Platelet-Rich Plasma: Advances and Controversies in Hair Restoration and Skin Rejuvenation.

BACKGROUND: Platelet-rich plasma (PRP) and its combined therapeutic modalities have catalyzed new possibilities in dermatology; however, limitations in evidence and lack of consensus remain among clinicians regarding optimal composition, protocol, technique, and application. OBJECTIVE: To provide an update and analysis of the evidence for PRP in hair restoration and skin rejuvenation through review of recent available data, highlighting controversies and expert insights to guide future studies, and stimulate discourse and innovations benefitting patients. METHODS: A structured review and expert analysis of PubMed publications before October 2023, with a focus on recent literature from January 2020 through October 2023. RESULTS AND CONCLUSION: Growing literature supports the utility and benefits of PRP and related autologous products for applications for skin and hair, with strongest evidence for androgenetic alopecia and skin rejuvenation. However, this is limited by lack of consensus regarding best practices and protocols. Randomized, controlled trials with uniform metrics comparing outcomes of various compositions of autologous blood products, preparation methods, dosimetry, and frequency of treatments are still required. This will allow the medical discourse to grow beyond the realm of expert opinion into consensus, standardization, and more wide spread adoption of best practices that will benefit patients.

Dermatology's role in the fight against human trafficking: A report from the AAD Ad Hoc Task Force and call to action.

While the majority of American Academy of Dermatology members have some broad awareness of human trafficking, most are not aware of it in their communities or of the skin signs that could prompt identification of those being exploited, and have requested educational resources to assist patients affected by trafficking. The American Academy of Dermatology Ad Hoc Task Force on Dermatologic Resources for the Intervention and Prevention of Human Trafficking has been working to develop relevant resources, including an online toolkit on the American Academy of Dermatology website: https://www.aad.org/member/clinical-quality/clinical-care/human-trafficking.

The Burden of Air Pollution on Skin Health: a Brief Report and Call to Action.

INTRODUCTION: Air pollution in North America has intensified due to wildfires in recent years. In 2023, the wildfires in the Canadian province of Quebec caused a southward spread of pollutants, negatively affecting air quality and thereby aggravating certain health conditions in northeastern USA. This study examines the impact of air pollution on atopic dermatitis (AD) and skin health and how wildfires can exacerbate the burden of disease. METHODS: Carbon monoxide levels measured by the U.S. Environmental Protection Agency (EPA) in the Boston region during the months following the Canadian wildfires of 2023 were collected from the U.S. EPA Outdoor Air Quality webpage. Patient records on dermatology clinic visits for dermatitis and eczema at the Mass General Brigham (MGB) hospital system, 300 miles from the wildfires, were examined, and the data compared with data from the corresponding months in 2019-2022 for historical control. No individual patient data were collected. RESULTS: A notable rise and atypical summer peak in carbon monoxide (CO) levels in the Boston region during 2023 correlated with a spike in AD, dermatitis, and eczema-related dermatology clinic visits within the MGB hospital system, as compared with the prior 4 years. CONCLUSION: The synchronized atypical peaks of CO levels and AD-related visits during the summer of 2023 highlight the potential impact of acute air pollution events such as wildfires on air quality and the consequences for skin health. Air pollution, exacerbated by wildfires, can damage the skin through the smoke and chemicals utilized for extinguishing fires, which contain multiple potential allergens and irritants to the skin, such as CO, particulate matter (PM2.5), and ammonium phosphates, triggering airway and skin inflammation and flares of AD. This issue disproportionately affects vulnerable populations, including low-income communities and the geriatric and pediatric populations. Healthcare professionals and government agencies must work together to improve air quality and purification policies and initiatives to lower the burden of skin disease, especially for vulnerable communities.

Our Post-Zoom Reflection: Turning Off the Monitor.

Over a year ago, the COVID-19 pandemic resulted in lockdowns and isolation, quickly shifting social interactions online. During this time, the authors cited worsening self-perception due to the altered and distorted image produced by front facing cameras, later called "Zoom Dysmorphia." A recent survey study was then conducted analyzing the mental health and self-image of people as they returned to in-person activities. Increased time spent online and use of filters, which provoked unrealistic expectations, correlated with worsening anxiety and worsening self-perception, especially in respondents under the age of 24 years. A large percentage of this cohort also planned to invest in their appearance to cope with this anxiety. After a year of being behind the screen, with the ability to enhance features with the click of a button, individuals are concerned about their appearance and their ability to return to a life in-person. Aesthetic physicians should be prepared to discuss the cosmetic concerns provoked by photo editing, filters, and videoconferencing to educate about realistic surgical goals and outcomes for patients.

Zooming into cosmetic procedures during the COVID-19 pandemic: The provider's perspective.

The COVID-19 pandemic has seen a massive shift toward virtual living, with video-conferencing now a primary means of communication for both work and social events. Individuals are finding themselves staring at their own video reflection, often for hours a day, scrutinizing a distorted image on screen and developing a negative self-perception. This survey study of over 100 board-certified dermatologists across the country elucidates a new problem of Zoom dysmorphia, where patients seek cosmetic procedures to improve their distorted appearance on video-conferencing calls.

The art of prevention: COVID-19 vaccine preparedness for the dermatologist.

As COVID-19 vaccinations begin, dermatologists must be aware of the cutaneous adverse events reported in the clinical trials, including injection site and hypersensitivity reactions, and emerging evidence of dermal filler injection reactions after vaccination. The filler reaction may represent the development of a delayed-type hypersensitivity in the setting of another immunologic trigger (i.e., the vaccine). After conducting a literature review of similar reactions, their pathophysiology, and management, we present a set of timely clinical considerations for counseling, prevention, and management of possible cutaneous sequelae of the COVID-19 vaccine. We encourage documentation of vaccine-related reactions to aid the safety data collection in the Vaccine Adverse Event Reporting System and the American Academy of Dermatology COVID-19 Registry.

Identification of skin signs in human-trafficking survivors.

Human-trafficking survivors suffer significant physical, mental, and social health consequences, prompting them to seek health care services. Although there is research regarding identification protocols for human-trafficking victims, there is no framework outlining the dermatologic patterns of survivors of human trafficking. We sought to identify the dermatologic signs reported in human-trafficking victims to create a framework for dermatologists and the broader medical community to appropriately screen patients at risk. After screening 577 pertinent records in the PubMed and Google Scholar databases for information about the physical signs of human trafficking in health care, 10 final studies were selected. Significant findings of rashes and brandings, such as tattoos, were more likely in sex-trafficked patients, whereas burns, injuries, and deep cuts were more likely to be found in labor-trafficked patients. This review outlines important identification guidelines that dermatologists and the broader medical community can use to recognize victims and take appropriate action while also raising awareness of human trafficking as an emerging public health issue.

Life after lockdown: Zooming out on perceptions in the post-videoconferencing era.

BACKGROUND: The COVID-19 pandemic has deeply disrupted daily life across the globe, with profound effects on mental and physical health. After more than a year of isolation and communication via videoconferencing, people are returning to in-person activities. OBJECTIVE: This study aimed to investigate worsening self-perception, mental health, and anxiety with the return to in-person activities, with a focus on the influence of videoconferencing, social media, and the use of filters. METHODS: An anonymous survey was distributed online through social media platforms and student network pages. RESULTS: A total of 7295 participants responded to the survey. Seventy-one precent reported anxiety or stress related to returning to in-person activities, and nearly 64% sought mental health support services. Thirty-percent stated they plan to invest in their appearance as a coping strategy to deal with the anxiety of returning to in-person, and >30% plan to take action in changing their appearance. The most reported dermatologic concerns were skin discoloration (32.36%), wrinkles (24.45%), and acne (14.85%). The prevalence of anxiety and mental health services increased relative to the use of filters in 18- to 24 year-olds. CONCLUSION: This survey study of >7000 participants across the country elucidates worsening self-perception, anxiety, and mental health as we return to in-person activities in relation to increased videoconferencing, social media usage, and the use of filters. Physicians should be aware of these effects to better serve their patients.