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Atiyeh B, Emsieh S. Comment on: Safety and Effectiveness of Endodermal Radiofrequency for Skin Rejuvenation: A Systematic Review. Aesthetic Plast Surg 2024; 48:4-7. [PMID: 36278992 DOI: 10.1007/s00266-022-03148-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 10/12/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Bishara Atiyeh
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Saif Emsieh
- American University of Beirut Medical Center, Beirut, Lebanon.
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Nilforoushzadeh MA, Heidari-Kharaji M, Shahverdi M, Nouri M, Enamzadeh R, Nobari NN, Fakhim T, Rafiee S. Microneedle fractional radiofrequency in the treatment of periorbital dark circles. J Cosmet Dermatol 2023. [PMID: 37326254 DOI: 10.1111/jocd.15870] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 05/28/2023] [Accepted: 06/04/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Periorbital hyperpigmentation (POH) is a common disorder in the patients. Women are more upset with POH in compare to males. Several methods have been used to the POH, with different efficacy and adverse reactions. AIM The aim of the present study is to evaluate the efficacy of microneedle fractional radiofrequency (MRF) in treating POH. METHODS So, nine patients with POH and the age range of 25-57 years, were treated by microneedle fractional radiofrequency (MRF). The outcome was evaluated via biometric assessment. The colorimeter was used to assess the skin lightness. Mexameter was used for evaluated the amount of Melanin in the periorbital skin. Cutometer was used for skin elasticity assessment. The skin ultrasound imaging system was utilized to estimate the epidermis and dermis diameter and density. Furthermore, Visioface was applied to assessed the skin color and wrinkles. Also patient's satisfaction and physician's assessment were evaluated. RESULTS The results displayed that the periorbital skin lightness 32.38% ± 5.67 and elasticity of the R2: 40.29% ± 8.18, R5: 39.03 ± 5.38 and R7: 42.03% ± 14.16 were significantly improved after treatment (p < 0.05). Also the melanin content of the skin was decreased (49.41% ± 9.12). The skin layers were denser in the dermis and also in the epidermis (skin density: 30.21% ± 10.16 and skin thickness: 41.12% ± 13.21) (p < 0.05). The results revealed the decrease in the percent change of the skin color (30.34% ± 9.30) and wrinkle (area: 25.84% ± 6.43 and volume: 30.66% ± 8.12) (p < 0.05). Similarly, the physician and patient's assessment were confirmed the obtained outcomes. CONCLUSION In conclusion, the microneedle RF technique is practicable, effective and safe method for periorbital dark circles treatment.
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Affiliation(s)
- Mohammad Ali Nilforoushzadeh
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Skin Repair Research Center, Jordan Dermatology and Hair Transplantation Center, Tehran, Iran
| | - Maryam Heidari-Kharaji
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Skin Repair Research Center, Jordan Dermatology and Hair Transplantation Center, Tehran, Iran
- Institut National de la Recherche Scientifique (INRS)-Centre Armand-Frappier Santé Biotechnologie (CAFSB), Laval, Quebec, Canada
| | - Mohammadhasan Shahverdi
- Skin Repair Research Center, Jordan Dermatology and Hair Transplantation Center, Tehran, Iran
| | - Maryam Nouri
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Niloufar Najar Nobari
- Skin Repair Research Center, Jordan Dermatology and Hair Transplantation Center, Tehran, Iran
- Department of Dermatology, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
| | - Tannaz Fakhim
- Skin Repair Research Center, Jordan Dermatology and Hair Transplantation Center, Tehran, Iran
| | - Shohreh Rafiee
- Skin Repair Research Center, Jordan Dermatology and Hair Transplantation Center, Tehran, Iran
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Rezapour A, Arabloo J, Moradi N, Ehsanzadeh SJ, Hourzad M, Alipour V. Safety and Effectiveness of Endodermal Radiofrequency for Skin Rejuvenation: A Systematic Review. Aesthetic Plast Surg 2023; 47:378-386. [PMID: 36178511 DOI: 10.1007/s00266-022-03097-x] [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: 05/28/2022] [Accepted: 09/04/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND With the advent of new technologies, the demand for non-invasive and effective procedures to treat skin laxity has increased. In this research, we aimed to review studies conducted on the safety and effectiveness of endodermal radiofrequency (ER) for skin rejuvenation. METHODS We searched the databases of Embase, PubMed, Scopus, and Google Scholar from 2000 to 2020 to conduct a systematic review based on the PRISMA statement. Screening of titles, abstracts, and full-text articles was performed independently by two reviewers according to inclusion and exclusion criteria. RESULTS This study showed that ER resulted in improvement in wrinkles and sagging, reduction of fat, tightening of skin of the face, neck, and jawline, improvement in skin elasticity, pigmentation, contouring of the body, and epidermal thickness decrease. ER technology leads to a significant and satisfactory improvement in skin rejuvenation, lower contouring of skin of the face and neck, as well as patients' satisfaction. Side effects of ER are temporary, and usually disappear spontaneously after a few days to one month. CONCLUSION Cosmetic services providers can use this effective and safe technology to treat skin laxity and skin rejuvenation as a substitute for surgery. Level of evidence III 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 .
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Affiliation(s)
- Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Najmeh Moradi
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Jafar Ehsanzadeh
- School of Health Management and Information Sciences, Iran University of Medical Sciences, No. 6, Rashid Yasemi St. Vali -e Asr Ave, P.O Box: 1996713883, Tehran, Iran
| | - Maryam Hourzad
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran. .,School of Health Management and Information Sciences, Iran University of Medical Sciences, No. 6, Rashid Yasemi St. Vali -e Asr Ave, P.O Box: 1996713883, Tehran, Iran.
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The Efficacy of Intense Pulsed Light as a Treatment for Benign Pigmented Lesions on the Dorsal Hand. Dermatol Surg 2022; 48:827-832. [PMID: 35917263 DOI: 10.1097/dss.0000000000003494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Intense pulsed light (IPL) is a noninvasive therapeutic option to treat benign pigmented lesions by targeting melanin. OBJECTIVE The purpose of this study was to assess IPL as a treatment for benign pigmented dorsal hand lesions. MATERIALS AND METHODS A total of fifteen subjects, 40 to 73 years old, received 3 monthly IPL treatments over the dorsal hands. Subjects followed up 1 and 3 months after treatment. At every visit, photographs were taken using the VISIA Complexion Analysis System (Canfield Scientific, Fairfield, NJ) and analyzed using the RBX Brown Spots Analysis algorithm. The Clinician Global Aesthetic Improvement Scale and Subject Global Aesthetic Improvement Scale were completed at both follow-up visits. RESULTS A total of fifteen subjects completed all six visits. The number of brown spots decreased 9.26% ( p = .0004) and 7.52% ( p = .0132) at each follow-up visit. The mean brown intensity decreased 6.15% ( p = .0183) and 7.67% ( p = .0178), whereas the mean contrast intensity decreased 8.88% ( p < .0001) and 6.60% ( p = .0007) 1 and 3 months after treatment, respectively. The mean Clinician Global Aesthetic Improvement Scale was 2.03 and 2.23, whereas the mean Subject Global Aesthetic Improvement Scale 1 and 3 months after treatment was 1.6 and 1.8, respectively. CONCLUSION Objective analysis, along with clinician and subject assessments, showed an improvement in the appearance of benign pigmented lesions in the treated area after 3 IPL treatments.
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Wu X, Liu Y, Zhu J, Yu W, Lin X. A Prospective Trial of the Microneedle Fractional Radiofrequency System Application in the Treatment of Infraorbital Dark Circles. Clin Cosmet Investig Dermatol 2022; 15:1293-1300. [PMID: 35836477 PMCID: PMC9275426 DOI: 10.2147/ccid.s372409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/03/2022] [Indexed: 11/23/2022]
Abstract
Background Infraorbital dark circles (IDC) are commonly consulted in aesthetic practice. There is not yet a multifactorial approach to facilitating their treatment. Objective To investigate the safety and efficacy of the microneedle fractional radiofrequency (MRF) system for the treatment of IDC. Methods A prospective, split-face, evaluator-blind clinical trial was conducted to study the change in the overall appearance, color, and wrinkles in 21 female patients with mixed type IDC before and after MFR treatment. Results Both patients and independent evaluators found significant improvement on the global aesthetic scales after the MFR treatment, especially on periorbital wrinkles (p=0.031). Trends in decreased melanin density in the IDC area were found, but no statistical differences were established. No side effects were observed. Conclusion MFR is a safe and effective modality for improving mixed type IDC by correcting the structural factors.
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Affiliation(s)
- Xianglei Wu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Ying Liu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Jiafang Zhu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Wenxin Yu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Xiaoxi Lin
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.,Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
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Wamsley CE, Vingan N, Barillas J, Culver A, Turer DM, Kenkel JM. A Single-Center Pilot Study to Classify Signs of Dorsal Hand Aging Using 3 Grading Scales. Aesthet Surg J Open Forum 2022; 4:ojab059. [PMID: 35211668 PMCID: PMC8862723 DOI: 10.1093/asjof/ojab059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background While validated scales must be created in order to systemically evaluate patients and quantify outcomes of aesthetic hand treatments, scales currently available are limited to the analysis of volume loss alone. Objectives The purpose of this study was to develop 3 validated scales for the assessment of dorsal hand aging that also take into consideration wrinkling and pigmentation. Methods Fifty (50) healthy volunteers (40 females and 10 males) with Fitzpatrick skin types I-IV were recruited, and standard photographs of their left and right dorsal hands were taken with a Nikon D7100 (Nikon; Minato, Tokyo, Japan) camera. Using 25 randomized photographs, 11 plastic surgery physicians (3 chief residents, 6 senior residents, and 2 aesthetic surgery fellows) were trained on the 3 scales under investigation as well as the already-validated Merz Hand Grading Scale (MHGS). The evaluators then viewed the remaining 75 photographs independently and assigned a grade for each of the 4 scales to each photograph. Inter-rater variability was calculated for each scale. Results The Kappa score for the MHGS was 0.25, indicating fair agreement; 0.40 for wrinkle scale, indicating fair agreement; and 0.48 and 0.46 for the pigmentation density and intensity scales, respectively, indicating moderate agreement (P < 0.001). Conclusions The results show that after receiving training, the inter-rater agreement for the 3 scales under investigation was similar or slightly higher than that for the MHGS. These 3 photographic classification systems can be used consistently and reliably to characterize multiple signs of dorsal hand aging. Level of Evidence: 2
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Affiliation(s)
- Christine E Wamsley
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Nicole Vingan
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Jennifer Barillas
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Abby Culver
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - David M Turer
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Jeffrey M Kenkel
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
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Sales AFS, Pandolfo IL, de Almeida Cruz M, Parisi JR, Garcia LA, Martignago CCS, Renno ACM, Vassão PG. Intense Pulsed Light on skin rejuvenation: a systematic review. Arch Dermatol Res 2021; 314:823-838. [PMID: 34609598 DOI: 10.1007/s00403-021-02283-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/18/2021] [Accepted: 09/16/2021] [Indexed: 11/25/2022]
Abstract
Aged skin is characterized by appearance of wrinkles, vascular lesions, hyperpigmentation, lentignes, texture, rhytides, and pores. These changes occur under the influence of intrinsic and extrinsic factors, as hormone alterations and exposure to ultraviolet light (UV) irradiation, respectively. Skin changes associated with aging have been assuming an important role in nowadays and bring to affect the quality of life. Intense Pulsed Light (ILP) is a noncollimated, polychromatic, and noncoherent non-surgical cosmetic therapy to skin rejuvenation. This is the first systematic review evaluating ILP treatment on skin rejuvenation evaluated by digital photographs and self-reported treatment efficacy. A PRISMA compliant review includes a search of the databases Scopus and PubMed. Sixteen studies treating 637 participants (with Fitzpatrick skin types I to IV and age varying from 21 to 80 years) were included. Patients were treated a mean of 4.29 sessions (range 3-7). The most studies results showed the efficacy of IPL treatment in telangiectasia, wrinkles, pore, erythema, rhytids, texture, lentigines, hiperpigmentation, and photoaging score. Six studies showed IPL-positive effects in association with other treatment and seven studies showed superior effect of other treatment or association to IPL with other treatment related to IPL alone. Nine studies showed low methodological quality. In conclusion, ILP treatment is effective on skin rejuvenation. However, there is no consensus about the parameters and future studies are needed to sample size limitations, made RCTs with low risk of bias, and improve the methodological quality its. Trial registration: Prospero Systematic Review Registration ID: CRD42021237817.
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Affiliation(s)
- Abdias Fernando Simon Sales
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Rua Silva Jardim, 136, Vila Belmiro, Santos, SP, 11015-020, Brazil
| | - Isabella Liba Pandolfo
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Rua Silva Jardim, 136, Vila Belmiro, Santos, SP, 11015-020, Brazil
| | - Matheus de Almeida Cruz
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Rua Silva Jardim, 136, Vila Belmiro, Santos, SP, 11015-020, Brazil
| | - Julia Risso Parisi
- Metropolitan University of Santos, Av. Gen. Francisco Glicério, 8, Encruzilhada, Santos, SP, 11045-002, Brazil
| | - Lívia Assis Garcia
- Graduate Program in Biomedical Engineering, Brazil University, Estrada projetada F1, S/N Fazenda Santa Rita, Fernandópolis, São Paulo, SP, 15600-000, Brazil
| | - Cintia Cristina Santi Martignago
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Rua Silva Jardim, 136, Vila Belmiro, Santos, SP, 11015-020, Brazil
| | - Ana Cláudia Muniz Renno
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Rua Silva Jardim, 136, Vila Belmiro, Santos, SP, 11015-020, Brazil
| | - Patricia Gabrielli Vassão
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Rua Silva Jardim, 136, Vila Belmiro, Santos, SP, 11015-020, Brazil.
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Dorsal Hand Rejuvenation: A Systematic Review of the Literature. Aesthetic Plast Surg 2021; 45:1804-1825. [PMID: 33420511 DOI: 10.1007/s00266-020-02077-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 11/25/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Dorsal hand appearance undergoes changes with aging. Grading systems have been designed to provide numerical scores to dorsal hand appearance. Various modalities have been utilized to improve the aesthetic appearance and rejuvenate the dorsal hand. METHODS The MEDLINE database was searched for articles investigating dorsal hand rejuvenation. Studies were grouped by method including fat grafting, injectable filler, laser/light-based treatments and miscellaneous treatments. Treatment protocols and outcomes were compiled along with patient information and complications. RESULTS Forty-six articles were identified for inclusion. This included 9 studies of fat grafting procedures, 20 studies of injectable filler, 10 studies of laser/light-based treatments and 7 miscellaneous. Most studies showed overall good results with high patient satisfaction. Satisfaction rates were lower in laser/light-based treatments compared with the other modalities. The average patient age for included studies ranged from 41.5 to 69. Across all studies, 96.8% of patients were female and 3.2% male. CONCLUSIONS Procedures for dorsal hand rejuvenation in the literature include procedures to address volume atrophy and superficial wrinkling. These procedures are overall safe with most studies reporting no complications or only mild adverse events. With high satisfaction rates and anecdotal reports of increasing patient interest, these procedures represent a developing area in aesthetic surgery likely to continue increasing in popularity. LEVEL OF EVIDENCE III 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 .
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Yang Z, Duan X, Wang X, Li D, Xu Q, Xiang S, Guo B, He L. The effect of Q-switched 1064-nm dymium-doped yttrium aluminum garnet laser on the skin barrier and collagen synthesis through miR-24-3p. Lasers Med Sci 2021; 37:205-214. [PMID: 33400013 PMCID: PMC8803697 DOI: 10.1007/s10103-020-03214-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/26/2020] [Indexed: 11/26/2022]
Abstract
Due to the increase of the world’s population aging, how to restore youthfulness to the skin has attracted much attention. It is well known that collagen synthesis and changes in skin barrier play an important role in the process of skin aging. However, whether Q-switched 1064-nm Nd:YAG laser (1064-QSNYL) determines the involvement of miRNAs in skin collagen synthesis and skin barrier changes remains to be elucidated. Upstream miRNAs of p38 molecular pathway have been predicted by bioinformatic database and the relationship between miRNAs and p38 verified by dual-luciferase reporter gene and Western blotting. RT-qPCR analysis detected the expression of miR-24-3p and mRNA for collagen and skin barrier–related molecules, such as keratin 10 (K10), filaggrin, and Aquaporin 4 (APQ4), in mice back skin and in the keratinocyte cell line HaCaT. Western blotting and immunofluorescence (IF) have been used to detect collagen expression and to localize, as well as quantify K10, filaggrin, and APQ4, respectively. In this study, we show that p38 is the main target gene of miRNA-24-3p, and laser irradiation at 1.5 J/cm2 inhibits miR-24-3p expression. Irradiation treatment upregulates the moisture, elasticity, hydroxyproline, and superoxide dismutase content of mice skin, as well as inhibits trans-epidermal water loss. Irradiation also increases collagen, K10, filaggrin, and APQ4 in both mice skin and HaCaT cells. Interestingly, we found that miR-24-3p overexpression inhibits the effect of irradiation on collagen synthesis and skin barrier. We show for the first time that 1064-QSNYL promotes collagen synthesis and protective effects on skin barrier by downregulating miR-24-3p.
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Affiliation(s)
- Zhi Yang
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, Kunming, 650032, Yunnan Province, People's Republic of China.
| | - Xiaoxia Duan
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Xue Wang
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Dongqing Li
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Qi Xu
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Shunli Xiang
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Birun Guo
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Li He
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, Kunming, 650032, Yunnan Province, People's Republic of China.
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Abstract
Cosmetic devices using non-ionizing radiation (NIR) are increasingly available for people who wish to modify their appearance for aesthetic purposes. There are a wide range of NIR modalities used for cosmetic procedures, including devices that use optical radiation (laser, intense pulsed light, and light-emitting diode), electromagnetic fields, and ultrasound. Common procedures involving the application of NIR include epilation, skin rejuvenation, body sculpting and contouring, treatment of vascular and skin lesions, tattoo removal, and scar reduction. The majority of research on the use of NIR cosmetic devices has focused on the efficacy of the treatment rather than adverse effects or complications. Studies that assessed safety consisted mostly of case reports and small case series. Common adverse effects on the skin reported include mild and transient pain, erythema, swelling, and changes in pigmentation. Less common, more severe side effects include burns, blisters, scarring, persisting erythema, altered pigmentation, and eye damage. Some of the latter may have resulted from treatment errors. Particular groups of people that may be at greater risk from optical radiation include people with dark skin, with high sun exposure, and taking photosensitizing medications or supplements. There is lack of evidence for the safety profile of cosmetic NIR procedures during pregnancy. Reports of injuries to workers administering treatments with cosmetic NIR devices are rare, but inadvertent damage to the eye from optical devices may occur. Randomized controlled trials are required to fully assess potential adverse effects from the use of NIR cosmetic devices. Regulation varies worldwide and some regions apply the same safety classification and guidance as for medical devices. In order to reduce harm associated with the use of cosmetic devices, ICNIRP considers it important that regulations that cover all types and frequencies of cosmetic NIR devices are adopted worldwide and that there is greater oversight regarding their use.
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