The modified Fitzpatrick Wrinkle Scale: a clinical validated measurement tool for nasolabial wrinkle severity assessment

Assessment of the Effect of Rehmannia glutinosa Leaf Extract in Maintaining Skin Health: A Proof-of-Concept, Double-Blind, Randomized, Placebo-Controlled Clinical Trial

Purpose

A double-blind, placebo-controlled, randomized, proof-of-concept trial aimed to evaluate the efficacy and safety of VerbasnolTM [Rehmannia glutinosa Libosch leaf-based extract (RGLE)] in females, with moderate to severe acne vulgaris.

Participants and Methods

Twenty-two females aged 18 to 35 years having moderate to severe acne with Global Acne Grading System (GAGS) scores of 19 to 38 were included in the study and were randomized in a 1:1 ratio to receive either one capsule (100 mg/day) of RGLE or placebo orally after breakfast for 56 days. The primary outcome was a change in acne severity measured by the GAGS compared to the placebo on day 56. The secondary outcomes were changes in the number of inflammatory acne lesions, facial sebum secretion, quality of life, local pain and itching, skin wrinkle severity, and other skin characteristics, including radiance, luminosity, smoothness, texture, firmness, and hydration. Additionally, the percentage of responders and global tolerability and efficacy were evaluated.

Results

The mean GAGS score was reduced by 21.72% and 14.20% on day 28 in RGLE (n=10) and placebo groups (n=12), respectively, which further reduced in both groups on day 56. The RGLE group reported better improvement in other skin characteristics on day 56. No safety or tolerability concerns were reported for the extract. RGLE reduced acne and improved the skin quality in females compared to placebo as early as 28 days of supplementation.

Conclusion

RGLE supplementation at a dose of 100 mg/day has provided a clinically relevant decrease in acne severity and improved the skin hydration and quality of life of the participants with acne after 56 days of dose administration.

Comparison of two devices for facial skin analysis

BACKGROUND

The use of quantitative measures to assess patients' skin has turned the subjective nature of dermatology into an objective one. These measures allow for more accurate diagnosis and improved monitoring of diseases. While there are many skin analysis devices available, they often require specific equipment to function and can be costly, limiting their clinical use.

AIMS

The aim of our study was to compare a new skin analysis device that is easy to incorporate into dermatologic practice to a standard validated device.

METHODS

We recruited 50 patients from dermatology clinics and analyzed their skin with two facial analysis systems: an online application that can be downloaded on either an iPad or iPhone, and a computer-based analysis system that utilizes a facial imaging photobooth. Scores were recorded and compared between the two devices for the following five skin characteristics; "spots," "wrinkles," "redness," "texture," and "pores."

RESULTS

The tablet and the computer analysis system had an agreement rate of 67.7%. The highest agreement was in assessing texture (72.0%) and pores (68.2%). The lowest agreeance was in assessing redness (64%) and wrinkles (67%). When assessing the relationship between patients' raw score for wrinkles and their age, there was a strong correlation with the tablet (r = 0.79, p < 0.0001) compared with the computer system (r = 0.26, p < 0.06).

CONCLUSIONS

The application utilized in our study may serve as a cost-effective and clinic friendly tool to assess patients' skin. It produces similar results to other skin analysis devices and may be more sensitive in detecting and quantifying wrinkles.

Evaluation of the Efficacy and Safety of Blue Fenugreek Kale Extract on Skin Health and Aging: In-vitro and Clinical Evidences

Background

Objective

Methods

Results

Conclusion

Effects of Polynucleotide Dermal Filler in the Correction of Crow's Feet Using an Antera Three-Dimensional Camera

BACKGROUND

Dermal fillers are gaining interest for tissue enlargement and skin improvement. Among them, polynucleotides have demonstrated multiple skin beneficial effects. The effects of polynucleotide fillers were objectively evaluated using an Antera 3D camera, subjectively evaluated by participants and investigators.

METHODS

Thirty subjects with crow's feet were enrolled in the study. The subjects received polynucleotide filler for crow's feet. Crow's feet grading score (CFGS), global esthetic improvement scale (GAIS), and Antera 3D imaging results were evaluated.

RESULTS

Twenty-eight subjects (93.3%) completed the study. An improvement in CFGS compared with that at baseline (p < 0.001) was observed 18 weeks after the first injection of polynucleotides. Additionally, at the final visit, there were improvements in wrinkle, texture, pore, depression, and Hb values compared with those at baseline (p < 0.05). However, no significant difference in melanin level was detected between the initial and final visits.

CONCLUSIONS

Improvements in wrinkles, pores, texture, depression, and Hb level after polynucleotide filler injection were verified by objective and subjective evaluations. To the best of our knowledge, this is the first report on the objective evaluation of polynucleotide fillers in crow's feet using the Antera 3D camera.

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 .

Quantitative Evaluation of Nasolabial Fold by Three-Dimensional Imaging: A Comparison with WSRS Score

BACKGROUND

Nasolabial fold (NLF) reveals the aging of the face, and various treatments for NLF have been developed currently. However, most methods introduced to evaluate NLF are subjective and qualitative.

OBJECTIVES

This study was aimed to establish and validate a quantitative evaluation method by three-dimensional imaging, and thus accordingly to determine the relationship between quantitative measurements and wrinkle severity rating scale (WSRS) score.

METHODS

Seventy-five Asian female volunteers were enrolled for evaluating the severity of NLF based on both WSRS score and three-dimensional imaging. Three-dimensional imaging was used to collect the quantitative measurements of NLF, including length, width, and depth. The relationship between multiple WSRS scores and quantitative measurements was compared statistically. Besides, thirty patients with moderate or severe NLF were admitted to receive hyaluronic acid injection for NLF correction. All NLFs were evaluated quantitatively pre-injection and 3 months post-injection.

RESULTS

The results revealed a statistically significant positive relationship between the WSRS score and the length, width, and depth of NLF, respectively. After 3 months of hyaluronic acid injection, the mean WSRS score, the length, width, and depth of NLF were significantly reduced.

CONCLUSIONS

Three-dimensional imaging can be used to quantitatively assess the severity of the nasolabial folds, compensating for the deficiencies of traditional scales. This technique may help improve rejuvenation procedures for the aging nasolabial fold.

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 .

Preauricular Aging: A Three-Point Grading System to Guide Treatment in Facial Rejuvenation

BACKGROUND

Aging affects the face in all its dimensions. However, more has been published about the improvement of the periocular, midface, and perioral aging changes. We believe the profile view, particularly the preauricular area, is of great value when assessing the need for facial contouring procedures, as well as their effectiveness.

OBJECTIVE

To develop and evaluate a classification based on the aging changes around the preauricular area, which aims to provide an objective direction to the appropriate treatment method.

METHODS AND MATERIALS

All patients who attended the clinic for different aesthetic procedures between June 2019 and January 2020 were photographed. Two non-treating dermatologists and two non-treating plastic surgeons were asked to evaluate the perceived aging of the preauricular area using a three-point grading system. The assessment of each photograph was made once by each evaluator, and the inter-rater correlation was calculated.

RESULTS

A total of 158 profile pictures of the preauricular area of 158 patients were evaluated by two non-treating dermatologists and two non-treating plastic surgeons. The inter-rater correlation was excellent at 0.942. The mean grading system of the patient samples was 1.42, with a standard deviation of 0.9 and a variance of 0.001.

CONCLUSIONS

The preauricular area is often overlooked and undertreated. Our results demonstrate an excellent inter-rater correlation between plastic surgeons and dermatologists at assessing the degree of aging in the area. This relatively hidden lateral area can serve as a test point, evaluating response to selected treatment before proceeding to full-face intervention. We suggest using a simple three-point scale to help guide treatment of the preauricular area and as part of our holistic approach to facial rejuvenation.

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 .

Single Treatment, Single Depth Superficial Microfocused Ultrasound with Visualization for Rhytid Improvement

Background

Standard lifting and tightening protocols with microfocused ultrasound with visualization (MFU-V, Ultherapy) comprise the use of multiple transducer depths. We developed a shortened, single depth treatment protocol for patients seeking skin rejuvenation.

Methods

Single-center, prospective case series. Subjects with static periorbital wrinkles, perioral wrinkles, or accordion lines had a single MFU-V treatment comprising up to 340 lines (periorbital 120, perioral 100, and accordion 120) with the superficial depth transducer (10.0 MHz/1.5 mm). Efficacy was assessed using established rating scales as well as clinician- and subject-reported Global Aesthetic Improvement Scales at baseline, 90, and 180 days, and each subject served as their own control. Adverse events were documented.

Results

Nine subjects, women aged 38-64, received treatment. At 180 days, post treatment clinicians reported visible improvements in periorbital lines (6/6 cases), accordion lines (5/6 cases), and perioral lines (3/6 cases). Subjects' self-assessments mirrored those of the clinicians, reporting improvements in accordion lines (5/6 cases improved, 1/6 cases much improved), periorbital lines (3/6 cases improved, 3/6 cases much improved) and perioral lines (2/6 cases improved, 2/6 cases much improved). Subject-rated satisfaction was high (accordion lines 6/6 cases, periorbital lines 4/6 cases and perioral lines 4/6 cases). All subjects experienced mild, transient erythema; in one subject, wheals persisted for 24 hours, resolving on application of mild topical corticosteroid.

Conclusions

Shortened protocol, single depth MFU-V treatment was well-tolerated. It provided aesthetic improvements in periorbital and accordion lines, and to a lesser extent in perioral lines. Its utility as a noninvasive therapy for superficial skin rejuvenation warrants further investigation.

Defining Skin Quality: Clinical Relevance, Terminology, and Assessment

BACKGROUND

Flawless skin is one of the most universally desired features, and demand for improvements in skin quality is growing rapidly. Skin quality has been shown to substantially impact emotional health, quality of life, self-perception, and interactions with others. Although skin quality improvements are a common end point in studies of cosmeceuticals, they are rarely assessed in clinical studies of other aesthetic treatments and products. Descriptive terminology for skin quality parameters also varies considerably within the aesthetic field, relying on a range of redundant and occasionally contradictory descriptors. In short, skin quality has not been clearly defined.

OBJECTIVE

The goal of this review is to highlight the importance of skin quality to patients and physicians, explore known and unknown factors comprising skin quality, and provide clarity regarding terminology, descriptors, and evaluation tools for assessing skin quality.

MATERIALS AND METHODS

A review of the literature on skin quality was performed without limitation on publication date. Relevant articles are presented.

RESULTS AND CONCLUSION

We propose a framework of attributes contributing to skin quality rooted in 3 fundamental categories-visible, mechanical, and topographical-with the aim to provide information to help guide clinicians and inform future clinical studies.

A prospective, open-label, multicentric, single-arm, post-marketing clinical study to evaluate effectiveness and safety of Cross-Linked Sodium Hyaluronate 24mg with Lidocaine 3mg Injection in subjects undergoing treatment for facial wrinkles and lip augmentation

BACKGROUND

Hyaluronic acid (HA) fillers are quite commonly used since several years for soft tissue augmentation.

AIM

The purpose of this study was to evaluate primarily the safety and secondarily the clinical effectiveness of Cross-Linked Sodium Hyaluronate 24 mg with Lidocaine 3 mg (Jeunesso 24L) injection, in subjects undergoing treatment for facial wrinkles and lip augmentation.

METHOD

Patients between the age groups of 18 and 75 years, who were seeking soft tissue augmentation treatment on the face and with wrinkle severity score (WSS) ≥2 for bilateral Nasolabial Folds (NLF), were included in the study. The appropriate quantity of the filler was injected at the treatment site. Clinical efficacy assessments were conducted independently at 3 and 6 months after baseline. Clinical efficacy was assessed using Wrinkle Severity Rating Scale (WSRS) and a Global Aesthetic Improvement Scale (GAIS).

RESULTS

The mean pain score was found to be 2.57 ± 2.06 immediately after injection which was reduced to 0.1 ± 0.675 at 15 min and this further subsided to "No Pain" in any of the participants at 60 min post the injection. WSRS mean score before treatment was 2.76, which were significantly reduced to 2.14, at 3 months. Majority of participants found an improvement in the marionette line severity. Also, significant improvements were seen in the perioral and lip areas. The Study filler was well-tolerated and no side effects were reported.

CONCLUSION

The study indicates that this particular filler, HA+L, is useful for cosmetic improvements in the nasolabial folds and for enhancement of the lips.

Comparative analysis of skin characteristics evaluation by a dermatologist and the Janus-III measurement system

BACKGROUND

The Janus-III measurement system evaluates the overall skin characteristics such as skin pore, wrinkle, sebum, porphyrin, skin pigmentation, and skin color using high-resolution facial images. The values are measured from five different facial areas, namely, the forehead, nose, corner of/skin below the eyes, and cheeks. Owing to its convenience and diverse measuring characteristics, Janus-III has been widely used in skin research and the cosmetic industry in Korea. In our previous study, we revealed the consistency and reliability of the system with repeatedly measured values. Its measuring performance was investigated statistically, but to make it more reliable for academic skin research, additional verification by a professional dermatologist is needed.

MATERIALS AND METHODS

In this study, we conducted comparative analysis of three skin characteristics (pigmented spot, skin color, and eye wrinkle) by a dermatologist and the Janus-III measurement system. We utilized 330 image data that were cropped from the whole facial images of 330 different participants to avoid correlation among the three measuring items. Pearson's correlation coefficient exhibited similar patterns between the system and the dermatologist's findings.

RESULTS

The main finding of our study was that the measured value of skin characteristics by the Janus-III system showed clear correlation with the values evaluated by a dermatologist, especially in a pigmented spot.

CONCLUSION

Therefore, it would be a plausible idea to consider the Janus-III system for specialized research of skin characteristics even with a small sample size.

Anti-Wrinkle Efficacy of Cross-Linked Hyaluronic Acid-Based Microneedle Patch with Acetyl Hexapeptide-8 and Epidermal Growth Factor on Korean Skin

Background

Hyaluronic acid (HA)-based microneedle patch has recently been studied for wrinkle improvement. Cross-linked HA (CLHA) is widely used in dermal fillers. Acetyl hexapeptide-8 (AHP-8) and epidermal growth factor (EGF) are used for cosmetic ingredients.

Objective

This study aimed to verify the efficacy of the CLHA/HA-based patch with microstructure (microneedle patch) containing AHP-8 or EGF.

Methods

A total of 52 Korean females were enrolled in a double-blind, randomized, controlled, split-face trial. The subjects were divided into 3 groups: (1) microneedle patch alone, (2) microneedle patch/AHP-8, and (3) microneedle patch/EGF. The treatment was applied on the periorbital and nasolabial fold area for 4 hours to completely dissolve the microstructures once per week for 29 days. Evaluations, including photodamage scoring, image analysis with Antera 3D® (Miravex, Ireland), skin hydration measurement, and adverse effect assessments, were performed at each visit.

Results

Fifty subjects (96.2%) completed this clinical study. On day 29 after application, statistically significant improvements in wrinkle and skin hydration were observed in all groups (p<0.01). Treatment with microneedle patch/AHP-8 and microneedle patch/EGF showed statistically significant improvements in wrinkle compared with microneedle patch alone (p<0.05). No serious adverse effects were noted.

Conclusion

Combination of CLHA-based microneedle patch and functional cosmetic ingredients can improve wrinkle with minimal discomfort.

Performance of intraclass correlation coefficient (ICC) as a reliability index under various distributions in scale reliability studies

Many published scale validation studies determine inter‐rater reliability using the intra‐class correlation coefficient (ICC). However, the use of this statistic must consider its advantages, limitations, and applicability. This paper evaluates how interaction of subject distribution, sample size, and levels of rater disagreement affects ICC and provides an approach for obtaining relevant ICC estimates under suboptimal conditions. Simulation results suggest that for a fixed number of subjects, ICC from the convex distribution is smaller than ICC for the uniform distribution, which in turn is smaller than ICC for the concave distribution. The variance component estimates also show that the dissimilarity of ICC among distributions is attributed to the study design (ie, distribution of subjects) component of subject variability and not the scale quality component of rater error variability. The dependency of ICC on the distribution of subjects makes it difficult to compare results across reliability studies. Hence, it is proposed that reliability studies should be designed using a uniform distribution of subjects because of the standardization it provides for representing objective disagreement. In the absence of uniform distribution, a sampling method is proposed to reduce the non‐uniformity. In addition, as expected, high levels of disagreement result in low ICC, and when the type of distribution is fixed, any increase in the number of subjects beyond a moderately large specification such as n = 80 does not have a major impact on ICC.

Safety and efficacy of a novel diffractive lens array using a picosecond 755 nm alexandrite laser for treatment of wrinkles

Introduction

Picosecond lasers have been reported to be effective for removal of tattoo pigment. This prospective study evaluated the efficacy and safety of the treatment of peri‐oral and ‐ocular wrinkles using a novel diffractive lens array coupled with a picosecond 755 nm alexandrite laser.

Methods

Forty female subjects presenting with wrinkles from photodamage were enrolled in an IRB approved study. Subjects received four picosecond diffractive lens array treatments to the full face at 1 month intervals. Six subjects were biopsied (two subjects at 1 month, two subjects at 3 months, and two subjects at 6 months). Digital photographic images were taken at 1, 3, and 6 months post‐final treatment visits. Images were graded by blinded physicians for fine lines/wrinkles, erythema, dyschromia, and global improvement. Data on discomfort level, satisfaction, and side effects were recorded.

Results

Overall blinded physician rated global improvement ranged from improved to much improved at 1‐, 3‐, and 6‐month time points. At baseline the average Fitzpatrick wrinkle score was 5.48. At the 6‐month follow‐up the average score was 3.47. The overall average change in score from pre‐treatment to post‐treatment was 1.97. Subject self‐assessment at 6 months indicated that 90% of subjects were extremely or satisfied with their results. Unanticipated adverse events were absent with anticipated post‐treatment erythema lasting for just several hours.

Conclusions

A novel diffractive lens array used with a picosecond 755 nm alexandrite laser for treatment of wrinkles is highly effective and safe for wrinkles and other signs of photoaging. Lasers Surg. Med. 49:40–44, 2017. © 2016 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

A randomized, placebo-controlled, single-blinded, split-faced clinical trial evaluating the efficacy and safety of KLOX-001 gel formulation with KLOX light-emitting diode light on facial rejuvenation

Purpose

Many treatment modalities exist to counteract the effects of cutaneous aging. Ablative methods have been the mainstay for nonsurgical facial rejuvenation. In recent years, nonablative techniques have been developed with the aim of achieving facial rejuvenation without epidermal damage. Light-emitting diode (LED) photorejuvenation is a novel nonablative technique that induces collagen synthesis through biophotomodulatory pathways.

Materials and methods

A single-center, randomized, single-blinded, placebo-controlled, split-faced clinical trial was designed. Thirty-two patients were enrolled for a 12-week study. Patients were randomized into one of four groups: Group A, treatment with KLOX-001 gel formulation and white LED (placebo) light; Group B, treatment with a placebo/base gel (no active chromophore) formulation and KLOX LED light; Group C, treatment with KLOX-001 gel formulation and KLOX LED light; and Group D, treatment with the standard skin rejuvenating treatment (0.1% retinol-based cream). Patients received treatment at weeks 0, 1, 2, and 3, and returned to the clinic at weeks 4, 8, and 12 for clinical assessments performed by an independent, blinded committee of physicians using subjective clinician assessment scales. Tolerability, adverse outcomes, and patient satisfaction were also assessed.

Results

Analysis demonstrated that the KLOX LED light with KLOX placebo/base gel and the KLOX LED light + KLOX-001 gel formulation groups were superior to standard of care and KLOX-001 gel formulation with placebo light on subjective clinical assessment and multiple wrinkle scales, with statistically significant results obtained for brow positioning, perioral wrinkling, and total wrinkle score.

Conclusion

The study results show that KLOX LED light with KLOX-001 gel formulation and KLOX LED light with KLOX placebo/base gel are effective, safe, well-tolerated, and painless treatment modalities for skin rejuvenation.

Global Aesthetics Consensus: Botulinum Toxin Type A--Evidence-Based Review, Emerging Concepts, and Consensus Recommendations for Aesthetic Use, Including Updates on Complications

BACKGROUND

Botulinum toxin type A injection remains the leading nonsurgical cosmetic procedure worldwide, with a high rate of efficacy and patient satisfaction.

METHODS

A multinational, multidisciplinary group of plastic surgeons and dermatologists convened the Global Aesthetics Consensus Group to develop updated consensus recommendations with a worldwide perspective for botulinum toxin and hyaluronic acid fillers. This publication on botulinum toxin type A considers advances in facial analysis, injection techniques, and avoidance and management of complications.

RESULTS

Use of botulinum toxin has evolved from the upper face to also encompass the lower face, neck, and midface. The Global Aesthetics Consensus Group emphasizes an integrative, diagnostic approach. Injection dosage and placement are based on analysis of target muscles in the context of adjacent ones and associated soft and hard tissues. The indication for selection of botulinum toxin as a primary intervention is that excessive muscular contraction is the primary etiology of the facial disharmony to be addressed. Global Aesthetics Consensus Group recommendations demonstrate a paradigm shift toward neuromodulation rather than paralysis, including lower dosing of the upper face, more frequent combination treatment with hyaluronic acid fillers, and intracutaneous injection where indicated to limit depth and degree of action.

CONCLUSIONS

The accumulation of clinical evidence and experience with botulinum toxin has led to refinements in treatment planning and implementation. The Global Aesthetics Consensus Group advocates an etiology-driven, patient-tailored approach, to enable achievement of optimal efficacy and safety in patient populations that are rapidly diversifying with respect to ethnicity, gender, and age.

CLINICAL QUESTION/LEVEL OF EVIDENCE

Therapeutic, V.

A diagnostic model for impending death in cancer patients: Preliminary report

BACKGROUND

Several highly specific bedside physical signs associated with impending death within 3 days for patients with advanced cancer were recently identified. A diagnostic model for impending death based on these physical signs was developed and assessed.

METHODS

Sixty-two physical signs were systematically documented every 12 hours from admission to death or discharge for 357 patients with advanced cancer who were admitted to acute palliative care units (APCUs) at 2 tertiary care cancer centers. Recursive partitioning analysis was used to develop a prediction model for impending death within 3 days with admission data. The model was validated with 5 iterations of 10-fold cross-validation, and the model was also applied to APCU days 2 to 6.

RESULTS

For the 322 of 357 patients (90%) with complete data for all signs, the 3-day mortality rate was 24% on admission. The final model was based on 2 variables (Palliative Performance Scale [PPS] and drooping of nasolabial folds) and had 4 terminal leaves: PPS score ≤ 20% and drooping of nasolabial folds present, PPS score ≤ 20% and drooping of nasolabial folds absent, PPS score of 30% to 60%, and PPS score ≥ 70%. The 3-day mortality rates were 94%, 42%, 16%, and 3%, respectively. The diagnostic accuracy was 81% for the original tree, 80% for cross-validation, and 79% to 84% for subsequent APCU days.

CONCLUSIONS

Based on 2 objective bedside physical signs, a diagnostic model was developed for impending death within 3 days. This model was applicable to both APCU admission and subsequent days. Upon further external validation, this model may help clinicians to formulate the diagnosis of impending death.

An open-label uncontrolled, multicenter study for the evaluation of the efficacy and safety of the dermal filler Princess VOLUME in the treatment of nasolabial folds

The dermal filler Princess VOLUME is a highly cross-linked, viscoelastic hyaluronic acid injectable gel implant used for aesthetic treatment. To evaluate the efficacy and safety of Princess VOLUME in the treatment of nasolabial folds, an open-label uncontrolled, multicenter study was conducted. Forty-eight subjects were recruited who had moderate to deep wrinkles, according to the Modified Fitzpatrick Wrinkle Scale (MFWS). Subjects received Princess VOLUME in both nasolabial folds at Day 0. Nasolabial fold severity was evaluated at 30, 90, 180, and 270 days after treatment, using the MFWS and the Global Aesthetic Improvement Scale (GAIS). Adverse events and treatment site reactions were recorded. Among the 48 subjects, 93.8% were female with a median age of 52 years. There were significant improvements (P < 0.0001) in the MFWS scores at 30, 180, and 270 days after treatment compared with those at baseline, with a mean decrease of 1.484 (±0.408), 1.309 (±0.373), and 1.223 (±0.401), respectively; hence the primary endpoint was achieved and clinical efficacy demonstrated. Princess VOLUME was well tolerated, and most adverse events were injection site reactions of mild to moderate severity. Subject satisfaction (97.9%), subject recommendation of the treatment (93.6%), and investigators GAIS scores (97.9% improvement) were high.

Daily consumption of the collagen supplement Pure Gold Collagen® reduces visible signs of aging

With age, changes in the metabolic processes of structural components of the skin lead to visible signs of aging, such as increased dryness and wrinkle formation. The nutritional supplement, Pure Gold Collagen(®), which consists of hydrolyzed collagen, hyaluronic acid, vitamins, and minerals, was developed to counteract these signs. An open-label study was conducted to investigate the effects of this nutritional supplement on skin properties. Supplementation with 50 mL of Pure Gold Collagen on a daily basis for 60 days led to a noticeable reduction in skin dryness, wrinkles, and nasolabial fold depth. In addition, a significant increase in collagen density and skin firmness was observed after 12 weeks. The data from this study suggest that Pure Gold Collagen can counteract signs of natural aging.

A controlled trial to determine the efficacy of red and near-infrared light treatment in patient satisfaction, reduction of fine lines, wrinkles, skin roughness, and intradermal collagen density increase

OBJECTIVE

The purpose of this study was to investigate the safety and efficacy of two novel light sources for large area and full body application, providing polychromatic, non-thermal photobiomodulation (PBM) for improving skin feeling and appearance.

BACKGROUND DATA

For non-thermal photorejuvenation, laser and LED light sources have been demonstrated to be safe and effective. However, lasers and LEDs may offer some disadvantages because of dot-shaped (punctiform) emission characteristics and their narrow spectral bandwidths. Because the action spectra for tissue regeneration and repair consist of more than one wavelength, we investigated if it is favorable to apply a polychromatic spectrum covering a broader spectral region for skin rejuvenation and repair.

MATERIALS AND METHODS

A total of 136 volunteers participated in this prospective, randomized, and controlled study. Of these volunteers, 113 subjects randomly assigned into four treatment groups were treated twice a week with either 611-650 or 570-850 nm polychromatic light (normalized to ∼ 9 J/cm(2) in the range of 611-650 nm) and were compared with controls (n=23). Irradiances and treatment durations varied in all treatment groups. The data collected at baseline and after 30 sessions included blinded evaluations of clinical photography, ultrasonographic collagen density measurements, computerized digital profilometry, and an assessment of patient satisfaction.

RESULTS

The treated subjects experienced significantly improved skin complexion and skin feeling, profilometrically assessed skin roughness, and ultrasonographically measured collagen density. The blinded clinical evaluation of photographs confirmed significant improvement in the intervention groups compared with the control.

CONCLUSIONS

Broadband polychromatic PBM showed no advantage over the red-light-only spectrum. However, both novel light sources that have not been previously used for PBM have demonstrated efficacy and safety for skin rejuvenation and intradermal collagen increase when compared with controls.

Assessment of recovery time for the collagen products Dermicol-P35 27G and 30G

BACKGROUND

Dermicol-P35 27G and 30G are purified advanced collagen dermal fillers that are effective and well tolerated for cosmetic procedures.

OBJECTIVE

The primary objectives of this study were to: (1) document recovery time and return to daily activities after treatment with Dermicol-P35 27G, 30G, or both; and (2) assess the immediate adverse effects of these products and monitor their time to resolution.

METHODS

In all, 30 patients were treated with Dermicol-P35 27G, 30G, or both in nasolabial folds, lips, corners of the mouth, vermillion border, marionette lines, or a combination of these and monitored for 7 days. Comfort with resuming daily routine, adverse events, and satisfaction with results were documented by patients in diaries. The clinician assessed aesthetic improvement and rated satisfaction with results.

RESULTS

The majority of patients (63.4%) were very comfortable or comfortable returning to their daily routine immediately postprocedure. Most patients (86.7%) participated in normal work or social events within 2 days of treatment. Adverse events were mild to moderate and were resolved or tolerable by day 7. The clinician assessed that most patients had between 50% and 100% improvement over baseline for all procedures at all time points. Clinician and patients were very satisfied or satisfied with aesthetic results at days 2 and 7 postprocedure.

LIMITATIONS

The limitations of this study were the small number of patients, the assessment of short-term results, and the lack of touch-up injections.

CONCLUSIONS

Treatment with Dermicol-P35 27G, 30G, or both allowed for rapid return to daily activities and produced only transient and tolerable adverse events.