Abstracts

A summary of the latest clinical studies

Title: Efficacy Assessment for Low-Level Laser Therapy in the Treatment of Androgenetic Alopecia Authors: Qiu J, et al. Published: Lasers in Medical Science, February 2022 Keywords: Androgenetic Alopecia, Low-Level Laser Therapy Abstract: Low-level laser therapy has been a treatment modality by many androgenetic alopecia (AGA) patients in recent years. It remained unclear as to how long the treatment regime should be maintained, and which characteristics of patients should this be recommended. A study was carried out with an FDAcleared low-level laser helmet for 1,383 patients. Ordinal logistic regression analysis with propensity score matching (PSM) was used to investigate the factors related to efficacy assessment. More than 80% of users were between 18 and 40 years old. The median use times were 133 for mild AGA patients and 142 for moderate-to-severe AGA patients, which equated to 38 weeks and 40 weeks. The overall clinical effectiveness was nearly 80%. PSM analysis revealed that gender, use period, scalp conditions with dandruff, rash, and itchy symptoms were associated with the grading of efficacy assessment. Male users use for more than 180 times or use period for one year and those with scalp dandruff, rash, and itchy symptoms had better efficacy assessments. The recommended treatment regime with low-level laser helmet was more than one year or 180 use times. Male patients with dandruff, rash, and itchy symptoms in scalps tended to have a better efficacy assessment.

Title: Size and Perception of Facial Features with Selfie Photographs and Their Implication in Rhinoplasty and Facial Plastic Surgery Authors: Pressler M, et al. Published: Plastic and Reconstructive Surgery, February 2022 Keywords: Photography, Rhinoplasty Abstract: Patients use photographs taken with a front-facing smartphone camera – ‘selfies’ – to discuss their goals with a plastic surgeon. The purpose of this study was to quantify changes in size and perception of facial features when taking a selfie compared to the gold standard of clinical photography. 30 volunteers took three series of photographs. A 12-inch and 18-inch series were taken with a front-facing smartphone camera, and the 5-foot clinical photography series was taken with a digital single-lens reflex camera. Subjects filled out the FACE-Q inventory when viewing their 12-inch selfies and when viewing their clinical photographs. Measurements were taken of the nose, lip, chin, and facial width. Nasal length was, on average, 6.4% longer in 12-inch selfies compared to clinical photography, and 4.3% longer in 18-inch selfies compared to clinical photography. The alar base width did not change significantly in either set of selfies compared to clinical photography. The alar base to facial width ratio represents the size of the nose in relation to the face. This ratio decreased 10.8% when comparing 12-inch selfies to clinical photography and decreased 7.8% when comparing 18-inch selfies to clinical photography. This study quantifies the change in facial feature size/perception seen in previous camera-to-subject distance studies. This data allows for a more precise conversation between the surgeon and the patient. Title: Descriptive Study on Vascular Anatomy of the Upper Lip Authors: Mohanty S, et al. Published: Aesthetic Plastic Surgery, February 2022 Keywords: Embranchment, Facial Artery, Superior Labial Artery Abstract: The superior labial artery (SLA) is a facial artery (FA) that drains into the perioral region. Owing to the recent rise in the demand for reconstructive procedures and filler injections in this region, it is important to understand its arterial topography. This paper aims to study the embranchment pattern of the labial arteries in the eastern Indian population. An observational study using conventional dissection and dry dye injection methods was conducted to visualise the facial and superior labial arteries in 56 hemifaces. The origin, morphometry (length and diameter), branching pattern, and termination of the arteries were recorded and compared with the existing data. Two hemifaces were excluded from analysis (vessels damaged in dissection); in the remaining 54, a single SLA was present in all samples originating at a mean distance of 1.29 ± 0.32 cm from oral commissure. Lee type II (independent SLA giving off alar branch) was the predominant pattern, followed by type I (independent SLA and alar branches, 33%) and type III (FA terminating as SLA, 10.8%). The average length of SLA was 4.75 ± 1.28 cm and 4.56 ± 0.78 cm on the right and left sides. The SLA is highly variable in occurrence, course, and depth, sometimes occurring unilaterally; any intervention in this region should be done with caution. Since the SLA was not found subcutaneously at the vermillion border, the intradermal and the subcutaneous injections used here are relatively safer.

Title: Histopathological Changes Induced by Malassezin: A Novel Natural Microbiome Indole for Treatment of Facial Hyperpigmentation Authors: Grimes P, et al. Published: Journal of Drugs in Dermatology, February 2022 Keywords: Hyperpigmentation, Malassezin Abstract: Malassezin is a natural indole compound produced by the fungus Malassezia furfur and investigations have demonstrated an ability to suppress melanogenesis. In this study, seven subjects with facial hyperpigmentation caused by melasma or photodamage applied topical malassezin twice daily for 14 weeks, followed by eight weeks of observation. At baseline, 2mm punch biopsies were taken from hyperpigmented areas and adjacent uninvolved skin. Skin biopsies from hyperpigmented areas were repeated at 8, 14, and 22 weeks. Paraffin-embedded sections were cut and stained with H&ampE, Fontana Masson, and MART 1 and assessed for histopathological changes. Increased epidermal melanin and dermal melanophages were observed in all biopsies at baseline in the hyperpigmented compared to uninvolved skin of all subjects. Eight and 14 week biopsies of involved skin revealed decreased epidermal melanin in all subjects treated with malassezin. Melanocytes appeared less dendritic compared to baseline, and numbers were slightly reduced at eight weeks. Biopsies at 22 weeks showed no difference in epidermal melanin levels compared to baseline hyperpigmented skin, and melanocytes were comparable in number and dendricity to baseline. There was no evidence of melanocyte atypia in any of the biopsies. These features were similar in melasma and photo-damaged skin.