Skin of Color Skin Care Needs: Results of a Multi-Center-Based Survey.

Targeted marketing and media may serve as potential sources of health information for consumers, influencing knowledge, practices, perception, and utilization of health care services. In addition to this vulnerable consumerism, there are barriers to healthy consumerism including exposure to different sources or lack thereof, lack of knowledge, inadequate transportation, or proximity to stores, cost, and marketing of products that are not suitable for all skin types. We conducted a multi-center “Skin of Color Skin Care Needs” survey to characterize the skin care practices, concerns, and habits of both persons of color and non-Hispanic whites to evaluate barriers and influences on product choice and behaviors in these populations. One hundred and twenty-one respondents (74%) self-identified as a nonwhite racial group, while 31 respondents (19%) self-identified as non-Hispanic white. The top skincare concerns in the skin of color population were acne and blemishes (40%), dry skin (32%), and pigmentation/dark spots (26%). In the non-Hispanic white population, the top concerns were fine lines and wrinkles (42%), followed by acne and blemishes (39%), and dry skin (26%). When questioned about barriers respondents faced in discovering and using dermatologic products, SOC respondents were more likely to cite lack of available products for their skin type (11%), as compared to white respondents (0%). Skin of color respondents identified internet (42%) and social media (29%) as major sources of information regarding dermatologic products as compared to white respondents (26% and 13%, respectively). Health care disparities can be heightened by targeted marketing and the media, which have a major impact on patient health literacy and consumer choices. Dermatologists should be aware of this impact in order to address the knowledge gaps, minimize bias, and increase inclusivity for all skin types. J Drugs Dermatol. 2022;21(7):709-711. doi:10.36849/JDD.6557.

Cosmetic skin lightening use and side effects.

Cosmetic skin lightening is a growing dermatologic public health problem that affects communities of color worldwide. Despite well-documented adverse health effects, cosmetic skin lightening continues to be a popular practice among patients of color. Given the US's changing demographics, it is critical for dermatologists to be knowledgeable about the medical impact as well as social and cultural implications of this practice. This review article aims to serve as a primer for the dermatologist on the medical and sociocultural aspects of cosmetic skin lightening, as well as an approach to discuss the issue of cosmetic skin lightening with patients. We conducted a comprehensive PubMed search using the terms 'skin lightening agents,' 'skin bleaching,' and 'depigmenting agents,' and reviewed the literature on cosmetic skin lightening products, active ingredients, and adverse side effects. Herein, we review the prevalence, ingredients, and health implications of cosmetic skin lightening products. We also provide recommendations for counseling patients who practice cosmetic skin lightening in a culturally sensitive manner.

Home-based devices in dermatology: a systematic review of safety and efficacy.

There is increasing demand for home-based devices for the treatment of dermatologic conditions and cosmesis. Commercially available devices include intense pulsed light, laser diodes, radiofrequency, light-emitting diodes, and ultraviolet B phototherapy. The objective of this report is to evaluate the current evidence regarding the efficacy and safety of home-based devices for the treatment of skin conditions. A systematic search of PubMed, Embase, and Cinahl was conducted on November 9, 2020 using PRISMA guidelines. Original research articles that investigated the efficacy and safety of home-based devices for dermatologic use were included. Bibliographies were screened for additional relevant articles. Strength of evidence was graded using the Oxford Centre for Evidence-Based Medicine guidelines. Clinical recommendations were then made based on the quality of the existing literature. After review, 37 clinical trials were included-19 were randomized controlled trials, 16 were case series, and 2 were non-randomized controlled trials. Ultimately, from our analysis, we recommend the home-based use of intense pulsed light for hair removal, laser diodes for androgenic alopecia, low power radiofrequency for rhytides and wrinkles, and light-emitting diodes for acne vulgaris. Trials investigating ultraviolet B phototherapy for psoriasis revealed mixed evidence for home treatments compared to clinic treatments. All devices had favorable safety profiles with few significant adverse events. Limitations to our review include a limited number of randomized controlled trials as well as a lack of data on the long-term efficacy and safety of each device.

Light emitting diode-red light for reduction of post-surgical scarring: Results from a dose-ranging, split-face, randomized controlled trial.

Scarring has significant esthetic and functional consequences for patients. A need exists for anti-scarring therapeutics. Light emitting diode-red light (LED-RL) has been shown to modulate skin fibrosis. The aim of this study is to evaluate the safety and efficacy of LED-RL to reduce post-operative scarring. Cutaneous Understanding of Red-light Efficacy on Scarring was a randomized, mock-controlled, single-blind, dose-ranging, split-face phase II clinical trial. Starting 1 week post-surgery, patients received LED-RL irradiation and temperature-controlled mock therapy to incision sites at fluences of 160, 320 or 480 J/cm2 , triweekly for 3 weeks. Efficacy was assessed at 1, 3 and 6-12 months. The primary endpoint was difference in scar pliability between LED-RL-treated and control sites. Secondary outcomes included Patient and Observer Scar Assessment Scale, collagen and water concentration, and adverse events. There were no significant differences in scar pliability between treated and control scars. At certain fluences, treated scars showed greater improvements in observer rating and scar pliability, reflected by greater reductions in induration, from baseline to 6 months compared to control scars. Treatment-site adverse events included blistering (n = 2) and swelling (n = 1), which were mild and resolved without sequelae. LED-RL phototherapy is safe in the early postoperative period and may reduce scarring.

Proper Use and Compliance of Facial Masks During the COVID-19 Pandemic: An Observational Study of Hospitals in New York City.

Proper mask usage is a cornerstone of the prevention of COVID-19 transmission. Hospitals, in particular, are important settings for proper mask compliance due to the risk for viral exposure. Despite the presence of health care personnel and financial resources to ensure proper compliance, mask usage is variable in health care settings. The impact of mask compliance is particularly important in New York City (NYC) because of the burden of COVID-19 and at-risk demographics. We conducted a prospective observational study in 4 NYC hospitals assessing rates of proper mask compliance among adult patients entering the hospital. Six hundred unique individuals were observed for proper mask fit, exposure of the nose and mouth, and the presence of nontraditional face coverings in lieu of a mask at 4 NYC hospitals. Proper mask usage is a large health education gap that must be addressed by health care administrations and governmental agencies, as mask usage continues to be an effective form of COVID-19 prevention.

High-fluence light emitting diode-red light inhibits cell cycle progression in human dermal fibroblasts.

Skin fibrosis is a debilitating feature of several systemic and dermatologic diseases. While current treatment options carry significant risk of side effects and recurrence, high-fluence light emitting diode-generated red light (LED-RL) is an alternative therapeutic that is safe, non-invasive, and accessible. We previously demonstrated LED-RL decreases fibroblast proliferation, a key pathogenic component of fibrosis. However, the cellular mechanism by which high fluence LED-RL modulates fibroblast proliferation is unclear. Herein, we explored the effects of high fluence LED-RL on human dermal fibroblast cell cycle progression. We demonstrate that LED-RL at 640 J/cm2 induced significant arrest of cells in G0 /G1 compared to temperature-matched control. This was accompanied by a corresponding increase in expression of checkpoint regulator p53 in irradiated cells. These data demonstrate high fluence LED-RL may exert its anti-proliferative effect on fibroblasts by inducing G0 /G1 arrest. Further, this study provides insight into the molecular mechanism underlying LED-RL as an anti-fibrotic therapeutic.

The Vascular Component of Melasma: A Systematic Review of Laboratory, Diagnostic, and Therapeutic Evidence.

BACKGROUND: Melasma is a common acquired disorder of hyperpigmentation, classically manifesting as symmetric brown patches on the face. Although the exact pathogenesis is not fully understood, vascular abnormalities have been implicated in melasma. OBJECTIVE: To evaluate the laboratory and clinical evidence regarding the safety and efficacy of antivascular agents for the treatment of melasma. METHODS: A systematic review of PubMed, EMBASE, and Cochrane was conducted on May 13, 2020, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Original research articles investigating the role of vascularity and/or evaluating the use of antivascular therapeutics in melasma were included. Clinical recommendations were based on the American College of Physicians guidelines. RESULTS: A total of 34 original research articles as follows were identified: 4 laboratory studies, 15 diagnostic studies, and 15 therapeutic studies. CONCLUSION: There is promising evidence supporting the use of tranexamic acid and laser/light therapies to treat the vascular component of melasma, and more rigorous clinical trials are needed to validate their efficacy. Clinicians may consider treatment with one or more antivascular therapeutics in patients with melasma. Further research is warranted to characterize the role of cutaneous vascularization in melasma and may provide insights for novel therapies.

Preliminary analysis of distinct clinical and biologic features of bone metastases in melanoma.

Melanoma disseminates to the skeletal system where it is then difficult to treat. Yet, there remains limited research investigating metastatic bone disease (MBD) in melanoma. Here, we evaluate whether there are distinct clinicopathologic variables at the time of primary melanoma diagnosis that predispose metastases to engraft bone, and we test the hypothesis that patients with MBD have different responses to treatment. Cutaneous melanoma patients enrolled in a prospective database were studied. Individuals with metastatic melanoma and bone metastases (M-Bone) were compared to those with metastatic disease but no M-Bone. Of the 463 (42.7%) patients, 198 with unresectable metastatic melanoma had M-Bone and 98 developed bone metastasis (bone mets) as first site. Progression-free survival and overall survival were significantly worse in patients with M-Bone compared to those without M-Bone (P < 0.001) independent of treatment modalities, and in patients whose melanoma spread to bone first, compared to those who developed first mets elsewhere (P < 0.001). Interestingly, patients with bone mets presented with primary tumors that had more tumor infiltrating lymphocytes (P < 0.001) and less often a nodular histologic subtype compared to patients without M-Bone (P < 0.001). Our data suggest that melanoma bone metastasis is a distinct clinical and biological entity that cannot be explained by generalized metastatic phenotype in all patients. The observed dichotomy between more favorable primary histopathologic characteristics and a grave overall prognosis requires more studies to elucidate the molecular processes by which melanomas infiltrate bone and to build a mechanistic understanding of how melanoma bone metastases yield such detrimental outcomes.

Bioactive ingredients in Korean cosmeceuticals: Trends and research evidence.

BACKGROUND: Cosmeceuticals are commonly used in skincare regimens to maintain healthy skin and improve visible signs of aging. In recent years, South Korean skincare has gained prominence in the global beauty industry by introducing innovative cosmeceutical products and aesthetic trends. OBJECTIVES: To describe the global impact of Korean skincare and to review the current research evidence for bioactive ingredients commonly found in Korean cosmeceuticals. METHODS: A review of the biomedical literature was conducted using PubMed to identify laboratory, animal, and clinical studies that evaluated the biological properties and potential dermatologic uses of ingredients found in Korean cosmeceuticals. RESULTS: Bioactive ingredients in Korean cosmeceutical products are increasingly undergoing scientific validation and are derived from various sources including animals (eg, bee venom and snail mucin), plants (eg, dragon's blood and tiger grass extract), and biotechnology (eg, synthetic snake venom). Their bioactive components and pharmacologic activities have been shown to provide dermatologic benefits with potential applications for skin rejuvenation, photoprotection, wound healing, and more. CONCLUSION: Further research studies are warranted to elucidate any biological or therapeutic mechanisms of action of these ingredients, which may translate into clinical practice. With the rising public awareness and interest in Korean cosmeceuticals, patients may seek advice from dermatologists about how to incorporate these bioactive ingredients into their skincare regimens to improve skin health and aesthetics.