1
|
Lee JH, Kim J, Lee YN, Choi S, Lee YI, Suk J, Lee JH. The efficacy of intradermal hyaluronic acid filler as a skin quality booster: A prospective, single-center, single-arm pilot study. J Cosmet Dermatol 2024; 23:409-416. [PMID: 37705328 DOI: 10.1111/jocd.15944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/03/2023] [Accepted: 07/21/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND The use of "skin boosters" comprised of hyaluronic acid (HA)-based fillers to improve skin quality has gained popularity recently, especially in individuals interested in skin rejuvenation. AIM This study aimed to evaluate the efficacy and safety of intradermal micropuncture injections of HA-based gel filler combined with lidocaine (BYRYZN® SKINBOOSTER HA, ACROSS Co., Ltd., Gangwon-do, Korea). PATIENTS/METHODS A prospective, single-arm, open-label pilot study was conducted with study subjects who were aged between 30 and 60 years old and exhibited evidence of skin aging, such as wrinkles and loss of elasticity. They received three injections at 2-week intervals and were followed up for a total of 12 weeks. RESULTS Twenty subjects with a mean age of 54.1 years were included. The mean Lemperle wrinkle scale demonstrated a 40% decrease from 2.60 ± 0.60 at baseline to 1.55 ± 0.51 at week 8. The improvement rate was maintained at about 33% until week 12. The average maximum height of the wrinkle (Rz, μm), average skin roughness (Ra, μm), skin elasticity (R2, AU), facial curved length (mm), skin pore size (mm2 ), skin hydration (AU), TEWL (g/hm2 ), and skin glossiness (gloss value, AU) exhibited statistically significant improvements over time compared with the baseline measurements. No serious adverse effects or persistent adverse effects were reported, except for a transient subcutaneous nodule in one subject. CONCLUSIONS This study demonstrates that multiple microinjections of HA-based gel filler for facial skin aging are safe and effective in improving facial skin quality.
Collapse
Affiliation(s)
- Joo Hee Lee
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jemin Kim
- Scar Laser and Plastic Surgery Center, Yonsei Cancer Hospital, Yonsei University College of Medicine, Seoul, Korea
- Department of Dermatology, Yongin Severance Hospital, Yonsei University College of Medicine, Gyeonggi-do, Korea
| | - Yun Na Lee
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sooyeon Choi
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young In Lee
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Scar Laser and Plastic Surgery Center, Yonsei Cancer Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jangmi Suk
- Global Medical Research Center, Seoul, Korea
| | - Ju Hee Lee
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Scar Laser and Plastic Surgery Center, Yonsei Cancer Hospital, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
2
|
Han HS, Kim BR, Kim M, Na JI, Seo SB, Huh CH, Shin JW. Needleless laser injector versus needle injection for skin enhancement and rejuvenation effect of dermal filler. Lasers Surg Med 2023; 55:809-816. [PMID: 37632290 DOI: 10.1002/lsm.23719] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/11/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND AND OBJECTIVES A needleless laser-induced microjet injector is a novel transdermal drug delivery system that can rapidly inject a very small and precise drug dose into the skin with minimal pain and downtime. In this study, we aimed to compare the laser-induced microjet injection versus needle injection of polylactic acid/hyaluronic acid filler for skin enhancement and rejuvenation. PATIENTS AND METHODS A 24-week prospective, single-center, assessor-blinded, randomized, split-face study was conducted. The enrolled patients underwent one treatment session of dermal filler injection using a laser-induced microjet injector on one half of the face or a traditional needle injection on the other half of the face. Evaluation was conducted at baseline before treatment and at 4, 12, and 24 weeks after treatment. RESULTS A single treatment of filler injection with a laser-induced microjet injector resulted in similar improvements in skin hydration and elasticity as a single treatment of filler injection by using manual needle injection, with reduced pain, side effects, and decreased treatment time. CONCLUSIONS Laser-induced microjet injector enabled not only the application of a controlled dose and filler depth but also even distribution, improved clinical efficacy, reduced pain and side effects, and sufficient time for clinicians to perform treatment.
Collapse
Affiliation(s)
- Hye Sung Han
- Department of Dermatology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Gyeonggi-do, Korea
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Bo Ri Kim
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Minjae Kim
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-Im Na
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | | | - Chang-Hun Huh
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-Won Shin
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
3
|
Siquier-Dameto G, Boisnic S, Boadas-Vaello P, Verdú E. Anti-Aging and Depigmentation Effect of a Hyaluronic Acid Mechanically Stabilized Complex on Human Skin Explants. Polymers (Basel) 2023; 15:polym15112438. [PMID: 37299236 DOI: 10.3390/polym15112438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Solar radiation and environmental pollutants are factors that cause changes in the skin that trigger skin aging. The objective of the study is to evaluate the rejuvenating effects of a complex formed by hyaluronic acid supplemented with vitamins, amino acids and oligopeptides in explants of human skin. For this, surplus skin samples have been obtained from donors that have been resected and cultivated on slides with membrane inserts. The complex was administered to some skin explants and the percentage of cells with low, medium and high levels of melanin was evaluated as an indicator of the degree of pigmentation. Other skin segments were irradiated with UVA/UVB, then the product was administered on several slides and the levels of collagen, elastin, sulfated GAG and MMP1 were evaluated. The results show that the administration of the complex significantly reduces the percentage of skin cells with a high melanin content by 16%, and that in skin irradiated with UVA/UVB, there is a decrease in the content of collagen, elastin and sulfate GAGs, and the complex reverses this reduction without changing MMP1 levels. This suggests that the compound has anti-aging and depigmentation effects on the skin, giving a skin rejuvenation appearance.
Collapse
Affiliation(s)
- Gabriel Siquier-Dameto
- Dameto Clinics International, 1171 VC Badhoevedorp, The Netherlands
- Research Group of Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, E-17003 Girona, Catalonia, Spain
| | - Sylvie Boisnic
- Groupe de Recherche et d'Evaluation en Dermatologie et Cosmétologie (GREDECO), 75116 Paris, France
| | - Pere Boadas-Vaello
- Research Group of Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, E-17003 Girona, Catalonia, Spain
| | - Enrique Verdú
- Research Group of Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, E-17003 Girona, Catalonia, Spain
| |
Collapse
|
4
|
Ghatge AS, Ghatge SB. The Effectiveness of Injectable Hyaluronic Acid in the Improvement of the Facial Skin Quality: A Systematic Review. Clin Cosmet Investig Dermatol 2023; 16:891-899. [PMID: 37038447 PMCID: PMC10082573 DOI: 10.2147/ccid.s404248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/24/2023] [Indexed: 04/07/2023]
Abstract
Background Several studies have evaluated the role of various injectable formulations of hyaluronic acid (HA) in the improvement of the quality of facial skin. It is important to systematically summarize the available evidence in this regard. Methods Relevant databases were searched for clinical studies that evaluated the therapeutic role of any injectable formulation of HA in improving the quality of facial skin in adult humans until 31 December 2022. The available studies were critically analyzed and the data were extracted. Results A total of 2996 articles were screened and 13 studies were finally included. Eight studies evaluated the effect of various formulations of HA alone, while five evaluated the effect of various formulations of HA along with other active ingredients (cocktails) on the quality of facial skin. All types of HA formulations cause a significant improvement in facial skin quality, in terms of hydration, firmness, skin-tiring effect/fatigue, brightness, texture, radiance, and elasticity. The effect of HA monotherapy was more pronounced than that of the cocktail ingredients. HA treatment was quite safe and the patient satisfaction level was high. Conclusion The clinical evidence on the use of injectable HA alone in the improvement of the quality of facial skin, in terms of hydration, firmness, skin-tiring effect/fatigue, brightness, texture, radiance, and elasticity, is quite promising. Large randomized controlled trials are required in this regard.
Collapse
Affiliation(s)
- Anjali Sharad Ghatge
- Department of Dermatology, Apollo Clinic, Mumbai, 400001, India
- Correspondence: Anjali Sharad Ghatge, Apollo Clinic, Ground Floor, Eucharistic Congress Building No. 1, 5, Convent Street, Apollo Bandar, Colaba, Mumbai, Maharashtra, 400001, India, Tel +91-22-22021188, Email
| | - Sharad Balasaheb Ghatge
- Department of Radiology, Sir JJ Group of Hospitals and Grant Government Medical College, Mumbai, 400008, India
| |
Collapse
|
5
|
Iranmanesh B, Khalili M, Mohammadi S, Amiri R, Aflatoonian M. Employing hyaluronic acid-based mesotherapy for facial rejuvenation. J Cosmet Dermatol 2022; 21:6605-6618. [PMID: 36098653 DOI: 10.1111/jocd.15341] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/25/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Mesotherapy is a method of treatment in which biocompatible substances are injected in small aliquots into different levels of skin. This technique can be used for facial rejuvenation. AIM To comprehensively evaluate efficacy of different hyaluronic acid (HA) materials for skin rejuvenation, and discuss longevity of these products, potential adverse effects, and different injection techniques. MATERIAL AND METHODS We searched Pubmed, Scopus, Web of science, Google Scholar, Embase, Cochrane Library, and Science direct until April of 2022. Thirty-four articles were selected including 23 articles about non-cross-linked HA and 11 articles about cross-linked HA. RESULTS Eleven and five different non-cross-linked HA and cross-linked HA materials were utilized, respectively. Treatment sessions for non-cross-linked HA were between 1 and 6 at weekly-to-bimonthly interval, and for cross-linked HA were 1-3 at 4-36 weeks apart. In most of the studies, serial micropuncture technique with 23-32 gauge needles was used for injection. Other injection techniques were Nappage (picotage), depot and micro-linear. CONCLUSION Mesotherapy with HA-based fillers is a favorable method for restoring youthful appearance, rejuvenation, and revitalization of skin. Proper selection and precise placement of HA in desired level of dermis is an essential key to optimize improvement and minimize side effects including skin irregularities and Tyndall effect. Adjuvant therapy with additional rejuvenation procedures to enhance esthetic results is required especially in elderly individuals with severe photodamaged skin. Moreover, preservation of esthetic results requires maintenance therapy every few months.
Collapse
Affiliation(s)
- Behzad Iranmanesh
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Khalili
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Saman Mohammadi
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Rezvan Amiri
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahin Aflatoonian
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
6
|
Kerscher M, Wagner-Schiffler S, Noah EM, Fischer T, Greiner-Krüger D, Sattler S, Kaptan T, Drabik A, Hamed G, Reinecke J, Wehling J. Cell-Free Blood Cell Secretome (BCS) Counteracts Skin Aging: Multi-Center Prospective Regenerative Aesthetic Medicine Study Using Exokine®. Clin Cosmet Investig Dermatol 2022; 15:1157-1173. [PMID: 35784268 PMCID: PMC9248816 DOI: 10.2147/ccid.s357810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022]
Abstract
Background The “Inflammation Theory of Ageing” identifies pro-inflammatory cytokines and oxidative damage as one cause of cellular and mitochondrial deterioration and aging. Cell-free blood cell secretome (BCS) also known as autologous conditioned serum (ACS) has shown anti-inflammatory and regenerative mode of action in musculoskeletal disorders and radicular compression. Aim To confirm that BCS can improve signs of skin aging from a previous study in a multi-center setting. Methods Prospective, one-armed, multi-center interventional therapeutic study. Ninety-five women with skin firmness loss were treated with four intra-dermal injection sessions in both cheeks at 0, 2, 4 and 6 weeks. BCS was processed with Exokine® medical device according to manufacturer’s instructions. Primary endpoints were cutometric R0 and R3 at 12 and 24 weeks. GAIS, FACE-QTM, Patient Attractivity Self-Assessment and safety were evaluated. Results Mean skin firmness (R0) improved significantly from baseline 0.40 mm to 0.38 mm at week 12 and to 0.36 mm at week 24. Mean skin tiring (R3) improved significantly from baseline 0.45 mm to 0.42 mm at week 12 and to 0.40 at week 24. FACE-QTM “Satisfaction with Skin” significantly improved from baseline to weeks 12, 24 and 48. So did “Satisfaction with Facial Appearance” and “Psychological and Social Function”. “Satisfaction with Decision” and “Satisfaction with Outcome” were stable at week 24 and 48. At week 48 patients assessed their age 1.68 years younger vs Baseline. FACE-QTM aging appraisal improves from Baseline 52.94 to 65.23 at week 48. GAIS, by both physicians and patients, confirm improvement of skin. Conclusion For up to 48 weeks four intra-dermal injections with cell-free BCS increase facial skin firmness and resilience to tiring and patients’ satisfaction with their facial appearance and skin. Patients perceive their face as younger. BCS has the ability to sustainably rejuvenate facial skin safely. Study Registration Registration on German clinical trials register: DRKS00013014.
Collapse
Affiliation(s)
- Martina Kerscher
- Division of Cosmetic Sciences, University of Hamburg, Hamburg, Germany
| | | | | | | | | | | | | | | | - Glyn Hamed
- Practice Dr. Wehling and Partner, Düsseldorf, Germany
- Correspondence: Glyn Hamed, Email
| | | | | |
Collapse
|
7
|
Kleine‐Börger L, Hofmann M, Kerscher M. Microinjections with hyaluronic acid in combination with glycerol: How do they influence biophysical viscoelastic skin properties? Skin Res Technol 2022; 28:633-642. [PMID: 35643988 PMCID: PMC9907673 DOI: 10.1111/srt.13167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 05/03/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Skin quality improvement with hyaluronic acid microinjections is increasing as a clinical treatment indication and as a scientific issue. This present study assessed changes in biomechanical viscoelastic skin properties after microinjections with the skin quality booster CPM-HA20G (Belotero Revive). MATERIALS AND METHODS Fifteen subjects have been randomized in a 2:1 ratio to receive either three treatments (total 3 ml per side) or a single-dose treatment (total 1.5 ml per side) with CPM-HA20G at dermal level into the lower cheeks via microinjections. Treatments were provided 4 weeks apart. Biophysical measurements were performed describing the viscoelastic skin properties and the underlying skin structure. The measurements were performed before injection (week 0) and on follow-up visits 4, 8, 16, 24, and 36 weeks after the last injection treatment. RESULTS One (p = 0.028) as well as three (p = 0.003) consecutive treatments with CPM-HA20G improved statistically significant skin firmness (R0). For the multiple-treatment group improved significant differences were observed for skin fatigue (R3; p = 0.007) and skin density (p = 0.017) with stable skin thickness levels (p > 0.05), too. There were zero-to-weak correlations between skin thickness and biomechanical skin properties (R0, rs = 0.084; R3, rs = 0.093). CONCLUSION Overall, microinjections with CPM-HA20G improved biomechanical viscoelastic skin properties with a stronger and more pronounced effect in the multiple-treatment group. The observed changes may explain some of the skin quality improvements observed after treatment with CPM-HA20G.
Collapse
Affiliation(s)
- Linda Kleine‐Börger
- Cosmetic Science Institute of Biochemistry and Molecular Biology University of Hamburg Hamburg Germany
| | | | - Martina Kerscher
- Cosmetic Science Institute of Biochemistry and Molecular Biology University of Hamburg Hamburg Germany
| |
Collapse
|
8
|
[Skin quality and ways to improve skin quality]. Hautarzt 2021; 72:375-383. [PMID: 33834271 DOI: 10.1007/s00105-021-04797-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Skin quality has a significant impact on the perception of attractiveness. Procedures to improve skin quality, whose quality is assured, should have sufficiently documented scientific evidence of in vivo and in vitro efficacy and significant effects proven in studies. OBJECTIVES This paper will present findings from recent studies and experience of experts on skin quality and treatments to improve skin quality. MATERIALS AND METHODS A PubMed database search was conducted in February 2021 on the terms skin quality and minimally invasive skin quality improvement procedures. Two reviewers independently screened the titles, resulting in the selection of 30 papers. RESULTS Hyaluronic acid (HA) is the most commonly studied agent for skin rejuvenation treatments. The efficacy and safety of the superficially injected HA products are excellently proven on the basis of current data. According to these findings, they ensure an improvement of skin quality without significant volume changes. The skin is hydrated, its elasticity increased, the skin surface smoothened, the complexion (skin redness, glow) improved and fine lines and wrinkles are reduced. They are injected intradermally and have a clinically proven effect duration of up to 12 months. CONCLUSIONS Hyaluronic acid is outstandingly suitable for deep hydration of the skin, and its effect is long-term and safe. Natural treatment results fulfil the needs of the patients and increase the patient-practitioner relation. Superficially injected HA products are currently the criterion standard to increase skin quality.
Collapse
|
9
|
Hahn HM, Lee WB, Lee IJ. The Effects of Subcutaneously Injected Novel Biphasic Cross-Linked Hyaluronic Acid Filler: In Vivo Study. Aesthetic Plast Surg 2021; 45:322-331. [PMID: 33174067 DOI: 10.1007/s00266-020-02033-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/21/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Biphasic hyaluronic acid (HA) fillers have been used extensively to improve facial skin. However, in some cases, the skin surface is irregular because of the premature loss of HA solution. We propose a new biphasic filler (G-filler) to overcome this problem by using small particles of HA hydrogel instead of HA solution, which can provide a smooth skin surface and good durability. METHOD We evaluated the rheologic properties of G-filler and its physiologic effects after subcutaneous injection in a mouse model by histologic analysis. RESULTS The G-filler showed a similar elastic modulus (G') and complex viscosity (η*) as the conventional biphasic filler, but had a higher viscous modulus (G″) than the conventional monophasic filler. The highest material elasticity (tan δ) value and the lowest percentage elasticity value indicate the rheologic properties of G-filler are closer to those of liquids. After subcutaneous injection of G-filler, collagen content (~ 2-fold) and elastin fibers (~ 6.5-fold) were significantly increased at 12 weeks compared to those of the saline group. Fibronectin (~ 2.6-fold) and the laminin-immunolabeled cell number (~ 6-fold) were also significantly increased at 12 weeks. Significant increases in the CD31-immunoreactive cell numbers of the G-filler groups were observed at 2, 6, and 12 weeks (~ 3.7-fold) compared to those of the saline groups. There were no significant differences between the G-filler and saline groups in patterns of skin thickness and inflammatory cell numbers around loading sites. CONCLUSION These findings demonstrate that the injection of a new biphasic filler with improved rheologic properties can effectively stimulate extracellular matrix production and angiogenesis without safety concerns. NO LEVEL ASSIGNED 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 .
Collapse
Affiliation(s)
- Hyung Min Hahn
- Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, 16499, Republic of Korea
| | - Woo Beom Lee
- Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, 16499, Republic of Korea
| | - Il Jae Lee
- Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, 16499, Republic of Korea.
| |
Collapse
|
10
|
Arora G, Arora S, Sadoughifar R, Batra N. Biorevitalization of the skin with skin boosters: Concepts, variables, and limitations. J Cosmet Dermatol 2020; 20:2458-2462. [PMID: 33249741 DOI: 10.1111/jocd.13871] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 11/23/2020] [Indexed: 11/26/2022]
Abstract
Aging leads to diminished capacity in the functionality of all the skin layers, which in turn leads to a structurally weak and esthetically unappealing skin which is dull, dehydrated, and inelastic. Skin boosters can be defined as biological materials or bio-actives that help or encourage the skin to increase or improve its function. Boosters have been used in treating skin structural changes associated with aging as well as other factors such as corticosteroid-induced skin atrophy. Restoring the loss in skin nourishment and vital components is the concept involved in biorevitalization of the skin. The authors aim to present an update and a short review of skin boosters in this commentary.
Collapse
Affiliation(s)
- Gulhima Arora
- Department of Dermatology, Mehektagul Dermaclinic, New Delhi, India
| | - Sandeep Arora
- Command Hospital Air Force Bangalore, Bangalore, India
| | | | | |
Collapse
|
11
|
Kim J. Topographic computer analysis for acne scar treatment on face accompanying biopsy study after dermal injection of hydrotoxin mixture. J Cosmet Dermatol 2020; 20:75-83. [PMID: 32359014 PMCID: PMC7818118 DOI: 10.1111/jocd.13462] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 04/13/2020] [Accepted: 04/27/2020] [Indexed: 11/28/2022]
Abstract
Background Acne during youth can leave permanent facial scarring. The depressed acne scars can be treated by injection of stabilized hyaluronic acid (S‐HA) into the dermis. Due to the large number of acne scars, manual injection methods are technically difficult and bear high risk of lump formation in the dermis. Therefore, the author designed a specific injection method to solve the two abovementioned problems. Aims This research aims to assess the effect of the intradermal injection of S‐HA and aboborulinumtoxinA mixture in the treatment of all types of acne scars. Materials/Methods A total of 102 patients who suffered from acne scars were treated with a mixture of S‐HA (Restylane Vital®) and abobotulinumtoxinA (Dysport®). Using an automatic injector, micro‐droplets of the mixture (0.001 cc of S‐HA and 0.125 U abobotulinumtoxinA) were delivered into 1000 intradermal sites on whole face except eyelids. This instrument radically reduced injection amounts per site (0.001 cc), lessened manual operator efforts, and ensured consistent injection depth (from 0.8 to 1.2 mm depending on individual dermal thickness) into the facial dermis. The changes in each depression site of acne scars were evaluated by topographic computer analysis (point roughness), based on the 40 magnification microscopic photographs generated. Depth measurements of each small acne scar point were taken one by one at the exact same point before and after the treatments. Global Aesthetic Improvement Scale (GAIS) was measured for improvement of acne scars at 1‐ and 6‐month posttreatment. Additionally, serial histologic examinations of the biopsy specimens evaluated neocollagenesis, neoelastinogenesis, and longevity state of the S‐HA. Results A total of 78 patients showed improvements of depressed acne scars in physical examinations, medical photographs, and dermascopic photographs. Using topographic computer analysis, the average point roughness decreased 27.48% (at 1 month) from 29.042 ± 6.85 (baseline) to 21.05 ± 6.30 µm (P < .0001), corresponding with scar improvements observed in physical examinations, and 3.02 ± 0.66 of GAIS at 1‐month posttreatment. Using an injector allowed the hydrotoxin mixture into the deep dermal layer. Biopsy study proved that the injection depth was exactly in the dermis, and showed evidence of neocollagenesis and neoelastinogenesis. Also, the S‐HA particles remained after 1 year, which proved its longevity of at least 1 year. Conclusion The topographic computer analysis using point roughness showed improvement of all subtype acne scars at 1‐month posttreatment. The improvement may have resulted from dermal expansion due to the neocollagenesis and neoelastinogenesis. S‐HA lasted more than 1 year in human dermis.
Collapse
Affiliation(s)
- JongSeo Kim
- Kim-JongSeo Plastic Surgery Clinic, Seoul, Korea
| |
Collapse
|
12
|
Ayatollahi A, Firooz A, Samadi A. Evaluation of safety and efficacy of booster injections of hyaluronic acid in improving the facial skin quality. J Cosmet Dermatol 2020; 19:2267-2272. [DOI: 10.1111/jocd.13493] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/05/2020] [Accepted: 05/11/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Azin Ayatollahi
- Center for Research & Training in Skin Diseases and Leprosy Tehran University of Medical Sciences Tehran Iran
| | - Alireza Firooz
- Center for Research & Training in Skin Diseases and Leprosy Tehran University of Medical Sciences Tehran Iran
| | - Aniseh Samadi
- Center for Research & Training in Skin Diseases and Leprosy Tehran University of Medical Sciences Tehran Iran
| |
Collapse
|
13
|
Hu L, Zhao K, Song WM. Effect of mesotherapy with nanochip in the treatment of facial rejuvenation. J COSMET LASER THER 2020; 22:84-89. [PMID: 32223473 DOI: 10.1080/14764172.2020.1740272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Objective: To observe the clinical effect of mesotherapy with nanochip for facial rejuvenation.Methods: 24 volunteers with aging skin were treated with a polycomponent formulation - NCTF® BOOST 135 HA for 5 times (once weekly for 3 times and successively biweekly for 2 times). Photographs were taken by VISIA at baseline, and after 1, 4, 10 weeks, while global scores for photoaging (GSP), improvement scores, volunteers' satisfaction, parameters describing the properties of the skin, and adverse effects were assessed during each follow-up period.Results: Total 20 volunteers completed the treatment. Evaluation of the whole face showed that GSP, skin texture (ophthalmic wrinkles, dermal thickness, and intensity of collagen fibers of skin), and skin brightness (Lab value) significantly improved at 4 weeks compared to baseline, while the difference between 4 and 10 weeks was not statistically significant. No evident improvement was observed in pigmented spots, telangiectasia, skin tightening, trans-epidermal water loss (TEWL), and skin hydration. Slight erythema, pain was the most common side effect.Conclusion: Mesotherapy with nanochip can improve skin texture and brightness, but the effect is not permanent. It is recommended that the treatment be used as a complementary method for patients with facial rejuvenation needs.
Collapse
Affiliation(s)
- Lingling Hu
- Department of Dermatology, Yes Skin Care Center, Hangzhou, China
| | - Kejia Zhao
- Department of Dermatology, Yes Skin Care Center, Hangzhou, China
| | - Wei Min Song
- Department of Dermatology, Yes Skin Care Center, Hangzhou, China
| |
Collapse
|
14
|
Hertz-Kleptow D, Hanschmann A, Hofmann M, Reuther T, Kerscher M. Facial skin revitalization with CPM ®-HA20G: an effective and safe early intervention treatment. Clin Cosmet Investig Dermatol 2019; 12:563-572. [PMID: 31496779 PMCID: PMC6698156 DOI: 10.2147/ccid.s209256] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 06/27/2019] [Indexed: 11/23/2022]
Abstract
Background Hyaluronic acid (HA) fillers are popular for the treatment of signs of facial skin aging. Objective The objective of this study was to confirm the performance and safety of a new cohesive polydensified matrix HA filler ([CPM®-HA20G, Belotero Revive®, lidocaine-free], Merz Pharmaceuticals GmbH, Frankfurt, Germany) for the treatment of early signs of facial skin aging by use of biophysical measurements as well as subject and investigator satisfaction. Methods Twenty-five healthy female subjects with signs of facial skin aging were enrolled in this open-label, rater-blinded, observational post-market clinical follow-up study, and received 20 micropuncture treatments of 50 µL CPM®-HA20G each into the lower cheek area at three injection visits 4 weeks apart. Objective biophysical assessments were conducted to demonstrate effects on viscoelastic properties of the skin, surface roughness, tone and radiance, and hydration, at baseline and at all follow-up visits up to 36 weeks. Results CPM®-HA20G significantly increased gross elasticity of the skin (at weeks 9 and 12), skin firmness (up to week 24), skin tone and radiance and skin hydration (all up to 36 weeks). Significant reduction of skin fatigue (up to 9 weeks), skin roughness (up to 28 weeks), and redness (up to 36 weeks) was also observed. Subjects and blinded investigator were highly satisfied with the treatment outcomes. The treating investigator reported a high level of satisfaction with the ease of injection and the clinical performance of the device. Moreover, data demonstrated a good safety profile of the device. Conclusion CPM®-HA20G is considered to be an effective and safe HA injectable for skin revitalization in patients suffering from signs of skin aging and loss of skin elasticity. It seems to be a perfect early intervention approach in patients that do not need volumizing treatment and a combination approach in older patients with more pronounced aging.
Collapse
Affiliation(s)
- Dominique Hertz-Kleptow
- University of Hamburg, Division of Biochemistry and Molecular Biology, Cosmetic Science, D-20146 Hamburg, Germany
| | | | - Matthias Hofmann
- Global Clinical Development, Merz Pharmaceuticals GmbH, Frankfurt, Germany
| | - Tilmann Reuther
- University of Hamburg, Division of Biochemistry and Molecular Biology, Cosmetic Science, D-20146 Hamburg, Germany
| | - Martina Kerscher
- University of Hamburg, Division of Biochemistry and Molecular Biology, Cosmetic Science, D-20146 Hamburg, Germany
| |
Collapse
|
15
|
Campiche R, Jackson E, Laurent G, Roche M, Gougeon S, Séroul P, Ströbel S, Massironi M, Gempeler M. Skin Filling and Firming Activity of a Hyaluronic Acid Inducing Synthetic Tripeptide. Int J Pept Res Ther 2019. [DOI: 10.1007/s10989-019-09827-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
16
|
A Single Center, Prospective, Randomized, Sham-Controlled, Double-Blinded, Split-Face Trial Using Microinjections of Transparent Hyaluronic Acid Gel for Cheek Rejuvenation. Dermatol Surg 2018; 44:841-845. [DOI: 10.1097/dss.0000000000001460] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
17
|
Youn CS, Hong JY, Park KY, Kim BJ, Nam Kim M. A review of hydrolifting: A new modality for skin rejuvenation. J COSMET LASER THER 2017; 20:28-33. [DOI: 10.1080/14764172.2017.1358459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
| | - Ji Yeon Hong
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Kui Young Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Beom Joon Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Myeung Nam Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
18
|
Hersant B, SidAhmed-Mezi M, Niddam J, La Padula S, Noel W, Ezzedine K, Rodriguez AM, Meningaud JP. Efficacy of autologous platelet-rich plasma combined with hyaluronic acid on skin facial rejuvenation: A prospective study. J Am Acad Dermatol 2017; 77:584-586. [DOI: 10.1016/j.jaad.2017.05.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 05/11/2017] [Accepted: 05/21/2017] [Indexed: 01/06/2023]
|
19
|
Consensus Recommendations for Optimal Augmentation of the Asian Face with Hyaluronic Acid and Calcium Hydroxylapatite Fillers. Plast Reconstr Surg 2016; 136:940-956. [PMID: 26505699 DOI: 10.1097/prs.0000000000001706] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Although the use of filling agents for soft-tissue augmentation has increased worldwide, most consensus statements do not distinguish between ethnic populations. There are, however, significant differences between Caucasian and Asian faces, reflecting not only cultural disparities, but also distinctive treatment goals. Unlike aesthetic patients in the West, who usually seek to improve the signs of aging, Asian patients are younger and request a broader range of indications. METHODS Members of the Asia-Pacific Consensus group-comprising specialists from the fields of dermatology, plastic surgery, anatomy, and clinical epidemiology-convened to develop consensus recommendations for Asians based on their own experience using cohesive polydensified matrix, hyaluronic acid, and calcium hydroxylapatite fillers. RESULTS The Asian face demonstrates differences in facial structure and cosmetic ideals. Improving the forward projection of the "T zone" (i.e., forehead, nose, cheeks, and chin) forms the basis of a safe and effective panfacial approach to the Asian face. Successful augmentation may be achieved with both (1) high- and low-viscosity cohesive polydensified matrix/hyaluronic acid and (2) calcium hydroxylapatite for most indications, although some constraints apply. CONCLUSION The Asia-Pacific Consensus recommendations are the first developed specifically for the use of fillers in Asian populations. CLINCIAL QUESTION/LEVEL OF EVIDENCE Therapeutic, V.
Collapse
|
20
|
A Split-Face Study of the Effects of a Stabilized Hyaluronic Acid–Based Gel of Nonanimal Origin for Facial Skin Rejuvenation Using a Stamp-Type Multineedle Injector. Plast Reconstr Surg 2016; 137:809-816. [DOI: 10.1097/01.prs.0000480686.68275.60] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
21
|
|
22
|
Avantaggiato A, Girardi A, Palmieri A, Pascali M, Carinci F. Bio-Revitalization: Effects of NASHA on Genes Involving Tissue Remodeling. Aesthetic Plast Surg 2015; 39:459-64. [PMID: 26085225 DOI: 10.1007/s00266-015-0514-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 05/31/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND The "non-animal stabilized hyaluronic acid" (NASHA) is a widely used product in bio-revitalization injective procedures in esthetic medicine. The present research aimed to quantitatively evaluate the therapeutic effect of one of the more used bio-revitalization products on cultured dermal fibroblasts. RT-PCR was used for gene expression profiling of some proteins known to be relevant in skin homeostasis. METHODS Human dermal fibroblasts were seeded on a culture medium enriched with a product for dermal bio-revitalization, consisting of stabilized hyaluronic acid gel 20 mg/ml. After 24, 48, and 72 h of exposure, the cDNA was amplified by real-time PCR. Gene expression was quantified with the delta/delta calculation method. RESULTS In this study, the gene of metalloproteinase (MMP)-13 is strongly expressed after NASHA incubation. The MMP-2 encoding gene instead is less expressed, but both evidence the same temporal trend, being progressively up-regulated after 24 and 48 h, thereafter the expression decreases, whereas MMP-3 maintains the same up-regulation at 72 h. Hyaluronan synthase 1 and desmoplakin are progressively up-regulated and increase at 24, 48, and 72 h. Hyaluronidase 1 and neutrophil elastase genes are overexpressed, but at 72 h they both exhibit the same behavior as the other degradative enzymes MMP-13 and MMP-2. CONCLUSIONS Skin bio-revitalization by injecting the tested NASHA gel produces an enhancement in the expression of some genes involved in extracellular matrix degradation and organization. In this study, a time-dependent behavior, different for genes encoding degradative compared to synthesis proteins, was demonstrated.
Collapse
Affiliation(s)
- A Avantaggiato
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | | | | | | | | |
Collapse
|
23
|
Kim J. Effects of Injection Depth and Volume of Stabilized Hyaluronic Acid in Human Dermis on Skin Texture, Hydration, and Thickness. ARCHIVES OF AESTHETIC PLASTIC SURGERY 2014. [DOI: 10.14730/aaps.2014.20.2.97] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jongseo Kim
- Kim-Jongseo Plastic Surgery Clinic, Seoul, Korea
| |
Collapse
|
24
|
Baspeyras M, Rouvrais C, Liégard L, Delalleau A, Letellier S, Bacle I, Courrech L, Murat P, Mengeaud V, Schmitt AM. Clinical and biometrological efficacy of a hyaluronic acid-based mesotherapy product: a randomised controlled study. Arch Dermatol Res 2013; 305:673-82. [PMID: 23715889 PMCID: PMC3778226 DOI: 10.1007/s00403-013-1360-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 04/16/2013] [Accepted: 04/22/2013] [Indexed: 11/05/2022]
Abstract
Data demonstrating the efficacy of hyaluronic acid (HA)-based mesotherapy for skin rejuvenation are scarce. The aim of the study is to assess the efficacy of non-reticulated HA-based mesotherapy on skin elasticity and complexion radiance. 55 women with cutaneous ageing signs included in the Full Analysis Set (FAS) population blindly received intradermal micro-injections (50 × 0.02 mL) of non-cross-linked HA filler with mannitol (Glytone 1, HA concentration: 14 mg/g) in one cheek and saline physiological solution in the other according to hemifacial randomisation in 3 monthly sessions. Elasticity (E1 and E2 stiffness parameters) and dermis thickness were measured by cutometry and 20 MHz echography, before (D0) treatment and 1 (1M) and 3 months (3M) after the last injection. A trained panel blindly scored skin complexion radiance from standardised and calibrated photographs, using 100 mm analogue scales. In the FAS population, only HA filler significantly decreased E1 at 1M (−10.9 %, p = 0.026) and 3M (−10.5 %, p = 0.035) compared with D0; its effect versus the control tended to be more persistent, with a difference between treatments at 3M close to significance (p = 0.063). E2 also decreased at 1M (−8.2 %, p = 0.027 in the per protocol population, n = 53) and 3M after HA-treatment only. Dermis thickness significantly increased after HA-treatment at 1M (+3.4 %, p = 0.028) and 3M (+4 %, p = 0.008), and after control-treatment at 1M only (+2.5 %, p = 0.015). The HA filler significantly improved complexion radiance at 3M compared with the control (p = 0.012) and for 51 % of subjects, their skin status. Non-reticulated HA-based mesotherapy significantly and sustainably improves skin elasticity and complexion radiance.
Collapse
|
25
|
Ohshima H, Kinoshita S, Oyobikawa M, Futagawa M, Takiwaki H, Ishiko A, Kanto H. Use of Cutometer area parameters in evaluating age-related changes in the skin elasticity of the cheek. Skin Res Technol 2012; 19:e238-42. [DOI: 10.1111/j.1600-0846.2012.00634.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2012] [Indexed: 11/30/2022]
Affiliation(s)
| | - Shigemi Kinoshita
- POLA Laboratories; POLA Chemical Industries, Inc.; Totsuka-ku; Yokohama; Japan
| | - Midori Oyobikawa
- POLA Laboratories; POLA Chemical Industries, Inc.; Totsuka-ku; Yokohama; Japan
| | - Mikayo Futagawa
- POLA Laboratories; POLA Chemical Industries, Inc.; Totsuka-ku; Yokohama; Japan
| | | | - Akira Ishiko
- First Department of Dermatology; School of Medicine; Toho University; Omorinishi; Ota-ku; Tokyo; Japan
| | - Hiromi Kanto
- First Department of Dermatology; School of Medicine; Toho University; Omorinishi; Ota-ku; Tokyo; Japan
| |
Collapse
|
26
|
Ono I. A Study on the Alterations in Skin Viscoelasticity before and after an Intradermal Administration of Growth Factor. J Cutan Aesthet Surg 2011; 4:98-104. [PMID: 21976900 PMCID: PMC3183736 DOI: 10.4103/0974-2077.85022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: While photo-aging is believed to be preventable by the complete blockage of ultraviolet rays, there is no epoch-making method except sing fillers or autologous fat injection, for rejuvenating the skin once it has aged. Objective: Our group developed a new method for rejuvenating aged skin by the direct intradermal injection of basic fibroblast growth factor, the first method of its kind in the world. In this paper we report the results of long-term follow-up observations and alterations in skin viscoelasticity before and after this treatment. Materials and Methods: A single dose of growth factor was injected directly into aged skin of the dorsal surface of the hand intradermally. The skin viscoelasticity of 50 treated cases was measured by a cutometer just before the treatment and at 1, 3, 6, and 9 months after treatment, respectively. Results: We observed the following rejuvenating effects: improved skin softness, gradual improvement of turgor, improved thickness of atrophied skin, and greatly improved viscoelasticity which reveals the improvement of biomechanical properties of the treated aged skin. According to the comparisons of viscoelasticity between pre- and post-treatment, the rejuvenated changes of R2 and R7 values were comparable to an age difference of more than 20 years. Conclusion: This method was confirmed to have excellent effects in rejuvenating aged skin safely and reliably including biomechanical properties. With this advance, we expect conventional non-physiological skin rejuvenating treatments to be replaced by a much more fundamental method using one-time injections of the growth factor.
Collapse
Affiliation(s)
- Ichiro Ono
- Department of Dermatology, Sapporo Medical University School of Medicine, South-1 West16 Chuoku Sapporo, Hokkaido, Japan
| |
Collapse
|
27
|
Ribé A, Ribé N. Neck skin rejuvenation: histological and clinical changes after combined therapy with a fractional non-ablative laser and stabilized hyaluronic acid-based gel of non-animal origin. J COSMET LASER THER 2011; 13:154-61. [PMID: 21699363 DOI: 10.3109/14764172.2011.594060] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The laser Affirm™ (LA) is a microthermal, non-ablative fractional laser used for skin rejuvenation. Restylane Vital™ Light (RVL) in the Restylane® Injector, a formulation of stabilized hyaluronic acid-based gel of non-animal origin, is indicated for rejuvenation of delicate skin. OBJECTIVES To assess the interaction between the LA and RVL in aging skin of the neck using clinical and histological parameters, and to determine whether combined therapy is effective. METHODS Nine female patients aged 42-62 years received four treatments, each comprising RVL followed immediately by LA treatment. Photographs and skin biopsies were taken before treatment, after the fourth session and 1 month later. RESULTS Improvements in fine wrinkles, tightness and skin texture were observed. Histologic evaluations showed favourable changes in cellularity, collagen and elastic fibres. Laser-induced effects (400 μm) and an inflammatory reaction (1000 μm) were seen. RVL was present at the mid-deep dermis (1000-1500 μm). CONCLUSIONS Combined treatment with the LA and RVL improved skin appearance and structure as assessed, for the first time, with histology. The LA produced epidermal and superficial dermal changes whereas RVL acted deeper, together treating the full skin thickness.
Collapse
Affiliation(s)
- Adriana Ribé
- Ribé Clinic (Dermo Laser Technology), Barcelona, Spain.
| | | |
Collapse
|