The Potential Role of Topically Applied Heparan Sulfate in the Treatment of Photodamage.

Heparan sulfate is an essential glycosaminoglycan that plays important roles in development, homeostasis, and disease. As a group, the glycosaminoglycans provide mechanical strength to skin, as they can absorb water and occupy the space between elastin fibers and collagen. Heparan sulfate is also a key participant in cell proliferation, cell migration, collagen fiber formation, basement membrane regeneration, granulation tissue formation, and cell adhesion associated with wound healing. A variety of dermatological disorders are associated with changes in glycosaminoglycans or their associated proteoglycans. A new topical formulation of low molecular weight heparan sulfate glycosaminoglycan has been shown to penetrate the epidermis, basement membrane, and dermis within 24 hours of application. In an 8-week study, 15 patients using this new formulation showed improvement in skin hydration, skin firmness, skin elasticity, skin barrier function, and global fine lines and wrinkles. Incorporating low molecular weight heparan sulfate into topically applied formulations may represent a new approach to improving the appearance of photodamaged skin.

The skin health and beauty pyramid: a clinically based guide to selecting topical skincare products.

The use of cosmeceuticals by patients is now commonplace. Without consultation and direction from an informed clinician, marketing pressures can lead consumers to make poor product choices that can result in wasted money and unsatisfactory outcomes. Skin professionals need a scientifically based, succinct tool to guide their patients toward best topical skincare practices. The Skin Health and Beauty Pyramid is an educational framework and product guide created from extensive scientific literature and study review on ingredients, formulations and technologies affecting skin biology. This clinical tool can simplify product choices for physicians and clinicians in the process of professionally guiding patients toward the optimal use of topical products to achieve best outcomes for skin health and beauty.

Prospective, multicenter study to determine the safety and efficacy of a unique radiofrequency device for moderate to severe hand wrinkles.

Radiofrequency has been shown in a number of studies to be effective in tightening the skin of the face and neck. This multicenter study was undertaken to determine the efficacy of a monopolar radiofrequency system (Pellevé S5 Wrinkle Treatment Generator; Ellman International Inc, Oceanside, NY) in tightening the skin of the hands and is the first such study assessing the improvement of skin laxity of the hands. A total of 31 female patients with a median age of 56 years were enrolled in 2 centers. Each had a single hand treated, with randomization of the hand to be treated. A total of 3 treatments were performed at 2-week intervals. Follow-up photos were taken at 45 and 90 days after the final treatment. At 90 days, 89% of patients had visible improvement of the appearance of the treated hand based on the visual Global Aesthetic Improvement Scale. Of these, 50% had visible improvement from baseline, and 39% had marked improvement from baseline. Patients reported only mild to moderate discomfort during the treatment. No adverse events or side effects were reported. Monopolar radiofrequency was found to be safe and effective for treating hand wrinkles.

Multiple facial burns with the new Thermage CPT system.

A 45-year-old man requested treatment with Thermage for skin tightening. He was treated with the new Thermage CPT system and received several facial burns due to failure of the dielectric membrane. It may be contraindicated to treat male patients with this system.

Retrospective analysis of pimecrolimus cream 1% for treatment of facial vitiligo.

OBJECTIVE: To explore the effectiveness of pimecrolimus cream 1% used twice daily (BID) for the treatment of facial vitiligo. METHODS: Patients who had used pimecrolimus cream 1% monotherapy BID for at least 3 months and who had photographs taken at baseline and after initiation of therapy were analyzed in a retrospective study. The total affected surface area (cm2) of facial vitiligo in the baseline and follow-up photographs was compared. The extent of facial depigmentation was scored using a 7-point scale (0 = no disease to 6 = 100% involvement). RESULTS: Eight patients met study entry criteria. Mean time from initiation of treatment to the final follow-up visit was 11 months (SD +/- 7.5 months). Mean affected surface area at baseline and follow-up were 79.40 cm2 and 17.96 cm2, respectively, (P = .012) with a mean percent improvement 72.5% (SD +/- 20.4%). Mean depigmentation score decreased from 2.8 at baseline to 1.4 at follow-up. No adverse events were reported. CONCLUSION: Pimecrolimus cream 1% may be a viable alternative to current therapies for the treatment of facial vitiligo.

Skin tightening with a combined unipolar and bipolar radiofrequency device.

Monopolar radiofrequency (RF) devices are well established treatment modalities for tightening facial skin. A 60-year-old woman presented with a desire to tighten the lax skin and improve the appearance of both upper arms. A combination unipolar and bipolar RF device may provide volume reduction as well as skin tightening in the upper arm.