Efficacy of fractional radiofrequency in the treatment of erythematous capillary rosacea: A split-face study.

OBJECTIVE: To assess the effectiveness and safety of treating erythematotelangiectatic rosacea using fractional radiofrequency (FRF). METHODS: Twenty patients with a confirmed diagnosis of erythema capillaris rosacea were selected, and one side of each patient's face was randomly assigned to receive FRF treatments for three to six times, with an interval of 2 weeks between each treatment. VISIA, dermoscopy, and the Clinician's Erythema Evaluation Scale (CEA) were applied to evaluate the efficacy of the treatment before and after the treatment, to record the VAS scores and adverse reactions, and to conduct a patient satisfaction survey. RESULTS: The characteristic counts and scores of red zone and porphyrin as assessed by VISIA test were significantly decreased, and the difference between the treated side and the pretreatment side was statistically significant (p < 0.05), and the efficacy of the treatment was statistically insignificant compared with the control side, except for the red zone and porphyrin which were statistically significant before and after the treatment (p > 0.05). By CEA score, the difference between the treated side after treatment and the control side was statistically significant (p < 0.05), and the difference between the treated side before and after treatment was statistically significant (p < 0.05); the difference between the control side before and after treatment was not statistically significant (p > 0.05). Dermatoscopic observation showed reduction in pore size, reduction of yellowish-white and black horn plugs within the pores, lightening of the red background and thinning and blurring of the capillary structure on the treated side of the skin compared to the control side, and the skin on the treated side showed the above mentioned changes before and after the treatment as well. The mean pain score of the subjects was obtained by VAS score 3.67 ± 0.90. Adverse effects included mild edema, erythema, and microscopic crusting; no long-term adverse effects were seen in all patients. The efficacy of FRF treatment was evaluated 1 month after the final treatment, and 85% of the subjects rated it as satisfactory, very satisfactory, and very satisfactory. CONCLUSION: FRF for the treatment of erythematous capillary dilatation rosacea is effective, safe, and suitable for clinical promotion.

The efficacy and safety of neubotulinumtoxinA for the treatment of forehead horizontal lines in Asians - A clinical, prospective, interventional, split-face study.

BACKGROUND: Botulinum toxin injections are widely sought after in the field of medical aesthetics, offering consumers a variety of brand choices. Two commonly available botulinum toxin products, onabotulinumtoxinA and neubotulinumtoxinA, are featured in numerous clinics, leading many to question whether there are discernible differences in results, given their varying price ranges. OBJECTIVE: To evaluate the efficacy and safety of neubotulinumtoxinA for the treatment of forehead horizontal lines. METHODS: A 12-week prospective, single-centre, interventional split-face study was conducted, including 30 subjects. These enrolled subjects received a single treatment session, with neubotulinumtoxinA applied to the left side of the forehead and onabotulinumtoxinA to the right side. A superficial injection was performed in all individuals, where the product was injected subdermally in the frontalis muscle. Evaluation was conducted at baseline, 7 days, 14, days and 4, 8, and 12 weeks after treatment, both when the eyebrows were at maximum lift and in a resting position. Treatment efficacy was assessed by two physicians and self-assessed by the patients, using the Fitzpatrick Wrinkle Classification system. Adverse events were documented to evaluate safety. RESULTS: The study found no statistically significant difference in the efficacy of neubotulinum and onabotulinum for treating forehead wrinkles, as indicated by p-values above 0.05 for both static and dynamic conditions. No safety and adverse events were observed in both formulations. CONCLUSION: This study has demonstrated that neither formulation is inferior to each other in the treatment of forehead horizontal lines.

A Prospective Randomized Controlled Pilot Study to Assess the Response and Tolerability of Cold Atmospheric Plasma for Rosacea.

INTRODUCTION: Rosacea is a common, facial, chronic inflammatory skin disease. Due to its complex pathogenesis, adequate therapy of rosacea can be challenging. An innovative recent therapeutic tool is cold atmospheric plasma (CAP), which is already established in the treatment of chronic wounds and promising in different other skin diseases. METHODS: In a split-face pilot study we investigated dielectric-barrier-discharged CAP in erythemato-telangiectatic (ETR) and/or papulopustular rosacea (PPR). CAP treatment was applied on lesional skin of a randomized side once daily (90 s/area) for 6 weeks. The other untreated side served as control. Co-primary endpoints were ≥1 improvement of the Investigator Global Assessment (IGA) score on the treated side compared to control and a decline of the Dermatology Life Quality Index (DLQI) after 6 weeks. Secondary endpoints included inflammatory lesion count (papules and pustules), skin redness intensity and erythema size. Adverse events (AEs) were recorded constantly. Additionally, participants were weekly assessed for symptoms, skin condition, trigger factors, skin care, treatment success, and local tolerance parameters. All p values were calculated using the Wilcoxon signed-rank test. RESULTS: Twelve subjects (ETR, n = 3; ETR and PPR, n = 9) completed the study. DLQI was significantly improved after 6 weeks (p = 0.007). On the CAP-treated side, lesions (p = 0.007) and erythema size (p = 0.041) were significantly reduced compared to the control. IGA (p = 0.2) and skin redness intensity (p = 0.5) did not differ significantly between control and CAP-treated side. No serious AEs occurred and treatment was well tolerated. CONCLUSION: CAP is a promising new treatment of rosacea, especially for PPR.

Microneedle-mediated intradermal injection with hyaluronic acid for the treatment of sensitive skin: a split-face study / 中华皮肤科杂志

Objective@#To evaluate clinical efficacy and safety of microneedle-mediated intradermal injection with hyaluronic acid for the treatment of sensitive skin.@*Methods@#A total of 53 female patients aged 21-54 years and diagnosed with sensitive skin were enrolled from Department of Cosmetic Dermatology, Dermatology Hospital of Southern Medical University from January to June in 2018, and were divided into 3 groups by using a random number generator and a residue-based method: high-pressure jet injection group (n = 23) receiving high-pressure jet injection with hyaluronic acid on the right side of the face (treatment side) and high-pressure jet injection with 0.9% sodium chloride solution on the left side of the face (control side) once every 2 weeks, microneedle injection group (n = 15) receiving microneedle-mediated injection with hyaluronic acid on the right side of the face (treatment side) and microneedle-mediated injection with 0.9% sodium chloride solution on the left side of the face (control side) once every 4 weeks, combination group (n = 15) receiving microneedle-mediated injection with hyaluronic acid on the right side of the face (treatment side) and high-pressure jet injection with hyaluronic acid on the left side of the face (control side) once every 4 weeks. All the patients in the above 3 groups received 4 consecutive sessions of treatment. Before the initial treatment and 2 weeks after the final treatment, erythema and skin pore scores were determined on the right and left sides of the face by using VISIA facial imaging system, lactic acid stinging test was performed, and skin sensitivity including severity of itching, dryness, erythema and scaling was evaluated. Two weeks after the final treatment, the overall improvement was evaluated with the Global Aesthetic Improvement Scale (GAIS) by clinicians and patients. Adverse reactions were recorded during and after treatment. Statistical analysis was carried out by using paired t test, Wilcoxon sign rank sum test and chi-square test.@*Results@#Two weeks after the final treatment, the improvement of skin pore score in the treatment side was superior to that in the control side in the high-pressure jet injection group (t = 2.19, P = 0.03) , while no significant difference in the improvement of erythema score was observed between the treatment side and control side (t = 1.10, P = 0.27) ; in the microneedle injection group, the improvement of erythema and skin pore scores was greater in the treatment side than in the control side (t = 2.47, 3.02, both P = 0.01) ; in the combination group, the VISIA erythema score in the treatment and control sides was 0.59 ± 0.25 and 0.85 ± 0.31 respectively, the improvement of erythema score in the treatment side was superior to that in the control side (t = 5.02, P < 0.01) , while there was no significant difference in the improvement of skin pore score between the treatment side and control side (P > 0.05) . Two weeks after the final treatment, the severity of itching, dryness and scaling was significantly improved in both the treatment and control sides in the 3 groups compared with those before the initial treatment (P < 0.05) , while the severity of erythema was significantly improved only in the treatment side in the microneedle injection group and combination group when compared with that before the initial treatment (Z = -2.236, -2.887, respectively, both P < 0.05) . Moreover, both the microneedle injection group and combination group showed significantly decreased severity of erythema in the treatment side compared with that in the control side two weeks after the final treatment (Z = -2.646, -2.887, respectively, both P < 0.05) . Two weeks after the final treatment, the positive rate of the lactic acid stinging test significantly decreased in the treatment side compared with that before the initial treatment in the microneedle injection group (χ2 = 4.821, P = 0.028) , but showed no significant changes in the other groups (all P > 0.05) . No severe adverse reactions were observed during or after the treatment.@*Conclusion@#Microneedle intradermal injection with hyaluronic acid can effectively and safely improve erythema, skin pore and sensitive symptoms in patients with sensitive skin.

Microneedle-mediated intradermal injection with hyaluronic acid for the treatment of sensitive skin: a split-face study / 中华皮肤科杂志

Objective To evaluate clinical efficacy and safety of microneedle-mediated intradermal injection with hyaluronic acid for the treatment of sensitive skin.Methods A total of 53 female patients aged 21-54 years and diagnosed with sensitive skin were enrolled from Department of Cosmetic Dermatology,Dermatology Hospital of Southern Medical University from January to June in 2018,and were divided into 3 groups by using a random number generator and a residue-based method:high-pressure jet injection group (n =23) receiving high-pressure jet injection with hyaluronic acid on the right side of the face (treatment side) and high-pressure jet injection with 0.9％ sodium chloride solution on the left side of the face (control side) once every 2 weeks,microneedle injection group (n =15) receiving microneedle-mediated injection with hyaluronic acid on the right side of the face (treatment side)and microneedle-mediated injection with 0.9％ sodium chloride solution on the left side of the face (control side) once every 4 weeks,combination group (n =15) receiving microneedle-mediated injection with hyaluronic acid on the right side of the face (treatment side) and high-pressure jet injection with hyaluronic acid on the left side of the face (control side) once every 4 weeks.All the patients in the above 3 groups received 4 consecutive sessions of treatment.Before the initial treatment and 2 weeks after the final treatment,erythema and skin pore scores were determined on the right and left sides of the face by using VISIA facial imaging system,lactic acid stinging test was performed,and skin sensitivity including severity of itching,dryness,erythema and scaling was evaluated.Two weeks after the final treatment,the overall improvement was evaluated with the Global Aesthetic Improvement Scale (GAIS)by clinicians and patients.Adverse reactions were recorded during and after treatment.Statistical analysis was carried out by using paired t test,Wilcoxon sign rank sum test and chi-square test.Results Two weeks after the final treatment,the improvement of skin pore score in the treatment side was superior to that in the control side in the high-pressure jet injection group (t =2.19,P =0.03),while no significant difference in the improvement of erythema score was observed between the treatment side and control side (t =1.10,P =0.27);in the microneedle injection group,the improvement of erythema and skin pore scores was greater in the treatment side than in the control side (t =2.47,3.02,both P =0.01);in the combination group,the VISIA erythema score in the treatment and control sides was 0.59 ± 0.25 and 0.85 ± 0.31 respectively,the improvement of erythema score in the treatment side was superior to that in the control side (t =5.02,P ＜ 0.01),while there was no significant difference in the improvement of skin pore score between the treatment side and control side (P ＞ 0.05).Two weeks after the final treatment,the severity of itching,dryness and scaling was significantly improved in both the treatment and control sides in the 3 groups compared with those before the initial treatment (P ＜ 0.05),while the severity of erythema was significantly improved only in the treatment side in the microneedle injection group and combination group when compared with that before the initial treatment (Z =-2.236,-2.887,respectively,both P ＜ 0.05).Moreover,both the microneedle injection group and combination group showed significantly decreased severity of erythema in the treatment side compared with that in the control side two weeks after the final treatment (Z =-2.646,-2.887,respectively,both P ＜ 0.05).Two weeks after the final treatment,the positive rate of the lactic acid stinging test significantly decreased in the treatment side compared with that before the initial treatment in the microneedle injection group (x2 =4.821,P =0.028),but showed no significant changes in the other groups (all P ＞ 0.05).No severe adverse reactions were observed during or after the treatment.Conclusion Microneedle intradermal injection with hyaluronic acid can effectively and safely improve erythema,skin pore and sensitive symptoms in patients with sensitive skin.

Depositing α-mangostin nanoparticles to sebaceous gland area for acne treatment.

Although entrapment of nanoparticles of appropriate sizes at hair follicles has been clarified, there is no report on specific clinical application of this finding. Since sebaceous gland is associated with hair follicle, we hypothesize that effective acne vulgaris treatment/prevention can be achieved by depositing anti-acne agent in nanoparticle form at the hair follicles. Challenge of this strategy, however, lies at the finding of effective anti-acne particles with minimal skin irritation. Here using cellulose-based nanoparticles as nano-reservoir and α-mangostin (an active component isolated from the edible Garcinia mangostana Linn. fruit) as anti-acne agent, we prepare nanoparticles highly loaded with α-mangostin. Ability of the obtained particles to sustained release α-mangostin into synthetic sebum is demonstrated. The obtained mangostin particles are verified for their insignificant skin irritation through the two-week, twice-daily open application test in 20 healthy human volunteers. Excellent entrapment and sustainment of the mangostin nanoparticles at the hair follicles are elucidated in six human volunteers by detecting the presence of α-mangostin at the roots of hairs pulled from the treated skin area. The 4-week-randomized, double-blind, placebo-controlled, split-face study in 10 acne patients indicates significant improvement in acne vulgaris condition on the side twice daily applied with mangostin nanoparticles.

Treatment of enlarged pores with the quasi long-pulsed versus Q-switched 1064 nm Nd:YAG lasers: A split-face, comparative, controlled study.

BACKGROUND AND AIMS: A variety of treatment modalities have been used to reduce the size of en-larged pores. The 1064 nm Nd:YAG laser, in addition to its role in removal of tattoos and age-related dyschromia, depilation and skin rejuvenation, may also play a role in reducing the size of enlarged pores. The present split-face controlled study assessed and compared the efficacy between the quasi long-pulsed (micropulsed) and the Q-switched modes of the Nd:YAG laser in the treatment of enlarged pores. SUBJECTS AND METHODS: Twenty subjects with enlarged pores were recruited for the micropulsed vs Q-switched study, all treated with the same 1064 nm Nd:YAG laser system. Ten subjects were treated with the 300 µs micropulsed mode and the other ten subjects were treated with the 5 ns Q-switched mode. All subjects were treated on the right half of the face, the left half serving as an untreated control. Five laser sessions were performed. The pore sizes were measured using an image analysis program and the sebum level was measured with a Sebumeter(®) before and after the treatments. RESULTS: The pore size and sebum level significantly decreased with treatment on the treated side (right cheek and right half of nose) in both the micropulsed and Q-switched modes compared to the control side (p<0.05), but without any statistically significant difference between the modes. CONCLUSIONS: The micropulsed and Q-switched Nd:YAG laser treatments reduced pore size and sebum levels with more or less equal efficacy and with no adverse side effects.