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Jennings T, Duffy R, McLarney M, Renzi M, Heymann WR, Decker A, Lawrence N. Acne scarring-pathophysiology, diagnosis, prevention and education: Part I. J Am Acad Dermatol 2024; 90:1123-1134. [PMID: 35792196 DOI: 10.1016/j.jaad.2022.04.021] [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: 11/09/2021] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 12/01/2022]
Abstract
Acne scarring is common and can occur even with effective acne management. In addition, patients with acne scarring suffer from significant psychosocial morbidity, including depression and suicidality. Despite the availability and advancement of therapeutic modalities, treatment for acne scarring is not always optimized and often overlooked in patients with acne encounters. Using acne scarring assessment tools and identifying specific acne scar subtypes allows for a tailored therapeutic approach. Part I of this continuing medical education series covers the pathophysiology and morphology of textural and pigmented acne scars, scarring assessment tools, and medical treatment options. The principles reviewed will aid in approaching and initiating acne scar treatment in the outpatient setting.
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Affiliation(s)
- Tara Jennings
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey.
| | - Robert Duffy
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
| | - Matt McLarney
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
| | - Michael Renzi
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
| | - Warren R Heymann
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
| | - Ashley Decker
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
| | - Naomi Lawrence
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
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Renzi M, McLarney M, Jennings T, Duffy R, Heymann WR, Lawrence N, Decker A. Procedural and surgical treatment modalities for acne scarring: Part II. J Am Acad Dermatol 2024; 90:1137-1150. [PMID: 35469981 DOI: 10.1016/j.jaad.2022.04.022] [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: 11/09/2021] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 10/18/2022]
Abstract
The optimal treatment of acne scarring is challenging because several factors need to be considered, including the type and number of scars, Fitzpatrick skin type, and the amount of downtime permissible to the patient. This second article in the continuing medical education series discusses the procedural treatments available for acne scarring, including the use of chemical peels, fillers, radiofrequency microneedling, lasers, and surgical procedures. The indications for each modality, evidence for its benefits, and the adverse effects are discussed. This section aims to help guide the reader select and implement the most appropriate treatment based on the patient's preferences, acne scarring, and skin type.
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Affiliation(s)
- Michael Renzi
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
| | - Matt McLarney
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
| | - Tara Jennings
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey.
| | - Robert Duffy
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
| | - Warren R Heymann
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
| | - Naomi Lawrence
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
| | - Ashley Decker
- Cooper University Hospital and Cooper Medical School of Rowan University, Camden, New Jersey
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Shen WC, Cheng HT, Jan YK, Liau BY, Hsieh CW, Bau JG, Tai CC, Lung CW. Effect of negative pressure therapy on the treatment response to scar thickness and viscoelasticity. Front Bioeng Biotechnol 2024; 12:1353418. [PMID: 38712331 PMCID: PMC11070486 DOI: 10.3389/fbioe.2024.1353418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 03/12/2024] [Indexed: 05/08/2024] Open
Abstract
Patients with scars face a grave threat to their mental and physical health. Negative pressure has been used for scar therapy in medical care and provides a microenvironment conducive to scar healing while stimulating cell regeneration. Negative pressure may disrupt scar tissue regeneration when the pressure is too high or too low, so finding a suitable negative pressure is important. We hypothesized that different negative pressure magnitudes would affect scar tissue properties differently. This research aimed to provide practical recommendations for scar therapy. This study used three negative pressures (-105 mmHg, -125 mmHg, and -145 mmHg) to compare scar material properties. We measured scar tissue thickness and viscoelasticity with a motor-driven ultrasound indentation system. According to the results of this study, scar thickness is most effectively reduced at a negative pressure of -105 mmHg. In comparison, scar viscoelasticity continuously increases at a negative pressure of -125 mmHg. Negative pressure therapy can be recommended to scar care clinics based on the results of this study.
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Affiliation(s)
- Wei-Cheng Shen
- Department of Creative Product Design, Asia University, Taichung, Taiwan
| | - Hsu-Tang Cheng
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Asia University Hospital, Asia University College of Medical and Health Science, Taichung, Taiwan
- Department of Food Nutrition and Health Biotechnology, Asia University, Taichung, Taiwan
| | - Yih-Kuen Jan
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Ben-Yi Liau
- Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan
| | - Chang-Wei Hsieh
- Department of Electrical Engineering, National Dong Hwa University, Hualien, Taiwan
| | - Jian-Guo Bau
- Department of Agricultural Technology, National Formosa University, Yunlin, Taiwan
| | - Chien-Cheng Tai
- School of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Chi-Wen Lung
- Department of Creative Product Design, Asia University, Taichung, Taiwan
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States
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García PN, Andrino RL. Resurfacing of atrophic facial acne scars with a multimodality CO 2 and 1570 nm laser system. J Cosmet Dermatol 2024; 23 Suppl 1:13-18. [PMID: 38587296 DOI: 10.1111/jocd.16283] [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: 02/04/2024] [Revised: 03/03/2024] [Accepted: 03/06/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Scarring is one of the most prevalent long-term complications of acne vulgaris and has cosmetic, psychological, and social burdens. Contemporary management programs integrate multiple modalities to best address the multiple factors underlying their development and persistence. This work assessed the impact of sequential multimodal laser therapy on acne scar geometrics and texture. METHODS Adult patients (n = 16) with Fitzpatrick skin type II-IV and presenting with facial acne scars, underwent three combination ablative (CO2), and nonablative (1570 nm) laser treatment sessions at two-month intervals. Treatment was delivered using a ProScan Hybrid applicator, with each regimen including illumination with both ablative and a nonablative lasers applied in a grid mode sequence. Scar microtopography was assessed at baseline and 6 months after the last treatment session. RESULTS At baseline, all patients had both box and rolling scars, while only three had icepick scars. Six months following treatment, mean scar volume improved from 5.7 ± 5.2 mm3 at baseline to 3.1 ± 3.0 mm3 and mean affected area improved from 165.6 ± 134.0 mm2 94.0 ± 80.1 mm2, translating to 47.0 ± 7.9% and 43.2 ± 8.6% reductions from baseline, respectively. Patients were highly satisfied with treatment outcomes, and no serious adverse reactions were documented during the course of treatment or follow-up. CONCLUSION Multimodal CO2 and 1570-nm laser treatment improved the surface profilometry of patients with atrophic facial acne scars. Customization of both treatment intervals and laser settings to cosmetic regions, scar profiles and skin phototypes may further enhance treatment outcomes and expand its applicability to additional skin deformities.
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Tahiliani S, Mysore V, Ganjoo A, Udare S, Rajendran SC, Reddy R, Rathore VS, Bhatia S, Verma S, Katke V, Patil CY. Practical Aspects of Acne Scar Management: ASAP 2024. Cureus 2024; 16:e55897. [PMID: 38595878 PMCID: PMC11003649 DOI: 10.7759/cureus.55897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2024] [Indexed: 04/11/2024] Open
Abstract
Acne scars are one of the most common complications of acne. They can significantly affect the patient's quality of life. Often, several types of atrophic acne scars are observed simultaneously; therefore, consideration must be given to the type of scar while choosing the treatment modality. Effective treatment is not only important to prevent and improve acne scars but also crucial in preventing psychosocial effects. Treatment of acne scars requires an algorithmic approach that targets each component of the scars, and combination therapy on a patient-specific basis may offer the best chance for significant improvement. The goal of the current article is to discuss the practical aspects of management of atrophic acne scars using the vast modalities of treatment available. The panel of dermatologists and plastic surgeons, each one with at least 20 years of experience in acne scar treatment, participated in a series of 'Practical Aspects of Acne Scar Management' (ASAP) meetings: ASAP 2024. ASAP meetings were organized by "Scar Forum India" from March 2023 to July 2023 in four Indian cities (Mumbai, Delhi, Bengaluru, and Kolkata), each one for a duration of at least three hours. During these meetings and discussions, panelists reviewed and discussed the acne scar-related literature, their clinical experience in its management, available treatment options, along with recent advances. Consequently, a summary of the discussion and practical approach for the management of acne scars is developed. It was concluded that, though there is no specific guideline available to optimize acne scar management despite the multitude of treatment options, the best results can be achieved through the synergy of multiple treatment modalities and using the algorithmic approach.
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Affiliation(s)
- Sushil Tahiliani
- Dermatology, Dr. Sushil Tahiliani Clinic, Mumbai, IND
- Dermatology, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, IND
| | - Venkatraman Mysore
- Dermatology, The Venkat Centre for Skin and Plastic Surgery, Bengaluru, IND
| | - Anil Ganjoo
- Dermatology, Skinnovation Clinics, New Delhi, IND
| | - Satish Udare
- Dermatology, Dr. Udare Skin and Hair Clinic, Navi Mumbai, IND
| | - S C Rajendran
- Dermatology, Cosmetic Skin Care Clinic, Bengaluru, IND
| | - Raghunatha Reddy
- Dermatology, Roots Institute of Dermatological Sciences, Bengaluru, IND
| | - V S Rathore
- Plastic Surgery, Kaayakalp Clinic, Kolkata, IND
| | | | | | - Vaishali Katke
- Medical Affairs, A. Menarini India Pvt Ltd., Mumbai, IND
| | - Chetan Y Patil
- Medical Affairs, A. Menarini India Pvt Ltd., Mumbai, IND
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Hartman N, Loyal J, Borsack S, Goldman M. Alternating Treatment With Nonablative Fractional Laser and Radiofrequency Microneedling for the Treatment of Acne Scars: A Prospective, Randomized, Split-Face Study. Dermatol Surg 2024; 50:81-85. [PMID: 37962952 DOI: 10.1097/dss.0000000000003994] [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: 11/16/2023]
Abstract
BACKGROUND Acne scarring is an unfortunate sequela affecting up to 95% of patients with acne and carries profound psychosocial impact. Both nonablative fractional lasers (NAFL) and microneedling with radiofrequency (MNRF) have demonstrated comparable efficacy in the treatment of atrophic acne scars. OBJECTIVE To determine whether alternating NAFL and MNRF is superior to NAFL alone in the treatment of atrophic acne scars. METHODS AND MATERIALS This was a prospective, single-center, double-blinded, split-face clinical trial. Twenty patients with atrophic acne scars who had their facial halves randomized to receive either NAFL alone or NAFL alternating with MNRF. Patients received 4 total treatments at 4-week intervals. RESULTS Ninety days after the final treatment, both facial halves demonstrated a significant improvement in the mean global échelle d'évaluation clinique des cicatrices d'acné (ECCA) score from baseline ( p < .001 for both halves). The average percentage improvement at the final end point was 20% to 30% from baseline. No significant difference was noted between facial halves for mean global ECCA score or percentage improvement at any time point. CONCLUSION Although both NAFL and MNRF are safe and effective in the treatment of atrophic acne scars, alternating NAFL and MNRF does not seem to be superior to NAFL alone.
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Affiliation(s)
- Nina Hartman
- Lupo Center for Aesthetic and General Dermatology, New Orleans, Louisiana
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Ning X, Wang Z, Fei W, Han Y, Liu B, Xu J, Li C, Cui Y, Yu R. Efficacy and safety of 1565-nm nonablative fractional laser combined with mucopolysaccharide polysulfate cream for erythematous acne scars. J Cosmet Dermatol 2023; 22:3008-3016. [PMID: 37464984 DOI: 10.1111/jocd.15935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 06/12/2023] [Accepted: 07/09/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To evaluate the efficacy and safety of 1565-nm nonablative fractional laser (NAFL) combined with mucopolysaccharide polysulfate (MPS) cream in the treatment of erythematous acne scars. METHODS A total of 28 subjects with erythematous acne scars from June 2021 to April 2022 were enrolled. One side of each subject's face was randomly assigned to be treated with 1565-nm NAFL (at 2 sessions with four-week intervals) combined with MPS cream (twice daily) for 8 weeks, and the other side with 1565-nm NAFL combined with placebo cream. CBS® images and parameters, dermoscopic images and the quantitative data processed by ImageJ software, and quantitative global scarring grading system (GSS) score were obtained at baseline and after treatment. Subjects' satisfaction assessment was performed after treatment. Adverse events were recorded during treatment. RESULTS In CBS® parameters, the red area, red area concentration, and smoothness were improved more significantly on the 1565-nm NAFL combined with MPS cream side than on the 1565-nm NAFL combined with placebo cream side after treatment (p = 0.015, p = 0.013, and p = 0.021). For dermoscopy, both scar area and scar redness achieved a significantly greater percentage of improvement on the side of 1565-nm NAFL combined with MPS cream than the side of 1565-nm NAFL combined with placebo cream after treatment (p = 0.005 and p = 0.041). The reduction of quantitative GSS score and Subjects' satisfaction assessment were similarly superior on the 1565-nm NAFL combined with MPS cream side. Temporary erythema was experienced by all subjects after each 1565-nm NAFL treatment. No subject reported intolerance or allergy to the cream during follow-up. CONCLUSIONS The combined application of 1565-nm NAFL and MPS cream could be an effective and safe treatment for erythematous acne scars. ImageJ software enables quantitative evaluation of dermoscopic images of acne scars.
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Affiliation(s)
- Xiaoli Ning
- Graduate School of Capital Medical University, Beijing, China
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
| | - Ziyi Wang
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Wenmin Fei
- Graduate School of Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Yang Han
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Baoyi Liu
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Jingkai Xu
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
| | - Chengxu Li
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
| | - Yong Cui
- Graduate School of Capital Medical University, Beijing, China
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
| | - Ruixing Yu
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
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Patel P, Pal R, Butani K, Singh S, Prajapati BG. Nanomedicine-fortified cosmeceutical serums for the mitigation of psoriasis and acne. Nanomedicine (Lond) 2023; 18:1769-1793. [PMID: 37990979 DOI: 10.2217/nnm-2023-0147] [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] [Indexed: 11/23/2023] Open
Abstract
Cosmetics have a long history of use for regenerative and therapeutic purposes that are appealing to both genders. The untapped potential of nanotechnology in cosmeceuticals promises enhanced efficacy and addresses the issues associated with conventional cosmetics. In the field of cosmetics, the incorporation of nanomedicine using various nanocarriers such as vesicle and solid lipid nanoparticles significantly enhances product effectiveness and promotes satisfaction, especially in tackling prevalent skin diseases. Moreover, vesicle-fortified serum is known for high skin absorption with the capacity to incorporate and deliver various therapeutics. Additionally, nano-embedded serum-based cosmeceuticals hold promise for treating various skin disorders, including acne and psoriasis, heralding potential therapeutic advancements. This review explores diverse nanotechnology-based approaches for delivering cosmetics with maximum benefits.
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Affiliation(s)
- Priya Patel
- Department of Pharmaceutical Sciences, Saurashtra University, Rajkot, Gujarat, 360005, India
| | - Rohit Pal
- Department of Pharmaceutical Sciences, Saurashtra University, Rajkot, Gujarat, 360005, India
| | - Krishna Butani
- Department of Pharmaceutical Sciences, Saurashtra University, Rajkot, Gujarat, 360005, India
| | - Sudarshan Singh
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand
- Office of Research Administration, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Bhupendra G Prajapati
- Department of Pharmaceutics & Pharmaceutical Technology, Shree S.K. Patel College of Pharmaceutical Education & Research, Ganpat University, Mehsana, Gujarat, 384012, India
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Vingan NR, Wamsley CE, Panton JA, Mangalagiri D, Turer D, Akgul Y, Barillas J, Culver A, Kenkel JM. Investigating the Efficacy of Modified Lipoaspirate Grafting to Improve the Appearance of Atrophic Acne Scars: A Pilot Study. Aesthet Surg J 2023; 43:NP613-NP630. [PMID: 37051925 DOI: 10.1093/asj/sjad102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Processed lipoaspirate grafting describes several techniques theorized to leverage the inflammatory and regenerative capacities of mechanically processed adipocytes to rejuvenate and correct skin pathology. Although lipoaspirate grafting is typically leveraged to fill visible defects such as depressed scars and dermal lines, additional fat processing allows grafts to stimulate mechanisms of wound healing, including the promotion of fibroblast activation, neovascularization, and neocollagenesis. OBJECTIVES This study intends to assess the efficacy and tolerability of processed lipoaspirate grafting monotherapy to improve the clinical appearance of atrophic acne scars. METHODS Patients underwent a single autologous processed lipoaspirate grafting procedure at the site of atrophic acne scars. Objective and subjective scar analysis was performed at 3 and 6 months posttreatment. Scars were assessed with standard photography, topographic analysis, and noninvasive skin measurements. In addition, microbiopsies were obtained before and after treatment to assess histological or genetic changes. Clinical improvement was assessed with patient and clinician Global Aesthetic Improvement Scales (GAIS) and blinded photographic evaluation. RESULTS Ten patients between ages 18 and 60 completed the study. Clinical evaluation demonstrated that fat grafting improved the appearance of atrophic acne scars. Clinician GAIS and patient GAIS scores showed clinical improvement at both 3- and 6-month follow-up compared with baseline (P < .05). Blinded clinician GAIS scores also showed statistically significant improvement when clinicians compared clinical photographs taken at 6-month follow-up to baseline (P < .0001). The attenuation coefficient increased at 6-month follow-up, suggesting collagen remodeling and reorganization over the study period. Patients experienced anticipated posttreatment symptoms including transient erythema and edema; however, no unexpected adverse events were reported. CONCLUSIONS Micronized lipoaspirate injection is a viable and effective option to improve the appearance of facial acne scarring. Favorable improvements in atrophic acne scarring were captured by objective analysis of skin ultrastructure as well as improvement in subjective assessments of scarring. LEVEL OF EVIDENCE: 4
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Lotfi E, Kaveh R, Nezhad NZ, Iranmanesh B, Hosseini SA, Ahramiyanpour N. Endo-radiofrequency subcision in the treatment of acne scars: a pilot investigative study. Lasers Med Sci 2023; 38:154. [PMID: 37400740 DOI: 10.1007/s10103-023-03819-w] [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: 12/03/2022] [Accepted: 06/20/2023] [Indexed: 07/05/2023]
Abstract
Acne vulgaris is a common condition, mostly involving teenagers. Post-acne scarring can cause many psychosocial problems. Treatments include topical agents, chemical peels, ablative lasers, fractional lasers, and more invasive approaches like subcision and surgery. We aimed to build on data regarding the efficacy and safety of endo-radiofrequency subcision in treating acne scars. This trial involved 30 patients (26 females and 4 males) suffering from acne scars. Patients were treated with endo-radiofrequency subcision. Outcomes were measured by Goodman and Baron scores (GBA), Patient's Global Assessment (PGA), and Investigator's Global Assessment (IGA). All 30 patients completed the trial. The mean baseline quantitative Goodman and Baron score was 13.2 ± 4.31, which improved to 5.37 ± 2.83 by the end of the study (P < 0.001). A significant improvement was also noted in the Goodman and Baron qualitative assessment of acne scars (P < 0.001). According to the PGA, the improvement rate was 25-50% in most patients (60%), while according to the IGA, the improvement rate was 25-49% in most patients (50%). Eleven patients (36.7%) were satisfied with the treatment process, while the other 19 patients (63.3%) were very satisfied. Side effects were minimal and transient. A single session of endo-radiofrequency subcision is a fairly safe and effective treatment, with a high satisfaction rate among treated patients.
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Affiliation(s)
| | - Roxana Kaveh
- Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Behzad Iranmanesh
- Department of Dermatology, Afzalipour Faculty of Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, 7616913555, Iran
| | | | - Najmeh Ahramiyanpour
- Department of Dermatology, Bushehr University Of Medical Sciences, Bushehr, Iran.
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Hunt A, Qian V, Olds H, Daveluy S. The Current Clinical Trial Landscape for Hidradenitis Suppurativa: A Narrative Review. Dermatol Ther (Heidelb) 2023:10.1007/s13555-023-00935-x. [PMID: 37261652 DOI: 10.1007/s13555-023-00935-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 05/04/2023] [Indexed: 06/02/2023] Open
Abstract
Hidradenitis suppurativa (HS) is a skin disease resulting from chronic, recurrent inflammation around hair follicles, characterized by proinflammatory cytokines such as IL-1, IL-17, IL-23, and TNF-α. While adalimumab, a TNF-α targeting human IgG monoclonal antibody, is the only approved treatment for HS, there are many other therapies being investigated now targeting other key players in inflammatory pathways such as the cytokines listed above, C5a in the complement pathway, and Janus kinase (JAK). This review discusses current clinical trials for biologics and small molecules, procedures, and wound dressings undergoing study in hidradenitis suppurativa.
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Affiliation(s)
- Amanda Hunt
- Western Michigan University Homer Stryker M.D. School of Medicine, 300 Portage Street, Kalamazoo, MI, 49007, USA.
| | - Victoria Qian
- Wayne State University School of Medicine, Detroit, MI, USA.
| | - Hailey Olds
- Department of Dermatology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Steven Daveluy
- Department of Dermatology, Wayne State University School of Medicine, Detroit, MI, USA
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12
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Mokhtari F, Safavi Z, Faghihi G, Asilian A, Shahmoradi Z. A Comparative Study on the Usefulness of Fractional CO 2 and Fractional Er:YAG in Acne Scars: A Split-Face Trial. Adv Biomed Res 2023; 12:90. [PMID: 37288037 PMCID: PMC10241645 DOI: 10.4103/abr.abr_330_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 04/26/2022] [Accepted: 04/30/2022] [Indexed: 06/09/2023] Open
Abstract
Background Acne is a dermatologic condition with a high burden in terms of psychosocial consequences as a result of scars remaining on the skin. Its effects are severe in adolescence and finding treatments with short therapy courses, superior results, and fewer adverse effects are of high importance. Materials and Methods We included 30 individuals with acne vulgaris scars in Al-Zahra academic training hospital from June 2018 to Jan 2019. Each individual received both fractional CO2 and fractional Er:YAG lasers on right and left sides of the face, respectively. Three sessions of laser treatment were applied to each side with one-month intervals. Results were evaluated by patients according to subjective satisfaction and physicians' assessment and photo evaluation by two blinded dermatologists. Improvement was graded by a quartile grading scale: less than 25%: mild, 25% to 50%: moderate, 51% to 75%: good, and 76% to 100%: excellent response. Assessments were obtained at baseline and one month after the last visit. Results Based on subjective satisfaction (p < 0.05) and physicians' assessment (p < 0.01), fractional CO2 laser was significantly more effective than Erbium:YAG laser. Also, Post-treatment side effects were mild and transient in both groups. Conclusion Laser therapies are common in the treatment of scars and each modality has special advantages and disadvantages. Choosing among them should be based on various criteria. Fractional CO2 lasers have been revealed favorable results in most reports. Large comprehensive trials could help experts in choosing among alternatives for different subgroups.
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Affiliation(s)
- Fatemeh Mokhtari
- Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Skin and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Safavi
- Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gita Faghihi
- Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Skin and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Asilian
- Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Skin and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Dermatology Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zabihollah Shahmoradi
- Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Skin and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Dermatology Department, Isfahan University of Medical Sciences, Isfahan, Iran
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13
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Lobo Y, Lim DS. Surgical Subcision for Acne Scars: A Review of Instrumentation. Dermatol Surg 2023; 49:355-362. [PMID: 36943759 DOI: 10.1097/dss.0000000000003706] [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: 03/23/2023]
Abstract
BACKGROUND Subcision is a surgical technique for managing atrophic acne scars. Over time, new instruments have emerged to increase the efficiency, efficacy, and safety of the subcision procedure, including sharp, blunt, and energy-assisted devices. OBJECTIVE To review the instrumentation used for the subcision of acne scars and to provide clinicians with practical information regarding the selection of instrumentation, with a focus on advantages and disadvantages. METHODS A search of PubMed, MEDLINE, and Google Scholar was conducted for articles from January 2000 to June 2022 describing the use of subcision alone for the management of acne scarring. Demographic and clinical data were collected from the included articles. RESULTS A total of 417 patients from 17 articles were included; 155 patients underwent sharp subcision, 235 patients underwent blunt subcision, and 27 patients underwent energy-assisted subcision. The main indication for subcision was atrophic facial acne scars. Subcision using sharp, blunt, and energy-assisted instruments were all effective in treating atrophic acne scars. Adverse effects common to all subcision methods included erythema and edema. CONCLUSION Subcision is a safe and effective modality for the revision of selected acne scars and is a valuable skill set for dermatologists who perform scar revision to master.
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Affiliation(s)
- Yolanka Lobo
- Department of Dermatology, Royal Brisbane and Women's Hospital, Brisbane, Australia
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14
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Nunez JH, Strong AL, Comish P, Hespe GE, Harvey J, Sorkin M, Levi B. A Review of Laser Therapies for the Treatment of Scarring and Vascular Anomalies. Adv Wound Care (New Rochelle) 2023; 12:68-84. [PMID: 35951024 DOI: 10.1089/wound.2021.0045] [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] [Indexed: 01/15/2023] Open
Abstract
Significance: Laser use has become part of the gold standard of treatment as an effective adjuvant in multimodal therapy for pathologic scarring caused by burns, trauma, acne, and surgery, as well as vascular anomalies. Understanding indications and applications for laser therapy is essential for physicians to improve patient outcomes. Recent Advances: Since the 1980s, the medical use of lasers has continuously evolved with improvements in technology. Novel lasers and fractionated technologies are currently being studied in the hopes to improve treatment efficacy, while reducing complications. Recent advancements include acne treatment with novel picosecond lasers, new hypertrophic scar therapies with simultaneous laser and intense pulsed light use, and novel systems such as lasers with intralesional optical fiber delivery devices. In addition, optimizing the timing of laser therapy and its use in multimodal treatments continue to advance the field of photothermolysis. Critical Issues: Selecting the correct laser for a given indication is the fundamental decision when choosing a laser balancing effective treatment with minimal complications. This article covers the principles of laser therapy, the preferred lasers used for the treatment of scarring and vascular anomalies, and discusses the current evidence behind these laser choices. Future Directions: To optimize laser therapy, larger randomized control trials and split scar studies are needed. Continued advancement through better randomized controlled studies will help to improve patient outcomes on a broader scale.
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Affiliation(s)
- Johanna H Nunez
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Amy L Strong
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Paul Comish
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Geoffrey E Hespe
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Jalen Harvey
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Michael Sorkin
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Benjamin Levi
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Vempati A, Zhou C, Tam C, Khong J, Rubanowitz A, Tam K, Hazany S, Vasilev R, Hazany S. Subcision for Atrophic Acne Scarring: A Comprehensive Review of Surgical Instruments and Combinatorial Treatments. Clin Cosmet Investig Dermatol 2023; 16:125-134. [PMID: 36698445 PMCID: PMC9868281 DOI: 10.2147/ccid.s397888] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/22/2022] [Indexed: 01/19/2023]
Abstract
Subcutaneous incisionless surgery, also known as subcision, is a minimally invasive procedure that is commonly indicated for the treatment of atrophic acne scars. In recent years, many new techniques have been developed to maximize results from this procedure. This review article aims to identify an updated list of instruments and combinatorial treatments available for atrophic acne scar patients undergoing subcision. We constructed a comprehensive PubMed search term and performed triple-blinded screening on all resulting studies for mentions of subcision as indicated by acne scarring. Our results show that there are four main categories of subcision tools that are commonly employed to treat atrophic acne scars: needles, cannulas, wires, and blunt-blade instruments. Usage of these devices varies by scar depth, personal preference, and combinatorial treatment options. Overall, subcision is a particularly effective treatment for atrophic acne scars, and there is vast potential for further innovation with this technique.
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Affiliation(s)
- Abhinav Vempati
- Scar Healing Institute, Los Angeles, CA, USA,Correspondence: Abhinav Vempati, Scar Healing Institute, Los Angeles, CA, USA, Tel +1 424 225 2453, Fax +1 310 571 8435, Email
| | | | - Curtis Tam
- Scar Healing Institute, Los Angeles, CA, USA
| | - Jeffrey Khong
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Kevin Tam
- Scar Healing Institute, Los Angeles, CA, USA
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16
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Mohamed NE, Shabaan SN, Raouf AH. Microbotox (Mesobotox) versus microneedling as a new therapeutic modality in the treatment of atrophic post-acne scars. J Cosmet Dermatol 2022; 21:6734-6741. [PMID: 36169570 DOI: 10.1111/jocd.15419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Given that most patients with moderate to severe acne develop post-acne scars, many treatment modalities can be used to ameliorate scaring; chemical peels, surgical excision, dermabrasion, fat transfer, autologous collagen, punch grafting, diverse filler injection, and lasers. Microneedling is one of the promising modalities based on the breaking of dermis-damaged collagen and enhancing new collagen formation. Microbotox (Mesobotox) injection may have a beneficial effect by causing muscular paralysis with subsequent dermal edema due to transient and mild lymphatic insufficiency. The comparison between these two modalities has not been yet assessed. The aim of this study was to evaluate and compare the safety and efficacy of both methods (Microbotox and microneedling) in the treatment of atrophic post-acne scars. METHODS Between May 2021 to April 2022, patients with atrophic post-acne scars were selected from the out-patients clinics of the Department of Dermatology, Faculty of Medicine. The face was divided into two sides: the right side was treated with Mesobotox for three sessions once monthly and followed up 3 months later after the last session and the left side was treated with dermapen (microneedling) for six sessions every 2 weeks and followed up 3 months after the last session. The feasibility, safety, and efficacy of both lines of treatment were studied. RESULTS This study included 20 patients with atrophic post-acne scars. They were 13 females (65%) and 7 males (35%), and their ages ranged between 15 and 35 years with a mean ± sd age of 24.40 ± 5.90 based on the significant improvement between S1 (baseline acne scar score) and both S2 (acne scar score at end of treatment) and S3 (acne scar score 3 months after the last session). Microneedling showed also similar results to Mesobotox. CONCLUSIONS Microbotox and microneedling were effective and tolerated.
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Affiliation(s)
- Noha E Mohamed
- Department of Dermatology, STDs and Andrology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Samar N Shabaan
- Department of Dermatology, STDs and Andrology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Amel H Raouf
- Department of Dermatology, STDs and Andrology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
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17
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Aljefri YE, Ghaddaf AA, Alahmadi RA, Alkhamisi TA, Alkhunani TA, Samarkandy SJ, Alamri AM. Ablative fractional carbon dioxide laser combined with autologous platelet-rich plasma in the treatment of atrophic acne scars: A systematic review and meta-analysis. Dermatol Ther 2022; 35:e15888. [PMID: 36183145 DOI: 10.1111/dth.15888] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/07/2022] [Accepted: 09/29/2022] [Indexed: 11/29/2022]
Abstract
Atrophic acne scars are the most common cutaneous seqaule of acne vulgaris, representing 80%-90% of all acne scars. Ablative fractional carbon dioxide (FCO2 ) laser is the gold standard treatment for atrophic scars. Additionally, platelet-rich plasma (PRP) is suggested to accelerate the healing process and collagen synthesis. The aim of the present systematic review and meta-analysis was to determine the efficacy and safety of PRP combined with Ablative FCO2 laser in the treatment of moderate to severe atrophic acne scars. Randomized controlled trials (RCTs) that have compared PRP in combination with ablative FCO2 laser to ablative FCO2 laser alone with respect to the efficacy and safety measures were included. We have systematically explored Embase, Medline, and CENTRAL databases via Ovid. The outcomes that our systematic review sought to evaluate were clinical improvement, patient satisfaction, and Goodman and Baron's qualitative acne scar score. The dichotomous outcomes were presented as odds ratio (OR) while the continuous outcomes were presented as standardized mean difference (SMD). Eleven RCTs that represents 313 participants were included. The combined use of laser and PRP showed a statistically significant clinical improvement and patient satisfaction compared to the use of laser alone (OR = 2.56, 95% CI 1.37-4.78 and OR = 3.38, 95% CI 1.80-6.34, respectively). Also, a significant improvement in Goodman and Baron's score was achieved by combining PRP with laser (SMD = -0.40, 95% CI -0.65 to -0.14). The combined treatment of laser and PRP was highly synergistic, effective, and safe in treating moderate to severe atrophic acne scars.
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Affiliation(s)
- Yara E Aljefri
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Abdullah A Ghaddaf
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Rana A Alahmadi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Taif A Alkhamisi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Tala A Alkhunani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Sahal J Samarkandy
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Department of Dermatology, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Awadh M Alamri
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Department of Dermatology, King Abdulaziz Medical City, Jeddah, Saudi Arabia
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Lotfi E, Shafie'ei M, Ahramiyanpour N. Radiofrequency‐assisted subcision combined with polycaprolactone‐based dermal fillers in the management of atrophic facial acne scars: A pilot investigative study. Skin Res Technol 2022; 28:865-871. [PMID: 36321243 PMCID: PMC9907701 DOI: 10.1111/srt.13228] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 10/15/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The scar's appearance and psychological burden are the most esthetically challenging issues in acne vulgaris. This study investigated the effectiveness and safety profile of combined radiofrequency-assisted subcision, which, even though effective on both Icepeak and Rolling subtypes, is only mildly effective on boxcar lesions, and polycaprolactone-based dermal filler with collagen stimulation potency in managing atrophic postacne scars. METHODS Our quasi-experimental single-arm study, after the inclusion of 10 cases over the age of 18 with moderate to severe mixed atrophic facial acne scarring, was carried out in two 3-month separate sessions, during and after the intended intervention of which the experienced lesion improvements and also adverse events were documented. Moreover, all cases were followed for 3 months after the last session, evaluating the differences in the mentioned outcomes. RESULTS We found the combined intervention to be highly effective in improving the intended outcomes, with the total number of acne lesions (p-value < 0.001), along with the total number of Ice peak (p-value = 0.002), Rolling (p-value < 0.001), and boxcar (p-value = 0.023) lesions demonstrating statistically significant changes. CONCLUSION Radiofrequency-assisted subcision combined with polycaprolactone-based dermal fillers can be an effective intervention in managing postacne scars. However, we recommend that randomized clinical trials with larger sample sizes be carried out for a more precise conclusion.
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Affiliation(s)
| | | | - Najmeh Ahramiyanpour
- Department of Dermatology Afzalipour Hospital, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences Kerman Iran
- Pathology and Stem Cell Research Center Kerman University of Medical Sciences Kerman Iran
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19
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Shen YC, Chiu WK, Kang YN, Chen C. Microneedling Monotherapy for Acne Scar: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Aesthetic Plast Surg 2022; 46:1913-1922. [PMID: 35426044 DOI: 10.1007/s00266-022-02845-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/12/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Acne scarring, formed by the deposition of collagen following inflammatory acne, not only represents a cosmetic problem but also poses a psychological health risk to patients. As microneedling has become a common treatment for acne scarring, an increasing number of studies have compared the efficacy and safety of microneedling. In this study, we conducted a meta-analysis of randomized controlled trials (RCTs) comparing microneedling with other treatments. METHOD Three databases, namely Embase, PubMED, and Cochrane library, were searched until June 20, 2021, for RCTs only. Studies using microneedling in both treatments were excluded. RESULTS Twelve studies, totaling 414 participants, were included in our meta-analysis. For objective scar improvement, the pooled estimate analysis of the first group, treated with microneedling without radiofrequency, yielded a mean difference of 0.42 (95% CI-0.12-0.73%) with a significant difference at the 5% significance level. The second group, treated with fractional radiofrequency microneedling, exhibited no significance at the 5% significance level. Regarding subjective satisfaction, most results exhibited no significant difference between microneedling and other treatments. Although no case of secondary scarring or infection was reported in our study, the pooled result of postinflammatory hyperpigmentation was significant at the 5% significance level and preferred microneedling treatment. CONCLUSION Microneedling without radiofrequency achieved superior results in terms of scar improvement. No form of microneedling caused postinflammatory hyperpigmentation-an advantage in acne scar treatment. Thus, microneedling is a favorable choice for the treatment of acne scarring. LEVEL OF EVIDENCE III 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)
- Yu-Chun Shen
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wen-Kuan Chiu
- Division of Plastic Surgery, Department of Surgery, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-No Kang
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
- Evidence-Based Medicine Center, Wan Fang Hospital, Medical University Hospital, Taipei, Taiwan
- Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Institute of Health Policy & Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chiehfeng Chen
- Division of Plastic Surgery, Department of Surgery, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan.
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.
- Evidence-Based Medicine Center, Wan Fang Hospital, Medical University Hospital, Taipei, Taiwan.
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Gronovich Y, Maisel Lotan A. Treatment of scars with autologous fat grafting and 1540 nm non-ablative erbium laser. J COSMET LASER THER 2022; 24:80-83. [PMID: 35318875 DOI: 10.1080/14764172.2022.2055078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Scars may be devastating for patients. Fat grafting and non-ablative lasers are available options for improvement. The former reshapes and improves scar quality by adding volume and regenerative adipose-derived stem cells, whereas the latter facilitates synthesis and deposition of new dermal collagen. The combination may be synergic, leading to better cosmetic outcome.This was a prospective study of 16 consecutive patients treated with autologous fat grafting and non-ablative 1540-nm erbium laser for facial scars between January 2015 and December 2015. Treatment protocol included fat injection followed by five treatments with 1540-nm erbium laser (ICONTM Cynosure; Westford, MA, USA) a month later. We evaluated patients before, after treatments, and 6 months after the final treatment.Sixteen patients participated in our study. Mean patient age was 42 years (range 16-59 years). Scars were either traumatic (73%) or acne induced (27%). Traumatic scars were mainly new scars, with the majority of patients were treated within 30 days of injury. There were no reported complications. Scars improved in both texture and appearance and patient satisfaction was high in all cases.Treatment of scars with autologous fat grafting and fractional non-ablative 1540-nm erbium laser is safe and efficient and results in improved scar appearance and texture.
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Affiliation(s)
- Yoav Gronovich
- Hebrew University, Jerusalem, Israel.,Department of Plastic and Reconstructive Surgery, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Adi Maisel Lotan
- Hebrew University, Jerusalem, Israel.,Department of Plastic and Reconstructive Surgery, Shaare Zedek Medical Center, Jerusalem, Israel
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21
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Kang C, Lu D. Combined Effect of Microneedling and Platelet-Rich Plasma for the Treatment of Acne Scars: A Meta-Analysis. Front Med (Lausanne) 2022; 8:788754. [PMID: 35237616 PMCID: PMC8882957 DOI: 10.3389/fmed.2021.788754] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 11/29/2021] [Indexed: 01/23/2023] Open
Abstract
Background Microneedling is a promising method for the treatment of acne scars, while the effect of microneedling combined with platelet-rich plasma (PRP) remains unknown. We performed a meta-analysis of controlled studies to compare the efficacy and safety of microneedling treatment with and without additional PRP in patients with acne scars. Methods Randomized and non-randomized controlled studies were identified by search of Medline, Embase, and Cochrane's Library databases. Results were pooled with a random-effects model, incorporating the possible heterogeneity. Results Four randomized and 10 split-face non-randomized controlled studies with 472 patients were included. Compared to microneedling therapy without PRP, combined treatment with microneedling and PRP was associated with increased odds of clinical improvement of >50% in Goodman's qualitative scale [GQS: odds ratio (OR): 2.97, 95% confidence interval (CI): 1.96–4.51, p < 0.001; I2 = 0%], and a significantly improved mean GQS score (mean difference: −0.32, 95% CI: −0.44 to −0.20, p < 0.001; I2 = 0%). Combined treatment was associated with a higher patient satisfying rate (OR: 4.15, 95% CI: 2.13 to 8.09, p < 0.001; I2 = 53%), while the incidence of severe adverse events such as severe erythema (OR: 1.59, 95% CI:.73 to 3.46, P = 0.24; I2 = 0%) and severe edema (OR: 1.14, 95% CI: 0.47 to 2.76, P = 0.77; I2 = 0%) were not significantly different. Conclusions Combined treatment with microneedling with PRP is more effective than microneedling without PRP for patients with acne scars.
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22
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Ebrahim HM, Artima AY, Elardi A, Mohamed Morsi H. Clinical and Histopathological evaluation of different tools for the Subcision of Atrophic Acne Scars. J Cosmet Dermatol 2021; 21:1127-1134. [PMID: 34806274 DOI: 10.1111/jocd.14562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 10/06/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Acne scarring can lead to social and psychological distress. OBJECTIVE To compare the safety, efficacy, and long-term improvement of subcision using tri-beveled hypodermic (Th) needle versus cannula for the treatment of atrophic post-acne scars. METHODS Forty-six patients with atrophic post-acne scars were treated with subcision using (Th) needle on one side of the face and a blunt cannula on the other side of the face for 6 sessions one month apart. The primary outcome was based on the clinical improvement and patient satisfaction score. Skin biopsies were taken at baseline and 3months after the final session. Follow-up was 9 months. RESULTS Three months after the final session, a statistically highly significant difference was detected in both sides from the baseline (p < 0.001). The overall improvement was 73.9% on the (Th) needle side versus 65.2% on the cannula side (p = 0.68). There was no significant difference in acne severity scarring grade between both sides (p = 0.86). The mean number of sessions was significantly less in the (Th) needle side (p < 0.001). Collagen deposition and reorganization were achieved with both modalities. Patient satisfaction showed no significant difference between both sides. The side effects were mild and significantly higher in the (Th) needle side (p = 0.001). CONCLUSION Both modalities are effective and economic techniques. However, using a cannula is associated with much fewer side effects, more convenient for the patients and physicians compared to the (Th) needle.
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Affiliation(s)
| | | | - Amal Elardi
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
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23
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Rusk A, Marathe K, Lucky AW. What the Pediatric and Adolescent Gynecology Clinician Needs to Know about Acne. J Pediatr Adolesc Gynecol 2021; 34:591-596. [PMID: 33727191 DOI: 10.1016/j.jpag.2021.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/28/2021] [Accepted: 03/04/2021] [Indexed: 12/18/2022]
Abstract
Acne vulgaris is a common skin condition encountered in specialties outside of dermatology, including obstetrics and gynecology. The pathophysiology of acne is complex and includes disruption of the cutaneous microbiome, abnormal keratinization, inflammation, and hormonal influences. Various topical and systemic treatment modalities target each component of acne pathophysiology. Clinically, acne can be broken down into noninflammatory, inflammatory, or mixed subtypes. The age of the patient at presentation and signs and symptoms of hormonal imbalance might prompt workup for underlying disorders. The severity as well as type of acne dictates the type of treatment.
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Affiliation(s)
- Amanda Rusk
- University of Cincinnati Medical Center, Department of Dermatology, Cincinnati, Ohio.
| | - Kalyani Marathe
- University of Cincinnati Medical Center, Department of Dermatology, Cincinnati, Ohio; Cincinnati Children's Hospital Medical Center, Department of Dermatology, Cincinnati, Ohio
| | - Anne W Lucky
- University of Cincinnati Medical Center, Department of Dermatology, Cincinnati, Ohio; Cincinnati Children's Hospital Medical Center, Department of Dermatology, Cincinnati, Ohio
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24
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Liu Y, Li Z, Hu J, Wang M, Qu C, Wu H, Su X, Wang L. Treatment of nasal depressed scars using micro-plasma radiofrequency technology combined with subcision. J Cosmet Dermatol 2021; 21:2458-2462. [PMID: 34496123 DOI: 10.1111/jocd.14431] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/23/2021] [Accepted: 08/24/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND The nose is located in the middle of the face; therefore, nasal scarring will bring a significant psychological impact on patients. Although there are many treatment methods for depressed scars, these methods have varying degrees of efficacy and all carry certain adverse effects. A better treatment method is urgent to be found. In this study, the effect of micro-plasma radiofrequency technology combined with subcision to treat nasal depressed scars is evaluated. METHODS 18 Chinese patients with nasal depressed scars participated in this study. All patients received one session of micro-plasma radiofrequency treatment first. 2 months later, subcision combined with micro-plasma radiofrequency technology was performed on them at 6-month intervals, and a total of 2 sessions of combined treatment were performed. Goodman and Baron Scale was used to evaluate nasal scars before treatment and 6 months after the final session. RESULTS All 18 patients in this study had Grade 4 nasal scars before treatment. 6 months after the end of treatment, 13 patients (72.2%) showed excellent or near total improvement, and 5 patients (27.8%) showed marked improvement. No adverse side effects were observed during treatment. Patient self-evaluation indicated that all patients were satisfied with the cosmetic outcomes. CONCLUSIONS In this study, we explored a new treatment method for nasal depressed scars. We used micro-plasma radiofrequency technology combined with subcision to treat nasal depressed scars and obtained relatively satisfactory results with no adverse effects.
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Affiliation(s)
- Yue Liu
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zehui Li
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jintian Hu
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Meng Wang
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chunan Qu
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huanhuan Wu
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xueshang Su
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lianzhao Wang
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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25
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Abstract
Scars affect millions of patients worldwide, yet their treatment efficacy and options clinically remain limited. In recent years, increased understanding of scar formation pathways leading to developments in nanotechnology have opened many opportunities for scar detection, prevention, and treatment due to the nanoscale features and therapeutic delivery capabilities of such technologies. Led by nanoparticles (NPs) and nanofibers, these novel strategies can aid in reducing scar contracture, improving wound-healing efficacy, and advancing progress towards scarless wound healing.
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Zang H, Xu YN. Effectiveness of CO2 laser therapy in treating acne depressed scar: A protocol of systematic review. Medicine (Baltimore) 2021; 100:e23732. [PMID: 33545938 PMCID: PMC7837843 DOI: 10.1097/md.0000000000023732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 11/17/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study is to assess the effectiveness of CO2 laser therapy (COLT) in treating patients with acne depressed scar (ADS). METHODS Relevant randomized controlled trials will be checked by search the electronic databases of Cochrane Library, PUBEMD, EMBASE, Web of Science, Allied and Complementary Medicine Database, VIP Database, CBM database, and China National Knowledge Infrastructure. All potential randomized controlled trials of COLT for patients with ADS will be identified by 2 independent authors by searching all sources from inception to present. Two authors will independently undertake literature selection, data collection and study quality assessment. Any divergences between 2 authors will be settled down by a third author through discussion. RevMan 5.3 software will be used for statistical analysis. RESULTS This study will assess the effectiveness of COLT for patients with ADS. CONCLUSIONS This study may provide helpful evidence to determine whether COLT is an effective intervention for patients with ADS. STUDY REGISTRATION OSF (osf.io/m9ghv).
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Affiliation(s)
- Huan Zang
- Department of Dermatology, Urumqi Maternal and Child Health Hospital, Urumqi, Xinjiang
| | - Ya-nan Xu
- Department of Dermatology, Yan’an People's Hospital, Yan’an, Shaanxi, China
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Sarac G, Kapicioglu Y, Cenk H. An evaluation of the efficacy of a single-session 577 nm pro-yellow laser treatment in patients with postacne erythema and scarring. Dermatol Ther 2020; 34:e14611. [PMID: 33258538 DOI: 10.1111/dth.14611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/14/2020] [Accepted: 11/23/2020] [Indexed: 12/20/2022]
Abstract
Erythema and scarring are among the most common complications of severe inflammatory acne. In this study, we aimed to share our experience with pro-yellow laser and document the efficacy and safety of this treatment in postacne erythema and scarring. The study included 40 patients, 24 (60%) females, and 16 (40%) males with a mean age of 29.5 ± 8.16 (min. 18 years, max. 57 years). The pro-yellow laser was applied to all patients as a single session with irradiation of 22 J/cm2 . Improvement in postacne erythema and scars were evaluated after the treatment. The study included 40 patients, 24 patients (60%) were females and 16 patients (40%) were males with the mean age of 29.5 ± 8.16 (ranged between 18 and 57 years old). A total of 21 patients (52.5%) had good improvement (51%-75% regression), 10 patients (25%) had excellent improvement (76%-100% regression), and a moderate improvement (26%-50%) was detected in 9 patients (22.5%). Also, there were mild improvement (1%-25%) in 20 patients (76.9%) and a moderate improvement (26%-50%) in 6 patients (23.1%). We found that pro-yellow laser is highly effective in the treatment of postacne erythema, while its effectiveness was mild to moderate in atrophic acne scars. Also, it has been observed that the pro-yellow laser system can be used safely immediately after cessation of systemic isotretinoin treatment.
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Affiliation(s)
- Gulbahar Sarac
- Department of Dermatology, Inonu University, Malatya, Turkey
| | | | - Hulya Cenk
- Department of Dermatology, Pamukkale University, Denizli, Turkey
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Cenk H, Sarac G. Effectiveness and safety of 2940-nm multifractional Er: YAG laser on acne scars. Dermatol Ther 2020; 33:e14270. [PMID: 32882085 DOI: 10.1111/dth.14270] [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: 08/08/2020] [Revised: 08/23/2020] [Accepted: 08/30/2020] [Indexed: 01/18/2023]
Abstract
Erbium: Yttrium-aluminum-garnet laser (Er: YAG) treatment has been used in resurfacing the acne scars for a long time; however, we could not find any study reporting the recovery rates after each session of the treatment. In this study, we aimed to report the improvement rates after each session. We retrospectively analyzed the data of 35 patients with acne scars treated with fractional ablative Er: YAG laser. The patients received one to four sessions of treatment with 4-week intervals and improvement rates were recorded after each session. Data are available on request from the authors. The improvement rate of the lesions varied between 1% and 25% in 34 patients at the end of the first session, while in one patient, the improvement rate was detected as 26% to 50%. At the end of the fourth session, the rate of improvement was 26% to 50% in 14 out of 24 patients and 51% to 75% in 10 patients. None of the patients showed a 76% to 100% improvement at the end of the fourth session, whereas 48.6% of the patients were satisfied with the treatment. In patients with a high expectation of an excellent improvement, a higher number of sessions of the laser treatment and/or combination treatments with different treatment methods should be planned.
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Affiliation(s)
- Hulya Cenk
- Department of Dermatology, Pamukkale University, Denizli, Turkey
| | - Gulbahar Sarac
- Department of Dermatology, Inonu University, Malatya, Turkey
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Pan BH, Zhang Q, Lam CH, Yin Yuen H, Kuang S, Zhao X. WITHDRAWN: Petite miracles: insight into the nano-management of scarless wound healing. Drug Discov Today 2020; 25:1772. [PMID: 32268202 DOI: 10.1016/j.drudis.2020.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/08/2020] [Accepted: 03/23/2020] [Indexed: 12/22/2022]
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Affiliation(s)
- Bei Ho Pan
- Department of Biomedical Engineering, the Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Qiang Zhang
- Department of Biomedical Engineering, the Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Chun Hei Lam
- Department of Biomedical Engineering, the Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Ho Yin Yuen
- Department of Biomedical Engineering, the Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Shifeng Kuang
- Department of Plastic Surgery, Guangdong Provincial People's Hospital, Guangzhou 510080, China.
| | - Xin Zhao
- Department of Biomedical Engineering, the Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.
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Marasca C, Ruggiero A, Marasca D, Megna M, Fabbrocini G. Skin Needling in Combination with Antimicrobial Peptides for the Treatment of Keloids: A Novel Perspective Proposal and Approach for Skin Scars. Dermatology 2020; 236:601-602. [PMID: 32659756 DOI: 10.1159/000507927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Claudio Marasca
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy,
| | - Angelo Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Dario Marasca
- Department of Dentistry, University of Naples Federico II, Napoli, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
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Mahamoud WA, El Barbary RA, Ibrahim NF, Akmal EM, Ibrahim SM. Fractional carbon dioxide laser combined with intradermal injection of autologous platelet-rich plasma versus noncross-linked hyaluronic acid in the treatment of atrophic postacne scars: A split face study. J Cosmet Dermatol 2020; 19:1341-1352. [PMID: 32333512 DOI: 10.1111/jocd.13427] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/02/2020] [Accepted: 04/02/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Atrophic acne scarring is a common cosmetic problem that may affect 95% of patients with acne. AIMS The objective is to evaluate the efficacy of the fractional CO2 laser combined with intradermal injection of PRP versus intradermal injection of noncross-linked hyaluronic acid in the treatment of different types of atrophic postacne scars. METHODS The study included 30 patients with postacne scars. All the patients received 3 treatments of fractional CO2 laser combined with intradermal injection of PRP at one side of the face compared with intradermal injection of noncross-linked hyaluronic acid at the other side of the face. Efficacy of the treatment was assessed by the physician's clinical assessment using Goodman and Baron's qualitative and quantitative grading systems and histopathological evaluation from six participants. RESULTS The study included 30 patients ages ranging from 25 to 44 years old. There was a statistically significant reduction in the severity of acne scars on both sides after treatment using qualitative and quantitative Goodman and Baron. Histopathological evaluation showed an increase in the collagen and elastic fiber content in both modalities with a more favorable outcome in the PRP-treated side. CONCLUSION Both treatment modalities resulted in a significant clinical and histopathological improvement in atrophic postacne scar with insignificant difference between them.
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Affiliation(s)
- Wafaa A Mahamoud
- Dermatology and Venereology, Faculty of medicine for girls, Al-Azhar University, Cairo, Egypt
| | - Rasha A El Barbary
- Dermatology and Venereology, Faculty of medicine for girls, Al-Azhar University, Cairo, Egypt
| | - Noha F Ibrahim
- Health radiation research Department, National centre for radiation research and technology, Egyptian Atomic Energy Authority, Cairo, Egypt
| | - Eman M Akmal
- Health radiation research Department, National centre for radiation research and technology, Egyptian Atomic Energy Authority, Cairo, Egypt
| | - Shady Mahmoud Ibrahim
- Dermatology and Venereology, Faculty of medicine for boys, Al-Azhar University, Cairo, Egypt
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The Clinical Efficacy of ReCell® Autologous Cell Regeneration Techniques Combined with Dermabrasion Treatment in Acne Scars. Aesthetic Plast Surg 2020; 44:535-542. [PMID: 31451856 DOI: 10.1007/s00266-019-01481-8] [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: 06/02/2019] [Accepted: 08/13/2019] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To evaluate the efficacy of ReCell® autologous cell regeneration techniques combined with dermabrasion treatment on the therapy of acne scars. METHODS We analyzed retrospectively 78 patients with acne scars who presented to the Department of Plastic Surgery at Peking Union Medical College Hospital from May 2015 to May 2017; 30 patients were treated with dermabrasion (Group 1), and the other 48 patients were treated with ReCell® autologous regeneration techniques combined with dermabrasion (Group 2). Efficacy was evaluated through self-evaluation of the patient, third-party evaluation and photographs taken before and after treatment. The wound healing time and postoperative complication rate were also recorded. RESULTS The study revealed a significant difference in healing time (P < 0.001) between patients treated with dermabrasion (Group 1) and patients treated with ReCell® autologous regeneration techniques combined with dermabrasion (Group 2). The average healing time of Group 1 was 12.30 ± 1.725 days, while the average healing time of Group 2 was 5.27 ± 1.086 days. In Group 2, patient self-evaluation and third-party evaluation were more satisfactory than those of Group 1 (P < 0.001). Moreover, there were no postoperative complications in Group 2 such as pigmentation and scar hyperplasia. CONCLUSION The ReCell® technique is simple, minimally invasive, biocompatible and effective in the treatment of acne scars. It can shorten healing time and reduce the occurrence of postoperative complications, thereby providing a safe and effective treatment approach for patients with facial acne scars. 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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Treatment of Atrophic Facial Acne Scars With Microneedling Followed by Polymethylmethacrylate-Collagen Gel Dermal Filler. Dermatol Surg 2020; 45:1570-1579. [PMID: 30807389 DOI: 10.1097/dss.0000000000001872] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Microneedling and soft-tissue filler injections have been used independently to improve acne scarring. The effectiveness of a combined approach using microneedling followed by polymethylmethacrylate (PMMA)-collagen gel has not been carefully studied. OBJECTIVE The goal of this study was to assess the effectiveness and safety of microneedling alone versus microneedling followed by injection of PMMA-collagen gel filler for correction of atrophic facial acne scars. METHODS We conducted a multicenter, open-label, randomized, prospective study on subjects with distensible atrophic acne scars in the face to determine whether microneedling with PMMA-collagen gel is a superior acne scar treatment over microneedling alone. Forty-four subjects received 3 microneedling treatments over a 12-week period followed by randomization to treatments with PMMA-collagen gel (treatment group) or no further treatment (control group). RESULTS At 24 weeks, the treatment group achieved a statistically significant improvement in acne scores over microneedling alone. The improvement continued at 36 weeks. At 24 weeks, the treatment group showed a strong trend in improvement on the Physician Global Aesthetic Improvement Scale compared with microneedling alone.
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Abstract
Purpose:to evaluate the efficacy and safety of minocycline in the therapy of medium-heavy and severe forms of acne vulgaris according to modern ideas about pathogenesis of the disease.Materials and methods. Long-term multi-purpose observation which included 28 patients with the established diagnosis of acne vulgaris, medium-weight and severe forms is made. Patients received monotherapy by Minoleksin® medicine, depending on severity — 50–100 mg a day. Prior to the research and after the end of treatment inspection of the patient with calculation the rash elements, clinical and biochemical blood analysis, a research of function of sebaceous glands, the laser scanning microscopy, a laser Doppler floumetry, definition of the dermatological index of quality of life, photography (was performed at the consent of the patient). In the course of therapy inspection of the patient and assessment of tolerance of drug was performed.Results.The evidence of efficiency of minocycline in treatment of vulgar acnes of average and heavy severity is obtained that is confirmed by visual dermatological indicators, non-invasive methods of a research (results of a sebumetriya, the confocal laser scanning microscopy, a Doppler floumetriya), indicators of the dermatological index of quality of life. When studying clinical and laboratory indicators security concerns are not revealed. The undesirable phenomena in the course of the research are not registered.Conclusion.Minolexin® (minocycline) is highly effective and safe drug for treatment of vulgar acnes of average and heavy severity and it can be recommended for practical application in out-patient practice.Conflict of interest: the author states that there is no potential conflict of interest requiring disclosure in this article.
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Affiliation(s)
- E. S. Snarskaya
- I. M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation
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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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Abstract
Over the past 30 years, the treatment of acne scars has undergone changes that have been significantly influenced by the concurrent development of new devices. The advent of fractional resurfacing lasers was a watershed moment for acne scarring therapy. The author recounts a career history of considerations of acne scarring treatments as well as the literature supporting the experiences causing changes in practice. Fractional ablative and nonablative lasers, sublative radiofrequency, picosecond lasers, microneedling with and without radiofrequency and fillers are the bulk of the treatments covered, along with a discussion of combination therapy. A practical algorithm for acne scarring for selection of treatment modalities is presented.
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Affiliation(s)
- Amy Forman Taub
- Advanced Dermatology, Lincolnshire and Glencoe, IL, USA.
- Northwestern University Medical School, Chicago, USA.
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Kosche C, Mansh M, Luskus M, Nguyen A, Martinez-Diaz G, Inwards-Breland D, Yeung H, Boos MD. Dermatologic care of sexual and gender minority/LGBTQIA youth, Part 2: Recognition and management of the unique dermatologic needs of SGM adolescents. Pediatr Dermatol 2019; 36:587-593. [PMID: 31259441 PMCID: PMC6750974 DOI: 10.1111/pde.13898] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Sexual and gender minority (SGM) individuals, including lesbian, gay, bisexual, transgender/gender diverse, questioning/queer, intersex, and asexual (LGBTQIA) persons, represent a historically underserved population within the field of medicine, though their unique health needs are increasingly recognized. Part 2 of this two-part review will address unique concerns regarding acne, tanning behavior, sexually transmitted infections, and other health disparities among SGM adolescents. A more comprehensive understanding of the dermatologic needs of SGM youth will better allow pediatric dermatologists to actively and compassionately care for this health disparity population.
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Affiliation(s)
- Cory Kosche
- Rush Medical College, Rush University School of Medicine, Chicago, Illinois
| | - Matthew Mansh
- Department of Dermatology, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Mark Luskus
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Andy Nguyen
- Department of Medicine, Mount Auburn Hospital, Cambridge, Massachusetts
| | | | - David Inwards-Breland
- Division of Adolescent Medicine, Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Washington
| | - Howa Yeung
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Markus D Boos
- Division of Dermatology, Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Washington
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Prospective Evaluation of Atrophic Acne Scars on the Face With Needle-Free High-Pressure Pneumatic Injection: Quantitative Volumetric Scar Improvement. Dermatol Surg 2019; 45:829-835. [DOI: 10.1097/dss.0000000000001708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Noninvasive Atrophic Acne Scar Treatment in Asians With a 755-nm Picosecond Laser Using A Diffractive Optic Lens—A Retrospective Photographic Review. Dermatol Surg 2019; 45:195-202. [DOI: 10.1097/dss.0000000000001669] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Affiliation(s)
- Neil S. Sadick
- Weill Cornell Medical College, Cornell University, New York, NY, USA
| | - Andrea Cardona
- Residente de tercer año, Universidad del Rosario, Bogota, Columbia
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Injection technique in neurotoxins and fillers: Indications, products, and outcomes. J Am Acad Dermatol 2018; 79:423-435. [DOI: 10.1016/j.jaad.2018.01.037] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Yang JH, Yoon JY, Moon J, Min S, Kwon HH, Suh DH. Expression of inflammatory and fibrogenetic markers in acne hypertrophic scar formation: focusing on role of TGF-β and IGF-1R. Arch Dermatol Res 2018; 310:665-673. [PMID: 30167815 DOI: 10.1007/s00403-018-1856-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 07/20/2018] [Accepted: 08/11/2018] [Indexed: 12/13/2022]
Abstract
Acne vulgaris is a universal skin disease and it may leave a scar when the original skin lesion disappears. These scars can cause cosmetic problems and psychological burden, leading to poor quality of life of patients. Acne scars are classified into atrophic scars and hypertrophic scars. As most of the acne scars are atrophic, many studies have been conducted focusing on the treatment of atrophic lesions. This study was conducted to investigate the underlying pathogenesis of acne hypertrophic scars by identifying roles of fibrogenetic and inflammatory markers. Skin biopsy samples were obtained from hypertrophic scars of face and back and from adjacent normal tissues as control group. Some samples from back were immature hypertrophic scars and the other samples were in mature stages. Immunohistochemistry staining and quantitative PCR were performed for fibrogenetic and inflammatory markers. Both in mature and immature hypertrophic scars, vimentin and α-SMA were increased. Production of TGF-β3 protein as well as transcription of TGF-β3 was also significantly elevated. In contrast, expression of TGF-β1 showed no increase. Instead, expression levels of SMAD2 and SMAD4 were increased. Elevations of CD45RO, TNF-α and IL-4 and reduction of IL-10 were observed. In immature hypertrophic scars, IGF-1R and insulin-degrading enzyme expression were increased. Increased apoptosis was observed in immature stages of hypertrophic scars but not in mature stages. Elevations of TGF-β3, SMAD2 and SMAD4 in hypertrophic scars and increase of IGF-1R in immature stages may give some clues for acne hypertrophic scar formation.
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Affiliation(s)
- Ji Hoon Yang
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea.,Acne, Rosacea, Seborrheic Dermatitis and Hidradenitis Suppurativa Research Laboratory, Department of Dermatology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080, Seoul, South Korea
| | - Ji Young Yoon
- Acne, Rosacea, Seborrheic Dermatitis and Hidradenitis Suppurativa Research Laboratory, Department of Dermatology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080, Seoul, South Korea
| | - Jungyoon Moon
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea.,Acne, Rosacea, Seborrheic Dermatitis and Hidradenitis Suppurativa Research Laboratory, Department of Dermatology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080, Seoul, South Korea
| | | | | | - Dae Hun Suh
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea. .,Acne, Rosacea, Seborrheic Dermatitis and Hidradenitis Suppurativa Research Laboratory, Department of Dermatology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080, Seoul, South Korea.
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Tian J, Lei XX, Xuan L, Tang JB, Cheng B. Application of plasma-combined regeneration technology in managing facial acne scars. J COSMET LASER THER 2018; 21:138-144. [PMID: 30110184 DOI: 10.1080/14764172.2018.1481512] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Ju Tian
- Department of Plastic Surgery, Guangzhou School of Clinical Medicine, Southern Medical University (Guangzhou General Hospital of Guangzhou Military Region), Guangzhou, Guangdong, P.R. China
- Department of Plastic Surgery, Guangzhou General Hospital of People’s Liberation Army, the Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLA, Guangzhou, Guangdong, P.R. China
- Department of Plastic Surgery, ZhongShanCityPeople’Hospital, ZhongShan, Guangdong, P.R. China
| | - Xiao Xuan Lei
- Department of Plastic Surgery, Guangzhou School of Clinical Medicine, Southern Medical University (Guangzhou General Hospital of Guangzhou Military Region), Guangzhou, Guangdong, P.R. China
- Department of Plastic Surgery, Guangzhou General Hospital of People’s Liberation Army, the Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLA, Guangzhou, Guangdong, P.R. China
| | - Li Xuan
- Department of Human Resources, Guangzhou General Hospital of People’s Liberation Army, the Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLA, Guangzhou, Guangdong, P.R. China
| | - Jian Bing Tang
- Department of Plastic Surgery, Guangzhou General Hospital of People’s Liberation Army, the Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLA, Guangzhou, Guangdong, P.R. China
| | - Biao Cheng
- Department of Plastic Surgery, Guangzhou School of Clinical Medicine, Southern Medical University (Guangzhou General Hospital of Guangzhou Military Region), Guangzhou, Guangdong, P.R. China
- Department of Plastic Surgery, Guangzhou General Hospital of People’s Liberation Army, the Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLA, Guangzhou, Guangdong, P.R. China
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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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Casabona G. Combined use of microfocused ultrasound and a calcium hydroxylapatite dermal filler for treating atrophic acne scars: A pilot study. J COSMET LASER THER 2018; 20:301-306. [DOI: 10.1080/14764172.2017.1406606] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Shan X, Choi JH, Kim KJ, Lee YJ, Ryu YH, Lee SJ, Moon SH, Rhie JW. Adipose Stem Cells with Conditioned Media for Treatment of Acne Vulgaris Scar. Tissue Eng Regen Med 2018; 15:49-61. [PMID: 30603534 PMCID: PMC6171636 DOI: 10.1007/s13770-017-0105-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 11/27/2017] [Accepted: 11/27/2017] [Indexed: 12/14/2022] Open
Abstract
This study was to investigate the effect of subcutaneous injection of the adipose stem cells (ASCs) with conditioned media (CM) in the treatment of acne vulgaris scar. We used Adult male New Zealand white rabbit ears as an animal model and induced acne formation by Kignman method. Adipose tissue was isolated and harvested from the scapula of rabbits, and ASCs were cultured and expanded until passage 1. There have four groups in our experiment, include phosphate buffered saline (PBS), ASCs with PBS (ASC + PBS), CM, and ASCs with CM (ASC + CM) group. This solution of 0.6 ml injected to subcutaneous in each group. ASC + PBS and ASC + CM groups were containing ASCs of 5.0 × 106 cells/ml. We analyzed the treatment of 4 groups to scar tissue after 2 and 4 weeks by hematoxylin and eosin stain, immunohistochemistry, and RNA expression level of tumor necrosis factor-α (TNF-α), interleukin-1α (IL-1α), and matrix metalloproteinase-2 (MMP-2). Also, the expression of keratin 16 (K16) was detected by western blot analysis. H&E stain showed that infiltration of inflammation cells was significantly reduced at 2 and 4 weeks, as well as re-epithelialization was improved in the ASC + CM group. The ASC + CM gourp was reduced both expression levels of TNF-α, IL-1α, and MMP-2 and K16 protein level. In conclusion, the ASCs with CM has a significant curative effect on acne vulgaris scar, more to the point, the CM has a key role on treatment. It could be applied to a therapeutic approach to regenerate to treat acne vulgaris scar.
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Affiliation(s)
- Xing Shan
- Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
| | - Jong Hyeon Choi
- Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
| | - Ki Joo Kim
- Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
| | - Yoon Jae Lee
- Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
| | - Yeon Hee Ryu
- Department of Molecular Biomedicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
| | - Su Jin Lee
- Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
| | - Suk-Ho Moon
- Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
| | - Jong Won Rhie
- Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
- Department of Molecular Biomedicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
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Calcium Hydroxylapatite Combined with Microneedling and Ascorbic Acid is Effective for Treating Stretch Marks. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2017; 5:e1474. [PMID: 29062646 PMCID: PMC5640351 DOI: 10.1097/gox.0000000000001474] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 07/10/2017] [Indexed: 11/29/2022]
Abstract
Background: Stretch marks can have a negative psychological impact on some individuals. Methods are available for treating stretch marks, but high-quality evidence supporting their use is limited. We treat stretch marks using injections of diluted calcium hydroxylapatite (CaHA, Radiesse) filler combined with microneedling and topical ascorbic acid. This retrospective study evaluated the effectiveness of this combined therapy. Methods: Subjects presented with red (n = 25) or white (n = 10) striae on their buttocks, thighs, knees, abdomen, and breasts. CaHA filler was diluted 1:1 with lidocaine 2% without epinephrine. A maximum of 3.0 mL of filler was injected per patient at all skin depths using a 23G needle. This was immediately followed by microneedling and topical application of 20% ascorbic acid. Microneedling with ascorbic acid was repeated after 1 and 2 months. Skin biopsies were obtained from a patient who later underwent abdominoplasty. Results: The mean (±SD) pretreatment Manchester Scar Scale scores were 12.0 (±0.8), decreasing to 7.1 (±1.4) 1 month after the final treatment, indicating improvement in stretch mark appearance (P < 0.001). Subjects were very satisfied (n = 22; 62.9%), satisfied (n = 8; 22.9%), neither satisfied nor dissatisfied (n = 4; 11.4%), or unsatisfied (n = 1; 2.8%) with their treatment results. Analysis revealed a significant correlation between Scar Scale scores and Patient Satisfaction scores (r = 0.483; P = 0.003). Skin biopsies showed increased quantity and quality of collagen and elastin fibers in areas treated with combination therapy. Procedures were well tolerated. Conclusion: Combining 1:1 diluted CaHA with microneedling and topical ascorbic is safe and effective for treating stretch marks.
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Hussain SN, Goodman GJ, Rahman E. Treatment of a traumatic atrophic depressed scar with hyaluronic acid fillers: a case report. Clin Cosmet Investig Dermatol 2017; 10:285-287. [PMID: 28814892 PMCID: PMC5546592 DOI: 10.2147/ccid.s132626] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Hyaluronic acid filler has been documented in the treatment of atrophic depressed acne scars relatively frequently in the literature but rarely in chronic depressed traumatic atrophic facial scars. METHODS This case report discusses the use of hyaluronic acid fillers in the correction of a post-traumatic facial atrophic scar on the right cheek. RESULTS The right cheek scar was substantially corrected with one session of two different hyaluronic acids injected in a deep and superficial plane. CONCLUSION Relatively accurate, simple and effective correction of this atrophic traumatic scar may suggest that fillers are a suitable alternative to surgery for such scars.
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Affiliation(s)
| | - Greg J Goodman
- Department of Primary Care, Monash University, Clayton.,Skin and Cancer Foundation Inc, Carlton, VIC, Australia
| | - Eqram Rahman
- Faculty of Medical Science, Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford, UK
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Kim H, Yoo KH, Zheng Z, Cho SB. Pressure- and dose-controlled transcutaneous pneumatic injection of hypertonic glucose solution for the treatment of atrophic skin disorders. J COSMET LASER THER 2017; 19:479-484. [PMID: 28665146 DOI: 10.1080/14764172.2017.1343950] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Needleless transcutaneous pneumatic injections (TPIs) are a minimally invasive way to deliver the solution into the skin for therapeutic purposes. The suggested action mechanisms of TPI therapy include mechanical stimulation, immediate tissue shrinkage and late wound healing. METHODS Thirteen Korean patients were treated with TPI for atrophic skin disorders, including acne scars, striae albae, post-furuncle, or carbuncle scars, and horizontal wrinkles with lipoatrophy. At each TPI treatment session, a single pass was made along with the atrophic skin lesions without overlapping. Thereafter, two dermatologists objectively evaluated the clinical improvement in the lesions in the photographs via the global aesthetic improvement scale (GAIS). RESULTS One month after the final treatment, the overall mean GAIS score was 2.3 ± 0.8. Six of the 13 (46.2%) patients exhibited clinical improvement of grade 3, five (38.5%) patients grade 2 and two (15.4%) patients grade 1. The overall mean subjective satisfaction score with the TPI treatment was 2.3 ± 0.9. Six of the 13 (46.2%) patients achieved subjective satisfaction of grade 3, six (46.2%) patients grade 2 and one (7.7%) patient grade 0. CONCLUSIONS The present study demonstrated that the TPI treatment is effective and safe for treating atrophic skin disorders of varying causes in Korean patients.
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Affiliation(s)
- Heesu Kim
- a Department of Dermatology and Cutaneous Biology Research Center, International St. Mary's Hospital , Catholic Kwandong University, College of Medicine , Incheon , Republic of Korea
| | - Kwang Ho Yoo
- a Department of Dermatology and Cutaneous Biology Research Center, International St. Mary's Hospital , Catholic Kwandong University, College of Medicine , Incheon , Republic of Korea
| | - Zhenlong Zheng
- a Department of Dermatology and Cutaneous Biology Research Center, International St. Mary's Hospital , Catholic Kwandong University, College of Medicine , Incheon , Republic of Korea.,b Department of Dermatology , Yanbian University Hospital , Yanji , China
| | - Sung Bin Cho
- a Department of Dermatology and Cutaneous Biology Research Center, International St. Mary's Hospital , Catholic Kwandong University, College of Medicine , Incheon , Republic of Korea.,c Kangskin Sillim Dermatology Clinic , Seoul , Republic of Korea
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Faghihi G, Poostiyan N, Asilian A, Abtahi-Naeini B, Shahbazi M, Iraji F, Fatemi Naeini F, Nilforoushzadeh MA. Efficacy of fractionated microneedle radiofrequency with and without adding subcision for the treatment of atrophic facial acne scars: A randomized split-face clinical study. J Cosmet Dermatol 2017; 16:223-229. [PMID: 28432727 DOI: 10.1111/jocd.12346] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is no gold standard treatment for facial acne scars, and overall, little literature exists about the combination therapy for treatment of acne scar. AIMS The aim of this study was to evaluate the efficacy of fractionated microneedle radiofrequency (FMR) vs FMR combined with subcision for the treatment of atrophic acne scars. PATIENTS/METHODS This was a randomized, split-face clinical study of 25 patients with II-IV Fitzpatrick skin types with moderate to severe facial atrophic acne scars. Initially, standard subcision by Nokor needle was performed on one side. Two weeks after subcision, FMR treatment was performed on both cheeks of each participant. Second and third FMR treatment sessions were performed within 4-week intervals. Two-blinded dermatologists performed clinical assessments using a quartile grading scale, and patients were also asked to judge their satisfaction using a visual analog scale (VAS) scoring system. RESULTS The age of the patients varied from 24 to 40 years (mean: 30.08±4.94 years). Only nine patients (36%) were males. Clinical assessment by two-blinded dermatologists showed statistically significant improvement in the combination (FMR+subcision) group (P=.009). Patient satisfaction was statistically significantly better in the combination group (P=.001). A darkening of skin phototype was associated with a decrease in patient's satisfaction VAS score (P=.07). CONCLUSION The combination of subcision and FMR is a safe and effective modality for mixed type acne scars. Additional randomized clinical study with long-term follow-up is necessary for further evaluation of FMR in combination with other procedures. The full trial protocol can be accessed in: http://www.irct.ir/searchresult.php?keyword=%20%20IRCT2016103130597N1&id=30597&number=1&field=a&prt=1&total=1&m=1. The clinical trial registration number is IRCT2016103130597N1.
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Affiliation(s)
- Gita Faghihi
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nazila Poostiyan
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Asilian
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahareh Abtahi-Naeini
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoom Shahbazi
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Iraji
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farahnaz Fatemi Naeini
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Ali Nilforoushzadeh
- Department of Dermatology, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
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