Efficacy and safety of a home-use handheld multi-energy-based device for skin rejuvenation: clinical, ex vivo, and histological studies.

Alongside increases in the average lifespan and a growing interest in anti-aging remedies, the demand for at-home skincare devices is rapidly expanding in the cosmetic market. This study aimed to assess the safety and efficacy of a novel home-use handheld multi-energy-based device for skin rejuvenation that simultaneously emits low level light, low-dose radiofrequency, low-energy microcurrent, and low-intensity ultrasonic wave. This prospective, randomized, split-face clinical trial enrolled 36 healthy Korean women. After 8 weeks of device use, parameters associated with skin aging were assessed. Additionally, a preliminary ex vivo study and skin biopsy following device use were performed to confirm safety and efficiency of the device. Parameters associated with skin aging including skin hydration, elasticity, roughness, skin pore size, and eye wrinkle volume showed significant improvements after 8 weeks of the device use, relative to baseline measurements and the control side. No adverse effects were observed during the follow-up period. Results of ex vivo and in vivo skin tissue studies correlated with clinical findings, which showed an increase in the expression of type 1 collagen and a decrease in the expression of matrix metalloproteinase-1, which is related to the skin aging phenotype. The expression of loricrin and involucrin, major components of the epidermal skin barrier, also increased after the use of the device. Multi-energy-based device is effective for skin rejuvenation and tolerable, without any considerable adverse effects.

The efficacy of intradermal hyaluronic acid filler as a skin quality booster: A prospective, single-center, single-arm pilot study.

BACKGROUND: The use of "skin boosters" comprised of hyaluronic acid (HA)-based fillers to improve skin quality has gained popularity recently, especially in individuals interested in skin rejuvenation. AIM: This study aimed to evaluate the efficacy and safety of intradermal micropuncture injections of HA-based gel filler combined with lidocaine (BYRYZN® SKINBOOSTER HA, ACROSS Co., Ltd., Gangwon-do, Korea). PATIENTS/METHODS: A prospective, single-arm, open-label pilot study was conducted with study subjects who were aged between 30 and 60 years old and exhibited evidence of skin aging, such as wrinkles and loss of elasticity. They received three injections at 2-week intervals and were followed up for a total of 12 weeks. RESULTS: Twenty subjects with a mean age of 54.1 years were included. The mean Lemperle wrinkle scale demonstrated a 40% decrease from 2.60 ± 0.60 at baseline to 1.55 ± 0.51 at week 8. The improvement rate was maintained at about 33% until week 12. The average maximum height of the wrinkle (Rz, µm), average skin roughness (Ra, µm), skin elasticity (R2, AU), facial curved length (mm), skin pore size (mm2 ), skin hydration (AU), TEWL (g/hm2 ), and skin glossiness (gloss value, AU) exhibited statistically significant improvements over time compared with the baseline measurements. No serious adverse effects or persistent adverse effects were reported, except for a transient subcutaneous nodule in one subject. CONCLUSIONS: This study demonstrates that multiple microinjections of HA-based gel filler for facial skin aging are safe and effective in improving facial skin quality.

Enhancing Security of Web-Based IoT Services via XSS Vulnerability Detection.

The Internet of Things (IoT) technology is experiencing significant growth and integration into various aspects of daily life. With the rising number of connected devices, diverse security challenges are emerging as substantial threats to IoT. Cross-Site Scripting (XSS) is one of the major security risks in web services and so is within the application layer of IoT. Many existing web applications remain susceptible to XSS vulnerabilities. In this paper, we propose an XSS detection scheme aimed at enhancing the security of IoT, particularly concerning web application services. To achieve this, we developed a framework for combining symbolic execution and dynamic taint analysis to provide a comprehensive security assessment. Our objective is to increase the ratio of vulnerability detection while avoiding false alarms and keeping the required analysis time as minimal. To realize our idea, we have defined an instrumentation scheme for taint analysis and concolic executions and automated the process of vulnerability detection for a web application. Our framework is capable of pinpointing the precise locations of security vulnerabilities and the exact input datasets at risk of XSS threats. Subsequently, the detected flaws can be easily removed. The experimental results demonstrate the validity of the proposed scheme. We achieved a detection rate of XSS threats of 90.62% using a test set of SecuriBench Micro and 69.11% using OWASP while showing 0% false positives.

Combination of Fractional Microneedling Radiofrequency and Ablative Fractional Laser versus Ablative Fractional Laser Alone for Acne and Acne Scars.

PURPOSE: Fractional microneedle radiofrequency (FMR) systems are used to treat inflammatory acne and scarring. Nonetheless, few controlled studies have combined this treatment with the traditional ablative fractional laser (AFL). We aimed to assess the safety and efficacy of the combination of FMR and AFL versus AFL alone in treating acne and acne scars. MATERIALS AND METHODS: In this 20-week, randomized, split-face study, 23 Korean patients with facial acne and acne scars underwent FMR and AFL treatments. One half of each patient's face was randomly assigned to receive FMR+AFL, whereas the other half received AFL alone. Treatments were administered in three consecutive sessions at 4-week intervals. This study investigated the severity of inflammatory acne, acne scars, individual lesion counts, depressed scar volumes, as well as patient and physician satisfaction. In addition, five patients underwent skin biopsy, and sebum output was measured. RESULTS: The FMR+AFL treatment demonstrated superior efficacy compared to AFL alone in terms of inflammatory acne and acne scar grading, lesion counts, and subjective satisfaction. The side effects were minimal and well-tolerated in both groups. Immunohistochemical findings from skin biopsy samples revealed that the application of FMR+AFL could induce an inhibitory effect on sebum secretion at the molecular level. CONCLUSION: FMR combined with AFL is a well-tolerated and effective treatment modality for inflammatory acne and acne scarring.

Augmented Decision-Making in wound Care: Evaluating the clinical utility of a Deep-Learning model for pressure injury staging.

BACKGROUND: Precise categorization of pressure injury (PI) stages is critical in determining the appropriate treatment for wound care. However, the expertise necessary for PI staging is frequently unavailable in residential care settings. OBJECTIVE: This study aimed to develop a convolutional neural network (CNN) model for classifying PIs and investigate whether its implementation can allow physicians to make better decisions for PI staging. METHODS: Using 3,098 clinical images (2,614 and 484 from internal and external datasets, respectively), a CNN was trained and validated to classify PIs and other related dermatoses. A two-part survey was conducted with 24 dermatology residents, ward nurses, and medical students to determine whether the implementation of the CNN improved initial PI classification decisions. RESULTS: The top-1 accuracy of the model was 0.793 (95% confidence interval [CI], 0.778-0.808) and 0.717 (95% CI, 0.676-0.758) over the internal and external testing sets, respectively. The accuracy of PI staging among participants was 0.501 (95% CI, 0.487-0.515) in Part I, improving by 17.1% to 0.672 (95% CI, 0.660-0.684) in Part II. Furthermore, the concordance between participants increased significantly with the use of the CNN model, with Fleiss' κ of 0.414 (95% CI, 0.410-0.417) and 0.641 (95% CI, 0.638-0.644) in Parts I and II, respectively. CONCLUSIONS: The proposed CNN model can help classify PIs and relevant dermatoses. In addition, augmented decision-making can improve consultation accuracy while ensuring concordance between the clinical decisions made by a diverse group of health professionals.

Cutaneous neurogenic inflammation mediated by TRPV1-NGF-TRKA pathway activation in rosacea is exacerbated by the presence of Demodex mites.

BACKGROUND: Rosacea is a common chronic inflammatory skin condition that is often refractory to treatment, with frequent relapses. Alterations in the skin immunological response and Demodex mite infestation are the primary aetiologic factors targeted for treatment. Transient receptor potential cation channel subfamily V member 1 (TRPV1) is a nociceptive cation channel that plays a role in cutaneous neurogenic pain and can be activated by various rosacea triggers. OBJECTIVES: We investigated the effects of TRPV1 modulation in rosacea, focussing on Demodex mite colonization and cutaneous neurogenic inflammation. METHODS: We examined mRNA expression levels according to Demodex population counts. An in vitro study using capsazepine as a TRPV1 antagonist was performed to assess the influence of TRPV1 in keratinocytes. A rosacea-like mouse model was generated by the injection of the 37-amino acid C-terminal cathelicidin peptide (LL37), and changes in the skin, dorsal root ganglion (DRG) and ears were examined. RESULTS: Increased Demodex mite population counts were associated with increased expression levels of TRPV1, tropomyosin receptor kinase A (TrkA) and nerve growth factor (NGF), and these levels could be reduced by capsazepine treatment in keratinocytes. In an in vivo study, the downstream effects of TRPV1 activation were investigated in the skin, DRG and ears of the rosacea-like mouse model. CONCLUSIONS: The findings of this study are instrumental for understanding the underlying causes of rosacea and could potentially lead to the development of new treatments targeting the NGF-TrkA-TRPV1 pathway. The identification of this pathway as a therapeutic target could represent a major breakthrough for rosacea research, potentially resulting in more effective and targeted rosacea treatments. This study contributes to an improved understanding of rosacea pathophysiology, which may lead to the development of more effective treatments in the future.

Predicting the severity of postoperative scars using artificial intelligence based on images and clinical data.

Evaluation of scar severity is crucial for determining proper treatment modalities; however, there is no gold standard for assessing scars. This study aimed to develop and evaluate an artificial intelligence model using images and clinical data to predict the severity of postoperative scars. Deep neural network models were trained and validated using images and clinical data from 1283 patients (main dataset: 1043; external dataset: 240) with post-thyroidectomy scars. Additionally, the performance of the model was tested against 16 dermatologists. In the internal test set, the area under the receiver operating characteristic curve (ROC-AUC) of the image-based model was 0.931 (95% confidence interval 0.910‒0.949), which increased to 0.938 (0.916‒0.955) when combined with clinical data. In the external test set, the ROC-AUC of the image-based and combined prediction models were 0.896 (0.874‒0.916) and 0.912 (0.892‒0.932), respectively. In addition, the performance of the tested algorithm with images from the internal test set was comparable with that of 16 dermatologists. This study revealed that a deep neural network model derived from image and clinical data could predict the severity of postoperative scars. The proposed model may be utilized in clinical practice for scar management, especially for determining severity and treatment initiation.

Age-related changes in scalp biophysical parameters: A comparative analysis of the 20s and 50s age groups.

BACKGROUND: Age-related changes in scalp parameters affect hair quality and scalp condition. However, detailed data on biophysical parameters of the scalp across age groups remain scarce. We aimed to investigate the differences in scalp parameters between individuals in their 20s and 50s and analyze their sex-specific variations. MATERIALS AND METHODS: Two hundred participants (160 women and 40 men) were equally divided into 20s and 50s age groups. Biophysical parameters of the scalp, including elasticity, pH, trans-epidermal water loss (TEWL), sebum production, desquamation, firmness, redness, and yellowness, were measured in the vertex, occipital, and temporal regions. Hair density and thickness were measured in the temporal region. The accumulation of advanced glycation end products (AGEs) in the skin was noninvasively measured in a subset of 60 women. RESULTS: Skin firmness and redness increased with age in women, whereas yellowness increased with age in both sexes. Sebum production and pH levels were significantly lower in the 50s age group than in the 20s age group, particularly in women. TEWL was lower in men in their 50s than in those in their 20s, particularly in the occipital region. A significant reduction in hair density was observed in the 50s age group in both sexes. AGE accumulation in the skin increased with age and was correlated with scalp skin yellowness. CONCLUSION: Age-related changes in scalp parameters have important implications for hair health and scalp condition. These findings emphasize the importance of considering age and sex when developing hair care strategies.

Biomechanical effects of fatigue on lower-body extremities during a maximum effort kettlebell swing protocol.

Kettlebell training provides multiple health benefits, including the generation of power. The primary purpose of this study was to examine the kinematics and kinetics of lower-body joints during a repeated, maximum effort kettlebell swing protocol. Sixteen resistance and kettlebell swing experienced males performed 10 rounds of a kettlebell swing routine (where one round equates to 30s of swings followed by 30s of rest). Kinematic (i.e., swing duration and angular velocities) and kinetic (i.e., normalised sagittal plane ground reaction force, resultant joint moment [RJM] and power) variables were extracted for the early portion and late portion of the round. Average swing duration and the magnitude of normalised ground reaction forces (GRF) increased within rounds, while hip joint power decreased. Changes in swing duration were minimal, but consistent due to an increase in overall fatigue. An increase in the magnitude of GRF was observed at the end of rounds, which is a potential concern for injury. Hip joint power decreased primarily due to a slower angular velocity. This protocol may be an effective routine for those who are resistance trained with kettlebell swing experience, and who want to optimise power in their exercise program.

Efficacy and safety of silymarin containing antioxidant serum as an adjuvant treatment of mild-to-moderate acne vulgaris: A prospective, open-label pilot study.

BACKGROUND: Silymarin is the active component of milk thistle, which has antioxidant properties by scavenging free radicals and potential comedolytic properties. AIMS: This study aimed to assess the efficacy and safety of 0.5% silymarin-loaded antioxidant serum (SAS) used to treat mild-to-moderate acne. PATIENTS AND METHODS: A prospective, open-label pilot study was conducted. We enrolled 22 Korean acne patients who applied the 0.5% SAS on the whole face twice daily while continuing the current anti-acne medications. Grade of acne severity, individual lesion counts, sebum output levels, skin erythema, and melanin pigmentation were assessed. RESULTS: After a 4-week application, the modified Global Acne Grading Score (mGAGS), Global Evaluation Acne (GEA) scale, and the acne lesion counts were significantly decreased. Sebum secretion, skin pigmentation, and erythema were also reduced during the study period, yet only the melanin pigmentation index reached statistical significance. Subgroup analysis revealed that the patients who took the low-dose oral isotretinoin during the study period showed more noticeable improvements in skin sebum output and melanin pigmentation. Additionally, no adverse event was associated with using the 0.5% SAS. CONCLUSION: The 0.5% silymarin-containing antioxidant formulation improved acne's clinical severity and related skin biophysical parameters.

Oral Supplementation of Low-Molecular-Weight Collagen Peptides Reduces Skin Wrinkles and Improves Biophysical Properties of Skin: A Randomized, Double-Blinded, Placebo-Controlled Study.

Orally administered collagen peptides could contribute to antiaging by replacing the degraded extracellular matrix proteins caused by photoaging. This study aimed to evaluate the efficacy and safety of low-molecular-weight collagen peptides for treating photoaged and dry skin. In this randomized, placebo-controlled, parallel-group, double-blinded trial, we randomly assigned study participants (n = 100) to either the test product group or placebo group at a 1:1 ratio for 12 weeks. The wrinkle scale score, eye wrinkle volume, roughness parameters, such as the average maximum height of the wrinkle (Rz), arithmetic average within the total measuring length of the wrinkle (Ra), maximum profile valley depth of the wrinkle (Rv), and skin hydration, transepidermal water loss (TEWL), overall elasticity (R2), and ratio of elastic recovery to total deformation (R7) were evaluated at baseline, 6 weeks, and 12 weeks. Safety assessments with serial blood tests were also conducted. Efficacy assessments of data from 84 participants were conducted as the per-protocol analysis. After 12 weeks, the 10-grade crow's feet photo scale score, eye wrinkle volume, skin roughness parameters (Rz, Ra, and Rv), skin elasticity (R2 and R7), skin hydration, and TEWL were significantly improved in the test product group compared to the placebo group. There were no adverse events or abnormalities according to laboratory analysis associated with using the test material during the study period. This study showed that the oral supplementation of low-molecular-weight collagen peptides could improve the wrinkles, elasticity, hydration, and barrier integrity of photoaged facial skin. This clinical study was registered with the Korean Clinical Research Information Service and International Clinical Trials Registry Platform (No: KCT0006500).

Combined use of energy-based interventions with low-dose isotretinoin for the treatment of inflammatory acne: An retrospective cohort analysis.

BACKGROUND: The combined use of oral isotretinoin with energy-based interventions including fractional microneedle radiofrequency, pulsed dye laser, and ablative fractional laser is an effective way to treat moderate-to-severe inflammatory acne lesions. However, studies regarding its efficacy and safety are limited. AIMS: This study aimed to assess the efficacy and safety of a treatment using low-dose isotretinoin with energy-based interventions for inflammatory acne. PATIENTS AND METHODS: This retrospective cohort study included 126 patients who were diagnosed with inflammatory acne and were treated with systemic isotretinoin for at least 3 months. Patients were divided into EBD (energy-based intervention) (n = 82) and non-EBD groups (n = 44). Clinical outcomes of both groups were assessed using medical records and digital photographs. RESULTS: After treatment, the modified Global Acne Grading Score of the EBD and non-EBD groups decreased by 35.1 ± 17.2 and 25.6 ± 10.1, respectively. The improvement in acne severity was significantly greater in the EBD group than in the non-EBD group. Cumulated isotretinoin dose and frequency of drug-related side effects were significantly higher in the non-EBD group than in the EBD group. CONCLUSION: Combined treatment with low-dose isotretinoin and energy-based intervention is well tolerated and associated with positive responses in patients with inflammatory acne.

Association between Gastrointestinal Diseases and Migraine.

Migraine is a common disease worldwide, and recent studies showed that the incidence of migraine was increased in patients with gastrointestinal (GI) diseases. In addition, preclinical evidence suggested a bidirectional relationship between the GI nervous system and the central nervous system called the gut−brain axis. This study aimed to determine the association between several high-prevalence GI diseases and migraine. Patients diagnosed with migraine or GI diseases were classified as the patient group at least twice a year. We included peptic ulcer disease, dyspepsia, inflammatory bowel disease, irritable bowel syndrome, and gastroesophageal disease as GI diseases. A total of 781,115 patients from the HIRA dataset were included in the study. The prevalence of migraine was about 3.5 times higher in patients with one or more GI diseases after adjusting for age, gender, and insurance type (adjusted odds ratio (ORadj = 3.46, 95% CI: 3.30−3.63, p < 0.001). In addition, the prevalence of migraine was increased as the number of comorbid GI diseases increased. The prevalence of GI disease was also higher in patients with medication for migraine, both preventive and acute treatment, compared to patients with either acute preventive or acute treatment. There was a statistically significant association between the prevalence of GI diseases and migraine, and the higher the number of accompanying GI diseases, the higher the correlation was in patients using both preventive and acute treatment drugs for migraine.

Treatment of Human Immunodeficiency Virus-Associated Facial Lipoatrophy With Hyaluronic Acid Filler Mixed With Micronized Cross-Linked Acellular Dermal Matrix.

BACKGROUND: Human immunodeficiency virus (HIV)-associated facial lipoatrophy (FLA) is a stigmatizing side effect associated with the use of highly active antiretroviral therapy. We sought to evaluate the safety and efficacy of the hyaluronic acid filler mixed with micronized cross-linked acellular dermal matrix (HA/MADM) in HIV-associated FLA. METHODS: We conducted an open-label safety and efficacy study in patients with HIV-associated FLA. Fourteen patients received single injection of the HA/MADM, and 13 patients completed the 24-week follow-up evaluation. Treatment efficacy, safety, and patient and physician satisfaction were evaluated. Repeated measure analysis of variance with post-hoc analysis with the Wilcoxon signed rank test was performed to compare and incorporate parameters at each time point. RESULTS: All 13 patients maintained a significant improvement of the Carruthers Lipoatrophy Severity Scale grade throughout the study period, along with improvement of the depressed volume due to lipoatrophy measured using a three-dimensional camera system. More than 80% of patients and physicians were satisfied with the treatment, and no treatment-related adverse events were reported, except for one case of transient subcutaneous nodule formation. CONCLUSION: Our study findings suggest that injectable HA/MADM is a potentially effective and safe treatment option for treating HIV-positive patients with FLA.

Contact hypersensitivity and Demodex mite infestation in patients with rosacea: a retrospective cohort analysis

Background: Contact hypersensitivity or Demodex mite infestation is commonly reported in patients with rosacea. However, the associations and clinical implications of these two phenomena are poorly described in the literature. Objectives: This study aimed to investigate the association between clinical characteristics, contact sensitization profiles, and Demodex mite infestation in patients with rosacea. Materials & Methods: We retrospectively reviewed 189 patients diagnosed with rosacea, and categorized the patients into a rosacea-contact hypersensitivity or rosacea-non-contact hypersensitivity group. Results: The rosaceacontact hypersensitivity group had older age (median: 45.5 vs. 37.0 years; p = 0.006), a higher frequency of itching (63.0% vs. 45.1%; p = 0.040), and a higher Demodex mite density (15.0/cm2 vs. 7.0/cm2; p = 0.002) than the rosacea-non-contact hypersensitivity group. Nickel sensitization was correlated with a higher Demodex mite density, female sex, and papulopustular subtype of rosacea. Based on the multivariate regression model, a favourable clinical outcome was correlated with nickel sensitization alone (odds ratio: 2.20, 95% confidence interval: 1.01-4.81). Conclusion: Patients with rosacea and contact hypersensitivity showed distinctive clinical features and a higher Demodex mite density. The association between nickel sensitization, Demodex mite infestation, and treatment response may reflect the role of allergen-specific TH polarization in the pathogenesis of rosacea.

Proteoglycan Combined with Hyaluronic Acid and Hydrolyzed Collagen Restores the Skin Barrier in Mild Atopic Dermatitis and Dry, Eczema-Prone Skin: A Pilot Study.

Dry and eczema-prone skin conditions such as atopic dermatitis and xerotic eczema primarily indicate an impaired skin barrier function, which leads to chronic pruritus. Here, we investigated the effects of a novel emollient containing H.ECMTM liposome, which contains a soluble proteoglycan in combination with hydrolyzed collagen and hyaluronic acid. A prospective, single-arm study was conducted on 25 participants with mild atopic dermatitis or dry skin to assess the hydration and anti-inflammatory effect of the novel emollient applied daily over four weeks. All efficacy parameters, including itching severity, transepidermal water loss, and skin hydration, improved significantly after four weeks. The in vitro and ex vivo studies confirmed the restoration of the skin's barrier function. The study revealed the clinical and laboratory efficacy of H.ECMTM liposome in reducing itching and improving the skin's barrier integrity. Thus, the use of H.ECMTM liposome can be considered a therapeutic option for dry and eczema-prone skin.

A pilot study evaluating the efficacy and safety of retinaldehyde-loaded niosomes against mild-to-moderate acne.

BACKGROUND: Retinoids are the mainstay of topical therapy for acne. To improve the efficacy and minimize the side effects of retinoids, various novel drug delivery mechanisms, including nanoparticles, have been developed. AIM: To evaluate the efficacy and safety of a retinaldehyde-loaded niosome (RA-N) nanoemulsion against sebum secretion and keratinization on mild-to-moderate acne. PATIENTS/METHODS: Twenty-three participants exhibiting mild-to-moderate acne with both closed and open comedones were included. They applied a 0.05% RA-N nanoemulsion daily for 4 weeks, did not to use any other emollient or topical pharmaceutical, and were asked to report any symptoms and treatment satisfaction. RESULTS: The participants demonstrated significantly fewer closed and open comedones after 2 and 4 weeks of treatment than at baseline (*p < 0.05). The mean sebum secretion, measured using Sebumeter®, was 327.95 ± 90.20 µg cm-2 at baseline and reduced to 282.60 ± 99.70 and 250.65 ± 97.6 µg cm-2 , respectively, after 2 and 4 weeks of treatment (*p < 0.05). The mean desquamation index, determined using Visioscan®, was 10.99 ± 1.69 at baseline and decreased to 9.81 ± 1.10 and 8.89 ± 1.32, respectively, after 2 and 4 weeks of treatment (*p < 0.05). The application of the RA-N nanoemulsion resulted in a significantly lower desquamation level, suggesting that the RA-N nanoemulsion was well-tolerated without any skin irritation. None of the participants reported a serious adverse event during this study. CONCLUSION: Our findings suggest that the RA-N nanoemulsion was effective in improving comedones in acne-prone skin and safe for long-term application. Further studies are necessary to investigate the long-term effects of the application of the RA-N nanoemulsion in participants with inflammatory acne and acne scars.

Treatment of Linear Morphea (en Coup de Sabre) with Micronized Acellular Dermal Matrix Filler: A Case Report.

En coup de sabre variant of linear morphea (LM) is a rare sclerotic skin disorder characterized by disfiguring linear depression of the frontal or frontoparietal forehead. Current attempts for cosmetic correction of atrophic lesions must be preceded by an evaluation of disease activity of LM, either by a sufficient clinical assessment or histologic evidence. Corrective procedures including corrective surgery, autologous fat grafting, hyaluronic acid filler injections were performed with varying degrees of success; still, there is a need for treatment options with non-invasive and long-term maintenance effects. Herein we report the use of micronized acellular dermal matrix filler as a novel and successful treatment for the atrophic defect of LM in a 24-year-old female. Molecular characteristics of the micronized acellular dermal matrix filler give enhanced durability and prolonged volume consistency, which results in a long-term extracellular matrix remodeling effect.

Synergistic Effect of 300 µm Needle-Depth Fractional Microneedling Radiofrequency on the Treatment of Senescence-Induced Aging Hyperpigmentation of the Skin.

Aging-associated dermatological pigmentary diseases are associated with accumulation of senescence cells and the disruption of basement membrane due to chronic ultraviolet radiation (UVR) exposure. Our study is on the synergistic effect of the novel 300 µm needle-depth fractional microneedling radiofrequency (FMR) treatment and conventional Q-switched ND:YAG laser on aging-associated hyperpigmentation of the skin. The prospective controlled clinical trial of 25 Asian women revealed significantly higher improvements not only on wrinkles, but also on hyperpigmentation. Additional ex vivo study revealed significant reduction of pro-melanogenic markers as well as senescent keratinocytes, while increased expression of collagen type IV on the epidermal basement membrane, after additional FMR treatment on UV-irradiated human tissues. These results demonstrate that 300 µm needle-depth FMR might effectively remove senescent keratinocytes that secrete pro-melanogenic markers, and repair disrupted basement membrane, therefore preventing constant hyperpigmentation of the aged skin.