Improvement In Skin Appearance Research Articles

Effect of ultrasound and hyaluronidase on gynoid lipodystrophy type II – An ultrasonography study

Introduction: The objective of this study was to evaluate the effect of ultrasound and the technique of phonophoresis with hyaluronidase in patients with cellulite edematous type II in the gluteal region. Methods: Forty-two individuals, all females, were selected and randomly divided into two groups with 21 patients in each. Group I was treated with ultrasound without hyaluronidase and Group II was treated with ultrasound with hyaluronidase. To evaluate individuals, inspection, palpation, photography data and diagnostic ultrasound were performed before and after the treatment. The gluteal region was divided into four areas of 2.5 cm2; each area received an application of ultrasound. Results: After 10 days of application, both treatments were effective in improving skin appearance and reducing its thickness (epidermis and dermis), as well as that of the hypodermis (p > 0.05). Ultrasound with hyaluronidase induced a larger reduction in skin thickness in the upper medial quadrant and in the lower lateral and medial quadrants, compared to treatment without hyaluronidase. Moreover, there was a significant reduction of the hypodermis in the upper lateral quadrant with hyaluronidase (p > 0.05). Conclusion: Both treatments effectively reduced the thickness of skin and the hypodermis; however, the group treated with hyaluronidase-associated ultrasound showed more significant results than that treated with ultrasound only.

Reduction of facial wrinkles depth by sleeping on copper oxide‐containing pillowcases: a double blind, placebo controlled, parallel, randomized clinical study

Copper up-regulates the secretion of extracellular skin proteins and stabilizes the extracellular matrix once formed. As copper can be absorbed through intact skin, we reasoned that sleeping on pillowcases containing copper-impregnated fibers would reduce skin wrinkles. Demonstrate that sleeping on pillowcases containing copper-impregnated fibers reduce facial skin wrinkles. An 8-week, double blind, parallel, randomized study was carried out, in which healthy volunteers, aged 30-60, used either copper oxide-containing pillowcases (1% weight/weight) (test group, n = 30) or control pillowcases without copper (control group, n = 31). Skin conditions of the subjects were evaluated by visual grading by two expert graders and by 3D Image Analysis GFM PRIMOS(®) at baseline (before treatment) and following 4 and 8 weeks of sleeping on the pillowcases. The use of the copper oxide-containing pillowcase resulted in significant decrease of crow's feet after 4 (P = 0.01) and 8 (P = 0.002) weeks, but none was observed in the control group, as determined by the expert graders. On the basis of the 3D measurements, three roughness (R) parameters were improved after 4 and 8 weeks (P < 0.02) and the Rmax parameter at 8 weeks (P = 0.016) in the test group, but there were no changes in the R-parameters during the course of the study in the control group. The average reduction per month in the R-parameters was approximately 9%. No adverse reactions were observed or reported during the 8 weeks study. Sleeping on copper oxide-containing pillowcases results in reduction of wrinkles depth and overall improvement of skin appearance.

Interaction of mineral salts with the skin: a literature survey

There is growing scientific evidence that the health, well-being and the attractiveness of the skin are strongly influenced by nutrition. Consumers recognize this and have supported the creation of a global cosmeceuticals market estimated in 2010 at $27.2 billion. Early in 2011, the US Department of Health and Human Services and Department of Agriculture issued the Dietary Guidelines for Americans, 2010. Twelve vitamins and nine minerals were recognized as essential. The minerals include calcium, copper, iron, magnesium, phosphorus, selenium, zinc, potassium and sodium. Although the topical benefits of several minerals such as zinc, magnesium and iron are recognized and, in some cases, approved by the FDA, the topical benefits of the others to the skin are largely unexplored and unexploited. This review attempts to summarize what has been published in the literature on the interactions of the eight of the nine essential elements with the skin.

Exploring Channeling Optimized Radiofrequency Energy: a Review of Radiofrequency History and Applications in Esthetic Fields

Because of its high efficiency and safety, radiofrequency (RF) energy is widely used in the dermatological field for heating biological tissue in various esthetic applications, including skin tightening, skin lifting, body contouring, and cellulite reduction. This paper reviews the literature on the use of nonablative RF energy in the esthetic field and its scientific background. The purpose of this article is to describe in detail the extensive use of medical devices based on RF technology, the development of these medical devices over the years, and recent developments and trends in RF technology. The authors conducted a systematic search of publications that address safety and efficacy issues, technical system specifications, and clinical techniques. Finally, the authors focused on their own clinical experiences with the use of patented Channeling Optimized RF Energy technique and mechanical massage. An in-vivo study was conducted in domestic pigs, with a thermal video camera. Twenty-seven female patients participated in a cellulite and body shaping study. The treatments were conducted according to a three-phase protocol. An additional 16 females participated in a skin tightening case study. All of the patients underwent three treatment sessions at 3-week intervals, each according to a protocol specific to the area being treated. The review of the literature on RF-based systems revealed that these systems are safe, with low risks for potential side effects, and effective for cellulite, body contouring, and skin tightening procedures. The in-vivo measurements confirmed the theory that the penetration depth of RF is an inverse function of its frequency, and using a vacuum mechanism makes an additional contribution to the RF energy penetration. The heating effect of RF was also found to increase blood circulation and to induce collagen remodeling. The results from the cellulite and body shaping treatments showed an overall average improvement of 55% in the appearance of cellulite, with an average circumferential reduction of 3.31 cm in the buttocks, 2.94 cm in the thighs, and 2.14 cm in the abdomen. The results from the skin tightening procedure showed moderate improvement of skin appearance in 50% and significant improvement in 31%. At the follow-up visits the results were found to be sustained without any significant side effects. Of all tissue heating techniques, RF-based technologies appear to be the most established and clinically proven. The design and specifications of the described vacuumassisted bipolar RF device fall within the range of the specifications currently prescribed for esthetic, nonablative RF systems.

Recruited Minced Skin Grafting for Improving the Skin Appearance of the Donor Site of a Split-Thickness Skin Graft

To improve skin appearance at the donor site of a split-thickness skin graft, part of the harvested skin was minced and grafted back onto the site in a process we named "recruited minced skin grafting." Thirteen Japanese patients who needed split-thickness skin grafts were treated with recruited minced skin grafting. Five patients were used as controls, in whom donor sites were treated with the traditional method. Part of the split-thickness skin was minced using two surgical blades (number 24) to an approximate particle size of less than 0.5 mm. Minced skin was spread and transplanted onto the donor site and covered with polyurethane foam. Twelve months after the operation, donor sites were scored for hypopigmentation, hyperpigmentation, redness, and disruption of skin texture. Gross appearance was evaluated according to total score. Donor sites treated with recruited minced skin grafts had significantly better appearance than those of controls. Donor sites that had more than 5% of the total area treated tended to have better results. Recruited minced skin grafting is a good method of improving the appearance of the donor site.

Neck skin rejuvenation: Histological and clinical changes after combined therapy with a fractional non-ablative laser and stabilized hyaluronic acid-based gel of non-animal origin

Background: The laser Affirm™ (LA) is a microthermal, non-ablative fractional laser used for skin rejuvenation. Restylane Vital™ Light (RVL) in the Restylane® Injector, a formulation of stabilized hyaluronic acid-based gel of non-animal origin, is indicated for rejuvenation of delicate skin. Objectives: To assess the interaction between the LA and RVL in aging skin of the neck using clinical and histological parameters, and to determine whether combined therapy is effective. Methods: Nine female patients aged 42–62 years received four treatments, each comprising RVL followed immediately by LA treatment. Photographs and skin biopsies were taken before treatment, after the fourth session and 1 month later. Results: Improvements in fine wrinkles, tightness and skin texture were observed. Histologic evaluations showed favourable changes in cellularity, collagen and elastic fibres. Laser-induced effects (400 μm) and an inflammatory reaction (1000 μm) were seen. RVL was present at the mid–deep dermis (1000–1500 μm). Conclusions: Combined treatment with the LA and RVL improved skin appearance and structure as assessed, for the first time, with histology. The LA produced epidermal and superficial dermal changes whereas RVL acted deeper, together treating the full skin thickness.

Patient Satisfaction After Nd:YAG Laser-Assisted Lipolysis

Laser-assisted lipoplasty has potential attractive advantages over traditional liposuction, though review of the literature reveals some variation in outcomes. The patient's perspective regarding the procedure and outcome is described from the results of a survey administered to sequential patients undergoing laser-assisted lipoplasty in an office setting. The average perception of reduction in size is 3.94 on a scale of 1 to 5, with 5 being the most noticeable. The average perception of improvement in skin appearance is 3.1 (1-5, with 5 being most noticeable). The overall satisfaction is 3.78 (1-5, with 5 being very satisfied). Return to normal activity was 1.5 days. Of all the respondents, 75% took only 0 to 1 pain pills after the procedure. Though we found a positive patient response to the technique, further study is needed to answer remaining questions.

Avaliação da técnica de drenagem linfática manual no tratamento do fibro edema geloide em mulheres

Introdução: A drenagem linfática manual (DLM) é uma terapia utilizada no tratamento do fibro edema geloide (FEG). Objetivo: Analisar o efeito da DLM no tratamento do FEG. Métodos: Realizou-se uma avaliação no início e no fim do tratamento em 10 voluntárias com FEG, de grau I ao III, que constava de anamnese, inspeção, palpação, perimetria e testes específicos. Foram feitos registros fotográficos dos glúteos e das coxas superiores. A terapia constou de 10 sessões de DLM com duração de 60 minutos. Na análise de dados, utilizaram-se os testes t pareado, exato de Fisher e Wilcoxon, com nível de significância de p0.05. Resultados: Houve diferença estatística no grau de satisfação das pacientes com o FEG. Não houve diferença significante no grau do FEG, porém constatou-se melhora clínica no aspecto da pele. Todas as pacientes relataram estar satisfeitas com o tratamento. Não houve diferença estatística na perimetria. Conclusão: A DLM demonstrou ser uma terapêutica coadjuvante no tratamento do FEG, com melhora da autoestima e da satisfação das pacientes.

Fate of Flavonoids in the Outer Skins of Onion (Allium cepa L.) Throughout Curing

Reducing the current U.K. curing temperature from 28 to 20 °C would help to reduce energy costs; however, onion skin appearance and consumer acceptability may be detrimentally affected. The aim of this study was to elucidate the compounds responsible for the difference in color between brown and red onions cured at 20 and 28 °C by monitoring dynamic biochemical changes in the skin at set intervals during curing and after storage from two years' data. Sugar concentrations appeared to play no role in the difference in onion skin appearance when cured at different temperatures. Using regression, principal component, and partial least-squares discriminant analyses, the decrease in skin H° after the curing of brown onion cultivars at 28 °C was linked to a decrease in individual flavonol concentrations, possibly due to their oxidation at higher temperatures into brown pigmented compounds. Red onion cultivars cured at lower temperatures and for a shorter curing period had higher concentrations of individual anthocyanins as well as a darker skin color. Skin water content was reduced significantly in only the first 6 days of curing. Taken together, this suggests that current U.K. curing practice could be carried out at a lower temperature (20 °C) and/or for a shorter duration, resulting in reduced curing costs and possibly improved skin appearance.

Percutaneous collagen induction. Scarless skin rejuvenation: fact or fiction?

Photoageing is generally treated by ablative procedures that injure the epidermis and basement membrane, and lead to fibrosis of the dermis. Percutaneous collagen induction (PCI) therapy is an alternative treatment for photoaged skin that does not result in clinical signs of dermal fibrosis. In this study, the immediate effects of PCI on the skin were assessed, including the systemic inflammatory response and the production and gene expression of transforming growth factor (TGF) isoforms beta1, beta2 and beta3. Eighty rats were split into four groups: group 1 (n = 24; PCI plus skin care); group 2 (n = 24; skin care only); group 3 (n = 24; PCI only) and group 4 (n = 8; controls). Microarray analysis showed that TGF-beta3, an essential marker for preventing scarring, was upregulated and expressed for 2 weeks postoperatively. PCI might offer a regenerative therapy to improve skin appearance and quality and to improve or even prevent scarring.

Regulation of Skin Collagen Metabolism In Vitro Using a Pulsed 660 nm LED Light Source: Clinical Correlation with a Single-Blinded Study

It has been reported that skin aging is associated with a downregulation in collagen synthesis and an elevation in matrix metalloproteinase (MMP) expression. This study investigated the potential of light-emitting diode (LED) treatments with a 660 nm sequentially pulsed illumination formula in the photobiomodulation of these molecules. Histological and biochemical changes were first evaluated in a tissue-engineered Human Reconstructed Skin (HRS) model after 11 sham or LED light treatments. LED effects were then assessed in aged/photoaged individuals in a split-face single-blinded study. Results yielded a mean percent difference between LED-treated and non-LED-treated HRS of 31% in levels of type-1 procollagen and of -18% in MMP-1. No histological changes were observed. Furthermore, profilometry quantification revealed that more than 90% of individuals showed a reduction in rhytid depth and surface roughness, and, via a blinded clinical assessment, that 87% experienced a reduction in the Fitzpatrick wrinkling severity score after 12 LED treatments. No adverse events or downtime were reported. Our study showed that LED therapy reversed collagen downregulation and MMP-1 upregulation. This could explain the improvements in skin appearance observed in LED-treated individuals. These findings suggest that LED at 660 nm is a safe and effective collagen-enhancement strategy.

Improvement in arm and post‐partum abdominal and flank subcutaneous fat deposits and skin laxity using a bipolar radiofrequency, infrared, vacuum and mechanical massage device

Skin laxity of the body is a growing cosmetic concern. Laxity can result from chronological or photoaging and changes in body dimensions during pregnancy or weight loss. The end result is loose, sagging skin, and localized fat deposits. Liposuction and abdominoplasty or brachioplasty are established approaches to these issues. Patient desire for alternatives to surgical correction has spawned the development of non-invasive body contouring devices. The combination of infrared light (IR), bipolar radiofrequency (RF), vacuum and mechanical massage (Velashape, Syneron Medical Ltd, Israel) has demonstrated efficacy in improving skin appearance and circumference of the thighs [Goldberg et al., Derm Surg 2008; 34:204-209; Fisher et al., Derm Surg 2005; 31:1237-1241; Arnoczky and Aksan, J Am Acad Orthop Surg 2000; 8:305-313; Alster and Tanzi, J Cosmetic Laser Therapy 2005; 7:81-85; Wanitphakdeedecha and Manuskiatti, J Cosmet Dermatol 2006; 5:284-288; Nootheti et al., Lasers Surg Med 2006; 38: 908-912], but only anecdotal evidence has supported its use on other anatomic locations. This study was designed to evaluate the efficacy and safety of Velashape on additional body sites and more rigorously examine the technology's impact on upper arm as well as abdominal and flank circumference. Subjects were 28-70 years old, skin types I-V. Nineteen subjects underwent 5 weekly treatments of the upper arms, and 10 subjects underwent 4 weekly treatments of the abdomen and flanks. Treatments were performed using Velashape. Circumference measurements, photographs, and subject weights were performed prior to treatment and at 1- and 3-month follow-ups. Subjects were asked to record their treatment satisfaction level. Change in arm circumference, at the 5th treatment was statistically significant with a mean loss of 0.625 cm. At 1- and 3-month follow-ups, mean loss was 0.71 and 0.597 cm respectively. Reduction of abdominal circumference at 3rd treatment was statistically significant with a 1.25 cm mean loss. At 1- and 3-month follow-ups, average loss was 1.43 and 1.82 cm respectively. This study demonstrates with statistical significance, sustainable reduction in circumference and improvement in appearance of arms and abdomen following treatment with Velashape.

Cosmeceuticals: undefined, unclassified, and unregulated

The cosmeceutical category is an undefined, unclassified, and unregulated area of dermatology that is yet in its infancy. Traditional cosmeceuticals involve the topical application of biologically active ingredients that affect the skin barrier and overall skin health. The ability of these ingredients to enhance skin functioning depends on how they are formulated into products that can maintain the integrity of the active ingredient, deliver it in a biologically active form to the skin, reach the target site in sufficient quantity to exert an effect, and properly release from the carrier vehicle. In the United States, cosmeceuticals are sold as cosmetics, making marketing, packaging, and aesthetic appeal important considerations. Ideally, the cosmeceutical should be clinically tested for efficacy to ensure a proven skin benefit and also to substantiate marketing claims. Governmental limitations of efficacy claims restrict cosmeceutical development because products can only be assessed in terms of their ability to improve skin appearance but not function. Improving function would remove the cosmeceutical from the cosmetic category and place it in the drug category. Herein lies the challenge of defining the cosmeceutical category.

A multicenter study of cellulite treatment with a variable emission radio frequency system

Radio frequency (RF) systems have been reported as producing electrothermally mediated and subcutaneous effects. The present study evaluates a new approach to treat cellulite with a bipolar RF device. The buttocks of 50 patients were treated, 10 from each of five multinational centers with a novel bipolar RF technology set at 6 J/cm(3), which changes its frequency between 0.6 and 2.4 MHz according to impedance of tissue. Twelve weekly sessions were given for 12 minutes on each buttock, with a treatment end point of 42 degrees C external skin temperature. Cellulite changes and tissue condition were assessed before and immediately after the first session, before the final 12th session, and 2 months thereafter. The patient Satisfaction Index was recorded. Objective evaluation involved clinical photography, three-dimensional optical skin surface measurement, and histological findings. Almost all patients noted improvement of cellulite and body silhouette at the final session, which slightly decreased at the 2-month assessment. Improved skin appearance was objectively detected. Histological findings following the first session showed reactive edema and lysis of adipocyte membranes, possibly implicated in the final effects achieved. The RF technology used in the present multicenter study improved the general aspect of skin and cellulite, with high patient Satisfaction Index. Maintenance sessions might lead to even better and longer-lasting results.

Percutaneous Collagen Induction: Minimally Invasive Skin Rejuvenation without Risk of Hyperpigmentation—Fact or Fiction?

Photoaging is generally treated by ablative procedures that injure the epidermis and basal membrane and lead to fibrosis of the papillary dermis. Damaging the epidermis significantly can cause potential adverse effects such as dyspigmentation. It was recently shown in clinical trials that percutaneous collagen induction therapy is an alternative for safely treating wrinkles and scars and for smoothening the skin without the risk of dyspigmentation. The purpose of this study was to increase current knowledge regarding whether percutaneous collagen induction therapy presents an effective means for skin rejuvenation without risk of dyspigmentation, as the authors' clinical data suggested. Fifty-six rats were assigned to three groups: group A (n = 24), percutaneous collagen induction therapy plus skin care; group B (n = 24), skin care; and group C (n = 8) controls. The authors evaluated the effect of percutaneous collagen induction therapy on the epidermis, melanocytes, and the pigmentation markers interleukin-10 and melanocyte-stimulating hormone. Percutaneous collagen induction therapy left the epidermis intact without any damage to the stratum corneum, any other layers of the epidermis, or the basal membrane. No signs of dermabrasive reduction of epidermal thickness were evident 24 hours after the procedure. The number of melanocytes neither increased nor decreased in any of the groups. DNA microarray experiments demonstrated that interleukin-10 was increased in percutaneous collagen induction therapy-treated skin after 2 weeks. Concerning the MC1R (melanocyte-stimulating hormone) gene, gene expression microarray analysis indicated a faint down-regulation both 24 hours and 2 weeks after percutaneous collagen induction therapy. Percutaneous collagen induction therapy offers a modality with which to rejuvenate and improve skin appearance and quality without risk of dyspigmentation.

Non‐invasive evaluation techniques to quantify the efficacy of cosmetic anti‐cellulite products1

The majority of women suffer from the unattractive sight of dimpling skin on the thighs and buttocks, globally known as cellulite. Cellulite can be regarded as the most investigated non-disease, because, from the cosmetic viewpoint, most women desire a reduction in cellulite severity. Despite investigations made, cellulite is still not well understood at the cellular level, which leads to controversy regarding the investigative methods for cellulite reduction as well as the development of products to treat cellulite skin. The aim of our work was to improve the set up of macrophotography for making images of dimpled skin and to automatize image analysis of 20 MHz ultrasound imaging - these two methods being just two of a variety of available methods for investigating cellulite skin. Macrophotography was standardized on the aspects of volunteer's positioning, skin illumination, background used, and camera position. It was performed before, during and after a 3-month-treatment of a cosmetic product. Scoring assessments of the generated images were made by the volunteers themselves as well as by six trained experts. Ultrasound imaging was performed at the baseline visit in order to correlate the newly developed analysis with the visually rated cellulite score. A second study is also presented showing a variety of parameters that can be used for cosmetic testing of cellulite products: skin firmness, blood circulation and circumferential thigh measurements. Standardization of macrophotography minimized differences in image features between assessment times, therefore, enabling follow-up rating assessments of the images. A custom-made rating program simplified the scoring procedure by presenting images as blind and randomized, and by implementing computer-based analysis using an online rating scale. Volunteers and experts scored significant improvement of skin appearance over the course of a 3-month cosmetic treatment. Image analysis of ultrasound imaging was automatized, and a modification of the commonly known roughness parameter Ra was implemented to characterize cellulite severity. Comparison with the visually rated cellulite score showed an existing correlation between the score and the modified parameter Ra(m). Further parameters investigated in an exemplary study, as mentioned above, demonstrated a significant improvement of skin appearance after treatment with a cosmetic product. Macrophotography and ultrasound imaging can be regarded as important tools for determining and quantifying the aspects of cellulite. With a gold standard missing for investigating cellulite severity, these two methods may not determine cellulite at the cellular level, but they do characterize the skin appearance so typical for cellulite. Combined with a variety of other methods, macrophotography and ultrasound imaging can very well define cellulite-reducing efficacy from the cosmetic point of view.

Effects of cellulite treatment with RF, IR light, mechanical massage and suction treating one buttock with the contralateral as a control

Background and objectives: A system that combines bipolar radio frequency (RF) and intense infrared light (IR) together with mechanical massage and suction has recently been reported as being efficient for cellulite treatment. The present split study was designed to evaluate the efficacy of such a system through various treatments of cellulite located on the buttocks. Methods: Ten patients were enrolled for 12 sessions of 30 minutes each performed over one buttock, the other buttock serving as an untreated control. Sessions were conducted twice a week for a period of 12 weeks. Clinical photography and profilometry were carried out to assess textural changes before (baseline) and 2 months after the final treatment. Histopathology was performed at baseline, 2 hours after the first session, and just before the 12th session and 2 months thereafter. Results: All patients noted improvement in the treated buttock before the final session, which was maintained at the 2‐month assessment. Improved skin appearance was noticed after the first session and was maintained throughout the study. All patients were satisfied with the results and requested further treatment in order to balance the results in both buttocks. Random histological analyses suggested dermal firmness, fibre compaction and tightening of skin layers, including the subcutis, as possible reasons for the effects achieved. The authors recognize that the small number of participants limits the statistical power of the study. Conclusions: Treatment sessions with the combined RF, IR light and mechanical massage and suction system were complication free, produced improvements in the overall cellulite appearance and skin condition, suggesting that further treatment sessions for maintenance could sustain patient satisfaction index (SI) and lead to lasting results. Based on the good results in the limited trial population, further studies with larger patient populations are warranted.

The latest cosmeceutical approaches for anti‐aging

SummaryBackground Cosmeceuticals provide a new therapeutic frontier for anti‐aging in dermatology. The most dramatic signs of cutaneous aging include the lack of skin surface regularity, the formation of rhagades, and the increased presence of dyspigmentation.Background The objective of this review is to illustrate how these three needs of maturing skin can be met by novel ingredients incorporated into carefully constructed formulations designed to deliver scientifically measurable and visibly noticeable improvement.Conclusion Skin surface irregularity can be improved through increased skin turnover facilitated by topical niacinamide, while the appearance of fine lines can be diminished through the application of moisturizers containing engineered peptides and over‐the‐counter retinoids, such as retinyl propionate. Finally, skin pigmentation can become more regular with the topical application of N‐acetyl glucosamine and ultraviolet A photoprotective ingredients. Furthermore, combining cosmeceutical ingredients in a moisturizing vehicle can magnify benefits and profoundly improve skin appearance.

Effects of Topical Copper Tripeptide Complex on CO2 Laser–Resurfaced Skin

To evaluate the role of skin care products that contain a copper tripeptide complex, glycyl-l-histidyl-l-lysine-Cu(2+) (GHK-Cu), in treating carbon dioxide (CO(2)) laser-resurfaced skin. Patients meeting the inclusion criteria underwent circumoral skin resurfacing using a CO(2) laser at standard settings. Patients were then randomized to receive posttreatment skin regimens with or without GHK-Cu. Evaluations for erythema throughout the posttreatment period were performed using computer software and blinded evaluators. In addition, overall improvement in wrinkles and overall improvement in skin appearance 12 weeks after treatment were assessed. Patients completed a validated questionnaire before and 12 weeks after treatment. Thirteen patients completed the study. Computer analysis and blinded evaluators found no statistically significant differences between groups for earlier resolution of erythema. All the patients experienced significant improvement in wrinkles and overall skin quality, but no differences were found between groups. The results of the questionnaire indicated a significant difference in the posttreatment improvement of overall skin quality for patients using GHK-Cu (P = .04). Copper tripeptide complex (GHK-Cu) skin care products placed on CO(2) laser-resurfaced skin offered no significant reduction or resolution of posttreatment erythema. Objective evaluation found no significant improvement in wrinkles or overall skin quality. However, patient satisfaction was significantly higher for those who used GHK-Cu skin care products after CO(2) laser skin resurfacing.

Cutaneous effects compared between higher fluence with fewer treatments and lower fluence with more treatments in a combined IR laser/radio frequency system

Background and aims: A combined infrared (IR) laser/radio frequency (RF) system has recently been reported to create rejuvenation‐related cutaneous effects, but was associated with high levels of pain and some complications. The present study was designed to evaluate the cutaneous effects of the same system with a lower fluence and more treatments. Methods: Twenty patients were randomly assigned into two groups of 10 individuals each: Group A was treated at 50 J/cm2 / 100 J/cm3 (laser/RF), respectively, two passes, three treatment sessions 30 days apart; Group B at 30 J/cm2 / 50 J/cm3, three passes, five treatment sessions 15 days apart. Objective comparisons were made at the same time points with a computer program based on the clinical photography. Results: Group A noted more improvement in wrinkles than Group B at the first assessment, but both groups showed slight and progressive deterioration at the 2‐ and 6‐month assessments. Improved skin appearance was maintained throughout in both groups. The authors recognize that the comparatively small number of subjects possibly limits the statistical power of the study. Conclusions: Lower fluences and more treatment sessions with the combined 900 nm laser/RF system were complication‐free, produced improvements in the overall skin condition and less pain during sessions, suggesting that this combination may produce better patient compliance. Further treatment sessions may improve the results with implications in skin rejuvenation.