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Siperstein R, Nestor E, Meran S. Prospective Clinical Trial Demonstrating the Efficacy of Hyaluronic Acid Filler for the Improvement of Atrophic Facial Scars up to 2 years. Dermatol Surg 2024:00042728-990000000-00869. [PMID: 38968085 DOI: 10.1097/dss.0000000000004315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2024]
Abstract
BACKGROUND Hyaluronic acid (HA) filler longevity has been studied for wrinkles. However, its long-term use for treating atrophic facial scars has not yet been analyzed in long-term prospective studies. OBJECTIVE Analyze the safety and duration of a HA filler for the use in atrophic scars. MATERIALS AND METHODS Fifteen subjects received VYC-17.5L in atrophic scars on 1 randomized cheek and saline on the other, with 1 optional touch-up treatment and crossover after the short-term trial. Grading for this long-term extension was done on Day 720, using the Global Aesthetic Improvement Scale (GAIS) and the Quantitative Global Scarring Grading System. RESULTS On Day 720, a live blind evaluator rated the VYC-17.5L assigned side as having significant reduction in scar severity (-7.2 [t(22) = -6.01, p = .00009]) and number of scars (-8.8 [t(22) = -6.25, p = .00006]) as compared with baseline. There was no significant difference in the results from Day 120 to Day 720. Ninety-two percent (11/12) of subjects reported improvement (GAIS), were satisfied with the treatment, thought it looked natural, and had fewer side effects than expected. There were no persistent or late-onset side effects. CONCLUSION VYC-17.5L improved rolling atrophic facial scars, and the results were sustained throughout the 2-year trial without side effects.
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Affiliation(s)
- Robyn Siperstein
- Florida Atlantic University, Boca Raton, Florida
- Siperstein Dermatology Group, Boynton Beach, Florida
| | | | - Suzanne Meran
- Siperstein Dermatology Group, Boynton Beach, Florida
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Dastgheib M, Heidari S, Azizipour A, Kavyani M, Lajevardi V, Ehsani AH, Teimourpour A, Daneshpazhooh M, Kashani MN, Balighi K. Investigating the impact of added Profhilo mesogel to subcision versus subcision monotherapy in treating acne scars; a single-blinded, split-face randomized trial. J Cosmet Dermatol 2024; 23:1992-2000. [PMID: 38429946 DOI: 10.1111/jocd.16258] [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: 06/08/2023] [Revised: 02/10/2024] [Accepted: 02/13/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Acne scar is an inflammatory condition, which commonly occurs in patients with acne vulgaris, especially in adults. Mesogels have been reported effective in improving atrophic acne scars. AIMS We investigated the efficacy of adding Profhilo (a hyaluronic acid-based filler) to subcision as a new treatment method. METHODS Twelve patients aged 18-45 years with atrophic acne scars on both sides of the face participated in this single-blinded, split-face, randomized controlled trial. Each side of the face was randomly assigned to one of the treatment methods, including subcision alone and subcision + Profhilo. Patients in the Profhilo arm received mesogel (1 cc) in addition to the subcision procedure. Both methods were carried out two times at 1-month intervals. Assessments were done based on the sonographic depth of scars, and two blinded observers examined photographs at baseline and 3 months after the final session and the results were reported based on an exclusively made formula as the total score. The Global Improvement Scale and Visual Analogue Scale (VAS) (for patient satisfaction) were also used. RESULTS The VAS score of patient satisfaction was statistically significant in the Profhilo arm, with a mean improvement of 528.08 and 219.06 in the subcision arm (p = 0.02). No significant difference was seen in total acne scar reduction comparing the two methods (29.74 in the Profhilo arm and 22.27 in the subcision arm, p = 0.56). Sonographic depth reduction was also non-significant, with a mean of 29.21 in the Profhilo arm and 28.53 in the subcision arm (p = 0.4). The mean global improvement was reported as four in both arms, and no statistical significance was observed (p = 0.89). The best response to treatment belonged to the rolling subtype in both methods (p = 0.029 for the Profhilo arm and p = 0.001 for the subcision arm). CONCLUSION Despite no significant difference between the methods, Profhilo is more effective due to a higher satisfaction rate and better physiologic effects.
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Affiliation(s)
- Mani Dastgheib
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sama Heidari
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arghavan Azizipour
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Kavyani
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahide Lajevardi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hooshang Ehsani
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Teimourpour
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Daneshpazhooh
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansour Nassiri Kashani
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamran Balighi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Behrangi E, Dehghani A, Sheikhzadeh F, Goodarzi A, Roohaninasab M. Evaluation and comparison of the efficacy and safety of cross-linked and non-cross-linked hyaluronic acid in combination with botulinum toxin type A in the treatment of atrophic acne scars: A double-blind randomized clinical trial. Skin Res Technol 2024; 30:e13541. [PMID: 38174839 PMCID: PMC10765352 DOI: 10.1111/srt.13541] [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: 10/31/2023] [Accepted: 11/16/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Acne vulgaris is a common skin condition that affects a significant percentage of adolescents, with scarring being one of its permanent complications. This study aims to compare the efficacy and safety of using botulinum toxin type A (BTA) in combination with cross-linked and non-cross-linked hyaluronic acid (HA) for the treatment of atrophic acne scars. METHOD Our study is a randomized, double-blind clinical trial conducted on 16 patients with atrophic acne scars. The patients were randomly assigned to one of two groups: one group received a single session of BTA and crossed link HA combination, while the other group received two sessions of BTA and non-crossed link HA, 1 month apart. The patients were followed up at 3 and 6 months after baseline to evaluate the number and area of fine and large pores and spots, scar grading, patient satisfaction, and complications. RESULTS The mean age of individuals in both the cross-linked HA and non-cross-linked HA groups was 32.75 ± 4.26 and 31.50 ± 8.48 years, respectively (p = 0.71). In terms of gender, three (37.5%) and seven (87.5%) individuals in the cross-linked and non-cross-linked HA groups were female, respectively (p = 0.11). There were no significant differences in the count and area of fine and large pores and spots between the two groups at baseline and the first follow-up session. However, in the second follow-up session, the non-cross-linked HA group had significantly better results than the cross-linked HA group in terms of large pores count and area (p = 0.01). In terms of changes over time, the non-cross-linked HA group showed significantly better improvements in the count and area of large pores compared to the cross-linked HA group (p = 0.03). Additionally, both groups experienced a significant decrease in the count and area of fine pores over time (p = 0.001), but the amount of changes was not statistically significant between the two groups (p = 0.06). Concerning acne grade, initially, 62.5% and 12.5% of cases in the cross-linked HA and non-cross-linked HA groups, respectively, had severe grades. However, in the last session, these percentages significantly decreased to 0% for both groups (p = 0.002 and 0.005, respectively). In terms of treatment complications, none of the patients experienced any adverse effects. CONCLUSION The study demonstrated that both cross-linked HA and non-cross-linked HA were effective in reducing acne severity and improving the appearance of pores and spots. The treatments had similar effects on fine pores, spots, and overall acne severity. However, non-cross-linked HA appeared to have a better result on large pores compared to cross-linked HA.
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Affiliation(s)
- Elham Behrangi
- Department of DermatologyRasool Akram Medical Complex Clinical Research Development Center (RCRDC)School of MedicineIran University of Medical Sciences (IUMS)TehranIran
| | - Abbas Dehghani
- Department of DermatologyRasool Akram Medical Complex Clinical Research Development Center (RCRDC)School of MedicineIran University of Medical Sciences (IUMS)TehranIran
| | | | - Azadeh Goodarzi
- Department of DermatologyRasool Akram Medical Complex Clinical Research Development Center (RCRDC)School of MedicineIran University of Medical Sciences (IUMS)TehranIran
| | - Masoomeh Roohaninasab
- Department of DermatologyRasool Akram Medical Complex Clinical Research Development Center (RCRDC)School of MedicineIran University of Medical Sciences (IUMS)TehranIran
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Shir-az O, Berl A, Mann D, Bilal BS, Levy Y, Shalom A. Treatment of Scleroderma-Related Microstomia Using Hyaluronic Acid: An Interventional Study. Life (Basel) 2023; 13:2176. [PMID: 38004316 PMCID: PMC10671914 DOI: 10.3390/life13112176] [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: 10/06/2023] [Revised: 10/25/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
Systemic sclerosis (SSc) or scleroderma is a rare, systemic, autoimmune connective tissue disease. It causes increased collagen synthesis, leading to multi-organ sclerosis, including the skin and joints. Patients' overall health and quality of life are harmed dramatically. Involvement of the face and, especially, the oral opening can limit patients' ability to speak and eat, oral hygiene, and cosmetic appearance. Profhilo® (NAHYCO®) is an over-the-counter product consisting of pure hyaluronic acid. It is used to improve skin quality by increasing collagen production and adipocyte vitality. This interventional study evaluated the results of perioral injections of hyaluronic acid in terms of improved skin quality, elasticity, and increased oral opening. Patients diagnosed with SSc received an injection of one syringe of Profhilo® (2 mL of hyaluronic acid) at each of two clinic visits at one-month intervals. The oral opening was measured between the upper and lower central incisors before and after treatment. Quality of life was assessed using the modified Rodnan Skin Score and Health Assessment Questionnaire-Disability Index. A total of 14 patients received the first treatment, and 11 received the second treatment. The mean oral opening increased from 31.6 mm (range 17-50 mm) prior to therapy to 35.8 mm (range 21-56) 2 months following the second injection. Statistical analysis showed that there was a significant increase in the oral opening as observed one week (36.2 mm, p = 0.011), one month (36.2 mm, p = 0.007), and three months (31.6 mm, p = 0.023) after the second injection, at the 5-month follow-up. Treatment of SSc patients' perioral area with Profhilo® can result in significant improvements in oral opening and quality of life.
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Affiliation(s)
- Ofir Shir-az
- Department of Plastic Surgery, Meir Medical Center, Kfar Saba 4428164, Israel; (O.S.-a.); (D.M.); (B.S.B.); (A.S.)
- The Tel Aviv Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Ariel Berl
- Department of Plastic Surgery, Meir Medical Center, Kfar Saba 4428164, Israel; (O.S.-a.); (D.M.); (B.S.B.); (A.S.)
- The Tel Aviv Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Din Mann
- Department of Plastic Surgery, Meir Medical Center, Kfar Saba 4428164, Israel; (O.S.-a.); (D.M.); (B.S.B.); (A.S.)
- The Tel Aviv Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Biader Samih Bilal
- Department of Plastic Surgery, Meir Medical Center, Kfar Saba 4428164, Israel; (O.S.-a.); (D.M.); (B.S.B.); (A.S.)
- The Tel Aviv Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Yair Levy
- The Tel Aviv Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
- Department of Internal Medicine E, Meir Medical Center, Kfar Saba 4428164, Israel
| | - Avshalom Shalom
- Department of Plastic Surgery, Meir Medical Center, Kfar Saba 4428164, Israel; (O.S.-a.); (D.M.); (B.S.B.); (A.S.)
- The Tel Aviv Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
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Mehrabi J, Shehadeh W, Gallo ES, Artzi O, Horovitz T. Comparison of 2 Hyaluronic Acid-based Fillers for the Treatment of Acne Scars: Structural Lifting Versus Biostimulatory Effect. Dermatol Surg 2023; 49:581-586. [PMID: 37052609 DOI: 10.1097/dss.0000000000003789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
BACKGROUND Hyaluronic acid (HA)-based fillers are effective at mitigating acne scars due to their filling effect. Complexes of high and low molecular weight HA demonstrated a delayed biostimulatory effect. OBJECTIVE The authors sought to compare the results of acne scar treatment using a filler composed of complexes of high and low molecular weight HA versus a traditional cross-linking HA filler. METHODS Thirty patients with moderate-to-severe atrophic acne scarring were included in this prospective, split-face, double-blinded, randomized controlled study. Each underwent 3 monthly injections of a novel formula of combined high and low molecular weight HA (P) to the base of acne scars on 1 side of the face and traditional cross-linking HA (JV) filler on the other. Patients were evaluated 6 months after their last treatment for objective and subjective improvements. RESULTS For JV, statistically significant reductions were observed in the acne scar volume but nearly no change in elasticity and stretch during early treatments. For P, no significant differences were observed in early treatments; however, statistically significant improvements were observed in later visits. CONCLUSION Although the traditional JV filler demonstrated an earlier impact than P, the latter produced delayed positive changes that were more pronounced than the traditional filler.
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Affiliation(s)
- Joseph Mehrabi
- Maimonides Medical Center, Department of Medicine, Brooklyn, New York
| | - Waseem Shehadeh
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Elisa S Gallo
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ofir Artzi
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tamir Horovitz
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Efficacy and Safety of Transplantation of Autologous Fat, Platelet-Rich Plasma (PRP) and Stromal Vascular Fraction (SVF) in the Treatment of Acne Scar: Systematic Review and Meta-analysis. Aesthetic Plast Surg 2023:10.1007/s00266-023-03295-1. [PMID: 36881139 DOI: 10.1007/s00266-023-03295-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 02/04/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND The efficacy and safety evaluation of the transplantation of autologous fat, platelet-rich plasma (PRP) and stromal vascular fraction (SVF) in acne scars has not been completely unified. This article will analyze and process the data of the included studies through evidence-based medicine to evaluate the efficacy and safety of autologous fat grafting, PRP and SVF for acne scar treatment, so as to provide treatment basis and strategy for the clinical treatment of acne scars. METHODS We searched the PubMed, Embase, Cochrane Library databases, CNKI, Wanfang and CQVIP databases for studies published during the time between the establishment of the databases through October 2022. We included studies that report autologous fat grafting, SVF and PRP for patients with acne scars. We excluded repeated publication, researches without full text, incomplete information or inability to conduct data extraction and animal experiments, case report, reviews and systematic reviews. STATA 15.1 software was used to analyze the data. RESULTS The findings showed that fat grafting had excellent improvement, marked improvement, moderate improvement and mild improvement rates of 36%, 27%, 18% and 18%, respectively, PRP had excellent improvement, marked improvement, moderate improvement and mild improvement rates of 0%, 26%, 47% and 25%, respectively, and the SVF had excellent improvement, marked improvement, moderate improvement and mild improvement rates of 73%, 25%, 3% and 0%, respectively. Additionally, the pooled results showed that there was no significant difference between PRP treatment and pre-treatment in Goodman and Baron scale score. However, Shetty et al. reported that Goodman and Baron scale score after fat grafting was significantly lower than pre-treatment. The results also showed that after fat grafting treatment, incidence of pain after fat grafting was 70%. After PRP treatment, in addition to pain (17%), there is a higher probability of postinflammatory hyperpigmentation (17%) and hematoma (6%). After SVF treatment, the incidence of postinflammatory hyperpigmentation and hematoma was all 0%. CONCLUSION Autologous fat grafting, PRP and SVF are effective for the treatment of acne scars, and the safety of autologous fat grafting, PRP and SVF is acceptable. Autologous fat grafting and SVF may be a better treatment for acne scars than PRP. However, this hypothesis still needs to be tested in the future large randomized controlled trials. LEVEL OF EVIDENCE III 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 .
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de Wit A, Siebenga PS, Wijdeveld RW, Koopmans PC, van Loghem JAJ. A split-face comparative performance evaluation of injectable hyaluronic acid-based preparations HCC and CPM-HA20G in healthy females. J Cosmet Dermatol 2022; 21:5576-5583. [PMID: 35699361 DOI: 10.1111/jocd.15157] [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: 01/04/2022] [Revised: 04/29/2022] [Accepted: 05/18/2022] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Skin revitalizers are used for skin quality improvement purposes. Hyaluronan hybrid cooperative complexes (HCC, Profhilo®, IBSA Pharmaceuticals) are an anti-aging treatment with a large amount of pure hyaluronic acid (HA) based on stable, cooperative, and hybrid complexes. Cohesive polydensified matrix Hyaluronic Acid (CPM-HA20, Belotero Revive®, Merz Pharmaceuticals GmbH) is a slightly cross-linked HA (20 mg/ml) with glycerol (17.5 mg/ml). AIMS To evaluate the performance of HCC and CPM-HA20G for skin quality improvement in healthy female subjects. METHODS This was a split-face, single-blinded study that enrolled 24 healthy female subjects. Injections were given on three separate occasions. HCC was injected on the right cheek, while CPM-HA20G was injected on the left cheek. A battery of skin property measurements was used to evaluate the skin. Skin properties and overall satisfaction were analyzed using mixed models with the values at baseline, at week 1, week 8, and week 14 as an outcome and a random effect of subject and fixed effects of treatment, visit, and the treatment by visit interaction. RESULTS Both products showed evidence of effect relative to baseline on surface hydration (AU), elasticity (N/m) TEWL (g/m2 h), and melanin (AU). CPM-HA20G also showed significant evidence of effect relative to baseline on water content (%), and HCC on pore count (n) and hemoglobin (AU). Satisfaction reported by the subjects themselves showed positive trends of satisfaction over time for multiple skin properties. There were no significant differences between the tested products in the observed skin characteristics over time. CONCLUSION These devices are effective and safe treatments for skin quality improvement, especially moisturization, with high patient satisfaction and generally mild and transient side effects.
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Affiliation(s)
| | | | | | | | - Jani A J van Loghem
- UMA Institute, Amsterdam, The Netherlands.,University of Amsterdam, Amsterdam, The Netherlands
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Hung YT, Cheng CY, Huang YL. Pinch and stretch test to assess and categorize the severity of acne rolling scars. J Am Acad Dermatol 2022; 87:e133-e134. [PMID: 35987394 DOI: 10.1016/j.jaad.2022.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/09/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Yi-Teng Hung
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taipei, Taoyuan, Taiwan
| | - Chun-Yu Cheng
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taipei, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Cosmetic Science, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Center of Tissue Engineering, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yau-Li Huang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taipei, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Cosmetic Science, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
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Zhang X, Huang B, Yang M, Yin B, Cai L, Tang X, Li F, Han X. Single session of combined microfat and subcision in the treatment of Grade 4 atrophic acne scars. J Cosmet Dermatol 2022; 21:4254-4260. [PMID: 35038371 DOI: 10.1111/jocd.14784] [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: 12/07/2021] [Revised: 01/05/2022] [Accepted: 01/10/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Severe atrophic acne scars (AAS) remain the "Achilles's heel" of AAS treatment. The combination of microfat and subcision treatment is a potential solution for severe AAS. AIMS This study aimed to evaluate the efficacy and safety of combined microfat and subcision treatment for severe (Grade 4) AAS. METHODS Data of patients with Grade 4 AAS who underwent combined microfat and subcision treatment between September 2016 and December 2020 were reviewed. Post-treatment evaluation was performed at least 3 months postoperatively. The severity of AAS was graded based on Goodman's qualitative classification. The volume of concavities was measured using an Antera 3D camera. Complications were documented. RESULTS A total of 42 patients received a single treatment session. Excellent response was observed in 5 (11.9%) patients, very good in 13 (31.0%), good in 22 (52.4%), and poor response in 2 (4.7%). The average reduction of the total volume of concavities was 28.0%. The most common minor side effects were mild swelling and bruising. No major complications were observed. CONCLUSIONS Combined microfat and subcision treatment is a safe and effective treatment for severe AAS. The approach will be a significant treatment for severe AAS.
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Affiliation(s)
- Xinyu Zhang
- Department of Body Contouring and Liposuction Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, China
| | - Beng Huang
- Department of Body Contouring and Liposuction Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, China
| | - Mingxia Yang
- Department of Dermatology, Hospital of Renmin University of China, Haidian District, Beijing, China
| | - Bo Yin
- Department of Body Contouring and Liposuction Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, China
| | - Lei Cai
- Department of Body Contouring and Liposuction Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, China
| | - Xiaojun Tang
- Department of Body Contouring and Liposuction Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, China
| | - Facheng Li
- Department of Body Contouring and Liposuction Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, China
| | - Xuefeng Han
- Department of Body Contouring and Liposuction Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, China
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Siperstein R, Nestor E, Meran S, Grunebaum L. A split-face, blind, randomized placebo-controlled clinical trial investigating the efficacy and safety of hyaluronic acid filler for the correction of atrophic facial scars. J Cosmet Dermatol 2022; 21:3768-3778. [PMID: 35689521 PMCID: PMC9796717 DOI: 10.1111/jocd.15153] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/27/2022] [Accepted: 05/12/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hyaluronic acid fillers have been studied extensively for facial wrinkles; however, their efficacy for atrophic facial scars has yet to be analyzed in a prospective placebo-controlled study. OBJECTIVE To analyze the efficacy and safety of a hyaluronic acid filler for atrophic facial scars. METHODS & MATERIALS Fifteen subjects were randomized to receive up to 1 ml of VYC-17.5 L on one cheek and up to 1 ml of saline on the other side, with an optional touch-up treatment. Subjects were graded by a live blind evaluator using the Quantitative Global Scarring Grading System (QGSGS) (J Cosmet Dermatol. 2006;5:48), the Global Aesthetic Improvement Scale (GAIS), and Canfield photo-analysis. RESULTS According to the blind evaluator, there was a significant reduction 90 days after the last treatment on the QGSGS for VYC-17.5L compared with saline (-6.6 VYC-17.5L vs -1.7 saline [t(28) = -4.3196, p = 0.008]). There was a smaller, but still significant reduction on the QGSGS for saline alone (10.4 to 8.6 [t(14) = -3.453, p = 0.004]). In addition, 93% (13/14) of subjects chose VYC-17.5L over saline treatment and reported an improvement on the GAIS. There were no serious side effects and all minor side effects resolved by Day 30. CONCLUSION VYC-17.5L achieved significant improvements in rolling atrophic scars as compared to saline, though saline also had modest improvements.
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Affiliation(s)
- Robyn Siperstein
- Siperstein Dermatology GroupFlorida Atlantic UniversityBoynton Beach, Boca RatonFloridaUSA
| | | | | | - Lisa Grunebaum
- Mayo Clinic College of Medicine and ScienceScottsdaleArizonaUSA
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11
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Amer A, Elhariry S, Al-Balat W. Combined autologous platelet-rich plasma with microneedling versus microneedling with non-cross-linked hyaluronic acid in the treatment of atrophic acne scars: Split-face study. Dermatol Ther 2020; 34:e14457. [PMID: 33107665 DOI: 10.1111/dth.14457] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/12/2020] [Accepted: 09/18/2020] [Indexed: 11/28/2022]
Abstract
Acne scarring causes cosmetic discomfort, depression, low self-esteem and reduced quality of life. Microneedling is an established treatment for scars. A multimodality approach to scar treatment is usually necessary to achieve the best cosmetic results. The objective of this study was to evaluate the efficacy and safety of platelet rich plasma (PRP) combined with microneedling in comparison with microneedling with non-cross-linked hyaluronic acid for the treatment of atrophic acne scars. Forty-one patients of 20-40 years of age with atrophic acne scars were included. Microneedling was performed on both halves of the face. Topical application of PRP was given on right half of the face, while the left half of the face was treated with topical application of non-cross-linked hyaluronic acid. Four treatment sessions were given at an interval of 1 month consecutively. Goodman's Qualitative scale and the quartile grading scale are used for the final evaluation of results. There was a statistically significant improvement in acne scars after treatment among the studied group. Right and left halves showed 85.4% and 82.9% improvement, So the difference of the improvement between the two modalities is statistically insignificant P > 0.05 We conclude that microneedling has efficacy in the management of atrophic acne scars. It can be combined with either PRP or noncross-linked hyaluronic acid to enhance the final clinical outcomes in comparison with microneedling alone. The difference between the two modalities is insignificant.
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Affiliation(s)
- Amin Amer
- Department of Dermatology, Medical School, Zagazig University, Zagazig, Egypt
| | - Seham Elhariry
- Department of Dermatology, Medical School, Zagazig University, Zagazig, Egypt
| | - Waleed Al-Balat
- Department of Dermatology, Medical School, Zagazig University, Zagazig, Egypt
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Vinshtok Y, Cassuto D. Biochemical and physical actions of hyaluronic acid delivered by intradermal jet injection route. J Cosmet Dermatol 2020; 19:2505-2512. [PMID: 32799371 DOI: 10.1111/jocd.13674] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 08/10/2020] [Indexed: 11/29/2022]
Abstract
Administration of exogenous hyaluronic acid (HA) by liquid jet injection is considered as a beneficial therapy for dermatology conditions. This paper reviews variety of the factors which would optimize the clinical output of hyaluronic acid in this treatment modality. A pneumatically accelerated jet penetrates the epidermis and spherically spreads micro-droplets of HA in the dermis without significant damage to the tissue and blood vessels. Kinetic energy of the jet activates two parallel mechanisms of action-mechanical and biological-which act synergistically to initiate and augment the regenerative effect. Jet-induced micro-trauma stimulates collagen synthesis and tissue repair without inflammation. Aside from the biophysical stimulation of dermal fibroblast, the biomolecular properties of exogenous HA provide excellent clinical results for skin atrophy, remodeling of dermal scarring, and reverse formation of fibrotic tissue. The effect is mediated by HA-specific cell receptors and depends on molecular weight and the rheological properties of HA polymer. Skin mechanical properties play a key role in predicting HA dispersion patterns. Tolerability and safety of the treatment approach are determined by the jet's physical impact on the tissue and/or by the safety profile of the injected material. Although pneumatic jet delivery of a hyaluronic acid has a limited use in clinical practice, this treatment approach has a strong potential for extended implementation in esthetic dermatology. The synergistic mechanism has significant advantages of predictable and rapid clinical outcomes with a low discomfort. Additional well-designed investigations are required for establishing a scientific foundation and guidelines for this treatment modality.
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