Regenerative topical skincare: stem cells and exosomes.

Regenerative medicine and its offshoot, regenerative aesthetics, have been hot topics over the past 15 years. Studies with heterochronic parabiosis and others pointed to a circulating factor that could rejuvenate aging tissues. Stem cells are known to have regenerative powers, but they are difficult to extract, grow in culture or maintain.

Jowl Improvement With Injectable Fillers: Jawline Injections Alone Versus Jawline and Cheek Injections.

Background: Jowling is a common aesthetic complaint in aging individuals.

Objective: Injectable filler placed at the lateral jawline will improve the appearance of jowls, as defined by the Merz Aesthetic Jawline Grading Scale (MAJGS). This improvement will be independent of concomitant injection of filler into the lateral cheek.

The Treatment of Acne Scars, a 30-Year Journey.

Over the past 30 years, the treatment of acne scars has undergone changes that have been significantly influenced by the concurrent development of new devices. The advent of fractional resurfacing lasers was a watershed moment for acne scarring therapy. The author recounts a career history of considerations of acne scarring treatments as well as the literature supporting the experiences causing changes in practice.

Stem Cells in Dermatology and Anti-aging Care of the Skin.

Multipotent stem cells have paved the way for new applications and deeper understanding in regenerative medicine and the pathophysiology of aging. During skin aging, cumulative photodamage, exhaustion of endogenous stem cell populations, mechanical stress, and increased fibrosis lead to skin with decreased epidermal thickness and compromised dermal integrity. Specific stem cells in the hair follicle create new keratinocytes after activation by defensin peptides, released by neutrophils during wounding.

Advancing the Care of Post-Acne Scarring: Expert Insights Into New Treatment Options.

Most patients with acne have some degree of facial scarring even after their acne resolves, extending the period of psychosocial distress. Unfortunately, management of acne scars remains challenging. Many treatments for post-acne scarring including chemical peels, skin needling, laser resurfacing, surgical repair, subcision lifting, and punch elevation lifting, are limited by moderate and unpredictable results, significant morbidity, and substantial patient investments in time and money.

New Methods for the Clinical Enhancement of Photodynamic Therapy.

The prolonged incubation time of Photodynamic Therapy (PDT) as well as the need for two treatments to achieve high efficacy have motivated physicians to experiment with treatment parameters and PDT enhancements in order to maximize results and practicality. This review explores recent published strategies including occlusion, temperature elevation, pretreatment with topical 5-FU, and microneedle or laser-assisted reduction of the stratum corneum barrier. All of these innovations improve efficacy, reduce the need for multiple treatments or both, although there are concomitant increases in post-procedure side effects.

Cheek augmentation improves feelings of facial attractiveness.

Objective: Aesthetic fillers aim to rejuvenate the aging face, but the true end goal is to help patients feel better about their appearance. Cheek augmentation seems to elicit immediate recognition of an improved appearance. This study aims to quantify that impression.

Facial tightening with an advanced 4-MHz monopolar radiofrequency device.

Background: Over the past 10 years, radiofrequency (RF) technology has been utilized for nonablative treatments for the treatment of rhytides and skin laxity. This manuscript reviews the scientific background of collagen synthesis in vivo and in response to RF energy as well as a clinical study of 17 patients receiving a series of facial treatments with a 4-MHz monopolar RF (Pellevé, Ellman International, Inc, Oceanside, NY). Clinical methods, results, and a review of the literature for RF aesthetic treatments of the face are presented.

A randomized, blinded, bilateral intraindividual, vehicle-controlled trial of the use of photodynamic therapy with 5-aminolevulinic acid and blue light for the treatment of actinic keratoses of the upper extremities.

Background/objective: Actinic keratoses (AKs) on the upper extremities are difficult to treat. This study compares the efficacy and tolerability of photodynamic therapy (PDT) using 20% 5-aminolevulinic acid solution (ALA) and blue light versus ALA vehicle and blue light for the treatment of AKs of the dorsal hand and forearm.

Methods: Subjects were treated twice at an eight-week interval by ALA with blue light on one hand and forearm and with ALA vehicle and blue light on the contralateral hand and forearm.

Treatment of Acne Scars of Skin Types II to V by Sublative Fractional Bipolar Radiofrequency and Bipolar Radiofrequency Combined with Diode Laser.

Objective: This study evaluated the safety and efficacy of sublative fractional bipolar radiofrequency and bipolar radio frequency combined with diode laser for the treatment of both superficial and deep acne scars in patients with skin types II to V.

Design: Prospective, single-center study. Subjects received up to five treatments with sublative fractional bipolar radiofrequency and bipolar radiofrequency combined with diode laser.

Treatment of 2,453 acne vulgaris patients aged 12-17 years with the fixed-dose adapalene-benzoyl peroxide combination topical gel: efficacy and safety.

Acne vulgaris is a common disease in adolescents, and early treatment may minimize its physical and psychological effects. A fixed-dose combination gel of adapalene 0.1% and benzoyl peroxide 2.

Effect of multisyringe hyaluronic acid facial rejuvenation on perceived age.

Background: The objective of aesthetic treatments is to create a more youthful appearance. Most injectable fillers are indicated for the reduction of nasolabial folds, but the current aesthetic movement is toward volume replacement in multiple areas, known as global fillers or liquid face-lift.

Objectives: To quantify the degree of perceived age reduction from multisyringe hyaluronic acid treatment.

Sublative rejuvenation: experience with a new fractional radiofrequency system for skin rejuvenation and repair.

Several laser-based ablative resurfacing and nonablative rejuvenation technologies offer non-surgical options for improving the appearance of the skin. Although efficacy and good safety profiles have been demonstrated, limitations do exist with these systems. A more recent technology has been developed that employs fractionated bipolar radiofrequency (RF) energy.

Skin rejuvenation and wrinkle reduction using a fractional radiofrequency system.

Introduction: Skin resurfacing has evolved rapidly over the past 15 years from ablative techniques to nonablative methods and most recently fractional ablative resurfacing. The purposes of this study were to analyze the degree of tissue ablation, coagulation, and heating; and to evaluate the clinical efficacy and safety of a fractional radiofrequency (RF) device, for the treatment of wrinkles with fractional skin ablation and coagulation.

Material And Methods: Individuals scheduled for abdominoplasty received fractional RF treatment to the abdomen area, using different tips at varying energy densities and coverage rates.

Procedures offered in the medical spa environment.

Medical spas' menus of services vary widely and depend greatly on the medical director or owner's experience and predilection. Core services include: microdermabrasion, mild chemical peels, medical facials, laser hair removal, photorejuvenation, botulinum toxin, and injectable fillers. Common procedures include cellulite reduction, tissue tightening, and acne treatments.

Successful treatment of erythematotelangiectatic rosacea with pulsed light and radiofrequency.

Introduction: Many laser and light devices have reported to be successful in the treatment of the flushing, background erythema, and telangiectasias that characterize erythematotelangiectatic rosacea including pulsed dye laser, potassium titanyl phosphate, intense pulsed light, and dual-wavelength lasers. A technology called ELOS (electro-optical synergy) combines pulsed light or laser with bipolar radiofrequency. This combination, developed in 2000, was based on the premise that these two forms of energy could be synergistic.

Fractionated delivery systems for difficult to treat clinical applications: acne scarring, melasma, atrophic scarring, striae distensae, and deep rhytides.

Fractional resurfacing or laser therapy (FLT) represents a technology that seeks to address the limitations of both ablative resurfacing and nonablative treatments. Many companies now offer versions of fractionated erbium or carbon dioxide lasers. The purpose of this paper is to examine FLT for difficult to treat applications such as melasma, acne scarring, atrophic scarring, striae distensae, and deep rhytides.

A comparison of intense pulsed light, combination radiofrequency and intense pulsed light, and blue light in photodynamic therapy for acne vulgaris.

Background: Photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) is an emerging modality for the treatment of acne vulgaris. However, optimal therapeutic protocols have not been established.

Objectives: To compare the efficacies of 3 different light sources for activating ALA-induced protoporphyrin IX for the treatment of acne vulgaris.

Procedural treatments for acne vulgaris.

Background: Simple procedural treatments such as comedone extraction and intralesional steroids have been utilized for many years as adjunctive therapy for acne. In the past 5 years, new technologies and procedures have become available that present new options for the treatment of acne.

Objectives: The objective was to review, summarize, and evaluate the key studies of procedural therapies for the treatment of acne as well as place them in perspective with current clinical practice.

Photodynamic therapy: other uses.

Mainstream uses for photodynamic therapy (PDT) in dermatology include nonmelanoma skin cancer and its precursors, acne vulgaris, photorejuvenation, and hidradenitis suppurativa. Many other dermatologic entities have been treated with PDT, including psoriasis, lichen planus, lichen sclerosus, scleroderma, cutaneous T cell lymphoma, alopecia areata, verruca vulgaris, Darier's disease and tinea infections. Nondermatologic applications include anal and vulva carcinoma, palliation of metastatic breast cancer to skin, Barrett's esophagus, and macular degeneration of the retina.

Multicenter clinical perspectives on a broadband infrared light device for skin tightening.

Modalities for skin tightening include radiofrequency (RF) energy, lasers, and combination RF and diode lasers. A new broadband infrared light device (BILD) (Titan, Cutera, Inc, Brisbane, CA) targets water to achieve dermal heating and collagen remodeling for skin tightening. Although thousands of procedures have been performed worldwide with this device, only one article (to the author's knowledge) describing its performance in skin tightening has been published.

Evaluation of a nonsurgical, muscle-stimulating system to elevate soft tissues of the face and neck.

Non-invasive procedures for tissue tightening and elevation are new frontiers in dermasurgery. Current methods for achieving a "nonsurgical face-lift" include radiofrequency and infrared light devices which disrupt non-covalent collagen bonds and stimulate collagen production. This study evaluated a novel treatment protocol designed to achieve a nonsurgical face-lift with electrical stimulation of muscle.