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Fasola E, Nobile V. Low Molecular Weight Hyaluronic Acid Added to Six Specific Amino Acids in the Treatment of Striae Alba (SA): An Observational Study. Aesthetic Plast Surg 2024; 48:2475-2483. [PMID: 38561575 PMCID: PMC11239720 DOI: 10.1007/s00266-024-03911-8] [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: 01/08/2024] [Accepted: 02/05/2024] [Indexed: 04/04/2024]
Abstract
Striae distensae or stretch marks are a common complaint among women and can be distressing. The present study aimed to assess the efficacy of a mixture of low molecular weight hyaluronic acid and six amino acids when applied with a specific intradermal injection technique known as intra-mural fluid technique. A clinical study was carried out in 32 patients (with a dropout rate by 9.4%) with striae distensae alba (SA) in one or more of the following anatomical areas: breast, abdomen, inner thigh, trochanteric area, gluteal area, posterior supra-iliac area, and lumbar area. Product efficacy was assessed by the investigator using the Global Aesthetic Improvement Scale, while a Likert scale was used to evaluate to score the treatment tolerability and a QoL stretch marks questionnaire was used to investigate the patients' self-body image. The treatment was effective in improving the appearance of SA fifteen days after the second treatment and 6 months after the first treatment (and after a total of 4 treatments). The product efficacy and tolerability were also perceived by the patients during each treatment session. Our results suggest that the test treatment is a valid treatment option to decrease the appearance of SA. 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 https://www.springer.com/00266.
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Affiliation(s)
- Elena Fasola
- Microsurgeon at Gyplast Medical Institute, 20129, Milan, MI, Italy
| | - Vincenzo Nobile
- R&D Department, Complife Italia, 27028, San Martino Siccomario, PV, Italy.
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2
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Ugwu N, Xun H, Dover JS, Boustany AN, Chung HJ. Histological Assessment of the Effectiveness of Microneedling Device-Assisted Filler Delivery. Dermatol Surg 2024:00042728-990000000-00781. [PMID: 38691514 DOI: 10.1097/dss.0000000000004206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
BACKGROUND Microneedling is used to enhance transcutaneous drug delivery. However, the extent to which microneedling devices impact filler delivery and whether this varies by filler type, microneedling device type, and treatment sequence is not known. OBJECTIVE To histologically assess and quantify the delivery of commonly used fillers through microneedling, using both a microneedling pen and a microneedling roller. In addition, the authors investigated whether there is a variation in filler delivery based on the sequence of microneedling in relation to topical filler application. METHODS Ex vivo human abdominal skin samples were subjected to microneedling pen or microneedling roller treatment. Black tissue marking ink, hyaluronic acid, poly-l-lactic acid, or undiluted calcium hydroxyapatite was topically applied before or immediately after microneedling treatment. RESULTS Histological evaluation revealed a notable presence of black ink within channels formed by both microneedling treatments (15.5%-98.1%), whereas there was limited presence of the various filler types tested (0%-6.6%) in all settings. Topical application before microneedling treatment led to relatively higher filler/ink deposition within the channels formed by the microneedling treatments compared with topical application after microneedling. CONCLUSION Transcutaneous delivery of fillers was not significantly helped by microneedling treatment, whereas the microneedling devices demonstrated effective delivery of an aqueous solution.
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Affiliation(s)
- Nelson Ugwu
- Harvard Combined Dermatology Residency Training Program, Boston, Massachusetts
| | - Helen Xun
- Department of Plastic Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Jeffrey S Dover
- SkinCare Physicians, Chestnut Hill, Massachusetts
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Ashley N Boustany
- Department of Plastic Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Hye Jin Chung
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts
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3
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Amiri M, Meçani R, Niehot CD, Phillips T, Kolb J, Daughtry H, Muka T. Skin regeneration-related mechanisms of Calcium Hydroxylapatite (CaHA): a systematic review. Front Med (Lausanne) 2023; 10:1195934. [PMID: 37332763 PMCID: PMC10273839 DOI: 10.3389/fmed.2023.1195934] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/08/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction Calcium Hydroxylapatite (CaHA) is a common dermal filler used in aesthetic medicine for volumizing and contouring. Understanding mechanisms of actions of CaHA can help improve our understanding of its clinical applications. Methods We performed a systematic review to summarize the skin-regeneration related mechanisms of CaHA. Five bibliographic databases were searched for English-language publications that evaluated CaHA in skin regeneration outcomes including neocollagenesis, cell proliferation and growth factors, angiogenesis, vascular dynamic and inflammatory markers, among others. Methodological rigor of included studies was assessed. Results Of 2,935 identified citations, 12 studies were included for final analysis. Collagen production was reported by nine studies, cell proliferation by four, elastic fibers and/or elastin by four, and three studies on angiogenesis, while limited studies were available on the other outcomes. Six were clinical/observational studies. Only seven studies had a control group. Overall, studies showed CaHA resulted in increased cell proliferation, increased collagen production and angiogenesis, as well as in higher elastic fiber and elastin formation. Limited and inconclusive evidence was available on the other mechanisms. The majority of the studies had methodological limitations. Discussion Current evidence is limited but indicates several mechanisms through which CaHA could lead to skin regeneration, volume enhancement, and contouring. Systematic review registration https://doi.org/10.17605/OSF.IO/WY49V.
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Affiliation(s)
- Mojgan Amiri
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
- Epistudia, Bern, Switzerland
| | - Renald Meçani
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | | | | | | | - Hua Daughtry
- Merz North America, Inc., Raleigh, NC, United States
| | - Taulant Muka
- Epistudia, Bern, Switzerland
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
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4
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Shu X, Huo W, Zou L, Li Z, Tang Y, Li L, Wang X. Treatment of Stretch Marks Using a New Formulation Combining Nanofractional Radiofrequency Plus Magnetic Nanofractional Radiofrequency. Dermatol Ther (Heidelb) 2023:10.1007/s13555-023-00926-y. [PMID: 37171578 DOI: 10.1007/s13555-023-00926-y] [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: 02/21/2023] [Accepted: 04/12/2023] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION Stretch marks are common atrophic dermal scars with significant physical and psychological effects. Therefore, there is a need for effective cosmetics and procedures for stretch mark treatment. This study aimed to evaluate the efficacy and safety of a novel treatment for stretch marks that is made up of topical formulations containing beta-glucan combined with nanofractional radiofrequency. METHODS This randomized, blinded control trial enrolled 64 Chinese women aged 20-45 years at > 6 months after delivery with obvious white or silver abdominal stretch marks. Participants were randomly allocated to group A (blank group), group B (topical product group), group C (product combined with nanofractional radiofrequency), and group D (vehicle combined with nanofractional radiofrequency). The stretch mark width, skin elasticity, skin color, skin thickness, and collagen density were noninvasively measured. Two trained assessors evaluated the severity, color, outline, and relaxation of the striae. RESULTS Group C showed the best treatment efficacy, with no adverse effects observed during the study period. CONCLUSION Our findings indicate that stretch mark treatment using topical formulations containing beta-glucan, combined with nanofractional radiofrequency plus magnetic nanofractional radiofrequency, is tolerable and effective. TRIAL REGISTRATION ChiCTR2200056725.
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Affiliation(s)
- Xiaohong Shu
- Center of Cosmetic Evaluation, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Wei Huo
- Center of Cosmetic Evaluation, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Lin Zou
- Center of Cosmetic Evaluation, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Zhaoxia Li
- Center of Cosmetic Evaluation, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Ying Tang
- Center of Cosmetic Evaluation, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Li Li
- Center of Cosmetic Evaluation, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Department of Dermatology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China
| | - Xi Wang
- Center of Cosmetic Evaluation, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
- Department of Dermatology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China.
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5
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Alsharif SH, Alghamdi AS, Alhumaidi WA, AlRobaish OA, Al Hamoud MH, Alruwaili AS, AlQefari GB, Almutairi RT. Treatment of Striae Distensae with Filler Injection: A Systematic Review. Clin Cosmet Investig Dermatol 2023; 16:837-845. [PMID: 37033784 PMCID: PMC10078536 DOI: 10.2147/ccid.s405715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 03/21/2023] [Indexed: 04/03/2023]
Abstract
Background Stretch marks, also known as striae cutis distensae (SD), are visible linear scars that occur in regions of dermal damage due to skin stretching. Stretch marks are not serious health issues, but they may have a major psychological effect on patients. Due to poor skin color improvement or prolonged skin atrophy, there is no standard treatment for SD. Fillers have been studied for their effectiveness in the treatment of SD. Objective This systematic review aims to determine the efficacy of fillers on SD. Methods This systematic review is reported following PRISMA guidance. We included all relevant articles published up to November 2022 in the following electronic databases: Science Direct, Midline, the Web of Science, CINAHL, and Google Scholar. The initial search yielded 119, of which seven were included after applying inclusion and exclusion criteria. Results The systematic review included a total of 184 female participants who were over the age of 18 years old. Three studies used jet volumetric remodeling (JVR) to inject HA pneumatically. One study injected polycaprolactone filler. One study used calcium hydroxylapatite, micro-needling, and ascorbic acid. MFU-V and CaHA were given in one study. One study delivered MFU-V using micro-focused ultrasound. All studies showed that it reduces SD with only mild, temporary side effects. More favor was given to combining CaHA and MFU-V, which had the fewest side effects compared to other dermal fillers. Conclusion As monotherapy or combination therapy, injectable dermal fillers may treat SD with minimal adverse effects. We suggest that more RCTs look into injectable dermal filler to find out what is best for patients with SD and compare it to other treatment methods in terms of results, costs, and side effects to provide satisfactory practice and basic guideline interventions for these cases.
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Affiliation(s)
- Sahar Hasan Alsharif
- Department of Dermatology, Ministry of Health, Makkah, Saudi Arabia
- Correspondence: Sahar Hasan Alsharif, Department of Dermatology, Ministry of Health, Makkah, Saudi Arabia, Tel +966555539141, Email
| | | | | | | | | | | | - Ghaida B AlQefari
- Department of Medicine and Surgery, Qassim University, Qassim, Saudi Arabia
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Park JY, Chen JF, Choi H, Ho WWS, Lesthari NNI, Lim JTE, Lim TS, Lowe S, Ong-Amoranto B, Vachiramon V, Wanitphakdeedecha R, Kerscher M. Insights on Skin Quality and Clinical Practice Trends in Asia Pacific and a Practical Guide to Good Skin Quality from the Inside Out. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2022; 15:10-21. [PMID: 35783570 PMCID: PMC9239129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE We sought to examine the current skin quality trends and gaps in clinical practice in the Asia Pacific region and develop a practical guide to improve skin quality. METHODS Medical practitioners from 11 countries in the Asia Pacific region completed an online survey on current trends in skin quality treatment. A panel of 12 leading experts convened for a virtual meeting to develop a practical guide for skin quality improvement. RESULTS A total of 153 practitioners completed the survey. The four most common skin quality issues were uneven skin tone, skin surface unevenness, skin laxity, and sebaceous gland hyperactivity and enlarged pores. Most practitioners reported using a combination of treatment modalities for each skin quality issue. It was also observed that each treatment modality could be used to treat several skin quality issues. A multimodal approach targeting different interrelated issues across the tissue planes was recommended for balanced results. The panel developed a practical guide for the appropriate combinations and sequence of treatments, and created treatment protocols for specific skin quality outcome goals. The guide employed an "inside-out" approach, treating the deeper tissue planes prior to the superficial layers to achieve harmonious results. LIMITATIONS Future studies are needed to support the recommended treatment protocols for skin quality improvement. CONCLUSION These findings provide valuable insights on current skin quality trends and gaps in clinical practice. The practical guide provides a framework for practitioners to customize their treatment plan according to each patient's needs.
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Affiliation(s)
- Je-Young Park
- Dr. Park is with the Apkoo-Jung Oracle Dermatology Clinic in Seoul, South Korea
| | - Jeng-Feng Chen
- Dr. Chen is with Beauté J'adore Dermatology and Esthetic Medicine in Taipei, Taiwan
| | - Hosung Choi
- Dr. Choi is with the Piena Clinic in Seoul, South Korea
| | - Wilson W S Ho
- Dr. Ho is with The Specialists: Lasers, Aesthetic & Plastic Surgery in Hong Kong
| | | | - Joyce Teng Ee Lim
- Dr. Teng Ee Lim is with Joyce Lim Skin and Laser Clinic in Singapore
| | - Ting Song Lim
- Dr. Ting Song Lim is with the Clique Clinic in Kuala Lumpur, Malaysia
| | - Stephen Lowe
- Dr. Lowe is with MUSE Clinic in Sydney, Australia
| | - Beverly Ong-Amoranto
- Dr. Ong-Amoranto is with the Department of Dermatology at Asian Hospital and Medical Center in Metro Manila, Philippines
| | - Vasanop Vachiramon
- Dr. Vachiramon is with the Division of Dermatology, Faculty of Medicine Ramathibodi Hospital at Mahidol University in Bangkok, Thailand
| | - Rungsima Wanitphakdeedecha
- Dr. Wanitphakdeedecha is with the Department of Dermatology, Faculty of Medicine at Siriraj Hospital, Mahidol University in Bangkok, Thailand
| | - Martina Kerscher
- Dr. Kerscher is with the Division of Cosmetic Science and Aesthetics at the University of Hamburg in Hamburg, Germany
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7
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Pavicic T. Commentary on: Skin Tightening With Hyperdilute CaHA: Dilution Practices and Practical Guidance for Clinical Practice. Aesthet Surg J 2022; 42:NP38-NP40. [PMID: 34487518 DOI: 10.1093/asj/sjab331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
BACKGROUND Microneedling is a minimally invasive procedure that stimulates collagen and elastin proliferation. It is used in the treatment of various skin pathologies, that is, scarring, photodamage, and hair loss; however, its safety profile has yet to be comprehensively reviewed. OBJECTIVE This review will discuss the reported side effects of microneedling in the current literature and delineate factors that increase the risk of complications. MATERIALS AND METHODS A literature search in August 2019 was conducted using the PubMed database to identify studies reporting adverse events (AEs) after microneedling therapy. RESULTS Eighty-five articles were included in this systematic review. The most common reported AEs are transient procedural events that are expected postprocedure lasting up to 7 days, such as transient erythema/edema and pain, postinflammatory hyperpigmentation (PIH), dry skin/exfoliation, lymphadenopathy, and irritant contact dermatitis. Persistent serious adverse effects included PIH, tram-track scarring, and granulomatous reactions. Factors that increase the risk of events are active infections, darker skin, and metal allergies. CONCLUSION Microneedling is a relatively safe therapy. Most reported AEs are minimal, resolving quickly and spontaneously. Caution should be taken in patients with active infection, darker skin types, metal allergies, and when used in conjunction with products not approved for intradermal use.
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9
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La Padula S, Hersant B, Pizza C, Chesné C, Jamin A, Ben Mosbah I, Errico C, D’Andrea F, Rega U, Persichetti P, Meningaud JP. Striae Distensae: In Vitro Study and Assessment of Combined Treatment With Sodium Ascorbate and Platelet-Rich Plasma on Fibroblasts. Aesthetic Plast Surg 2021; 45:1282-1293. [PMID: 33474574 DOI: 10.1007/s00266-020-02100-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/13/2020] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Striae distensae (SD) appear clinically as parallel striae, lying perpendicular to the tension lines of the skin. SD evolve into two clinical phases, an initial inflammatory phase in which they are called "striae rubrae" (SR) and a chronic phase in which they are called striae albae (SA). Fibroblasts seem to play a key role in the pathogenesis of stretch marks. This study was aimed at describing and analyzing stretch marks-derived fibroblasts (SMF), the differences between SR- and SA-derived fibroblasts (SRF, SAF), testing two treatments in vitro (sodium ascorbate and PrP) on SAF. MATERIAL AND METHODS To characterize the SMF, the expression of alpha smooth muscle actin (alpha SMA) was investigated. Type I collagen expression was measured in SAF, before and after adding different PrP concentrations and sodium ascorbate in the culture medium. Results were processed through statistical analysis models using the Student's t-test. RESULTS A significant increase in alpha SMA (P <0.001) was observed in SRF. SAF treated with PrP and sodium ascorbate showed a resumption of their metabolic activity by an increase in collagen type I production and cell proliferation. After 24 h of incubation with PrP 1% and PrP 5% + sodium ascorbate, cell viability was increased by 140% and 151% and by 156 and 178% after 48 h, respectively, compared to the control. CONCLUSION Our study shows that a biologically mediated improvement in SMF metabolic activity is possible. Our promising results require further trials to be able to confirm the reproducibility of this combined treatment, particularly in vivo. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable.
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Treating Striae Distensae Albae in Asians: Efficacy and Safety of Combined MFU-V and CaHA. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3429. [PMID: 33680674 PMCID: PMC7929617 DOI: 10.1097/gox.0000000000003429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/22/2020] [Indexed: 11/11/2022]
Abstract
This study evaluated the efficacy and safety of a single treatment combining microfocused ultrasound with visualization (MFU-V) and subdermal diluted calcium hydroxylapatite with lidocaine (CaHA+) for Striae Distensae Albae (SDA).
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11
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Zvezdin V, Kasatkina T, Kasatkin I, Gavrilova M, Kazakova O. Microneedle patch based on dissolving, detachable microneedle technology for improved skin quality of the periorbital region. Part 2: Clinical Evaluation. Int J Cosmet Sci 2020; 42:429-435. [DOI: 10.1111/ics.12636] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/26/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Affiliation(s)
- V. Zvezdin
- Microneedles Inc. 919 North Market Street Wilmington DE USA
| | - T. Kasatkina
- Microneedle Industrial LLC 1130‐42 Bolshoj bulvar Moscow Russia
| | - I. Kasatkin
- Microneedle Industrial LLC 1130‐42 Bolshoj bulvar Moscow Russia
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12
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Hong J, Han H, Kwon T, Kim J, Na J, Kim B. Remarkable improvement of striae distensae with polycaprolactone filler injection. J Eur Acad Dermatol Venereol 2019; 33:e399-e400. [DOI: 10.1111/jdv.15702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J.Y. Hong
- Department of Dermatology Chung‐Ang University College of Medicine 102, Heukseok-ro, Dongjak-gu Seoul 06973 South Korea
| | - H.S. Han
- Department of Dermatology Chung‐Ang University College of Medicine 102, Heukseok-ro, Dongjak-gu Seoul 06973 South Korea
| | - T.R. Kwon
- Department of Dermatology Chung‐Ang University College of Medicine 102, Heukseok-ro, Dongjak-gu Seoul 06973 South Korea
| | - J.H. Kim
- Department of Dermatology Chung‐Ang University College of Medicine 102, Heukseok-ro, Dongjak-gu Seoul 06973 South Korea
| | - J.T. Na
- Department of Dermatology Chung‐Ang University College of Medicine 102, Heukseok-ro, Dongjak-gu Seoul 06973 South Korea
| | - B.J. Kim
- Department of Dermatology Chung‐Ang University College of Medicine 102, Heukseok-ro, Dongjak-gu Seoul 06973 South Korea
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13
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Casabona G. Microfocused Ultrasound with Visualization for the Treatment of Stretch Marks. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2019; 12:20-24. [PMID: 30881579 PMCID: PMC6415706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objective: Stretch marks (striae) can be distressing for many people, and currently available treatments are less than optimal. A previous study showed that the use of a calcium hydroxylapatite (CaHA) filler followed by the topical application of 20% ascorbic acid solution and microneedling significantly improved striae appearance. We sought to evaluate additional improvements in atrophy and color of striae following treatment with microfocused ultrasound with visualization (MFU-V) in subjects who received previous treatments using CaHA, 20% ascorbic acid, and microneedling. Participants: Subjects with remaining skin atrophy (N=20) were treated with MFU-V using transducers with a frequency of 7MHz and 10MHz and a focal depth of 3.0 mm and 1.5 mm, respectively, applied in a cross-hatch pattern. Measurements: Efficacy was based on changes in Manchester Scar Scale scores. Results: At Day 90 post-treatment, the mean (± standard deviation) baseline Manchester Scar Scale score decreased from 9.35 (±1.18) to 6.30 (±1.26) (p<0.001) and the mean Patient Satisfaction Scale score increased from 3.75 (±0.44) to 4.70 (±0.47) (p<0.001). Most subjects (70%) were very satisfied with their results. No adverse events were reported. Conclusion: The combined use of CaHA, 20% ascorbic acid, and microneedling appears to be effective in improving the appearance of striae. Additional esthetic improvements were seen with the application of MFU-V.
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Affiliation(s)
- Gabriela Casabona
- Dr. Casabona is Scientific Director at Ocean Clinic in MarbelIa, Spain
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14
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Hu S, Belcaro G, Hosoi M, Feragalli B, Luzzi R, Dugall M. Postpartum stretchmarks: repairing activity of an oral Centella asiatica supplementation (Centellicum®). ACTA ACUST UNITED AC 2019; 70:629-634. [PMID: 30293400 DOI: 10.23736/s0026-4784.18.04254-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This registry study evaluates the effects of oral Centellicum®, a new preparation of Centella asiatica (CA) on cutaneous stretchmarks (SMs) on the lower abdominal wall in comparison with the topical treatment with a specific antistretch cream. This cream is used for pregnancy SMs. The aim of the management was to give back to the structurally damaged skin areas (apparent as SMs) a normal elasticity and resistance and improving the local microcirculation. METHODS We selected 78 healthy women with SMs at least 6 months postpartum available to follow the registry plan. The subjects were evaluated in three treatment groups: Clarins, stretch mark minimizer, the hydrating control cream and Centellicum® 3X225 mg/day for 6 weeks. RESULTS The three registry groups of otherwise healthy subjects were comparable at inclusion and 6 weeks: 25 women used the SMs cream 1 (mean age 34.4;3.2); 28 control women (age 35.2;2) used the hydrating control cream. The third group (25 women; mean age 35.3;1.5) used the hydrating control cream and oral Centellicum® as a supplementary management. Standard management was used in all groups. As for the safety issue, no allergy, no side effects and no tolerability problems were observed. The compliance was very good and there were no drop outs. No other drug or treatment was used during the registry period. Skin thickness (ultrasound, measuring at the edge of at the largest visible stretchmark) increased significantly more at 6 weeks with Centellicum® in comparison with both controls (P<0.05). Skin thickness at the center of the SM (skin was less dense at this level) was also increased more with the supplement in comparison with the other managements (P<0.05). The grey scale median improved more (increased) with Centellicum at 6 weeks (P<0.05). The skin included more collagen components and become whiter or denser at ultrasound. Skin perfusion measured by laser Doppler showed a higher improvement with Centellicum® (P<0.05). Skin temperature, considered a function of nutritional and thermoregulatory dermal perfusion, improved more with the supplement (P<0.05). Elasticity (measured by elastosonography) was improved more with the supplement (P<0.05). The subjective evaluation with an analogue score resulted better (the SMs were less visible and the score decreased) with Centellicum® (P<0.05). The number of visible SMs was decreased more with Centellicum® (P<0.05). CONCLUSIONS Oral supplementation with Centellicum® appears to improve SMs in a relatively short period of time. Larger studies are needed to evaluate the protective and repairing potentials of CA.
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Affiliation(s)
- Shu Hu
- IRVINE3 Labs, Department of Medical and Oral Sciences, and Biotechnologies, G. D'Annunzio University, Chieti, Italy.,International Agency for Pharma Standard Supplements (IAPPS), Chieti, Italy
| | - Gianni Belcaro
- IRVINE3 Labs, Department of Medical and Oral Sciences, and Biotechnologies, G. D'Annunzio University, Chieti, Italy - .,International Agency for Pharma Standard Supplements (IAPPS), Chieti, Italy
| | - Morio Hosoi
- IRVINE3 Labs, Department of Medical and Oral Sciences, and Biotechnologies, G. D'Annunzio University, Chieti, Italy.,International Agency for Pharma Standard Supplements (IAPPS), Chieti, Italy
| | - Beatrice Feragalli
- IRVINE3 Labs, Department of Medical and Oral Sciences, and Biotechnologies, G. D'Annunzio University, Chieti, Italy.,International Agency for Pharma Standard Supplements (IAPPS), Chieti, Italy
| | - Roberta Luzzi
- IRVINE3 Labs, Department of Medical and Oral Sciences, and Biotechnologies, G. D'Annunzio University, Chieti, Italy.,International Agency for Pharma Standard Supplements (IAPPS), Chieti, Italy
| | - Mark Dugall
- IRVINE3 Labs, Department of Medical and Oral Sciences, and Biotechnologies, G. D'Annunzio University, Chieti, Italy.,International Agency for Pharma Standard Supplements (IAPPS), Chieti, Italy
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Global Consensus Guidelines for the Injection of Diluted and Hyperdiluted Calcium Hydroxylapatite for Skin Tightening. Dermatol Surg 2019; 44 Suppl 1:S32-S41. [PMID: 30358631 DOI: 10.1097/dss.0000000000001685] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Calcium hydroxylapatite (CaHA) is approved to correct moderate-to-severe wrinkles and folds and soft-tissue volume loss in the face and hands. More recently, subdermal injection using diluted CaHA has been used to improve skin laxity. OBJECTIVE To review evidence for the safe and effective use of diluted CaHA in the face and body and provide best practice recommendations. METHODS A global panel of expert aesthetic physicians convened to develop consensus-based guidelines for treating laxity and superficial wrinkles using diluted (ratio of 1:1) and hyperdiluted (≥1:2) CaHA. RESULTS Diluted and hyperdiluted CaHA stimulates targeted neocollagenesis in the injection area to improve laxity and skin quality in the mid- and lower face, neck, décolletage, upper arms, abdomen, upper legs, and buttocks. Treatment can be used as an adjunct to volume augmentation or combined with additional modalities for optimal results. Adverse events are related to the injection and include bruising, swelling, mild pain, and induration. In thinner and darker skin, too-superficial injections of less diluted CaHA can lead to more adverse events. CONCLUSION This report provides preliminary guidelines for the novel off-label use of CaHA for biostimulation in the face and body. Further trials will provide additional clarity regarding treatment paradigms for optimal outcomes.
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Wollina U, Brzezinski P. Aesthetic dermatology: What's new, what's true? Dermatol Ther 2018; 32:e12623. [PMID: 30182495 DOI: 10.1111/dth.12623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 05/08/2018] [Indexed: 01/21/2023]
Abstract
Aesthetic dermatology (AD) is a rapidly growing subspecialty of dermatology. The acceptance of AD in scientific community and the society is associated with its competence, efficiency, and seriousness. This review highlights some recent developments toward new tools, techniques, and understanding in the field of AD. Analyzing the specific needs of patients and assessing the effect by objective measurements is important for further progress. For long time ignored, white adipose tissue has gained increasing interest in biology and rejuvenation. Characterization of dermal and subcutaneous white adipose tissue has made progress. The interaction of hyaluronic acid and calcium hydroxyl apatite (CaHA) fillers with adipocytes could be responsible for clinical efficacy. New developments of oral collagen treatment and highly diluted CaHA to contour the body outside the face will be discussed. Submental contouring using purified desoxycholic acid is another new development.
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Affiliation(s)
- Uwe Wollina
- Department of Dermatology and Allergology, Academic Teaching Hospital Dresden, Dresden, Germany
| | - Piotr Brzezinski
- Faculty of Mathematics and Natural Sciences, Institute of Biology and Environmental Protection, Pomeranian Academy, Slupsk, Poland.,Department of Dermatology, 6th Military Support Unit, Ustka, Poland
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