Hyperspectral assessment of acne skin exposed to intense pulsed light (IPL) intense pulsed light in acne treatment.

BACKGROUND: The mechanism of intense pulsed light action on the skin is based on selective photothermolysis. The light delivered to the tissue is scattered and absorbed by chromophores that absorb a beam of radiation of a specific length. The skin reflectance changes depending on the physiological state of the tissue, as shown by the hyperspectral camera. The aim of the study was to assess the hyperspectral reflectance of acne skin before and after intense pulsed light (IPL) therapy and to compare it with the reflectance of healthy skin. MATERIALS AND METHODS: The study involved 27 volunteers with diagnosed moderate acne. The control group consisted of 20 people without acne lesions. All acne volunteers underwent a series of four treatments using IPL at weekly intervals. The volunteers with acne lesions were photographed before the series of treatments and a week after the 4th treatment. RESULTS: Acne skin shows lower reflectance than healthy skin. Acne skin after IPL therapy is characterized by a higher reflectance compared to acne skin before the therapy and resembles the reflectance of the skin of the control group. A statistically significant difference was found between the acne skin before the treatments and the skin of the control group. CONCLUSIONS: The effect of IPL therapy on acne skin is the increase of its reflectance by reducing the number of chromophores, which brings it closer to the reflectance value of healthy skin. Hyperspectral imaging allows for: the evaluation of the treated skin at each stage, a precise selection of the light wavelength depending on the problem, and therefore, for optimizing the number of irradiations and increasing the safety of the therapy.

Application of a three-dimensional scanner to the quantitative assessment of the nail plate condition after a hybrid manicure procedure-Preliminary study.

BACKGROUND: About 90% of women worldwide use nail care products, including manicure ones. A manicure procedure results in nail damage, therefore it is necessary to search for new, objective methods of assessing the impact of the procedures and products applied within the nail plate. In this study, an attempt was made to quantify the impact of manicure procedures on the nail plate condition. MATERIALS AND METHODS: Twenty thumb nail plates were examined. Before the manicure procedures, alginate casts were prepared for each of the subjects. The analysis of the three-dimensional (3D) nail surface structure included the assessment of the nail sections and the assessment of differences in the nail structure after superposition of 3D images of the nail plates before and after the manicure procedures. RESULTS: The obtained results show that the nail plate structure changed to a similar extent in each measured section after the manicure procedure. A change in the height of the nails is not a desirable phenomenon as it suggests damage to the nail caused by the substances included in the preparations applied to the nails, acetone, or filing the nail plate. This proves the great influence of the technique of removing artificial nails on the structure of the natural plate. CONCLUSION: The use of a 3D scanner allows for precise, biometric, quantitative, and repeatable measurements of changes in the nail structure after a manicure procedure. The use of the hybrid and gel manicure procedure causes significant damage to the nail plate, especially in its distal portion.

CO2 laser treatment for pearly penile papules - personal experience.

Pearly penile papules (PPP) are physiological lesions in the epithelium of the corona of the glans penis which extend to its neck. These lesions may also appear on both sides of the frenulum. Although they are not pathological, the lesions frequently cause concern or embarrassment/discomfort in patients. They are the most common reason for seeing a dermatologist. There are several methods of treatment for PPP such as cryosurgery, electrocoagulation, treatment with CO2, Er:YAG, or pulsed dye lasers. This paper describes the authors' experience in removing PPP with a CO2 laser.

Image analysis and processing methods in verifying the correctness of performing low-invasive esthetic medical procedures.

BACKGROUND: Efficacy and safety of various treatments using fractional laser or radiofrequency depend, to a large extent, on precise movement of equipment head across the patient's skin. In addition, they both depend on uniform distribution of emitted pulses throughout the treated skin area. The pulses should be closely adjacent but they should not overlap. Pulse overlapping results in amplification of irradiation dose and carries the danger of unwanted effects. METHODS: Images obtained in infrared mode (Flir SC5200 thermovision camera equipped with photon detector) were entered into Matlab environment. Thermal changes in the skin were forced by CO2RE laser. Proposed image analysis and processing methods enable automatic recognition of CO2RE laser sites of action, making possible to assess the correctness of performed cosmetic procedures. RESULTS: 80 images were acquired and analyzed. Regions of interest (ROI) for the entire treatment field were determined automatically. In accordance with the proposed algorithm, laser-irradiated Li areas (ROI) were determined for the treatment area. On this basis, error values were calculated and expressed as percentage of area not covered by any irradiation dose (δo) and as percentage area which received double dose (δz). The respective values for the analyzed images were δo=17.87±10.5% and δz=1.97±1.5%, respectively. CONCLUSIONS: The presented method of verifying the correctness of performing low-invasive esthetic medical (cosmetic) procedures has proved itself numerous times in practice. Advantages of the method include: automatic determination of coverage error values δo and δz, non-invasive, sterile and remote-controlled thermovisual mode of measurements, and possibility of assessing dynamics of patient's skin temperature changes.

Impact of IPL treatments on parameters of acne skin.

BACKGROUND: In the treatment of acne, skin parameters such as sebum secretion, hydration, and the content of hemoglobin and melanin are very important. The values of these parameters at the appropriate level show the maintenance of good functionality of the epidermal barrier and the impact of a given treatment procedure on the condition and physiology of the epidermis. AIMS: The aim of the study was to evaluate the effectiveness of anti-acne therapy with IPL by volunteers, as well as to quantify parameters such as sebum secretion, hydration level, and the content of melanin and hemoglobin in the skin. PATIENTS/METHODS: The study involved 27 volunteers with moderate acne. A series of 4 treatments was performed with intense pulse light at weekly intervals. The secretion of sebum, skin hydration, and the content of melanin and hemoglobin was measured. RESULTS: A decrease in sebum secretion in the forehead area after light treatments was observed, the level of hydration remained the same in all areas examined, as did the levels of melanin and hemoglobin. The volunteers were asked about the satisfaction with the effects of the treatment: 100% answered that they were satisfied with the effects of the treatment to a degree of 7.8 ± 1.5. CONCLUSIONS: During anti-acne therapy, therapists usually focus only on reducing acne lesions, forgetting that proper care has a large impact on the success of dermatological therapies. It is very important to know the influence of treatment procedures on the parameters of the skin in order to choose the right care for the best treatment effect.

Quantitative Evaluation of the Effectiveness of Chemical Peelings in Reducing Acne Lesions Based on Gray-Level Co-Occurrence Matrix (GLCM).

Purpose: Acne vulgaris is a chronic, inflammatory disease accompanied by lesions affecting the structure of the skin. Chemical peels are one of the methods of reducing acne vulgaris. There is still a lack of quantitative methods of assessing impact of cosmetic procedure on the skin. Skin condition depends on skin texture characterization; therefore, the analysis that provides data about the textures can be helpful in assessing the effectiveness of cosmetic treatments. Patients and Methods: The study involved 24 volunteers with acne lesions. Each participant underwent 4 treatments using chemical peels at two-week intervals. Before, during and after procedure clinical photography were made. To assess effectiveness of chemical peeling in acne lesion reduction, we were used gray-level co-occurrence matrix (GLCM) analysis. Qualitative assessment of acne severity was made by 12 experts in dermatology. Results: After a series of treatments, the GLCM contrast value decreased in each area of the face, and the GLCM homogeneity value increased, which means that the number of acne lesions was reduced. Expert assessment according to the IGA scale confirms the effectiveness of therapy with both salicylic and glycolic acid and pyruvic acid. Conclusion: The results of this study prove that GLCM analysis is a useful tool for assessing the effectiveness of chemical peel treatments. It can also be used for quantitative assessment of skin texture.

The Influence of Carboxytherapy on Scar Reduction.

Introduction: Although it is not a new method, a carboxytherapy, which is based on intradermal or subcutaneous administration of controlled doses of CO2, is gaining more and more recognition among aesthetic medicine doctors, dermatologists and cosmetologists around the world. The consequence of applying carbon dioxide directly into tissues is associated with an immediate expansion of blood vessels, improvement of local blood supply, and, thus, tissue metabolism. It does also support natural regenerative processes. Oxygen and growth factors released from blood, within the area which undergoes treatment, stimulate fibroblasts to produce collagen and formation of new blood vessels also known as neovascularization. In addition to biochemical mechanisms, CO2 injection into the dermis or subcutaneous tissue leads to a mechanical effect exerted by pressure and flow of CO2 which is injected. It is of particular importance in scar treatments. Methods: Twelve mature scars were subjected to the carboxytherapy which was performed in people aged 23-45 years. A small amount of heated, medical CO2 was injected till the moment a scar turns white. The applied flow rate equalled 100 mL/min (cc/min). Before and after a series of four treatments, the level of hydration, elasticity and colour of the skin were measured. A structured-light 3D scanner was used to determine an exact morphology of the examined scars. The 3D scanning device is seen as a sensitive and precise method of qualitative and quantitative assessment of a morphology of scars. Results: The results of the measurements performed showed a reduction in the surface of the analyzed changes, as well as proved the ability of CO2 to rebuild collagen fibres. The decrease in value of parameters, which have been obtained thanks to the kutometric examination, indicates softening and loosening of connective tissue. It does confirm the effectiveness of carboxytherapy.

Analysis of the effectiveness of chemical peelings in the treatment of acne vulgaris assessed using high-frequency ultrasound-A comparative study.

BACKGROUND: The use of high-frequency ultrasound for noninvasive assessment of skin during chemical peeling therapies may be a useful tool. AIMS: To determine whether high-frequency ultrasound is a useful tool to noninvasive assessment of skin and evaluation therapy progress. PATIENTS/METHODS: The 14 women underwent four treatments with chemical peelings at 2-week intervals. Before, after 4 weeks and after 9 weeks, photographic documentation and scans were recorded using a high-resolution ultrasound system. RESULTS: As a result of applying pyruvic acid peeling, the thickness of the entrance echo on the forehead, cheek, and chin was reduced. After applying the peeling consisting of a mixture of glycolic and salicylic acids, the thickness of the entrance echo of the epidermis decreased on the forehead, cheek, and chin. As a result of applying a 50% pyruvic acid peeling, the density of dermis on the forehead, cheeks, and chin increased. A similar increase in the density of dermis was observed on the forehead, cheeks, and chin after applying a mixture of glycolic and salicylic acid. CONCLUSION: High-frequency ultrasound is a useful tool for monitoring the progress in the treatment of acne vulgaris using chemical peelings.

The use of light in the treatment of acne vulgaris-a review.

Topical and oral antibiotic therapy is also a popular method of treatment. The effectiveness of this method is limited by the increasing resistance of bacteria to antibiotics. Over the decades since the introduction of antibiotics to treat acne, the resistance levels of bacteria have changed. This defense mechanism is developed evolutionarily. Modifications of antibiotic receptor sites, alteration of drug influx/efflux, or enzymatic degradation are common mechanisms used by bacteria to initiate and strengthen internal antibiotic resistance. The basic chromophores used in light therapy are hemoglobin, melanin, water bound to proteins, and porphyrins. Hemoglobin absorbs light mainly at 580 nm, while melanin absorbs the entire visible spectral range (400-750 nm). Porphyrins are aromatic compounds, classified as photosensitizing substances, intensively absorbing blue light, and to a lesser extent in long visible bands, such as orange and red light. Using IPL makes it possible to cover the maximum light absorption of porphyrins and hemoglobin, therefore it can be an effective tool in the treatment of inflammatory lesions in acne vulgaris. In view of the effectiveness of light therapy and its effect even on antibiotic-resistant bacteria, it is worth considering the possibility of using light therapy instead of antibiotic therapy. Due to the increasing resistance of bacteria to antimicrobials, they should be used with caution and as a last resort. The high-energy light treatment act only locally (unlike with antibiotics taken orally) and on a chromophore, such as melanin, hemoglobin, or porphyrins.

A split-face comparative study to evaluate the efficacy of 50% pyruvic acid against a mixture of glycolic and salicylic acids in the treatment of acne vulgaris.

BACKGROUND: One of the ways to treat acne is by using chemical peels. Salicylic, glycolic and pyruvic acids due to their keratolytic and antibacterial properties are often recommended for acne patients. AIMS: The aim of the study was to compare the effect of a preparation containing glycolic and salicylic acids with pyruvic acid. PATIENTS/METHODS: 14 women diagnosed with acne took part in the study. The facial treatment area was divided into two parts: right (a preparation containing 50% pyruvic acid) and left side ( a preparation containing glycolic and salicylic acids). A series of four treatments was performed at 2-week intervals. Skin parameters, namely hydration, sebum secretion and skin colour were measured. RESULTS: As a result of using 50% pyruvic acid, the hydration of the right side of the face increased statistically and there was a decrease in the amount of melanin in the epidermis. On the left side of the face, there was an increase in skin hydration after using a mixture of glycolic and salicylic acids. The increase in skin hydration on the left side of the chin and nose was not statistically significant. The use of the mixture of glycolic and salicylic acids affected the skin colour on the left side of the face, on the forehead, cheek and nose. CONCLUSION: Chemical peels affect a wide range of pathological factors of acne. A mixture of acids yields fewer side effects than a single acid used in high concentration, but the therapeutic effects are comparable.

In vivo dynamic thermal imaging of skin radiofrequency treatment.

In recent years, popularity of radiofrequency (RF) has increased significantly. They are characterized by a low risk of complications and relatively high effectiveness. RF use high-frequency currents causing oscillating motion of ions resulting in temperature rise stimulating skin regeneration processes. The aim of this work was the thermographic evaluation of the skin exposed to RF of different intensity. The dynamic thermal imaging was used to study the temperature of the skin exposed to RF. The research was carried out in two locations with different adipose tissue content: abdomen (ROI1) and forearm (ROI2). In the ROI1 area, RF was applied at nominal power range from 250 to 1750 W, while in ROI2 area: from 250 to 1000 W. The obtained thermographic data were fitted to exponential functions. A clear dependence of obtained thermokinetic parameters with the anatomical location of exposure to RF was demonstrated. Thicker layer of adipose tissue directly under the skin resulted in obtaining higher maximum temperatures of the skin surface during the procedure (maximum obtained temperature equaled 40.8°C). The temperature of the skin under the head of the device does not translate to subjective patient experiences. In anatomic locations filled with less adipose tissue mass, tolerance to RF is much lower. The dynamics of skin temperature changes, after the RF treatment, can be described by means of a single exponential function where the key parameter is the time constant t1 defining the dynamics of skin temperature changes. The depth of the RF influence is slightly correlated with the RF power.

The use of microtomographic imaging in the identification of counterfeit medicines.

The practice of drug counterfeiting is an important challenge due to the extremely rapid growth rate of this disturbing trend and its immense potential harmfulness. According to WHO even 10% of counterfeit medicines can be exact copies of genuine medicines: they have exactly the same quantitative and qualitative composition in terms of both API and excipients. Thus, the identification of such drugs using chemical analysis methods can be very difficult or even impossible. The aim of this study was to verify the effectiveness of using computed microtomography in the identification of counterfeit medicines. The General Electric v|tome|x s microtomography system was used in the study. The recorded microtomographic scans were subjected to analysis and image processing. The following parameters of image analysis and processing were identified: mean brightness, homogeneity, contrast, quadratic tree decomposition. The original and falsified 100-mg Viagra® tablets (Pfizer) were compared. 8 original Viagra® tablets (hereinafter referred to as T) and 8 falsified tablets (hereinafter referred to as F1-F8) were tested. The range of variation for the genuine medicines against fake products was: brightness: 90.9-117.1 vs 33.8, 50.1, homogeneity: 0.84-0.92 vs 0.94-1.01 and quadratic tree decomposition for the 1 × 1 mask: 55768-58792 vs 0-439. The proposed method of microtomographic image analysis and processing enables to identify solid dosage forms, including those that are an accurate chemical copy, with high sensitivity and specificity, 94.5% and 97%, respectively. The advantage of the µCT method is its high efficiency and speed, whereas the disadvantages include the possibility of using only solid dosage forms and high equipment costs.

The Use of Directional Reflectance Measurement for in vivo Assessment of Protective Properties of Cosmetics in the Infrared Radiation Range.

Photoprotection of skin is now focused on UV radiation. The aim of this study was to evaluate in vivo cosmetic products in terms of protection against infrared radiation (IR) and propose a methodology for conducting such measurements. The directional reflectance (DR) of 12 UV filters, six care creams and two preparations containing fumed silica applied on the forearm of 36 volunteers was examined in six spectral bands for two angles of incidence. SOC-410 Directional Hemispherical Reflectometer was used to measure DR. There is very little change in DR for all spectral bands for both incident angles for both UV filters, care creams and preparations containing fumed silica. For example, for 15% of fumed silica in glycerin for the spectral band of 0.9-1.1 µm and the incident angle of 20°, skin DR prior to application was 0.543; 5 min after application was 0.533 and 30 min after application was 0.559. Both UV filters, care creams and fumed silica do not protect skin against IR. The proposed method of in vivo measurements is superior to in vitro studies which have been conducted so far because it takes into account both the refractive index at the tissue/air interface and the absorption of IR by adipose tissue.