for the dryness and peeling that could occur.