Synergic effect of plasma exeresis and non-cross-linked low and high molecular weight hyaluronic acid to improve neck skin laxities

Intradermal Treatment with a Hyaluronic Acid Complex Supplemented with Amino Acids and Antioxidant Vitamins Improves Cutaneous Hydration and Viscoelasticity in Healthy Subjects

Intradermal injection of bioactive compounds is used to reduce the effects of aging skin. The aim of this work is to study the response of facial injection of a hyaluronic acid complex supplemented with amino acids and antioxidant vitamins on skin rejuvenation. A total of 40 healthy adult subjects were recruited to whom this complex was injected into the facial skin, three consecutive times every two weeks. Together with assessing the degree of skin hydration, the level of skin microcirculation, wrinkles, skin color, and skin biomechanical parameters were evaluated. Using the GAIS scale, the degree of satisfaction of the participants was assessed. At 42 days (D42), there was an 11-12% increase in skin hydration and viscoelasticity, a 23% increase in skin density, a 27% increase in skin microcirculation, and a significant lightening and whitening of skin color, but without causing changes in skin wrinkles. A value between 1 and 3 on the GAIS scale was observed between 70 and 92% of the participants, and 87% of subjects found their skin more beautiful, 85% would recommend this treatment, and more than 50% found their face rejuvenated. In summary, the intradermal treatment tested suggests skin rejuvenation, with a good degree of safety.

Histopathologic analysis of hyaluronic acid composite solution following intravascular injection: Variability and safety

BACKGROUND

Although a composite solution of non-crosslinked hyaluronic acid is generally considered safe, few studies have investigated its safety after intravascular injection.

METHODS

Male Sprague-Dawley rats were administered 0.05 mL of a non-crosslinked hyaluronic acid composite solution via intravascular injection into bilateral inferior epigastric arteries (IEA). Artery samples were obtained at multiple time points for histopathologic analysis. Bilateral abdominal flaps supplied by the IEA were lifted and the same dose of solution was injected into the artery, and flap survival was analyzed.

RESULTS

Histopathologic analysis showed that the non-crosslinked hyaluronic acid composite solution remained temporarily in the artery lumen following intravascular injection. With continuous blood flow, the filler gradually disintegrated and the artery became recanalized. At 24 h, no filler remained in the lumen. At 7 days after the filler was injected into the IEA feeding the flap, there was no significant difference between the experimental and control groups with respect to flap survival rate.

CONCLUSIONS

Non-crosslinked hyaluronic acid composite solution is relatively safe when a minimal volume is administered by intravascular injection. The filler will remain in the vessel for a short time, after which the vessel recanalizes.

Hyaluronic Acid Compound Filling Plus Mesotherapy vs Botulinum Toxin A for the Treatment of Horizontal Neck Lines: A Multicenter, Randomized, Evaluator-Blinded, Prospective Study in Chinese Subjects

Background

Although energy devices and botulinum toxin A (BTX-A) can alleviate age-related laxity, ptosis, and platysmal bands, they have limited efficacy on horizontal neck lines.

Objectives

The purpose of this study was to investigate the efficacy, safety, and subject satisfaction of a combined treatment of non–cross-linked hyaluronic acid (HA) compound filling plus mesotherapy for the correction of horizontal neck lines, in comparison with BTX-A.

Methods

This multicenter, randomized, evaluator-blinded, prospective study enrolled female patients with moderate-to-severe horizontal neck lines corrected with either 2 or 3 sessions of of non–cross-linked HA compound filling plus mesotherapy or 1 session of BTX-A injection. Improvement of the neck lines grades, Global Aesthetic Improvement Scale (GAIS), patient satisfaction, and adverse events (AEs) were evaluated and compared at 1, 3, 6, and 10 months after the final treatment.

Results

Twenty-five patients received HA filling plus mesotherapy and 23 received BTX-A injection. Compared with BTX-A, the HA compound filling plus mesotherapy significantly improved the horizontal neck lines grades on all follow-up visits (P = 0.000). Cases of different baseline grades (2, 2.5, and 3) demonstrated similar outcomes. The GAIS and patients’ satisfaction ratings were significantly higher for the HA filling plus mesotherapy treatment group (P = 0.000). Significantly higher pain ratings, higher incidence, and longer recovery of AEs (erythema, edema, and ecchymosis) were noticed in the combined treatment group (P < 0.001). No serious AEs occurred.

Conclusions

Compared with BTX-A, combined treatment with HA compound filling plus mesotherapy significantly improved moderate-to-severe horizontal neck lines and achieved a high level of patient satisfaction.

Level of Evidence: 4

Evaluation of the efficacy and safety of plasma exeresis in periorbital rejuvenation using the Reviscometer®

BACKGROUND

Periorbital rejuvenation is performed through various methods. Recently, plasma exeresis has been suggested for the treatment of dermatochalasis and periorbital wrinkles.

AIMS

To evaluate the clinical efficacy and safety of plasma exeresis in periorbital rejuvenation and palpebral laxity and assess its effectiveness using the Reviscometer^® .

PATIENTS/METHODS

Fifty-six women with mild-to-severe dermatochalasis and periorbital wrinkles volunteered to participate in this clinical trial. They received plasma exeresis thrice at one-month intervals. The efficacy of the intervention was evaluated according to the Cutaneous Resonance Running Time (CRRT) value changes, photographic changes, patients' satisfaction, and clinical side effects.

RESULTS

This study showed significant clinical improvements in dermatochalasis and palpebral laxity after treatment compared with the baseline (p < 0.001). Most of the participants had relative satisfaction, and no significant or permanent side effects were observed.

CONCLUSION

The findings of this study suggest that plasma exeresis is a safe and effective nonsurgical method for periorbital rejuvenation. Furthermore, the procedure has no serious adverse effects if performed correctly and for the right patient.

Safety evaluation of the atmospheric low-temperature plasma (ALTP) on the conjunctiva: an animal study and histopathological findings; 6-month follow-up

BACKGROUND

Plasma medicine is an innovative research field focused on the application of atmospheric-pressure low-temperature plasmas (ALTP) for therapeutic purposes. Considering the potentials of plasma in ophthalmology, in this study, we evaluated the safety of plasma on the conjunctival tissue in animal models for 6 months.

METHODS

Twelve adult male New Zealand albino rabbits were divided into four groups. The right eye of each rabbit was chosen for the test and the left eye was considered as the control. Experiments were performed using the Plexr device (GMV, Rocca Priora, RM, Italy). Four plasma spots were applied on the superior part of the conjunctiva (from 10 to 2 o'clock positions) using the continuous mode and a low power level (white handpiece) of the Plexr. For evaluation of the plasma safety, the histopathological changes were assessed 1 week (A), 1 month (B), 3 months (C), and 6 months (D) after the intervention.

RESULTS

According to the histopathological findings, a mild decrease in blood vessels and severe stromal edema, as well as a superficial epithelium loss, were observed in group A. No chronic inflammation, scar tissue, deposition, and hemorrhage were found in group B. Epithelialization was confirmed by the histological examinations after 1 month. There was no evidence of atypia or dysplasia after 3 and 6 months.

CONCLUSION

In conclusion, there were no persistent histopathological changes on conjunctival tissue after plasma exposure. Then, plasma can be considered as a minimally invasive alternative method for treating some ocular surface disorders.

Favre-Racouchot disease: protective effect of solar elastosis

Favre-Racouchot disease (FRD) is an occupational disorder characterized by solar elastosis with open and cystically dilated comedones that tend to appear on the periorbital and temporal face of elderly light-complexioned men. It is a benign condition caused by chronic excessive ultraviolet exposure, as well as ionizing radiation and/or smoking. However, malignant skin neoplasms are uncommonly observed arising in FRD, which suggests a protective role of some element of FRD against carcinogenesis. We explore elastosis as a possibly beneficial tissue response. The clinical manifestations, pathogenesis, and recommended treatment options of this disorder are reviewed.

Topical treatment of radiation-induced dermatitis: current issues and potential solutions

Approximately 95% of patients receiving radiotherapy (RT) will ultimately develop radiation-induced dermatitis (RID) during or after the course of treatment, with major consequences on quality of life and treatment outcomes. This paper reviews the pathophysiology of RID and currently used topical products for the prevention and treatment of RID. Although there is no consensus on the appropriate management, recent evidence suggests that the use of topical products supports to protect and promote tissue repair in patients with RID. Basic recommendations include advice to wear loose clothing, using electric razors if necessary, and avoiding cosmetic products, sun exposure or extreme temperatures. Based on mechanisms involved and on the clinical characteristics of oncological patients, the profile of the ideal topical product for addressing RID can be designed; it should have limited risk of adverse events, systemic adsorption and drug–drug interactions, should be characterized by multiple clinical activities, with a special focus on localized pain, and should have a careful formulation as some vehicles can block the RT beam.