Fractional carbon dioxide laser versus combined fractional CO2 laser and platelet rich plasma in treatment of facial wrinkles: A comparative split face study.

BACKGROUND: Wrinkles are the most visible sign in skin aging and for which many people seek different aesthetic procedures. Treatment options varies from invasive to non-invasive procedures. Combining platelet rich plasma and fractional carbon dioxide laser (CO2 ) has been used frequently for showing promising results in treating photoaged skin generally and wrinkles specifically since the microscopic thermal zones created by the fractional laser facilitates the delivery of the plasma into the dermis which aids the process of collagen induction and skin rejuvenation. AIM OF THE WORK: To compare and assess the clinical efficacy of fractional CO2 laser alone versus combined fractional CO2 laser and platelet rich plasma in treatment of facial rhytides (in terms of size, depth, and overall appearance). SUBJECTS AND METHODS: Twenty-six female patients were selected and each face was split into 2 halves a control side (Laser + saline) and an experimental side (Laser + platelet rich plasma). Treatment plan was 1 laser session per month for a total of 4 sessions. Clinical objective evaluation was done by the Antera camera in addition to assessment by two blinded dermatologists. RESULTS: The combined treatment was as effective in improving wrinkles as fractional CO2 laser alone. Antera camera scores showed statistical significance in overall wrinkles measurements on each side equally. CONCLUSION: Both treatment modalities gave optimum cosmetic results with no significant difference noticed when compared with each other, although overall satisfaction with wrinkles and skin were statistically greater than the initial satisfaction scores.

Trichoscopy in Healthy Adult Egyptian Females: Normal Values of Hair Measurable Parameters.

Introduction: Documenting normal hair values through trichoscopy can provide a useful baseline when evaluating and treating hair loss in different populations. The aim of our study was to document normal values for measurable parameters of hair in adult Egyptian females. Methods: This cross-sectional study involved 90 Egyptian females (age range 18-48 years), with no symptoms or signs of hair or scalp disease. Trichoscopy was performed in different scalp areas using FotoFinder Medicam 1000 videodermoscopy. Trichoscopy images were subjected to statistical processing using TrichoLAB system. Results: The frontal area demonstrated the highest number of hairs (190 ± 29/cm2), greatest average hair shaft thickness (63 ± 8 µm), greatest percentage of thick hairs (71% ± 12), highest mean cumulative hair thickness (12 ± 2 mm/cm2), and highest mean number of follicular units (82 ± 8/cm2). The temporal area showed the highest percentage of thin hairs (9% ± 5) and single-hair pilosebaceous units (23% ± 7), lowest mean number of hairs (154 ± 25/cm2), least average hair shaft thickness (60 ± 9 µm), least mean cumulative hair thickness (9 ± 2 mm/cm2), and least mean number of follicular units (70 ± 8/cm2). The occipital area showed the greatest percentage of triple-hair follicles (43% ± 12). Based on trichoscopy, the norms for hair parameters were calculated. Conclusion: Normal hair parameters in adult Egyptian females differ from those documented from other ethnicities. Evaluating and treating hair loss in clinical practice should be done in reference to documented normal values, which can be set through trichoscopy.

Ascorbic acid derivative-loaded modified aspasomes: formulation, in vitro, ex vivo and clinical evaluation for melasma treatment.

Vitamin C (L-Ascorbic acid) has many favourable effects on the skin such as antioxidant, anti-aging and whitening effects. Its instability and low permeability limit its pharmaceutical use in cosmetic and dermatological products. Instead, Mg ascorbyl phosphate (MAP), an ascorbic acid derivative, has the same effect with higher stability is being used. In this work, a vesicular system, aspasomes, containing MAP was developed and evaluated. Aspasomes are multilayered vesicles formed by amphiphiles molecules, Ascorbyl palmitate (ASP), in combination with cholesterol and charged lipids for drug encapsulation. Here, we investigated the use of lecithin instead of the charged lipid dicetyl phosphate for aspasomes development. Nine formulations were prepared and evaluated for their entrapment efficiency, particle size, polydispersity index (PDI) and zeta potential. Their entrapment efficiency ranged from 33.00 ± 2.27 to 95.18 ± 1.06, while their particle size was from 373.34 ± 60.85 to 464.37 ± 93.46 nm with acceptable PDI (from 0.212 ± 0.068 to 0.351 ± 0.061) and zeta potential (from -37.52 ± 2.42 to -50.36 ± 1.82). Three formulations were selected and evaluated for their drug release, permeation and retention into skin. One formulation was selected to be formulated as aspasomal topical cream and gel. The aspasomal cream was found to have enhanced drug permeation and skin retention over the aspasomal gel as well as the aspasomes formulation. MAP aspasomal cream was evaluated clinically as an effective treatment for melasma against 15% trichloroacetic acid (TCA) and the results recorded that the aspasomal cream showed the greatest degree of improvement regarding the hemi-MASI scores with 35% of patients rating it as excellent treatment. The study showed that MAP aspasomal cream can be considered a novel treatment of melasma which is free of side effects. Its efficacy as a monotherapy is superior to that of chemical peeling using 15% TCA.