Microdermabrasion followed by a 5% retinoid acid chemical peel vs. a 5% retinoid acid chemical peel for the treatment of photoaging - a pilot study.

BACKGROUND: Both retinoid acid (RA) chemical peeling and microdermabrasion are minimally invasive procedures recently developed for the treatment of photoaging. The efficacy of each procedure has been proved, but the results of the combination of these two methods have not been studied until now. OBJECTIVES: To assess and compare the efficacy of microdermabrasion followed by a 5% RA chemical peel with that of a 5% RA chemical peel alone. METHODS: Six female patients with moderate degrees of photodamage were evaluated. Three submitted to microdermabrasion followed by the application of a 5% RA chemical peel and three submitted to a 5% RA chemical peel alone. Each patient underwent three treatment sessions, with intervals of 7-10 days. Photographs were taken, and both biopsies and histological assessments were carried out, before treatment and 7 days after the final treatment session. RESULTS: In the opinion of the patients, in both groups there was improvement in the texture, pigmentation, and appearance of the treated skin, and this was confirmed with the assessment of the pre- and post-treatment photographs. The combination of microdermabrasion followed by a 5% RA peel showed slightly greater improvement in the histological alterations resulting from photoaging. Conclusion Both methods, microdermabrasion followed by a 5% RA chemical peel and a 5% RA chemical peel alone are effective in the treatment of photoaging.

Phosphatidylcholine in the treatment of localized fat.

Phosphatidylcholine was initially used in emergencies and in the treatment of atheroma plaques in cardiac diseases. Recently, it has also been used in the treatment of localized fat deposits. We report on the authors' clinical experience of the use of 250 mg/ml phosphatidylcholine injections in the treatment of subcutaneous fat deposits, showing the clinical response and side-effects. Volunteers received phosphatidylcholine injections in several areas of localized fat deposits, with a minimum interval of one week and mean interval of 15 days between applications. Laboratory tests were performed during the period of the drug use. Clinical results reflect that phosphatidylcholine was efficacious in reducing the fatty pads in the treated areas, with few side effects. From the authors' point of view, the off-label use of phosphatidylcholine in the treatment of fatty pads and small areas of localized fat is safe, low cost, and effective.

Multicenter, double-blind study of the efficacy of injections with botulinum toxin type A reconstituted up to six consecutive weeks before application.

BACKGROUND: It is recommended that botulinum toxin be used immediately or within 2 weeks after its reconstitution because its efficacy might be compromised by prolonged storage. OBJECTIVES: To evaluate the efficacy of botulinum toxin type A (BTX-A) reconstituted over 6 consecutive weeks for the treatment of glabellar frown lines. METHODS: Four vials of BTX-A were reconstituted each of 7 days over a period of 6 weeks, totaling 28 vials, corresponding to seven reconstitution dates. During this period, the BTX-A was stored according to the manufacturer's instructions. On the day after the last reconstitution, all of the reconstituted vials were injected in patients from four dermatologic centers taking part in this study. A total of 88 patients were treated on the same day and were followed every 2 weeks for 4 months. All patients were photographed at all stages. A number of professionals assessed the efficacy of reconstituted BTX-A based on the reduction of the maximum frowning capacity of the treated muscles. RESULTS: Of the 88 patients who were selected, 3 were excluded. Three forms of evaluation were applied, and no statistically significant differences were found in the results presented. CONCLUSION: BTX-A may be applied up to 6 weeks after reconstitution without losing its effectiveness. Other factors, which are probably individual, may influence the response to BTX-A injections.