Radio Peel-Synergism Between Nano-fractional Radiofrequency and 20% Trichloroacetic Acid Chemical Peeling

High-frequency ultrasound in anti-aging skin therapy monitoring

Over the last few decades, high-frequency ultrasound has found multiple applications in various diagnostic fields. The fast development of this imaging technique opens up new diagnostic paths in dermatology, allergology, cosmetology, and aesthetic medicine. In this paper, being the first in this area, we discuss the usability of HFUS in anti-aging skin therapy assessment. The fully automated algorithm combining high-quality image selection and entry echo layer segmentation steps followed by the dermal parameters estimation enables qualitative and quantitative evaluation of the effectiveness of anti-aging products. Considering the parameters of subcutaneous layers, the proposed framework provides a reliable tool for TCA-peel therapy assessment; however, it can be successfully applied to other skin-condition-related problems. In this randomized controlled clinical trial, forty-six postmenopausal women were randomly assigned to the experimental and control groups. Women were treated four times at one-week intervals and applied skin cream daily between visits. The three month follow-up study enables measurement of the long-term effect of the therapy. According to the results, the TCA-based therapy increased epidermal (entry echo layer) thickness, indicating that the thinning process has slowed down and the skin's condition has improved. An interesting outcome is the obtained growth in the intensity of the upper dermis in the experimental group, which might suggest a reduced photo-aging effect of TCA-peel and increased water content. The same conclusions connected with the anti-aging effect of TCA-peel can be drawn by observing the parameters describing the contribution of low and medium-intensity pixels in the upper dermis. The decreased share of low-intensity pixels and increased share of medium-intensity pixels in the upper dermis suggest a significant increase in local protein synthesis.

Subject satisfaction following treatment with nanofractional radiofrequency for the treatment and reduction of acne scarring and rhytids: A prospective study

Background

Skin‐related changes, such as fine lines, wrinkles, and acne scarring, are a source of distress to both men and women. Nanofractional radiofrequency delivers thermal energy to skin layers leading to dermal remodeling that can address skin conditions related to aging. The objective of this study was to evaluate the subject satisfaction of nanofractional radiofrequency for the treatment of facial wrinkles and acne scarring in both lighter and darker skin tones.

Materials and methods

30 subjects (skin types II‐VI) were enrolled in this prospective, evaluator‐blind study. The average age of subjects was 51.9 ± 13.5 years. Subjects received three treatments at 3‐ to 5‐week intervals on both sides of the face using the 80‐ or the 160‐pin tip disposables. Follow‐up visits were conducted at 6‐ and 12 weeks after the last treatment. Subject satisfaction was evaluated using a self‐assessment of a reduction of wrinkles or acne scars, and subject satisfaction questionnaire. Pain, tolerability, and safety were monitored throughout.

Results

Subjects treated for acne or wrinkles were satisfied with their treatment at both the 6‐week and 12‐week follow‐up visit (mean score 3.0; range 0 = very unsatisfied to 4 = very satisfied). The treatments were well tolerated at all treatment sessions, averaging a score of 3.5 on the tolerability scale (0 = very intolerable to 4 = very tolerable) with treatment‐associated pain reported to be mild (3.2 out of 10). There were no adverse events or unanticipated side effects.

Conclusions

This clinical study demonstrates subjects are satisfied with nanofractional radiofrequency treatments for improvement of their wrinkles and acne scars.

Trichloroacetic Acid Peeling for Treating Photoaging: A Systematic Review

Photoaging can significantly contribute to lower quality of life. Medium-deep peeling using trichloroacetic acid allows controlled keratocoagulation through the dermis and into the dermal papillary layer that is effective for skin rejuvenation. The purpose of this article is to give updates regarding the efficacy, possible adverse events, and patient satisfaction of trichloroacetic acid (TCA) peeling for skin rejuvenation by assessing various photoaging parameters. A systematic review of prospective trial articles collected from PubMed, MEDLINE, EMBASE, Cochrane, and Scopus databases was conducted on November 2, 2020. Treatment efficacy was assessed based on the photoaging parameters used by each study. Adverse events and patient satisfaction as the secondary outcome were assessed based on patients-perceived improvements. Five studies included three randomized comparison studies and two prospective cohort studies. These studies show that TCA peeling significantly improve the cosmesis of photoaged facial skin. Low concentration is effective for superficial sun damage. Medium-depth peels using a higher concentration of TCA or as combination therapy are effective as skin resurfacing agents to reduce wrinkles. Some adverse effects may occur but usually resolve within weeks. Overall patients were satisfied with the treatment result. An equivalent basic skin preparation such as topical retinoic acid skin priming prior to intervention is necessary for more objective comparison. Further research studies with a larger sample size and longer follow-up period are required. This evidence suggests that TCA peeling is effective in photoaging treatment, either as monotherapy or as combination therapy with other modalities.

Medium-depth Trichloroacetic Acid and Deep Phenol-Croton Oil Chemical Peeling for Facial Rejuvenation: An Update

ABSTRACT

Face-lift is an established rejuvenation modality; however, when performed alone, it lacks the ability to improve the appearance of fine wrinkles and dyschromias that are an important component of facial rejuvenation. Although it is only natural to be attracted by the latest technologically advanced innovative skin resurfacing techniques, chemical peeling has been proven to be a simple and effective method with a relatively good safety profile. Unfortunately, the practice of chemical peeling has relied for a long time on dogmas perpetuated by early reports without any real scientific basis. Moreover, application of peels has been hindered by difficult estimation of penetrance and control of depth. Three decades ago, a shift has occurred from early dogmatic empirical application to better understanding of the peeling formulations and mechanism of action together with appreciation of the interaction between the various components of the peeling formulations in addition to better estimation of clinical end points and peel depth. Given the increasing demand for none or minimally invasive cosmetic procedures, the current review is aimed at highlighting the recent applications of available medium-depth and deep chemical peels for optimal facial rejuvenation and for the treatment of photo-related aging skin changes.