A Randomized, Double-Blind, Split-Body, Placebo-Controlled Clinical Study to Evaluate the Efficacy and Tolerability of a Topical Body Firming Moisturizer for Upper Arm Rejuvenation

The Innovative and Evolving Landscape of Topical Exosome and Peptide Therapies: A Systematic Review of the Available Literature

Topical antiaging therapies provide noninvasive delivery of active therapeutics. Exosomes, or extracellular nanovesicles, and peptides, small strings of amino acids, have shown promise as topical therapies in early trials, but neither is FDA approved. This review aims to elucidate the current and future landscape of topical exosomes and peptides as therapeutics for skin rejuvenation. A literature search was conducted using the keywords "peptides" OR "exosomes" AND "skin" OR "rejuvenation." Primary endpoints included mechanisms of action in humans or live animals as well as clinical data supporting the use of exosomes or peptides topically for skin rejuvenation or wound healing. Secondary endpoints were safety, side effects, and efficacy. The articles were collected, organized, and sorted using the Covidence software (Melbourne, Australia) for systematic review. Nine articles evaluating topical application of exosomes and 9 of peptides met inclusion criteria. Topical exosomes were found to increase collagen deposition, accelerate wound healing, and improve overall cosmesis. Several clinical trials are currently underway. Topical peptides were found to improve appearance of fine lines and wrinkles, elasticity and viscoelasticity, skin texture, skin thickness, and the potential for accelerated wound healing. Peptides are quite common in "cosmeceutical" products, and several patents have been filed for topical peptide products aimed at increasing skin rejuvenation. This could indicate a movement toward pursuing FDA approval. The future of topical exosome and peptide products for the purpose of skin rejuvenation appears promising. Preliminary data from the studies reviewed here indicates that these products have the potential to be safe and effective.

Level of Evidence 3

A Rejuvenating treatment targeting "tech neck" lines and wrinkles in Chinese women: A prospective, open-label, single-center study

BACKGROUND

Aging of neck and jawline skin is caused by intrinsic and extrinsic factors and is evidenced by wrinkling, laxity, skin dyspigmentation, loss of the mandibular contour, accumulation of submental fat, density loss, and prominent platysma bands. Early intervention with topical cosmeceuticals, especially in younger subjects with "tech neck," can offer a solution and potentially mitigate aging of the neck and jawline.

AIM

The objective of this prospective, open-label, single-center clinical study was to assess the efficacy and tolerability of a topical anti-aging neck treatment (TNT) in a cohort of Chinese women with mild to moderate signs of aging on the neck and jawline.

SUBJECTS/METHODS

This study was approved by an ethics committee and involved healthy Chinese subjects. Thirty-five female subjects, 25-50 years old, with mild to moderate signs of aging of the neck and jawline were recruited. Subjects applied the TNT to the neck and jawline twice daily for 84 days. Long-term efficacy and tolerability, clinical photography, bioinstrumentation, and a self-assessment questionnaire were performed at baseline and post-baseline.

RESULTS

The TNT significantly improved horizontal neck fold lines and neck skin elasticity, hydration, gloss/radiance, and skin tone evenness post-baseline. Clinical photography and ultrasound corroborated these findings. The product was well perceived and well tolerated by subjects.

CONCLUSION

This study demonstrated the TNT was effective against both extrinsic and intrinsic aging of the neck and jawline. The TNT provides a topical solution for Chinese women concerned with an aging appearance of the neck including "tech neck."

Current and Future Photography Techniques in Aesthetic Surgery

Background

The rapidly increasing modalities and mediums of clinical photography, use of 3-dimensional (3D) and 4-dimensional (4D) patient modeling, and widening implementation of cloud-based storage and artificial intelligence (AI) call for an overview of various methods currently in use as well as future considerations in the field.

Objectives

Through a close look at the methods used in aesthetic surgery photography, clinicians will be able to select the modality best suited to their practice and goals.

Methods

Review and discussion of current data pertaining to: 2-dimensional (2D) and 3D clinical photography, current photography software, augmented reality reconstruction, AI photography, and cloud-based storage.

Results

Important considerations for current image capture include a device with a gridded viewing screen and high megapixel resolution, a tripod with leveling base, studio lighting with dual-sourced light, standardized matte finish background, and consistency in patient orientation. Currently, 3D and 4D photography devices offer advantages such as improved communication to the patient on outcome expectation and better quality of patient service and safety. AI may contribute to post-capture processing and 3D printing of postoperative outcomes. Current smartphones distort patient perceptions about their appearance and should be used cautiously in an aesthetic surgery setting. Cloud-based storage provides flexibility, cost, and ease of service while remaining vulnerable to data breaches.

Conclusions

While there are advancements to be made in the physical equipment and preparation for the photograph, the future of clinical photography will be heavily influenced by innovations in software and 3D and 4D modeling of outcomes.