Treatment Of Photodamage Research Articles

A new peptide originated from amphibian skin alleviates the ultravioletB-induced skinphotodamage.

Although amphibian-derived bioactive peptides have attracted increasing attention for their potential use in the treatment of photodamage, research is still in its infancy. In this study, we obtained a new antioxidant peptide, named OA-GI13 (GIWAPWPPRAGLC), from the skin of the odorous frog Odorrana andersonii and determined its effects on ultraviolet B (UVB)-induced skin photodamage as well as its possible molecular mechanisms. Results showed that OA-GI13 directly scavenged free radicals, maintained the viability of hydrogen peroxide-challenged keratinocytes, promoted the release of superoxide dismutase, catalase, and glutathione, and reduced the level of lactate dehydrogenase. Furthermore, topical application of OA-GI13 in mice alleviated dorsal skin erythema and edema and protected the skin against UVB irradiation by increasing antioxidant levels and decreasing peroxide, malondialdehyde, and 8-hydroxydeoxyguanosine levels. OA-GI13 also alleviated oxidative stress injury in vivo and in vitro, possibly by inhibiting p38 protein phosphorylation. Our study confirmed the anti-photodamage effects of this novel amphibian-derived peptide, thus providing a new molecule for the development of drugs and topical agents for the treatment of skin photodamage.

Retrospective study on the safety and tolerability of clinical treatments with a novel Thermomechanical Ablation device on 150 patients.

There are currently not many publications on the safety of thermomechanical ablation (TMA) devices, and those that are published only have small numbers of subjects. This treatment is gaining popularity in Europe and Asia, and thus there is a need to look at the safety of this treatment. The purpose of this retrospective study was to evaluate the safety of the clinical use of the novel TMA system (Tixel, Novoxel, Israel) for facial rejuvenation and treatment of acne scars. We did a retrospective review of our first 150 patients who were treated with the TMA device. One hundred and fifty consecutive patients aged 20years to 82years with Fitzpatrick skin types I to V treated with the TMA device were included in this study. The total number of treatment sessions was 327 (average 2.18 treatment per patient). The total number of pulses delivered to these patients was 1 48 856 (average 455 pulses per session). The indications for the treatment were photodamaged skin (n=145) and acne scarring (n=5). All patients were able to use makeup immediately after the treatment at lower settings, thus needing no real recovery time. Patients treated at higher settings were able to use makeup after 2days. There were four reported complications: post-inflammatory hyperpigmentation (n=2), impetigo (n=1), and dermatitis (n=1). Using the TMA device in the treatment of photodamage and acne scarring is safe in skin types I to V and has a low incidence of temporary side effects with no permanent side effects.

Research progress on skin photoaging and oxidative stress.

Skin photoaging, which is a kind of exogenous aging, refers to skin elasticity degradation, skin roughening, and wrinkle formation processes because of cascading reactions of a series of kinases after growth factor receptors and cytokine receptors are activated on a cell surface under the UV effect. An extensively recognized skin photoaging mechanism is free radical–oxidative stress concept, proposed by Sohal who represents the authority of the US aging studies. Over the past decade, many new developments in the oxidative stress mechanism have been achieved in terms of the occurrence, development, prevention, and treatment of photodamage.

A split-face comparison between single band vs. dual band pulsed light technology for the treatment of photodamage

A split-face comparison between single band vs. dual band pulsed light technology for the treatment of photodamage

Evaluating the safety and efficacy of the 1,440‐nm laser in the treatment of photodamage in Asian skin

As the demand for diminished procedure-associated downtime continues to increase, nonablative fractional laser resurfacing is becoming a more popular intervention in the progression of photoaging. Patients with pigmented skin and a mild degree of photodamage may be particularly suited for a less intensive laser treatment. In this study, we have evaluated the safety and efficacy of a low energy, low density 1,440-nm fractional laser in the treatment of multiple signs of photoaging including dyspigmentation, wrinkling, tissue laxity, enlarged pores, and skin roughness in Asians. Ten Chinese subjects with Fitzpatrick skin types III-V and visible signs of photodamage participated in this study. Patients received four treatments at 2-week intervals with a 1,440-nm diode-based fractional laser. Photographs were taken at baseline, 2 weeks after each of the first three treatments and 4 weeks after the final treatment. Images were evaluated independently by two physicians. Clinical improvement and adverse events were analyzed. Discomfort, heat sensation and overall patient satisfaction associated with the procedure were also quantified. In this prospective single-arm study, signs of photoaging were examined after treatment with the 1,440-nm laser. Here we show that a series of four treatments with this device produced a mild improvement in skin texture, pigmentation, and wrinkling. Changes in pore size and skin laxity failed to reach statistical significance. Immediate after-effects of the procedure included erythema and edema which were transient and left no permanent sequela. A significant proportion of patients reported some degree of discomfort during the procedure despite use of a topical anesthetic. One patient developed a discrete, localized area of post-inflammatory hyperpigmentation which completely resolved by the final follow up visit. The low energy, low density nonablative 1,440-nm fractional laser produces a mild improvement in select signs of photodamage after four treatments without any long-term adverse effects.

Ablative Fractionated CO2 Laser Resurfacing for the Face and Neck

Introduction: There has been little information reported on the use of fractionated CO2 laser resurfacing of the neck. We describe our initial experience with conservative treatment on the neck with concurrent treatment to the face. Materials and Methods: We retrospectively reviewed all cases of full-face and neck ablative fractionated CO2 laser resurfacing at our institution performed for the treatment of photodamage. Results: Eighteen consecutive patients were included with at least 3 months of follow-up. All neck settings were lower than the face settings. Eleven patients were treated with a 120μ spot size and 7 patients with a 300μ spot size. Average time of reepithelialization was 5 to 7 days for the full face and 7 to 14 days for the neck. Similarly for erythema resolution, patients reported an average of 4 weeks for improvement versus 6 weeks for the neck area. Two patients reported being dissatisfied with the procedure, and all others were happy with neck results. Complications included 1 case of herpes simplex virus reactivation with perioral lesions, 3 cases of postinflammatory hyperpigmentation of the face, and 1 case of postinflammatory hyperpigmentation with persistent erythema of the neck. Conclusions: Fractionated CO2 laser treatment to the neck involved delayed healing times despite the use of lower laser settings.

Criopeeling para tratamento de fotodano e ceratoses actínicas: comparação entre nitrogênio líquido e sistema portátil

Cryopelling uses diffuse cryotherapy not only on lesions of actinic keratosis but all over the photodamaged skin. The aim of this study was to compare two cryopeeling methods (liquid nitrogen- LN and portable system - PS) and demonstrate their efficiency in the treatment of actinic keratoses, patient tolerance, researcher and patient preference and aesthetic results. Sixteen patients (N = 16) with multiple actinic keratoses on the forearms were subjected to cryopeeling with LN on one of the forearms and PS on the other, randomly. In the treatment of actinic keratoses, LN obtained 74% efficiency and PS, 62% (p = 0.019). The mean visual analogue scale (0-10) was 5.7 ± 1.61 with LN and 4.3 ± 1.44 with PS (p = 0.003). There was no significant statistical difference between the two methods in terms of researcher and patient preference. An analysis of the photos showed improvement of the skin appearance with both treatments (p <0.001). Treatment with LN obtained some degree of improvement in 62.5% of the cases, while treatment with PS obtained some degree of improvement in 52% of the cases (p> 0.05). Treatment with the PS showed better tolerance, but was less efficient than LN. Although LN has been the preferred method, there was no statistical difference between the methods. The cryopeeling technique may be an option in the treatment of photodamage. The PS can be an interesting alternative in clinical practice with good tolerance and acceptable results in the treatment of actinic keratoses.

Efficacy of a new fractional CO2 laser in the treatment of photodamage and acne scarring

This study evaluates the efficacy and safety of a novel fractional CO(2) laser device for improving facial rhytids, hyperpigmentation, enlarged pores, skin laxity, and acne scarring. Subjects (n= 15) were treated three to five times at 3-week intervals. Biopsy specimens were used to evaluate healing response and neocollagenesis. Clinical improvement was rated on a quartile rating scale from digital photographs. Subject discomfort during treatment was evaluated on a scale of 0 to 5. Fourteen subjects who completed the study achieved good to excellent improvement in overall appearance, with 60% rated excellent. Improvement in photodamage was good to excellent in 92% of subjects, and reduction in rhytids was good to excellent in 85%. A total of 79% of subjects achieved good to excellent improvement in pore sizes and skin laxity. Subject discomfort during treatment was 3.0 +/- 0.7. Erythema persisted for 2-3 days, and subjects resumed normal activities 1-2 days after the procedure. Histological slides after a single treatment showed new collagen formation. The SmartSkin fractional CO(2) system (Cynosure, Inc., Westford, MA, USA) provides significant improvement for the treatment of facial wrinkles, hyperpigmentation, pore size, and skin laxity associated with photodamage.

Clinical evaluation of a microablative/fractional carbon dioxide laser for the treatment of photodamage and scars

Clinical evaluation of a microablative/fractional carbon dioxide laser for the treatment of photodamage and scars

A study examining the safety and efficacy of a fractional laser in the treatment of photodamage on the hands

Background: Few clinical studies have been reported in the literature documenting the efficacy of non‐ablative modalities in the treatment of non‐facial areas such as the hand. Objective: The present study examined the clinical and histopathological effects of a fractional 1550 nm erbium diode fiber laser in patients with bilateral moderate hand photodamage. Methods: Nine subjects with Fitzpatrick skin types I–III, a mean age of 57 years with an average Fitzpatrick wrinkle score of 4.44 were entered in the present study. Five to six laser treatments were administered to each individual. Physician analysis based on a quartile improvement scale for wrinkling, pigmentation, skin texture and overall photodamage was assessed at 1‐month, 3‐month and 6‐month follow‐up visits. In addition, histological analyses (H&E) were carried out on three individuals. Results: Each photodamage characteristic exhibited statistically significant improvement or better (23%) in overall photodamage at the 6‐month follow‐up visit. Histologic evaluation showed a reduction in atypical keratinocytes, improvement in rete ridge formations, increased collagen density and a reduction in solar elastosis at 6 months post‐treatment. Conclusion: The present study demonstrates the potential of non‐ablative fractional lasers for the treatment of non‐facial anatomic areas such as the dorsum of the hands.

Evaluation of histologic and electron microscopic changes after novel treatment using combined microdermabrasion and ultrasound‐induced phonophoresis of human skin

Background: Mechanical exfoliation using microdermabrasion has been used as a minimally invasive treatment of photodamage, as well as to improve absorption of topical agents. Phonophoresis, a method of electrically assisted percutaneous delivery of macromolecules, relies on ultrasonic waves producing alterations within the stratum corneum that result in increased absorption. Objective: To determine the effects on photodamaged facial skin that resulted from the ultrasound‐enhanced delivery of a combined hyaluronic acid, retinol, and peptide‐containing complex following microdermabrasion. Methods: Seven individuals, aged 40–65, with Fitzpatrick skin types I–III and class I–III rhytids, underwent eight weekly aluminum oxide crystal microdermabrasion procedures (Parisian Peel®; Aesthetic Technologies, Golden, CO, USA), followed by administration of a topical combined hyaluronic acid, retinol, and peptide‐containing complex, propelled through ultrasound phonophoresis. The participants continued manual twice‐daily application of the topical complex between treatments. Clinical evaluation included digital photography, and patient and investigator assessment of changes in skin dryness, texture, brightness, tone, and rhytids. The 3‐month post‐treatment histologic evaluation consisted of pre‐ and post‐treatment biopsies evaluated for microscopic and ultrastructural changes. Results: An overall mild clinical improvement in the skin was noted. A slight increase in vascularity within the papillary dermis, increased reticulin stain (type III collagen), and ultrastuctural evidence of increased type I collagen indicate dermal injury with resulting new collagen formation. Conclusion: Microdermabrasion followed by ultrasonic phonophoretic application of topical products represents a novel dermal delivery approach to photorejuvenation.

Novel use of lasers in cutaneous disorders

There have been substantial advances in the use of lasers for skin disorders. The pulsed dye laser is the treatment of choice for vascular lesions and is also efficacious in psoriasis, acne vulgaris, and as a light source for photodynamic therapy. The long-pulsed alexandrite and neodymium: yttrium-aluminum-garnet lasers are effective for epilation even in darker skin types and may be useful for bulky and hypertrophic vascular lesions. The xenon chloride excimer laser has been introduced recently to dermatology and is efficacious for psoriasis and vitiligo. Other disorders, including hand dermatitis, oral lichen planus, alopecia areata and mycosis fungoides also appear to be responsive to this laser. A variety of lasers are used for non ablative rejuvenation, although improvement in appearance of photodamaged skin is modest at best. However, fractional photothermolysis and radiofrequency devices are recently introduced devices that are gaining popularity by facilitating the treatment of photodamage without...

Tazarotene versus tazarotene plus hydroquinone in the treatment of photodamaged facial skin: A multicenter, double‐blind, randomized study

Objectives: To compare the efficacy and tolerability of tazarotene plus hydroquinone versus tazarotene alone in the treatment of facial photodamage. Methods: Patients with facial mottled hyperpigmentation of at least moderate severity and an overall integrated assessment of photodamage score of at least moderate applied tazarotene 0.1% cream each evening and either hydroquinone 4% cream or placebo cream each morning for up to 24 weeks. Results: Among 131 patients enrolled, 114/124 (92%) with exit data completed. Both regimens were highly effective in reducing photodamage, with tazarotene plus hydroquinone showing superiority over tazarotene alone for some efficacy measures. The incidence of ⩾1‐grade improvement from baseline (on a scale of none, minimal, mild, moderate, or severe) was significantly greater with tazarotene plus hydroquinone than with tazarotene alone for lentigines (weeks 12–24, p⩽0.01) and mottled hyperpigmentation (week 16, p⩽0.05). The incidence of ⩾50% global improvement was also significantly superior with the combination regimen as early as week 8 (p⩽0.01). Both regimens were associated with good tolerability and high patient satisfaction (no significant between‐group differences). Conclusions: The adjunctive use of hydroquinone can enhance the efficacy of tazarotene in reducing dyspigmentation associated with photodamage.

Tazarotene cream and botulinum toxin type A in the treatment of photodamage: A placebo-controlled study in identical twins

Tazarotene cream and botulinum toxin type A in the treatment of photodamage: A placebo-controlled study in identical twins

A multicenter, randomized, double-blind trial of tazarotene 0.1% cream in the treatment of photodamage

Previous studies indicate that tazarotene is efficacious in reducing signs of photodamage. Objective We sought to confirm the efficacy and tolerability of tazarotene 0.1% cream in the treatment of facial photodamage. A total of 568 patients with at least moderate fine wrinkling or mottled hyperpigmentation applied tazarotene 0.1% cream or vehicle cream to their face once daily for 24 weeks. Tazarotene cream was significantly more effective than vehicle in reducing fine wrinkles, mottled hyperpigmentation, lentigines, irregular depigmentation, apparent pore size, elastosis, tactile roughness, and an overall integrated assessment of photodamage. Significance was achieved as early as week 2 for some parameters and had not plateaued by week 24. The majority of patients reported improvements in their photodamage as early as week 4. Adverse events were predominantly mild or moderate signs or symptoms of skin irritation. Once-daily tazarotene 0.1% cream is effective in ameliorating multiple signs of facial photodamage.

The Versatile Golden Peel: When Less Is More

Golden Peels made of two concentrations of resorcin, are simple, effective, inexpensive, and safe. Some specific steps must be followed when these peels are applied in order to gain all their advantages and avoid complications. They are useful in the improvement of superficial wrinkles, actinically damaged skin, and active acne. When combined with Jessner solution (Golden Peel Plus) they are effective for treatment of photodamage not only to the face but in the v-line of the neck and upper limbs. They may be used for the improvement of breast flaccidity and striae distensae.

Treatment of photodamage with topical tretinoin: An overview

Topical administration of tretinoin has proved to be effective in treating clinical signs of photodamaged skin. In large-scale, double-blind, placebo-controlled, 6-month trials, 0.05% tretinoin emollient cream (Renova, Retinova) reduced fine wrinkles and skin roughness, and it produced histologic changes such as epidermal thickening, increased granular layer thickness, stratum corneum compaction, and decreased melanin content. Smaller changes were also observed at lower tretinoin concentrations. Continued for another 6 months, 0.05% tretinoin emollient cream produced some additional clinical improvement but the histologic changes observed in the epidermis (with the exception of melanin content) regressed toward baseline, raising questions as to what was responsible for the clinical improvement. After 12 months of treatment, there were additional signs of tissue normalization including deposition of new collagen in the papillary dermis and ultrastructural evidence of dermal reconstruction with improvement in the dermoepidermal junction and correction of keratinocyte degeneration, changes that presumably relate directly to tretinoin's mechanism of action. There was no suggestion of cytologic atypia in these studies or in biopsy specimens obtained after up to 4 years of continued use. Mild to moderate dermatitis was the only common adverse reaction to tretinoin use. Percutaneous tretinoin absorption is low, raising plasma levels by amounts that are negligible compared with the normally low endogenous tretinoin levels. No teratogenic effects have been observed in retrospective studies of topical tretinoin application during the first trimester of pregnancy. Thus, topical tretinoin is safe and effective in the treatment of photodamage. (J Am Acad Dermatol 1997;36:S27-S36.)