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3.
J Cosmet Dermatol ; 21(1): 48-50, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1522768

ABSTRACT

This commentary evaluates trends in the factors influencing consumer decision-making for cosmetic dermatologic procedures during the COVID-19 pandemic in the United States. This is a follow-up national survey to one that was published 1 year ago. This study compares the data from Summer 2020 to early Summer 2021, which presents a stark contrast. Our results demonstrate that consumers are now more interested in cosmetic dermatologic procedures compared to 1 year prior. Additionally, they still value the overall safety of the clinic, so physicians should ensure that certain safety measures remain in place despite any decreasing rates of COVID-19 positivity. Our survey sheds more light on current consumer perspectives, which may in turn help physicians adjust their practices to meet current demand. It is important for physicians to be knowledgeable regarding the patterns of consumer decision-making in order to deliver appropriate patient education and provide proper patient outreach during the COVID-19 pandemic.


Subject(s)
COVID-19 , Cosmetic Techniques , Dermatology , Consumer Behavior , Humans , Pandemics , SARS-CoV-2 , United States/epidemiology
4.
Dermatol Surg ; 47(7): 931-933, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1517923

ABSTRACT

BACKGROUND: The reallocation of health care resources to focus on the acute care needs of COVID-19 patients leads to a delay and deferral of outpatient surgical procedures such as Mohs surgery. OBJECTIVE: Planning for the resumption of regular outpatient surgical care and preparing for future surges in COVID-19 cases requires identifying surrogate markers of health care demand. MATERIALS AND METHODS: United States national and state-based Google search data for "Mohs surgery" and other common elective surgical and cosmetic procedures were evaluated. These were compared with national and state-wide COVID-19 case number and death data from the Johns Hopkins University. Pearson correlation coefficients were generated to assess the association between COVID-19 cases and deaths with Google search trends. RESULTS: Search volume for "Mohs surgery" and other elective surgical and cosmetic procedures significantly decreased as the number of new deaths from COVID-19 increased. Statistically significant inverse correlation was noted between "Mohs surgery" search volume and new COVID-19 deaths on a national and state-based level. CONCLUSION: Search metric analysis may be used as part of a big data model to help predict health care demand during the reopening phase of the COVID-19 pandemic.


Subject(s)
Ambulatory Surgical Procedures/statistics & numerical data , Attitude to Health , COVID-19/epidemiology , Cosmetic Techniques/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Mohs Surgery/statistics & numerical data , Humans , Pandemics , Pneumonia, Viral/epidemiology , SARS-CoV-2 , United States/epidemiology
6.
J Cosmet Dermatol ; 20(11): 3349, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1501458
11.
Clin Dermatol ; 39(1): 23-32, 2021.
Article in English | MEDLINE | ID: covidwho-1300688

ABSTRACT

The first cases of coronavirus disease 2019 (COVID-19) in Iran were detected on February 19, 2020. Soon the entire country was hit with the virus. Although dermatologists were not immediately the frontline health care workers, all aspects of their practice were drastically affected. Adapting to this unprecedented crisis required urgent appropriate responses. With preventive measures and conserving health care resources being the most essential priorities, dermatologists, as an integral part of the health system, needed to adapt their practices according to the latest guidelines. The spectrum of the challenges encompassed education, teledermatology, lasers, and other dermatologic procedures, as well as management of patients who were immunosuppressed or developed drug reactions and, most importantly, the newly revealed cutaneous signs of COVID-19. These challenges have paved the way for new horizons in dermatology.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Dermatology/standards , Hospitals, University , Skin Diseases/etiology , Skin Diseases/therapy , COVID-19/complications , COVID-19/drug therapy , Cosmetic Techniques , Dermatitis/etiology , Dermatologic Surgical Procedures , Dermatology/education , Dermatology/methods , Dermoscopy , Drug Eruptions/etiology , Hand Dermatoses/etiology , Hand Disinfection , Humans , Internship and Residency , Iran/epidemiology , Laser Therapy , Personal Protective Equipment/adverse effects , Phototherapy , Practice Guidelines as Topic , Private Practice , SARS-CoV-2 , Skin Diseases/drug therapy , Telemedicine
13.
J Cosmet Dermatol ; 20(9): 2684-2690, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1282006

ABSTRACT

BACKGROUND: The use of hyaluronic acid soft tissue fillers in aesthetic medicine exploded in recent years for many reasons, including being relatively safe. Incidence of delayed inflammatory reactions (DIRs) to hyaluronic acid soft tissue fillers range between 0.3% and 4.25%. These reactions are mediated by T-lymphocytes and can be triggered by flu-like illnesses, including SARS-CoV-2 infection. Vaccination may also induce hypersensitivity. AIM: In this case report, we present two cases of delayed reaction after hyaluronic acid soft tissue filler treatment of the tear trough area and following mRNA vaccination against SARS-Cov-2, also known as COVID-19, months later. PATIENTS: A 39-year old female who previously had her tear trough area treated with hyaluronic acid soft tissue filler developed swelling days after getting the mRNA Pfizer-BioNTech COVID-19 vaccine. Another patient, a 61-year-olf female, developed intermittent facial swelling in areas previously treated with hyaluronic acid soft tissue fillers days after receiving her first dose of the mRNA Pfizer-BioNTech COVID-19 vaccine. RESULTS: As demonstrated in our case report, vaccination against COVID-19 may induce DIRs in patients who previously had hyaluronic soft tissue fillers. CONCLUSION: Delayed inflammatory reactions to hyaluronic acid soft tissue fillers are uncommon and usually self-limited, with frequent spontaneous resolution. However, considering the ongoing pandemic and the worldwide demand for vaccines against COVID-19, the aesthetic providers should be conscious of the risks posed by the interaction of such vaccines in patients who previously had or seeking hyaluronic acid soft tissue filler injections.


Subject(s)
COVID-19 , Cosmetic Techniques , Dermal Fillers , Adult , COVID-19 Vaccines , Cosmetic Techniques/adverse effects , Dermal Fillers/adverse effects , Female , Humans , Hyaluronic Acid/adverse effects , SARS-CoV-2 , Vaccination/adverse effects
14.
J Plast Reconstr Aesthet Surg ; 74(9): 2311-2318, 2021 09.
Article in English | MEDLINE | ID: covidwho-1252519

ABSTRACT

BACKGROUND: The COVID-19 pandemic has transformed the delivery of medical and surgical services globally. Subsequently, all elective and aesthetic procedures have been cancelled or deferred in accordance with government-mandated quarantine measures. The Cosmetic Surgery Governance Forum (CSGF) is a network of aesthetic plastic surgery consultants which has enabled a sharing of expertise during challenging times. We conducted a cross-sectional survey to assess the impact of the COVID-19 pandemic on aesthetic plastic surgeons and their practice in the UK. METHODS: On 15 June 2020, 131 respondents from the CSGF and wider aesthetic plastic surgeons in the UK were invited to respond to an online survey. An anonymised questionnaire was created using SmartSurveyTM and distributed at the end of the quarantine period. Questions regarding their current scope of practice, willingness to recommence face-to-face consultations, financial loss and psychological impact were asked. RESULTS: A total of 101 Consultant Plastic surgeons (76%) completed the questionnaire. If strict protocols and adequate personal protective equipment were available, 50-55% of respondents would consider offering non-surgical treatments as soon as the private clinic was open. Furthermore, 51% would consider procedures under general anaesthetic, whilst 89% of respondents would offer local anaesthetic only in the initial phase. Moreover, 66% reported experiencing a psychological impact and 100% of respondents reported a significant financial impact. CONCLUSIONS: This survey aims to give an account of the current state (May-July 2020) of aesthetic plastic surgery in the UK. There is ongoing uncertainty and deliberation regarding the timing and organisational changes required for aesthetic practice to restart.


Subject(s)
Attitude of Health Personnel , COVID-19/prevention & control , Cosmetic Techniques/trends , Practice Patterns, Physicians'/trends , Surgeons/trends , COVID-19/economics , Cosmetic Techniques/economics , Cross-Sectional Studies , Health Policy , Humans , Infection Control/methods , Infection Control/trends , Practice Patterns, Physicians'/economics , Quarantine , Surgeons/economics , Surgeons/psychology , Surveys and Questionnaires , United Kingdom
15.
BMJ Case Rep ; 14(3)2021 Mar 18.
Article in English | MEDLINE | ID: covidwho-1155946

ABSTRACT

Soft tissue fillers used for facial rejuvenation can cause complications. We present two cases of late migration of injected fillers mimicking other pathology in the periocular area. Case 1 is a 52-year-old woman referred with chronic bilateral upper lid swelling, mimicking blepharochalasis syndrome, 51/2 years after undergoing injection of hyaluronic acid filler in both brows. Extensive blood investigations were normal. Bilateral, sequential upper lid biopsy revealed migrated hyaluronic acid filler, which was successfully treated with hyaluronidase. Case 2 is a 62-year-old woman who presented with a right lower lid mass 8 years after undergoing injection of polyalkylimide gel into both cheeks. CT scanning confirmed an intermediate density soft tissue mass overlying the inferior orbital rim. Histology from surgical excision reported chronic granulomatous inflammation due to migrated polyalkylimide gel. An awareness of late migration of fillers causing eyelid swelling and masses in the periocular area will prevent unnecessary investigations and facilitate prompt management.


Subject(s)
Cosmetic Techniques , Eyelids/diagnostic imaging , Female , Humans , Hyaluronic Acid , Hyaluronoglucosaminidase , Middle Aged , Rejuvenation
16.
J Cosmet Dermatol ; 20(5): 1557-1562, 2021 May.
Article in English | MEDLINE | ID: covidwho-1140266

ABSTRACT

The incidence of hypersensitivity reactions to hyaluronic acid dermal fillers is between 0.3 and 4.25%, mediated by T-lymphocytes. Flu-like illness can trigger immunogenic reactions at the site of filler placement. Cases of SARS-CoV-2 are significant and pose a possible risk of inducing hypersensitivity. This case report is of a delayed-type hypersensitivity after hyaluronic acid dermal filler treatment of the nose and subsequent infection with SARS-CoV-2. Risk factors for the development of such symptoms were identified as the presence of hyaluronic acid combined with flu-like illness and repeated treatment of one area. The case resolved without intervention. Clinicians should be mindful of the risk posed by the interaction of hyaluronic acid dermal filler with SARS-CoV-2 in light of the pandemic.


Subject(s)
COVID-19/complications , Dermal Fillers , Hyaluronic Acid , Hypersensitivity/etiology , Cosmetic Techniques , Dermal Fillers/adverse effects , Humans , Hyaluronic Acid/adverse effects
20.
Lasers Surg Med ; 53(1): 115-118, 2021 01.
Article in English | MEDLINE | ID: covidwho-1060012

ABSTRACT

INTRODUCTION: The COVID-19 pandemic requires us all to re-evaluate aesthetic practices to ensure optimal patient safety during elective procedures. Specifically, energy-based devices and lasers require special consideration, as they may emit plume which has been shown to contain tissue debris and aerosolized biological materials. Prior studies have shown transmission of viruses and bacteria via plume (i.e., HIV and papillomavirus). The purpose of this study was to evaluate plume characteristics of the Er:YAG resurfacing laser (Sciton; Palo Alto, CA) and compare it to the Morpheus8 fractional radiofrequency device (InMode; Lake Forest, CA). METHODS: Five patients who underwent aesthetic resurfacing and/or skin tightening of the face and neck were treated with the Er:YAG (Sciton Joule, Palo Alto, CA) and/or fractional radiofrequency (Morpheus8, Lake Forest, CA) between April 1 and May 11, 2020. Data collected included patient demographics, past medical history, treatment parameters, adverse events, particle counter data, as well as high magnification video equiptment. Patients were evaluated during treatment with a calibrated particle meter (PCE; Jupiter, FL). The particle meter was used at a consistent focal distance (6-12 inches) to sample the surrounding environment during treatment at 2.83 L/min to a counting efficiency of 50% at 0.3 µm and 100% at >0.45 µm. Recordings were obtained with and without a smoke evacuator. RESULTS: Of our cohort (n = 5), average age was 58 years old (STD ±7.2). Average Fitzpatrick type was between 2 and 3. Two patients received Er:YAG fractional resurfacing in addition to fractional radiofrequency during the same treatment session. Two patients had fractional radiofrequency only, and one patient had laser treatment with the Er:YAG only. There were no adverse events recorded. The particle counter demonstrated ambient baseline particles/second (pps) at 8 (STD ±6). During fractional radiofrequency treatment at 1-mm depth, the mean recording was 8 pps (STD ±8). At the more superficial depth of 0.5 mm, recordings showed 10 pps (STD ±6). The Er:YAG laser resurfacing laser had mean readings of 44 pps (STD ±11). When the particle sizes were broken down by size, the fractional radiofrequency device had overall smaller particle sizes with a count of 251 for 0.3 µm (STD ±147) compared with Er:YAG laser with a count of 112 for 0.3 µm (STD ±84). The fractional radiofrequency did not appear to emit particles >5 µm throughout the treatment, however, the Er:YAG laser consistently recorded majority of particles in the range of 5-10 µm. The addition of the smoke evacuator demonstrated a 50% reduction in both particles per second recorded as well as all particle sizes. CONCLUSION: Re-evaluation of the plume effect from aesthetic devices has become important during the COVID-19 pandemic. Further studies are required to characterize viability of COVID-19 viability and transmissibility in plume specimens. Based on this pilot study, we recommend that devices that generate little to no plume such as fractional radiofrequency devices be used in Phase I reopening of practice while devices that generate a visible plume such as Er:YAG laser resurfacing devices be avoided and only used with appropriate personal protective equipment in addition to a smoke evacuator in Phase IV reopening.


Subject(s)
COVID-19/transmission , Cosmetic Techniques/instrumentation , Laser Therapy/instrumentation , Lasers, Solid-State/therapeutic use , Radiofrequency Ablation/instrumentation , Skin Aging/radiation effects , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Cohort Studies , Face , Female , Humans , Male , Middle Aged , Neck , Particle Size , Pilot Projects , Risk Assessment
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