Abstracts

A summary of the latest clinical studies

Title: Botulinum Toxin Injections for Masseter Reduction in East Asians Authors: Cheng J, Hsu SH, et al. Published: Dermatologic Surgey, February 2018 Keywords: Masseter, botulinum toxin Abstract: Cultural ideals for a slimmer face have led to an upsurge in interest in facial contouring among East Asians. Although surgical resection has traditionally been the main treatment option, botulinum toxin injection is becoming a popular, noninvasive alternative. Only the studies conducted in East Asian countries were analyzed in this review, exception of one study from Thailand. A total of 12 publications were identified. Each study was reviewed to extract relevant information on patient selection, injection techniques, efficacy, dosage, frequency, and main side effects of treating masseters with botulinum toxin. Botulinum toxin injection for masseter reduction in East Asians is efficacious and generally considered safe with no significant side effects. Future areas for investigation include defining the criteria for benign masseteric hypertrophy, minimum effective dosage of botulinum toxin, and the potential long-term effects of the injection.

Title: Nitrogen plasma skin regeneration for the treatment of mild-to-moderate periorbital wrinkles: A prospective, randomized, controlled evaluator-blinded trial Authors: Theppornpitak N, Udompataikul M, et al. Published: Journal of Cosmetic Dermatology, February 2019 Keywords: nitrogen plasma, periorbital darkening, periorbital rejuvenation Abstract: Nitrogen plasma skin regeneration is a novel device that produces heat to the skin, resulting in the production of new collagen. Because of lower energy with safer skin damage and lesser adverse effects who have high Fitzpatrick’s skin type especially Thais, this technique is very interesting for clinical application for skin esthetic treatment. However, this treatment has yet been empirically studied as the treatment for mild-to-moderate periorbital wrinkles. This study aimed to evaluate clinical efficacy of nitrogen plasma for the treatment of mild-to-moderate periorbital wrinkles. Eighteen volunteers were enrolled. Each volunteer was randomized to receive nitrogen plasma treatment on one side of periorbital wrinkles with three sessions at a three-week interval and compared with contralateral side without treatment. Photographic examination, skin wrinkle (SEw) score, melanin index, patients’ satisfaction score, side effect, and pain score were reported. At over fourteen weeks, all volunteers completed the study. Treatment with nitrogen plasma group had significantly better improvement for periorbital wrinkles score by Lemperle scale, skin wrinkle (SEw) score by Visioscan® VC 98, and the melanin index by Mexameter® than the control groups (P = 0.004, P < 0.001, P < 0.001, respectively). This study also showed significantly greater satisfaction score to favor the nitrogen plasma treatment group than the control group (P < 0.001). The short-term adverse effects included erythema, scaling, temporary hyperpigmentation, pruritus, and dryness. Nitrogen plasma skin regeneration is effective and safe for the treatment of mild-tomoderate periorbital wrinkles and darkening. Title: Treatment of Atrophic Facial Acne Scars with Microneedling Followed by Polymethylmethacrylate-Collagen Gel Dermal Filler Authors: Biesman BS, Cohen JL, et al. Published: Dermatologic Surgery, February 2019 Keywords: Acne, microneedling, dermal filler Abstract: Microneedling and soft-tissue filler injections have been used independently to improve acne scarring. The effectiveness of a combined approach using microneedling followed by polymethylmethacrylate (PMMA)-collagen gel has not been carefully studied. The goal of this study was to assess the effectiveness and safety of microneedling alone versus microneedling followed by injection of PMMA-collagen gel filler for correction of atrophic facial acne scars. We conducted a multicenter, open-label, randomized, prospective study on subjects with distensible atrophic acne scars in the face to determine whether microneedling with PMMA-collagen gel is a superior acne scar treatment over microneedling alone. Fortyfour subjects received 3 microneedling treatments over a 12-week period followed by randomization to treatments with PMMAcollagen gel (treatment group) or no further treatment (control group). At 24 weeks, the treatment group achieved a statistically significant improvement in acne scores over microneedling alone. The improvement continued at 36 weeks. At 24 weeks, the treatment group showed a strong trend in improvement on the Physician Global Aesthetic Improvement Scale compared with microneedling alone.

Title: Comparison of Antiaging Effects on Rat Skin of Cog Thread and Poly-L-Lactic Acid Thread Authors: Kapicioğlu Y, Gül M, et al. Published: Dermatologic Surgery,March 2019 Keywords: Skin rejuvenation, cog threads, poly-L-lactic acid Abstract: Polydioxanone Cog thread and poly-L-lactic acid (PLLA) thread have been used clinically for lifting and antiaging purposes. However, the histological changes in tissue and the efficacy of these 2 different types of thread have not been compared. This study used hematoxylin and eosin (H&E) staining, Masson’s trichrome staining, and electron microscopy (EM) to compare the results associated with the use of Cog thread and PLLA thread in rat skin. Thirty female rats were divided into 3 groups of 10 rats each: a control group; a Cog group; and a PLLA group. Biopsy specimens obtained at 1, 3, and 6 months were examined using H&E, MT, and EM. Although significant increases were observed in dermal thickness and the numbers of fibroblasts in the PLLA group compared with the control group within the first month (p: .019), there were no significant differences between the Cog and control groups during this period (p: .245). Dermal thickness (p: .002) and numbers of fibroblasts (p: .001) were similar in samples obtained from the PLLA and Cog groups at 3 and 6 months, and both groups showed significantly improved outcomes compared with the control group. Poly-L-lactic acid and Cog sutures were effective in facial rejuvenation; both increased dermis thickness and stimulated collagen production.