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Post-Inflammatory Hyperpigmentation post-ablative treatments A novel approach to minimise the risk

Egor V. Kolodtchenko MD (Koherent Clinic, Ukraine), Anna G. Funikova MD (Academy of Health Clinic, Ukraine), Tiina Meder MD (Meder Beauty International, UK)

POST-INFLAMMATORY HYPERPIGMENTATION (PIH) following laser, or chemical peel ablative treatments are not uncommon, and while skin improvement may have been achieved, the potential resulting pigmentation can contribute to patient dissatisfaction. A group of scientists headed by Koherent Clinic in Ukraine conducted a trial using a cosmetic preparation Nrj-Soin Serum developed by Meder Beauty Science to identify its effectiveness in defending the skin from PIH. The article below is an abstract from the research paper presented by Tiina Meder. Laser treatments in aesthetic medicine have been growing increasingly popular in the past decade, and this trend is likely to persist. Laser can be used for a variety of purposes, from acne therapy to scar and skin tag removal; and controlled epidermal injury is a significant treatment option in aesthetic medicine. According to numerous research studies the risk of side effects and complications resulting from aesthetic laser treatments can be considered low. However, certain side effects that may be classified as insignificant, may cause noticeable discomfort and can lead to the patient’s dissatisfaction with the treatment effect, even when the results are satisfactory from an objective point of view. Among such side effects is pigmentation disturbance caused by epidermal injury and the development of inflammatory changes in the tissue in the process of post-laser recovery. Post-inflammatory hyperpigmentation (PIH) is one of the most commonly described side effects of laser treatments. Various research data show that the rate of PIH after nonablative fractional laser treatment reaches 31% for melasma therapy, 25% for antiageing correction and 41% for post-acne scarring removal. Ablative laser treatment bears even a higher degree of risk: up to 80% of PIH with CO2 laser and 60% with Erbum YAG laser. The power of laser impact correlates with the risk of post-treatment pigmentation. Generally, patients with already present melasma need to be informed that laser therapy, including non-ablative laser, may increase pigmentation after a single treatment. Thus, PIH prevention must be one of the priorities in the

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patient’s preparation for laser treatment. In the past, in the presence of risk factors, such as melasma, PIH manifestation, the use of photosensitising skincare in the previous few weeks and the taking of photosensitising drugs as prophylactic measures were recommended for at least 14–28 days prior to the treatment. Today the standard for PIH prevention is applying topical solutions with confirmed anti-tyrosinase activity. Most commonly used are solutions based on kojic acid, azelaic acid, arbutin and hydroquinone, the latter often used in combination with tretinoin and topical steroids (the use of hydroquinone-containing solutions is banned in EU). Apart from these, the daily use of sunscreens with SPF UVA UVB 30–50 is routinely recommended to laser patients. However, most of the above, with the exception of sunscreens, actually increase the skin’s sensitivity to ultraviolet, exposing patients to the risk of PIH in the recovery period after laser or other treatment involving epidermal injury.

DISCLOSURE Exploring ways that this hyperpigmentation could be minimised a team of researchers conducted a trial. For the purpose of this research 100 bottles of Meder Beauty Science Nrj-Soin Serum were provided. The packaging was 50 ml airless bottles, unmarked. The serum was provided by Meder Beauty International Ltd (UK). The research participants were not rewarded. The clinical professionals, who participated in the research, did not receive any grants, rewards, payments or any other compensation, material or otherwise. This study was conducted without any sponsor support from the manufacturing company. The aim of this research was to explore the possibilities and prospects of PIH prevention with the use of a topical solution with brightening and anti-inflammatory effect which does not increase the skin’s sensitivity to UV radiation.

METHOD This research was conducted in several clinics in Ukraine. 54 women, aged 25–52 participated in the research. Participants were selected to the following criteria: •

Good general health at the time of research

Profile for APAN - Aesthetics Practitioners Advisory Network

APJ Vol 38 2018  

Aesthetics Practitioners Journal Volume 38 Spring 2018 - The official publication of the Aesthetics Practitioners Advisory Network (APAN)

APJ Vol 38 2018  

Aesthetics Practitioners Journal Volume 38 Spring 2018 - The official publication of the Aesthetics Practitioners Advisory Network (APAN)