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Tabaie SM, Shirkavand A, Mansouri P, Mehrizi AAH, Farshi S. Evaluation of the effects of carboxytherapy in the treatment of periorbital dark circles. J Cosmet Dermatol 2024; 23:2711-2715. [PMID: 38831554 DOI: 10.1111/jocd.16331] [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] [Received: 10/30/2023] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Dark eye circle (DEC) is one of the most common cosmetic problems. It has a great impact on the patients' quality of life. Carboxytherapy is a cosmetic technique using pure carbon dioxide for different uses in different areas of the body. The goal of this study is to evaluate the efficacy and tolerability of carboxytherapy in the cosmetic correction of DECs. METHODS This study was conducted on 27 patients requesting the correction of DEC. The treatment was performed using a carboxy device in medical grade. The gas injection was performed intradermal after local anesthesia, with a pressure of one tenth bar and a speed of 20 cc/min, 1 cc in each upper and lower eyelid. The treatment sessions were done every 2 weeks for four sessions. RESULTS The mean physicians' score of DECs before and after treatment was 8.7 ± 0.81 and 4.6 ± 1.1, respectively. The mean patients' score before and after treatment was 9.2 ± 0.5 versus 5.41 ± 1.37. The mean scores showed a significant reduction of skin discoloration without major side effects (p < 0.00001). CONCLUSION Carboxytherapy seems to be an effective treatment option for dark circles around the eyes with a good safety profile and patient satisfaction.
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Affiliation(s)
- Seyed Mehdi Tabaie
- Department of Medical Laser, Medical Laser Research Center, Yara Institute, ACECR, Tehran, Iran
| | - Afshan Shirkavand
- Department of Photodynamic, Medical Laser Research Center, Yara Institute, ACECR, Tehran, Iran
| | - Parvin Mansouri
- Department of Medical Laser, Medical Laser Research Center, Yara Institute, ACECR, Tehran, Iran
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Asghar Haeri Mehrizi
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Susan Farshi
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Liew S, Doreian S, Kunathathorn W, Lam S, Jorge A, Lan LB, Selkon E, Arendse S, Silleri J, Telfer T. Lower Eyelid Dark Circles (Tear Trough and Lid-Cheek Junction): A Stepwise Assessment Framework. Aesthet Surg J 2024; 44:NP476-NP485. [PMID: 38489829 PMCID: PMC11177555 DOI: 10.1093/asj/sjae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/06/2024] [Accepted: 03/06/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Despite increasing popularity, the use of hyaluronic acid (HA) fillers for the correction of dark under-eye shadows remains challenging. Specific guidance on patient assessment is limited. OBJECTIVES The aim of this study was to develop a stepwise assessment framework for lower eyelid dark shadows to help practitioners classify patients based on their underlying problems and facilitate a more strategic approach to treatment. METHODS Literature review and peer collaboration informed the current availability of educational material for use by experienced injectors when assessing patients presenting with dark circles. A practitioner survey provided insight into current practices. A focus group convened to review the survey results and discuss best practice approaches to patient assessment. RESULTS Surveyed practitioners (n = 39) reported patient concern about under-eye hollows (91%), dark eye circles (80%), and looking tired (60%). All (100%) agreed that midcheek volume was critical when treating tear-trough depression, and only 26% reported use of a tear-trough classification system. The focus group developed a framework for assessing tear-trough depression and the lid-cheek junction in patients presenting with dark circles. Key factors within this framework included the importance of appropriate lighting when conducting a visual inspection, regional inspection of the cheek and tear trough, palpation of the orbital rim and soft tissues, determination of the orbital vector, and assessment of lower eyelid pigmentation and skin quality. CONCLUSIONS Careful step-by-step assessment can reduce the challenges of treating dark circles by identifying patients in whom dark eye circles may be improved without the need to directly inject filler into the tear trough. LEVEL OF EVIDENCE: 5
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Affiliation(s)
- Steven Liew
- Corresponding Author: Dr Steven Liew, 501/19A Boundary St, Darlinghurst, NSW 2010, Australia. E-mail: ; Instagram and X: @liewlift
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Rajabi-Estarabadi A, Hartman CL, Iglesia S, Kononov T, Zahr AS. Effectiveness and tolerance of multicorrective topical treatment for infraorbital dark circles and puffiness. J Cosmet Dermatol 2024; 23:486-495. [PMID: 38112168 DOI: 10.1111/jocd.16122] [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] [Received: 09/22/2023] [Revised: 11/15/2023] [Accepted: 11/28/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Treatment of infraorbital dark circles and under-eye puffiness is challenging due to its multifactorial nature and lack of broadly applicable, effective treatments. A daily skincare treatment option that is multimodal, effective, and tolerable across a broad patient population is an unmet need. AIM A multicorrective topical eye cream (MTEC) formulated with Tetrahexyldecyl (THD) ascorbate (vitamin C), prebiotic Inula Helenium, bioavailable peptides, botanical extracts, chrysin, and caffeine is hypothesized to improve the appearance of infraorbital dark circles and under-eye puffiness by targeting microvasculature congestion and permeability, melanin accumulation and hemoglobin degradation-related pigmentation, and skin health. METHODS An IRB approved, open-label, 12-week clinical study set out to evaluate the efficacy and tolerability of the MTEC across a broad patient population including varying ethnicities and Fitzpatrick Skin Types (FST). Female subjects (n = 40) ages 35-60 years old, with moderate-to-severe under-eye dark circles, moderate under-eye puffiness, and mild-to-moderate fine lines were enrolled into the study. Objective (Chromameter, VISIA® imaging, and Laser Doppler) and subjective assessments (clinical grading and self-assessment questionnaire) were conducted at baseline and post-baseline timepoints. RESULTS Thirty-seven subjects completed the study, and the MTEC efficaciously demonstrated short-term and long-term improvements in objective and subjective assessments across a broad patient population. Specifically, the MTEC demonstrated significant improvement of infraorbital dark circles, mainly by the reduction in microvasculature congestion and permeability, melanin, and hemoglobin degradation-related pigmentation. CONCLUSION Topical application of the MTEC may offer an effective and tolerable treatment option for infraorbital dark circles and puffiness.
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Cengizler Ç, Kabakci AG, Bozkır DM, Sire Eren D, Bozkır MG. A Cluster Validity Index-Based Objective Criteria for Aesthetic Evaluation of Periorbital Treatment. Clin Cosmet Investig Dermatol 2023; 16:2537-2546. [PMID: 37736396 PMCID: PMC10509608 DOI: 10.2147/ccid.s425797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/05/2023] [Indexed: 09/23/2023]
Abstract
Purpose Dark circles and pigmentation around the eyes are common reasons people see dermatologists. An effective assessment of the severity of infraorbital color and texture differences is critical for determining appropriate treatment. Evaluation of the visual severity of cases is mostly based on visual inspection. Treatment efficiency is often measured using patient questionnaires in many cases. The subjectivity of assessments may lead to a prolonged healing process, misdiagnosis, and excessive use of drugs or chemicals. Patients and Methods In this study, a computer-aided objective evaluation approach was proposed for grading periorbital facial rejuvenation. This approach is based on the analysis of numerical features extracted from different facial regions in digital images. Healing was objectively graded by evaluating data clusters formed using the extracted features. Accordingly, an increase in the visual similarity between paired facial regions is accepted as an indicator of healing, which directly affects the form of data clusters. An intracluster validity index was measured to evaluate the clusters as dense and well separated. A total of 144 facial regions were extracted and examined, and the automatically calculated grades were compared with expert evaluations. Results The cosmetic effects of the experimental drug were evaluated during the experiments, and expert grades were accepted as the ground truth. The results show that the proposed automated grading approach can evaluate rejuvenation with an accuracy of up to 0.91 accuracy in the upper orbital region. Conclusion This study concluded that the proposed data-clustering-based approach is promising and can be functional without any special instruments.
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Affiliation(s)
- Çağlar Cengizler
- Biomedical Device Technology Program, Vocational School of Health Services, Izmir Democracy University, Izmir, Turkey
| | - Ayse Gul Kabakci
- Department of Anatomy, Faculty of Medicine, Cukurova University, Adana, Turkey
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Spyridonos P, Gaitanis G, Likas A, Seretis K, Moschovos V, Feldmeyer L, Heidemeyer K, Zampeta A, Bassukas ID. Image Perceptual Similarity Metrics for the Assessment of Basal Cell Carcinoma. Cancers (Basel) 2023; 15:3539. [PMID: 37509205 PMCID: PMC10377636 DOI: 10.3390/cancers15143539] [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: 06/10/2023] [Revised: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
Efficient management of basal cell carcinomas (BCC) requires reliable assessments of both tumors and post-treatment scars. We aimed to estimate image similarity metrics that account for BCC's perceptual color and texture deviation from perilesional skin. In total, 176 clinical photographs of BCC were assessed by six physicians using a visual deviation scale. Internal consistency and inter-rater agreement were estimated using Cronbach's α, weighted Gwet's AC2, and quadratic Cohen's kappa. The mean visual scores were used to validate a range of similarity metrics employing different color spaces, distances, and image embeddings from a pre-trained VGG16 neural network. The calculated similarities were transformed into discrete values using ordinal logistic regression models. The Bray-Curtis distance in the YIQ color model and rectified embeddings from the 'fc6' layer minimized the mean squared error and demonstrated strong performance in representing perceptual similarities. Box plot analysis and the Wilcoxon rank-sum test were used to visualize and compare the levels of agreement, conducted on a random validation round between the two groups: 'Human-System' and 'Human-Human.' The proposed metrics were comparable in terms of internal consistency and agreement with human raters. The findings suggest that the proposed metrics offer a robust and cost-effective approach to monitoring BCC treatment outcomes in clinical settings.
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Affiliation(s)
- Panagiota Spyridonos
- Department of Medical Physics, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Georgios Gaitanis
- Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Aristidis Likas
- Department of Computer Science & Engineering, School of Engineering, University of Ioannina, 45110 Ioannina, Greece
| | - Konstantinos Seretis
- Department of Plastic Surgery and Burns, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Vasileios Moschovos
- Department of Plastic Surgery and Burns, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Laurence Feldmeyer
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Kristine Heidemeyer
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Athanasia Zampeta
- Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Ioannis D Bassukas
- Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
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Hamdi H, Shirbeigi L, Rahimzadeh M, Firooz A, Amin G, Mousavizadeh K, Zargaran A. Evaluation of the Effect of Artemisia Absinthium L. Eye-Cream on Infra-Orbital Dark Circle: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Galen Med J 2023; 12:1-11. [PMID: 38774851 PMCID: PMC11108669 DOI: 10.31661/gmj.v12i.2413] [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: 02/02/2022] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND The relative darkening of the lower eyelid skin, which is often linked with dark circles, may make you seem fatigued and older than your real age. Considering the recommendations in the sources of Persian medicine regarding Artemisia absinthium L., the purpose of this clinical trial is investigating the effectiveness of cream prepared from the aqueous extraction of A.absinthium to remove periorbital dark circles. MATERIALS AND METHODS The eye cream is made with 20% of aqueous extract of A.absinthium in the base of the cream. It was standardized based on Artemisinin via HPLC method. For the clinical trial, 60 patients equally enrolled in two drug and placebo groups. Erythema and Pigmentation were evaluated via a mexameter instrument. RESULTS The cream is standardized, including 1.29±0.02 µg/mg Artemisinin in the product. Finally, 21 and 24 patients reached the end of study in drug and placebo groups, respectively. In these groups, the difference in the mean (SD) DE, DL, Erythema and Melanin factors before and after the research were significant (p0.05). However, the rate of reduction of DE, Erythema, and Melanin and rise of DL is greater in the treatment group than in the placebo group. Furthermore, the mean value of DE and DL factors before the research were significantly different in two groups (p0.001), but after the research did not show a significant difference. The mean value of Erythema factor in the two groups before (p=0.25) and after (p=0.5) did not show a significant difference. The mean value of Melanin after the research between two groups showed a significant difference (p=0.01). CONCLUSION The results show that the cream prepared from the herbal composition of Persian medicine improves Infra Orbital Dark circle around the eyes.
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Affiliation(s)
- Hanan Hamdi
- Department of Traditional Pharmacy, School of Persian Medicine, Tehran University of
Medical Sciences, Tehran, Iran
| | - Laila Shirbeigi
- Department of Traditional Medicine, School of Persian Medicine, Tehran University of
Medical Sciences, Tehran, Iran
| | - Mitra Rahimzadeh
- Department of Biostatistics and Epidemiology, School of Health, Social Determinants
of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Alireza Firooz
- Center for Research & Training in Skins Diseases & Leprosy, Clinical Trial
Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Amin
- Department of Pharmacognosy, Faculty of Pharmacy, Tehran University of Medical
Sciences, Tehran, Iran
| | - Kazem Mousavizadeh
- Department of Pharmacology, School of Medicine, Iran University of Medical Sciences
| | - Arman Zargaran
- Department of Traditional Pharmacy, School of Persian Medicine, Tehran University of
Medical Sciences, Tehran, Iran
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Kabakci AG, Bozkır DM, Cengizler Ç, Sire Eren D, Bozkır MG. Assessing the Rejuvenation Effectiveness of a Hyaluronic Acid and Amino Acid Mixture in the Periorbital Region. Clin Cosmet Investig Dermatol 2023; 16:973-980. [PMID: 37051585 PMCID: PMC10084865 DOI: 10.2147/ccid.s406173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/24/2023] [Indexed: 04/08/2023]
Abstract
Purpose We performed an assessment of the rejuvenation effect of an amino acid and hyaluronic acid mixture in the periorbital area. Methods A total of 23 of the 35 participants completed all application sessions and measurements. These 23 women were aged 30-55 years. A hyaluronic acid and amino acid mixture was injected into the participants' periorbital area. Three sessions of application with 15-day intervals were undertaken. Subjects' age, height, weight, smoking status, and sport participation were recorded. A photonumeric dark circle scale and Fitzpatrick's periorbital wrinkling classification were used for evaluation of dark circles and wrinkles in the periorbital area. Anatomical measurements (height of upper and lower eyelids) were done using ImageJ and a skin-analysis system (Observ 520). Results The 23 women had a mean age of 42.46±9.33 years, mean height 164.46±4.96 cm, and mean weight 63.94±8.26 kg. Before the sessions, the mean heights of the upper eyelids were 1.24±013 cm (right) and 1.21±013 cm (left), while those of the lower eyelids were 0.98±014 cm (right) and 0.97±0.17 cm (left). One month after the third session, mean upper-eyelid heights were 1.30±0.09 cm (right) and 1.28±0.11 cm (left) and lower-eyelid ones 1.02±0.11 cm (right) and 1.02±0.13 cm (left). Dark-circle and wrinkle-scale scores showed significantly positive results between before the sessions and 1 month after the third session. Conclusion A hyaluronic acid and amino acid mixture can be used to rejuvenation of the periorbital area in women aged 30-55 years.
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Affiliation(s)
- Ayse Gul Kabakci
- Department of Anatomy, Faculty of Medicine, Cukurova University, Adana, Turkey
- Correspondence: Ayse Gul Kabakci, Cukurova University, Faculty of Medicine, Department of Anatomy, Sarıçam, Adana, 01250, Turkey, Tel +90 322 338 60 60-3489, Fax +90 322 338 65 72, Email
| | | | - Çağlar Cengizler
- Biomedical Device Technology Program, Vocational School of Health Services, Izmir Democracy University, Izmir, Turkey
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Suwannasang S, Zhong Q, Thumthanaruk B, Vatanyoopaisarn S, Uttapap D, Puttanlek C, Rungsardthong V. Physicochemical properties of yogurt fortified with microencapsulated Sacha Inchi oil. Lebensm Wiss Technol 2022. [DOI: 10.1016/j.lwt.2022.113375] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fabi S, Alexiades M, Chatrath V, Colucci L, Sherber N, Heydenrych I, Jagdeo J, Dayan S, Swift A, Chantrey J, Stevens WG, Sangha S. Facial Aesthetic Priorities and Concerns: A Physician and Patient Perception Global Survey. Aesthet Surg J 2022; 42:NP218-NP229. [PMID: 34626170 PMCID: PMC8922705 DOI: 10.1093/asj/sjab358] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Minimally invasive and noninvasive facial aesthetic treatments are increasingly popular, and a greater understanding of patient perspectives on facial aesthetic priorities is needed. Objectives The authors surveyed facial aesthetic concerns, desires, and treatment goals of aesthetically conscious men and women, and physicians, in 18 countries. Methods This was a global, internet-based survey on desired appearance and experiences with, or interest in, facial aesthetic treatments. Eligible respondents were aesthetically conscious adults (21-75 years). Eligible aesthetic physicians were required to see ≥30 patients per month for aesthetic reasons, have 2 to 30 years of experience in clinical practice, and spend ≥70% of their time in direct patient care. Results A total of 14,584 aesthetically conscious adults (mean age, 41 years; 70% women) and 1315 aesthetic physicians (mean age, 45 years; 68% men) completed the survey. Most respondents (68%) reported that aesthetic procedures should be sought in their 30s to 40s; physicians recommended patients seek treatment earlier. Respondents expressed greatest concern over crow’s feet lines, forehead lines, facial skin issues, hair-related concerns, and under-eye bags or dark circles; in contrast, physicians tended to underestimate concerns about under-eye bags or dark circles, mid-face volume deficits, and skin quality. Although both physicians and respondents cited cost as a major barrier to seeking aesthetic treatments, respondents also emphasized safety, fear of injections or procedure-related pain, and concern about unnatural-looking outcomes. Conclusions This global survey provides valuable insight into facial aesthetic concerns and perspectives that may be implemented in patient education and consultations to improve patient satisfaction following aesthetic treatments.
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Affiliation(s)
| | | | | | | | | | | | - Jared Jagdeo
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | | | | | | | - W Grant Stevens
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sara Sangha
- Allergan Aesthetics, an AbbVie company, Irvine, CA, USA
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