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Babakurd FM, Azzawi SK, Alkhouli M, Al-Nerabieah Z. Evaluation of EMLA cream with microneedle patches in palatal anesthesia in children: a randomized controlled clinical trial. Sci Rep 2024; 14:15295. [PMID: 38961171 PMCID: PMC11222482 DOI: 10.1038/s41598-024-66212-9] [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: 11/01/2023] [Accepted: 06/28/2024] [Indexed: 07/05/2024] Open
Abstract
Palatal injections are considered to be one of the most painful dental procedures. As a result, it was important to find alternatives to this painful injection to improve children's cooperation. The dental literature mentioned using EMLA cream as a possible alternative to conventional injections, but its anesthetic effect was debated. Therefore, it was valuable to research the impact of microneedle patches to enhance the effectiveness of this cream. The purpose of this randomized controlled clinical trial was to compare the effectiveness of different methods of anesthesia and pain levels in children aged 7-11 years. The study compared the use of EMLA cream, EMLA with microneedles, and conventional palatal injections. A total of 90 children were randomly assigned to three groups: Group 1 received conventional palatal anesthesia (control), Group 2 received EMLA cream only, and Group 3 received EMLA with microneedles. Pain levels were assessed using the FLACC and Wong-Baker scales at three different time points: T1(during anesthesia), T2(on palatal probing), and T3(during extraction). The FLACC scale revealed a significant difference in pain between groups only at T1 (P value = 0.000). It was found that the conventional palatal injection group had a higher pain level than the EMLA cream-only group and the group using microneedle patches with EMLA cream (P value = 0.000). However, the other groups did not show significant differences in pain levels during the anesthesia (P value = 1.00). Similarly, the Wong-Baker scale also demonstrated a statistically significant difference in pain between groups only at T1 (P value = 0.000). It was found that the conventional palatal injection group had a higher pain level than the EMLA cream-only group and the group using microneedle patches with EMLA cream (P value = 0.000). However, the other groups did not show significant differences in pain levels during the anesthesia (P value = 0.091). The study concludes that both EMLA cream alone and EMLA with microneedles can be used as an alternative to conventional palatal anesthesia for children.
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Affiliation(s)
- Farah M Babakurd
- Pediatric Dentistry Department, Faculty of Dentistry, University of Damascus, Damascus, Syria.
| | - Shadi K Azzawi
- Pediatric Dentistry Department, Faculty of Dentistry, University of Damascus, Damascus, Syria
| | - Muaaz Alkhouli
- Pediatric Dentistry Department, Faculty of Dentistry, University of Damascus, Damascus, Syria
| | - Zuhair Al-Nerabieah
- Pediatric Dentistry Department, Faculty of Dentistry, University of Damascus, Damascus, Syria
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Pincelli TP, Zawawi S, Shapiro SA, Heckman MG, Hochwald AP, Arthurs J, Tolaymat L, Bruce A. Evaluation of Platelet-rich Plasma and Microneedling for Facial Skin Rejuvenation. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5829. [PMID: 38798929 PMCID: PMC11124655 DOI: 10.1097/gox.0000000000005829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/22/2024] [Indexed: 05/29/2024]
Abstract
Background The regenerative properties of platelet growth factors make platelet-rich-plasma (PRP) an attractive modality for treatment of aging skin. The main objective of this study was to determine efficacy and safety of PRP injections and microneedling compared with saline injections in women with aging skin of the face. Methods In this prospective, randomized clinical trial, 18 women with facial aging were randomized to receive either PRP injections to the unilateral face and saline injections to the contralateral side, or vice versa. Microneedling was performed after injections on the entire face. Physician assessment, photographs, and treatment satisfaction questionnaires were used for outcome assessment at baseline and 16- and 24-week follow-ups. Results There was no evidence of improvement and suggestion of worsening in skin laxity and rhytides from baseline to weeks 4, 16, and 24 for PRP and saline (all P ≤ 0.004) and no notable difference in skin roughness between baseline and follow-up time points for PRP or saline (all P ≥ 0.19). The degree of change in skin laxity, rhytides, and skin roughness from baseline to follow-up time points was similar for PRP and saline. All patients experienced some degree of pain/discomfort and burning/stinging sensation at treatment weeks 4, 8, and 12 for both saline and PRP. Conclusions PRP injections did not seem to be effective for treatment of aging skin of the face in women, with no notable macroscopic improvement in appearance when compared with baseline or saline injections. Advanced age of study participants (>45 years) and less-sensitive methods of evaluation may be potential contributing factors to the lack of detected response.
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Affiliation(s)
- Thais P. Pincelli
- From the Department of Dermatology, Mayo Clinic Florida, Jacksonville, Fla
| | - Suha Zawawi
- From the Department of Dermatology, Mayo Clinic Florida, Jacksonville, Fla
| | - Shane A. Shapiro
- Center for Regenerative Biotherapeutics, Mayo Clinic Florida, Jacksonville, Fla
| | - Michael G. Heckman
- Division of Clinical Trials and Biostatistics, Mayo Clinic Florida, Jacksonville, Fla
| | - Alexander P. Hochwald
- Division of Clinical Trials and Biostatistics, Mayo Clinic Florida, Jacksonville, Fla
| | - Jennifer Arthurs
- Center for Regenerative Biotherapeutics, Mayo Clinic Florida, Jacksonville, Fla
| | - Leila Tolaymat
- From the Department of Dermatology, Mayo Clinic Florida, Jacksonville, Fla
| | - Alison Bruce
- From the Department of Dermatology, Mayo Clinic Florida, Jacksonville, Fla
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Ghasemiyeh P, Fazlinejad R, Kiafar MR, Rasekh S, Mokhtarzadegan M, Mohammadi-Samani S. Different therapeutic approaches in melasma: advances and limitations. Front Pharmacol 2024; 15:1337282. [PMID: 38628650 PMCID: PMC11019021 DOI: 10.3389/fphar.2024.1337282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
Melasma is a chronic hyperpigmentation skin disorder that is more common in the female gender. Although melasma is a multifactorial skin disorder, however, sun-exposure and genetic predisposition are considered as the main etiologic factors in melasma occurrence. Although numerous topical and systemic therapeutic agents and also non-pharmacologic procedural treatments have been considered in melasma management, however, the commonly available therapeutic options have several limitations including the lack of sufficient clinical effectiveness, risk of relapse, and high rate of unwanted adverse drug reactions. Recruitment of nanotechnology for topical drug delivery in melasma management can lead to enhanced skin penetration, targeted drug delivery to the site of action, longer deposition at the targeted area, and limit systemic absorption and therefore systemic availability and adverse drug reactions. In the current review, first of all, the etiology, pathophysiology, and severity classification of melasma have been considered. Then, various pharmacologic and procedural therapeutic options in melasma treatment have been discussed. Afterward, the usage of various types of nanoparticles for the purpose of topical drug delivery for melasma management was considered. In the end, numerous clinical studies and controlled clinical trials on the assessment of the effectiveness of these novel topical formulations in melasma management are summarized.
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Affiliation(s)
- Parisa Ghasemiyeh
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rahil Fazlinejad
- Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Kiafar
- Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shiva Rasekh
- Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Soliman Mohammadi-Samani
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
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4
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Williams S, McDonald KA, Beach RA. Same But Different: An 18-Month Cross-Sectional Study of Cosmetic Procedures in Patients With Skin Phototype I-III Versus IV-VI in Toronto, Canada. Dermatol Surg 2024; 50:272-276. [PMID: 38113172 DOI: 10.1097/dss.0000000000004034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
BACKGROUND Patients with darker skin phototypes self-report less facial aging than their lighter-skinned counterparts. However, the association of skin phototype with the type of cosmetic procedures received, is yet to be established in a Canadian context. OBJECTIVE To compare the pattern of nonsurgical cosmetic procedures performed on people with different Fitzpatrick SPTs. MATERIALS AND METHODS Cross-sectional study of patient encounters from October 2020-April 2022. Charts and photographs were reviewed and analyzed for age, sex, SPT, and procedure type. Participants were stratified by SPT into 2 cohorts: SPT I-III and SPT IV-VI. SPTs were collapsed into groups based on definitions of "skin of color" (SPT IV-VI) in previous literature. RESULTS We analyzed 350 patients with mean age 43.4, of whom 320 (91%) were female and 30 (9%) were male. The SPT I-III cohort was older (mean age 45 vs 38.5 years, p < .0001) and more frequently underwent neuromodulator injection. The SPT IV-VI cohort more frequently underwent microneedling, platelet-rich plasma, or electrodessication. CONCLUSION There are distinct patterns of cosmetic procedures performed. The SPT I-III cohort more commonly received procedures to manage facial aging. The SPT IV-VI cohort was younger and more commonly underwent procedures to manage hyperpigmentation.
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Affiliation(s)
- Stephen Williams
- Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Renée A Beach
- DermAtelier on Avenue-Medical & Cosmetic Dermatology, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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Wong R, Murphy A, Lira M, Sichmann MGDO, Kim AR, Saechee VD, Hermanson KD, Hawkins SS. Microneedling with a Novel, n-3-PUFA-Rich Formulation Accelerates Inflammation Resolution to Improve Skin Recovery Outcomes in Adults with Healthy Skin. Dermatol Ther (Heidelb) 2023; 13:3057-3069. [PMID: 37833618 PMCID: PMC10689607 DOI: 10.1007/s13555-023-01049-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
INTRODUCTION Microneedling is a cosmetic procedure that leverages the skin's natural ability to heal in order to promote collagen formation and skin rejuvenation. To provide improved results, the technique can be combined with topical formulations. A new formulation of multiple actives, including omega-3 (n-3) polyunsaturated fatty acids (PUFAs), was designed to accelerate the resolution of inflammation and wound healing following micro-injury treatments, while enhancing the visible appearance of procedure results, including erythema, luminosity and skin texture. METHODS In this randomised, controlled, split-face study, we examined 32 healthy female participants aged 30-70 years for 4 weeks following microneedling treatment with a novel multiple-active-ingredient formulation or conventional microneedling protocol with a hyaluronic acid control serum. Changes in skin condition were assessed by blinded clinical photography and expert evaluation. Measurements were collected at baseline, 1 h, 1 day, 7 days and 28 days post treatment. RESULTS Significantly greater improvements in expert-assessed erythema, luminosity and skin texture were reported following application of the novel multiple-active-ingredient formulation than the hyaluronic acid control serum. This was confirmed by representative VISIA®-CR imaging. CONCLUSION These data provide new evidence for the role of a novel multiple-active-ingredient formulation for improving skin outcomes up to 28 days following microneedling in adults with healthy skin when compared with a hyaluronic acid serum. The n-3 PUFA content of this formulation may drive accelerated inflammation resolution and wound healing alongside the complementary action of the other active ingredients, leading to the observed improvements in erythema, luminosity and skin texture.
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Affiliation(s)
- Russell Wong
- Rejuvenation Medical Group, 5083 Windermere Blvd Unit 101, Edmonton, AB, T6W 0J5, Canada.
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Van Wicklin SA. Cosmetic Procedures in Patients With Skin of Color. PLASTIC AND AESTHETIC NURSING 2023; 43:164-169. [PMID: 37774160 DOI: 10.1097/psn.0000000000000523] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Affiliation(s)
- Sharon Ann Van Wicklin
- Sharon Ann Van Wicklin, PhD, RN, CNOR, CRNFA(E), CPSN-R, PLNC, ISPAN-F, FAAN, is the Editor-in-Chief, Plastic and Aesthetic Nursing, and is a Perioperative and Legal Nurse Consultant, Aurora, CO
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7
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Lazar M, De La Garza H, Vashi NA. Exogenous Ochronosis: Characterizing a Rare Disorder in Skin of Color. J Clin Med 2023; 12:4341. [PMID: 37445377 DOI: 10.3390/jcm12134341] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Exogenous ochronosis is a rare dyschromia that primarily impacts those with skin of color. It is characterized by blue-black pigmentation and is associated with the long-term application of skin-lightening creams containing hydroquinone. Commonly confused with other dyschromias, the use of skin lightening topicals can cause paradoxical skin darkening in patients with known exogenous ochronosis. This is highly distressing to patients, often worsening the underlying dyschromia and making treatment more difficult. A 10-year retrospective analysis was conducted that revealed 25 patients with exogenous ochronosis. The average patient used a skin lightening cream for 9.2 years, with exogenous ochronosis most commonly arising on the cheeks (68%), forehead (24%), and temples (20%). Furthermore, this study identified that patients with exogenous ochronosis may respond well to treatment with Q-switched Alexandrite laser and microneedling. The incidence of exogenous ochronosis is likely to increase as demographics shift and access to a wide range of over-the-counter topicals becomes more available, both in the United States and worldwide. Therefore, it is imperative to better characterize exogenous ochronosis to identify best treatment practices for all patients.
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Affiliation(s)
- Michelle Lazar
- Department of Dermatology, Boston University School of Medicine, 609 Albany St, J502, Boston, MA 02118, USA
| | - Henriette De La Garza
- Department of Dermatology, Boston University School of Medicine, 609 Albany St, J502, Boston, MA 02118, USA
| | - Neelam A Vashi
- Department of Dermatology, Boston University School of Medicine, 609 Albany St, J502, Boston, MA 02118, USA
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8
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Feng J, Zhang L, Qi J, Huang L. Histological damage characteristics and quantitive analysis of porcine skin with non-insulated microneedle radiofrequency. Skin Res Technol 2023; 29:e13396. [PMID: 37357651 PMCID: PMC10264746 DOI: 10.1111/srt.13396] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 06/06/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVE In recent years, the microneedle radiofrequency (MRF) has been widely used for skin rejuvenation, but histological studies on the immediate trauma caused by different parameters of non-insulated RF microneedles METHODS: The skin of three pigs was treated with different needle depths, pulse widths and energy levels of non-insulated microneedle RF. Samples were collected before, immediately, and 2 weeks after treatment. The immediate histological response of each group was assessed and quantified by hematoxylin and eosin staining, Masson staining and Victoria Blue staining. RESULTS In the treatment of non-insulated microneedle RF, different energy levels affected mainly the range of thermal damage (p = 0.044), and different needle depths affected mainly the depth of the cavity (p = 0.022). But the width of the coagulation zone width was determined by different factors. There was no significant difference in the histology of immediate damage caused by different pulse widths. Reepithelialization of the epidermis and basic wound repair can be completed within 2 weeks. CONCLUSION Non-insulated RF microneedle therapy is an effective and safe treatment that can stimulate dermal wound healing with less thermal coagulation and a wide range of reversible thermal damage. However, it should be noted that the set needle depth may not correspond to the actual penetration depth, nor to the actual depth of histologic trauma.
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Affiliation(s)
- Jiayi Feng
- Laser Aesthetic CenterPlastic Surgery Hospital, Peking Union Medical College and Chinese Academy of Medical SciencesBeijingChina
| | - Ling Zhang
- Laser Aesthetic CenterPlastic Surgery Hospital, Peking Union Medical College and Chinese Academy of Medical SciencesBeijingChina
| | - Jun Qi
- Laser Aesthetic CenterPlastic Surgery Hospital, Peking Union Medical College and Chinese Academy of Medical SciencesBeijingChina
| | - Lvping Huang
- Laser Aesthetic CenterPlastic Surgery Hospital, Peking Union Medical College and Chinese Academy of Medical SciencesBeijingChina
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9
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Amechi M, Halpin J. Considerations for Laser Therapy, Microneedling, and Chemical Peels When Treating Patients With Skin of Color. PLASTIC AND AESTHETIC NURSING 2023; 43:14-21. [PMID: 36583583 DOI: 10.1097/psn.0000000000000483] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Over the past 10 years, we have seen exponential growth in the aesthetic industry. With this growth, we have also seen an influx of patients of differing ethnicities, in all varying shades of color. Some clinicians may not have the necessary knowledge and skill to appropriately treat these patients using modalities such as laser therapy, microneedling, and chemical peels. The aesthetic industry provides courses, conferences, and educational guides for helping aesthetic practitioners determine which patients are eligible to undergo these treatments. However, there is a considerable lack of information available for clinicians about treatment modalities that can be safely and effectively used on patients with Fitzpatrick skin types IV-VI. As the population of patients of various ethnic origins seeking aesthetic treatments continues to grow, it is imperative for clinicians performing these treatments to increase their knowledge and skill related to treating patients with skin of color. The purpose of this article is to educate aesthetic clinicians about appropriate treatments, procedures, and protocols for preventing adverse reactions in patients with skin of color who are undergoing aesthetic treatments using lasers, microneedling, and chemical peels.
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Affiliation(s)
- Marisa Amechi
- Marisa Amechi, RN, CANS, is an aesthetic registered nurse in private practice in Santa Clarita, California and is cofounder of Skin of Color Aesthetics
- Jacklyn Halpin, DNP, APRN, FNP-C, is an aesthetic nurse practitioner in private practice in Highpoint, NC and is cofounder of Skin of Color Aesthetics
| | - Jacklyn Halpin
- Marisa Amechi, RN, CANS, is an aesthetic registered nurse in private practice in Santa Clarita, California and is cofounder of Skin of Color Aesthetics
- Jacklyn Halpin, DNP, APRN, FNP-C, is an aesthetic nurse practitioner in private practice in Highpoint, NC and is cofounder of Skin of Color Aesthetics
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10
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Jia L, Xiong J, Guo R, Li Y, Jiang H. A Comprehensive Review of Microneedling as a Potential Treatment Option for Androgenetic Alopecia. Aesthetic Plast Surg 2022; 46:2979-2994. [PMID: 35930041 DOI: 10.1007/s00266-022-03042-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/21/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Microneedling refers to a minimally invasive technique that uses multiple fine needles targeted skin epidermis for mechanical stimulation to obtain therapeutic or cosmetic effects. It is suitable for the treatment of a variety of dermatological conditions, including androgenetic alopecia (AGA). OBJECTIVE This article aims to make a comprehensive review of the relevant studies on microneedling for the management of AGA. METHODS Extensive literature search was performed using PubMed, Web of Science, and EBSCO databases. 4 in vivo studies and 25 clinical trials were included according to the inclusion and exclusion criteria. RESULTS The effects of microneedling on AGA was investigated in animal experiments. Several clinical trials, including randomized controlled trials, strengthen the validity of the findings. Microneedling therapy showed some encouraging results with minor complications when used alone or in combination with topical products. CONCLUSIONS Microneedling appears to be a safe and effective therapeutic option for AGA. Larger and more randomized controlled trials regarding the role of microneedling in AGA are strongly recommended to provide more definitive evidence. 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 www.springer.com/00266.
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Affiliation(s)
- Lingling Jia
- Department of Plastic Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Jiachao Xiong
- Department of Plastic Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Rong Guo
- Department of Plastic Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Yufei Li
- Department of Plastic Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China.
| | - Hua Jiang
- Department of Plastic Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China.
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11
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Liang X, Li J, Yan Y, Xu Y, Wang X, Wu H, Liu Y, Li L, Zhuo F. Efficacy of Microneedling Combined With Local Application of Human Umbilical Cord-Derived Mesenchymal Stem Cells Conditioned Media in Skin Brightness and Rejuvenation: A Randomized Controlled Split-Face Study. Front Med (Lausanne) 2022; 9:837332. [PMID: 35685406 PMCID: PMC9171013 DOI: 10.3389/fmed.2022.837332] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/14/2022] [Indexed: 11/20/2022] Open
Abstract
Background Fighting skin aging signs is one of the major challenges of the 21st century, recently, mesenchymal stem cells (MSCs) and microneedling (MN) have been applied for anti-aging. This study aims to evaluate the efficacy of the combination of MN and human umbilical cord-derived mesenchymal stem cells conditioned media (hUC-MSCs-CM) in skin brightness and rejuvenation. Methods Thirty volunteers with facial skin aging were recruited for the randomized, controlled split-face study. The left and right sides of the face were randomly applied with saline via MN or hUC-MSCs-CM via MN. Five sessions were performed for each volunteer at 2-week intervals. Two dermatologists evaluated the clinical improvement, in terms of skin brightness and texture. A satisfaction score based on a self-evaluation questionnaire was recorded at 2 weeks after the last treatment. The objective evaluation was recorded before the first treatment, and at 2 weeks after the last treatment. Results Twenty-eight volunteers with a mean (SD) age of 41 (6.54) years old completed the trial. The investigator’s assessment for skin brightness and texture, and the self-satisfaction score revealed statistically better effects in hUC-MSCs-CM -plus-MN group than in MN alone (MN saline) group. No severe side effects were reported during the whole study period. Compared to MN alone group, the objective assessment revealed significant improvements in skin brightness (reduced melanin index, ultraviolet spots, and brown spots) and skin texture (reduced wrinkles and pores, and increased skin elasticity) in hUC-MSCs-CM-plus-MN group, while there were no obvious differences in skin hydration, trans-epidermal water loss, and the erythema index. Conclusion The combination of hUC-MSCs-CM and MN exhibite anti-aging efficacy, and this could be used for facial rejuvenation in the future.
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Affiliation(s)
- Xuelei Liang
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jiaying Li
- Department of Dermatology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yan Yan
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yongsheng Xu
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiujuan Wang
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Haixuan Wu
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yi Liu
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Linfeng Li
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Fenglin Zhuo
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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12
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Anjani QK, Sabri AHB, Utomo E, Domínguez-Robles J, Donnelly RF. Elucidating the Impact of Surfactants on the Performance of Dissolving Microneedle Array Patches. Mol Pharm 2022; 19:1191-1208. [PMID: 35235330 PMCID: PMC9097526 DOI: 10.1021/acs.molpharmaceut.1c00988] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
![]()
The
need for biocompatible polymers capable of dissolving in the
skin while exhibiting reasonable mechanical features and delivery
efficiency limits the range of materials that could be utilized in
fabricating dissolving microneedle array patches (MAPs). The incorporation
of additives, such as surfactants, during microneedle fabrication
might be an alternative solution to overcome the limited range of
materials used in fabricating dissolving MAPs. However, there is a
lacuna in the knowledge on the effect of surfactants on the manufacture
and performance of dissolving MAPs. The current study explores the
role of surfactants in the manufacture and performance of dissolving
MAPs fabricated from poly(vinyl alcohol) (PVA) and poly(vinyl pyrrolidone)
(PVP) loaded with the model drugs, ibuprofen sodium and itraconazole.
Three nonionic surfactants, Lutrol F108, Pluronic F88, and Tween 80,
in solutions at varying concentrations (0.5, 1.0, and 2.0% w/w) were
loaded into these dissolving MAPs. It was discovered that all of the
dissolving MAPs that incorporated surfactant displayed a lower reduction
in the microneedle height (≈10%) relative to the control formulation
(≈20%) when subjected to a compressive force of 32 N. In addition,
the incorporation of surfactants in some instances enhanced the insertion
profile of these polymeric MAPs when evaluated using ex vivo neonatal porcine skin. The incorporation of surfactant into ibuprofen
sodium-loaded dissolving MAPs improved the insertion depth of MAPs
from 400 μm down to 600 μm. However, such enhancement
was not apparent when the MAPs were loaded with the model hydrophobic
drug, itraconazole. Skin deposition studies highlighted that the incorporation
of surfactant enhanced the delivery efficiency of both model drugs,
ibuprofen sodium and itraconazole. The incorporation of surfactant
enhanced the amount of ibuprofen sodium delivered from 60.61% up to
≈75% with a majority of the drug being delivered across the
skin and into the receptor compartment. On the other hand, when surfactants
were added into MAPs loaded with the model hydrophobic drug itraconazole,
we observed enhancement in intradermal delivery efficiency from 20%
up to 30%, although this did not improve the delivery of the drug
across the skin. This work highlights that the addition of nonionic
surfactant is an alternative formulation strategy worth exploring
to improve the performance and delivery efficiency of dissolving MAPs.
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Affiliation(s)
- Qonita Kurnia Anjani
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, U.K
| | - Akmal Hidayat Bin Sabri
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, U.K
| | - Emilia Utomo
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, U.K
| | - Juan Domínguez-Robles
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, U.K
| | - Ryan F Donnelly
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, U.K
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Esmat S, Shokeir HA, Samy NA, Mahmoud SB, Sayed SSED, Shaker E, Hilal RF. Automated Microneedling Versus Fractional CO2 Laser in Treatment of Traumatic Scars: A Clinical and Histochemical Study. Dermatol Surg 2021; 47:1480-1485. [PMID: 34468410 DOI: 10.1097/dss.0000000000003227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND/OBJECTIVES Microneedling has shown satisfactory effects in scar rejuvenation. Comparisons of its results with fractional laser are limited. This study aims to compare the efficacy and safety of automated microneedling versus fractional carbon dioxide (CO2) laser in treatment of traumatic scars on clinical and histochemical bases. MATERIALS AND METHODS Thirty patients with traumatic facial scars were randomized to treatment with 4 monthly sessions of either automated microneedling or fractional CO2 laser. Assessment of scars was performed at baseline and 3 months after the last treatment session, clinically by the modified Vancouver Scar Scale (mVSS) and histochemically by quantitative assessment of collagen and elastic fibers. RESULTS Both groups showed improvement in mVSS, collagen, and elastin contents after treatment. Percentage improvement of collagen and elastin content was higher after treatment by a laser compared with microneedling, in case of the collagen content. Percentage increase in the collagen content after treatment was higher in atrophic scars of the laser group than those of the microneedling group. CONCLUSION In this small study, microneedling was as safe as fractional CO2 laser for rejuvenation of traumatic scars with comparable clinical effects. Fractional CO2 laser is more powerful in stimulating neocollagenesis. Automated microneedling is effective for treatment of hypertrophic scars.
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Affiliation(s)
- Samia Esmat
- Department of Dermatology, Kasr Al Ainy Teaching Hospital, Cairo University, Cairo, Egypt
| | - Hisham Ali Shokeir
- Department of Medical Applications of Laser, National Institute of Laser Enhanced Sciences, Cairo University, Cairo, Egypt
| | - Nevien Ahmed Samy
- Department of Medical Applications of Laser, National Institute of Laser Enhanced Sciences, Cairo University, Cairo, Egypt
| | - Sara Bahaa Mahmoud
- Department of Dermatology, Kasr Al Ainy Teaching Hospital, Cairo University, Cairo, Egypt
| | - Safinaz Salah El Din Sayed
- Department of Histology, Cairo University, Cairo, Egypt; Department of Dermatology, Students' Hospital, Cairo University, Cairo, Egypt
| | - Enas Shaker
- Department of Histology, Cairo University, Cairo, Egypt; Department of Dermatology, Students' Hospital, Cairo University, Cairo, Egypt
| | - Rana Fathy Hilal
- Department of Dermatology, Kasr Al Ainy Teaching Hospital, Cairo University, Cairo, Egypt
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Ziaeifar E, Ziaeifar F, Mozafarpoor S, Goodarzi A. Applications of microneedling for various dermatologic indications with a special focus on pigmentary disorders: A comprehensive review study. Dermatol Ther 2021; 34:e15159. [PMID: 34657363 DOI: 10.1111/dth.15159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/09/2021] [Accepted: 10/13/2021] [Indexed: 11/30/2022]
Abstract
Microneedling can accelerate skin repair through numerous complex processes triggered by micro-injuries it produces on the skin surface with very thin needles. The current growth in the application of microneedling in the treatment of cutaneous diseases can be explained by its numerous effects on the skin as reported in the literature. Despite the numerous studies conducted on the application of microneedling in the treatment of skin lesions, its effects on pigmented skin lesions have remained relatively unexplored. The present review comprises an examination of the evidence for the application of microneedling in skin diseases in general and a comprehensive review of the applications of microneedling in pigmentation disorders. The review involved a search of all clinical studies, including trials, case reports, and case series, in the databases MEDLINE/PubMed and Google Scholar using the following keywords: "microneedling," "dermal needling," "percutaneous collagen induction," "skin needling," "dermaroller," and "dermatology disorder." Pertinent data were extracted from all relevant articles published from 1990 to April 2021, and focused on the application of microneedling in the treatment of pigmented skin lesions. Despite the limited number of available studies, evidence suggests the effectiveness and safety of microneedling in treating vitiligo, melasma, and periorbital hypermelanosis. It is noteworthy that the combination of any type of non-aggressive needing technique with other effective therapies (especially topical agents and mesotherapy) yields more promising therapeutic results than single therapy for melasma, dark cycles, and vitiligo as the prototype of pigmentary disorders. However, single needling therapy is significantly effective, too.
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Affiliation(s)
- Elham Ziaeifar
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine، Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Fatemeh Ziaeifar
- Department of General Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Samaneh Mozafarpoor
- Department of Dermatology, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine، Iran University of Medical Sciences (IUMS), Tehran, Iran
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Bosamiya SS, Jain SM. A Pilot Study to Compare Therapeutic Efficacy and Safety of Combined Treatment of Skin Microneedling and Depigmenting Cream versus Depigmenting Cream Alone in Facial Melasma at Tertiary Care Center. J Cutan Aesthet Surg 2021; 14:156-159. [PMID: 34566356 PMCID: PMC8423208 DOI: 10.4103/jcas.jcas_182_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Melasma is a commonly acquired, chronic, and relapsing disorder that results in symmetrical, brownish facial pigmentation. It is more common in women than in men, which generally starts between 20 and 40 years of age, and it can lead to considerable embarrassment and distress. Managing melasma is a difficult challenge that requires long-term treatment with a number of topical agents. Microneedling has been described as a new technique to enhance the drug’s transdermal penetration, and has also been reported to result in sustained long-term improvement of recalcitrant melasma. Aim: The aim of this article was to compare the therapeutic efficacy and safety of combined treatment of skin microneedling and depigmenting cream versus depigmenting cream alone in the treatment of melasma. Materials and Methods: A prospective study was conducted with a sample size of 40 patients, with twenty in each of the treatment arms; 20 patients were treated with combined skin needling and depigmenting cream and 20 with depigmenting cream alone. The outcome was evaluated periodically for up to 2 months using the modified Melasma Area and Severity Index (MASI) score. Results: Significant reduction was observed in modified MASI score in the combined treatment, with P value <0.05. Conclusion: Combining microneedling with Kligman’s regimen gives better results in melasma treatment compared to topical treatment alone.
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Affiliation(s)
- Sanjay S Bosamiya
- Department of Dermatology, Venereology, and Leprosy, Surat Municipal Institute of Medical Education and Research (SMIMER), Surat, Gujarat, India
| | - Sonal M Jain
- Department of Dermatology, Venereology, and Leprosy, Surat Municipal Institute of Medical Education and Research (SMIMER), Surat, Gujarat, India
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Nandini AS, Sankey SM, Sowmya CS, Sharath Kumar BC. Split-face Comparative Study of Efficacy of Platelet-rich Plasma Combined with Microneedling versus Microneedling alone in Treatment of Post-acne Scars. J Cutan Aesthet Surg 2021; 14:26-31. [PMID: 34084005 PMCID: PMC8149994 DOI: 10.4103/jcas.jcas_160_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Context: Skin conditions contribute substantial burden toward global morbidity and mortality. Acne vulgaris, with its rising prevalence, has become a cause of concern among researchers as well as dermatologists due to scarring. Aims: The aim of this study was to compare the efficacy of microneedling alone versus microneedling combined with platelet-rich plasma (PRP) in post-acne scars using a split-face method. Materials and Methods: Thirty patients with atrophic post-acne facial scars were offered four sittings of treatment monthly once. As a standard protocol, the right side of the face was subjected to microneedling with PRP (Group A) and the left side of the face with microneedling alone (Group B). Objective evaluation of improvement was performed by the physician recording the acne scar assessment score at baseline and thereafter at every visit using Goodman and Baron scale. Alongside patients also graded the improvement in acne scars at the end of the study. Statistical Analysis Used: The collected information was entered in MS Excel (Bellevue, WA, USA) and analyzed using appropriate statistical methods with Statistical Package for the Social Sciences software (IBM Corp., Armonk, NY). The significance of the outcomes of the study was assessed by calculating the P value and the value of P < 0.05 was considered statistically significant. Results: The mean age of patients was 25 years. Thirteen (43%) patients in Group A had an excellent response as compared to 6 (20%) patients in Group B according to physician assessment. Patient’s satisfaction was more in Group A as compared to Group B as 11 (36%) patients had more than 75% improvement in Group A as compared to 1 (3%) patient in Group B. Conclusion: The study showed a decrease in scar severity grade in all the patients enrolled for treatment. However, the combined use of microneedling and PRP was found to be more effective than a single method used for treatment of acne scars.
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Affiliation(s)
- A S Nandini
- Department of Dermatology, Venereology, and Leprosy, Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bengaluru, Karnataka, India
| | - Sana M Sankey
- Department of Dermatology, Venereology, and Leprosy, Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bengaluru, Karnataka, India
| | - C S Sowmya
- Department of Dermatology, Venereology, and Leprosy, Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bengaluru, Karnataka, India
| | - B C Sharath Kumar
- Department of Dermatology, Venereology, and Leprosy, Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bengaluru, Karnataka, India
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Bailey AJM, Li HOY, Tan MG, Cheng W, Dover JS. Microneedling as an adjuvant to topical therapies for melasma: A systematic review and meta-analysis. J Am Acad Dermatol 2021; 86:797-810. [PMID: 33857549 DOI: 10.1016/j.jaad.2021.03.116] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 03/12/2021] [Accepted: 03/26/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Microneedling as an adjuvant to topical medications has shown promising but variable results in the treatment of melasma. OBJECTIVE To conduct a systematic review and meta-analysis on the efficacy of microneedling as an adjuvant to topical therapies for the treatment of melasma. METHODS This study followed PRISMA guidelines. All comparative, prospective studies on the use of topical interventions with microneedling for the treatment of melasma were included. Studies involving radiofrequency microneedling were excluded. RESULTS Twelve eligible studies comprising 459 patients from 7 different countries were included. Topical therapies included topical tranexamic acid, vitamin C, platelet-rich plasma, non-hydroquinone-based depigmentation serums, and hydroquinone-based depigmenting agents. Topical therapy with microneedling improved melasma severity with a large effect (standardized mean difference >0.8) beyond 8 weeks, with best results seen at 12 weeks. Compared to topical therapy alone, topical therapy with microneedling resulted in an additional improvement in melasma severity with a moderate effect at 8 weeks and a large effect at 12-16 weeks. Microneedling was well tolerated across studies, with no serious adverse events reported. LIMITATIONS Heterogeneity in study designs did not allow for a comparison of the efficacy of various topical therapies with microneedling. CONCLUSION Microneedling is useful adjuvant to topical therapies for the treatment of melasma.
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Affiliation(s)
| | - Heidi Oi-Yee Li
- Faculty of Medicine, The University of Ottawa, Ottawa, Ontario, Canada
| | - Marcus G Tan
- Faculty of Medicine, The University of Ottawa, Ottawa, Ontario, Canada; Division of Dermatology, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Wei Cheng
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Jeffrey S Dover
- SkinCare Physicians, Chestnut Hill, Massachusetts; Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut; Brown Medical School, Providence, Rhode Island.
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18
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Adotama P, Papac N, Alexis A, Wysong A, Collins L. Common Dermatologic Procedures and the Associated Complications Unique to Skin of Color. Dermatol Surg 2021; 47:355-359. [PMID: 34328287 DOI: 10.1097/dss.0000000000002813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The skin of color (SOC) population in the United States continues to grow, and these patients are undergoing various cosmetic and surgical procedures at increasing rates. There is a paucity of data on the potential complications associated with surgical and cosmetic procedures in this patient population. OBJECTIVE We aim to educate dermatologic surgeons and clinicians on surgical and cosmetic procedures in patients of color and increase awareness of the potential complications unique to this patient population. MATERIALS AND METHODS A thorough PubMed literature search was performed to conduct this review. RESULTS There are a number of complications in SOC that require special attention, including keloids, postoperative infections, postinflammatory hyperpigmentation, and hypopigmentation. There are also various precautions to consider when performing cosmetic procedures, such as neurotoxin and filler injections, laser therapy, microneedling, and chemical peels. CONCLUSION Dermatologists should be aware of the potential cosmetic and surgical complications of this growing patient population to provide optimal evidence-based medical care.
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Affiliation(s)
- Prince Adotama
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Nicole Papac
- Department of Dermatology, University of Oklahoma Health Sciences Center, College of Medicine, Oklahoma City, Oklahoma
| | - Andrew Alexis
- Department of Dermatology, Icahn School of Medicine, New York, New York
| | - Ashley Wysong
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Lindsey Collins
- Department of Dermatology, University of Oklahoma Health Sciences Center, College of Medicine, Oklahoma City, Oklahoma
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19
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Sitohang IBS, Sirait SAP, Suryanegara J. Microneedling in the treatment of atrophic scars: A systematic review of randomised controlled trials. Int Wound J 2021; 18:577-585. [PMID: 33538106 PMCID: PMC8450803 DOI: 10.1111/iwj.13559] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 12/04/2022] Open
Abstract
To date, treatment of atrophic acne scars remains a therapeutic challenge for dermatologists, yet there is no standard option on the most effective treatment. Microneedling (MN) is a minimally invasive technology that involves repetitive skin puncture using sterile microneedles to disrupt dermal collagen that connects the scar tissue. Recent studies have demonstrated the potency of MN, such as dermaroller and fractionated microneedle radiofrequency, in the treatment of atrophic scars. The objective of this review is to evaluate systematically the current literature on MN for atrophic acne scars. A systematic search of literature was performed from PubMed, Medline, Cochrane Central, and Google Scholar databases for articles published during the last 20 years. Only randomised controlled trials (RCTs) with full‐text version of the manuscript available were included in our study. Nine RCTs were included in this review. All treatment modalities demonstrated consistent results that MN was efficacious in treating atrophic acne scars as a monotherapy or in combination with other treatments. Moreover, no serious adverse effects were reported in all studies after MN treatment. MN is a well‐tolerated and effective therapeutic modality in treating atrophic acne scars. Further research is required to validate the efficacy of MN with a larger sample size and lengthy follow‐up.
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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
| | - Sondang Aemilia Pandjaitan Sirait
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Jose Suryanegara
- Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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20
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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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21
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Samizadeh S, Belhaouari L. Effectiveness of growth factor-induced therapy for skin rejuvenation: A case series. J Cosmet Dermatol 2020; 20:1867-1874. [PMID: 33025713 DOI: 10.1111/jocd.13750] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 09/15/2020] [Accepted: 09/24/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Microneedling in combination with the use of growth factors can help with a range of indications, including skin rejuvenation. There is an increase in request for safe minimally invasive procedures with no-to-minimal downtime. This procedure offers regeneration and is becoming popular as part of the regenerative, minimally invasive era. AIMS To examine the efficacy of a course of two sessions of growth factor-induced therapy using propriety preparation of AQ recovery serum. METHODS Thirty women with various ethnic backgrounds (Chinese, Caucasian and Latino) with an average age of 38 years old participated and mild-moderate visual facial aging signs Two sessions with 2-week intervals were completed using a derma stamp (transdermal drug delivery method) and 2 mL of growth factor serum (AQ Skin Solution recovery serum-contain a mixture of contains a mix of transforming growth factor beta (TGF-β), granulocyte monocyte-colony-stimulating factor, and platelets-derived growth factor with patented technology for extraction and composition at each session. The procedures were carried out for anti-aging and skin rejuvenation. Clinical assessment, VISIA photography, independent assessment of before and after photographs baseline and six weeks by two clinicians and two laypersons were carried out. The participants used FACE-Q questionnaire (outcome satisfaction) and scored changes in terms of their skin texture, radiance, pore size, wrinkles, pigmentation, tightness and overall skin appearance. RESULTS Physician's global assessment revealed growth factor-induced therapy resulted in skin rejuvenation in all races with 95% confidence, and this increased to 98% confidence for Latinos and Caucasians within the six weeks. Participants' subjective rating revealed improvement of overall skin appearance with 95% confidence. Most noted improvements were in brightness, skin texture, and tightness. CONCLUSION This study revealed improvement in overall skin appearance, brightness, skin texture, and tightness. The treatment is non-invasive, safe, with no or minimal downtime and resulted in high participant satisfaction.
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Affiliation(s)
- Souphiyeh Samizadeh
- Great British Academy of Aesthetic Medicine, London, UK.,University College London, London, UK.,Visiting Clinical Teacher, King's College London, London, UK
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22
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A Systematic Review of the Efficacy and Safety of Microneedling in the Treatment of Melasma. Dermatol Surg 2020; 46:1636-1641. [DOI: 10.1097/dss.0000000000002763] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Karadağ Köse Ö, Borlu M. Efficacy of the combination of Q-switched Nd:YAG laser and microneedling for melasma. J Cosmet Dermatol 2020; 20:769-775. [PMID: 32696614 DOI: 10.1111/jocd.13629] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/03/2020] [Accepted: 07/15/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Melasma is a common, multifactorial, and recurring disease which is not easy to treat. AIMS The purpose of this study is to evaluate the efficacy of microneedling in combination with Q-switched neodymium-doped yttrium aluminum garnet laser (QsNd-YAG laser) for treatment of melasma. PATIENTS/METHODS Fifteen female patients with epidermal or mixed-type melasma on the face were included in the study. Patients were first treated with QsNd-YAG laser, and then with microneedling containing mesotherapy products of biomimetic peptides, at the same session. Modified Melasma Area Severity Index (mMASI) scores were calculated before the first session and again 2 weeks after the last session. The same treatment protocol was repeated every 2 weeks for five sessions within period of 3 months of therapy. The evaluation was performed according to the before and after photographs taken from three angles including 90-degree front and 45 degrees from left and right with the VISIA device. RESULTS Of the 15 patients included in the study, the mean mMASI scores before and after treatment were 9.2 ± 5.7 (3.8-23.1) and 3.6 ± 4.0 (0.6-16.8), respectively. mMASI scores were significantly reduced after completion of the protocol. Six (40%) patients had "very good response," 4 (26.7%) patients had "good response," and 5 (33.3%) patients were "unresponsive." Six (40%) patients were followed up for 1 year, and only 1 patient had a recurrence (6.7%). CONCLUSIONS In addition to the use of photoprotective measures, multimodality treatment including QsNd-YAG laser and microneedling with mesotherapy products containing biomimetic peptides is effective to treat melasma and they work synergistically.
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Affiliation(s)
- Özlem Karadağ Köse
- Department of Dermatology and Venereology, Saltat Policlinic, İstanbul, Turkey
| | - Murat Borlu
- Department of Dermatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
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Madu PN, Syder N, Elbuluk N. Postinflammatory hypopigmentation: a comprehensive review of treatments. J DERMATOL TREAT 2020; 33:704-708. [DOI: 10.1080/09546634.2020.1793892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Pamela N. Madu
- USC Department of Dermatology, Keck School of Medicine, Los Angeles, CA, USA
| | - Nicole Syder
- USC Department of Dermatology, Keck School of Medicine, Los Angeles, CA, USA
| | - Nada Elbuluk
- USC Department of Dermatology, Keck School of Medicine, Los Angeles, CA, USA
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Microneedling with autologous platelet-rich plasma versus microneedling with topical insulin in the treatment of postacne atrophic scars: A simultaneous split-face comparative study. J Am Acad Dermatol 2020; 84:810-811. [PMID: 32540414 DOI: 10.1016/j.jaad.2020.05.152] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/27/2020] [Accepted: 05/30/2020] [Indexed: 11/20/2022]
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27
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Shamsi Meymandi S, Mozayyeni A, Shamsi Meymandi M, Aflatoonian M. Efficacy of microneedling plus topical 4% tranexamic acid solution vs 4% hydroquinone in the treatment of melasma: A single-blind randomized clinical trial. J Cosmet Dermatol 2020; 19:2906-2911. [PMID: 32406162 DOI: 10.1111/jocd.13392] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 01/11/2020] [Accepted: 02/24/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND There are various treatment modalities for melasma, but none of them are effective on dermal component of melasma. AIMS In this study, we decided to evaluate the efficacy of microneedling plus tranexamic acid in comparison with 4% hydroquinone in the treatment of melasma. METHODS This is a single-blind randomized clinical trial on 70 participants with 14% dropout, and therefore, 60 patients with melasma completed the study. Patients were randomized based on simple randomization in 2 groups of A (microneedling plus topical 4% tranexamic acid, monthly) and B (topical 4% hydroquinone, nightly). Evaluation of mean MASI score, patient and physician assessments was performed at 4th, 8th and12th weeks of the treatment. Statistical analysis was performed by paired t test, chi-square test and Fisher's exact test, respectively. RESULTS Sixty women (30 patients in each group) were completed the study. Mean MASI score in group A was significantly lower at the end of the treatment (6.84 ± 4.31) than at the baseline (12.89 ± 5.16) (P < .01). Mean MASI score in group B was significantly lower at the end of the treatment (7.16 ± 4.38) than at the baseline (13.56 ± 4.88) (P < .01). There was no statistical difference between 2 groups regarding MASI score, physician and patient assessments during the treatment. Percentage of patient satisfaction was significantly higher than physician satisfaction in both treatment groups (P < .01). CONCLUSION In our study, the combination of microneedling with tranexamic acid did not differ from 4% hydroquinone in the treatment of melasma.
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Affiliation(s)
- Simin Shamsi Meymandi
- Pathology and Stem Cell Research Center, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | | | | | - Mahin Aflatoonian
- Pathology and Stem Cell Research Center, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
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Abstract
BACKGROUND Melasma is an acquired, chronic pigmentary disorder predominantly affecting women. It may significantly affect quality of life and self-esteem due to its disfiguring appearance. Multiple treatments for melasma are available, with mixed results. OBJECTIVE The aim of this article was to conduct an evidence-based review of all available interventions for melasma. METHODS A systematic literature search of the PubMed electronic database was performed using the keywords 'melasma' and/or 'chloasma' in the title, through October 2018. The search was then limited to 'randomized controlled trial' and 'controlled clinical trial' in English-language journals. The Cochrane database was also searched for systematic reviews. RESULTS The electronic search yielded a total of 212 citations. Overall, 113 studies met the inclusion criteria and were included in this review, with a total of 6897 participants. Interventions included topical agents, chemical peels, laser- and light-based devices, and oral agents. Triple combination cream (hydroquinone, tretinoin, and corticosteroid) remains the most effective treatment for melasma, as well as hydroquinone alone. Chemical peels and laser- and light-based devices have mixed results. Oral tranexamic acid is a promising new treatment for moderate and severe recurrent melasma. Adverse events from all treatments tend to be mild, and mainly consist of skin irritation, dryness, burning, erythema, and post-inflammatory hyperpigmentation. CONCLUSIONS Hydroquinone monotherapy and triple combination cream are the most effective and well-studied treatments for melasma, whereas chemical peels and laser- and light-based therapies are equal or inferior to topicals, but offer a higher risk of adverse effects. Oral tranexamic acid may be a safe, systemic adjunctive treatment for melasma, but more studies are needed to determine its long-term safety and efficacy. Limitations of the current evidence are heterogeneity of study design, small sample size, and lack of long-term follow-up, highlighting the need for larger, more rigorous studies in the treatment of this recalcitrant disorder.
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Affiliation(s)
- Jacqueline McKesey
- Department of Dermatology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9190, USA
| | | | - Amit G Pandya
- Department of Dermatology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9190, USA.
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29
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Farshi S, Mansouri P. Study of efficacy of microneedling and mesoneedling in the treatment of epidermal melasma: A pilot trial. J Cosmet Dermatol 2020; 19:1093-1098. [DOI: 10.1111/jocd.13369] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/06/2020] [Accepted: 02/24/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Susan Farshi
- Tehran University of Medical Sciences Tehran Iran
| | - Parvin Mansouri
- Skin and Stem Cell Research Center Tehran University of Medical Sciences Tehran Iran
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Menon A, Eram H, Kamath PR, Goel S, Babu AM. A Split Face Comparative Study of Safety and Efficacy of Microneedling with Tranexamic Acid versus Microneedling with Vitamin C in the Treatment of Melasma. Indian Dermatol Online J 2020; 11:41-45. [PMID: 32055507 PMCID: PMC7001392 DOI: 10.4103/idoj.idoj_22_19] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction Melasma is a common pigmentary disorder affecting the face. Although a few risk factors have been identified, the exact pathogenesis remains elusive. Many treatment modalities have been tried, but none have been completely successful. Aim To compare safety and efficacy of microneedling with Tranexamic acid versus microneedling with Vitamin C in the treatment of melasma. Materials and Methods It was a split face, comparative study conducted on 30 female melasma patients. After obtaining informed consent, microneedling with Tranexamic acid was done on left side and microneedling with Vitamin C was done on right side of face. The improvement was evaluated on the basis of clinical photographs, MASI, Physician Global Assessment (PGA) and Patient Global Assessment (PtGA) at each visit (0, 4 and 8 weeks). Z test was used to test the significant difference in the means of the 2 groups at 4 weeks and at 8 weeks. Results At the end of 8 weeks, MASI, PGA and PtGA showed improvement with both tranexamic acid and vitamin C. However the improvement was more with tranexamic acid than with vitamin C, although not statistically significant. Conclusion Both TXA and Vitamin C are effective and safe treatments for melasma. But, TXA was found to be more effective.
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Affiliation(s)
- Ashok Menon
- Department of Dermatology, Venerology and Leprosy, A.J Institute of Medical Sciences, Mangalore, Karnataka, India
| | - Hafsa Eram
- Department of Dermatology, Venerology and Leprosy, A.J Institute of Medical Sciences, Mangalore, Karnataka, India
| | - Prashanth R Kamath
- Department of Dermatology, Venerology and Leprosy, A.J Institute of Medical Sciences, Mangalore, Karnataka, India
| | - Saumya Goel
- Department of Dermatology, Venerology and Leprosy, A.J Institute of Medical Sciences, Mangalore, Karnataka, India
| | - Amita Murali Babu
- Department of Dermatology, Venerology and Leprosy, A.J Institute of Medical Sciences, Mangalore, Karnataka, India
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Ebrahim HM, Elkot R, Albalate W. Combined microneedling with tacrolimus vs tacrolimus monotherapy for vitiligo treatment. J DERMATOL TREAT 2020; 32:999-1004. [PMID: 32041441 DOI: 10.1080/09546634.2020.1716930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background: Miconeedling has been used to augment the transdermal drug delivery. Combination modalities may accelerate and improve the repigmentation in vitiligo.Objective: To determine the efficacy and tolerability of combined microneedling with tacrolimus vs tacrolimus 0.1% ointment for the treatment of vitiligo.Patients and Method: Forty-eight patients with vitiligo were randomized into two groups: group I applied tacrolimus once daily for 6 months. Group II received microneedling with topical tacrolimus at 2 weeks intervals for a maximum of 6 months. The assessment was based on the clinical improvement and immunohistochemical changes. Skin biopsies were taken at baseline and after the treatment for c-kit + expression.Results: After treatment, the repigmentation >75% was observed in 50% of the patients in group II compared to 29.2% in group I (p .02). There was an earlier response in group II than in group I (p .002). The improvement was significantly higher in the legs and extremities in group II than in group I (0.003). The immunohistochemical results showed significantly higher expression of c-kit in group II than group I (p .01). No severe side effects were reported.Conclusion: The results suggest the superiority of the combination regimen (tacrolimus and microneedling) for vitiligo treatment.
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Affiliation(s)
- Howyda M Ebrahim
- Department of Dermatology, venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Reham Elkot
- Department of Dermatology, venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Waleed Albalate
- Department of Dermatology, venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Afra TP, Razmi T M, Narang T, Dogra S, Kumar A. Topical Tazarotene Gel, 0.1%, as a Novel Treatment Approach for Atrophic Postacne Scars: A Randomized Active-Controlled Clinical Trial. JAMA FACIAL PLAST SU 2020; 21:125-132. [PMID: 30452511 DOI: 10.1001/jamafacial.2018.1404] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance Evidence is robust for the effectiveness of microneedle therapy in the management of postacne atrophic scarring. A home-based topical treatment with an efficacy comparable to microneedling would be a useful addition in the armamentarium of acne scar management. Objective To compare the efficacy of topical tazarotene gel, 0.1%, with microneedling therapy in the management of moderate to severe atrophic acne scars. Design, Setting, and Participants Prospective, observer-blinded, active-controlled, randomized clinical trial with 6 months of follow-up conducted between June 2, 2017, and February 28, 2018, at a tertiary care hospital in India. Thirty-six patients with grade 2 to 4 facial atrophic postacne scars and without a history of procedural treatment of acne scars within the previous year were recruited. Analyses were conducted using data from the evaluable population. Interventions Both halves of each participant's face were randomized to receive either microneedling or topical tazarotene therapy. Microneedling was conducted on 1 side of the face with a dermaroller having a needle length of 1.5 mm for a total of 4 sessions during the course of 3 months. Participants were instructed to apply topical tazarotene gel, 0.1%, to the other side of the face once every night during this same period. Main Outcomes and Measures Patients were followed up at 3 and 6 months by a blinded observer, and improvements in acne scar severity based on Goodman and Baron quantitative and qualitative scores and a subjective independent dermatologist score (range, 0-10, with higher scores indicating better improvement) were assessed. Patient satisfaction was assessed using a patient global assessment score (ranging from 0 for no response to 10 for maximum improvement) at these follow-up visits. Results There were 36 participants (13 men and 23 women; mean [range] age, 23.4 [18-30] years), and the median (interquartile range [IQR]) duration of acne was 6 (4-8) years. For the 34 participants included in the complete data analyses, the median (IQR) quantitative score for acne scar severity at the 6-month follow-up visit following treatment with either tazarotene (from a baseline of 8.0 [6.0-9.8] to 5.0 [3.0-6.0]) or microneedling (from a baseline of 7.0 [6.0-10.8] to 4.5 [3.0-6.0]) indicated significant improvement (P < .001) that was comparable for both treatments (median [IQR] change in severity score from baseline, 2.5 [2.0-4.0] vs 3.0 [2.0-4.0]; P = .42). By contrast, median qualitative acne scar scores were the same for both treatment groups at baseline and did not significantly change following either treatment. Conclusions and Relevance The present clinical trial showed comparable outcomes of both treatments for the overall improvement of quantitative facial acne scar severity. Level of Evidence 1. Trial Registration ClinicalTrials.gov identifier: NCT03170596.
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Affiliation(s)
- T P Afra
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Muhammed Razmi T
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tarun Narang
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Dogra
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashok Kumar
- National Institute of Nursing Education, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Alster TS, Li MKY. Microneedling of Scars: A Large Prospective Study with Long-Term Follow-Up. Plast Reconstr Surg 2020; 145:358-364. [DOI: 10.1097/prs.0000000000006462] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ali R, Mehta P, Arshad MS, Kucuk I, Chang MW, Ahmad Z. Transdermal Microneedles-A Materials Perspective. AAPS PharmSciTech 2019; 21:12. [PMID: 31807980 DOI: 10.1208/s12249-019-1560-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/06/2019] [Indexed: 12/17/2022] Open
Abstract
Transdermal drug delivery is an emerging field in the pharmaceutical remit compared with conventional methods (oral and parenteral). Microneedle (MN)-based devices have gained significant interest as a strategy to overcome the skin's formidable barrier: the stratum corneum. This approach provides a less invasive, more efficient, patient friendly method of drug delivery with the ability to incorporate various therapeutic agents including macromolecules (proteins and peptides), anti-cancer agents and other hydrophilic and hydrophobic compounds. This short review attempts to assess the various materials involved in the fabrication of MNs as well as incorporation of other excipients to improve drug delivery for novel medical devices. The focus will be on polymers, metals and other inorganic materials utilised for MN drug delivery, as well as their application, limitations and future work to be carried out.
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Bulbul Baskan E, Akin Belli A. Evaluation of the efficacy of microneedle fractional radiofrequency in Turkish patients with atrophic facial acne scars. J Cosmet Dermatol 2019; 18:1317-1321. [PMID: 30417509 DOI: 10.1111/jocd.12812] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 10/10/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Scarring is an undesirable and severe complication of acne resulting in loss of self-esteem in young people. Although microneedle fractional radiofrequency (MFR) system has emerged as a good option to treat acne scars in recent years, it was examined in a few studies which were commonly from Asian countries. AIMS We sought to evaluate the efficacy of MFR in Turkish patients with facial acne scars. METHODS Nine patients with atrophic facial acne scars treated with MFR device were included in the study. The number of treatment sessions was varied from one to five (median three) with 4-week intervals. Demographic and basal clinical features were recorded. Efficacy of the device was evaluated by the physicians' global assessment and patients' self-assessment scales 4 weeks after the last treatment session. RESULTS Of nine patients, two were male and seven were female (mean age, 31.33 years). Two patients had mild, four had moderate, and three had severe facial acne scars. Mean acne scar age was 13.22 ± 8.79 years. According to the predominant scar subtype, three patients had V-shaped, three had U-shaped, and three had M-shaped atrophic acne scars. A clinical improvement of >25% has been reported in seven patients (77.7%) and eight patients (88.9%) by the physicians and patients, respectively. U-shaped atrophic acne scars responded better to the treatment than the other types, as statistically nonsignificant. There were no severe side effects. CONCLUSIONS Microneedle fractional radiofrequency system showed a quite good efficacy and safety in the treatment of atrophic facial acne scars (Department of Dermato-Cosmetology, Uludag University Medical School).
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Affiliation(s)
- Emel Bulbul Baskan
- Department of Dermatology, Uludag University Medical School, Bursa, Turkey
| | - Asli Akin Belli
- Department of Dermatology, Mugla Sitki Kocman University Training and Research Hospital, Mugla, Turkey
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Ismail ESA, Patsatsi A, Abd El-Maged WM, Nada EEDAEA. Efficacy of microneedling with topical vitamin C in the treatment of melasma. J Cosmet Dermatol 2019; 18:1342-1347. [PMID: 30770637 DOI: 10.1111/jocd.12878] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 12/01/2018] [Accepted: 01/03/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Despite the wide therapeutic options available for the treatment of melasma, including many active topical medications, technologies with lights and peelings, clinical control of this disorder is extremely challenging. OBJECTIVES To evaluate the effect of microneedling with topical vitamin C in the treatment of melasma. METHODS Thirty female patients with melasma received six sessions of microneedling with addition of topical vitamin C every two weeks. At each session, photos were taken and Melasma Area and Severity Index (MASI) score was calculated to assess the clinical improvement. RESULTS Mean age of the eligible patients was 33.2 ± 5.77 years. About 50% of cases were of Fitzpatrick skin type III. All patients showed improvement at the end of the sessions. Mean MASI score in the first session was 8.61 ± 4.45 and there was a gradual decline in its value till it reached a mean of 5.75 ± 4.16 in the last session (P < 0.0001). CONCLUSION Microneedling with topical vitamin C is an effective and safe treatment option for epidermal melasma especially in Fitzpatrick skin phototypes I-III.
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Affiliation(s)
- Esraa Salah Ali Ismail
- Faculty of Medicine, Department of Dermatology, Sohag University, Sohag University Hospital, Sohag, Egypt
| | - Aikaterini Patsatsi
- Faculty of Medicine, 2nd Department of Dermatology, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
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Attwa EM, Khashaba SA, Ezzat NA. Evaluation of the additional effect of topical 5‐fluorouracil to needling in the treatment of localized vitiligo. J Cosmet Dermatol 2019; 19:1473-1478. [DOI: 10.1111/jocd.13152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 07/24/2019] [Accepted: 08/27/2019] [Indexed: 01/24/2023]
Affiliation(s)
- Enayat Mohamed Attwa
- Dermatology, Venereology and Andrology Department Faculty of Medicine Zagazig University Zagazig Egypt
| | - Shrook A. Khashaba
- Dermatology, Venereology and Andrology Department Faculty of Medicine Zagazig University Zagazig Egypt
| | - Nehal Anwar Ezzat
- Dermatology, Venereology and Andrology Department Faculty of Medicine Zagazig University Zagazig Egypt
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Dai Y, Chuang Y, Chen P, Chen C. Efficacy and Safety of Ablative Resurfacing With A High‐Energy 1,064 Nd‐YAG Picosecond‐domain Laser for the Treatment of Facial Acne Scars in Asians. Lasers Surg Med 2019; 52:389-395. [DOI: 10.1002/lsm.23151] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Ying‐Xiu Dai
- Department of DermatologyTaipei Veterans General HospitalTaipei 11221 Taiwan
- Department of Dermatology, School of MedicineNational Yang‐Ming UniversityTaipei 11221 Taiwan
| | | | - Po‐Yu Chen
- Department of DermatologyTaipei Veterans General HospitalTaipei 11221 Taiwan
| | - Chih‐Chiang Chen
- Department of DermatologyTaipei Veterans General HospitalTaipei 11221 Taiwan
- Department of Dermatology, School of MedicineNational Yang‐Ming UniversityTaipei 11221 Taiwan
- Institute of Clinical MedicineNational Yang‐Ming UniversityTaipei 11221 Taiwan
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Sasaki GH. The Significance of Trans-Epidermal Water Loss After Microneedling and Microneedling-Radiofrequency Procedures: Histological and IRB-Approved Safety Study. Aesthet Surg J Open Forum 2019; 1:ojz017. [PMID: 33791612 PMCID: PMC7671250 DOI: 10.1093/asjof/ojz017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Microneedling (MN) and microneedling-radiofrequency (MN-RF) result in skin rejuvenation and skin exposure to pathogens. Objectives The aim was to determine histopathological changes of needle-depth injuries in preauricular skin and measure time-dependent repair of transepidermal water loss (TEWL) in subjects. Methods MN and MN-RF procedures were performed at 0.5- and 1.5-mm needle depths on preauricular skin strips from a facelift patient. In 10 subjects, MN and MN-RF procedures were performed at 0.5-mm needle lengths on 6 marked opposing face and body sites. MN and MN-RF at 1.5-mm needle lengths were also carried out on each subject’s midface skin lateral to the nasolabial fold. TEWL measurements were recorded with a calibrated DermaLab Cortex device (Hadsund, Denmark). Results Histological examination confirmed that the penetration depths of microchannels closely approximated the 0.5- or 1.5-mm needle lengths. In addition, MN-RF exhibited zones of coagulation injury at the distal end of the channel. After MN or MN-RF at 0.5-mm needle length, TEWL values were greatest immediately after needling to scalp, midface, neck, chest, arm, and thigh sites and remained slightly higher than baseline throughout the 48-h evaluation period. TEWL measurements after MN or MN-RF at 1.5-mm needle length resulted in the highest- and longest-lasting values throughout the 2-day observation period. Conclusions MN and MN-RF devices are novel devices that require further investigation into optimal treatment parameters and protocols, patient selection, and protection against intrusion of external pathogens and reactive cosmeceutical ingredients with barrier repair. Level of Evidence: 2
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Affiliation(s)
- Gordon H Sasaki
- Department of Plastic Surgery, Loma Linda Medical University, Loma Linda, CA
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Expanding the applications of microneedles in dermatology. Eur J Pharm Biopharm 2019; 140:121-140. [DOI: 10.1016/j.ejpb.2019.05.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/30/2019] [Accepted: 05/02/2019] [Indexed: 12/14/2022]
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Jung JW, Kim WO, Jung HR, Kim SA, Ryoo YW. A Face-Split Study to Evaluate the Effects of Microneedle Radiofrequency with Q-Switched Nd:YAG Laser for the Treatment of Melasma. Ann Dermatol 2019; 31:133-138. [PMID: 33911561 PMCID: PMC7992684 DOI: 10.5021/ad.2019.31.2.133] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 05/26/2018] [Accepted: 08/30/2018] [Indexed: 12/18/2022] Open
Abstract
Background Laser toning using a low-fluence 1,064 nm Q-switched Nd:YAG laser is one of the most frequently used treatment modalities for melasma. However, this therapy is time consuming because it requires a lot of treatment sessions. Recently, it has been reported that transdermal radiofrequency (RF) is effective for the treatment of melasma. Objective To determine whether microneedle RF conduction could be an adjunct therapy for melasma, we have studied the effect of simultaneous treatments with laser toning and RF for melasma. Methods Fifteen patients with melasma underwent five sessions of laser toning and microneedle RF on the right side of the face, and only laser toning on the left side. Responses to treatments were evaluated using the Mexameter® (Courage Khazaka, Germany) score, the pigmentation and severity index (PSI) score, and the patient's overall assessment. Additionally, an electron microscopic study of a skin biopsy was performed. Results Both laser toning and combination therapy showed significant decreases in the Mexameter® and PSI score after five treatment sessions. Combination therapy showed a more significant improvement of melasma than laser toning. No remarkable side effects were reported. Electron microscopic analysis showed a greater number of vacuolar changes and increased loosening of melanocytes and adjacent epidermal cells after combination therapy. Conclusion The combination treatment of laser toning and microneedle RF therapy showed a better therapeutic effect for melasma than laser toning alone. Therefore, the microneedle RF technique could be a new and safe adjunct therapy for the treatment of melasma.
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Affiliation(s)
- Jin Woong Jung
- Department of Dermatology, Keimyung University School of Medicine, Daegu, Korea
| | - Won Oh Kim
- Department of Dermatology, Keimyung University School of Medicine, Daegu, Korea
| | - Hae Ra Jung
- Department of Pathology, Keimyung University School of Medicine, Daegu, Korea
| | - Sung Ae Kim
- Department of Dermatology, Keimyung University School of Medicine, Daegu, Korea
| | - Young Wook Ryoo
- Department of Dermatology, Keimyung University School of Medicine, Daegu, Korea
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Abstract
BACKGROUND Modalities for atrophic acne scarring can be classified depending upon the needs they satisfy; that is, resurfacing, lifting/volumization, tightening, or surgical removal/movement of tissue that is required for correction. A plethora of treatment options have resulted from the need to treat various acne scar types, variability of responses noted in various skin types, and increasing popularity of minimally invasive modalities. Still, there is a lack of consensus guidelines on treatment or combination therapies for various clinical scenarios. OBJECTIVE This systematic review includes a critical evaluation of the evidence relevant to these modalities and various multimodality therapies. METHODS We performed a systematic literature search in Medline and EMBASE databases for studies on acne scar management. Also, we checked the reference lists of included studies and review articles for further studies. A total of 89 studies were included in our quality of evidence evaluation. RESULTS The efficacy of lasers and radiofrequency in atrophic acne scarring is confirmed by many comparative and observational studies. Other modalities can be used as an adjunct, the choice of which depends on the type, severity, and number of atrophic scars. Minimally invasive procedures, such as fractional radiofrequency and needling, provide good outcomes with negligible risks in patients with dark or sensitive skin types. CONCLUSIONS There is a lack of high-quality data. Fractional lasers and radiofrequency offer significant improvement in most types of atrophic acne scars with minimal risks and can be combined with all other treatment options. Combination therapies typically provide superior outcomes than solo treatments.
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Ibrahim ZA, Hassan GF, Elgendy HY, Al‐shenawy HA. Evaluation of the efficacy of transdermal drug delivery of calcipotriol plus betamethasone versus tacrolimus in the treatment of vitiligo. J Cosmet Dermatol 2018; 18:581-588. [DOI: 10.1111/jocd.12704] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 05/14/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Zeinab A. Ibrahim
- Dermatology and Venereology, Faculty of Medicine Tanta University Tanta Egypt
| | - Ghada F. Hassan
- Dermatology and Venereology, Faculty of Medicine Tanta University Tanta Egypt
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Markiewicz A, Zasada M, Erkiert‐Polguj A, Wieckowska‐Szakiel M, Budzisz E. An evaluation of the antiaging properties of strawberry hydrolysate treatment enriched with L‐ascorbic acid applied with microneedle mesotherapy. J Cosmet Dermatol 2018; 18:129-135. [DOI: 10.1111/jocd.12545] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Agata Markiewicz
- Department of Cosmetic Raw Materials Chemistry Faculty of Pharmacy Medical University of Lodz Lodz Poland
| | - Malwina Zasada
- Department of Cosmetic Raw Materials Chemistry Faculty of Pharmacy Medical University of Lodz Lodz Poland
| | - Anna Erkiert‐Polguj
- Department of Cosmetology and Aesthetic Dermatology Faculty of Pharmacy Medical University of Lodz Lodz Poland
| | - Marzena Wieckowska‐Szakiel
- Department of Immunology and Infectious Biology Faculty of Biology and Environmental Protection University of Lodz Lodz Poland
| | - Elzbieta Budzisz
- Department of Cosmetic Raw Materials Chemistry Faculty of Pharmacy Medical University of Lodz Lodz Poland
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Al Qarqaz F, Al-Yousef A. Skin microneedling for acne scars associated with pigmentation in patients with dark skin. J Cosmet Dermatol 2018. [DOI: 10.1111/jocd.12520] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Firas Al Qarqaz
- Department of Dermatology; Jordan University of Science and Technology; Irbid Jordan
| | - Ali Al-Yousef
- Computer Department; Computer and Information Technology College; Jerash University; Jerash Jordan
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Fertig RM, Gamret AC, Cervantes J, Tosti A. Microneedling for the treatment of hair loss? J Eur Acad Dermatol Venereol 2017; 32:564-569. [PMID: 29194786 DOI: 10.1111/jdv.14722] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 11/15/2017] [Indexed: 01/16/2023]
Abstract
Microneedling is a minimally invasive dermatological procedure in which fine needles are rolled over the skin to puncture the stratum corneum. This therapy is used to induce collagen formation, neovascularization and growth factor production of treated areas. It has been used in a wide range of dermatologic conditions, including androgenetic alopecia (AGA) and alopecia areata, among others. While there are a limited number of studies examining this therapy in the use of hair loss, microneedling has been successfully paired with other hair growth promoting therapies, such as minoxidil, platelet-rich plasma and topical steroids, and shown to stimulate hair follicle growth. It is thought that microneedling facilitates penetration of such first-line medications, and this is one mechanism by which it promotes hair growth. To date, the area most studied and with the most success has been microneedling treatment of AGA. While the current evidence does not allow one to conclude superiority of microneedling over existing standard therapies for hair loss, microneedling shows some promise in improving hair growth, especially in combination with existing techniques. This review summarizes the current literature regarding microneedling in the treatment of alopecia and calls for further studies to define a standard treatment protocol.
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Affiliation(s)
- R M Fertig
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - A C Gamret
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - J Cervantes
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - A Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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