Split-face Clinical Trial Research Articles

Therapeutic Performance of Needle Injection Versus Needle-Free Jet Injector System for Polynucleotide Filler in Skin Rejuvenation.

Polynucleotide (PN) filler often causes pain and can lead to delivery inaccuracies when applied via intradermal injection using a traditional needle. To evaluate the efficacy of treatment and the pain during the procedure using conventional needle injection versus a needle-free jet system for intradermal PN filler application. In this split-face clinical trial, 10 Korean subjects were enrolled. Each subject received an intradermal injection of PN filler on one side of the face and a needle-free jet injection using CureJet on the other side. Assessments included global and 3D skin imaging at each visit. Pain intensity was evaluated using visual analogue scale (VAS) scores during the injection. Additionally, patient satisfaction and adverse events were documented. Findings revealed that Global Aesthetic Improvement Scale scores and patient satisfaction were significantly higher with the CureJet compared to the needle injection method. VAS scores were notably lower on the CureJet side. Improvements in both pore and wrinkle indices were observed from baseline, with a more pronounced improvement rate on the CureJet side compared to the needle injection side. Needle-free injection of PN for aging skin was found to be effective in enhancing pore and wrinkle improvement, while reducing associated discomfort.

Combination of Plasma Rich in Growth Factors With Topical 4% Hydroquinone Compared With Topical 4% Hydroquinone Alone in the Treatment of Dermal Type of Melasma: A Single-Blinded Randomized Split-Face Study.

Response to the current available treatments of melasma, dermal type, in particular, is usually gradual and can result in possible side effects. In this study, we aim to evaluate the efficacy of the combination of plasma rich in growth factors (PRGF) and topical 4% hydroquinone (HQ) in comparison with monotherapy using topical 4% HQ alone in the treatment of dermal type of melasma. This is a single-blinded, randomized, split-face clinical trial on twenty female patients with dermal type of melasma. Patients were asked to apply topical 4% HQ on both sides of their face at night for 6 months. In each participant, one side of the face was randomly chosen to receive monthly intradermal injections of PRGF for 3 sessions. Efficacy of the treatment was assessed using hemi melasma area and severity index (MASI) score, physician's global assessment (PGA), and patients' global assessment (PtGA). Both groups revealed significant improvement in hemi-MASI score during the treatment course. Mean percentage of improvement at the end of study was 40.38 ± 6.04% and 33.42 ± 3.23% in the combination therapy and monotherapy groups, respectively (P = 0.31). PGA demonstrated excellent-to-marked improvement in melasma in 25% and 5% of patients in the combination therapy and monotherapy groups, respectively (P = 0.31). PtGA showed high levels of satisfaction in 15% of patients in the combination therapy group (vs. 0% in the monotherapy group) (P = 0.05). Differences between the two treatment groups in terms of hemi-MASI and PGA scores were not statistically significant; however, patients demonstrated higher satisfaction with combination of PRGF and topical 4% HQ compared with topical HQ alone. Thereby, combination of PRGF and topical 4% HQ can be suggested as a safe alternative therapeutic approach and may hold promise in the development of future therapeutic options for dermal type of melasma.

Evaluation and comparison of the efficacy and safety of the combination of topical phenytoin and microneedling with microneedling alone in the treatment of atrophic acne scars: A controlled blinded randomized clinical trial.

Severe acne breakouts often lead to atrophic acne scars, which affect millions of people worldwide and can significantly affect a person's self-confidence and self-image. Given the difficulty in treating atrophic acne scars, this study aims to investigate the efficacy of topical phenytoin in the treatment of atrophic acne scars. This split face clinical trial on 25 patients between the ages of 18 and 40 involved the application of microneedling on one side of the face, with three sessions taking place over the course of a month. On the other side, a 1% phenytoin cream was administered three times daily for 1 week following the microneedling procedure. Baseline information was collected for all patients, and follow-up assessments were conducted during the treatment sessions and 2 months after the last session. The assessments included evaluating the number and area of pores and spots, determining scar severity, assessing patient satisfaction, and recording any potential complications. Among patients, 20 individuals (80%) were females, and the average age of the participants was 35.96±9.23. In terms of the fine pore area, despite the fine pore count, both groups showed improvement over time (p: 0.03vs. 0.06). Also, regarding large pore count and area, and the count and area of spots, both groups showed improvement over time (p: 0.001). However, there were no significant differences between the two groups (p>0.05). On the other hand, when it comes to acne scar grade and patients' satisfaction, the phenytoin group outperformed the control group in all follow-up sessions and this difference was found to be significant (p: 0.001). It is worth noting that no complications were observed among any of the patients. It appears that combining phenytoin cream with microneedling has a more effective therapeutic outcome in enhancing atrophic acne scars, when compared to microneedling alone, and this method can be regarded as a viable alternative in treating these types of scars.

Simultaneous versus sequential fractional CO2 laser and subcision combination for management of post-acne atrophic scars: A split-face comparative study.

A combination of fractional CO2 laser and subcision is usually employed for the treatment of post-acne atrophic scars. However, the efficacy and safety of both simultaneous and sequential combination therapies should be explored. To compare the efficacy and safety of simultaneous and sequential fractional CO2 laser and subcision combination therapies for post-acne atrophic scars. This single-blind, split-face clinical trial included 34 patients with post-acne atrophic scars at our institution. Each patient underwent three sessions of subcision combined with fractional CO2 laser, with a 1-month interval between each session. The left side of the face was treated with simultaneous combination therapy, whereas the right side was treated with sequential combination therapy. Treatment efficacy was assessed at 4, 8, and 12 weeks; and 3 and 6 months after the last session. Simultaneous and sequential treatments demonstrated comparable efficacy. Regarding the adverse events, the side of the face undergoing simultaneous treatment experienced longer swelling duration, higher pain levels during laser treatment, and shorter downtime. Despite the longer swelling time and higher pain levels during laser treatment in the simultaneous treatment side, the effectiveness and satisfaction level of the CO2 fractional laser and subcision for treatment of the acne scars were comparable between the two combinations, with a shorter downtime for the simultaneous than for the sequential combination therapy.

Comparative Effectiveness of 20% Azelaic Acid with 1064-nm Nd:YAG Picosecond Laser vs Azelaic Acid Alone for Melasma Treatment in Thai Female Patients: A Split-Face Study

Melasma is one of the most concerning pigmented skin conditions, especially in females. It can be influenced by sunlight, occupation, gender, and drug use, which can aggravate the disease. This split-face clinical trial assesses the effectiveness of picosecond laser in melasma treatment combined with topical azelaic acid compared with azelaic alone. The primary outcome of this study is the Hemi-MASI score, while the secondary outcome is demographic data, physicians' global assessment, patient satisfaction score, and adverse events. The study recruited twenty Thai females aged between 18 and 65 diagnosed with bilateral symmetrical malar-type melasma. The patients were treated with low fluence 1064-nm Nd:YAG picosecond laser three sessions every two weeks combined with topical azelaic acid twice daily on the right side of the face, whereas the left side was treated with topical azelaic acid twice daily alone for 16 weeks. The mean Hemi-MASI decrease is 3.52%, 9.38%, and 19.94% on the combination side, while there are 1.93%, 7.89%, and 16.73% at the 8th, 12th, and 16th, respectively in the topical azelaic alone side. There were no severe side effects from both picosecond laser and azelaic acid, and they can be relieved without treatment. Thus, the overall clinical result demonstrates the improvement as the patient satisfaction score is satisfied. Still, the mean Hemi-MASI score between the two sides is not statistically significantly different (p>0.05). In conclusion, combining the picosecond laser with azelaic acid alone in melasma treatment results in a better overall general outcome than the azelaic alone.

A Comparative Study on Adipose-Derived Mesenchymal Stem Cells Secretome Delivery Using Microneedling and Fractional CO2 Laser for Facial Skin Rejuvenation.

The efficacy of adipose-derived mesenchymal stem cells (ADMSCs) secretome for skin aging has been established, yet no studies hitherto directly investigated the best administration method for such purpose. We aimed to compare microneedling (MN) versus fractional CO2 laser (FL) as methods of delivery for ADMSCs secretome in the treatment of aging skin. A single-blind, randomized split-face clinical trial was conducted on 30 Indonesian women (aged 35-59 years old) with signs of facial cutaneous senescence. Their initial aging status was assessed by dermoscopy photoaging scale (DPAS) and Janus-III measurement system. In the second and fourth weeks, all participants were treated with both MN and FL, followed by the application of a four-fold concentrated ADMSC secretome. The assignment of which side of the face received MN or FL was done by computer-based randomization. Skin parameters were reevaluated on the fourth and sixth weeks, along with patient satisfaction, level of comfort, preference for administration techniques, and also adverse events experienced during the study. Appropriate statistical analyses were subsequently performed at a significance level of 0.05. Significant improvements in total DPAS and wrinkles were found in the MN and FL groups at the end of the trial. In contrast, no statistical differences in all parameters were observed between groups in the fourth and sixth weeks. FL scored higher than MN for satisfaction and preference, but lower in terms of comfort. Pain, burning sensation, and itch were the side effects experienced by subjects upon treatment. Two patients had prolonged reddish skin succeeding FL treatment, which relieved with moisturizer application. Both MN and FL yielded comparable results for improving several skin aging features. However, subjective preference for ADMSCs secretome administration method may differ when considering satisfaction, comfort, and possible adverse events.

Chemical peeling with 35% glycolic acid for the treatment of disseminated facial verruca plana: A randomized, split-face, evaluator-blinded trial.

Disseminated facial verruca plana is a chronic disorder that causes significant psychological distress. However, safe and effective treatment is lacking. This study aimed to explore the efficacy and safety of 35% glycolic acid (GA) for the treatment of disseminated facial verruca plana. A split-face clinical trial was conducted to explore the efficacy and safety of using chemical peeling with 35% GA for the treatment of disseminated facial verruca plana. One side of the face was applied with 35% GA once every fortnight for a total of three times. Adapalene gel was applied every night to the other side of the face as the control. The clearance rate of lesions was evaluated at different time points. Between June 2020 and December 2020, 30 patients with disseminated verruca plana who visited the Dermatology Hospital of Southern Medical University were enrolled. After three chemical peelings with 35% GA that was applied at 2-week intervals, 15 (50%) patients achieved >70% lesion reduction. The same effective rate in the adapalene gel-treated side of the face was documented in eight patients. Subgroup analysis showed a higher clearance rate in patients with a shorter disease duration. Moreover, concurrent improvements in facial roughness were observed in the 35% GA-treated group. Adverse effects including mild erythema and desquamation were observed during chemical peeling with 35% GA. In conclusion, chemical peeling with 35% GA could be a safe and effective option for treating disseminated facial verruca plana, especially for those who desire skin improvement.

Platelet-Rich Fibrin in Fat Grafts for Facial Lipofilling: A Randomized, Controlled Split-Face Clinical Trial.

ObjectivePrevious studies have reported that platelet-rich fibrin (PRF) may enhance the efficacy of fat grafts in facial lipofilling. However, these studies either lacked objective data or were not randomized, controlled trials. Thus, we aimed to objectively evaluate the efficacy of PRF in facial lipofilling.MethodsA controlled, split-face, randomized trial (January 2018 to May 2019) based on 18 patients who underwent fat grafts for bilateral temple lipofilling was performed. Each patient received a combination of an autologous fat graft and PRF on one side and a fat graft combined with an equal volume of saline on the other side. The effects of PRF were evaluated by comparing the remaining bilateral fat graft volumes through a digital three-dimensional reconstruction technique. Improvements in the appearance and recovery time of each temple were assessed by both a surgeon and patients who were blinded to the treatment assignment. Complications were also recorded.ResultsBilateral temple lipofilling showed no evidence of fat embolism, vascular/nerve injury, infection, massive edema, or prolonged bruising. Three-dimensional reconstruction data and the assessments from both the surgeon and patients revealed no significant differences in fat graft retention volume between the PRF-positive and PRF-negative lipofilling groups. However, recovery time in the PRF-positive lipofilling sites was significantly shortened compared with that of the PRF-negative lipofilling sites.ConclusionFacial filling with autologous fat grafts is effective and safe. Our results show that PRF does not markedly improve fat graft volume retention in the temple but significantly reduces postoperative recovery time.Trial Registration NumberChiCTR2100053663.

Effectiveness of a Radiofrequency Device for Rejuvenation of Aged Skin at Home: A Randomized Split-Face Clinical Trial.

IntroductionSeveral techniques, including the use of radiofrequency (RF) devices, are currently utilized for the treatment of skin aging. This study aimed to evaluate the anti-aging effects imparted by a home-based RF beauty device and to compare these results with those of a marketed anti-aging cosmetic in vivo.MethodsThirty-three women aged 35–60 years were enrolled in this randomized, controlled, split-face trial. This study involved a 12-week trial with five repeated measurements (at baseline, 2, 4, 8 and 12 weeks). One side of the face was randomly selected to be part of the experimental group and treated with the RF beauty device, while the other side was considered as control and was treated with an anti-aging cosmetic. Treatment safety was evaluated. Skin wrinkles, hydration, radiance, elasticity, color and thickness were evaluated using noninvasive equipment.ResultsThirty-two participants completed the study; one withdrew for personal reasons. Compared with the anti-aging cosmetic-treated facial side, the experimental side showed statistically significant improvements in wrinkles, skin radiance, color and thickness (p < 0.05).ConclusionsThe home-based RF beauty device was safe and effective for rejuvenation. The device was more effective than the commercially available anti-aging cosmetics.

Evaluation of the anti-wrinkle effect of a lipophilic pro-vitamin C derivative, tetra-isopalmitoyl ascorbic acid.

Tetra-isopalmitoyl ascorbic acid (VC-IP), an oil-soluble vitamin C derivative, is known to be effective for treating photoaging skin caused by oxidative stress. In addition, it is known that morphological changes of the skin occur on the face with aging, and the main cause has been reported to be photoaging. There have not been any published reports that examined the clinical effects of vitamin C derivatives on periorbital wrinkles. The purpose of this study was to characterize the potential anti-wrinkle effect of VC-IP. A double-blind, randomized, placebo-controlled, split face clinical trial was performed on 3groups of 23 female subjects each who used 1%, 2%, or 3% VC-IP creams versus a placebo cream to treat their facial wrinkles. VC-IP cream was applied on the periorbital area on one side of the face of each subject twice a day for 8weeks and a placebo cream was applied on the other side. Anti-wrinkle effects were evaluated by visual wrinkle grading and topographic assessments. Periorbital wrinkles treated with VC-IP twice a day for 8weeks showed marked or moderate improvements according to visual observations and grading of photographs. Moreover, topographic assessments confirmed the improving effects of VC-IP, and more interestingly, the appearance of those effects differed depending on the VC-IP concentration. In addition, sufficient improvement was observed in parameters reported to be associated with dermal structure at lower concentrations of VC-IP. These results indicate that topical application of VC-IP cream reduces periorbital wrinkles caused by skin aging.

Efficacy of Erbium-Doped Yttrium Aluminium Garnet 2,940 and 1,064 nm Laser Treatment for Facial Rejuvenation-A Randomized Controlled Split-Face Clinical Trial.

The 2,940 nm erbium-doped yttrium aluminium garnet and 1,064 nm neodymium-doped yttrium aluminium garnet lasers have been widely applied in facial rejuvenation, but no randomized trials exist to evaluate the efficacy of the combination treatment. The efficacy of the combined treatment for facial rejuvenation. A total of 20 subjects with facial aging were enrolled and randomly assigned into 2 groups: one side of the face was treated with a 2,940 nm or 1,064 nm laser alone and the other side was treated with the combined lasers. The patients were treated by 3 sessions with 1-month intervals. The efficacies were quantitatively accessed by digitalized high-resolution photographs. The 1,064 nm laser alone showed significant improvements on indexes of skin texture, spore, brown spots, elasticity, and melanin as compared with the baseline (p < .05). The 2,940 nm laser alone showed significant improvements on indexes of wrinkle, texture, pore, and elasticity (p < .05). The combined treatments showed significant improvements on the abovementioned indexes as compared with either a 1,064 nm or 2,940 nm laser treatment (p < .05). A combination of 1,064 nm and 2,940 nm laser treatment renders significantly better efficacies for facial rejuvenation as compared with a 2,940 nm or 1,064 nm laser alone.

A randomized split-face clinical trial of conventional vs indoor-daylight photodynamic therapy for the treatment of multiple actinic keratosis of the face and scalp and photoaging

Background Recently, indoor daylight photodynamic therapy (idl-PDT) has been developed; however, its efficacy and tolerability remain to be assessed. Objective This is a not-inferiority study to compare treatment outcomes of cPDT with a red LED lamp and idlPDT with a polychromatic white LED lamp in adult patients affected by symmetrical AKs of face and/or scalp. Methods In this comparative, intra-patient, split-face, randomized clinical trial forty-three adult patients were enrolled. Two contralateral and symmetrical target areas of the face and/or scalp harboring at least 5 AKs were selected and randomized 1:1 to treatment with cPDT and idlPDT. The AKs number and cumulative area were assessed at baseline (T0). Efficacy and cosmetic outcome were assessed 3 months after treatment (T1). Results Total AKs number and area reduced significantly with both idlPDT (p < .0001) and cPDT (p < .0001) in comparison to baseline. cPDT was more painful (p < .0001) and induced a more severe inflammation (p < .0001). Twenty-nine patients (70.7%) gave their overall preference to idlPDT (p < .001). Conclusion idlPDT may represent an alternative treatment protocol to cPDT for in-office treatment of AKs patients with better tolerability and a not inferior efficacy.

The Effects of Myrtle (Myrtus communis) and Clindamycin Topical Solution in the Treatment of Mild to Moderate Acne Vulgaris: A Comparative Split-Face Study.

ObjectivesAlthough Acne vulgaris is a chronic skin disease, which its standard treatment causes therapeutic limitations and some common adverse effects, medicinal plants can be effective in treatment with low adverse effects as combination therapy. Myrtle (Myrtus Communis) has some beneficial properties, which has been administered topically and orally for some skin diseases in Persian medicine. This study aimed to compare the efficacy and safety of Myrtle formula and 1% clindamycin topical solution.MethodsThis was a split-face clinical trial that was done on 55 patients with mild to moderate acne vulgaris for 16 weeks. The patients received topical Myrtle solution to the right side of the face (group 1) and clindamycin solution to the left side (group 2) twice daily for 12 weeks. All participants were examined for the acne severity index (ASI) and total acne lesions counting (TLC) at certain times during the study. Then, they stopped using them for four weeks. They also did not take the drug in the final four weeks of the study.ResultsForty-eight patients completed the study for 16 weeks; 40 (83.2%) patients were female and the rest of them were male. The mean age and standard deviation were 25.62 ± 7.62 years. After 12 weeks, the percentage changes of comedones, inflammatory lesions, ASI and TLC were significantly reduced in both groups (p < 0.001). The percentage change of inflammatory lesions and ASI decrease was significantly higher in the group 1 (p = 0.03). There was no significant difference in the incidence of side effects between the two groups. There was a more significant decrease in sebum percentage change in the group 1 (p = 0.003).ConclusionMyrtle lotion was effective and safe for the treatment of mild to moderate acne vulgaris.

Efficacy and safety of fractional CO2 laser and tranexamic acid versus microneedling and tranexamic acid in the treatment of infraorbital hyperpigmentation

Objective To compare the efficacy and safety of microneedling and fractional CO2 laser in combination with tranexamic acid (TA) in the treatment of infra-orbital hyperpigmentation. Patients and methods This split-face clinical trial performed on 30 volunteers. The patients were randomly assigned to treat with fractional CO2 laser and microneedling, both combined with TA topically. Three monthly treatment sessions were performed. Two blinded dermatologists evaluated the response after each treatment session and one and three months after the last session. We also asked patients to evaluate their overall satisfaction at the final follow up. Adverse effects have also been documented. Results Both methods showed significant improvement in all sessions comparing with the baseline state (p value <.05). There were no significant differences between two methods on the days 30, 90, and 150. But the laser showed significantly higher improvement on day 60. The patients’ satisfaction did not reveal any significant difference between the two sides. Adverse events were temporary with no significant difference between both sides except for erythema that lasts longer with microneedling. Conclusions Both fractional CO2 laser and microneedling in combination with topical TA seem to be effective modalities in the treatment of infraorbital hyperpigmentation with no significant side effects.

Randomized, Double-Blinded, Split-Face Study Comparing the Efficacy and Tolerability of Two Topical Products for Melasma

Background: Melasma is a common disorder of hyperpigmentation that disproportionately affects individuals with skin of color. There is a paucity of studies evaluating non-hydroquinone (HQ) topical therapies for the treatment of melasma in darker skin types. Objective: To compare the safety, efficacy, and tolerability of a HQ-free, retinol-free cosmetic topical brightener (CTB) and HQ 4% in the treatment of moderate symmetric facial melasma in patients with Fitzpatrick skin types (FST) III–VI. Methods & Materials: This was a randomized, double-blinded, split-face clinical trial. Eighteen adult patients with facial melasma were treated with CTB and HQ 4%, each to a different side of the face, twice daily for 12 weeks. Clinical assessments included half-face Melasma Area Severity Index (MASI), Overall Hyperpigmentation scale, and Melasma Severity Rating Scale (MSRS). Patients completed a Melasma Quality of Life (MelasQoL) questionnaire and clinical photographs were taken at each visit. Results: CTB and HQ 4% demonstrated statistically significant improvements in half-face MASI, Overall Hyperpigmentation, MSRS and MelasQol compared to baseline. HQ 4% showed statistically significant improvements in MSRS at week 12 compared to CTB, but was non-superior for all other clinical endpoints. Conclusion: HQ-free, retinol-free CTB and HQ 4% both are effective and well-tolerated in the treatment of moderate facial melasma in FST III–VI. J Drugs Dermatol. 2020;19(9):822-827. doi:10.36849/JDD.2020.5353

Efficacy of home-use light-emitting diode device at 637 and 854-nm for facial rejuvenation: A split-face pilot study.

The use of light-emitting diode (LED) in combination wavelength for facial rejuvenation has been previously reported. Nowadays, there has been a growing market for home-use cosmetic devices because of its low cost and convenience. To evaluate the efficacy and safety of home-use LED device on facial rejuvenation. This was a prospective split-face clinical trial with a total of 24 subjects, who presented with photo aging skin. All subjects were treated with the home-use LED device on the left side of their face, twice a week for 8weeks. Primary outcomes measured in the study were the changes in the biophysical properties of the skin assessed with the following parameters: skin elasticity, skin hydration, texture, and wrinkles. Evaluations were done at baseline, 2-, 4-, 6-, and 8-week follow-up. Subjects' self-improvement scores and adverse reactions were also recorded. All 24 subjects completed the study and attended all follow-up. Skin elasticity was significantly higher in the LED group compared to the control during the 6- and 8-week follow-up (P<.05). In the LED group, an image of the treated skin captured using Visioscan® showed improvement of the skin texture at 8-week follow-up. Majority of the subjects in the LED group scored good improvement on all follow-ups (37.5%, 41.7%, 58.3%, and 62.5%) when compared to the baseline. No adverse reactions or pain were recorded in the study. The home-use LED device, with a combination wavelength of 637 and 854nm, is safe and can be used as an adjunctive treatment for self-administered facial rejuvenation.

239 Multi-functional in vitro and in vivo efficacy of Tiliacora triandra, natural ingredient with clinical anti-aging skin benefits

Tiliacora triandra is a flowering plant also known as “bai yanang”. It is native to Southeast Asia and used particularly in the cuisines of northeast Thailand and Laos. Traditionally recommended for fever reduction and for relief from hangover. Pharmacological activities include anti-bacterial, anti-fungal, and anti-inflammatory properties, suggesting its adaptogenic function. The present study is to identify biological endpoints of proprietary extract of T.triandra. Testing in vitro in 3D skin model showed strong effect on hyaluronic acid production. After topical application of the ingredient in vivo, histological analysis of skin biopsy samples confirmed this observation. In addition effect on collagen production and epidermal turnover was also observed. In vivo bioinstrumentational analysis confirmed skin firming and wrinkle reduction benefits in a dermatologist-supervised, double-blind, randomized, placebo-controlled, split face clinical trial. Additionally, anti-inflammatory properties of T.triandra extract were confirmed by in vivo redness reduction assay. Interestingly, when tested in vitro, T.triandra was able to stimulate HSP70 pathway, confirming its potential not only as anti-aging but also adaptogenic ingredient, i.e. plant derived substance with protecting and balancing properties.

Efficacy of stem cell-conditioned medium vs. platelet-rich plasma as an adjuvant to ablative fractional CO2 laser resurfacing for atrophic post-acne scars: a split-face clinical trial

Objectives To explore the impact of using topical stem cell-conditioned medium (SC-CM) after fractional carbon dioxide laser (FCL) vs. combined FCL and platelet-rich plasma (PRP) or FCL alone in treatment of atrophic acne scars. Methods Thirty-three patients were randomly divided into two split-face groups. Group I (n = 17) received FCL plus topical SC-CM on one side or FCL plus saline on the other. Group II (n = 16) received FCL plus topical PRP or SC-CM. All patients had three monthly sessions. Clinical assessment was done at each visit, with a final assessment after 3 months. Skin biopsies were obtained for histological and quantitative molecular analysis after treatment. Results No significant difference in clinical improvement of acne scars was observed between the FCL/SC-CM and FCL only sides (p = .63), while better and faster improvement was detected on FCL/PRP side compared to FCL/SC-CM side (p = .006). There was no significant difference in downtime or adverse effects between the treated sides in either group. Dermal collagen was increased and procollagen type I gene was upregulated in both FCL/PRP and FCL/SC-CM sides compared to FCL only sides (p = .001 and p = .041, respectively). Conclusions Topical SC-CM could potentially enhance the efficacy of FCL. However, PRP seems to be a better alternative.

The efficacy and safety of BM-PHA for the correction of nasolabial folds: a multicenter, randomized, double-blind, split-face clinical trial

Background: Multiple types of fillers have been developed for soft tissue augmentation.Objective: We investigated the efficacy and safety of the novel filler BM-PHA.Methods: In this multicenter, randomized, split-face study, 91 participants received injections of BM-PHA and Restylane Perlane (PER) into the nasolabial folds. Efficacy was determined by the improvements in the Wrinkle Severity Rating Score (WSRS) and Global Esthetic Improvement Scale (GAIS), and safety by adverse events, laboratory tests, and a check of vital signs.Results: WSRS scores assessed by independent evaluators at Week 24, the primary efficacy measure, showed no significant difference between the two treatments. The treatments also showed no significant differences in WSRS scores assessed by the evaluators at Week 8 and WSRS and GAIS scores assessed by the treating investigators and participants at Weeks 8 and 24. The proportion of nasolabial folds whose WSRS scores improved by at least one grade at Week 24 was similar between the treatments. Only minor local side effects were reported without sequelae.Conclusion: BM-PHA was not inferior to PER in the treatment of moderate to severe nasolabial folds and may be an appropriate alternative product for their improvement. Further studies are needed to confirm the long-term safety of BM-PHA.

Combination of Hydroquinone and Fractional CO2 Laser versus Hydroquinone Monotherapy in Melasma Treatment: A Randomized, Single-blinded, Split-face Clinical Trial.

Background:Melasma is a chronic hyperpigmentation skin disorder mainly affecting women in the reproductive age. Available treatments for melasma do not lead to long-term satisfactory results.Aims:This study aimed to compare the efficacy of fractional CO2 laser in combination with topical therapy to topical therapy alone.Materials and Methods:Forty women with bilateral melasma were studied in this randomized single-blinded clinical trial. Each side of the face was randomly allotted to either topical hydroquinone 4% or combination of topical hydroquinone 4% and fractional CO2 laser. Patients received three sessions of laser therapy at 3-week intervals. Hydroquinone 4% application on both sides maintained for 3 months after the last laser session. The clinical improvement (darkness [D] and homogeneity [H] of hyperpigmentation) was measured by a blinded main investigator and an outcome assessor. Furthermore, improvement was assessed by physician's global assessment (PGA) and patient satisfaction (visual analog scale [VAS] score).Results:Significant reduction in D observed 3 weeks after combination therapy (P<0.001) and 6 weeks after monotherapy (P<0.001). Reduction in H became significant after 6 weeks in both groups (P<0.001). However, the two methods were not considerably different in any session (P>0.05). Furthermore, control and experiment sides were not significantly different considering VAS score and PGA (P>0.05).Conclusion:Considering the short-term outcome of laser and hydroquinone therapy, we can apply it to obtain earlier positive results. However, because of the lack of significant difference between the two methods and also the high cost of laser therapy, it seems better not to recommend fractional CO2 laser to patients as adjunctive therapy for long-term treatment of melasma.