Patient-reported outcomes after incobotulinumtoxinA treatment for upper facial wrinkles.

BACKGROUND: Botulinum toxins are used for facial rejuvenation. OBJECTIVE: To investigate the efficacy, patient satisfaction, and skin physiology after incobotulinumtoxinA treatment of the upper face. MATERIALS AND METHODS: Thirty women aged 35 to 55 were enrolled in this single-center prospective 16-week study. Patients and an investigator blinded to visit number assessed wrinkle severity after incobotulinumtoxinA treatment of glabellar, periorbital, and forehead lines using Validated Assessment Scales at Days 0 (baseline), 2, 7, 14, 28, and 112. Responder rates (for each region) and mean wrinkle scores (whole upper face) were calculated. Treatment satisfaction was self-assessed by questionnaire. Transepidermal water loss (TEWL), stratum corneum hydration, and skin pH were measured to assess skin barrier function. RESULTS: Wrinkle severity decreased rapidly after treatment. Responder rates generally peaked at Days 7 to 14. At 112 days, mean scores remained significantly lower than baseline (p < .05). Patients were significantly more satisfied with their appearance after treatment; most felt "younger" and "more attractive" (p < .05). Transepidermal water loss decreased significantly throughout (p < .05), and stratum corneum hydration increased. No treatment-related adverse events occurred. CONCLUSION: IncobotulinumtoxinA rapidly improved wrinkle severity, and improvements were maintained for up to 112 days. Increased stratum corneum hydration and reduced TEWL may improve skin quality. IncobotulinumtoxinA was well tolerated and improved patients' self-perception.

Stabilized hyaluronic acid-based gel of non-animal origin for skin rejuvenation: face, hand, and décolletage.

BACKGROUND: Mid-dermal injection of stabilized hyaluronic acid (HA) is well established as a treatment to reduce the effects of skin aging. OBJECTIVE: To assess the efficacy and safety of a stabilized HA-based gel of non-animal origin manufactured using the patented NASHA® technology (Restylane® Vital Light, Q-Med AB, Uppsala, Sweden) administered using a pre-filled micropuncture injector device for rejuvenation of the skin. METHODS: Three treatment sessions 4 weeks apart were performed on one side of the face, the dorsum of one of the hands and one side of the décolletage, leaving the other side untreated. Skin quality was assessed via blinded live evaluation and subject satisfaction by questionnaire. Aesthetic change was evaluated independently by the subject and a blinded evaluator. Subjects were followed up to week 36. RESULTS: Thirty subjects aged 40-65 years were enrolled. Overall skin quality across all three treatment areas was judged to be improved on the treated side in over 80% of subjects throughout the study. Significant aesthetic improvements on the treated sides were observed at all visits, with the exception of the décolletage at week 36. CONCLUSIONS: This was the first study that used a micropuncture injector device for injection of NASHA gel, and reveals that this is a promising treatment option for rejuvenation of the skin.

Hyperhidrosis plantaris - a randomized, half-side trial for efficacy and safety of an antiperspirant containing different concentrations of aluminium chloride.

BACKGROUND: Primary focal hyperhidrosis plantaris can cause impairment in social, physical, leisure and occupational activities. Topical treatment with aluminium chloride is the first-line treatment. The aim of this trial was to evaluate efficacy and safety of two different concentrations of aluminium chloride hexa-hydrate (12.5%, 30%) for 6 weeks. PATIENTS AND METHODS: 20 volunteers with hyperhidrosis plantaris were included. Efficacy was evaluated using a clinical rating scale of the hyperhidrosis level and qualitative assessments including Minor's (iodine-starch) test and a standardized sniff test. Furthermore a patient questionnaire and measurements of skin surface pH were done to evaluate the subjective assessments and side effects. RESULTS: The hyperhidrosis level significantly decreased in both concentrations. There were no differences in tolerability regarding the skin surface pH and the patient questionnaires. In addition the hidrotic areas decreased after application of both products and the sniff test improved. CONCLUSION: Topical application of an antiperspirant containing aluminium chloride reduced sweat production in plantar hyperhidrosis significantly. As both 12.5% and 30% were efficacious and safe, we would recommend 12.5% for outpatient treatment.

Age-related changes in skin mechanical properties: a quantitative evaluation of 120 female subjects.

BACKGROUND/PURPOSE: The most commonly used method to determine the mechanical ability of skin is the creep test using suction chamber devices. Until now, there is no scientific consensus upon which skin deformation parameters and which body sites are particularly suitable to describe age-related changes in human skin mechanics. The aim of this study was to find those mechanical skin parameters best representing influence of aging at five different body sites. METHODS: A total of 120 healthy women aged 18-65, divided into four similar age groups, were included in this study. The biomechanical properties of the skin were measured using the Cutometer® MPA 580 on five body sites: cheek, neck, cleavage, volar forearm and back of the hand. In order to analyze parameters referred to 1 mm skin thickness, we also used 20 MHz sonography (DUB 20). RESULTS: A high average correlation with age was found for the parameters U(a)/U(f), U(r)/U(e), U(r), U(r)/U(f) and U(a). Only low correlation with age was found for the parameters U(v)/U(e), U(f)-U(a), U(f5)/U(f), U(d)/U(f) and U(a5). The localizations cheek, forearm and neck showed the highest correlation with age, while cleavage showed only low correlation. CONCLUSION: According to the results of our study, we recommend the parameter ratio of elastic recovery to distensibility (U(r)/U(f) ) as well as the gross elasticity (U(a)/U(f)) for evaluation of aging effects on the mechanical properties of skin. Their high correlation with age makes them particularly applicable to represent the influence of aging onto skin mechanical properties. Most suitable localizations to evaluate skin aging are cheek, forearm and neck.