Cosmetic Dermatologic Procedures Research Articles

Robotic-Assisted Procedures in Cosmetic Dermatology.

Robotic-Assisted Procedures in Cosmetic Dermatology.

What's New in Diode Laser Hair Removal?

ABSTRACTIntroductionLaser hair removal remains one of the most common procedures in cosmetic dermatology. It has always been challenging because of the higher competing epidermal melanocyte as the targeted hair chromophore is also melanin. As a result, to avoid unwanted side effects from laser therapy while maintaining high efficacy levels, the use of the right laser device, appropriate settings, and customized pre and posttreatment care are crucial. With more efficient versions of existing lasers in the market, the safety profile has been taken care of without compromising the efficacy. Diode lasers along with long pulsed Nd:YAG and alexandrite are considered as the safest hair removal lasers.ObjectiveTo summarize recent developments in diode laser hair reduction focusing on improvements in efficiency, safety, and patient compliance with recent innovations.Materials and MethodsA review of recent literature updates in diode laser hair reduction technology focusing on multiwavelength systems, safety profiles, and innovations in laser device was searched using keywords diode laser hair removal and mutliwavelength diode laser devices.ResultsCurrently, 810 nm diode laser is the most extensively used technology for the long term elimination of unwanted hair, thus establishing itself as an efficacious and safe modality. The rapid multiple pass in motion technique with lesser fluence and gradual heating of the skin epidermis was more well tolerated in patients than the higher fluence single shot method. Most popular combination of triple wavelength was 755, 810, and 1064 nm, which is considered most effective with least complications.ConclusionDiode lasers still remain the gold standard in laser hair removal especially on darker skin types. Recent innovations in diode laser have significantly improved the efficacy, safety, and patient compliance with hair reduction. Multiwavelength platforms seems to be the way forward, however the basic principles and certain problems like minimal pain, treating thin hair, paradoxical hair growth, white hair removal still remains a challenge.

Minimally Invasive Injectable Cosmetic Procedures Increase Feelings of Authenticity.

Minimally invasive cosmetic dermatology procedures continue to be increasingly popular; however, the extant literature has poorly documented the psychological antecedents of interest in cosmetic procedures and their psychological consequences. To better inform dermatologists on their patients' motivations for cosmetic enhancement. In a general population survey, an online representative sample of 984 Americans reported the extent to which they feel authentic using the validated authenticity scale and whether they were interested in undergoing a cosmetic procedure. In a prospective dermatology office survey, 102 participants reported their feelings of authenticity immediately before and 2 weeks after receiving a minimally invasive injectable cosmetic procedure. In the general population survey, participants interested in cosmetic procedures felt significantly less authentic than participants who were not interested (p = .003). In the prospective dermatology office survey, participants felt significantly more authentic 2 weeks after their minimally invasive injectable cosmetic procedure than before (p = .018). Lower feelings of authenticity are associated with interest in cosmetic procedures. Participants felt more authentic 2 weeks after receiving a minimally invasive injectable cosmetic procedure. Cosmetic procedures may present patients with an opportunity to feel more like their real, genuine selves.

Practices in Pediatric Cosmetic Dermatologic Procedures: A National Survey.

Adult populations have traditionally been the primary recipients of cosmetic treatments, but a growing trend shows an increase in such procedures among pediatric patients. The objective of the authors' study was to investigate types of procedures currently being performed by pediatric and cosmetic dermatologists and factors that may influence their choice of treatments in a pediatric population. The authors conducted an anonymous online survey targeting healthcare practitioners who frequently use lasers for pediatric cutaneous conditions. The survey collected information on participants' primary scope of practice, pediatric cosmetic procedures they performed, counseling topics, and procedural details. Of 85 survey respondents, 73 (86.00%) completed all questions. Most respondents identified as pediatric dermatologists (77.65%), followed by general dermatologists (18.82%), cosmetic dermatologists (8.24%), and dermatologic/Mohs surgeons (1.18%). Top pediatric cosmetic conditions treated included hypertrophic/traumatic scars (95.29%), acne (89.41%), axillary and facial hyperhidrosis (77.65%), hypertrichosis/hirsutism (67.06%), and pigmented lesion removal (64.71%). Commonly performed procedures were vascular lasers (77.65%), laser hair removal (50.59%), and pigmented lasers (28.24%), among others. Respondents prioritized understanding risks/benefits, clinically indicated treatment, and the natural course of the condition. As the first multisociety, national survey, these results offer valuable insight into the current landscape of pediatric cosmetic treatments from the perspective of dermatologists.

A practical classification scale for the dermatology management of individuals with skin of color: the colorimetric scale for skin of color.

A simple and rapid method that is not based on race and ethnicity for classifying people with skin of color is of paramount importance in dermatology. The currently used Fitzpatrick classification of sun-reactive skin types is inadequate. Newer scales that have been used in immigration surveys and sociology studies are not applicable in the office setting. A new, non-racial and non-ethnic, colorimetric scale for skin of color has recently been proposed that is simple to perform. The scale has five colors: very light beige (skin color type 1), light brown (skin color type 2), medium brown (skin color type 3), dark brown (skin color type 4) and very dark brown (skin color type 5); an individual with white skin, such as in albinism, would have a skin color type 0 in this classification. In conclusion, the colorimetric scale enables the rapid classification of individuals with skin of color and allows for accurate assessment of skin cancer risk, more appropriate management of cosmetic dermatologic procedures and aesthetic devices, and enhanced ability for focused counseling regarding hair products, skin care interventions, and color-targeted makeup based on the person's skin tone.

The influence of social media on public attitudes and behaviors towards cosmetic dermatologic procedures and skin care practices: A study in Saudi Arabia.

Social media has fostered a landscape where trends, ideals, and beauty standards have significantly proliferated. Images of flawless skin, sculpted features, and curated aesthetics inundate user feeds, potentially shaping their self-perceptions and aspirations. The rise of influencers, dermatologist social media engagement, and beauty campaigns sharing skincare routines and product recommendations wield substantial influence over individual appearance-related decisions. The main aim of this study is to determine the pattern of behavior in using social media to seek dermatological procedures and skin care routine. We conducted a nationwide, online cross-sectional study targeting the general Saudi population. Our survey aimed to understand participant social media behaviors and gather insights into skincare products, cosmetic procedures, and makeup habits. Gender-related differences emerged in seeking skincare advice. Females preferred dermatologists on social media (p < 0.001) and beauty influencers (p < 0.001), whereas men leaned towards pharmacists (p < 0.001). Women displayed stronger engagement with dermatologist social media reputation regarding non-cosmetic concerns (p < 0.001), education (p < 0.001), and social media impact on cosmetic decisions (p = 0.001). They frequently sought dermatologists on social media before appointments (p = 0.001), whereas men emphasized dermatologists' fame (p = 0.024). Common cosmetic barriers included high costs (62.5%), complications (40.3%), and trust issues (40.2%). Women underwent various cosmetic procedures (p < 0.05), influenced by social media in their decisions and skincare routines. Our study reveals significant gender-based disparities in seeking skincare advice. Women rely on social media, clinics, friends, and beauty influencers, whereas men prefer pharmacists. Additionally, women depend on dermatologists' social media reputation and conduct thorough pre-appointment research. Their heightened social media engagement links to skincare practices and influences cosmetic procedure considerations based on age and usage frequency.

The Differences in the Practice of Cosmetic Dermatologic Procedures Between Physicians and Nonphysicians.

With a rise in demand for cosmetic dermatologic procedures comes an increase in nonphysician providers performing such procedures. However, little is known about the practice of cosmetic procedures performed by nonphysicians. To assess the differences in the practice of cosmetic procedures provided by physicians and nonphysicians. A cross-sectional analysis was performed using participant ( n = 4,062) responses to an 18-point, web-based survey about previous cosmetic procedures. In total, 1,328 participants reported having previous cosmetic procedures done by a physician ( n = 828), a nonphysician ( n = 413), or an unknown provider ( n = 87). Respondents of all age ranges and male respondents ( p < .001) tended to choose physicians over nonphysician providers when choosing a practice. Moderate adverse events were more frequently seen when nonphysician providers completed cosmetic procedures ( p < .001). Despite a higher frequency (73.3% vs 51.8%) of more moderate complications seen in procedures done by nonphysician providers, over 70% of respondents believe that nonphysician providers are qualified enough to continue performing cosmetic procedures. People should be encouraged to make an informed decision when choosing a provider because cosmetic procedures are still considered medical procedures.

Psychiatric comorbidity and pharmacology in a cosmetic dermatology setting: A retrospective cohort study

To the Editor: Cosmetic dermatologic procedures are on the rise, and while studies have displayed links between the desire for a cosmetic procedure and psychiatric disorder, the scarce literature on the subject mostly comes from the realm of plastic surgery. 1 Shah P. Rangel L.K. Geronemus R.G. Rieder E.A. Cosmetic procedure use as a type of substance-related disorder. J Am Acad Dermatol. 2021; 84: 86-91 Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar Elucidating this relationship can help us better understand a patient's motivation for a procedure and is critical to an appropriate consultation visit.

LB959 The influence of social media on non-surgical cosmetic dermatologic procedures: A qualitative study using survey responses

The rise of social media in recent years has changed the landscape of social interaction and profoundly impacted culture– this study aims to identify its role in influencing society’s perceptions of non-surgical dermatologic procedures. We accomplished this by conducting a cross-sectional Qualtrics survey distributed via Instagram, Facebook, GroupMe, Twitter, and email. Questions addressed frequency and type of social media use, exposure to cosmetic procedures through these platforms, and their desires to seek out cosmetic procedures.

Cosmetic dermatology training perspectives during residency: A survey‐based report from Jordan

There has been an evident increase in the number of cosmetic dermatologic procedures performed by dermatologists. Those procedures vary from a simple office-based one to more complex procedures requiring general anesthesia. Therefore, it is essential to assess the adequacy of cosmetic dermatology training among dermatology residents to meet patients' expectations. We sought to assess dermatology residents' educational exposure to cosmetic dermatology and identify the practices and educational gaps of esthetic dermatology residency programs in Jordan. An online cross-sectional study targeted almost all dermatology residents in Jordan from April to June 2021. Forty-two dermatology residents completed an English online questionnaire that involved sociodemographic data, the resident's educational exposure to cosmetic dermatology, and the resident's opinion regarding the training programs. Out of the 42 participants, 16 (38.1%) were males, and 26 (61.9%) were females. More than half (54.8%) of the participants reported that cosmetic procedures were done in the department they are attending. The majority (64.3%) did not attend cosmetic training or procedures. The majority strongly agree that hands-on training is the most beneficial way of cosmetic residency training (88.1%). More than 85% believe that cosmetic dermatology training should be practical and that final-year residents should perform cosmetic procedures independently. Only 2.4% and 4.8% of the residents were very satisfied or satisfied, respectively, with the current level of cosmetic procedural training. The dermatology residents in Jordan are dissatisfied regarding the current level of cosmetic procedural training. Therefore, infrastructure must be improved; educational training quality must be improved by providing theoretical and practical education in clinics.

Balancing medical education in aesthetics: Review and debate

The demand for minimally invasive cosmetic procedures is rising, and the public and other physicians deem dermatologists as top providers of these services. Given these expectations, dermatologic residency training must equip resident physician trainees to care for the growing population of patients with aesthetic concerns. As it stands, formal hands-on cosmetic dermatology training in residency is lacking specific structure. Educational, cultural, time, and monetary barriers exist, among others, which restrict residents from attaining proficiency in cosmetic dermatology procedures prior to graduation. This may adversely impact patient safety and deter graduates from offering aesthetic procedures. The standardization of core residency competencies in minimally invasive cosmetic procedures is fundamental to guarantee patient safety and satisfaction while ensuring practitioner competence. The balance between these elements is essential for optimal patient care. We review and debate modifying and strengthening the current curriculum requirements while presenting means to overcome barriers.

Trends in cosmetic consumer preferences during COVID-19 pandemic: Comparing 2021 to 2020.

This commentary evaluates trends in the factors influencing consumer decision‐making for cosmetic dermatologic procedures during the COVID‐19 pandemic in the United States. This is a follow‐up national survey to one that was published 1 year ago. This study compares the data from Summer 2020 to early Summer 2021, which presents a stark contrast. Our results demonstrate that consumers are now more interested in cosmetic dermatologic procedures compared to 1 year prior. Additionally, they still value the overall safety of the clinic, so physicians should ensure that certain safety measures remain in place despite any decreasing rates of COVID‐19 positivity. Our survey sheds more light on current consumer perspectives, which may in turn help physicians adjust their practices to meet current demand. It is important for physicians to be knowledgeable regarding the patterns of consumer decision‐making in order to deliver appropriate patient education and provide proper patient outreach during the COVID‐19 pandemic.

Office practices that may improve the experience of the cosmetic dermatology patient.

Patients presenting for cosmetic dermatology procedures are often interested in lifestyle enhancement rather than treatment of an inflammatory or neoplastic disease or condition. In addition to good clinical outcomes, they may also particularly value the quality of the patient experience in the dermatology office. A list of beneficial practices that may improve patient experience was generated by interviewing staff members from several US practices, including clinic administrators, nurses, nurse managers, medical assistants, physician assistants, patient care coordinators, and dermatologists. Each was asked ten open-ended questions. The list of beneficial practices thereby obtained was ordered based on the number of participants who recommended each practice. Practices were further categorized into four categories: clinician improvement, administrative improvement, clinic improvement, and team improvement. For clinics providing cosmetic dermatology services, certain well-accepted beneficial practices may improve patient experience.

Types of Cosmetic Procedures Requested by Different Types of Patients and the Reasons for These Preferences.

The type of cosmetic dermatologic procedures patients' desire may be influenced by demographic factors. To better understand the type of cosmetic procedures requested by patients of different age, gender, education, race, and geographic location. To understand the most common motivations of patients who requested particular types of treatments. Multicenter data from the Cosmetic Motivation Database were analyzed. Bivariable analyses and linear regressions were undertaken to determine whether patient demographic features were associated with particular procedures of interest. Patients younger than 45 years were more interested in acne scar treatment, laser hair removal, liposuction, and tattoo removal. Older patients were more likely to want soft-tissue fillers and wrinkles and jowls tightening treatment. Non-White patients were more likely to be interested in laser hair removal, liposuction, cellulite treatment, and tattoo removal. Types of procedures desired varied by the geographic region but not by the educational level. Different motivations drove patients who wanted different types of treatments. Different types of patients demand different types of cosmetic treatments, and the motivations of patients who ask for particular procedures also differ. Better understanding of patient preferences may help physicians allocate resources and meet patient needs.

Skin during pregnancy

During pregnancy, many systemic changes may occur, them being haematological, car-diac, renal, respiratory, gastro-intestinal, endocrine or metabolic. Some other modifica-tions may target the cutaneous layers. It seems logical that during pregnancy, hormonal or other less well-explained pathways may influence one or more of the skin cell types. Pigmentary changes, such as melasma, but also vascular or structural modifications may affect the skin of pregnant women. Among the latter, striae distensae are probably the most common. Hair disorders featuring hair loss are frequently of concern during this pe-riod. Endocrine changes will often affect the skin glands, especially sebaceous ones, provoking acne. By contrast, some specific diseases originating in the skin may also oc-cur during the course of the gestation. Most of them present pruritic symptoms and for this reason affect the quality of life of pregnant women. Cutaneous infections such are vari-cella zoster virus, genital warts, infestation by Candida, Lyme disease or scabies may be observed during the period of gestation. Skin is modified during pregnancy and/or postpartum. These changes are usually only physiologi-cal, expressing changes in hormones or other factors secreted though the placenta, ovaries or en-larged pituitary gland. However, various dermatoses may specifically develop during this period and may influence the foetal outcome or, more rarely, the mother’s health. Therefore, being able to di-agnose and manage them is of high importance. Further, the increasing demand about cosmetic procedures, even during pregnancy, makes necessary to adapt our knowledge about their safety during this period.In this review, cutaneous modifications will be classified as physiological changes, spe-cific dermatoses of pregnancy, cutaneous infections that may modify the prognosis of pregnancy, miscellaneous skin diseases that may be affected by pregnancy and finally the safety of cosmetic dermatologic procedures during pregnancy will be overviewed, in order to offer to the dermatologists updated information permitting them to bring accurate assistance to their pregnant patien

Laser Treatment in Hirsutism: An Update.

Unwanted hair growth, which is a common aesthetic problem, has traditionally been treated using various techniques such as shaving, waxing, and epilation, but most of these provide only a temporary solution. Laser and light-based technology for hair removal has become one of the fastest growing procedures in modern cosmetic dermatology in the last decade. Clinical experience suggests that in the ideal subject with fair skin and dark hair, laser treatment can reduce hair growth significantly. This article reviews the various laser and light-based devices used for hair removal along with the various laser and patient parameters that affect the outcome of laser treatment for hair removal. Photoepilation, when properly used, offers clear advantages when compared with older, traditional techniques.

Nonphysician Practice of Cosmetic Dermatology: A Patient and Physician Perspective of Outcomes and Adverse Events.

Nonphysicians are expanding practice into specialty medicine. There are limited studies on patient and physician perspectives as well as safety outcomes regarding the nonphysician practice of cosmetic procedures. To identify the patient (consumer) and physician perspective on preferences, adverse events, and outcomes following cosmetic dermatology procedures performed by physicians and nonphysicians. Internet-based surveys were administered to consumers of cosmetic procedures and physician members of the American Society for Dermatologic Surgery. Descriptive statistics and graphical methods were used to assess responses. Comparisons between groups were based on contingency chi-square analyses and Fisher exact tests. Two thousand one hundred sixteen commenced the patient survey with 401 having had a cosmetic procedure performed. Fifty adverse events were reported. A higher number of burns and discoloration occurred in the nonphysician-treated group and took place more often in a spa setting. Individuals seeing nonphysicians cited motivating factors such as level of licensure (type) of nonphysician, a referral from a friend, price, and the location of the practitioner. Improper technique by the nonphysician was cited most as a reason for the adverse event. Both groups agree that more regulation should be placed on who can perform cosmetic procedures. Recall bias associated with survey data. Patients treated by nonphysicians experienced more burns and discoloration compared with physicians, and they are encountering these nonphysicians outside a traditional medical office, which are important from a patient safety and regulatory standpoint. Motivating factors for patients seeking cosmetic procedures may also factor into the choice of provider. Both patients and physicians think more regulation should be in place on who can perform cosmetic procedures. More adverse events such as burns and discolorations occurred with patients seeing nonphysicians compared with those seeing physicians. In addition, for those seeing nonphysicians, a majority of these encounters took place in spa settings. Patient safety is of utmost concern when it comes to elective cosmetic medical procedures. More adverse events and encounters occurring outside traditional medical settings when nonphysicians performed these procedures call into question the required training and oversight needed for such procedures.

Patients believe that cosmetic procedures affect their quality of life: An interview study of patient-reported motivations

Although treatmentsto address cosmetic concerns are common, patients' self-reported motives for considering such procedures have not been systematically explored. To develop a framework of categories to describe patients' self-reported motivations for undergoing minimally invasive cosmetic procedures. Face-to-face, semistructured patient interviews were conducted with adult participants who had undergone or were considering minimally invasive cosmetic dermatologic procedures. A qualitative constant comparative approach was used to analyze interview transcripts, yielding themes and subthemes. A total of 30 interviews were completed. Most patient-reported motivations for cosmetic procedures could be subsumed under 8 general categories (themes): (1) mental and emotional health, (2)cosmetic appearance, (3) physical health, (4) work and/or school success, (5) social well-being, (6) cost and/or convenience, (7) procedural perceptions, and (8) timing of treatment. Many individual motivations in these categories were unrelated to desire for physical beauty. In particular, participants wanted to avoid being self-conscious, enhance confidence, reduce the time and expense required to conceal physical imperfections, and be perceived as capable at work. Only English-speaking patients in the United States were interviewed. Patient-reported motivations for cosmetic procedures mostly pertained to physical and psychosocial well-being. Indeed, a desire for improved cosmetic appearance was only 1 of the 8 themes revealed through the patient interviews.

Awareness of Cosmetic Dermatology Procedures among Health Workers in a Tertiary Care Hospital.

Introduction:Cosmetic dermatology is a branch of dermatology which deals with the enhancement of beauty. There is a rise in cosmetic dermatological procedures throughout the world, but its awareness is limited not only in the general population but also among the health workers.Materials and Methods:We conducted a cross-sectional questionnaire-based study to know the knowledge and awareness of cosmetic dermatological procedures among health workers in a hospital setting.Results:There were a total of 155 respondents. The maximum number of respondents belonged to age group of 20–30 years (65.2%). Female respondents were 66% and males were 34%. Of the total respondents, 39% were medical students, 31% doctors, 23% nurses, 6% OPD assistants, and 1% ward maids. Hinduism was practiced by 91% of the respondents. About 84.5% of subjects were aware of cosmetic dermatological procedures. Regarding the source of information, 34.2% implicated textbooks. According to 53.5% participants, cosmetic dermatological procedures are done by a dermatologist. Around 59.4% responded that they were aware of many procedures such as botox injections, laser hair removal, hair transplant, and chemical peeling; 51% were aware of risks associated with procedures, such as allergy, burns, and pigmentation; 44.5% rated the facility as good; 31% believed that outcome of the procedures is different in Nepal as compared to a foreign countries. About 23.9% thought public disposition will change if they underwent the procedures. Around 11.6% thought this shall negatively affect them; however, 53.5% believed it would be socially acceptable. About 78.1% thought that these procedures are done only in cities with 62.6% believing it is commonly done by high-class economic status people. About 73.5% respondents believed that this was adopted by literate people; 7.1% were concerned about taboos against cosmetic dermatosurgical procedures; 84.5% agreed that there should be awareness program on these procedures.Conclusion:We found lack of awareness, knowledge, attitudes, and disposition about cosmetic dermatosurgical procedures among health workers. Further community-based population studies and awareness programmes should be carried out regarding this aspect.

Following-up skin penetration of lidocaine from different vehicles by Raman spectroscopic mapping

The application of local anesthetics, usually administered by subcutaneous injection, is common in the course of diagnostic, therapeutic, and cosmetic dermatology procedures. The effective dermal delivery of lidocaine could offer a solution to many adverse effects caused by needle insertion, such as pain, local reactions or toxicity, and additionally, it avoids the disruption of anatomical landmarks. Therefore, novel dermal formulations of local anesthetics are needed to overcome the barrier function of the skin and provide sufficient and prolonged anesthesia. In our study, we aimed to investigate and compare the penetration profiles of four different lidocaine containing formulations (hydrogel, oleogel, lyotropic liquid crystal and nanostructured lipid carrier) by Raman microscopic mapping of the drug. The application of Raman spectroscopy provided information about the spatial distribution of lidocaine in the skin ex vivo. The penetration of lidocaine from lyotropic liquid crystal and nanostructured carrier reached deeper skin layers and a higher amount of the drug was diffused into the skin, compared with hydrogel and oleogel. This study confirmed that nanostructured carriers can improve skin penetration properties of lidocaine and proved the applicability of Raman spectroscopy in the research of dermatological preparations ex vivo as a nondestructive, relatively easy and fast technique.