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Almeman AA. Evaluating the Efficacy and Safety of Alpha-Hydroxy Acids in Dermatological Practice: A Comprehensive Clinical and Legal Review. Clin Cosmet Investig Dermatol 2024; 17:1661-1685. [PMID: 39050562 PMCID: PMC11268769 DOI: 10.2147/ccid.s453243] [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: 02/07/2024] [Accepted: 06/23/2024] [Indexed: 07/27/2024]
Abstract
The global market for alpha-hydroxy acids (AHAs) is undergoing significant expansion, propelled by increasing demand for skincare products that address aging and environmental damage. This review focuses on the dermatological applications of AHAs, particularly in cosmetic formulations like chemical peels. We have identified that AHAs, such as glycolic and lactic acids, enhance skin rejuvenation by promoting apoptosis in skin cells, boosting collagen and elastin synthesis, and improving skin texture and luminosity. Our comprehensive analysis reveals a nuanced understanding of AHAs' effectiveness across various skin types and conditions, demonstrating their broad utility in treating conditions like acne, hyperpigmentation, and photoaging. However, the optimal concentrations for therapeutic efficacy with minimal side effects are yet to be precisely defined, necessitating further research. Regulatory compliance is underscored as essential for the safe application of AHAs in cosmetics, with international guidelines recommending specific concentrations and pH levels to minimize potential skin irritation. In Conclusion, the review highlights the effectiveness of AHAs in cosmetic dermatology, emphasizing the necessity for continued research and rigorous regulatory adherence to maximize their safe and beneficial application worldwide.
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Yenny SW, Julia DS, Lestari AF, Al Hazmi A, Ilmiawati C. A clinical and novel dermoscopic investigation of combined peels as a hand aging treatment. J Cosmet Dermatol 2024. [PMID: 38979887 DOI: 10.1111/jocd.16456] [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: 12/08/2023] [Revised: 05/16/2024] [Accepted: 07/01/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND The hands are one of the areas where skin aging is most noticeable, alongside the face, but limited studies used dermoscopic evaluation on hand aging. The Dermoscopy Photoaging Scale (DPAS) is frequently used to assess face aging but is never used for hand aging. Treating skin aging using chemical peeling is a commonly used method to rejuvenate the skin on the hands, as it is relatively affordable. Using multiple chemical peels may yield more significant results. AIMS To determine the effectiveness of a chemical peeling combination in retarding hand aging and to assess the utility of DPAS in this process. METHODS This study involved 69 Fitzpatrick skin types III-IV volunteers aged 20-69. One hand of each participant was treated with 20% glycolic acid (GA), while the other received a combination of peels consisting of 20% GA and 15% trichloroacetic acid (TCA). The hands were clinically examined before and after the treatments, and dermoscopic examinations were performed using a modified DPAS. RESULTS Four treatments improved clinical and dermoscopic characteristics in both hands. The combined peeling considerably improved pigmentation intensity on the dorsal hand compared to the GA peel (p < 0.001). Post-chemical peeling patient satisfaction increased significantly. CONCLUSIONS The modified DPAS is a valuable instrument to assess the signs of hand aging. The combination of GA and TCA effectively improves skin aging of the hands and offers an accessible and economical option for addressing skin aging.
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Affiliation(s)
- Satya Wydya Yenny
- Department of Dermatology and Venereology, dr. M. Djamil Hospital, Padang, West Sumatera, Indonesia
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Andalas, Padang, West Sumatera, Indonesia
- Klinik Utama Griya Satya Estetik, Padang, West Sumatera, Indonesia
| | | | - Andriani Fuji Lestari
- Department of Dermatology and Venereology, dr. M. Djamil Hospital, Padang, West Sumatera, Indonesia
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Andalas, Padang, West Sumatera, Indonesia
| | - Auliya Al Hazmi
- Department of Dermatology and Venereology, dr. M. Djamil Hospital, Padang, West Sumatera, Indonesia
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Andalas, Padang, West Sumatera, Indonesia
| | - Cimi Ilmiawati
- Department of Pharmacology and Therapeutic, Faculty of Medicine, Universitas Andalas, Padang, West Sumatera, Indonesia
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3
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Renzi M, McLarney M, Jennings T, Duffy R, Heymann WR, Lawrence N, Decker A. Procedural and surgical treatment modalities for acne scarring: Part II. J Am Acad Dermatol 2024; 90:1137-1150. [PMID: 35469981 DOI: 10.1016/j.jaad.2022.04.022] [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: 11/09/2021] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 10/18/2022]
Abstract
The optimal treatment of acne scarring is challenging because several factors need to be considered, including the type and number of scars, Fitzpatrick skin type, and the amount of downtime permissible to the patient. This second article in the continuing medical education series discusses the procedural treatments available for acne scarring, including the use of chemical peels, fillers, radiofrequency microneedling, lasers, and surgical procedures. The indications for each modality, evidence for its benefits, and the adverse effects are discussed. This section aims to help guide the reader select and implement the most appropriate treatment based on the patient's preferences, acne scarring, and skin type.
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Affiliation(s)
- Michael Renzi
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
| | - Matt McLarney
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
| | - Tara Jennings
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey.
| | - Robert Duffy
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
| | - Warren R Heymann
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
| | - Naomi Lawrence
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
| | - Ashley Decker
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
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4
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Yang L, Wang S, Pan H, Zhou X, Wei J, Zhou M, Yang Y, Quan Q. Glycolic acid-induced disruption of epidermal homeostasis in a skin equivalent model: Insights into temporal dynamics and mechanisms. Toxicol Lett 2024; 397:1-10. [PMID: 38710400 DOI: 10.1016/j.toxlet.2024.04.001] [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: 10/12/2023] [Revised: 03/29/2024] [Accepted: 04/12/2024] [Indexed: 05/08/2024]
Abstract
Glycolic acid (GA) is extensively used in cosmetic formulations and skin peeling treatments but its adverse effects, notably severe disruption of epidermal structure, limit its clinical utility. However, the detailed impact of GA on epidermal homeostasis, including changes in structure and protein expression over time, is not fully understood. This study employed a reconstructed human epidermis (RHE) model to assess the effects of varying GA concentrations on epidermal proliferation, differentiation, and desquamation at different time points. Through histology, immunofluorescence, and immunohistochemistry, we observed that 35% GA concentration adversely caused abnormal epidermal homeostasis by affecting epidermal proliferation, differentiation and desquamation. Our findings reveal time-specific responses of key proteins to GA: Filaggrin, Involucrin, Loricrin, and Ki67 showed very early responses; KLK10 an early response; and AQP3 and K10 late responses. This research provides a detailed characterization of GA's effects in an RHE model, mimicking clinical superficial peeling and identifying optimal times for detecting GA-induced changes. Our results offer insights for designing interventions to mitigate GA's adverse effects on skin, enhancing the safety and efficacy of GA peeling treatments.
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Affiliation(s)
- Lingli Yang
- Yunnan Baiyao Group Co., Ltd., Kunming 650000, PR China; East Asia Skin Health Research Center, Beijing 100081, PR China; REAL DermaSci & Biotech Co., Ltd., Beijing 100081, PR China
| | - Siyi Wang
- Yunnan Baiyao Group Co., Ltd., Kunming 650000, PR China; East Asia Skin Health Research Center, Beijing 100081, PR China; REAL DermaSci & Biotech Co., Ltd., Beijing 100081, PR China
| | - Haihao Pan
- Yunnan Baiyao Group Co., Ltd., Kunming 650000, PR China; East Asia Skin Health Research Center, Beijing 100081, PR China; REAL DermaSci & Biotech Co., Ltd., Beijing 100081, PR China
| | - Xue Zhou
- Chengdu Institute of Biology, Chinese Academy of Sciences, Chengdu 610041, PR China
| | - Jing Wei
- East Asia Skin Health Research Center, Beijing 100081, PR China; REAL DermaSci & Biotech Co., Ltd., Beijing 100081, PR China
| | - Ming Zhou
- Yunnan Baiyao Group Co., Ltd., Kunming 650000, PR China; East Asia Skin Health Research Center, Beijing 100081, PR China; REAL DermaSci & Biotech Co., Ltd., Beijing 100081, PR China
| | - Yang Yang
- Yunnan Baiyao Group Co., Ltd., Kunming 650000, PR China; East Asia Skin Health Research Center, Beijing 100081, PR China; REAL DermaSci & Biotech Co., Ltd., Beijing 100081, PR China.
| | - Qianghua Quan
- Yunnan Baiyao Group Co., Ltd., Kunming 650000, PR China; East Asia Skin Health Research Center, Beijing 100081, PR China; REAL DermaSci & Biotech Co., Ltd., Beijing 100081, PR China.
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5
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Măgerușan ȘE, Hancu G, Rusu A. A Comprehensive Bibliographic Review Concerning the Efficacy of Organic Acids for Chemical Peels Treating Acne Vulgaris. Molecules 2023; 28:7219. [PMID: 37894698 PMCID: PMC10608815 DOI: 10.3390/molecules28207219] [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: 10/01/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
Acne vulgaris stands out as the most prevalent skin disorder among teenagers and young adults, causing physical discomfort and considerable economic and psychological burdens on individuals and society. A wide range of topical and systemic therapies are available in acne treatment. Chemical peeling is a skin resurfacing technique designed to rebuild healthy skin using exfoliating substances, a simple and affordable process with various dermatological uses. Chemical peels, classified as superficial, medium, and deep, have been utilized for acne vulgaris and multiple other skin issues. In these chemical peels, a diverse range of chemical substances is employed, each with its unique mode of action. Among these, α-hydroxy and β-hydroxy acids have gathered attention for their efficacy in reducing acne lesions and enhancing overall skin appearance. Acids, such as salicylic acid, glycolic acid, or lactic acid, are commonly used in chemical peels due to their exfoliating and sebum-regulating properties. Despite the widespread use of these acids, there exists a lack of consensus regarding the most effective acid type and concentration for treating acne-prone skin. This review aims to bridge this knowledge gap by evaluating the effectiveness and safety of various organic acids used in chemical peels specifically for acne-prone skin. The findings of this comprehensive bibliographic review indicate that organic acid-based chemical peels represent effective and safe treatment options for individuals with acne-prone skin. Their adaptability sets these treatments apart; the choice of organic acid can be tailored to meet individual patient needs and tolerability levels. This personalized approach ensures that patients receive optimal care while minimizing the risks associated with the treatment. As research in this field progresses, it is anticipated that a more nuanced understanding of the ideal acid type and concentration will emerge, further enhancing the efficacy and safety of chemical peels for acne-prone skin.
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Affiliation(s)
| | - Gabriel Hancu
- Department of Pharmaceutical and Therapeutic Chemistry, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Tîrgu Mureș, 540142 Târgu Mureș, Romania; (Ș.E.M.); (A.R.)
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6
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Cohen A, Legouffe R, Mao J, Gaudin M, Bonnel D. MALDI Mass Spectrometry Imaging and Semi-Quantification of Topically Delivered Lactic Acid. Skin Res Technol 2023; 29:e13485. [PMID: 37881041 PMCID: PMC10579629 DOI: 10.1111/srt.13485] [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: 06/23/2023] [Accepted: 09/19/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Lactic acid is a common active ingredient in many topical skincare products; however, measuring its delivery into the skin is challenging due to the presence of a large level of endogenous lactic acid. In this study, matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI) was used to quantitatively and qualitatively measure the delivery of lactic acid into the skin from a range of topical skincare products. MATERIALS AND METHODS Porcine skin samples were treated with various skincare products containing lactic acid. After 24 h, skin samples were sectioned and treated via H&E staining or prepared for MALDI-MSI using chemical derivatization. Samples were then analyzed by MALDI-MSI imaging to obtain lactic acid distribution in the entire skin section. RESULTS Due to the high level of endogenous lactic acid in the skin, a "triple isotope" of lactic acid (L-Lactic acid-13 C3 ), was needed to provide full resolution from the skin's background signal with MALDI-MSI. With this approach, the topically delivered lactic acid could be quantitatively and qualitatively analyzed from a variety of skincare products. CONCLUSIONS The combination of L-Lactic acid-13 C3 and MALDI-MSI was successfully used to quantitatively and qualitatively measure the topical delivery of lactic acid from a variety of skincare products. This approach could be used in future work to better understand the mode of action of lactic acid as an active ingredient in skincare products.
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Affiliation(s)
- Aaron Cohen
- Personal Care Department of the Colgate‐Palmolive CompanyPiscatawayNew JerseyUSA
| | | | - Junhong Mao
- Personal Care Department of the Colgate‐Palmolive CompanyPiscatawayNew JerseyUSA
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7
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Darzé FM, Bridi EC, França F, Amaral FD, Turssi CP, Basting RT. Enamel and Dentin Etching with Glycolic, Ferulic, and Phosphoric Acids: Demineralization Pattern, Surface Microhardness, and Bond Strength Stability. Oper Dent 2023; 48:E35-E47. [PMID: 36656318 DOI: 10.2341/21-143-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2022] [Indexed: 01/20/2023]
Abstract
This study evaluated the etching pattern, surface microhardness, and bond strength for enamel and dentin submitted to treatment with phosphoric, glycolic, and ferulic acids. Enamel and dentin blocks were treated with phosphoric, glycolic, and ferulic acid to evaluate the surface and adhesive interface by scanning electron microscopy (2000×). Surface microhardness (Knoop) was evaluated before and after etching, and microtensile bond strength was evaluated after application of a two-step adhesive system (Adper Single Bond 2, 3M ESPE) at 24 hours and 12 months storage time points. Analysis of variance (ANOVA) and Tukey's test showed a decrease in the microhardness values for both substrates after application of each acid (p<0.0001). The reduction percentage was significantly higher for enamel treated with phosphoric acid (59.9%) and glycolic acid (65.1%) than for ferulic acid (16.5%) (p<0.0001), and higher for dentin that received phosphoric acid (38.3%) versus glycolic acid (27.8%) and ferulic acid (21.9%) (p<0.0001). Phosphoric and glycolic acids led to homogeneous enamel demineralization, and promoted the opening of dentinal tubules, whereas ferulic acid led to enamel surface demineralization and partially removed the smear layer. The adhesive-enamel interface showed micromechanical embedding of the adhesive in the interprismatic spaces when phosphoric and glycolic acids were applied. Ferulic acid showed no tag formation. Microtensile bond strength at both time points, and for both substrates, was lower with ferulic acid (p=0.0003/E; p=0.0011/D; Kruskal Wallis and Dunn). The bond strength for enamel and dentin decreased when using phosphoric and glycolic acids at the 12-month time evaluation (p<0.05). Glycolic acid showed an etching pattern and microhardness similar to that of phosphoric acid. Ferulic acid was not effective in etching the enamel or dentin, and it did not provide satisfactory bond strength to dental substrates.
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Affiliation(s)
- F M Darzé
- Fernanda Medeiros Darzé, DDS, MSc, PhD student, Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - E C Bridi
- Enrico Coser Bridi, DDS, MSc, PhD, professor, Instituto Nacional de Ensino Superior e Pós-Graduação Padre Gervásio, Minas Gerais, Brazil
| | - Fmg França
- Fabiana Mantovani Gomes França, DDS, MSc, PhD, professor, Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - Flb do Amaral
- Flávia Lucisano Botelho do Amaral, DDS, MSc, PhD, professor, Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - C P Turssi
- Cecilia Pedroso Turssi, DDS, MSc, PhD, professor, Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - R T Basting
- *Roberta Tarkany Basting, DDS, MSc, PhD, professor, Faculdade São Leopoldo Mandic, Campinas, Brazil
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8
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Amici JM, Cogrel O, Jourdan M, Raimbault C, Canchy L, Kerob D, Madfes DC, Tian Y, Araviiskaia E. Expert recommendations on supportive skin care for non-surgical and surgical procedures. J Eur Acad Dermatol Venereol 2023; 37 Suppl 3:16-33. [PMID: 36635618 DOI: 10.1111/jdv.18855] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/04/2023] [Indexed: 01/14/2023]
Abstract
A thorough knowledge of non-surgical procedures (laser, peelings, injections, threads) and surgical procedures (combined surgeries and skin grafts), including contraindications and potential risks and side effects, (e.g. infection, hypopigmentation, hyperpigmentation, and scarring) is essential to be able to reduce their incidence and ensure the patient receives the most benefit from the procedure. Individuals with darker skin and of high Fitzpatrick phototype are at higher risk of dyschromias, notably melasma and post-inflammatory hyperpigmentation, which may be treated using aesthetic procedures but may also arise as a complication of some procedures. A group of experts in cosmetic surgery and dermatology reviewed the published literature and discussed recommendations for optimizing outcomes with practical advice on supportive skincare before, during and after non-surgical or surgical procedures. A broad-spectrum sunscreen with a high sun protection factor against UVB and high protection against UVA, especially long UVA, is essential for all treatment modalities for the prevention and potential improvement of pigmentation disorders. Supportive skin care management to prepare, cleanse and protect the skin and post-procedure skin care with healing and anti-inflammatory ingredients are recommended to speed up regeneration and wound healing whilst minimizing scarring and downtime. Additionally, adjunctive skin care to procedures with antioxidant, anti-ageing and lightening properties may enhance skin benefits.
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Affiliation(s)
- Jean-Michel Amici
- Dermatology Department, CHU Bordeaux, Hôpital Saint-André, Bordeaux, France
| | - Olivier Cogrel
- Mohs Surgery and Laser Unit, Dermatology Department, University Hospital of Bordeaux, Bordeaux, France
| | - Marie Jourdan
- Centre Laser International de la Peau-Paris (CLIPP), Paris, France
| | | | - Ludivine Canchy
- Laboratoire Dermatologique La Roche-Posay, Levallois-Perret, France
| | - Delphine Kerob
- Laboratoire Dermatologique La Roche-Posay, Levallois-Perret, France
| | | | - Yan Tian
- Dermatology Department, Air Force Medical Center, PLA, Beijing, China
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Leow LJ, Zubrzycki N. Facial psoriasis in the etiology of prolonged erythema following medium-depth chemical peels for severe photodamage. J Cosmet Dermatol 2023; 22:1554-1559. [PMID: 36718835 DOI: 10.1111/jocd.15620] [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: 09/22/2022] [Revised: 11/23/2022] [Accepted: 12/26/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Chemical peeling is the controlled wounding of the epidermis and dermis for skin rejuvenation, involving the application of ablative agents to induce keratolysis and regeneration of damaged cell layers. Prolonged erythema is one complication of this procedure. We report the prevalence and probable etiology of prolonged facial erythema in a cohort of patients treated with medium-depth chemical peels. MATERIALS AND METHODS A retrospective audit was conducted of all medium-depth facial chemical peels performed at two major teaching hospitals. All patients had severe facial photodamage affecting at least 75% surface area of the face. The occurrence of prolonged erythema following this peel was then identified and analyzed. RESULTS Of our treatment cohort (n = 82, 51 women, 31 men) with 60 years mean (61.3 years for women, 56.7 years for men), 10 patients (12%; eight women, two men) experienced prolonged erythema beyond a month of treatment. Facial psoriasis was not apparent at the time of chemical peel but manifested as prolonged erythema beyond the expected timeframe following the procedure. CONCLUSION When patients experience prolonged erythema beyond a month of treatment and fail to respond to standard treatments, clinicians should examine carefully for extra-facial psoriasis prior to this procedure, and also consider facial psoriasis a possible cause of prolonged post-peel erythema.
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Affiliation(s)
- Liang Joo Leow
- St. Vincent's Private Hospital, Sydney, New South Wales, Australia.,Aesthetic Dermatology, Sydney, New South Wales, Australia
| | - Nicolas Zubrzycki
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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10
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Muacevic A, Adler JR, Wieland M, Qadri A, Brown M, Ejimogu J, Rasko YM. Insurance Coverage of Dermabrasion and Chemical Peel Procedures: A Critical Analysis of 58 American Insurance Companies. Cureus 2022; 14:e33184. [PMID: 36726896 PMCID: PMC9886408 DOI: 10.7759/cureus.33184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2022] [Indexed: 01/01/2023] Open
Abstract
Introduction Dermabrasion and chemical peels are infrequently utilized methods of treatment for medical-grade conditions despite demonstrations of favorable outcomes. Insurance coverage status has previously been shown to impact availability and accessibility to specific treatments. The purpose of this study is to evaluate the rate of insurance coverage provided for dermabrasion and chemical peel procedures in the treatment of acne, acne scarring, and non-melanoma skin cancers (NMSC). Methods A cross-sectional analysis of 58 insurance companies by web-based search or phone interview determined the number of insurers with a publicly available policy on dermabrasion or chemical peels. Coverage status and any corresponding criteria were extracted from existing company policies. Results Thirteen (22%) and 22 (38%) policies discussed dermabrasion in the treatment of basal cell carcinoma and actinic keratosis, with 62% and 73% of these policies providing coverage. Acne scarring was discussed in significantly more dermabrasion policies than basal cell carcinoma (45% vs 22%; p=0.018). However, significantly more insurers denied coverage of dermabrasion for active acne and acne scarring when compared to dermabrasion to treat basal cell carcinoma or actinic keratosis (p<0.001). Eighty-seven percent of companies (n=20) with a chemical peel policy for premalignant lesions would provide coverage, with required criteria present in 95% (n=19) of the policies that would cover chemical peels for actinic keratosis specifically. Of the 25 companies (43%) that discussed the treatment of acne with chemical peel procedures, 14 (56%) provided coverage, and 11 (44%) denied coverage. Coverage was denied by significantly less insurers for the treatment of active acne with chemical peel procedures compared to treatment with dermabrasion (44% vs 83%; p<0.006). Conclusion Significant discrepancies were noted in both the presence of a public policy and the coverage status of dermabrasion or chemical peel procedures among the United States health insurance companies. These inconsistencies, along with multiple criteria required for coverage, may create an artificial barrier to receiving care for specific medical-grade conditions.
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11
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Drozhdina MB, Bobro VA, Sennikova YA, Kornilova EI. Post-acne symptom complex. Approaches to therapy. VESTNIK DERMATOLOGII I VENEROLOGII 2022. [DOI: 10.25208/vdv1279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Postacne-persistent skin changes that appear as a result of long-term acne, inadequate therapy and manipulations performed in the management of this group of patients. The post-acne symptom complex is stable skin changes that appear as a result of long-term acne inadequate therapy and manipulations performed during the management of this group of patients. The pathogenetic mechanisms underlying the launch of acne currently look as follows: androgens cause hyperseborrhea, sebum lipids activate innate immunity; pathological keratinization due to the production of IL-1 inflammatory mediator and androgen hyperproduction; Cutibacterium acnes activate innate immune responses through toll-like receptors and metalloproteinases, stimulate the production of antimicrobial peptides and sebum production. The subsequent rupture of the follicles activates the wound healing process. Depending on the genetically determined features of the course of the inflammatory process, various individual postacne changes of the skin will prevail in different patients. The article highlights the main factors influencing the formation of post-acne, pathogenetic mechanisms underlying the formation of these changes, systematizes modern data on the classification, morphological and pathohistological characteristics of scars. Quantitative and qualitative scales of assessment of post-acne scars for determining the severity of the pathological process are presented, differentiated approaches to modern methods of therapy are discussed in detail, including the advantages and disadvantages of the most common methods of treating patients based on the principles of evidence-based medicine using a number of personalized methods.
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12
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Wang JV, Saedi N. Reflections on debates in aesthetic dermatology: Part I. Clin Dermatol 2022; 40:1-3. [DOI: 10.1016/j.clindermatol.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Mahmood F, Beach RA. Can it make me white again? A case report of 88% phenol as a depigmenting agent in vitiligo. SAGE Open Med Case Rep 2021; 9:2050313X21993307. [PMID: 33680467 PMCID: PMC7900787 DOI: 10.1177/2050313x21993307] [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] [Indexed: 11/17/2022] Open
Abstract
Vitiligo is the most common depigmenting disorder. However, therapies prove to be
time-consuming, costly, or slow to show efficacy. Here, we present a case of a 74-year-old
female with vitiligo who underwent full-body depigmentation treatment 50 years ago. Brown
patches of repigmentation appeared on the patient’s face and arms and were eventually
treated with 88% phenol. Patient was later switched to compounded 3% glutathione cream for
a more sustained effect. Phenol was an accessible, economical, and easily administrable
therapeutic option that can result in short-term depigmentation.
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Affiliation(s)
- Farhan Mahmood
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Renée A Beach
- Faculty of Medicine, Division of Dermatology, Women's College Hospital, University of Toronto, ON, Canada
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14
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Bhargava S, Goldust M, Singer H, Negbenebor N, Kroumpouzos G. Evaluating resurfacing modalities in aesthetics. Clin Dermatol 2021; 40:274-282. [DOI: 10.1016/j.clindermatol.2021.01.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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15
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Sitohang IBS, Rahmayunita G, Hosfiar VA, Ninditya S, Augustin M. Effectiveness of water as the neutralising agent for glycolic acid peels in skin phototypes IV-V. Australas J Dermatol 2020; 62:e212-e216. [PMID: 33070326 DOI: 10.1111/ajd.13486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/31/2020] [Accepted: 09/09/2020] [Indexed: 11/27/2022]
Abstract
The aim of the study is to evaluate the effectiveness of water as a substitute for sodium bicarbonate plus solution in the neutralisation process of chemical peeling using a 35% glycolic acid solution. This randomised, double-blind, split-face, controlled trial was conducted in an outpatient setting. A total of 126 healthy patients with skin phototypes IV-V aged between 18 and 60 years old were recruited. Chemical peeling was performed with 35% glycolic acid solution. One side of the face was neutralised with water, and the other side of the face was neutralised with a sodium bicarbonate plus solution. The main outcome of this study was measured by the degree of erythema, pruritus and pain scores. Significant difference in the pain score immediately after the neutralisation process of the chemical peeling with glycolic acid was seen. However, there were no significant differences in the degree of erythema or the pruritus score. These results indicate that water can be used as a substitute for sodium bicarbonate plus solution in the neutralisation process of chemical peeling with 35% glycolic acid in patients with skin phototypes IV-V.
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Affiliation(s)
- Irma Bernadette S Sitohang
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia, dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Githa Rahmayunita
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia, dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Vashty Amanda Hosfiar
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia, dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Shafira Ninditya
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia, dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Maureen Augustin
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia, dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Hamilton MM, Kao R. Recognizing and Managing Complications in Laser Resurfacing, Chemical Peels, and Dermabrasion. Facial Plast Surg Clin North Am 2020; 28:493-501. [PMID: 33010868 DOI: 10.1016/j.fsc.2020.06.008] [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] [Indexed: 11/29/2022]
Abstract
Skin resurfacing techniques allow improvement of skin texture and color. This includes the effacement of wrinkles, signs of photoaging, and the softening of scars. Laser resurfacing, chemical peels, and dermabrasion are associated with overlapping risks of complications. The most common of these include infection, hypopigmentation, hyperpigmentation, and scarring. Patient evaluation helps provide treatment that gives the maximal benefit with a minimization of risks. This includes understanding the extent of each patient's issues (Glogau scale) and Fitzpatrick type. A thorough knowledge of potential risks will reduce their incidence and optimize early recognition and treatment of these complications when they do occur.
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Affiliation(s)
- Mark M Hamilton
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, 340 West 10 th Street, Fairbanks Hall, Suite 6200, Indianapolis, IN 46202-3082, USA.
| | - Richard Kao
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, 340 West 10 th Street, Fairbanks Hall, Suite 6200, Indianapolis, IN 46202-3082, USA
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17
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18
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Gamea MM, Kamal DA, Donia AA, Hegab DS. Comparative study between topical tranexamic acid alone versus its combination with autologous platelet rich plasma for treatment of melasma. J DERMATOL TREAT 2020; 33:798-804. [DOI: 10.1080/09546634.2020.1781755] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Mohamed Mahmoud Gamea
- Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Doha Ali Kamal
- Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ahmed Atef Donia
- Pharmaceutical Technology Department, Faculty of Pharmacy, Menoufia University, Shibin el Kom, Egypt
| | - Doaa Salah Hegab
- Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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19
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Asilian A, Shahmoradi Z, Talakoub M, Mokhtari F, Siadat AH, Mohaghegh F, Adibi N, Mozafarpoor S, Kazemipour S, Danesh F, Hafezi H. Evaluation of combination therapy with peeling added to minimal invasive blepharoplasty in lower eyelid rejuvenation. J Cosmet Dermatol 2020; 19:2922-2928. [PMID: 32243049 DOI: 10.1111/jocd.13394] [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] [Received: 02/02/2019] [Revised: 09/18/2019] [Accepted: 03/06/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Aging is an inevitable process in life that can pose unsatisfactory changes in appearance. Recently, rejuvenation surgeries have opened an exciting new window toward people who are vulnerable according to their facial appearance. Periocular plastic microsurgeries are among the most common aesthetic surgeries with various outcomes. The current study was aimed to compare outcomes of blepharoplasty with and without peeling regarding lower eyelid rejuvenation. METHODS This is a randomized clinical trial study conducted on 30-patients referred for inferior lid rejuvenation in 2017-18. Patients were randomly divided into two 15-member subgroups of microinvasive blepharoplasty with and without peeling. Peeling for the group underwent blepharopeeling was performed all over the inferior periocular region using Phenol 89%. Then, skin and underlying muscle were incised superficially, and underlying fat tissue was excised. The other group underwent blepharoplasty without peeling. Patients were followed daily for 2 months to assess complications, patients' and physicians' satisfaction. RESULTS Two assessed groups were not statistically different regarding age and gender distribution (P-value = .417 and .666, respectively). Considering patients' opinion, symmetry, scar formation, skin laxity, swelling, and total satisfaction score were not different between two groups (P-value > .05) while physicians presented similar outcomes except for better scar formation status of peeling add-on therapy (P-value = .042). Rate of adverse effects was significantly higher among those under blepharoplasty plus peeling treatment (P-value < .05). CONCLUSION Outcomes of blepharoplasty alone versus blepharoplasty plus peeling were not significantly different regarding both patients' and physicians' assessments in general while fewer complications due to blepharoplasty without peeling were presented.
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Affiliation(s)
- Ali Asilian
- Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.,Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zabihollah Shahmoradi
- Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.,Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahboobeh Talakoub
- Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.,Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Mokhtari
- Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.,Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Hossein Siadat
- Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.,Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Mohaghegh
- Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.,Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Neda Adibi
- Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Samaneh Mozafarpoor
- Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Samira Kazemipour
- Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.,Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzaneh Danesh
- Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.,Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Hafezi
- Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.,Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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20
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Abou Eitta RS, Ismail AA, Abdelmaksoud RA, Ghezlan NA, Mehanna RA. Evaluation of autologous adipose-derived stem cells vs. fractional carbon dioxide laser in the treatment of post acne scars: a split-face study. Int J Dermatol 2019; 58:1212-1222. [PMID: 31297798 DOI: 10.1111/ijd.14567] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/22/2019] [Accepted: 06/07/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Scarring is a distressing outcome of acne, as it causes cosmetic and psychological problems to the patients. Unfortunately no single treatment is satisfactory; instead, employing multiple modalities may have better outcome. Autologous adipose tissue-derived adult stem cells (AT-ASCs) and their secretory factors can stimulate collagen synthesis; angiogenesis and migration of fibroblasts thus regenerate damaged tissues. Also, conventional treatments for acne scarring, such as lasers and topical regimens, induce new collagen synthesis via activation of dermal fibroblasts or growth factors. The aim of the study was to verify the effectiveness of AT-ASCs for the treatment of acne scarring vs. the fractional carbon dioxide laser (FxCR). SUBJECTS AND METHODS Split face comparative study included 10 adult patients with post-acne scars on both sides of the face. One side received AT-ASCs single injection while the other received three sessions of FxCR. Scars were then assessed using the global scoring system Goodman and Baron, scar area percent using NIH ImageJ software and functional assessment by measuring the transepidermal water loss (TEWL) and skin hydration. Both sides were followed for three months. RESULTS A significant improvement in the degree of scar severity, scar area percent, skin hydration, and TEWL after 3 months of treatment on both sides of the face with insignificant differences between both treatment modalities, provided that AT-ASCs treatment was employed once vs. three sessions of FxCR. CONCLUSION One injection of AT-ASCs is as effective as three sessions of FxCR in the treatment of atrophic acne scars.
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Affiliation(s)
- Rania S Abou Eitta
- Dermatololgy, Venereology and Andrology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Aisha A Ismail
- Dermatololgy, Venereology and Andrology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Rania A Abdelmaksoud
- Dermatololgy, Venereology and Andrology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Naser A Ghezlan
- Plastic surgery Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Radwa A Mehanna
- Medical Physiology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.,Center of Excellence for Research in Regenerative Medicine and Applications (CERRMA), Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Abstract
Smooth, wrinkle-free skin is associated with supposed attractiveness, youthfulness, and health, while rhytids have a negative impact on one's perceived appearance, image, and self-esteem. Noninvasive esthetic procedures such as laser or light therapy have been used to achieve and attain a more youthful appearance. Currently, there is a wide range of lasers and devices available for the regeneration and healing of skin. Lasers and light sources for skin rejuvenation involve the removal of aged skin tissue via thermal heat from high-powered lasers, stimulating the surrounding tissues to recover through natural wound-healing processes. In contrast, photobiomodulation, which makes use of low energy lasers or light emitting diodes, uses no heat and has shown positive effects in the reduction of wrinkles and improving skin laxity.
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22
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Trevelin LT, Villanueva J, Zamperini CA, Mathew MT, Matos AB, Bedran-Russo AK. Investigation of five α-hydroxy acids for enamel and dentin etching: Demineralization depth, resin adhesion and dentin enzymatic activity. Dent Mater 2019; 35:900-908. [PMID: 30975484 DOI: 10.1016/j.dental.2019.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/11/2019] [Accepted: 03/15/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Surface conditioning of enamel and dentin is a key step during adhesive restorative procedures and strategies. The aim of this study was to investigate the effectiveness of five α-hydroxy-acids (AHAs) as enamel and dentin surface etchants. METHODS Enamel and dentin specimens were prepared from human molars to determine the depth of demineralization by optical profilometry (Δz), the resin bond strength to enamel and dentin (μTBS), the micro-permeability of dentin-resin interfaces, and the gelatinolytic activity of dentin matrix induced by AHAs [glycolic (GA), lactic (LA), citric (CA), malic (MI) and tartaric (TA)] and controls [phosphoric (PA) and maleic (MA)]. All acids were prepared at 35% concentration. Adhesion studies employed Adper Single Bond Plus bonding system. Data were individually processed and analyzed by ANOVA, post-hoc tests and Pearson correlations (α = 0.05). RESULTS AHA exhibited statistically lower depth of demineralization of enamel and dentin (average 4 fold) than controls (p < 0.001). In enamel, MA and PA etching resulted in higher μTBS than AHA groups (p < 0.001). In dentin, GA, TA, CI and LA etching resulted in statistically similar μTBS than PA (p < 0.05). The hybrid-layer (HL) thickness and interfacial micro-permeability intensity were statistically lower for AHA groups (p < 0.05). A significant positive correlation was observed between the intensity of micro-permeability and the thickness of HL (p < 0.05). AHA etchants elicited lower dentin enzymatic activity than controls (p < 0.05). SIGNIFICANCE AHAs effectively etched enamel and dentin surfaces. In particular, GA and TA resulted in suitable μTBS and sealing ability as well as induced less gelatinolytic activity in dentin than PA and MA.
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Affiliation(s)
- Lívia Tosi Trevelin
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, UIC, Chicago, IL, USA; Department of Operative Dentistry, College of Dentistry, University of São Paulo, USP, São Paulo, SP, Brazil
| | - Jose Villanueva
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, UIC, Chicago, IL, USA
| | - Camila A Zamperini
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, UIC, Chicago, IL, USA
| | - Mathew T Mathew
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, UIC, Chicago, IL, USA
| | - Adriana Bona Matos
- Department of Operative Dentistry, College of Dentistry, University of São Paulo, USP, São Paulo, SP, Brazil
| | - Ana K Bedran-Russo
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, UIC, Chicago, IL, USA.
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23
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Radio Peel-Synergism Between Nano-fractional Radiofrequency and 20% Trichloroacetic Acid Chemical Peeling. Dermatol Surg 2019; 45:711-717. [PMID: 30908361 DOI: 10.1097/dss.0000000000001918] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Microneedling fractional radiofrequency (FRF) and chemical peels are widely used for skin rejuvenation. OBJECTIVE The authors aimed at evaluating the efficacy and safety of FRF and trichloroacetic acid 20% (TCA20%) peel in different combinations for determining the optimal treatment protocol. METHODS In this prospective clinical comparison of 4 protocols (FRF alone, TCA20% alone, TCA20% before FRF [TCA→FRF], and TCA20% following FRF [FRF→TCA]), the patients underwent 3.8 ± 1.2 successive treatments of one protocol at 4- to 6-week intervals. The patients and 2 dermatologists evaluated improvement of pigmentation and dyschromia, erythema and blood vessels, laxity and wrinkling, and skin imperfections using a global aesthetic improvement scale (GAIS) and a 1 to 5 scoring system. The patients rated their satisfaction and reported adverse effects and reduced activity. Skin impedance and histological changes following the different protocols were also evaluated on 3 additional volunteers. RESULTS Sixty-seven patients (age range 22-80 years) were studied. TCA→FRF caused skin impedance to decrease, yielding a more superficial and less-efficient penetration of FRF energy. FRF→TCA produced more significant improvement in overall facial skin appearance (GAIS) and most evaluated skin parameters. Adverse effects and satisfaction rates were similar for all approaches. CONCLUSION FRF→TCA had the best synergistic effect on skin rejuvenation compared with FRF or TCA20% alone and TCA→FRF.
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24
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Wiser I, Roni AS, Ziv E, Friedman M, Efraty S, Heller L, Landau M, Friedman T. Is There an Association Between Hyperbaric Oxygen Therapy and Improved Outcome of Deep Chemical Peeling? A Randomized Pilot Clinical Study. Plast Surg (Oakv) 2018; 26:250-255. [PMID: 30450343 DOI: 10.1177/2292550317749511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Phenol chemical peeling (PCP) treatment is associated with prolonged recovery and sustained adverse events. Hyperbaric oxygen therapy (HBOT) is known to accelerate wound healing. The purpose of the current study was to evaluate the effect of HBOT on PCP recovery period and adverse events. Methods This is a pilot randomized controlled clinical study. Women following PCP underwent 5 consecutive daily HBOT sessions, compared with PCP alone. Pain, pruritus, erythema, crusting, scaling, and edema were daily evaluated up to 28 days following PCP. Photographs taken on days 14 and 35 following PCP were assessed. Confidence to appear in public was assessed 14 days following PCP. Results Eight participants equally assigned to HBOT and control groups. Lower severity scores for erythema, scaling, and pruritus were documented in the HBOT group (mean difference 1.19, P = .006; .84, P = .04; and 2.19, P = .001, respectively). Photographic assessment severity score was higher for skin tightness, edema, erythema, crusting, and scaling in the control group on day 14 post PCP (P < .05) and for erythema on day 35 post PCP (P < .05). Epithelialization percentage was higher in the HBOT group on day 14 post PCP compared with controls (98.5% ± 1% vs 94.2% ± 1%; P = .021). The HBOT group scored higher in confidence to appear in public (20.8 ± 1.7 vs 14.5 ± 1.3; P = .029). Conclusion Hyperbaric oxygen therapy following PCP is associated with faster recovery as assessed by both patients and caregivers. So far, HBOT was mainly used in the treatment of problematic or chronic wounds. Our study suggests expanding the indications in which hyperbaric oxygen treatment is applicable and recommended.
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Affiliation(s)
- Itay Wiser
- Department of Plastic Surgery, Assaf Harofeh Medical Center, Tzrifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Averbuch Sagie Roni
- Department of Plastic Surgery, Assaf Harofeh Medical Center, Tzrifin, Israel
| | - Ella Ziv
- Department of Plastic Surgery, Assaf Harofeh Medical Center, Tzrifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mony Friedman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Hyperbaric Medicine Unit, Assaf Harofeh Medical Center, Tzrifin, Israel
| | - Shay Efraty
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Hyperbaric Medicine Unit, Assaf Harofeh Medical Center, Tzrifin, Israel
| | - Lior Heller
- Department of Plastic Surgery, Assaf Harofeh Medical Center, Tzrifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Marina Landau
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Dermatology Unit, Wolfson Medical Center, Holon, Israel
| | - Tali Friedman
- Department of Plastic Surgery, Assaf Harofeh Medical Center, Tzrifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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25
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In Jae J, Dong Ju H, Dong Hyun K, Yoon MS, Lee HJ. Comparative study of buffered 50% glycolic acid (pH 3.0) + 0.5% salicylic acid solution vs Jessner's solution in patients with acne vulgaris. J Cosmet Dermatol 2017; 17:797-801. [DOI: 10.1111/jocd.12445] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Jeong In Jae
- Department of Dermatology; CHA Bundang Medical Center; CHA University; Seongnam Korea
| | - Hyun Dong Ju
- Department of Dermatology; CHA Bundang Medical Center; CHA University; Seongnam Korea
| | - Kim Dong Hyun
- Department of Dermatology; CHA Bundang Medical Center; CHA University; Seongnam Korea
| | - Moon Soo Yoon
- Department of Dermatology; CHA Bundang Medical Center; CHA University; Seongnam Korea
| | - Hee Jung Lee
- Department of Dermatology; CHA Bundang Medical Center; CHA University; Seongnam Korea
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26
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O'Connor AA, Lowe PM, Shumack S, Lim AC. Chemical peels: A review of current practice. Australas J Dermatol 2017; 59:171-181. [DOI: 10.1111/ajd.12715] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 07/16/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Alicia A O'Connor
- Department of Dermatology; Royal Prince Alfred Hospital; Sydney New South Wales Australia
| | - Patricia M Lowe
- Department of Dermatology; Royal Prince Alfred Hospital; Sydney New South Wales Australia
- Sydney Medical School; University of Sydney; Sydney New South Wales Australia
| | - Stephen Shumack
- Sydney Medical School; University of Sydney; Sydney New South Wales Australia
- Department of Dermatology; Royal North Shore Hospital; Sydney New South Wales Australia
| | - Adrian C Lim
- Sydney Medical School; University of Sydney; Sydney New South Wales Australia
- Department of Dermatology; Royal North Shore Hospital; Sydney New South Wales Australia
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27
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Cameli N, Mariano M, Ardigò M, Corato C, De Paoli G, Berardesca E. Comparative instrumental evaluation of efficacy and safety between a binary and a ternary system in chemexfoliation. J Cosmet Dermatol 2017; 17:788-796. [PMID: 28940586 DOI: 10.1111/jocd.12424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To instrumentally evaluate the efficacy and the safety of a new ternary system chemo exfoliating formulation (water-dimethyl isosorbide-acid) vs traditional binary systems (water and acid) where the acid is maintained in both the systems at the same concentration. METHODS Different peelings (binary system pyruvic acid and trichloroacetic acid-TCA, and ternary system pyruvic acid and TCA) were tested on the volar forearm of 20 volunteers of both sexes between 28 and 50 years old. The outcomes were evaluated at the baseline, 10 minutes, 24 hours, and 1 week after the peeling by means of noninvasive skin diagnosis techniques. In vivo reflectance confocal microscopy was used for stratum corneum evaluation, transepidermal waterloss, and Corneometry for skin barrier and hydration, Laser Doppler velocimetry in association with colorimetry for irritation and erythema analysis. RESULTS The instrumental data obtained showed that the efficacy and safety of the new ternary system peel compounds were significantly higher compared with the binary system formulations tested. The new formulation peels improved chemexfoliation and reduced complications such as irritation, redness, and postinflammatory pigmentation compared to the traditional aqueous solutions. CONCLUSION The study showed that ternary system chemexfoliation, using a controlled delivery technology, was able to provide the same clinical effects in term of stratum corneum reduction with a significantly reduced barrier alteration, water loss, and irritation/erythema compared to traditional binary system peels.
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Affiliation(s)
- Norma Cameli
- San Gallicano Dermatological Institute, Rome, Italy
| | | | - Marco Ardigò
- San Gallicano Dermatological Institute, Rome, Italy
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28
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Costa IMC, Damasceno PS, Costa MC, Gomes KGP. Review in peeling complications. J Cosmet Dermatol 2017; 16:319-326. [DOI: 10.1111/jocd.12329] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2017] [Indexed: 11/28/2022]
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29
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Cohen BE, Bashey S, Wysong A. Literature Review of Cosmetic Procedures in Men: Approaches and Techniques are Gender Specific. Am J Clin Dermatol 2017; 18:87-96. [PMID: 28004257 DOI: 10.1007/s40257-016-0237-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The proportion of men receiving non-surgical cosmetic procedures has risen substantially in recent years. Various physiologic, anatomic, and motivational considerations differentiate the treatments for male and female patients. Nevertheless, research regarding approaches to the male cosmetic patient is scarce. We sought to provide an overview and sex-specific discussion of the most popular cosmetic dermatologic procedures pursued by men by conducting a comprehensive literature review pertaining to non-surgical cosmetic procedures in male patients. The most common and rapidly expanding non-surgical interventions in men include botulinum toxin, filler injection, chemical peels, microdermabrasion, laser resurfacing, laser hair removal, hair transplantation, and minimally invasive techniques for adipose tissue reduction. Important sex-specific factors associated with each of these procedures should be considered to best serve the male cosmetic patient.
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30
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Hung SJ, Tang SC, Liao PY, Ge JS, Hsiao YP, Yang JH. Photoprotective Potential of Glycolic Acid by Reducing NLRC4 and AIM2 Inflammasome Complex Proteins in UVB Radiation-Induced Normal Human Epidermal Keratinocytes and Mice. DNA Cell Biol 2017; 36:177-187. [DOI: 10.1089/dna.2016.3471] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Sung-Jen Hung
- Department of Dermatology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| | - Sheau-Chung Tang
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
- Department of Biochemistry, School of Medicine, Tzu Chi University, Hualien, Taiwan
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Pei-Yun Liao
- Department of Dermatology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| | - Jheng-Siang Ge
- Department of Dermatology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Yu-Ping Hsiao
- Institute of Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Dermatology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jen-Hung Yang
- Department of Dermatology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Department of Biochemistry, School of Medicine, Tzu Chi University, Hualien, Taiwan
- Institute of Medicine, School of Medicine, Tzu Chi University, Hualien, Taiwan
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31
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Abstract
Chemical peeling is a widely used procedure in the management of acne and acne scars. It causes controlled destruction of a part of or the entire epidermis, with or without the dermis, leading to exfoliation and removal of superficial lesions, followed by regeneration of new epidermal and dermal tissues. The most frequently used peeling agents are salicylic acid, glycolic acid, pyruvic acid, lactic acid, mandelic acid, Jessner solution, trichloroacetic acid, and phenol. The appropriate peel is chosen based on the patient's skin type, acne activity, and type of acne scars. Combination peels minimize side effects. In acne scars, chemical peels may be combined with other procedures to achieve better clinical results. A series of chemical peels can lead to significant improvement over a short period, leading to patient satisfaction and maintenance of clinical results. © 2016 Elsevier Inc. All rights reserved.
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Affiliation(s)
| | - Eftychia Platsidaki
- Department of Dermatology and Venereology, Andreas Sygros Skin Hospital, Athens, Greece.
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Meaike JD, Agrawal N, Chang D, Lee EI, Nigro MG. Noninvasive Facial Rejuvenation. Part 3: Physician-Directed-Lasers, Chemical Peels, and Other Noninvasive Modalities. Semin Plast Surg 2016; 30:143-50. [PMID: 27478423 DOI: 10.1055/s-0036-1584818] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A proper knowledge of noninvasive facial rejuvenation is integral to the practice of a cosmetic surgeon. Noninvasive facial rejuvenation can be divided into patient- versus physician-directed modalities. Patient-directed facial rejuvenation combines the use of facial products such as sunscreen, moisturizers, retinoids, α-hydroxy acids, and various antioxidants to both maintain youthful skin and rejuvenate damaged skin. Physicians may recommend and often prescribe certain products, but patients are in control with this type of facial rejuvenation. On the other hand, physician-directed facial rejuvenation entails modalities that require direct physician involvement, such as neuromodulators, filler injections, laser resurfacing, microdermabrasion, and chemical peels. With the successful integration of each of these modalities, a complete facial regimen can be established and patient satisfaction can be maximized. This article is the last in a three-part series describing noninvasive facial rejuvenation. Here the authors review the mechanism, indications, and possible complications of lasers, chemical peels, and other commonly used noninvasive modalities.
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Affiliation(s)
- Jesse D Meaike
- Division of Plastic Surgery, Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Nikhil Agrawal
- Division of Plastic Surgery, Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Daniel Chang
- Division of Plastic Surgery, Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Edward I Lee
- Division of Plastic Surgery, Department of Surgery, Baylor College of Medicine, Houston, Texas
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Kontochristopoulos G, Kouris A, Platsidaki E, Markantoni V, Gerodimou M, Antoniou C. Combination of microneedling and 10% trichloroacetic acid peels in the management of infraorbital dark circles. J COSMET LASER THER 2016; 18:289-92. [DOI: 10.3109/14764172.2016.1157363] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Case report: Inadvertent intra-arterial injection during sclerotherapy may not be the disaster you think. JOURNAL OF VASCULAR NURSING 2016; 34:12-6. [DOI: 10.1016/j.jvn.2015.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/17/2015] [Accepted: 09/17/2015] [Indexed: 12/27/2022]
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Affiliation(s)
- Gerd G Gauglitz
- Klinik und Poliklinik für Dermatologie und Allergologie der Ludwig-Maximilians-Universität, Frauenlobstraße 9-11, D-80337, München, Deutschland,
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Puri N. Efficacy of Modified Jessner's Peel and 20% TCA Versus 20% TCA Peel Alone for the Treatment of Acne Scars. J Cutan Aesthet Surg 2015; 8:42-5. [PMID: 25949022 PMCID: PMC4411592 DOI: 10.4103/0974-2077.155082] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Introduction: There is a paucity of studies on the use of chemical peels for acne scars among the Asian population. A trichloroacetic acid (TCA) and Jessner's combination chemical peel, originally described by Monheit, is said to be better than a TCA peel alone. Aims: The aim of the study was to compare the efficacy of 20% TCA and Jessner's solution versus 20% TCA alone for the treatment of acne scars. Materials and Methods : The patients were divided into two groups of 25 patients each. Chemical peeling was done in both the groups. In Group I, chemical peeling with Jessner's peel followed by 20% TCA was done and in Group II patients chemical peeling with 20% TCA peel alone was done. Results: In Group I (Jessner's peel and 20% TCA), mild improvement of acne scars was seen in 8% cases, moderate improvement in 32% cases and marked improvement of acne scars was seen in 60% patients. In Group II (20% TCA), mild improvement of acne scars was seen in 32% cases, moderate improvement in 40% cases and marked improvement of acne scars was seen in 28% patients. But, the difference in improvement of acne scars was not statistically significant in both the groups (P value > 0.05).
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Affiliation(s)
- Neerja Puri
- Department of Dermatology, Punjab Health Systems Corporation, Ludhiana, Punjab, India
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Bagatin E, Wagemaker TAL, Aguiar Júnior NDR, Gianeti MD, Gonçalves EMB, Campos PMBGM. Tretinoin-based formulations - influence of concentration and vehicles on skin penetration. BRAZ J PHARM SCI 2015. [DOI: 10.1590/s1984-82502015000100009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Tretinoin is used in the management of acne and it is part of a gold standard treatment for photoaging. It has also been reported as an agent for superficial chemical peeling in highly concentrated formulations with few considerations about skin penetration. The aim of this study was to evaluate the influence of drug concentration and vehicles currently used on skin penetration of tretinoin. In vitro permeation tests were carried out using Franz diffusion cells fitted with porcine ear skin and 10% aqueous methanol in the receptor compartment. Formulations studied, cream or hydroalcoholic dispersion, containing 0.25%, 1% and 5% of tretinoin were placed in the donor compartment for six hours. Tretinoin concentration in skin layers was measured by high performance liquid chromatography. The largest amount of tretinoin from both vehicles was detected in stratum corneum with significant differences among the three concentrations. The hydroalcoholic dispersion was the best vehicle. Significant amounts of tretinoin were found even in deep layers of epidermis. The formulation with 0.25% tretinoin showed better results when considered the amount of tretinoin on skin in terms of percentage. Finally, skin penetration of tretinoin was influenced by vehicle and concentration of this drug used in formulation.
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Hsieh PW, Aljuffali IA, Fang CL, Chang SH, Fang JY. Hydroquinone-salicylic acid conjugates as novel anti-melasma actives show superior skin targeting compared to the parent drugs. J Dermatol Sci 2014; 76:120-31. [DOI: 10.1016/j.jdermsci.2014.08.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 08/12/2014] [Accepted: 08/23/2014] [Indexed: 11/28/2022]
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Outcomes assessment of combination face lift and perioral phenol-croton oil peel. Plast Reconstr Surg 2014; 132:743e-753e. [PMID: 24165626 DOI: 10.1097/prs.0b013e3182a4c40e] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Face-lift surgery when combined with perioral phenol-croton oil peel is an underappreciated tool for face rejuvenation. The procedure results in significant central face skin tightening and wrinkle reduction. METHODS A retrospective review of 47 consecutive patients who underwent simultaneous face lift and perioral peel was performed. The objective measures used to evaluate the change in appearance of the patients included (1) a validated patient satisfaction questionnaire, (2) an evaluation of apparent age, and (3) an evaluation of perioral wrinkles by independent reviewers using a validated model. The assessment of apparent age was performed as follows: preoperative and postoperative photographs were shown randomly to six reviewers, who were asked to estimate the patient's age. The apparent age was compared with the patient's actual age, and the reduction in apparent age was calculated. Improvement in perioral rhytides was evaluated by using the Glogau classification system (range, 1 to 4). RESULTS Survey results documented overall patient satisfaction, which was rated as 6.5 on a scale of 1 to 7 (with higher scores indicating greater satisfaction). Patients' postoperative apparent age estimate was 8.2 years younger than their real age (p=0.0002). The Glogau classification system score demonstrated a mean reduction of 1.15 (3.3 preoperatively as compared with 2.15 postoperatively, p<0.0001). CONCLUSION Outcomes measurements, including patient satisfaction, objective evaluation of wrinkle improvement, and significant reduction in apparent age, document the power of this technique. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Abstract
Chemical peels have been time-tested and are here to stay. Alpha-hydroxy peels are highly popular in the dermatologist’s arsenal of procedures. Glycolic acid peel is the most common alpha-hydroxy acid peel, also known as fruit peel. It is simple, inexpensive, and has no downtime. This review talks about various studies of glycolic acid peels for various indications, such as acne, acne scars, melasma, postinflammatory hyperpigmentation, photoaging, and seborrhea. Combination therapies and treatment procedure are also discussed. Careful review of medical history, examination of the skin, and pre-peel priming of skin are important before every peel. Proper patient selection, peel timing, and neutralization on-time will ensure good results, with no side effects. Depth of the glycolic acid peel depends on the concentration of the acid used, the number of coats applied, and the time for which it is applied. Hence, it can be used as a very superficial peel, or even a medium depth peel. It has been found to be very safe with Fitzpatrick skin types I–IV. All in all, it is a peel that is here to stay.
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Hassan KM, Benedetto AV. Facial skin rejuvenation: Ablative laser resurfacing, chemical peels, or photodynamic therapy? Facts and controversies. Clin Dermatol 2013; 31:737-40. [DOI: 10.1016/j.clindermatol.2013.05.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Puri N. A study on fractional erbium glass laser therapy versus chemical peeling for the treatment of melasma in female patients. J Cutan Aesthet Surg 2013; 6:148-51. [PMID: 24163531 PMCID: PMC3800289 DOI: 10.4103/0974-2077.118410] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: Melasma is a commonly acquired hypermelanosis and a common dermatologic skin disease that occurs on sun-exposed areas of face. Aims: To assess the efficacy and safety of non-ablative 1,550 nm Erbium glass fractional laser therapy and compare results with those obtained with chemical peeling. Materials and Methods: We selected 30 patients of melasma aged between 20 years and 50 years for the study. The patients were divided into two groups of 15 patients each. Group I patients were subjected to four sessions of 1,550 nm Erbium glass non-ablative fractional laser at 3 weeks interval. In group II patients, four sessions of chemical peeling with 70% glycolic acid was performed. Results: After 12 weeks of treatment, percentage reduction in Melasma Area and Severity Index (MASI) score was seen in 62.9% in the laser group and 58.7% in the peels group. Conclusion: It was observed that 1,550 nm fractional laser is as effective as 70% glycolic acid peel in reducing MASI score in patients with melasma.
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Affiliation(s)
- Neerja Puri
- Punjab Health Systems Corporation, Ferozepur, Punjab, India
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Wollina U, Goldman A, Naoum C. [Side effects in aesthetic medicine. Spectrum, management and avoidance]. Hautarzt 2013; 64:155-62. [PMID: 23430168 DOI: 10.1007/s00105-012-2484-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Aesthetic medicine has become increasingly popular in the last two decades. The same trend has occurred in dermatology. Aesthetic dermatology prefers minimally invasive procedures. Nevertheless, even these procedures are not free of possible adverse effects. The spectrum of possible adverse effects, their management and prevention are discussed for four popular procedures in aesthetic dermatology, i.e. chemical peels, mesotherapy, botulinum toxin, and dermal fillers. Aesthetic procedures should only be performed by well-educated, well-trained medical doctors with an excellent medical background, never by lay persons.
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Affiliation(s)
- U Wollina
- Klinik für Dermatologie und Allergologie, Krankenhaus Dresden-Friedrichstadt - Städtisches Klinikum, Akademisches Lehrkrankenhaus der TU Dresden, Friedrichstr. 41, 01067 Dresden.
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Puri N. Comparative study of 15% TCA peel versus 35% glycolic acid peel for the treatment of melasma. Indian Dermatol Online J 2012; 3:109-13. [PMID: 23130283 PMCID: PMC3481880 DOI: 10.4103/2229-5178.96702] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Chemical peels are the mainstay of a cosmetic practitioner's armamentarium because they can be used to treat some skin disorders and can provide aesthetic benefit. OBJECTIVES To compare 15% TCA peel and 35% glycolic acid peel for the treatment of melasma. MATERIAL AND METHODS We selected 30 participants of melasma aged between 20 and 50 years from the dermatology outpatient department and treated equal numbers with 15% TCA and 35% glycolic acid. RESULTS Subjective response as graded by the patient showed good or very good response in 70% participants in the glycolic acid group and 64% in the TCA group. CONCLUSIONS There was statistically insignificant difference in the efficacy between the two groups for the treatment of melasma.
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Affiliation(s)
- Neerja Puri
- Punjab Health Systems Corporation, Punjab, India
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46
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Hexsel DM, Dumét Fernandes J, Hexsel CL. Chemical Peeling. Dermatol Surg 2012. [DOI: 10.1002/9781118412633.ch29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Levy LL, Emer JJ. Complications of minimally invasive cosmetic procedures: prevention and management. J Cutan Aesthet Surg 2012; 5:121-32. [PMID: 23060707 PMCID: PMC3461789 DOI: 10.4103/0974-2077.99451] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Over the past decade, facial rejuvenation procedures to circumvent traditional surgery have become increasingly popular. Office-based, minimally invasive procedures can promote a youthful appearance with minimal downtime and low risk of complications. Injectable botulinum toxin (BoNT), soft-tissue fillers, and chemical peels are among the most popular non-invasive rejuvenation procedures, and each has unique applications for improving facial aesthetics. Despite the simplicity and reliability of office-based procedures, complications can occur even with an astute and experienced injector. The goal of any procedure is to perform it properly and safely; thus, early recognition of complications when they do occur is paramount in dictating prevention of long-term sequelae. The most common complications from BoNT and soft-tissue filler injection are bruising, erythema and pain. With chemical peels, it is not uncommon to have erythema, irritation and burning. Fortunately, these side effects are normally transient and have simple remedies. More serious complications include muscle paralysis from BoNT, granuloma formation from soft-tissue filler placement and scarring from chemical peels. Thankfully, these complications are rare and can be avoided with excellent procedure technique, knowledge of facial anatomy, proper patient selection, and appropriate pre- and post-skin care. This article reviews complications of office-based, minimally invasive procedures, with emphasis on prevention and management. Practitioners providing these treatments should be well versed in this subject matter in order to deliver the highest quality care.
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Affiliation(s)
- Lauren L Levy
- Department of Dermatology, Mount Sinai School of Medicine, New York, NY, USA
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Barikbin B, Saadat N, Akbari Z, Yousefi M, Toossi P. Focal High-Concentration Trichloroacetic Acid Peeling for Treatment of Atrophic Facial Chickenpox Scar: An Open-Label Study. Dermatol Surg 2012; 38:1662-7. [DOI: 10.1111/j.1524-4725.2012.02541.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sharad J. Combination of microneedling and glycolic acid peels for the treatment of acne scars in dark skin. J Cosmet Dermatol 2012; 10:317-23. [PMID: 22151943 DOI: 10.1111/j.1473-2165.2011.00583.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Acne scars can cause emotional and psychosocial disturbance to the patient. Various modalities have been used for the treatment of acne scars like punch excision, subcision, peels, microdermabrasion, unfractionated and fractioned lasers. The latest in the treatment armamentarium is microneedling. Acne scars commonly coexist with postinflammatory hyperpigmentation. A combination of microneedling and glycolic acid (GA) peels was found to give excellent results in the treatment of such scars. The aim was to study the efficacy of a combination of microneedling with glycolic peel for the treatment of acne scars in pigmented skin. METHOD Thirty patients in the age group of 20-40 years with atrophic box type or rolling scars with postinflammatory hyperpigmentation were chosen for the study. Two groups were made. The first group comprised of 30 patients in whom only microneedling was performed once in 6 weeks for five sessions. In the second group of 30 patients, a combination of microneedling and 35% GA peels was carried out. Patients from both groups were evaluated on the basis of Echelle d'Evaluation clinique des Cicatrices d'acné classification. RESULTS Based on the objective scoring and its statistical analysis, there was significant improvement in superficial and moderately deep scars (grade 1-3). There was also improvement in skin texture, reduction in postacne pigmentation in the second group. CONCLUSION Microneedling is a simple, inexpensive office procedure with no downtime. It is safe in Indian skin (skin types III-IV). The combined sequential treatment with GA peel caused a significant improvement in the acne scars without increasing morbidity.
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Affiliation(s)
- Jaishree Sharad
- Skinfiniti the Aesthetic Skin and Laser Clinic, Navi Mumbai, Maharashtra, India.
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Abstract
BACKGROUND The aged hand is characterized by cutaneous and dermal atrophy, with deep intermetacarpal spaces, prominent bones and tendons, and bulging reticular veins. Epidermal changes include solar lentigines, seborrheic keratoses, actinic keratoses, skin laxity, rhytides, tactile roughness, and telangiectasia. STUDY DESIGN A Medline search was performed on hand rejuvenation from 1989 to 2011, and results are summarized. Practical applications of these procedures are also discussed. RESULTS Reports of injectable hyaluronic acid, calcium hydroxylapatite, poly-L-lactic acid, autologous fat transfer, vein treatment, and chemical peels, along with lasers and light sources such as Q-switched laser, intense pulsed light, photodynamic therapy, nonablative resurfacing lasers, and ablative resurfacing lasers, in the rejuvenation of hands were found. CONCLUSION Review of the literature revealed options for minimally invasive treatment for rejuvenation of the skin and volume restoration of the dorsal hand. These treatments include injectables and fat transfer for volume restoration; sclerotherapy or vein ablation for dorsal hand vein treatment; and chemical peels, lasers, light, and energies for the treatment of epidermal and dermal changes.
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Affiliation(s)
- Sabrina G Fabi
- Goldman, Butterwick, Fitzpatrick, and Groff Cosmetic Laser Dermatology, San Diego, CA 92121, USA.
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