The clinical efficacy of a new emulsion for acne and conspicuous facial pore amelioration

BACKGROUND

Oily skin is a common concern in the field of dermatology due to its association with excessive sebum production, acne, blackheads, and enlarged facial pores. Therefore, it is in great demand to develop effective cosmetics to manage oily skin.

OBJECTIVES

To evaluate the clinical efficacy of a novel emulsion containing niacinamide, lens esculenta seed extract, and white willow bark extract for oily skin.

METHODS

The efficacy of a novel emulsion was evaluated through a 56-day clinical trial. The clinical efficacy of the product to ameliorate acne, blackheads, and conspicuous facial pores was assessed on 30 subjects with oily skin by VISIA, PRIMOS, professional dermatologist evaluations, and subject self-assessment.

RESULTS

In the clinical trial, the participants showed high satisfaction with the emulsion's efficacy, reporting significant improvement in skin sebum secretion, acne, facial pores, and blackheads. The efficacy of the novel emulsion was further validated through VISIA and PRIMOS measurements, along with professional dermatologist evaluations.

CONCLUSION

Our results showed that the novel emulsion containing three active ingredients could effectively improve acne, blackheads, and conspicuous facial pores.

Comprehensive assessment of the efficacy and safety of a clay mask in oily and acne skin

BACKGROUND

Oily skin, characterized by excessive sebum production, can lead to acne and have psychosocial impacts due to changes in appearance. Recent research has shown interest in treatments for oil control, with kaolin and bentonite emerging as promising options. Despite their potential, comprehensive studies on these ingredients are still in the nascent stages.

AIM

This study aimed to assess the efficacy of a clay mask (La Roche-Posay Effaclar Sebo-Controlling Mask) in reducing skin oiliness and acne, and its safety for use.

METHODS

In this study, 75 adults with oily or combination skin were enrolled and provided with a clay mask for twice-weekly use over 4 weeks. Clinical assessments, using instruments like Sebumeter, Vapometer, and Corneometer, were conducted at baseline, and after 1, 2, and 4 weeks, evaluating acne lesions, skin irritation, sebum content, and skin hydration. Participant self-assessment questionnaires were also utilized for subjective evaluation. Statistical analyses were performed accordingly.

RESULTS

The study revealed significant improvements in acne-related outcomes, sebum content, skin evenness, stratum corneum water content, and transepidermal water loss following the application of the clay mask. Pore area and porphyrin area showed no significant changes. Tolerance assessment showed reduced dryness and irritation, with self-assessment indicating high product acceptability and perceived oil control effectiveness.

CONCLUSION

This study demonstrated the clay mask's efficacy in managing acne and oily skin, improving hydration and texture. Significant improvements in skin parameters and high product safety were observed, supporting its suitability.

Efficacy of anti-sebum moisturizing cream containing 2% l-carnitine and 5% epigallocatechin gallate in seborrhea: A randomized clinical trial

BACKGROUND

Seborrhea leads to facial greasiness and unpleasant feeling. People with seborrhea also have trouble with selecting moisturizers. l-Carnitine and epigallocatechin gallate (EGCG) are reported anti-sebum properties. However, neither efficacy comparison nor the combination effect of the two topical anti-sebum agents was studied. Moisturizing cream with these agents is supposed to provide skin with an optimal water-oil balance.

AIMS

To compare the efficacy of moisturizer containing 2% l-carnitine or 5% EGCG alone on sebum controlling, and the synergistic effect of these two agents.

METHODS

Three study creams were formulated by adding three kinds of anti-sebum agents which were 2% l-carnitine, 5% EGCG, and 2% l-carnitine plus 5% EGCG in moisturizing cream base of dimethicone and glycerin. A randomized clinical trial was conducted. Ninety subjects, divided into three groups, applied the cream for 4 weeks. Sebum level, skin capacitance, and transepidermal water loss (TEWL) were evaluated at Weeks 0, 1, 2, and 4. Life qualities and subjective outcomes were assessed before and after treatment.

RESULTS

The mean sebum reduction from baseline was statistically significant in all treatment groups (p < 0.01). The median time to oil control was longer in l-carnitine group. The combine group had significantly greater anti-sebum efficacy than l-carnitine group (p = 0.009). All three groups had significant improvement of other objective parameters and subjective outcomes.

CONCLUSIONS

The anti-sebum moisturizing cream exhibited beneficial effect on the sebum reduction with improve skin hydration in people with seborrhea and made users satisfied. The EGCG group and the combine group show the greater anti-sebum effect than the l-carnitine group.

In vitro and in vivo study of the efficacy of a new sebum control essence

BACKGROUND

People with oily skin often suffer from skin problems such as oily face, blackheads, acne, and enlarged pores. It is necessary to regulate oily skin with skin care products.

AIMS

To develop an effective sebum control essence to reduce oiliness of skin.

METHODS

The composition of the essence was designed in consideration of different oil control mechanism targets. The skin irritation was assessed in 30 volunteers by a single application close patch test. The efficacy of the essence was evaluated by in vitro experiment, short- and long-term clinical trials with over 60 volunteers.

RESULTS

The results of both in vitro and clinical trials showed that the essence had significant oil control and moisturizing effect, the skin oil content decreased by 21.8% within 8 h and 30.05% after 28 days, which indicated that the essence could achieve rapid and persistent sebum control efficacy. In addition, the essence could relieve the problems of enlarged pores, blackheads and whiteheads in long-term use.

CONCLUSIONS

The essence developed in this study can alleviate the problems of oily skin from many aspects, and achieve an excellent effect in oily skin regulation. It is suitable for a daily application in oily skin regulation.

Isotretinoin Use in Transmasculine Patients and Its Implication on Chest Masculinization Surgery: Scoping Review of the Literature

BACKGROUND

Acne often worsens in transmasculine patients who are on prolonged testosterone therapy. Isotretinoin is an oral retinoid used in the treatment of severe or refractory cases of acne, but it has the potential to cause delayed wound healing. Transmasculine patients may potentially be prescribed treatment for acne with isotretinoin while also planning to undergo chest masculinization surgery.

OBJECTIVE

This scoping review aims to determine whether isotretinoin has a negative impact on postoperative healing in transmasculine patients undergoing chest masculinization surgery.

METHODS

A scoping review was performed using the PubMed and Ovid databases. A total of 16 publications were selected for inclusion.

RESULTS

Acne tends to peak in transmasculine patients 6 months after initiation of testosterone treatment. Severe cases can be treated with isotretinoin; however, acne may recur once treatment is discontinued, given ongoing hormone therapy. There is little to no evidence in the medical literature regarding perioperative use of isotretinoin specifically among transmasculine patients undergoing chest masculinization surgery. In general, however, recent studies have found no evidence of increased hypertrophic scars or keloids in patients taking isotretinoin.

CONCLUSIONS

Further studies are required to strengthen the current evidence that suggests that isotretinoin does not need to be discontinued before or after incisional or excisional surgeries, including chest masculinization surgery in transmasculine patients.

"The efficacy and adverse effects of treatment options for facial pores: A review article"

INTRODUCTION

Skin pores are enlarged openings of the pilosebaceous follicles that can be affected by age, gender, genetics, exposure to UV light, ethnicity, and sebum secretion. Many treatment modalities reduce facial pores' count and area, including oral and topical medications as well as different wavelengths of lasers. Finding a safe and cost-effective treatment protocol is necessary since facial pores are one of the main reasons for cosmetic complaints.

AIM

This review compares available treatment options for reducing facial pores' number and area according to the published clinical trials.

METHODS

A search on PubMed and Google Scholar was performed. Nineteen published clinical trials regarding treatment options for facial pores were included and reviewed based on the authors' clinical experience.

RESULTS

A total number of 591 cases (83.7% female) aged 18-80 years were included. Three assessment methods including digital imaging, physician assessment, and patient' satisfaction were used in the studies to evaluate the therapeutic efficacy of each modality. Furthermore, combining different modalities increased the efficacy of reducing pores' size and number. Mild, reversible burning and erythema were common side effects.

CONCLUSION

Multiple sessions and combination therapies improve facial pores' area and number. In young patients, the focus should be on controlling sebum production, while in older patients, the focus should be on rejuvenation in addition to the control of sebum production.

Inhibition of lipogenesis and sebum secretion for Lotus corniculatus seed extract in vitro and in vivo

BACKGROUND

Botanical ingredients are widely used in hair- and skin-care products. However, few studies have investigated the effectiveness of botanical products on counteracting sebum synthesis and secretion.

OBJECTIVE

To investigate the composition of Lotus corniculatus seed extract (LC) and its potential inhibition of lipogenesis in SZ95 sebocytes and oily human skin.

METHODS

The active components of LC solutions were identified by high-performance liquid chromatography (HPLC) and nuclear magnetic resonance (NMR). The in vitro effects of LC were evaluated using SZ95 cells treated with linoleic acid (LA) and dihydrotestosterone (DHT) and incubated with LCs for 24 h and 72 h. Lipogenesis was assessed by Oil Red O and Nile Red staining of the cells. In vivo effects were assessed on 30 subjects with oily skin who were enrolled in a randomized, blank-controlled trial and were treated with LC solution for 6 h and 4 weeks. The skin sebum contents and area on the forehead and cheeks were evaluated using a Sebumeter SM815 and Sebfix sebutape with Visioscan VC98. In addition, VISIA was used to collect half-face photos for analysis.

RESULTS

A novel active molecule, 5'-o-rhamnosyl uridine, was identified in LC. LC exhibited a dose-dependent inhibitory effect on LA and DHT-induced lipid synthesis. When 5% LC was applied for 3 h, the skin sebum contents and area were significantly reduced compared with the vehicle control, with an obvious reduction after 6 h. Continued use of the serum containing 5% LC for 4 weeks resulted in a significant reduction in the skin sebum contents and area. No adverse reactions were reported during the study.

CONCLUSIONS

Topical application of LC resulted in an immediate and long-lasting reduction of the sebum contents and area of oily human skin by reducing sebaceous lipogenesis through the LA and DHT pathways. This indicates the potential of LC as a new biological treatment for oily skin.

Hydrolipidic Characteristics and Clinical Efficacy of a Dermocosmetic Formulation for the Improvement of Homeostasis on Oily Mature Skin

BACKGROUND

Although the scientific literature associates mature skin with dry skin and the secretion of sebum on the face decreases over the years, in tropical countries, such as Brazil, mature skin can still present oily characteristics. Thus, the knowledge of the hydrophilic characteristics of mature skin is fundamental to help the development of more effective treatments for this skin type. In this context, the study aimed to evaluate the hydrophilic characteristics and the clinical efficacy of a cosmetic formulation for mature skin added with alfalfa and lentil extracts by using biophysical and skin imaging techniques.

METHODS

Twenty-eight healthy females aged between 45 and 59 years were enrolled. Measurements of the stratum corneum water content, sebum content, transepidermal water loss, skin microrelief, and pores count were performed before and after the 28-day formulation application.

RESULTS

The mature skin presented as oily with wrinkles and pores. The proposed formulation significantly reduced the sebum content and the number of fine and large pores and improved skin microrelief and hydration after a 28-day period of the application when compared to the vehicle.

CONCLUSIONS

The proposed formulation was effective in oily mature skin treatment, improving its general skin aging and oiliness conditions, and reducing pores count in just 28 days.

Feasibility of Reflectance Confocal Microscopy Monitoring in Oily, Acne-Prone Facial Skin Treated with a Topical Combination of Alpha and Beta-Hydroxy Acids, Anti-Inflammatory Molecules, and Herculane Thermal Water: A Blinded, One-Month Study

Oily, acne-prone skin is a common skin type which may be monitored in vivo using reflectance confocal microscopy (RCM). The aim of the study was to assess the feasibility of RCM in evaluating the effectiveness of a topical combination of alpha- and beta-hydroxy acids, anti-inflammatory and antibacterial molecules, and Herculane thermal water on acne-prone skin. Thirty-five subjects with oily, acne-prone skin were prescribed topical combination products and were evaluated by clinical, Wood's lamp, and RCM imaging at baseline and after 28 days. At 28 days, the RCM-evaluated number of dilated infundibula, infundibula filled with keratotic material, and infundibula with thickened bright borders, as well as the density of the inflammatory infiltrate, were significantly decreased. Wood's light images at 28 days showed a significantly reduced number of C. acnes-colonized infundibula, and both the median area and the intensity of the red-orange fluorescence were decreased. The reduction in the clinical score was concurrent with the improvement in the RCM parameters, suggesting that this non-invasive imaging technique is appropriate for efficiency evaluations of topical acne treatments.

Microneedle delivery of botulinum toxin type A combined with hyaluronic acid for the synergetic management of multiple sternal keloids with oily skin: A retrospective clinical investigation

BACKGROUND

For the treatment of sternal keloids, corticosteroid therapy has side effects including abnormal sebum secretion and acne. Relapse of keloids is common after corticosteroid injection in patients with oily skin. To reduce side effects and keloid recurrence, we used a combination of botulinum toxin type A (BTX-A) and hyaluronic acid (HA) as synergetic management for multiple sternal keloids in patients with oily skin.

METHODS

In total, 58 patients with multiple sternal keloids who received monthly steroid injections were retrospectively included. Thirty-two patients in the intervention group received an additional injection of BTX-A/HA on the same day as the first injection of the steroid, while the remaining 26 patients were treated as the control group. At baseline and follow-up visits, sebum production and transepidermal water loss (TEWL) were assessed as primary outcomes, and the Vancouver Scar Scale (VSS) score, keloid recurrence, visual analog scale (VAS) score, and patient satisfaction were assessed as secondary outcomes.

RESULTS

In the control group, average sebum production and TEWL were increased to 132% and 104% of baseline, respectively, at the 24-week follow-up. In the intervention group, average sebum production and TEWL reached nadir at the 8-week follow-up and then increased to 96% and 91% of baseline, respectively, at the 24-week follow-up. Sternal keloid relapse was observed in 88.5% of the patients in the control group and none of the patients in the intervention group. The total VSS score at 24 weeks was 11.04 ± 0.14 and 8.93 ± 0.26 (p < 0.001) in the control group and intervention group, respectively, and the VAS score was 75 ± 5.10 and 19.14 ± 3.80 (p < 0.001) in the control group and intervention group, respectively. Higher patient satisfaction was reported in the intervention group.

CONCLUSIONS

Microneedle delivery of BTX-A/HA decreases sebum production while improving skin barrier function. Thus, this combined therapy can relieve the side effects of corticosteroid therapy and reduce keloid recurrence.

Botulinum Neurotoxin Type A in the Treatment of Facial Seborrhea and Acne: Evidence and a Proposed Mechanism

Intradermal injection of botulinum neurotoxin is a frequently performed procedure in aesthetic dermatology to improve facial skin tone, texture, fine wrinkles, and enlarged pores. In practice, botulinum neurotoxin type A is also used to reduce skin oiliness of the face. There is increasing evidence that acetylcholine plays specific roles in sebum production, suggesting that botulinum neurotoxin type A may reduce sebum production by interfering with cholinergic transmission between sebaceous glands and autonomic nerve terminals. Botulinum neurotoxins can also inhibit several pathogenetic components of acne development, suggesting that botulinum neurotoxins can be used as a safe and effective treatment modality for acne and other skin disorders related to overactivity of sebaceous glands. This review aims to explore the current evidence behind the treatment of facial seborrhea and acne with botulinum neurotoxin type A.

Influence of family history, body mass index, selected dietary factors, personal habits, and menstrual history on oily skin in young women

BACKGROUND

Sebum secretion is affected by many internal and external factors.

OBJECTIVE

To identify risk factors in terms of family history, body mass index, selected dietary factors, personal habits, and menstrual history that may be associated with oily skin in young women.

PARTICIPANTS AND METHODS

We conducted a case-control study of young women aged 18-35 who came to Beijing Tongren Hospital for attending a health checkup. Cases were subjects with subjective skin type as oily skin. Control subjects were people with normal or dry skin. A standardized questionnaire on subjective skin type, family history of oily skin in first-degree relatives, menstrual history, personal habits, and selected dietary factors was administered to 540 subjects. Univariate and multivariate logistic regression analyses were performed for risk factors associated with oily skin.

RESULTS

A family history in first-degree relatives and a body mass index of more than 24 kg/m² were risk factors that increases likelihood of oily skin in young women (odds ratio 3.281, 95% confidence interval 2.204-4.882; odds ratio 1.677, 95% confidence interval 1.081-2.600, respectively). For those who consumed more than three servings of milk or sweets per week, the risk increased with the diet (odds ratio 1.634, 95% confidence interval 1.126-2.370; odds ratio 1.970, 95% confidence interval 1.034-3.754, respectively). There was no correlation between smoking, drinking alcohol, or menstrual variables and the risk of oily skin.

CONCLUSIONS

Family history, overweight and obesity, and a diet rich in milk or sweets are risk factors that increase likelihood of oily skin in young women. These findings may provide an opportunity to better guide skin care for patients.

Therapeutic Use of Botulinum Neurotoxins in Dermatology: Systematic Review

Botulinum toxin is a superfamily of neurotoxins produced by the bacterium Clostridium Botulinum with well-established efficacy and safety profile in focal idiopathic hyperhidrosis. Recently, botulinum toxins have also been used in many other skin diseases, in off label regimen. The objective of this manuscript is to review and analyze the main therapeutic applications of botulinum toxins in skin diseases. A systematic review of the published data was conducted, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Botulinum toxins present several label and off-label indications of interest for dermatologists. The best-reported evidence concerns focal idiopathic hyperhidrosis, Raynaud phenomenon, suppurative hidradenitis, Hailey–Hailey disease, epidermolysis bullosa simplex Weber–Cockayne type, Darier’s disease, pachyonychia congenita, aquagenic keratoderma, alopecia, psoriasis, notalgia paresthetica, facial erythema and flushing, and oily skin. Further clinical trials are still needed to better understand the real efficacy and safety of these applications and to standardize injection and doses protocols for off label applications.

Plant cell culture extract of Cirsium eriophorum with skin pore refiner activity by modulating sebum production and inflammatory response

Facial pore enlargement is considered a significant esthetic and health concern in skincare cosmetics. The pores fulfill the critical function of keeping the skin surface hydrated and protected against microbial infections. The hyperseborrhea, the stress factors, and the hormonal triggers can cause pore size enlargement, causing higher susceptibility of the skin to microbe aggressions and inflammatory reactions. Thus, reducing excessive sebum production and keeping functional pores are two of the most requested activities in skincare cosmetics. A Cirsium eriophorum cell culture extract was investigated for its role in sebum regulation, stratum corneum desquamation, and anti-inflammation. The extract was able to regulate essential markers associated with sebum secretion and pore enlargements, such as the enzyme 5α-reductase, which plays a central role in sebum production, and the trypsin-like serine protease Kallikrein 5, which promotes skin exfoliation and antimicrobial response. Moreover, the extract showed a sebum-normalizing and pore refining activity in individuals having seborrheic or acne-prone skins, suggesting a role of the C. eriophorum extract in rebalancing altered skin conditions responsible for pore enlargement.

Oily sensitive skin: A review of management options

BACKGROUND

Due to the ever-increasing demands for the personalized care, people seek for the tailored management according to the accurate identification of their skin type. The Baumann Skin Type Indicator, which was proposed by Leslie Baumann, is composed of four parameters: oily or dry, resistant or sensitive, pigmented or nonpigmented, and wrinkled or tight. Among these, oily sensitive skin experiences significant discomfort and resists ordinary treatment.

AIMS

In this article, we will review the clinical manifestations, underlying pathogenesis and recommendations on treatment options that may be utilized to help patients with oily sensitive skin.

PATIENTS/METHODS

Literature search was conducted using PubMed. The literature concerning Baumann Skin Type Indicator and oily sensitive skin type were considered.

RESULTS

Oily sensitive (OS)-type skin is a complex of oily and sensitive skin that causes significant discomfort and undergoes stubborn resistance to treatments. Sebum dysfunction and hypersensitivity may play a key role in the development of sensitive skin. Considering the pathogenesis of OS-type skin, treatment should focus on both seborrhea and hypersensitivity.

CONCLUSION

Clinicians can effectively treat the oily sensitive skin by understanding underlying pathogenesis of it. Further investigations are necessary to reach a consensus on the basic pathophysiology and optimal management guidelines for oily sensitive skin.

The anti-sebum property of chitosan particles

BACKGROUND

Seborrhea is linked to several medical and mental conditions. Although it is common, effective agents and the standardized sebum level for seborrhea are not elucidated.

AIMS

To determine the efficacy of chitosan particles (CP) formulation on controlling sebum secretion, its extended effects on skin redness and texture after combining with proretinal nanoparticles (CP-PRN), and a correlation of the clinical grading with sebum levels that affect mental health.

PATIENTS/METHODS

A four-week clinical trial with forty subjects was conducted. Subjects applied either CP formulation or CP-PRN during nighttime. Objective measurements including sebum levels, transepidermal water loss (TEWL), skin corneometry, skin redness, and texture were analyzed. Subjects completed a self-assessment clinical grading of skin oiliness at every visit.

RESULTS

Both CP and CP-PRN significantly decreased sebum levels (P ≤ .01) at week 4 compared to baseline. CP also resulted in significant decreases in TEWL (P ≤ .05) and skin corneometry (P ≤ .05) throughout the study. A significant improvement in skin redness was observed with CP-PRN (P ≤ .01). A moderate correlation between the clinical grading and sebum levels was detected (coefficient of 0.5, P ≤ .001), with a sebum level of 106 μg cm^-2 indicating emotional discomfort. One subject experienced local irritation with the CP-PRN. Mild pruritic symptoms were reported in both groups.

CONCLUSIONS

Chitosan particles exhibited an interesting anti-sebum effect. It could be combined with PRN to extend benefits without losing the sebum controlling effect. The clinical grading may be useful in practice due to a modest correlation with sebum levels.

Comparative study into facial sebum level, pore size, and skin hydration between oily-skinned and dry-skinned Thai women

BACKGROUND

Subjective facial skin type is most frequently determined by the amount of sebum, which showed trends across subjective skin types in most previous studies while not in some. This study was conducted to evaluate the associations among subjective skin type, amount of sebum, stratum corneum hydration, and pore size in Thai women.

METHODS

Sixty-two healthy women with either self-described subjective oily or dry skin type were included and casual sebum level (CSL), sebum excretion rate (SER), clinical pore size score, mean pore area, and stratum corneum hydration were measured at several facial sites. Correlation coefficients between amount of sebum and other parameters were estimated.

RESULTS

Casual sebum level and sebum excretion rate were significantly higher in oily-skinned than dry-skinned group by 1.6-2.1 times. Mean pore area and clinical pore size score were not different between the 2 groups, nor did they correlate with CSL or SER. Corneometry was shown to be significantly higher in dry-skinned than oily-skinned group. Significant, negative correlations between corneometry and CSL were also found.

CONCLUSION

The subjective facial skin types were consistent with the amount of sebum, but not pore size or corneometry, among Thai women.

Use of Advanced Imaging Techniques for the Characterization of Oily Skin

Excessively oily skin leads to clinical signs that cause discomfort to patients, such as excessive shine, enlarged pores, acne, and an imbalance of the hydrolipidic layer. In this context, a constant demand for the research and development of products that prevent these features, has been noted in the field of cosmetics and dermatology. Thus, the objective of this study is to evaluate the cutaneous characteristics of oily skin due an excessive production of sebum through biophysical and skin imaging techniques. 19 participants with different skin types were selected and the following parameters were evaluated: pore count, determination of the number of sebaceous glands and amount of sebum in infundibulum, determination of cutaneous microrelief, count of comedones, evaluation of epidermis thickness, characterization of the cellular, and comedone size and its characteristics. These evaluations were done through biophysical and skin imaging techniques. The obtained results showed that different regions of the face presented different characteristics related to oiliness, quantity, and the appearance of pores and comedones. The malar region had a lower epidermis thickness and a larger number of large pores. Moreover, in this region excessive sebum production, which can be related to pores, not comedones, was noted. The nose region presented higher sebum content in the infundibulum and lower active sebaceous glands, showing a higher activity of sebaceous production in this region. The chin region presented a positive correlation between the sebum content, roughness parameter and the number of pores and comedones. As different skin properties are related and influence the appearance of undesirable clinical signs, we identified the need for a multifactorial approach for the effective treatment of oily skin. The rational development of multifunctional cosmetic products that promote the control of oily skin, that regulate the keratinization process, improve the microrelief and leads to a better epidermis and dermis structure, will not only improve oily skin conditions but will also allow for the reduction or disappearance of clinical signs that result from excessive oiliness, all of which causes concern and results in a relentless search for cosmetic and dermatological products that address the unaesthetic nature of these conditions.

Efficacy and possible mechanisms of botulinum toxin treatment of oily skin

BACKGROUND

Oily skin is one of the most common dermatological complaints. Oily skin may be accompanied by enlarged pores, acne, and seborrheic dermatitis. Moreover, oily skin has negative effects on self-perception. Most therapeutic approaches used to treat oily skin have had varying degrees of efficacy and include topical treatments, such as photodynamic therapy and lasers. However, certain of these therapies for oily skin may lead to severe side effects. With the expanding use and high safety profile of botulinum toxin type A (BoNT-A), its use in the treatment of oily skin has caused significant concerns; moreover, relevant reports have gradually accumulated to address the efficacy of BoNT-A and explore its mechanisms of action.

AIMS

The objective of this article was to review the efficacy and possible treatment mechanisms of BoNT-A on oily skin.

METHODS

A retrospective review of the published data was conducted.

RESULTS

Most studies have suggested that the intradermal injection of BoNT-A decreased sebum production and pore size. Furthermore, this treatment attained high patient satisfaction without significant side effects. BoNT-A effectively decreased sebum production and excretion, which was in keeping with previous studies, possibly via its blockade of cholinergic signaling and its neuromodulatory effects.

CONCLUSIONS

Intradermal BoNT-A injection may represent a promising new treatment for oily skin and other relevant dermatological problems, such as enlarged pores, acne, and seborrheic dermatitis. Further study is still needed to determine the specific mechanisms of BoNT-A and the optimal injection techniques and doses for oily skin and other relevant cosmetic concerns.

Vitamin A toxicity presenting as bone pain

A 4-year-old boy presented with severe bone pains, refusal to walk, diffuse bony swelling of forelimbs, skin changes and abdominal pain, with symptoms evolving over 6 weeks. Blood screening tests were normal except for raised aspartate aminotransferase (AST). Radiographs revealed thickened periosteum, widening of the diaphyses of long bones and lifted periosteum in mid-shaft of ulnae and right femur. Skeletal scintigraphy showed a high uptake of radionuclide at clinically affected and unaffected sites, suggestive of multifocal osteoblastic skeletal lesions. After repeated enquiries, his parents admitted to giving him massive doses of preformed vitamin A for over 3 months as 'health tablets'. Surprisingly, he did not have overt liver disease typically found with much smaller doses, although the dermal changes and musculoskeletal pathology were florid. He made a full clinical recovery within 2 months of cessation of vitamin A.

Cosmeceuticals in skin of color

Patients with skin of color have similar skin care needs as lighter-skin patients. However, they are less likely to use sun protection on a daily basis, which leads to an increased risk of dyschromia, skin cancer, and other disorders. This article discusses the importance of a correct and consistent skin care regimen and the various cutaneous issues that should be considered when prescribing a skin care regimen for patients with darker skin types. Adopting a standardized methodology to identify affordable, efficacious products and to streamline the process of skin-type diagnosis, skin care regimen prescribing, patient communication, and staff education will result in improved patient outcomes and increased patient satisfaction.

Facial skin pores: a multiethnic study

Skin pores (SP), as they are called by laymen, are common and benign features mostly located on the face (nose, cheeks, etc) that generate many aesthetic concerns or complaints. Despite the prevalence of skin pores, related literature is scarce. With the aim of describing the prevalence of skin pores and anatomic features among ethnic groups, a dermatoscopic instrument, using polarized lighting, coupled to a digital camera recorded the major features of skin pores (size, density, coverage) on the cheeks of 2,585 women in different countries and continents. A detection threshold of 250 μm, correlated to clinical scorings by experts, was input into a specific software to further allow for automatic counting of the SP density (N/cm²) and determination of their respective sizes in mm². Integrating both criteria also led to establishing the relative part of the skin surface (as a percentage) that is actually covered by SP on cheeks. The results showed that the values of respective sizes, densities, and skin coverage: 1) were recorded in all studied subjects; 2) varied greatly with ethnicity; 3) plateaued with age in most cases; and 4) globally refected self-assessment by subjects, in particular those who self-declare having “enlarged pores” like Brazilian women. Inversely, Chinese women were clearly distinct from other ethnicities in having very low density and sizes. Analyzing the present results suggests that facial skin pore’s morphology as perceived by human eye less result from functional criteria of associated appendages such as sebaceous glands. To what extent skin pores may be viewed as additional criteria of a photo-altered skin is an issue to be further addressed.