A Randomized, Controlled, Double-Blind Study Evaluating Melanin-Encapsulated Liposomes as a Chromophore for Laser Hair Removal of Blond, White, and Gray Hair

Expanded scalp flap combined with laser hair removal to reconstruct facial defects around the hairline

BACKGROUND

Congenital and acquired facial lesions around the hairline can bring huge physical and psychological trauma to patients. At present, reconstruction of this area remains a challenge. In this study, we present an alternative technique to reconstruct the aesthetic units using an expanded scalp flap combined with laser hair removal.

METHODS

We retrospectively reviewed 25 cases of facial lesions around the hairline reconstructed with this surgical technique between May 2014 and May 2020. Expander was implanted under the scalp as designed before the operation. After the expander was fully expanded, the lesion was removed and the scalp flap was transferred. Laser hair removal was performed on the transplanted skin flap 2 weeks after flap transfer.

RESULTS

There were ten cases of postburn scar, nine cases of congenital nevus, four cases of traumatic scar, one case of haemangioma, and one case of nevus sebaceous. The median times of laser treatment was 3 (range, 1-8). The median follow-up time was 11 months, ranging from 1 to 27 months. The colour and texture of expanded flaps were similar to adjacent tissue in all cases. The direction of reserved hair in transferred flaps was consistent with the direction of hair in the recipient area or contralateral hair. There were no complications, such as infection, blistering, discolouration, and ulceration. All patients were satisfied with the appearance of the reconstructed hairline and the surgical outcomes.

CONCLUSIONS

The expanded scalp flap combined with laser hair removal is a feasible and effective technique to reconstruct both sides of the hairline simultaneously from a single donor site with a good colour match and a similar texture and thickness.

Follicular Unit Extraction [FUE] - One Procedure, Many Uses

Follicular unit extraction [FUE] is a minimally invasive hair restoration surgery popularly known for its utility in androgenetic alopecia (AGA). In FUE, individual follicular grafts are extracted from donor area and implanted in the recipient area. Advantages of FUE are that it is comparatively 'scarless', has faster healing time, has less downtime and requires less technical staff. This article is aimed to highlight upon the multi-faceted utility of FUE technique in various dermatological indications like androgenetic alopecia, alopecia areata, facial hair restoration, tractional alopecia, scarring alopecia, body hair transplant, vitiligo as well as hirsutism.

Laser Treatment in Hirsutism: An Update

Unwanted hair growth, which is a common aesthetic problem, has traditionally been treated using various techniques such as shaving, waxing, and epilation, but most of these provide only a temporary solution. Laser and light-based technology for hair removal has become one of the fastest growing procedures in modern cosmetic dermatology in the last decade. Clinical experience suggests that in the ideal subject with fair skin and dark hair, laser treatment can reduce hair growth significantly. This article reviews the various laser and light-based devices used for hair removal along with the various laser and patient parameters that affect the outcome of laser treatment for hair removal. Photoepilation, when properly used, offers clear advantages when compared with older, traditional techniques.

Nanomaterials for transdermal drug delivery: beyond the state of the art of liposomal structures

A wide range of biomedical materials have been proposed to meet the different needs for controlled oral or intravenous drug delivery. The advantages of oral delivery such as self-administration of a pre-determined drug dose at defined time intervals makes it the most convenient means for the delivery of small molecular drugs. It fails however to delivery therapeutic macromolecules due to rapid degradation in the stomach and size-limited transport across the epithelium. The primary mode of administration of macromolecules is presently via injection. This administration mode is not without limitations, as the invasive nature of injections elicits pain and decreases patients' compliance. Alternative routes for drug delivery have been looked for, one being the skin. Delivery of drugs via the skin is based on the therapeutics penetrating the stratum corneum (SC) with the advantage of overcoming first-pass metabolism of drugs, to deliver drugs with a short-half-life time more easily and to eliminate frequent administrations to maintain constant drug delivery. The transdermal market still remains limited to a narrow range of drugs. The low permeability of the SC to water-soluble and macromolecular drugs poses significant challenges to transdermal administration via passive diffusion through the skin, as is the case for all topically administered drug formulations intended to bring the therapeutic into the general circulation. To widen the scope of drugs for transdermal delivery, new procedures to enhance skin permeation to hydrophilic drugs and macromolecules are under development. Next to the integration of skin enhancers into pharmaceutical formulations, nanoparticles based on lipid carriers have been widely considered and reviewed. While being briefly reviewed here, the main focus of this article is on current advancements using polymeric and metallic nanoparticles. Next to these passive technologies, the handful of active technologies for local and systemic transdermal drug delivery will be discussed and put into perspective. While passive approaches dominate the literature and the transdermal market, active delivery based on microneedles or iontophoresis approaches have shown great promise for transdermal drug delivery and have entered the market, in the last decade. This review gives an overall idea of the current activities in this field.

Efficacy and safety of mascara dyeing as an adjunct to Alexandrite and Nd:YAG laser applications for removing thin and white-colored facial and axillary hair

INTRODUCTION

There is no satisfactory and efficient method for long-term removal of white-colored and thin hair.

METHODS

We conducted a randomised clinical trial of hirsute patients with excessive white and/or thin hair on the face and/or axilla. In Group I (n: 16), the facial hair on one side of the face was painted with a black eyelash mascara immediately before Nd:YAG laser and the other half was only treated by Nd:YAG. In Group II (n: 20), the axillary hair on one side was painted with the mascara before the Alexandrite laser with the other side being only treated by Alexandrite.

RESULTS

The terminal hair counts on the painted facial and axillary sides were significantly lower than those on the control sides throughout the study except for the first month. The decrease in the terminal hair count was significant from the beginning of treatment to the second and sixth months on the painted and control facial sides and to the first and sixth months on the axillary sides.

CONCLUSION

Hair coloring with black eyelash mascara is a simple, efficient and safe adjunct to Alexandrite and Nd:YAG laser applications to enhance their clinical efficacy in eliminating white and thin facial or axillary hair.

Microneedling dilates the follicular infundibulum and increases transfollicular absorption of liposomal sepia melanin

Encapsulation of chemicals in liposomes and microneedling are currently used techniques to enhance the penetration of several substances through skin and hair. In this study, we apply a liposomal melanin–fluorescein compound to an ex vivo model of human skin, using a new electrical microneedling device (Nanopore turbo roller). The product was applied by hand massage (A) or with the assistance of the electrical roller for 2 minutes (B). An additional test was performed free of product and with only the E-roller (C). Histological changes and product absorption were evaluated by optical and fluorescent microscopy 60 and 90 minutes after the treatment. Site B showed larger deposits of melanin–fluorescein at superficial and deep levels of hair structures in comparison to site A. Light, epidermal deposits of the melanin–fluorescein complex were also observed. Sites B and C showed a significant widening (47%) of the follicular infundibulum which could explain the increased penetration of the formulation. Microneedling also removed the scales and sebum residues in the neighborhood of the infundibulum. Targeting hair follicles with melanin may be useful to dye poorly pigmented hairs, improving laser hair removal. The procedure accelerates the delivery of melanin into hair structures allowing an even absorption, larger pigment deposits, and deeper penetration of the formulation into the hair.

Topical Cyperus rotundus oil: a new therapeutic modality with comparable efficacy to Alexandrite laser photo-epilation

BACKGROUND

Topical Cyperus rotundus oil is an effective and safe method to decrease hair growth. The oil's flavonoids have antiandrogenic activity on androgenic hair. To date, there have been no randomized controlled trials comparing topical C rotundus oil to the available allopathic modalities, such as laser-assisted hair removal.

OBJECTIVES

In an open-label pilot study, the author prospectively evaluated the efficacy of C rotundus essential oil, compared with the Alexandrite laser (GentleLase; Candela Laser Corp, Wayland, Massachusetts) and saline, for reducing unwanted axillary hair.

METHODS

Eligible participants (n=65) with unwanted axillary hair were assigned randomly to 1 of 3 study groups: topical C rotundus oil (group 1), saline (group 2), and Alexandrite laser (group 3). Sixty patients completed the entire study. Three methods were used to evaluate the results: hair counts, observations of independent professionals, and patient self-assessments.

RESULTS

Overall results did not differ significantly between C rotundus oil and the Alexandrite laser (P>.05). However, statistically significant differences were noted with respect to decreased growth of white hair (P<.05), favoring the oil. This finding was evident by all 3 methods of assessment. No side effects were detected.

CONCLUSIONS

Cyperus rotundus essential oil is as effective as the Alexandrite laser for decreasing the growth of axillary hair (both dark and white).

LEVEL OF EVIDENCE

3.

Long-term removal of unwanted hair using light

Laser (or light) hair removal, also referred to as photoepilation, is the most commonly used laser or light-based cosmetic medical procedure. The extended theory of selective photothermolysis is the basic principle for destruction of hair follicles using light. In this type of laser application the chromophore is follicular melanin. Several types of lasers and light sources have been effective for hair reduction, including the ruby, alexandrite, diode, and neodymium:yttrium-aluminum-garnet lasers and broadband, intense pulsed light sources. This article provides a broad overview of how hair can be removed using light, with an emphasis on practical considerations.

An update on the application of physical technologies to enhance intradermal and transdermal drug delivery

A large number of biopharmaceuticals and other macromolecules are being developed for therapeutic applications. Conventional oral delivery is not always possible due to first-pass metabolism and degradation in the GI tract. Parenteral delivery is invasive and has poor patient compliance. Transdermal delivery provides one attractive route of administration. Transdermal administration can achieve the continuous and non-invasive delivery of drugs. However, passive transdermal delivery is restricted to small lipophilic molecules. Active physical-enhancement technologies are being investigated to increase the scope of transdermal delivery to hydrophilic molecules and macromolecules. Recent developments in transdermal technologies, such as microporation, iontophoresis and sonophoresis can enable therapeutic delivery of many drug molecules, biopharmaceuticals, cosmeceuticals and vaccines. This review provides an update of recent developments in transdermal delivery focusing on physical-enhancement technologies.

Successful white hair removal with combined coloring and intense pulsed Light (IPL): a randomized clinical trial

OBJECTIVE

The purpose of this study was to introduce adjunct therapy to intense pulsed light (IPL) and to assess it in terms of safety, expense, feasibility, and efficacy.

BACKGROUND DATA

Currently there is no satisfactory, efficient method for long-term white hair removal.

METHODS

We conducted a randomized clinical trial of hirsute patients with excessive white hair on the chin and cheeks. In addition to IPL, the patients were randomly assigned to have their white hair colored with either black eyeliner or black hair dye as an adjunct to IPL aided for of six sessions (with a 4-week interval between sessions). The primary efficacy outcome, which was defined as the outcome after six sessions of therapy, was scored as poor (<30%), fair (30?60%) or good (>60%) response to white hair removal in predefined areas. The secondary outcome was recurrence 6 months after the final therapy session.

RESULTS

In the eyeliner group (n=31), 15 (48.4%) individuals showed a fair response, and 16 (51.6%) individuals showed a good response. In the color-dye group (n=31), 1 (3.2%), 17 (54.8%) and 13 (41.9%) participants scored poor, fair, and good, respectively. There were no differences in clinician judgment of the treatment success between the eyeliner and color-dye groups after the six therapy sessions (p=0.895). Thirty-one patients had 6 months of visits (11 in the hair dye and 20 in the eyeliner group). Three participants in the color-dye group and five participants in the eyeliner group failed to show improvement 6 months after the laser surgery. There was no distinguishable pattern of failure between the two study groups (p=1).

CONCLUSION

This study supports that hair coloring is an efficient and feasible technique that can be combined with IPL to eliminate white facial hair.

Lasers and optical technologies in facial plastic surgery

Lasers and optical technologies play a significant role in aesthetic and reconstructive surgery. The unique ability of optical technologies to target specific structures and layers in tissues to effect chemical, mechanical, or thermal changes makes them a powerful tool in cutaneous rejuvenation, hair removal, fat removal, and treatment of vascular lesions such as port-wine stains, among many other procedures. With the development of adjunct techniques such as epidermal cooling, lasers and optical technologies have become more versatile and safe. The constant improvement of existing applications and the emergence of novel applications such as photodynamic therapy, nanoparticles, spectroscopy, and noninvasive imaging continue to revolutionize aesthetic medicine by offering a minimally invasive alternative to traditional surgery. In the future, therapies will be based on individualized, maximum, safe radiant exposure to deliver optimal dosimetry. Lasers and optical technologies are headed toward safer, easier, more quantifiable, and more individualized therapy.

Recent advances in laser dermatology

Lasers have revolutionized the practice of modern dermatology. Our understanding of laser physics and selective photothermolysis has expanded greatly over the last 20 years. In the last 2 years, we have looked beyond the traditional lasers and explored new concepts. This article will look at five of these new concepts. A strong understanding of these new techniques will allow dermatologists to use them either primarily or in combination with more conventional methods.

[Photoepilation: state-of-the-art]

The field of dermatological laser medicine consists of four main areas: therapy for blood vessels, therapy for pigmented lesions, ablation of tissue, and photoepilation. The first tests were carried out in 1993, and since 1996 there has been a growing demand for "permanent hair removal." This strong demand and the rapid development of devices call for extensive knowledge in terms of current technical innovation or affirmation of proven procedures. This article gives a general survey of the different systems that can be used for "permanent hair removal" [ruby laser, alexandrite laser, diode, Nd:YAG laser, so-called intense pulsed light (IPL) systems, and combined radio frequency/IPL systems], including their inherent advantages and disadvantages. Physical and biological aspects necessary for photoepilation are pointed out. Furthermore, we emphasize new methods concerning removal of depigmented and therapy-resistant hair, as well as the treatment of female patients with polycystic ovary syndrome.