Safety Assessment of Vinylpyrrolidone Polymers as Used in Cosmetics.

The Expert Panel for Cosmetic Ingredient Safety (Panel) reviewed the safety of 30 vinylpyrrolidone polymers as used in cosmetic products; most of these ingredients have the reported cosmetic function of film former in common. The Panel reviewed data relevant to the safety of these ingredients, and determined that 27 vinylpyrrolidone polymers are safe in cosmetics in the present practices of use and concentration described in the safety assessment. The Panel also concluded that the available data are insufficient to make a determination that 3 vinylpyrrolidone polymers (all urethanes) are safe under the intended conditions of use in cosmetic formulations.

Safety Assessment of Polyol Phosphates as Used in Cosmetics.

The Expert Panel for Cosmetic Ingredient Safety (Panel) reviewed the safety of 10 polyol phosphates. Some of the possible functions in cosmetics that are reported for this ingredient group are chelating agents, oral care agents, and skin conditioning agents. The Panel reviewed relevant data relating to the safety of these ingredients under the intended conditions of use in cosmetic formulations, and concluded that Sodium Phytate, Phytic Acid, Phytin, and Trisodium Inositol Triphosphate are safe in cosmetics in the present practices of use and concentration described in the safety assessment. The Panel also concluded that the data are insufficient to determine the safety of the following 6 ingredients as used in cosmetics: Disodium Glucose Phosphate, Manganese Fructose Diphosphate, Sodium Mannose Phosphate, Trisodium Fructose Diphosphate, Xylityl Phosphate, and Zinc Fructose Diphosphate.

Evaluation of the Safety of Cosmetic Ingredients and Their Skin Compatibility through In Silico and In Vivo Assessments of a Newly Developed Eye Serum.

The term "risk assessment" is often substituted with "safety assessment", to demonstrate the safe properties of cosmetic ingredients and formulations. With respect to the actual legislative framework, the proper use of in silico evaluation could offer a representative non-animal substitute for the toxicity evaluation of cosmetic ingredients. The in silico assessment needs to be integrated with other lines of proof (in vitro and/or in vivo data) in the form of a complex methodology in order to demonstrate the safety evaluation of cosmetic ingredients/products. The present study aimed to develop and characterize a new cosmetic formulation, designed for the skin care of the periorbital area. Quality control comprising stability, physicochemical, and microbiological evaluation was performed. Another objective of this study was to present a screening model for the safety evaluation of the cosmetic formulation by identifying individual ingredients, and to confirm the skin compatibility based on in vivo evaluation. The results demonstrated the in silico and in vivo safety profile of the cosmetic ingredients used in the present formulation. In silico evaluation, using a novel, specific software applicable for the risk evaluation of ingredients and formulations, showed that the incorporated ingredients were non-mutagenic and non-sensitizing, and considering the margin of safety (MoS), the cosmetic raw materials could be considered safe. Skin compatibility was confirmed by the patch test performed under dermatological control, evidencing the "non-irritating" potential of the developed cosmetic formulation.

Emergency complications during dermatological, surgical, or cosmetic procedures: A cross-sectional study among dermatologists.

BACKGROUND: Medical emergency complications may occur during dermatological, surgical, and cosmetic procedures. AIMS: This study aimed to investigate the frequency of dermatologists who experienced emergency complications as well as their level of knowledge regarding emergencies and basic life support. METHODS: The cross-sectional descriptive study was conducted online among 240 dermatologists to whom a questionnaire was sent via email and a closed social media group. The survey instrument asked about emergency complications during dermatological, surgical, or cosmetic procedures and the dermatologists' level of knowledge regarding emergencies and basic life support. RESULTS: Among the dermatologists, 53% reported emergency complications during dermatological and surgical procedures and 43.2% during cosmetic procedures. The most common complications were vasovagal syncope, hypotension/bleeding, and seizures. Emergency complications were more common among specialists, those with more than 15 years of professional experience, those working in their private clinics, and those performing an average of 10-50 dermatological/surgical procedures per week and fewer than 10 cosmetic procedures per week (p < 0.05). The knowledge level of dermatologists was highest among residents, dermatologists with 0-4 years of professional experience, those working in university hospitals, and those who had both theoretical and practical training in basic life support. CONCLUSIONS: This study shows a relatively high frequency of dermatologists who experienced emergency complications during dermatological, surgical, or cosmetic procedures. Although these complications seem to be common; most of them are mild, self-limiting, and not life-threatening. Nevertheless, dermatologists should be competent and prepared to intervene in medical emergencies in daily practice.

Superficial musculoaponeurotic system interpositional graft after temporomandibular joint discectomy.

Arthroplasty with discectomy is a proven treatment for internal derangement of the temporomandibular joint (TMJ), however there is no consensus on the type of interpositional graft that should be used after the disc is removed. While an ideal graft should be easy to obtain and provide an adequate buffer between the articular surfaces, the authors suggest that it should also minimize donor site morbidity. This Technical Note highlights the technique for harvesting and utilizing the superficial musculoaponeurotic system (SMAS) as an interpositional graft. Three patients were treated with a SMAS graft after TMJ arthroplasty with discectomy. The average pain score decreased from 9/10 preoperatively to 2/10 at 6 weeks postoperatively, while the average maximum incisal opening increased from 31 mm to 36.7 mm. Since these patients were concurrently treated with a facelift, they were asked about their esthetic outcome on a scale of 1-10, with 1 representing extremely dissatisfied and 10 representing extremely satisfied. The average esthetic rating at 6 weeks postoperatively was 9.3/10. The SMAS interpositional graft technique eliminates a second surgical site, improves function, reduces pain, and provides the opportunity for concurrent esthetic facial rejuvenation if desired.

Novel single-entry point injection technique for masseter hypertrophy treatment using botulinum neurotoxin based on patient-reported comfort.

INTRODUCTION: Botulinum neurotoxin (BoNT) injections are widely used for the treatment of masseter muscle hypertrophy in Southeast Asia. However, there remains a lack of consensus regarding the optimal injection technique. This study aimed to compare the efficacy and patient discomfort associated with single-entry point injections versus multiple three-point injections for masseter muscle hypertrophy treatment with BoNT. MATERIALS AND METHODS: Sixteen participants, comprising both male and female Korean adults aged 22-63, were enrolled in the study. On the left side of the face, single-entry point injections were administered, followed by multidirectional injections, while on the right side, three-point injections were given. Pain intensity during the procedure was assessed using visual analogue scale scores. RESULT: Our results revealed that participants experienced lower levels of pain with single-entry point injections compared to three-point injections (average visual analogue scores of 3.31 and 5.19, respectively). CONCLUSION: These findings highlight the potential benefits of single-entry point injections in reducing patient discomfort during masseter muscle hypertrophy treatment with BoNT. We advocate for further research to validate these findings and encourage practitioners to consider single-entry point injections as a viable option for enhancing treatment outcomes in their clinical practice.

Microspheres Based on Blends of Chitosan Derivatives with Carrageenan as Vitamin Carriers in Cosmeceuticals.

Chitosan (CS) has a natural origin and is a biodegradable and biocompatible polymer with many skin-beneficial properties successfully used in the cosmetics and pharmaceutical industry. CS derivatives, especially those synthesized via a Schiff base reaction, are very important due to their unique antimicrobial activity. This study demonstrates research results on the use of hydrogel microspheres made of [chitosan-graft-poly(ε-caprolactone)]-blend-(ĸ-carrageenan)], [chitosan-2-pyridinecarboxaldehyde-graft-poly(ε-caprolactone)]-blend-(ĸ-carrageenan), and chitosan-sodium-4-formylbenzene-1,3-disulfonate-graft-poly(ε-caprolactone)]-blend-(ĸ-carrageenan) as innovative vitamin carriers for cosmetic formulation. A permeation study of retinol (vitamin A), L-ascorbic acid (vitamin C), and α-tocopherol (vitamin E) from the cream through a human skin model by the Franz Cell measurement system was presented. The quantitative analysis of the release of the vitamins added to the cream base, through the membrane, imitating human skin, showed a promising profile of its release/penetration, which is promising for the development of a cream with anti-aging properties. Additionally, the antibacterial activity of the polymers from which the microspheres are made allows for the elimination of preservatives and parabens as cosmetic formulation ingredients.

Safety Assessment of Alkanoyl Lactyl Lactate Salts as Used in Cosmetics.

The Expert Panel for Cosmetic Ingredient Safety (Panel) reviewed the safety of 10 alkanoyl lactyl lactate salts. These ingredients have the surfactant function in cosmetics in common. The Panel reviewed data relevant to the safety of these ingredients, and concluded that these 10 ingredients are safe in cosmetics in the present practices of use and concentration described in the safety assessment when formulated to be nonirritating and nonsensitizing, which may be based on a quantitative risk assessment (QRA) or other accepted methodologies.

ToF-SIMS evaluation of PEG-related mass peaks and applications in PEG detection in cosmetic products.

Polyethylene glycols (PEGs) are used in industrial, medical, health care, and personal care applications. The cycling and disposal of synthetic polymers like PEGs pose significant environmental concerns. Detecting and monitoring PEGs in the real world calls for immediate attention. This study unveils the efficacy of time-of-flight secondary ion mass spectrometry (ToF-SIMS) as a reliable approach for precise analysis and identification of reference PEGs and PEGs used in cosmetic products. By comparing SIMS spectra, we show remarkable sensitivity in pinpointing distinctive ion peaks inherent to various PEG compounds. Moreover, the employment of principal component analysis effectively discriminates compositions among different samples. Notably, the application of SIMS two-dimensional image analysis visually portrays the spatial distribution of various PEGs as reference materials. The same is observed in authentic cosmetic products. The application of ToF-SIMS underscores its potential in distinguishing PEGs within intricate environmental context. ToF-SIMS provides an effective solution to studying emerging environmental challenges, offering straightforward sample preparation and superior detection of synthetic organics in mass spectral analysis. These features show that SIMS can serve as a promising alternative for evaluation and assessment of PEGs in terms of the source, emission, and transport of anthropogenic organics.

The role of artificial intelligence in cosmetic and functional gynecology: Stepping into the third millennium.

Cosmetic and functional gynecology have gained popularity among patients, but the scientific literature in this field, particularly regarding the cosmetic aspect, is lacking. The use of evidence-based medicine is crucial to validate diagnostic tools and treatment protocols. However, the advent of artificial intelligence (AI) offers a promising solution to address this issue. ChatGPT, a sophisticated language model, can revolutionize AI in medicine, enabling accurate diagnosis, personalized treatment plans, and expedited research analysis. Cosmetic and functional gynecology can leverage AI to develop the field and improve evidence gathering. AI can aid in precise and personalized diagnosis, implement standardized assessment tools, simulate treatment outcomes, and assess under-skin anatomy through virtual reality. AI tools can assist clinicians in diagnosing and comparing difficult cases, calculate treatment risks, and contribute to standardization by collecting global evidence and generating guidelines. The use of AI in cosmetic and functional gynecology holds significant potential to advance the field and improve patient outcomes. This novel combination of AI and gynecology represents a groundbreaking development in medicine, emphasizing the importance of appropriate and correct AI usage.

Energy-based devices and hyaluronic acid filler, polymer filler, and threads: Cadaveric study.

INTRODUCTION: The objective of this experiment was to investigate the thermal effects on hyaluronic acid fillers, PCL fillers, and PDO threads when exposed to controlled heat. This study aims to provide insights into how these materials respond to thermal energy, which is crucial for safe and effective cosmetic procedures involving combined modalities. MATERIALS AND METHODS: Cadaveric tissue was utilized to simulate clinical conditions. Hyaluronic acid fillers were injected at approximately 1 mm and 5 mm thicknesses, with variations in G' value (high and low). PCL fillers were similarly injected in 1 mm and 5 mm thicknesses. PDO threads were also inserted. All materials were injected at a depth of 2 cm. A thermometer was used to measure heat penetration, and a multi-wavelength laser was applied to the tissue. The temperature was maintained at 60°C for 5 min to assess whether heat penetrated more than 3 cm in thickness. Observations were made regarding the heat distribution and any physical changes in the fillers and threads. RESULTS: In thick layers, heat accumulated above the PCL filler without penetrating deeper layers. In thin layers, heat penetration was observed. For the HA fillers, heat energy was not blocked, regardless of the G' value or thickness. For the threads, no significant heat blockage effect was observed. For all materials, no visual changes were detected in any of the materials due to temperature exposure. DISCUSSION: The findings suggest that the thickness and composition of fillers significantly influence heat penetration. Thick PCL fillers act as a thermal barrier, whereas thin PCL fillers allow deeper heat penetration. Hyaluronic acid fillers do not impede heat transfer, regardless of their physical properties. PDO threads do not exhibit any notable thermal resistance. These insights are essential for optimizing the safety and efficacy of combined filler and energy-based device treatments in esthetic medicine.

Esthetic and medical tattooing: Part I: Tattooing techniques, implications, and adverse effects in healthy populations and special groups.

Tattooing, the introduction of exogenous pigments into the skin, has a rich history spanning thousands of years, with cultural, cosmetic, and medical significance. With the increasing prevalence of tattoos, understanding their potential complications and contraindications is of growing importance. The most common complications are hypersensitivity reactions, which may vary in morphology and timing. Infectious complications are often due to inadequate aseptic and hygienic practices during the tattooing process or healing period. Tattoo pigment can present diagnostic challenges, affecting cancer diagnosis and imaging. This CME article explores the history, cultural significance, epidemiology, chemistry, technique, contraindications, and complications of tattoos. Appreciating these factors can help individuals considering tattoos understand the safety and potential risks of their body art, and provide physicians with a thorough understanding of tattooing if consulted.

Understand the Stabilization Engineering of Ascorbic Acid, Mapping the Scheme for Stabilization, and Advancement.

Vitamin C is extensively used in cosmetic formulation, howbeit stability is the supreme demerit that limits its use in beautifying products. Numerous techniques are being employed to inhibit the degradation of vitamin C caused by formulation components to facilitate the use in skin rejuvenating products. Diverse materials are being exercised in formulation to stabilize the ascorbic acid and ingredients selected in this formulation composition help for stabilization. The initial stable prototype is developed and further optimization is accomplished by applying the design of experiment tools. The stable pharmaceutical formulations were evaluated for the evaluation parameters and designated as two optimized formulations. The analytical method for the assay of ascorbic acid from the United States pharmacopeia and the related substance method from European pharmacopeia has been modified to be used for cream formulation. The DoE design exhibited that the stability of formulation is impacted by citric acid and tartaric acid but not by propylene glycol and glycerin. The analysis results of topical formulations for the evaluation parameter exhibited satisfactory results. The in-vitro release study method has been developed, optimized, and validated to fit the analysis. The in-vitro studies have been performed for selected compositions and both the formulation has similar kinds of release patterns. The stability study as per ICH guidelines exhibited that the product is stable for accelerated, intermediate, and room-temperature storage conditions. The optimized formulation shows constant release and permeation of ascorbic acid through the skin. The formulation with the combinations of citric acid, tartaric acid, and tocopherol is more stable and the degradation of vitamin C has been reduced significantly. The beaucoup strategies in the unique composition help to protect the degradation by inhibiting the multitudinous degradation pathways.

Investigation of Appearance Anxiety Levels and Influencing Factors in Patients Undergoing Minimally Invasive Facial Cosmetic Procedures.

OBJECTIVE: This study aimed to investigate appearance anxiety and its influencing factors in patients undergoing minimally invasive facial cosmetic procedures. METHODS: A convenience sampling method was used to select 351 patients who attended the outpatient clinic of the Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January to August 2023. Patients completed self-administered and social appearance anxiety questionnaires before treatment. RESULTS: The mean appearance anxiety score was 2.49±0.85, indicating a moderate level of anxiety. Significant differences in appearance anxiety levels were observed based on age (p = 0.010), gender (p = 0.026), marital status (p = 0.032), number of children (p = 0.019), facial wrinkle removal procedures (p = 0.023), self-pleasure (p = 0.043), and special attention to the treatment area (p = 0.042). Multiple linear regression analysis identified facial wrinkle removal (p = 0.018), facial depression filling (p = 0.049), and special attention to the treatment area (p = 0.034) as significant factors. CONCLUSION: Younger populations are more likely to seek improved appearance for better opportunities. The uncertainty of treatment outcomes may also increase social appearance anxiety in patients. Patients can reduce this anxiety by increasing their self-efficacy and self-confidence. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Safety Assessment of Methylxanthines as Used in Cosmetics.

The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of three methylxanthines, Caffeine, Theobromine, and Theophylline, as used in cosmetics. All of these ingredients are reported to function as skin-conditioning agents in cosmetic products. The Panel reviewed the data relevant to the safety of these ingredients and concluded that Caffeine, Theobromine, and Theophylline are safe in cosmetics in the present practices of use and concentration described in this safety assessment.

Trichoblastic Carcinoma in the Glabella Treated With Mohs Micrographic Surgery.

Trichoblastic carcinoma (TBC) is a rare adnexal neoplasm of follicular germ cell differentiation with the potential for local invasion and metastasis. Histologic features of trichoblastic carcinoma have significant overlap with trichoblastoma and basal cell carcinoma (BCC), making diagnosis difficult in some cases. Treatment strategies are not well defined and include surgical excision for localized tumors and systemic therapies for metastatic disease. We present a case of trichoblastic carcinoma clinically resembling a benign cyst that was ultimately treated with Mohs micrographic surgery (MMS).

Complications of Chemical Peels, Lasers, and Energy-Based Device Procedures Performed by Core Cosmetic Physicians: A Retrospective Analysis.

BACKGROUND: There has been a proliferation of physicians of different levels of experience and training offering nonsurgical cosmetic procedures. Rising demand, compounded by increasing utilization of new and existing technologies by numerous physician specialties, compels discussion of adequate standardized training and patient safety. METHODS: A retrospective chart review of patients who presented to our single site dermatology clinic for managment of complications following chemical peel, laser or energy-based device treatments performed by core cosmetic physicians between the years of 2013 and 2024 was conducted. Core cosmetic physicians included plastic surgery, facial surgery/otolaryngology, oculoplastic surgery, and dermatology. Charts were reviewed for documentation of the type of complication, procedure causing the complication, and physician credentials, and referral source. RESULTS: Twenty-five patients were identified as having complications from chemical peeling, laser treatment or energy-based devices. Devices implicated included CO2 laser (fractional or fully ablative), chemical peels, 1064 nm long-pulsed Nd:YAG laser, 1320 nm Nd:YAG laser, intense pulsed light, 595 nm pulsed dye laser, Q-switched Nd:YAG laser, radiofrequency with and without microneedling, and 1550 nm erbium-doped fiber laser. Complications included hypertrophic scarring, atrophic scarring, post-inflammatory erythema, post-inflammatory hyperpigmentation, and post-inflammatory hypopigmentation. CONCLUSIONS: Even in experienced hands, complications can arise. It is imperative that all physicians offering cosmetic treatments are equipped to recognize clinical endpoints, identify and manage complications, or make a timely referral to decrease the risk of a permanent and potentially devastating esthetic outcome for patients.