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Fabi SG, Beleznay K, Berson DS, Cohen JL, Lee S, Dayan SH. Treatment of acne in the aesthetic patient: A round table update. J Cosmet Dermatol 2023; 22:2391-2398. [PMID: 37403516 DOI: 10.1111/jocd.15913] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/16/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND The popularity of social media appears to be increasing the acceptance of cosmetic treatments, prompting more consumers to seek cosmetic treatments. As the estimated prevalence of acne vulgaris among adult women may be as high as 54%, acne is commonly observed among patients presenting for cosmetic treatments. Concomitant treatment of acne in the aesthetic patient population will improve overall clinical outcomes. AIMS The goal of this work was to deliver a high-quality ethical and evidence-based educational program to physicians and adjunctive health care providers to advance patient care. METHODS This paper is based on a webcam presentation with roundtable discussion by several notable experts in their field. RESULTS A range of topical medications, injectable products, chemical peels, and energy-based devices are available for treating acne vulgaris. In most instances, these are compatible with rejuvenation procedures in the aesthetic patient. CONCLUSION The growth of social media is raising awareness of aesthetic procedures and appears to be increasing the number of patients seeking aesthetic treatment. Educating patients about the importance of treating acne vulgaris can improve overall treatment outcomes. In most instances, the presence of acne is not a barrier to aesthetic care.
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Affiliation(s)
| | - Katie Beleznay
- Humphrey & Beleznay Cosmetic Dermatology, Vancouver, British Columbia, Canada
| | - Diane S Berson
- Weill Cornell Medicine, New York-Presbyterian Hospital, New York, USA
| | - Joel L Cohen
- AboutSkin Dermatology and DermSurgery, PC, Greenwood Village, Colorado, USA
| | - Sandra Lee
- Skin Physicians & Surgeons, Upland, California, USA
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Comparative study of treatment for striae alba stage striae gravidarum: 1565-nm non-ablative fractional laser versus fractional microneedle radiofrequency. Lasers Med Sci 2021; 36:1823-1830. [PMID: 33411130 DOI: 10.1007/s10103-020-03203-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 11/17/2020] [Indexed: 10/22/2022]
Abstract
Striae gravidarum is a common dermatologic condition for females caused by multiple factors during pregnancy. It remains a therapeutic challenge especially in the striae alba (SA) stage, generating psychological and emotional distress to those affected. This study aims to compare the efficacy and safety of 1565-nm non-ablative fractional laser (NAFL) and fractional microneedle radiofrequency (MRF) for treatment of SA striae gravidarum. Fourteen Chinese women with SA striae gravidarum were included in this study. Patient abdomens were randomly divided into NAFL and MRF treatment sides, treated three times at 6-week intervals. Treatment efficacy was evaluated by subjective (clinical assessments, patient satisfaction rating, adverse effects assessment) assessments and objective (skin melanin index measurement, histological study) assessments. Clinical assessment suggested MRF was more effective (P = 0.0143) for improving the appearance of SA striae gravidarum. Both NAFL and MRF demonstrated effective improvement (P = 0.0082 and P = 0.0158, respectively), with no significant difference according to patient satisfaction ratings and changes in melanin index (P = 0.5900). Both treatments induced limited adverse reactions, but MRF treatment caused significant pain compared with the more moderate NAFL treatment (P = 0.0003). MRF treatment increased neocollagen and elastic fibers more significantly than NAFL, based on histological assessments (P = 0.0298 and P = 0.0048, respectively). MRF treatment improved collagen regeneration in SA striae gravidarum more than NAFL but caused considerable pain during treatment. Corresponding treatment or therapeutic strategies should be applied according to clinical scenario.
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Harrison LM, Shapiro R, Johnson RM. Tissue Modification in Nonsurgical Facelift Options. Facial Plast Surg 2020; 36:688-695. [PMID: 33368123 DOI: 10.1055/s-0040-1721115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Nonsurgical facelifts are a term for a heterogeneous group of procedures used by physicians to improve facial rejuvenation without the use of operative techniques. Patients demand these services due to the reduced recovery time and generally lower risk. However, nonsurgical techniques, to be effective, must induce conformational change in the cells and tissues of the face. Therefore, these techniques are significant procedures that have associated risks. Understanding the tissue modifications and mechanisms of action of these techniques is vital to their safe and effective use. The purpose of this article is to provide a background of tissue modification in nonsurgical facelift options.
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Affiliation(s)
- Lucas M Harrison
- Department of Plastic Surgery, Wright State University, Dayton, Ohio
| | - Ryan Shapiro
- Department of Plastic Surgery, Wright State University, Dayton, Ohio
| | - R Michael Johnson
- Department of Plastic Surgery, Wright State University, Dayton, Ohio
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Abstract
Striae distansae (SD) or stretch marks are very common, asymptomatic, skin condition frequently seen among females between 5 to 50 years of ages. It often causes cosmetic morbidity and psychological distress, particularly in women and in certain professions where physical appearances have significant importance. Of late, with the increasing emphasis on cosmetic management and awareness, patients approach dermatologists for stretch marks treatment. However, despite several advances, no fully effective treatment has emerged. Unfortunately, there is paucity of the strong evidence in the literature for the effective treatment of striae. A literature search using the terms 'striae distansae (SD or stretch marks' was carried out in the PubMed, Google Scholar and Medline databases. Only articles related to the treatment were considered and analysed for their data. Commonly cited treatments include topical treatments like tretinoin, glycolic acid, ascorbic acid and various lasers including (like) carbon dioxide, Er:YAG, diode, Q-switched Nd:YAG, pulse dye and excimer laser. Other devices like radiofrequency, phototherapy and therapies like platelet rich plasma, chemical peeling, microdermabrasion, needling, carboxytherapy and galvanopuncture have also been used with variable success. This article reviews all currently accepted modalities and their effectiveness in the treatment of stretch marks.
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Affiliation(s)
- Archana J Lokhande
- Department Of Dermatology, ESIC PGIMSR, Model Hospital, Basaidarapur, New Delhi, India
| | - Venkataram Mysore
- Venkat Charmalaya Centre for Advanced Dermatology and Postgraduate Training, Bangalore, Karnataka, India
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Meningaud JP, SidAhmed-Mezi M, Billon R, Rem K, La Padula S, Hersant B. Clinical benefit of using a multifractional Er:YAG laser combined with a spatially modulated ablative (SMA) module for the treatment of striae distensae: A prospective pilot study in 20 patients. Lasers Surg Med 2018; 51:230-238. [PMID: 30480320 DOI: 10.1002/lsm.23042] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND OBJECTIVE Striae distensae (SD) are cutaneous lesions that often occur on the breasts, abdomen, hips, and thighs. The aim of this study is to evaluate the effectiveness of a new technique using a non-invasive Er:YAG laser combined with Spatially Modulated Ablation (SMA) module for the treatment of SD. STUDY DESIGN/MATERIALS AND METHODS This prospective pilot clinical study included 20 patients with skin phototypes I to IV who are affected by SD. The Er:YAG 2940 nm laser with SMA module was used in scanning mode with fluences of 2.3 J/cm2 , frequency of 3 Hz, and pulse duration of 0.3 milliseconds. The laser beam is split into several microspots and penetrates only by 50 μm in the epidermis thickness. This technology induces also the generation of acoustic waves to stimulate tissue regeneration. Each patient underwent six laser sessions. An objective and subjective assessment of SD were used. All adverse events were reported. RESULTS Most patients reported good improvement and expressed their satisfaction with the treatment. Cutometric analysis showed significant improvement in skin elasticity at the end of study. Moreover, ultrasound analysis revealed an increase in dermal thickness (P < 0.01). POSAS scores decreased significantly at 3 and 6 months, reflecting improved skin quality. The average recovery time was 5 days, with no adverse effects reported. CONCLUSION Using Er:YAG laser (2,940 nm) with SMA technology to treat SD resulted in improved volume and textural appearance without side effects. The elasticity and thickness of the dermis also improved. The Er:YAG laser with SMA module may be considered as a novel and effective technique to treat SD lesions with minimal time recovery. Lasers Surg. Med. 51:230-238, 2019. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Jean Paul Meningaud
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Hopital Henri Mondor, Creteil, 94010, France
| | - Mounia SidAhmed-Mezi
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Hopital Henri Mondor, Creteil, 94010, France
| | - Raphaelle Billon
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Hopital Henri Mondor, Creteil, 94010, France
| | - Kessara Rem
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Hopital Henri Mondor, Creteil, 94010, France
| | - Simone La Padula
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Hopital Henri Mondor, Creteil, 94010, France
| | - Barbara Hersant
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Hopital Henri Mondor, Creteil, 94010, France
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Fąk M, Rotsztejn H, Erkiert-Polguj A. The early effect of microdermabrasion on hydration and sebum level. Skin Res Technol 2018; 24:650-655. [DOI: 10.1111/srt.12580] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2018] [Indexed: 12/24/2022]
Affiliation(s)
- M. Fąk
- Department of Cosmetology and Aesthetic Dermatology; Faculty of Pharmacy; Medical University of Lodz; Lodz Poland
| | - H. Rotsztejn
- Department of Cosmetology and Aesthetic Dermatology; Faculty of Pharmacy; Medical University of Lodz; Lodz Poland
| | - A. Erkiert-Polguj
- Department of Cosmetology and Aesthetic Dermatology; Faculty of Pharmacy; Medical University of Lodz; Lodz Poland
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A comparative clinical and histopathological study of microneedling versus microdermabrasion (aluminum oxide crystals) in the treatment of striae distensae. JOURNAL OF THE EGYPTIAN WOMEN’S DERMATOLOGIC SOCIETY 2017. [DOI: 10.1097/01.ewx.0000511156.50929.3b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
BACKGROUND Laser therapy is a continuously evolving treatment option for scars, and the underlying therapeutic mechanisms continue to be elucidated. OBJECTIVE To comprehensively review the literature to summarize the role of elastin in the formation scars, as well as treatment via therapeutic lasers. METHODS Review of the PubMED/MEDLINE database for available studies pertaining to the role of elastic fibers in scar formation and after laser-based therapy. RESULTS The loss and disorganization of elastic fiber components plays a role in the development of atrophic, hypertrophic, and keloid scars. While the majority of histologic studies focus on the underlying changes in collagen, neoelastogenesis and reorganization of elastic fibers have also been demonstrated in studies using ablative, nonablative, and fractional laser devices for the treatment of scars. CONCLUSION Production of novel elastin and normalization of elastic fiber organization occur after a variety of resurfacing procedures to treat scarring. As the treatment modalities to manage scars continue to evolve, further characterization of the role of elastin in the skin and in scar formation is merited.
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Bogdan C, Iurian S, Tomuta I, Moldovan M. Improvement of skin condition in striae distensae: development, characterization and clinical efficacy of a cosmetic product containing Punica granatum seed oil and Croton lechleri resin extract. Drug Des Devel Ther 2017; 11:521-531. [PMID: 28280300 PMCID: PMC5338857 DOI: 10.2147/dddt.s128470] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Striae distensae are a frequent skin condition associated with pregnancy, weight change or lack of skin elasticity. The aim of this research was to obtain a topical product containing herbal active ingredients with documented antioxidant and anti-inflammatory activity (Punica granatum seed oil and Croton lechleri resin extract) and demonstrate its positive effect on prevention and treatment of striae distensae. First, the cream base formulation was optimized through experimental design. Secondly, the cream containing the two active ingredients was investigated in an interventional nonrandomized clinical trial. The clinical outcome was assessed through biophysical parameters and ultrasonographic evaluation. The state of the skin was evaluated by biophysical measurements and ultrasonography at the beginning of the study and after 3 and 6 weeks. The experimental design was successfully used to set the best ranges for the technological and formulation factors to obtain a cosmetic formulation with optimal characteristics. The study of clinical efficacy on the optimal formulation revealed an increase in the dermis thickness, hydration and elasticity values in both groups after 6 weeks of cream application. The new oil-in-water cream containing P. granatum seed oil and C. lechleri resin extract can be helpful in the prevention or improving of skin changes associated with striae.
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Affiliation(s)
| | - Sonia Iurian
- Department of Pharmaceutical Technology and Biopharmacy, Faculty of Pharmacy, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
| | - Ioan Tomuta
- Department of Pharmaceutical Technology and Biopharmacy, Faculty of Pharmacy, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
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Abdel-Motaleb AA, Abu-Dief EE, Hussein MRA. Dermal morphological changes following salicylic acid peeling and microdermabrasion. J Cosmet Dermatol 2017; 16:e9-e14. [DOI: 10.1111/jocd.12315] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Amira A Abdel-Motaleb
- Faculty of Medicine; Department of Dermatology, Venereology and Andrology; Assiut University; Assiut Egypt
| | - Eman E Abu-Dief
- Faculty of Medicine; Department of Histology; Sohag University; Sohag Egypt
| | - Mahmoud RA Hussein
- Faculty of Medicine; Department of Pathology; Assiut University; Assiut Egypt
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11
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El-Domyati M, Hosam W, Abdel-Azim E, Abdel-Wahab H, Mohamed E. Microdermabrasion: a clinical, histometric, and histopathologic study. J Cosmet Dermatol 2016; 15:503-513. [PMID: 27357600 DOI: 10.1111/jocd.12252] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Microdermabrasion is a nonchemical superficial resurfacing procedure that removes the stratum corneum. Because it is a somewhat subtle procedure, it may be difficult to demonstrate its cosmetic benefit. OBJECTIVES To assess the efficacy of microdermabrasion in treatment of melasma, postacne scarring, striae distensae, and photoaging by a series of microdermabrasion sittings through clinical, histometric, and histopathologic analysis. PATIENTS AND METHODS The study was conducted on 38 patients constituting four groups (melasma, acne scars, striae destinsae, and photoaging), each patient was subjected to a series of 8 microdermabrasion treatments performed at 1-week interval. Punch biopsies, at base line, 1 week after the 4th and the 8th session, were obtained from each subject for histometric and histopathologic analysis. RESULTS Clinically, the improvement in melasma, acne scars, and striae distensae groups was mainly mild to moderate, while in photoaging group was mainly mild. Histometric analysis of epidermal thickness showed insignificant changes in all groups. Histopathologically, decreased melanization and regular distribution of melanosomes in the epidermis were noted in melasma group while increased density of collagen fibers with more regular arrangement in collagen bundles was detected in all candidates of acne scars, striae distensae, and photoaging groups. Meanwhile, Orcein stain did not show any significant changes in elastic fibers. CONCLUSIONS Microdermabrasion is an easy and safe technique. In this study, most cases showed mild to moderate improvement. Decreased melanization with regular distribution of melanosomes and increased collagen density with regular arrangement of collagen bundles were the most common observed histologic changes.
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Affiliation(s)
- Moetaz El-Domyati
- Department of Dermatology, Faculty of Medicine, Minia University, Al-Minya, Egypt
| | - Wael Hosam
- Department of Dermatology, Faculty of Medicine, Minia University, Al-Minya, Egypt
| | - Eman Abdel-Azim
- Department of Dermatology, Faculty of Medicine, Minia University, Al-Minya, Egypt
| | - Hossam Abdel-Wahab
- Department of Dermatology, Faculty of Medicine, Minia University, Al-Minya, Egypt
| | - Elshaymaa Mohamed
- Department of Dermatology, Faculty of Medicine, Minia University, Al-Minya, Egypt
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12
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Abstract
Active transdermal technology, commonly associated with drug delivery, has been used in recent years by the cosmetic industry for the aesthetic restoration of skin and delivery of cosmetic agents. In this article, we provide an overview of the skin's structure, various skin types, skin's self-repair mechanisms that are stimulated from the usage of cosmetic devices and discuss cosmetic applications. Summaries of the most common active transdermal technologies such as microneedles, iontophoresis, sonophoresis, lasers and microdermabrasion will be provided, in relation to the marketed cosmetic devices available that incorporate these technologies. Lastly, we cover combinations of active technologies that allow for more enhanced cosmetic results, and the current limitations of cosmetic devices.
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13
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Tretti Clementoni M, Lavagno R. A novel 1565 nm non-ablative fractional device for stretch marks: A preliminary report. J COSMET LASER THER 2015; 17:148-55. [PMID: 25633176 PMCID: PMC4673510 DOI: 10.3109/14764172.2015.1007061] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 01/05/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Striae Distensae (SD) is a very common dermatologic condition. We evaluated the effectiveness and safety of a novel non-ablative fractional 1565 nm laser (ResurFX) on the appearance of SD. MATERIALS AND METHODS Twelve Caucasian subjects with various stages of SD received three non-ablative laser treatments. Each treatment consisted of two different laser settings, in order to achieve a demarcated dense impact together with a diffused deep impact. Three months after the last treatment, SD improvement was assessed by blinded and non-blinded reviewers using clinical images and 3D image analyses. RESULTS Good clinical improvement (between 51% and 75%) was observed in all patients. Most patients showed improvement of > 50% in the volume of depressions and in lesion color (91.7% and 83.3% of patients, respectively). The average pain during treatment was generally defined as tolerable and the average downtime was 4 days. Transient erythema and severe edema were noted immediately after the procedure, but long-lasting or severe adverse effects were not observed. All patients noted a good improvement and were satisfied with the treatment and the results. CONCLUSIONS The treatment with the 1565 nm ResurFX laser resulted in improved pigmentation, volume, and textural appearance of SD.
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Affiliation(s)
| | - Rosalia Lavagno
- Department of Laser and Surgery, Istituto Dermatologico Europeo, Milano, Italy
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14
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Al-Himdani S, Ud-Din S, Gilmore S, Bayat A. Striae distensae: a comprehensive review and evidence-based evaluation of prophylaxis and treatment. Br J Dermatol 2014; 170:527-47. [DOI: 10.1111/bjd.12681] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2013] [Indexed: 12/29/2022]
Affiliation(s)
- S. Al-Himdani
- Plastic and Reconstructive Surgery Research; Manchester Institute of Biotechnology; University of Manchester; 131 Princess Street Manchester M1 7DN U.K
- Faculty of Medical and Human Sciences; Institute of Inflammation and Repair; Manchester Academic Health Science Centre; University Hospital of South Manchester NHS Foundation Trust; University of Manchester; Manchester U.K
| | - S. Ud-Din
- Plastic and Reconstructive Surgery Research; Manchester Institute of Biotechnology; University of Manchester; 131 Princess Street Manchester M1 7DN U.K
- Faculty of Medical and Human Sciences; Institute of Inflammation and Repair; Manchester Academic Health Science Centre; University Hospital of South Manchester NHS Foundation Trust; University of Manchester; Manchester U.K
| | - S. Gilmore
- Dermatology Research Centre; School of Medicine; University of Queensland; Brisbane Qld Australia
| | - A. Bayat
- Plastic and Reconstructive Surgery Research; Manchester Institute of Biotechnology; University of Manchester; 131 Princess Street Manchester M1 7DN U.K
- Faculty of Medical and Human Sciences; Institute of Inflammation and Repair; Manchester Academic Health Science Centre; University Hospital of South Manchester NHS Foundation Trust; University of Manchester; Manchester U.K
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15
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Fernandes M, Pinheiro NM, Crema VO, Mendonça AC. Effects of microdermabrasion on skin rejuvenation. J COSMET LASER THER 2013; 16:26-31. [DOI: 10.3109/14764172.2013.854120] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Hantash BM. Commentary: Gene profiling analysis of the early effects of ablative fractional carbon dioxide laser treatment on human skin. Dermatol Surg 2013; 39:1044-6. [PMID: 23815312 DOI: 10.1111/dsu.12133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Basil M Hantash
- Elixir Institute of Regenerative Medicine, San Jose, California 95138, USA.
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17
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Kim JE, Won CH, Bak H, Kositratna G, Manstein D, Dotto GP, Chang SE. Gene Profiling Analysis of the Early Effects of Ablative Fractional Carbon Dioxide Laser Treatment on Human Skin. Dermatol Surg 2013; 39:1033-43. [DOI: 10.1111/dsu.12170] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Exploration of nonsurgical scar modification options: can the irregular surface of matured mesh graft scars be smoothed with microdermabrasion? J Burn Care Res 2012; 33:e133-40. [PMID: 22079914 DOI: 10.1097/bcr.0b013e3182331e09] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to determine, in principle, whether microdermabrasion can alter waffle-pattern (meshed split-thickness skin graft) burn scars after scar maturation. Matured waffle-pattern mesh-graft scars were treated with multiple microdermabrasion sessions over the course of a year (maximum 20). Before and after treatment, the treated scars and the control scar on the same patient were assessed with subjective and objective scar assessment tools (scar scales, cutometer [elasticity], laser Doppler flowmeter [vascularity], Semmes-Weinstein filaments [sensation], and high-resolution ultrasound [thickness]). The treatment resulted in continuous improvement of some physiologic skin functions like perfusion response (feedback), thickness, and elasticity when compared with nontreated scar, although no statistical significance was reached. Both Vancouver scar scale and patient assessment scales showed significant improvement. The study showed that even mature waffle pattern scars can be modified by minimally invasive interventions. Larger study groups and more economic treatment modalities need to be studied in the future.
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Striae distensae after breast augmentation. Aesthetic Plast Surg 2012; 36:894-900. [PMID: 22538277 DOI: 10.1007/s00266-012-9902-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Accepted: 03/18/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND One known but not fully understood complication after breast augmentation is the new onset of stretch marks (striae distensae) on the surgically treated breast. To date, all publications on this subject have been case reports. No report has fully described the actual incidence, risk factors, or management of striae distensae after breast surgery. METHODS This study prospectively followed patients who underwent primary breast augmentation using silicone implants in a single group practice from 2007 to 2011. New-onset striae distensae were actively investigated. Time from surgery to the moment of striae onset, patient age, nulliparity, use of oral contraceptives, overweight, personal history of stretch marks, and other variables were evaluated. RESULTS A total of 409 patients were included in the study. In 19 cases (4.6%), new-onset striae distensae after breast augmentation were observed. The population with striae distensae was significantly younger than the total population (29.56 vs 20.91 years; p=0.012). Striae distensae also were more common in nulliparous than in multiparous women (8.29 vs 0.52%; p=0.006), overweight women (17.77 vs 3.02%; p=0.016), women using oral contraceptives (7.89 vs 0.55%; p=0.008), and women with a personal history of stretch marks (8.97 vs 3.36%; p=0.031). No relation was shown regarding implant pocket type, size, or profile. CONCLUSION Striae distensae may be a common but underreported complication after breast augmentation. In this series, striae distensae developed in 4.6% of the patients within 1 year after breast augmentation. Severity may vary from inconspicuous small marks (classifications 1 and 2) to wide red and active striae rubra (classifications 3 and 4). Nulliparity, use of oral contraceptives, overweight, personal history of stretch marks, and younger age were related to a higher incidence of striae distensae. The increased rates in these groups may be associated with their exposure to higher estrogen levels and the important role of this hormone in facilitating the formation of striae distensae. Further studies are needed to show whether changes in these risk factors (i.e., weight loss, contraceptive withdrawal) may help to decrease striae distensae rates is these populations. LEVEL OF EVIDENCE IV 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 at www.springer.com/00266.
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20
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Orringer JS, Sachs DL, Shao Y, Hammerberg C, Cui Y, Voorhees JJ, Fisher GJ. Direct quantitative comparison of molecular responses in photodamaged human skin to fractionated and fully ablative carbon dioxide laser resurfacing. Dermatol Surg 2012; 38:1668-77. [PMID: 22805255 DOI: 10.1111/j.1524-4725.2012.02518.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fractionated ablative laser resurfacing has become a widely used treatment modality. Its clinical results are often found to approach those of traditional fully ablative laser resurfacing. OBJECTIVE To directly compare the molecular changes that result from fractionated and fully ablative carbon dioxide (CO(2)) laser resurfacing in photodamaged human skin. METHODS AND MATERIALS Photodamaged skin of 34 adult volunteers was focally treated at distinct sites with a fully ablative CO(2) laser and a fractionated CO(2) laser. Serial skin samples were obtained at baseline and several time points after treatment. Real-time reverse transcriptase polymerase chain reaction technology and immunohistochemistry were used to quantify molecular responses to each type of laser treatment. RESULTS Fully ablative and fractionated CO(2) laser resurfacing induced significant dermal remodeling and collagen induction. After a single treatment, fractionated ablative laser resurfacing resulted in collagen induction that was approximately 40% to 50% as pronounced as that induced by fully ablative laser resurfacing. CONCLUSIONS The fundamental cutaneous responses that result from fully ablative and fractionated carbon dioxide laser resurfacing are similar but differ in magnitude and duration, with the fully ablative procedure inducing relatively greater changes including more pronounced collagen induction. However, the molecular data reported here provide substantial support for fractionated ablative resurfacing as an effective treatment modality for improving skin texture.
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Affiliation(s)
- Jeffrey S Orringer
- Department of Dermatology, School of Medicine, University of Michigan, Ann Arbor, Michigan 48109, USA.
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Jäger C, Brenner C, Habicht J, Wallich R. Bioactive reagents used in mesotherapy for skin rejuvenation in vivo induce diverse physiological processes in human skin fibroblasts in vitro- a pilot study. Exp Dermatol 2012; 21:72-5. [PMID: 22151394 DOI: 10.1111/j.1600-0625.2011.01400.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The promise of mesotherapy is maintenance and/or recovery of a youthful skin with a firm, bright and moisturized texture. Currently applied medications employ microinjections of hyaluronic acid, vitamins, minerals and amino acids into the superficial layer of the skin. However, the molecular and cellular processes underlying mesotherapy are still elusive. Here we analysed the effect of five distinct medication formulas on pivotal parameters involved in skin ageing, that is collagen expression, cell proliferation and morphological changes using normal human skin fibroblast cultures in vitro. Whereas in the presence of hyaluronic acid, NCTF135(®) and NCTF135HA(®) , cell proliferation was comparable to control cultures; however, with higher expression of collagen type-1, matrix metalloproteinase-1 and tissue inhibitor of matrix metalloproteinase-1, addition of Soluvit(®) N and Meso-BK led to apoptosis and/or necrosis of human fibroblasts. The data indicate that bioactive reagents currently applied for skin rejuvenation elicit strikingly divergent physiological processes in human skin fibroblast in vitro.
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Abstract
BACKGROUND Microdermabrasion (MDA) is one of the top five nonsurgical cosmetic procedures performed. It is a well-established technology with widespread applications in the cosmetic industry. AIMS To investigate the effects of MDA on skin and delivery of cosmeceuticals. METHODS The alternation of skin structure post-MDA was examined by histological sectioning and transepidermal water loss measurements. The effect of MDA treatment on skin permeation profiles of hydrophilic and lipophilic molecules was investigated by laser scanning confocal microscopy and in vitro permeation studies. RESULTS Confocal images indicated different absorption profiles and permeation depths for hydrophilic and lipophilic molecules. Microdermabrasion enhanced the transdermal delivery of nicotinamide, the model hydrophilic compound employed. On the other hand, permeation of retinol, the model lipophilic compound, did not improve after treatment with MDA. When treated with 20 passes, the skin recovered from MDA induced changes in 4 days. CONCLUSION Permeation of cosmeceuticals into skin was found to be affected by their lipophilicity. Application of skin care products post-MDA therapy may be promising to improve their dermal uptake.
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Affiliation(s)
- Yingcong Zhou
- College of Pharmacy and Health Sciences, Mercer University, Atlanta, GA, USA
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Orringer JS, Rittié L, Baker D, Voorhees JJ, Fisher G. Molecular mechanisms of nonablative fractionated laser resurfacing. Br J Dermatol 2011; 163:757-68. [PMID: 20854401 DOI: 10.1111/j.1365-2133.2010.09998.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Nonablative fractionated laser resurfacing improves the texture of treated skin, but little is known about the molecular mechanisms that underlie clinical improvements. OBJECTIVES We sought to examine and quantify the time course and magnitude of dermal matrix changes that occur in response to nonablative fractionated laser resurfacing, with the dual goals of better understanding the molecular mechanisms that underlie clinical improvements and of gaining knowledge that will enable evidence-based treatment parameter optimization. METHODS Twenty patients (mean age 58 years) with photodamaged skin were focally treated on dorsal forearms with a nonablative fractionated laser. Serial skin samples were obtained at baseline and at various times after treatment. Biopsies were examined with real-time polymerase chain reaction technology and immunohistochemical techniques. RESULTS Laser treatment resulted in an initial inflammatory response as indicated by statistically significant induction of proinflammatory cytokines (interleukin-1β and tumour necrosis factor-α). This was followed by substantial increases in levels of several matrix metalloproteinases and later by significant induction of type I collagen. Dermal remodelling was noted with both low and high microbeam energy treatment parameters. CONCLUSIONS Nonablative fractionated laser resurfacing induces a well-organized wound-healing response that leads to substantial dermal remodelling and collagen induction. Surprisingly, only minimal differences were observed between lower and higher microbeam energy settings. These data suggest that lower microbeam energy/higher microbeam density treatment parameters, which are generally better tolerated by patients, may yield dermal changes similar to those that result from higher microbeam energy/lower microbeam density treatment parameters.
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Affiliation(s)
- J S Orringer
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI 48109-0314, USA.
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Orringer JS, Rittié L, Hamilton T, Karimipour DJ, Voorhees JJ, Fisher GJ. Intraepidermal erbium:YAG laser resurfacing: impact on the dermal matrix. J Am Acad Dermatol 2011; 64:119-28. [PMID: 21167407 DOI: 10.1016/j.jaad.2010.02.058] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2009] [Revised: 01/27/2010] [Accepted: 02/14/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Various minimally invasive treatments enhance the skin's appearance. Little is known about the molecular mechanisms whereby treatments working at the epidermal level might alter the dermis. OBJECTIVE We sought to quantify the molecular changes that result from erbium:yttrium-aluminium-garnet (Er:YAG) laser microablative resurfacing. METHODS We performed biochemical analyses after intraepidermal Er:YAG laser resurfacing of 10 patients. Immunohistochemical analysis and polymerase chain reaction technology were utilized to measure key biomarkers. RESULTS The basement membrane remained intact after intraepidermal microablation, as demonstrated by laminin γ2 immunostaining. Epidermal injury was demonstrated with acute up-regulation of keratin 16. An inflammatory response ensued as indicated by increases in cytokines interleukin 1 beta (IL-1β) and IL-8 as well as a substantial neutrophil infiltrate. Levels of cJun and JunB proteins, components of the transcription factor AP-1 complex, were also elevated. Up-regulation of extracellular matrix degrading proteinases matrix metalloproteinase 1 (MMP-1), MMP-3, and MMP-9 was noted. A transient increase in keratinocyte proliferation, as indicated by staining for Ki67, was observed. Increased expression of type I and type III procollagen was demonstrated. LIMITATIONS The data presented are those that resulted from a single treatment session. CONCLUSIONS Although microablation was confined to the uppermost epidermis, marked changes in epidermal and dermal structure and function were demonstrated after Er:YAG laser microablative resurfacing. We demonstrated substantial dermal matrix remodeling, including a degree of collagen production that compares favorably with some more invasive interventions. Dermal remodeling and stimulation of collagen production are associated with wrinkle reduction. Thus these results suggest that the skin's appearance may be enhanced by creating dermal changes through the use of superficially acting treatments.
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Affiliation(s)
- Jeffrey S Orringer
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan 48109-0314, USA.
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Abstract
The quest for youth and beauty is an ongoing one. No organ conveys youth and beauty to the extent that skin does. Advances in research over the past several decades have yielded a tremendous amount of information on the molecular pathways involved in both intrinsic aging (natural) and extrinsic aging (photoaging). In this article, we aim to describe the molecular pathways that lead to an aged appearance and to describe the latest and most commonly employed drugs and procedures to reverse skin aging and stimulate the production of new collagen. With enhanced understanding of these molecular pathways, drugs and devices used to treat aging skin can be more precisely tuned.
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Abstract
Microdermabrasion is a popular technique used in the treatment of several skin problems, including acne, acne scarring, striae distensae, and photoaging. This article will review the relevant literature and use an evidence-based approach to evaluate the clinical efficacy of microdermabrasion in skin care. In summary, microdermabrasion appears to be a procedure that can produce changes in dermal matrix constituents and result in improvement in skin contour irregularities. It may also be beneficial in improving transepidermal delivery of certain medications. Its role in the treatment of dyschromias and acne vulgaris is limited.
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Gill HS, Andrews SN, Sakthivel SK, Fedanov A, Williams IR, Garber DA, Priddy FH, Yellin S, Feinberg MB, Staprans SI, Prausnitz MR. Selective removal of stratum corneum by microdermabrasion to increase skin permeability. Eur J Pharm Sci 2009; 38:95-103. [PMID: 19559791 DOI: 10.1016/j.ejps.2009.06.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Revised: 06/15/2009] [Accepted: 06/17/2009] [Indexed: 12/25/2022]
Abstract
This study sought to determine if microdermabrasion can selectively remove stratum corneum to increase skin permeability. Although, microdermabrasion has been used for cosmetic treatment of skin for decades, no study has assessed the detailed effects of microdermabrasion conditions on the degree of skin tissue removal. Therefore, we histologically characterized the skin of rhesus macaques and human volunteers after microdermabrasion at different conditions. Using mobile tip microdermabrasion, an increase in the number of treatment passes led to greater tissue removal ranging from minimal effects to extensive damage to deeper layers of the skin. Of note, these data showed for the first time that at moderate microdermabrasion conditions selective yet full-thickness removal of stratum corneum could be achieved with little damage to deeper skin tissues. In the stationary mode of microdermabrasion, selective stratum corneum removal was not observed, but micro-blisters could be seen. Similar tissue removal trends were observed in human volunteers. As proof of concept for drug delivery applications, a model fluorescent drug (fluorescein) was delivered through microdermabraded skin and antibodies were generated against vaccinia virus after its topical application in monkeys. In conclusion, microdermabrasion can selectively remove full-thickness stratum corneum with little damage to deeper tissues and thereby increase skin permeability.
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Affiliation(s)
- Harvinder S Gill
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332-0100, USA
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Elsaie ML, Baumann LS, Elsaaiee LT. Striae distensae (stretch marks) and different modalities of therapy: an update. Dermatol Surg 2009; 35:563-73. [PMID: 19400881 DOI: 10.1111/j.1524-4725.2009.01094.x] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Striae distensea (SD; stretch marks) are a well-recognized, common skin condition that rarely causes any significant medical problems but are often a significant source of distress to those affected. The origins of SD are poorly understood, and a number of treatment modalities are available for their treatment, yet none of them is consistently effective, and no single therapy is considered to be pivotal for this problem. With a high incidence and unsatisfactory treatments, stretch marks remain an important target of research for an optimum consensus of treatment. OBJECTIVE To identify the current treatment modalities and their effectiveness in the treatment of stretch marks. MATERIALS AND METHODS Review of the recent literature regarding clinical treatment of stretch marks with emphasis on the safety and efficacy of the newer optical devices and laser applications. RESULTS No current therapeutic option offers complete treatment, although there are a number of emerging new modalities that are encouraging. CONCLUSION The therapeutic strategies are numerous, and no single modality has been far more consistent than the rest. The long-term future of treatment strategies is encouraging with the advance in laser technologies.
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Affiliation(s)
- Mohamed L Elsaie
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida 33140, USA.
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30
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Jin H, Kumar L, Mathias C, Zurakowski D, Oettgen H, Gorelik L, Geha R. Toll-like receptor 2 is important for the T(H)1 response to cutaneous sensitization. J Allergy Clin Immunol 2009; 123:875-82.e1. [PMID: 19348925 DOI: 10.1016/j.jaci.2009.02.007] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2008] [Revised: 01/22/2009] [Accepted: 02/04/2009] [Indexed: 01/30/2023]
Abstract
BACKGROUND Atopic dermatitis and allergic contact dermatitis are skin disorders triggered by epicutaneous sensitization with protein antigens and contact sensitization with haptens, respectively. Skin is colonized with bacteria, which are a source of Toll-like receptor (TLR) 2 ligands. OBJECTIVE We sought to examine the role of TLR2 in murine models of atopic dermatitis and allergic contact dermatitis. METHODS TLR2(-/-) mice and wild-type littermates were epicutaneously sensitized with ovalbumin (OVA) or contact sensitized with oxazolone (OX). Skin histology was assessed by means of hematoxylin and eosin staining and immunohistochemistry. Ear swelling was measured with a micrometer. Cytokine mRNA expression was examined by means of quantitative RT-PCR. Antibody levels and splenocyte secretion of cytokines in response to OVA stimulation were measured by means of ELISA. Dendritic cells were examined for their ability to polarize T-cell receptor/OVA transgenic naive T cells to T(H)1 and T(H)2. RESULTS In response to OVA sensitization, TLR2(-/-) mice experienced skin infiltration with eosinophils and CD4(+) cells, as well as upregulation of T(H)2 cytokine mRNAs that was comparable with that seen in wild-type littermates. In contrast, epidermal thickening, IFN-gamma expression in the skin, IFN-gamma production by splenocytes, and IgG2a anti-OVA antibody levels were impaired in TLR2(-/-) mice. After OX ear challenge, contact sensitized TLR2(-/-) mice exhibited defective ear swelling with impaired cellular infiltration, decreased epidermal thickening and local IFN-gamma expression, and impaired OX-specific IgG2a responses. Dendritic cells from TLR2(-/-) mice induced significantly lower production of IFN-gamma but normal IL-4 and IL-13 production in naive T cells. CONCLUSIONS These results indicate that TLR2 promotes the IFN-gamma response to cutaneously introduced antigens.
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Affiliation(s)
- Haoli Jin
- Division of Immunology, Children's Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
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Dudelzak J, Hussain M, Phelps RG, Gottlieb GJ, Goldberg DJ. Evaluation of histologic and electron microscopic changes after novel treatment using combined microdermabrasion and ultrasound-induced phonophoresis of human skin. J COSMET LASER THER 2009; 10:187-92. [PMID: 19012051 DOI: 10.1080/14764170802524445] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Mechanical exfoliation using microdermabrasion has been used as a minimally invasive treatment of photodamage, as well as to improve absorption of topical agents. Phonophoresis, a method of electrically assisted percutaneous delivery of macromolecules, relies on ultrasonic waves producing alterations within the stratum corneum that result in increased absorption. OBJECTIVE To determine the effects on photodamaged facial skin that resulted from the ultrasound-enhanced delivery of a combined hyaluronic acid, retinol, and peptide-containing complex following microdermabrasion. METHODS Seven individuals, aged 40-65, with Fitzpatrick skin types I-III and class I-III rhytids, underwent eight weekly aluminum oxide crystal microdermabrasion procedures (Parisian Peel; Aesthetic Technologies, Golden, CO, USA), followed by administration of a topical combined hyaluronic acid, retinol, and peptide-containing complex, propelled through ultrasound phonophoresis. The participants continued manual twice-daily application of the topical complex between treatments. Clinical evaluation included digital photography, and patient and investigator assessment of changes in skin dryness, texture, brightness, tone, and rhytids. The 3-month post-treatment histologic evaluation consisted of pre- and post-treatment biopsies evaluated for microscopic and ultrastructural changes. RESULTS An overall mild clinical improvement in the skin was noted. A slight increase in vascularity within the papillary dermis, increased reticulin stain (type III collagen), and ultrastuctural evidence of increased type I collagen indicate dermal injury with resulting new collagen formation. CONCLUSION Microdermabrasion followed by ultrasonic phonophoretic application of topical products represents a novel dermal delivery approach to photorejuvenation.
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Affiliation(s)
- Jacob Dudelzak
- Skin Laser & Surgery Specialists of NY and NJ, New York, New York, USA
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Hantash BM, Ubeid AA, Chang H, Kafi R, Renton B. Bipolar fractional radiofrequency treatment induces neoelastogenesis and neocollagenesis. Lasers Surg Med 2009; 41:1-9. [DOI: 10.1002/lsm.20731] [Citation(s) in RCA: 192] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Chang SP, Tsai HH, Chen WY, Lee WR, Chen PL, Tsai TH. The wrinkles soothing effect on the middle and lower face by intradermal injection of botulinum toxin type A. Int J Dermatol 2008; 47:1287-94. [DOI: 10.1111/j.1365-4632.2008.03895.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Freedman BM. Topical antioxidant application enhances the effects of facial microdermabrasion. J DERMATOL TREAT 2008; 20:82-7. [PMID: 18720185 DOI: 10.1080/09546630802301818] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Microdermabrasion has been accepted as a reliable, non-invasive method for facial rejuvenation. Recently, there has been interest in combining this technique with other modalities to increase its efficacy. The purpose of this study was to determine whether the addition of an antioxidant-based serum enhanced the dermatologic changes seen following microdermabrasion. METHODS Ten female volunteers, aged 38-52 years, underwent a series of six diamond tip crystal-free microdermabrasion facial treatments spaced 7-10 days apart. An antioxidant serum rich in polyphenols was pneumatically applied to half the face immediately after each microdermabrasion treatment. Skin biopsies and skin polyphenolic antioxidant levels, determined by Raman spectroscopy, were obtained prior to and after the study period. Investigator ratings for efficacy were analyzed after the study period and compared to baseline. RESULTS Compared with the skin treated with microdermabrasion only, the skin treated with microdermabrasion plus antioxidant demonstrated significantly increased epidermal and papillary dermal thickness, and increased fibroblast density (p < 0.01). There was increased hyalinization of the papillary dermis with newly deposited collagen fibers. Skin polyphenolic antioxidant levels increased 32% in the skin treated with the polyphenolic antioxidant serum after microdermabrasion (p < 0.01). Clinical efficacy variables were significantly more improved in the antioxidant group when compared to baseline (p < 0.01). These changes were supported clinically via digital photography. CONCLUSION The addition of a polyphenolic antioxidant serum to a facial microdermabrasion regimen enhanced the clinical and histological changes seen following microdermabrasion alone. This combination should strengthen the use of microdermabrasion as a non-invasive facial rejuvenation tool and support the role of topical antioxidants as anti-aging factors.
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Affiliation(s)
- Bruce M Freedman
- Plastic Surgery Associates of Northern Virginia, McLean, Virginia, USA.
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Davari P, Gorouhi F, Jafarian S, Dowlati Y, Firooz A. A randomized investigator-blind trial of different passes of microdermabrasion therapy and their effects on skin biophysical characteristics. Int J Dermatol 2008; 47:508-13. [DOI: 10.1111/j.1365-4632.2008.03583.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Smith W, Bishop M, Gillis G, Maibach H. Topical proteolytic enzymes affect epidermal and dermal properties. Int J Cosmet Sci 2007; 29:15-21. [DOI: 10.1111/j.1467-2494.2007.00354.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Approaches to Document the Efficacy and Safety of Microdermabrasion Procedure. Dermatol Surg 2006. [DOI: 10.1097/00042728-200611000-00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
BACKGROUND Microdermabrasion is a popular cosmetic procedure for skin rejuvenation, which is achieved by mechanical abrasion of the skin at a superficial level. OBJECTIVE The objective was to study the efficacy of microdermabrasion in photoaging and to investigate the compatibility of a cleanser and a lotion with microdermabrasion. METHODS Sixteen women underwent microdermabrasion to the face once a week for a total of six treatments. Subjects were also given a personal skin care regimen (cleanser and lotion). Colorimetry values as well as investigator and patients ratings for safety and efficacy were analyzed at various time points and compared to baseline. RESULTS There were no significant changes in safety and tolerance variables throughout the study. Clinical efficacy variables (fine wrinkles, dullness, pigmentation, and large pores) significantly improved by the third treatment, with further improvement by the end of the study (six treatments). Subjects perceived improvement in facial photoaging variables. Colorimetry showed increased brightness and decreased yellowness of target skin sites on the face throughout the study. CONCLUSION Multiple microdermabrasions were effective in significantly improving various facial photoaging variables. The personal skin care regimen used was well tolerated by the subjects.
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Rabe JH, Mamelak AJ, McElgunn PJS, Morison WL, Sauder DN. Photoaging: Mechanisms and repair. J Am Acad Dermatol 2006; 55:1-19. [PMID: 16781287 DOI: 10.1016/j.jaad.2005.05.010] [Citation(s) in RCA: 340] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2004] [Revised: 04/23/2005] [Accepted: 05/03/2005] [Indexed: 12/21/2022]
Abstract
UNLABELLED Aging is a complex, multifactorial process resulting in several functional and esthetic changes in the skin. These changes result from intrinsic as well as extrinsic processes, such as ultraviolet radiation. Recent advances in skin biology have increased our understanding of skin homeostasis and the aging process, as well as the mechanisms by which ultraviolet radiation contributes to photoaging and cutaneous disease. These advances in skin biology have led to the development of a diversity of treatments aimed at preventing aging and rejuvenating the skin. The focus of this review is the mechanism of photoaging and the pathophysiology underlying the treatments specifically designed for its prevention and treatment. LEARNING OBJECTIVES At the conclusion of this learning activity, participants should be familiar with the mechanism of photoaging, the treatments for photoaging, and the data that supports the use of these treatments.
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Affiliation(s)
- Jessica H Rabe
- Department of Dermatology, Johns Hopkins University, USA
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41
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Effect of Serial Microdermabrasion on the Ceramide Level in the Stratum Corneum. Dermatol Surg 2006. [DOI: 10.1097/00042728-200603000-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Karimipour DJ, Kang S, Johnson TM, Orringer JS, Hamilton T, Hammerberg C, Voorhees JJ, Fisher G. Microdermabrasion with and without aluminum oxide crystal abrasion: a comparative molecular analysis of dermal remodeling. J Am Acad Dermatol 2006; 54:405-10. [PMID: 16488289 DOI: 10.1016/j.jaad.2005.11.1084] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2005] [Revised: 11/21/2005] [Accepted: 11/27/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Microdermabrasion is a popular method of superficial skin resurfacing with effects on dermal remodeling. OBJECTIVE The purpose of this study was to evaluate the relative importance of the two components of microdermabrasion, negative pressure and abrasion, in stimulating expression of key genes involved in dermal remodeling. METHODS Ten subjects were treated with a microdermabrasion machine using focal crystal abrasion and negative pressure or negative pressure alone for 3 seconds. Serial biochemical analyses were performed. Reverse transcriptase real-time polymerase chain reaction assays were used to evaluate changes in transcription factor activator protein-1, primary cytokines (interleukin 1beta, tumor necrosis factor-alpha), and matrix metalloproteinases (MMP-1, MMP-3, MMP-9). RESULTS Significant increases in gene expression of the c-Jun component of activator protein-1, interleukin 1beta, tumor necrosis factor-alpha, MMP-1, MMP-3, and MMP-9 were found with crystal abrasion combined with negative pressure. Negative pressure alone resulted in increased gene expression of MMP-1 and MMP-3 but of a quantitatively reduced magnitude when compared with negative pressure with crystal abrasion. LIMITATIONS It is unclear that molecular changes seen with these treatments can result in clinical effect. CONCLUSION The abrasive component of microdermabrasion is necessary for stimulating expression of key genes involved in dermal remodeling.
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Affiliation(s)
- Darius J Karimipour
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
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