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Kim EY, Wong JH, Hussain A, Khachemoune A. Evidence-based management of cutaneous scarring in dermatology part 2: atrophic acne scarring. Arch Dermatol Res 2023; 316:19. [PMID: 38059974 DOI: 10.1007/s00403-023-02737-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/05/2023] [Accepted: 10/18/2023] [Indexed: 12/08/2023]
Abstract
Atrophic acne scars are the most common type of acne scars and are classified into three main types: icepick, boxcar, and rolling scars. Various procedures and techniques for atrophic acne scarring are discussed in detail, with stronger evidence-based support for lasers (non-fractional, fractional, ablative, and non-ablative), platelet-rich plasma as adjunctive treatment, chemical peels (glycolic acid, trichloroacetic acid, and Jessner's solution), dermal fillers such as hyaluronic acid, and microneedling, and lesser quality evidence for microdermabrasion, subcision, and lipoaspirate grafting. Further research is needed to optimize treatment protocols, assess the efficacy of monotherapies, and establish standardized guidelines for clinicians. This paper will provide a comprehensive review of the evidence-based management of atrophic acne scars, including currently commonly utilized therapies as well as more innovative treatment options.
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Affiliation(s)
- Emily Y Kim
- Georgetown University School of Medicine, Washington, DC, USA
| | - Jasmine H Wong
- Georgetown University School of Medicine, Washington, DC, USA
| | - Aamir Hussain
- Galaria Plastic Surgery and Dermatology, LLC, Chantilly, VA, USA
| | - Amor Khachemoune
- Department of Dermatology, Veterans Affairs Medical Center, SUNY Downstate, 800 Poly Place, Brooklyn, NY, 11209, USA.
- Department of Dermatology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, NY, USA.
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Tan AU, Schlosser BJ, Paller AS. A review of diagnosis and treatment of acne in adult female patients. Int J Womens Dermatol 2017; 4:56-71. [PMID: 29872679 PMCID: PMC5986265 DOI: 10.1016/j.ijwd.2017.10.006] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 10/11/2017] [Accepted: 10/11/2017] [Indexed: 01/19/2023] Open
Abstract
This review focuses on the treatment options for adult female patients with acne. Acne in adult female patients may start during adolescence and persist or have an onset in adulthood. Acne has various psychosocial effects that impact patients’ quality of life. Treatment of acne in adult women specifically has its challenges due to the considerations of patient preferences, pregnancy, and lactation. Treatments vary widely and treatment should be tailored specifically for each individual woman. We review conventional therapies with high levels of evidence, additional treatments with support from cohort studies and case reports, complementary and/or alternative therapies, and new agents under development for the treatment of patients with acne.
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Affiliation(s)
- A U Tan
- Northwestern University, Department of Dermatology, Chicago, IL
| | - B J Schlosser
- Northwestern University, Department of Dermatology, Chicago, IL
| | - A S Paller
- Northwestern University, Department of Dermatology, Chicago, IL
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Dou C, Lay F, Ansari AM, Rees DJ, Ahmed AK, Kovbasnjuk O, Matsangos AE, Du J, Hosseini SM, Steenbergen C, Fox-Talbot K, Tabor AT, Williams JA, Liu L, Marti GP, Harmon JW. Strengthening the skin with topical delivery of keratinocyte growth factor-1 using a novel DNA plasmid. Mol Ther 2014; 22:752-61. [PMID: 24434934 PMCID: PMC3982499 DOI: 10.1038/mt.2014.2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 12/23/2013] [Indexed: 12/25/2022] Open
Abstract
Fragile skin, susceptible to decubitus ulcers and incidental trauma, is a problem particularly for the elderly and for those with spinal cord injury. Here, we present a simple approach to strengthen the skin by the topical delivery of keratinocyte growth factor-1 (KGF-1) DNA. In initial feasibility studies with the novel minimalized, antibiotic-free DNA expression vector, NTC8385-VA1, the reporter genes luciferase and enhanced green fluorescent protein were delivered. Transfection was documented when luciferase expression significantly increased after transfection. Microscopic imaging of enhanced green fluorescent protein-transfected skin showed green fluorescence in hair follicles, hair shafts, and dermal and superficial epithelial cells. With KGF-1 transfection, KGF-1 mRNA level and protein production were documented with quantitative reverse transcriptase-polymerase chain reaction and immunohistochemistry, respectively. Epithelial thickness of the transfected skin in the KGF group was significantly increased compared with the control vector group (26 ± 2 versus 16 ± 4 µm) at 48 hours (P = 0.045). Dermal thickness tended to be increased in the KGF group (255 ± 36 versus 162 ± 16 µm) at 120 hours (P = 0.057). Biomechanical assessment showed that the KGF-1-treated skin was significantly stronger than control vector-transfected skin. These findings indicate that topically delivered KGF-1 DNA plasmid can increase epithelial thickness and strength, demonstrating the potential of this approach to restore compromised skin.
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Affiliation(s)
- Chunqing Dou
- 1] Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chinese PLA General Hospital, Beijing, China [2] Department of Surgery and Hendrix Burn/Wound Laboratory, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Frank Lay
- Department of Surgery and Hendrix Burn/Wound Laboratory, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Amir Mehdi Ansari
- Department of Surgery and Hendrix Burn/Wound Laboratory, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Donald J Rees
- Department of Surgery and Hendrix Burn/Wound Laboratory, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ali Karim Ahmed
- Department of Surgery and Hendrix Burn/Wound Laboratory, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Olga Kovbasnjuk
- Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Aerielle E Matsangos
- Department of Surgery and Hendrix Burn/Wound Laboratory, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Junkai Du
- Department of Surgery and Hendrix Burn/Wound Laboratory, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sayed Mohammad Hosseini
- Department of Surgery and Hendrix Burn/Wound Laboratory, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Charles Steenbergen
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Karen Fox-Talbot
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | | | - Lixin Liu
- Department of Surgery and Hendrix Burn/Wound Laboratory, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Guy P Marti
- Department of Surgery and Hendrix Burn/Wound Laboratory, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - John W Harmon
- Department of Surgery and Hendrix Burn/Wound Laboratory, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Fabbrocini G, Annunziata MC, D'Arco V, De Vita V, Lodi G, Mauriello MC, Pastore F, Monfrecola G. Acne scars: pathogenesis, classification and treatment. Dermatol Res Pract 2010; 2010:893080. [PMID: 20981308 PMCID: PMC2958495 DOI: 10.1155/2010/893080] [Citation(s) in RCA: 177] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Revised: 09/07/2010] [Accepted: 09/28/2010] [Indexed: 11/30/2022] Open
Abstract
Acne has a prevalence of over 90% among adolescents and persists into adulthood in approximately 12%-14% of cases with psychological and social implications. Possible outcomes of the inflammatory acne lesions are acne scars which, although they can be treated in a number of ways, may have a negative psychological impact on social life and relationships. The main types of acne scars are atrophic and hypertrophic scars. The pathogenesis of acne scarring is still not fully understood, but several hypotheses have been proposed. There are numerous treatments: chemical peels, dermabrasion/microdermabrasion, laser treatment, punch techniques, dermal grafting, needling and combined therapies for atrophic scars: silicone gels, intralesional steroid therapy, cryotherapy, and surgery for hypertrophic and keloidal lesions. This paper summarizes acne scar pathogenesis, classification and treatment options.
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Affiliation(s)
- Gabriella Fabbrocini
- Division of Clinical Dermatology, Department of Systematic Pathology, University of Naples Federico II, Via Sergio Pansini 5, 80133 Napoli, Italy
| | - M. C. Annunziata
- Division of Clinical Dermatology, Department of Systematic Pathology, University of Naples Federico II, Via Sergio Pansini 5, 80133 Napoli, Italy
| | - V. D'Arco
- Division of Clinical Dermatology, Department of Systematic Pathology, University of Naples Federico II, Via Sergio Pansini 5, 80133 Napoli, Italy
| | - V. De Vita
- Division of Clinical Dermatology, Department of Systematic Pathology, University of Naples Federico II, Via Sergio Pansini 5, 80133 Napoli, Italy
| | - G. Lodi
- Division of Clinical Dermatology, Department of Systematic Pathology, University of Naples Federico II, Via Sergio Pansini 5, 80133 Napoli, Italy
| | - M. C. Mauriello
- Division of Clinical Dermatology, Department of Systematic Pathology, University of Naples Federico II, Via Sergio Pansini 5, 80133 Napoli, Italy
| | - F. Pastore
- Division of Clinical Dermatology, Department of Systematic Pathology, University of Naples Federico II, Via Sergio Pansini 5, 80133 Napoli, Italy
| | - G. Monfrecola
- Division of Clinical Dermatology, Department of Systematic Pathology, University of Naples Federico II, Via Sergio Pansini 5, 80133 Napoli, Italy
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Photodynamic therapy for acne vulgaris: A critical review from basics to clinical practice. J Am Acad Dermatol 2010; 63:183-93; quiz 193-4. [DOI: 10.1016/j.jaad.2009.09.056] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Revised: 09/10/2009] [Accepted: 09/10/2009] [Indexed: 11/23/2022]
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Kempiak SJ, Uebelhoer N. Superficial chemical peels and microdermabrasion for acne vulgaris. ACTA ACUST UNITED AC 2009; 27:212-20. [PMID: 18786500 DOI: 10.1016/j.sder.2008.06.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Superficial chemical peels and microdermabrasion are used for many dermatologic conditions. A common condition treated with these modalities is acne vulgaris. In this review, we discuss the theory behind the technique of these procedures and describe the application and complications of each of these procedures in the office setting. The evaluation of patients before proceeding with the procedure and discuss pre- and postpeel regimens used for patients is discussed. We also analyze studies on both of these in-office procedures and comparative studies between the 2 most commonly used superficial chemical peeling agents, glycolic and salicylic acid.
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Affiliation(s)
- Stephan John Kempiak
- University of California, San Diego, Division of Dermatology, San Diego, CA 92134, USA
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Davari P, Gorouhi F, Jafarian S, Dowlati Y, Firooz A. A randomized investigator-blind trial of different passes of microdermabrasion therapy and their effects on skin biophysical characteristics. Int J Dermatol 2008; 47:508-13. [DOI: 10.1111/j.1365-4632.2008.03583.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
BACKGROUND Simple procedural treatments such as comedone extraction and intralesional steroids have been utilized for many years as adjunctive therapy for acne. In the past 5 years, new technologies and procedures have become available that present new options for the treatment of acne. OBJECTIVES The objective was to review, summarize, and evaluate the key studies of procedural therapies for the treatment of acne as well as place them in perspective with current clinical practice. METHODS Studies selected for evaluation had at least 10 patients and clear statements of purpose, acne severity, patient selection, follow-up evaluations, previous and concurrent medications, treatment parameters, methods for evaluating results, and adverse effects. All studies were complete and published (in English) in peer-reviewed journals. RESULTS AND CONCLUSIONS Earlier procedural therapies were adjunctive to medical therapy, such as intralesional steroids, chemical peels, and microdermabrasion. Newer methods include radiofrequency, light or laser, and photodynamic therapy that represent treatment alternatives for systemic medications. Still early in their development, these new procedures provide an important, novel set of options for the treatment of acne. The most developed and studied therapies are blue or blue/red light combinations, 1,450-nm diode laser, and photodynamic therapy with 5-aminolevulinic acid or indocyanine green. Review of the literature of more up-to-date physical procedures provides a starting point for physicians seeking to treat their acne patients safely and effectively with these new methods.
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Lee WR, Tsai RY, Fang CL, Liu CJ, Hu CH, Fang JY. Microdermabrasion as a novel tool to enhance drug delivery via the skin: an animal study. Dermatol Surg 2006; 32:1013-22. [PMID: 16918563 DOI: 10.1111/j.1524-4725.2006.32224.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Microdermabrasion is a widely performed skin rejuvenation procedure. It can partly ablate and homogenize the stratum corneum (SC) layers. OBJECTIVE The effect of microdermabrasion treatment on the skin permeation of hydrophilic and lipophilic drugs was examined in this study. METHODS 5-Fluorouracil (5-FU) and clobetasol 17-propionate were used as the hydrophilic and lipophilic permeants, respectively. In vitro skin delivery using porcine skin and in vivo topical application employing nude mouse as the animal model were both used to examine the effect of microdermabrasion. The vacuum pressures used in this study (15-25 cmHg) were much lower than those used for therapeutic purposes. RESULTS The 5-FU permeation across microdermabrasion-treated skin was 8- to 24-fold higher than that across intact skin and depended on differences in treatment pressure and duration. An intensity of 15 cmHg for 10 seconds showed the greatest enhancement of 5-FU delivery via the skin. In contrast to the results for 5-FU, microdermabrasion reduced the skin permeation and deposition of topically applied clobetasol. The partitioning effect of clobetasol from the vehicle to the SC may have predominated this result. Microdermabrasion also enhanced the skin delivery of the hydrophilic 5-aminolevulinic acid (ALA). Confocal laser scanning microscopy (CLSM) of microdermabrasion-treated skin revealed intense red fluorescence of ALA-transformed protoporphyrin (PpIX) within the epidermis and upper dermis. CONCLUSIONS Microdermabrasion can improve the skin permeation of hydrophilic molecules.
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Affiliation(s)
- Woan-Ruoh Lee
- Department of Dermatology, Taipei Medical University Hospital, Taipei, Taiwan
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10
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Karimipour DJ, Kang S, Johnson TM, Orringer JS, Hamilton T, Hammerberg C, Voorhees JJ, Fisher G. Microdermabrasion with and without aluminum oxide crystal abrasion: a comparative molecular analysis of dermal remodeling. J Am Acad Dermatol 2006; 54:405-10. [PMID: 16488289 DOI: 10.1016/j.jaad.2005.11.1084] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2005] [Revised: 11/21/2005] [Accepted: 11/27/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Microdermabrasion is a popular method of superficial skin resurfacing with effects on dermal remodeling. OBJECTIVE The purpose of this study was to evaluate the relative importance of the two components of microdermabrasion, negative pressure and abrasion, in stimulating expression of key genes involved in dermal remodeling. METHODS Ten subjects were treated with a microdermabrasion machine using focal crystal abrasion and negative pressure or negative pressure alone for 3 seconds. Serial biochemical analyses were performed. Reverse transcriptase real-time polymerase chain reaction assays were used to evaluate changes in transcription factor activator protein-1, primary cytokines (interleukin 1beta, tumor necrosis factor-alpha), and matrix metalloproteinases (MMP-1, MMP-3, MMP-9). RESULTS Significant increases in gene expression of the c-Jun component of activator protein-1, interleukin 1beta, tumor necrosis factor-alpha, MMP-1, MMP-3, and MMP-9 were found with crystal abrasion combined with negative pressure. Negative pressure alone resulted in increased gene expression of MMP-1 and MMP-3 but of a quantitatively reduced magnitude when compared with negative pressure with crystal abrasion. LIMITATIONS It is unclear that molecular changes seen with these treatments can result in clinical effect. CONCLUSION The abrasive component of microdermabrasion is necessary for stimulating expression of key genes involved in dermal remodeling.
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Affiliation(s)
- Darius J Karimipour
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
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Karimipour DJ, Kang S, Johnson TM, Orringer JS, Hamilton T, Hammerberg C, Voorhees JJ, Fisher G. Microdermabrasion: A molecular analysis following a single treatment. J Am Acad Dermatol 2005; 52:215-23. [PMID: 15692465 DOI: 10.1016/j.jaad.2004.10.008] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Microdermabrasion is a popular method of superficial skin resurfacing. It is unclear if dermal remodeling actually occurs. OBJECTIVE To rigorously investigate the molecular alterations observed following a single microdermabrasion treatment. METHODS Forty-nine subjects received a single microdermabrasion treatment to buttock skin. Serial in vivo biochemical and immunohistological analyses were performed. Reverse transcriptase real-time polymerase chain reaction and immunohistochemistry assays were used to evaluate changes in transcription factors (AP-1, NF-kappaB), primary cytokines (interleukin-1beta, tumor necrosis factor-alpha), matrix metalloproteinases (MMP-1, MMP-3, MMP-9), barrier repair enzymes (acetyl-coenzyme A carboxylase, 3-hydroxy-3-methylglutaryl coenzyme A reductase), and type I procollagen. Results Elevation of transcription factors, primary cytokines, and matrix metalloproteinases occurs rapidly after a single microdermabrasion treatment. Two of 11 subjects also demonstrated increased type I procollagen messenger RNA and protein levels 14 days after treatment. No alteration in stratum corneum thickness was detected. CONCLUSION Microdermabrasion activates a dermal remodeling/wound healing cascade with minimal epidermal disruption. Evidence now exists to further study manipulation of variables such as number and timing of microdermabrasion sessions.
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Affiliation(s)
- Darius J Karimipour
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan 48109-0314, USA.
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Fang JY, Lee WR, Shen SC, Fang YP, Hu CH. Enhancement of topical 5-aminolaevulinic acid delivery by erbium:YAG laser and microdermabrasion: a comparison with iontophoresis and electroporation. Br J Dermatol 2004; 151:132-40. [PMID: 15270882 DOI: 10.1111/j.1365-2133.2004.06051.x] [Citation(s) in RCA: 108] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND 5-aminolaevulinic acid (ALA) is used as a protoporphyrin IX-precursor for the photodynamic therapy of superficial skin cancer and cutaneous metastases of internal malignancies. However, the permeability of hydrophilic ALA across the skin is very low. OBJECTIVES AND METHODS The objective of this study was to optimize and enhance the in vitro skin permeation of ALA by two resurfacing techniques: erbium:yttrium-aluminium-garnet (Erb:YAG) laser and microdermabrasion. Light microscopic changes in pig skin caused by these techniques were also compared. The electrically assisted methods, iontophoresis and electroporation, were also used to facilitate ALA permeation across laser- or microdermabrasion-treated skin. RESULTS Among the modalities tested in this study the Erb:YAG laser showed the greatest enhancement of ALA permeation. The laser fluence was found to play an important role in controlling the drug flux, producing enhancement ratios from 4-fold to 246-fold relative to the control. The skin permeation of ALA across microdermabrasion-treated skin was approximately 5-15-fold higher than that across intact skin. Both the ablated effect of the stratum corneum (SC) and ALA flux were proportional to the treatment duration of microdermabrasion. The application of iontophoresis or electroporation alone also increased the ALA permeation by approximately 15-fold and 2-fold, respectively. The incorporation of iontophoresis or electroporation with the resurfacing techniques caused a profound synergistic effect on ALA permeation. CONCLUSIONS This basic study has encouraged the further investigation of ALA permeation by laser or microdermabrasion.
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Affiliation(s)
- J-Y Fang
- Pharmaceutical Laboratory, Graduate Institute of Natural Products, Chang Gung University, Kweishan, Taoyuan, Taiwan.
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Coimbra M, Rohrich RJ, Chao J, Brown SA. A Prospective Controlled Assessment of Microdermabrasion for Damaged Skin and Fine Rhytides. Plast Reconstr Surg 2004; 113:1438-43; discussion 1444. [PMID: 15060359 DOI: 10.1097/01.prs.0000113026.94292.0b] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Aged skin is characterized by rhytides but also by epidermal and dermal atrophy, rough skin texture, irregular pigmentation, telangiectasias, and laxity. Microdermabrasion is an office-based mechanical resurfacing technique alternative to traditional dermabrasion. It has been used in Europe since 1992 with great acceptance. The purpose of this study was to evaluate and quantify the degree of visible improvement in photodamaged skin and fine rhytides following a series of microdermabrasion treatments. A single operator treated 20 patients with varying degrees of photodamage and rhytides with a series of eight microdermabrasion treatments at 1-week intervals; 17 subjects completed the entire study protocol. Standardized photographic documentation was performed before and after each treatment, and a survey questionnaire was completed by each subject. Punch biopsy specimens (3 mm) were collected on treated and matched nontreated control sites and evaluated for histological characteristics. Preprocedure and postprocedure photographs were rated on a 5-point scale by independent blinded observers. A total of 30 blinded observers (16 plastic surgeons and 14 laypersons) rated all photographs. The results showed that all observers rated a significant improvement of hyperchromic discoloration (p = 0.004), while only nonmedical observers observed improvement in fine rhytides. All patients were very satisfied with the results. Common side effects were mild to moderate discomfort occurring on bony areas during the treatment and an itching and tingling sensation for 2 days after treatment. No infections or scars were observed postoperatively. The average epidermal thickness in the untreated samples was 103 +/- 23 microM (mean +/- SD) before treatment compared with 148 +/- 41 microM after treatment (p < 0.001). Histologic analysis of the matched punch biopsy specimens showed an increase in organized collagen in treated versus nontreated sites. Treatment of aged skin using a series of microdermabrasion treatments is an effective, noninvasive method of skin rejuvenation with minimal risk and patient downtime. It is safe and improves skin quality by minimizing certain hyperchromic pigmentations.
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Affiliation(s)
- Maria Coimbra
- University of Texas Southwestern Medical Center, Dallas, 75390, USA
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Cotellessa C, Peris K, Fargnoli MC, Mordenti C, Giacomello RS, Chimenti S. Microabrasion versus microabrasion followed by 15% trichloroacetic acid for treatment of cutaneous hyperpigmentations in adult females. Dermatol Surg 2003; 29:352-6; discussion 356. [PMID: 12656812 DOI: 10.1046/j.1524-4725.2003.29084.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Cutaneous hyperpigmentations are common skin disorders that are often refractory to currently available treatments. OBJECTIVE To evaluate the efficacy of microabrasion alone or microabrasion with 15% trichloroacetic acid (TCA) for treatment of cutaneous hyperpigmentations. METHODS Twenty female patients were treated with microabrasion alone every 2 weeks (group 1), and 20 female patients were treated with microabrasion and application of 15% TCA every 3 weeks (group 2). All patients underwent up to eight treatments. The overall duration of treatment ranged from 2 to 4 months. RESULTS In group 1, a complete remission was observed in 8 of 20 cases (40%), partial remission in 10 of 20 cases (50%), and no remission in 2 of 20 cases (10%). In group 2, a complete remission was observed in 10 of 20 cases (50%), a partial remission in 8 of 20 cases (40%), and no remission in 2 of 20 cases (10%). No unexpected or serious side effects were observed in either group. CONCLUSIONS Microabrasion alone or microabrasion with 15% TCA is an effective, well-tolerated treatment for cutaneous hyperpigmentations.
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15
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Farris PK, Rietschel RL. An unusual acute urticarial response following microdermabrasion. Dermatol Surg 2002; 28:606-8; disscussion 608. [PMID: 12135517 DOI: 10.1046/j.1524-4725.2002.12013.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Microdermabrasion is widely performed in a number of clinical settings, including medical offices, salons, and spas. This procedure is generally regarded as safe and easy to perform. OBJECTIVE To determine if latex exposure caused an acute urticarial response following microdermabrasion in a latex-allergic patient. METHODS The patient was prick tested to saline and histamine controls, latex, and sterile medical grade 100 m aluminum oxide crystals that had been passed through the microdermabrader. RESULTS The strongly positive latex prick test confirmed latex allergy in our patient. Negative prick testing to aluminum oxide crystals that had passed through the microdermabrader make it unlikely that the patient was exposed to latex via this system. CONCLUSION Physicians need to carefully evaluate patients who are considering microdermabrasion and appreciate that unexpected serious complications can occur.
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Affiliation(s)
- Patricia K Farris
- Department of Dermatology, Tulane University School of Medicine and Department of Dermatology, Ochsner Clinic, New Orleans, Louisiana 70005, USA.
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Alam M, Omura NE, Dover JS, Arndt KA. Glycolic acid peels compared to microdermabrasion: a right-left controlled trial of efficacy and patient satisfaction. Dermatol Surg 2002; 28:475-9. [PMID: 12081674 DOI: 10.1046/j.1524-4725.2002.01144.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Glycolic acid peels and microdermabrasion are widely recommended by dermatologists and others for facial skin rejuvenation, but few studies have assessed their clinical efficacy. OBJECTIVE To compare the relative efficacy of glycolic acid peels and microdermabrasion for facial skin rejuvenation. METHODS An unblinded, randomized controlled trial was used. Each of 10 patients received paired treatments with glycolic acid peels (20%) and microdermabrasion (mild setting) for 6 consecutive weeks. The right and left sides of the face were treated with different modalities. Once a patient was assigned to receive a particular modality to a particular side of the face, all subsequent treatments were delivered in the same manner. Patient ratings, investigator ratings, and photographs were obtained before the first treatment and 1 week after the last treatment. RESULTS In terms of overall preference for a given type of treatment, seven patients chose glycolic acid peels, one selected microdermabrasion, and two had no favorite treatment. The relative preference for glycolic acid peels approached significance (P =.0578). Investigator ratings and photographic comparisons did not reveal treatment-specific differences or significant improvement from baseline. No serious side effects were seen with either treatment, and even mild effects were seldom reported. CONCLUSION In this study, patients appeared to prefer low-strength glycolic acid peels to low-intensity microdermabrasion for facial rejuvenation. Differences in patient satisfaction were subtle and may be technique dependent.
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Affiliation(s)
- Murad Alam
- SkinCare Physicians, Chestnut Hill, Massachusetts, USA.
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