Treatment Of Periorbital Wrinkles Research Articles

Comparative Study between Intense Pulsed Light and Fractional CO2 Laser in the Treatment of Periorbital Wrinkles

Abstract Background The periorbital region is one of the areas showing the earliest signs of aging and is especially prone to skin wrinkles and discoloration. Both fractional carbon dioxide (CO2) laser and intense pulsed light (IPL) have been evaluated in treatment of periorbital wrinkles. Objective The objective of this study was to evaluate and compare the efficacy of fractional CO2 laser and IPL in the treatment of periorbital wrinkles. Patients and Methods The present study is a prospective comparative split face study which included 20 adult female patients with mild to moderate periorbital wrinkles. Their age ranged from 30 to 40 years. Each patient received four treatment sessions with three weeks intervals on each side of the periorbital region, one with IPL and one with fractional CO2 laser. Evaluation was done before each treatment session and two months after last session with ordinary photographs and by wrinkles indentation index as calculated by the Antera 3D camera. Results There was a highly statistically difference between the mean percentage of improvement of the wrinkles indentation index by fractional CO2 laser as compared to IPL. Conclusion Both IPL and fractional CO2 laser are promising effective modalities of treatment of periorbital wrinkles which are easy and safe to use. However, fractional CO2 laser is more effective and leads to more improvement in wrinkles indentation index by Antera camera score.

Study of Platelet Rich Plasma Injection versus Plasma Gel in Periorbital Rejuvenation

Abstract Background Aging of the skin consists of a combination of genetically predisposed factors (intrinsic aging) and environmental factors (photo aging). The resulting clinical manifestations include mottled pigmentation, wrinkles, and change of the superficial texture leading to coarseness of the skin Dermal components such as collagen and elastic fibers gradually decrease, skin loses its elasticity and shows wrinkles. Loss of skin moisture and subcutaneous fat accelerates the process. Objective To evaluate the efficacy, possible side effects, durability and study of platelet rich plasma injection versus Plasma gel injection in periorbital rejuvenation. Methods This comparative split face study included 40 females with periorbital wrinkles and/or dark circles recruited from the Dermatology outpatient clinic of Ain-Shams University Hospitals.Right periorbital wrinkles was injected by platelet rich plasma while left periorbital side was injected by plasma gel. Results Treatment with plasma gel resulted in significant improvement of periorbital wrinkles with minimal complications compared to platelet rich plasma. While, dark haloes and skin texture were minimally affected whether with plasma gel or PRP injection. Conclusion Plasma gel as well as platelet rich plasma injections may play role in treatment of periorbital wrinkles but mostly for short durations. Plasma gel injection is more effective in periorbital rejuvenation than PRP injection although it has relatively higher complications rate. Both plasma gel and PRP injections has only minimal role in treatment of periorbital dark hallows.

Treatment of periorbital and perioral wrinkles with fractional Er:YAG laser: What are the effects of age, smoking, and Glogau stage?

Dynamic and static wrinkling are observed on the facial skin as a result of aging. Previously, it was showed that fractional Er:YAG laser was effective in the treatment of facial wrinkles. The aims of this study are to determine the effects of age, Glogau stage, and smoking status on the treatment efficacy of fractional Er:YAG laser; and to compare the success of laser treatment on periorbital wrinkles with perioral wrinkles. Periorbital and perioral wrinkles of the same patient were treated with fractional Er:YAG laser (2940nm) for 4 sessions with monthly intervals. Treatment parameters were affluence of 1.5J, a spot size of 7mm, and a frequency of 5Hz. Treatment efficacy was evaluated by a blinded physician evaluation scale and patient satisfaction scale 2months after the final treatment session. Fifteen patients completed the study. The mean age of the patients was 42.8years. The blinded physician evaluation of the improvement in the periorbital wrinkles decreased (P=.034) and the patient satisfaction in perioral wrinkles decreased (P=.049) with increasing age. The relationship between smoking and patient satisfaction in the treatment of periorbital wrinkles was also statistically significant (P=.014). No difference in terms of treatment efficacy was found between periorbital and perioral regions. Fractional Er:YAG laser (2940nm) is equally successful in the treatment of periorbital and perioral wrinkles. The treatment success decreases with smoking and increasing age.

Split-face comparison of grid fractional radiofrequency vs 1064-nm Nd-YAG laser treatment of periorbital rhytides among Filipino patients.

Despite multiple individual studies proving efficacy of grid fractional monopolar radiofrequency (Grid RF) and near-infrared irradiation 1064-nm long-pulsed neodymium:YAG laser (Laser Genesis), there is a lack of controlled comparative trials between these devices. This study aims to compare the efficacy and safety of Grid RF versus Laser Genesis in the treatment of periorbital rhytides. This is a randomized, single-blind, split-face, prospective study. Eight patients with moderate to severe periorbital rhytides were treated with either Grid RF or Laser Genesis on each side of the face. Photographic and live assessment with the Lemperle Wrinkle Assessment grading scale was compared after 2 months. Difference in scores between Grid RF vs Laser genesis groups after 2 months was not statistically significant (P = 0.244). Each group showed statistically significant improvement months post-procedure (P < .05). Immediate adverse effects and satisfaction scale were similar for both groups (P > .05). At 2 months follow-up, no adverse effects were seen. Grid monopolar radiofrequency (Grid RF) vs near-infrared radiation 1064 nm long-pulsed Nd-YAG laser (Laser Genesis) were equally efficacious, safe, and well-tolerated among patients in the treatment of periorbital wrinkles (P > .05).

A quasi interventional study on the efficacy of long pulsed Nd:YAG laser (LPND) in the treatment of periorbital wrinkles in a tertiary care hospital

Wrinkles or rhytids are a part of the natural ageing process of the human body. Long pulsed Nd: YAG laser (LPND) promotes dermal collagen remodelling without damaging the superficial layers and hence reduce periorbital wrinkles. Patients seeking treatment for periorbital wrinkles, and willing to participate in the study were included. Wrinkles were graded on the basis of wrinkle severity score (WSS) at baseline and one month after 4 monthly sessions of treatment. The 1064nm LPND was employed with settings of: spot size - 10mm, on time - 40 to 50 ms, fluence - 30 to 50 J/cm and frequency - 1 Hz. Three overlapping passes were done on both sides of the face. Outcome was measured by subjects, investigator and a blinded dermatologist. Appropriate statistical analysis was done. Twenty eight sites were treated in 14 subjects. Male to female ratio was 3:4. Their mean age was 45.86 ± 8.75. Mean WSS by investigator at baseline was 3.18 ± 1.188 and at the end of treatment was 1.89 ± 1.031 (p = 0.001). Mean WSS by the blinded dermatologist was 3.18 ± 1.188 at baseline and 2.43 ± 1.034 at end of the treatment (p =0.001). The subject’s degree of satisfaction was found to be 2.96 ± 1.036. There were no significant adverse events. LPND for periorbital wrinkles is both patient and physician friendly, offering maximum results with minimal discomfort and downtime. This modality needs further exploration in the treatment of periorbital wrinkles in the Indian population.

The Anti-Wrinkle Efficacy of Argireline, a Synthetic Hexapeptide, in Chinese Subjects

Argireline is a synthetic peptide that is patterned from the N-terminal end of the protein SNAP-25 and has been shown to reduce the degree of facial wrinkles. It is reported to inhibit vesicle docking by preventing formation of the ternary SNARE complex and by interfering in catecholamine release. The anti-wrinkle efficacy of argireline has not been studied in Chinese subjects. The objective of the study was to evaluate the safety and efficacy of argireline in the treatment of peri-orbital wrinkles in Chinese subjects. A total of 60 subjects received a randomized treatment of argireline or placebo in a ratio of 3:1. Argireline or placebo was applied to their peri-orbital wrinkles twice daily for 4 weeks, and then evaluations were made for the improvements in wrinkles. In the subjective evaluation, Daniell's classification and Seeman's standard were applied to make a global assessment of changes in the appearance of peri-orbital lines. In the objective evaluation, silicone replicas of the skin at the application area were made before and after the treatment, which were analyzed by a wrinkle-analysis apparatus. In the subjective evaluation, the total anti-wrinkle efficacy in the argireline group was 48.9 %, compared with 0 % in the placebo group. In the objective evaluation, the parameters of roughness were all decreased in the argireline group (p < 0.01), while no decrease was obvious in the placebo group (p > 0.05). This study showed that argireline had a significant anti-wrinkle effect in Chinese subjects.

The Efficacy and Safety of Succinylated Atelocollagen and Adenosine for the Treatment of Periorbital Wrinkles

The degradation of structural collagen contributes to the characteristic appearance of wrinkles. The anti-wrinkle effects of a variety of substances have been studied, but the potential anti-wrinkle effects of topical applications of collagen for periorbital wrinkles have not been investigated. To evaluate the effects of topical application of succinylated atelocollagen on periorbital wrinkles and to compare the results of treatment with adenosine, a clinical study on Korean participants was carried out. Each participant’s right or left periorbital area was treated with either a solution containing succinylated atelocollagen and adenosine or a solution containing only succinylated atelocollagen for two months. A placebo solution was applied to the opposite periorbital area of each patient’s face for two months. Based on objective and subjective measurements of clinical improvement, the assessment scores for treated sites were statistically significantly higher than scores for placebo sites after two months of treatment. Analysis of silicone casts of periorbital wrinkles demonstrated partial effects of succinylated atelocollagen on periorbital wrinkles. However, we did not observe any effects of adenosine on periorbital wrinkles. Succinylated atelocollagen may be an effective treatment option for periorbital wrinkles, but further studies including a longer treatment period and larger subject group are needed to verify these results.

Treatment of periorbital wrinkles with 1550‐ and 1565‐nm Er:glass fractional photothermolysis lasers: a simultaneous split‐face trial

This study aimed to compare the clinical efficacies of 1550- and 1565-nm Er:glass lasers in the treatment of periorbital wrinkles and to evaluate histological changes after treatment. Twenty patients received five treatments each at 3-week intervals. The right periorbital area was exposed to the 1550-nm Er:glass laser and the left periorbital area was exposed to the 1565-nm Er:glass laser. Clinical improvement was evaluated by two blinded physicians who assessed comparative photographs using a four-point scale at baseline and 3 months after the final treatments. Skin biopsies were performed in five volunteers before treatment and at 3 months after the final treatment. The mean improvement scores 3 months after treatment with the 1550- and 1565-nm Er:glass lasers were 2.25±0.62 and 2.28±0.59 respectively. Histological examination revealed increased epidermal thickening and decreased solar elastosis 3 months after the final laser treatments. Both 1550- and 1565-nm Er:glass lasers are safe and effective modalities in the treatment of periorbital wrinkles with no significant differences between the two lasers.

Treatment of periorbital wrinkles by repeated medium‐depth chemical peels in dark‐skinned individuals

The periorbital region serves as a barometer of chronological and environmental age and, as such, persons often seek its cosmetic rejuvenation. This study was conducted to determine the efficacy and safety of repeated, medium-depth chemical peels in the treatment of periorbital wrinkles in dark-skinned individuals. A total of 12 subjects (10 women and 2 men) with fine and/or medium-sized wrinkles were included in the study, the ages ranged from 30 to 55 years with a mean of 41.25. Focal, medium-depth peels of periorbital area including crow's foot wrinkles were performed using a combination of Jessner's solution followed by the application of 35% trichloroacetic acid (TCA). The study involved a four-session regimen. To be included in this study, the subject completed at least two peeling sessions, 1 month apart, and returned for follow-up according to the research schedule. Improvement occurred in 11 of 12 subjects. Marked improvement occurred in four subjects (33%), moderate improvement in three (25%), mild improvement in another three (25%), minimal improvement in one subject (8%), and no response in one subject (8%). There were seven patients with fine and five with medium periorbital wrinkles. For statistical analysis, the no and minimum response groups were categorized as nonresponders. The improvement that ranged between marked to mild occurred in 100% of subjects with fine wrinkles and 60% of subjects with medium wrinkles. Mild side effects appeared in four subjects (33%). It can be concluded that fine and/or medium periorbital wrinkling responds favorably to repeated, medium-depth chemical peels even in dark-skinned individuals with few mild side effects.

Treatment of periorbital wrinkles. A comparison of the SilkTouch carbon dioxide laser with a medium-depth chemical peel.

Chemical peels are an effective treatment for wrinkles, but their use is limited because of the associated risk of scarring, hypopigmentation, and the inability to accurately control the depth of tissue injury. High energy, pulsed, or computer scanned continuous wave carbon dioxide (CO2) lasers cause minimal thermal injury, decrease the risk of scarring, and allow for precise control of tissue vaporization to predictable depths. To compare the effectiveness and side effect profile of a medium-depth chemical peel to that of the SilkTouch CO2 laser in the treatment of periorbital wrinkles. Twenty-four subjects (nine male, 15 female) with moderate to severe periorbital wrinkles were assigned a wrinkle score (1 = mild through 5 = severe) before treatment and 6 months after treatment. Each subject was treated with Jessner's solution and 35% trichloroacetic acid on one side and the SilkTouch CO2 laser on the other side. The average periorbital wrinkle score decreased from 4.00 +/- 0.78 before laser treatment to 1.75 +/- 0.68 6 months after treatment. The chemical peel wrinkle score decreased from 4.13 +/- 0.85 to 3.29 +/- 0.99. The degree in which the wrinkle score improved after laser treatment compared with after chemical peel treatment was statistically significant. Posttreatment erythema lasted an average of 4.5 months for the laser-treated areas and 2.5 months for the chemical peel-treated areas. Treatment of periorbital wrinkles with the SilkTouch CO2 laser resulted in a greater degree of improvement than treatment with a medium-depth chemical peel but had longer lasting posttreatment erythema.