Triple combination therapy of narrowband ultraviolet B, fractional carbon dioxide laser and topical bimatoprost 0.01% for non-segmental vitiligo on non-facial areas: A randomized half-body, double-blind, placebo-controlled, comparative study.

Combination therapy shows superior outcomes over monotherapy in treating vitiligo. Topical bimatoprost is a melanogenic agent effectively used to induce repigmentation. However, topical bimatoprost 0.01% has never been explored in non-facial vitiligo, and triple therapy of phototherapy, fractional laser and topical bimatoprost has never been examined. This study aims to investigate the efficacy and safety of triple-modality treatment, combining narrowband ultraviolet B (NB-UVB), fractional carbon dioxide (CO2 ) laser and topical bimatoprost 0.01% for stable non-segmental vitiligo on non-facial areas. Fifteen vitiligo patients with at least two symmetrical, comparable-sized lesions on non-facial regions were included. The paired lesions were randomized to receive a treatment regimen of twice-daily application of either bimatoprost 0.01% solution or placebo in combination with once-monthly fractional CO2 laser and twice-weekly NB-UVB therapy for 12 weeks. There were no statistically significant differences in the vitiligo surface area (VSA) and melanin concentration (MC) at baseline between treatment sides. After 12 weeks of treatment, the percentage change from baseline of MC on the triple-therapy side was significantly higher than that on the dual-therapy side, 27.17 ± 13.62% versus 22.82 ± 10.10% (p = 0.028). The change from baseline of VSA was also greater on the triple-therapy side; however, a statistically significant difference was not reached. Improvement grades of repigmentation and adverse events were similar on both sides. Triple therapy with NB-UVB, fractional CO2 laser and topical bimatoprost 0.01% tends to be safe and more effective as compared to dual therapy of NB-UVB and fractional CO2 laser in non-facial vitiligo.

Detachable dissolvable microneedles: intra-epidermal and intradermal diffusion, effect on skin surface, and application in hyperpigmentation treatment.

Delivering bioactive compounds into skin tissue has long been a challenge. Using ex vivo porcine and rat skins, here we demonstrate that a detachable dissolvable microneedle (DDMN) array, a special dissolvable microneedle that allows needle detachment from the base within 2 min post administration, can effectively embed a model compound into epidermis and dermis. Diffusion of the compound from the needle embedding sites to the nearby skin tissue is demonstrated at various post administration periods. The relationship between the time that a conventional dissolvable microneedle array is left on skin without needle detachment from the base and the degree of skin surface abrasion at each microneedle penetration spot is also demonstrated on skin of human volunteers. Co-loading glutathione with vitamin C (vitC) can stabilize vitC in the DDMN. DDMN loaded with vitC and glutathione can help erasing post-acne-hyperpigmentation spots.