No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Efficacy of microneedling with topical vitamin C in treatment of acne scars
Abstract
Introduction: Acne scars are largely preventable complications of acne. 95% of the scars occur over the face thus impacting the quality of life. Correction of scars is the priority for acne patients. There is no single treatment modality that has been shown to be universally effective. Microneedling is a relatively new minimally invasive procedure used as a collagen induction therapy for skin rejuvenation and facial scars.
Aim of the work: Evaluation of efficacy of microneedling with topical vitamin C in treatment of acne scars.
Patients and Methods: Ten patients with post acne atrophic facial scars attending the outpatient clinic of Dermatology in Sohag University Hospitals between June 2014 to September 2017 were offered six microneedling sessions plus topical vit. C (during the session of microneedling and daily topical application in between sessions) microneedling sessions were four weeks apart. They were evaluated monthly and one month after completion of sessions for both efficacy and safety of the procedure.
Results: The mean ± SD of the patients' age in the study population were 28.900 ±5.384yers old nine females and one males with mean acne scars duration ± SD 11.900±5.506 years, 90%% of patients had psychological distress from their acne scars. At the end of study duration Out of the ten patients 6(60%) achieved one grade reduction in their Goodman and Baron qualitative grading score and 2 (20%) achieved two grade reduction. According to the quantitative ECCA " Echella d'e valuation Clinique des cicatrices d'acne" score 80% 0f patients achieved reduction in their score with 27.5% improvement in the ECCA score. The mean ECCA score value of V scar started to decrease earlier than both U scar, and M scar. 40% of patients had excellent satisfaction and 60% had very good satisfaction. All treated patients, had adverse events of temporary erythema, edema, bleeding, or a serous ooze resolving with crusting or scabbing following each session of microneedling, bacterial infection not occurred in any of our patients.
Conclusion: Multiple minimally invasive sessions of skin microneedling with topical vitamin C during sessions and daily application is an effective treatment for post-acne atrophic scars with the advantage of being a relatively risk-free, in-office procedure with minimal patient recovery time.
Key words: Microneedling, Vitamen C, acne scar.
... The patients received six microneedling sessions with topical Vitamin C spaced four weeks apart, along with topical vitamin C application every day in between the sessions. At the conclusion of the trial, two patients (20%) and six patients (60%) respectively achieved two grade reductions and one grade reduction in their Goodman and Baron qualitative grading scores (13) . Our results were higher than these two results because we used combined punch elevation with microneedling and PRP Non-ablative laser therapy of acne scars produced positive outcomes. ...
... 13 Two previous studies revealed excellent improvement in acne scars with topical application of vitamin c preceded by microneedling. 14,15 The role of topical insulin in wound healing has been under scrutiny in literature since 1960's and 1970's. 16,17 Various studies have been done in animal models and humans and it has been found that topical Insulin therapy exerts its effects via IGF 1 receptor. ...
Background:
Post acne scars following sebaceous injury and abnormal wound healing during the course of acne is a prevalent and challenging to treat condition.
Aim of the work:
To evaluate microneedling by dermapen with topical vitamin C versus microneedling with topical insulin in treating atrophic post-acne scars.
Patients and methods:
A split -face comparative study included 30 subjects with atrophic post-acne scars. Human insulin was topically applied to the left side of the face and on the right side, vitamin C serum was applied. Scars were assessed via the Acne Scar Assessment Scale (ASAS) and Scar quartile grading scale (SQGS).
Results:
After one month of 4 treatments, a statistically significant mean improvement in ASAS value was reported on both split sides of the face (2.13 and 1.83) compared to baseline (3.03 and 2.93) (p=0.005; p=0.001 respectively). When compared to baseline, the mean ASAS value improved significantly with a slight more improvement on the vitamin c treated side CONCLUSION: Topical insulin and vitamin c combined with microneedling, may both achieve comparable significant improvement for treating post acne scars. Insulin can be a promising novel anti-scarring therapy pending larger controlled studies to verify its efficacy. This article is protected by copyright. All rights reserved.
Background and aim
Postacne scars may affect about 95% of patients with past history of acne that is related to its duration and severity of. Treatment of acne scarring is challenging. Microneedling with platelet-rich plasma (PRP) or vitamin C is a new, simple, and effective treatment modality for such scars. The authors aimed to compare between microneedling plus PRP versus microneedling plus vitamin C in treatment of postacne scars.
Patients and methods
This is a comparative study that was carried out on 20 patients (their ages ranged from 22 to 37 years). They are four males and 16 females, they presented with postacne scars. The patients were divided randomly to receive microneedling plus PRP on one side of the face, and microneedling plus vitamin C on the other side.
Results
The authors found a significant improvement of atrophic acne scars, with significant reduction in the number of acne scars as well as Goodman score after treatment by microneedling plus PRP as well as microneedling plus vitamin C, moreover, most of the patients were satisfied after treatment with no significant difference between both treatment methods. Microneedling with PRP and vitamin C was well-tolerated with no major adverse events that were observed.
Conclusion
PRP as well as vitamin C combined with microneedling is a safe, effective, and promising option in treatment of acne scars.
Objective: Treatment of acne scarring is always a challenge. Microneedling therapy or percutaneous collagen induction is a new addition to the treatment modalities for such scars and has been reported to be simple and effective in atrophic acne scar treatment. The aim of this study is to evaluate the clinical effect and objectively quantify the histological changes of acne scarring in response to skin microneedling. Design: A prospective clinical study. Participants: Ten patients with different types of atrophic acne scars were subjected to three months of skin microneedling treatment (six sessions at two-week intervals). Measurements: Patients were photographed, and skin biopsies were obtained at baseline as well as one and three months from the start of treatment. Histometry for epidermal thickness and quantitative evaluation of total elastin; newly synthesized tropoelastin; collagen types I, III, and VII; and newly synthesized collagen were performed for all biopsies. Results: Compared to the baseline, patients' evaluations revealed noticeable clinical improvement in atrophic post-acne scars in response to skin microneedling. There was a statistically significant increase (p<0.05) in the mean of collagen types I, III, and VII and newly synthesized collagen, while total elastin was significantly decreased (p<0.05) after the end of treatment. Conclusions: Multiple minimally invasive sessions of skin microneedling are an effective treatment for post-acne atrophic scars as it stimulates the repair processes with the advantage of being a relatively risk-free, in-office procedure with minimal patient recovery time.
One of the thrust areas in drug delivery research is transdermal drug delivery systems (TDDS) due to their characteristic advantages over oral and parenteral drug delivery systems. Researchers have focused their attention on the use of microneedles to overcome the barrier of the stratum corneum. Microneedles deliver the drug into the epidermis without disruption of nerve endings. Recent advances in the development of microneedles are discussed in this review for the benefit of young scientists and to promote research in the area.
Microneedles are fabricated using a microelectromechanical system employing silicon, metals, polymers or polysaccharides. Solid coated microneedles can be used to pierce the superficial skin layer followed by delivery of the drug. Advances in microneedle research led to development of dissolvable/degradable and hollow microneedles to deliver drugs at a higher dose and to engineer drug release. Iontophoresis, sonophoresis and electrophoresis can be used to modify drug delivery when used in concern with hollow microneedles. Microneedles can be used to deliver macromolecules such as insulin, growth hormones, immunobiologicals, proteins and peptides. Microneedles containing 'cosmeceuticals' are currently available to treat acne, pigmentation, scars and wrinkles, as well as for skin tone improvement.
Literature survey and patents filled revealed that microneedle-based drug delivery system can be explored as a potential tool for the delivery of a variety of macromolecules that are not effectively delivered by conventional transdermal techniques.
Acne has a prevalence of over 90% among adolescents and persists into adulthood in approximately 12%-14% of cases with psychological and social implications. Possible outcomes of the inflammatory acne lesions are acne scars which, although they can be treated in a number of ways, may have a negative psychological impact on social life and relationships. The main types of acne scars are atrophic and hypertrophic scars. The pathogenesis of acne scarring is still not fully understood, but several hypotheses have been proposed. There are numerous treatments: chemical peels, dermabrasion/microdermabrasion, laser treatment, punch techniques, dermal grafting, needling and combined therapies for atrophic scars: silicone gels, intralesional steroid therapy, cryotherapy, and surgery for hypertrophic and keloidal lesions. This paper summarizes acne scar pathogenesis, classification and treatment options.
Microneedling with dermaroller is a new treatment modality for the treatment of scars, especially acne scars, stretch marks, wrinkles, and for facial rejuvenation. It is a simple and relatively cheap modality that also can be used for transdermal drug delivery.
The influence of ageing on the density of the functional entities of the papillae containing nutritive capillaries, here in terms as the papillary index, and the effect of topically applied vitamin C were investigated by confocal laser scanning microscopy (CLSM) in vivo.
The age dependency of the papillary index was determined by CLSM on 3 different age groups. Additionally, we determined the effect of a topical cream containing 3% vitamin C against the vehicle alone using daily applications for four months on the volar forearm of 33 women.
There were significant decreases in the papillary index showing a clear dependency on age. Topical vitamin C resulted in a significant increase of the density of dermal papillae from 4 weeks onward compared to its vehicle. Reproducibility was determined in repeated studies.
Vitamin C has the potential to enhance the density of dermal papillae, perhaps through the mechanism of angiogenesis. Topical vitamin C may have therapeutical effects for partial corrections of the regressive structural changes associated with the aging process.
Background: Biofilms are diverse groups of microorganisms encased in a self-produced matrix that offers protection against unfavourable conditions and antibiotics.
Methods: We performed a literature search using the MEDLINE electronic database. Only original articles published in English were considered for review.
Results: Biofilms have been implicated in the pathogenesis of acne, eczema, hidradenitis suppurativa, onychomycosis, miliaria, and impetigo. Adverse dermal-filler reactions are also linked to biofilms. Strict aseptic technique and prophylactic antibiotics are recommended in order to avoid such complications. Finally, biofilms are implicated in wounds, mainly chronic and diabetic, where they impede healing and cause recurrent infections. Several novel anti-biofilm agents and wound debridement have been shown to be beneficial.
Conclusions: Biofilms are a significant cause of disease with wide implications in the field of dermatology. Several novel treatments have been found to be effective against biofilms, depending on the underlying microbes and type of disease.
Importance
Neocollagenesis can be achieved using a dermal rolling needle device, thereby reducing the appearance of acne scars.Objective
To determine the efficacy of a needling device for treatment of acne scars.Design, Setting, and Participants
We performed a single-center, rater-blinded, balanced (1:1), split-face, placebo-controlled, parallel-group randomized clinical trial at an urban academic institution. The study took place from November 30, 2009, through July 27, 2010. Twenty healthy adults (age range, 20-65 years) with acne scars on both sides of the face were enrolled. Fifteen individuals completed the study, and no enrolled participants were withdrawn for adverse effects.Interventions
For each participant, one side of the face was randomized for needling. Three needling treatments were performed at 2-week intervals.Main Outcomes and Measures
Two blinded dermatologists separately rated participants’ acne scars based on standard digital photographs obtained at baseline and at the 3-month and 6-month follow-up visits on the quantitative global scarring grading system.Results
Mean scar scores were significantly lower in the treatment group compared with baseline at 6 months (mean difference, 3.4; 95% CI, 0.2-6.5; P = .03) and nominally but not significantly lower compared with baseline at 3 months (mean difference, 2.4; 95% CI, −0.01 to 4.8; P = .052). In the control group, mean scar scores did not vary significantly from baseline at 3 months (mean difference, 1.0; 95% CI, −1.4 to 3.4; P = .96) and at 6 months (mean difference, 0.4; 95% CI, −2.3 to 3.5; P > .99). The needling procedure was not particularly painful, with a mean pain rating of 1.08 of 10. Participants perceived a 41% mean improvement in overall scar appearance on the treated side. No adverse events were reported.Conclusions and Relevance
After 3 needling treatments, there was improvement in the appearance of acne scars over time compared with the control group, with minimal pain reported.Trial Registration
clinicaltrials.gov Identifier: NCT00974870
Background
Acne scars occur consequent to abnormal wound healing following sebaceous follicular inflammation in acne. Various types of acne scars are icepick, rolling, boxcar, hypertrophic, and keloidal. Different modalities of treatment include subcision, dermaroller, cryoroller, punch excision, chemical peeling, and lasers.Objectives
To compare the efficacy of combined subcision and dermaroller vs. combined subcision and cryoroller in acne scar treatment.Methods
Thirty patients (19 males and 11 females) with grade 2, 3, and 4 postacne scarring (Goodman and Baron qualitative grading system) were enrolled in the study. Three sittings each at 1-month interval were carried out of subcision under nerve block on the entire face followed by derma roller (2.5 mm) and cryoroller on one half of the face. Standardized digital photography was performed preprocedure and at 6 months. Grading of acne scar photographs using the Goodman and Baron qualitative and quantitative grading scale was carried out by a blinded observer pre- and postprocedure at 6 months. Patients' own evaluation based on patient scar severity perception scale of 1–10 was also taken into account.ResultsAssessment using the quantitative grading scale showed a 57% improvement using combined subcision and cryoroller against 40% improvement with combined subcision and dermaroller. Average improvement perceived by the subjects was 61% with combined subcision and cryoroller against 45% with combined subcision and dermaroller. The data were analyzed using Wilcoxon signed rank test and found statistically significant. Postinflammatory hyperpigmentation on the cryoroller side and erythema, edema, and hematoma formation due to subcision was transient.Conclusion
Combined subcision and cryoroller is more effective than combined subcision and dermaroller for treatment of acne scars.
Acne vulgaris is a common inflammatory skin condition affecting most individuals at some point during their lives. Although acne is more commonly seen in adolescents, it can be seen in younger patients as well. It can be useful to classify pediatric acne based on the age of presentation as infantile, mid-childhood, or preadolescent. We describe a practical approach to the evaluation and treatment of acne in each of these age groups.
The aim of this study was to estimate the efficacy of skin needling in the treatment of the aging neck. Eight patients with aging necks were included in the study. Each patient was treated with 2 sessions of needling. The evaluation of treatment effectiveness was based on changes from baseline on the Global Aesthetic Improvement Scale, the Wrinkle Severity Rating Scale, photographic and ultrasonographic images, and silicone rubber microrelief impressions of a selected neck region before and after therapy. Analysis of the photographs, the degree of irregularity of the surface microrelief, and the ultrasound images showed that, after 2 sessions, the lesions' severity grade was reduced in almost 90% of the patients. The present study presents evidence for the efficacy of skin needling for the aging neck.
Free radicals have long been studied as a contributor to aging and disease processes. Endogenous production of radicals from cellular metabolism and exogenous sources from ultraviolet radiation and pollution can damage the skin on the cellular and tissue levels. Although the body possesses an elegant defense system to prevent radical damage, this innate system can be overwhelmed and lead to a state of oxidative stress or immunosuppression, and can even trigger carcinogenesis. Topical supplementation of antioxidants can provide additional protection to neutralize reactive oxygen species from both endogenous and exogenous sources. This review will discuss our current understanding of the mechanisms of free radical damage and evaluate the potential benefit of topical antioxidants in sunscreens and skin care products.
Acne scars can cause emotional and psychosocial disturbance to the patient. Various modalities have been used for the treatment of acne scars like punch excision, subcision, peels, microdermabrasion, unfractionated and fractioned lasers. The latest in the treatment armamentarium is microneedling. Acne scars commonly coexist with postinflammatory hyperpigmentation. A combination of microneedling and glycolic acid (GA) peels was found to give excellent results in the treatment of such scars. The aim was to study the efficacy of a combination of microneedling with glycolic peel for the treatment of acne scars in pigmented skin.
Thirty patients in the age group of 20-40 years with atrophic box type or rolling scars with postinflammatory hyperpigmentation were chosen for the study. Two groups were made. The first group comprised of 30 patients in whom only microneedling was performed once in 6 weeks for five sessions. In the second group of 30 patients, a combination of microneedling and 35% GA peels was carried out. Patients from both groups were evaluated on the basis of Echelle d'Evaluation clinique des Cicatrices d'acné classification.
Based on the objective scoring and its statistical analysis, there was significant improvement in superficial and moderately deep scars (grade 1-3). There was also improvement in skin texture, reduction in postacne pigmentation in the second group.
Microneedling is a simple, inexpensive office procedure with no downtime. It is safe in Indian skin (skin types III-IV). The combined sequential treatment with GA peel caused a significant improvement in the acne scars without increasing morbidity.
Percutaneous collagen induction (PCI) promotes removal of damaged collagen and induces more collagen immediately under the epidermis. The chemical reconstruction of skin scars (CROSS) method is a focal application of full-concentration trichloroacetic acid (TCA) to atrophic acne scars. The CROSS method has the advantage of reconstructing acne scars by increasing dermal thickening and collagen production.
To compare the safety and efficacy of PCI and the 100% TCA CROSS method for the treatment of atrophic acne scars.
Thirty participants were randomly equally divided into two groups; group 1 underwent four sessions (4 weeks apart) of PCI, and group 2 underwent four sessions (4 weeks apart) of 100% TCA CROSS.
Acne scarring improved in 100% of patients. Scar severity scores improved by a mean of 68.3% (p<.001) in group 1 and a mean of 75.3% (p<.001) in group 2. The difference in the degree of improvement was not statistically significant between the groups (p=.47).
PCI and 100% TCA CROSS were effective in the treatment of atrophic acne scars.
Acne is a common condition seen in up to 80% of people between 11 and 30 years of age and in up to 5% of older adults. In some patients, it can result in permanent scars that are surprisingly difficult to treat. A relatively new treatment, termed skin needling (needle dermabrasion), seems to be appropriate for the treatment of rolling scars in acne.
To confirm the usefulness of skin needling in acne scarring treatment.
The present study was conducted from September 2007 to March 2008 at the Department of Systemic Pathology, University of Naples Federico II and the UOC Dermatology Unit, University of Rome La Sapienza. In total, 32 patients (20 female, 12 male patients; age range 17-45) with acne rolling scars were enrolled. Each patient was treated with a specific tool in two sessions. Using digital cameras, photos of all patients were taken to evaluate scar depth and, in five patients, silicone rubber was used to make a microrelief impression of the scars. The photographic data were analysed by using the sign test statistic (alpha < 0.05) and the data from the cutaneous casts were analysed by fast Fourier transformation (FFT).
Analysis of the patient photographs, supported by the sign test and of the degree of irregularity of the surface microrelief, supported by FFT, showed that, after only two sessions, the severity grade of rolling scars in all patients was greatly reduced and there was an overall aesthetic improvement. No patient showed any visible signs of the procedure or hyperpigmentation.
The present study confirms that skin needling has an immediate effect in improving acne rolling scars and has advantages over other procedures.
A survey of 1066 healthy women and 1089 healthy men aged 18-70 years, performed to determine the prevalence of facial acne, showed that clinical acne was not confined to adolescents. Though it was more prevalent among men than women at 18, beyond the age of 23 clinical acne was more prevalent among women as the prevalence in men gradually declined. At 40-49 years 3% of men and 5% of women still had definite, albeit mild, clinical acne, and at 50-59 years 6% of men and 8% of women had physiological acne. The surprisingly high prevalence of acne in adults may be related to antibiotic treatment or, in women, to the use of oral contraceptives or cosmetics, though this survey did not study their influence. Further studies in different populations are needed to establish the prevalence of acne in the community, and its distribution.
Despite scarring being a recognized sequel of acne, the actual extent and incidence of residual scarring remains unknown. One hundred and eighty-five acne patients were included in this study (101 females, 84 males). Patients were selected from acne clinics and their acne scarring was examined. The scarring was quantified according to a lesion count and allocated a score. The type and extent of scarring was correlated to the age and sex of the patient, the site of the acne, the previous acne grade according to the Leeds Technique, acne type (noted in clinic at the original referral time) and duration of acne, before adequate therapeutic measures had been instituted. Results indicate that facial scarring affects both sexes equally and occurs to some degree in 95% of cases. Total scarring on the trunk was significantly greater in males, as was hypertrophic and keloid scarring in these sites (P < 0.05). There were significant correlations between the initial acne grade and the overall severity of scarring in all sites and in both sexes (P < 0.01). Superficial inflamed papular acne lesions as well as nodular lesions were capable of producing scars. A time delay up to 3 years between acne onset and adequate treatment related to the ultimate degree of scarring in both sexes and in all three sites. This emphasizes the need for earlier adequate therapy in an attempt to minimize the subsequent scarring caused by acne.
The ECCA grading scale (échelle d'évaluation clinique des cicatrices d'acné) is a tool designed to help dermatologists to assess the severity of acne scars and to standardize the discussions about the treatments of scars.
We developed an acne scar clinical grading scale called ECCA, which consists of 6 items designed to assess easily and quickly the severity of acne scars by a global score. The interobserver reliability of the ECCA grading was statistically validated.
The statistical analysis showed the interinvestigator reliability of the ECCA grading scale among 7 dermatologists who used it on the same group of 10 acne patients.
ECCA is a new tool which will now be available for dermatologists to use in their everyday practice and for clinical trials evaluating the efficacy of treatments on acne scars.
There is no global qualitative grading system for assessing the disease load and global severity of disease in a patient with postacne scarring.
The purpose of this article is to provide a simple qualitative grading system that would allow better communication between practitioners of a patient's global disease severity and the most appropriate corresponding therapy for that degree of acne scarring.
Four grades of postacne scarring are described, and appropriate therapeutic interventions are presented for each. Grade assignment is made by lesion morphologies and disease load as indicated by patient perception of severity (i.e., whether or not an individual can easily disguise his or her disease at social distances).
A simple qualitative global acne scarring grading system is presented.
The determination of disease load in terms of patient perception of severity is intrinsically imperfect due to varying subjectivity among individuals.
A global acne scarring grading system is presented that is simple to use and may optimize therapeutic intervention. This system would also allow investigators, educators, and proceduralists to compare their cases more accurately and to have a more objective discussion of the efficacy of operative interventions or therapies.
We investigated the inhibitory effects of a novel amphiphilic ascorbic derivative, disodium isostearyl 2-O-L-ascorbyl phosphate (VCP-IS-2Na), synthesized from a hydrophilic ascorbic derivative, sodium-2-O-L-ascorbyl phosphate (VCP-Na), on melanogenesis in cultured human melanoma cells, normal human melanocytes, and three-dimensional cultured human skin models. Melanin synthesis in melanoma cells treated with VCP-IS-2Na at 300 muM and melanocytes treated with VCP-IS-2Na at 100 muM decreased to 23% and 52% of that in non-treated cells, respectively, and the cell viability was not affected. VCP-IS-2Na also significantly suppressed the cellular tyrosinase activity of melanoma cells and melanocytes. Melanin synthesis in human skin models was evaluated by macro- and microscopic observations of its pigmentation and quantitative measurements of melanin. Treatment of the human skin models with 1.0% VCP-IS-2Na did not inhibit cell viability, while melanin synthesis was decreased to 21% of that in the control. In contrast, L-ascorbic acid (VC) and VCP-Na did not seem to inhibit melanin synthesis and cellular tyrosinase activity. These results indicate that VCP-IS-2Na may be an effective whitening agent for the skin, and we expect the application of VCP-IS-2Na in the cosmetic industry.
A split-face comparative study to evaluate efficacy of combined subcision and dermaroller PDF created with pdfFactory Pro trial version www
- R Gadkari
- C Nayak
Gadkari R, Nayak C. A split-face
comparative study to evaluate efficacy of
combined subcision and dermaroller
PDF created with pdfFactory Pro trial version www.pdffactory.com
SOHAG MEDICAL JOURNAL
Efficacy of microneedling with topical vitamin C
Vol. 22 No.1 Jan 2018
Tissue repair and the dynamics of the extracellular matrix. The international journal of biochemistry & cell biology
- K S Midwood
- L V Williams
- J E Schwarzbauer
Midwood
KS,
Williams
LV,
Schwarzbauer JE. Tissue repair and the
dynamics of the extracellular matrix. The
international journal of biochemistry &
cell biology. 2004;36(6):1031-7.
Minimally invasive percutaneous collagen induction. Oral and maxillofacial surgery clinics of North America
- D Fernandes
Fernandes
D.
Minimally
invasive
percutaneous collagen induction. Oral and
maxillofacial surgery clinics of North
America. 2005;17(1):51-63, vi.
Protective effects of a topical antioxidant mixture containing vitamin C, ferulic acid, and phloretin against ultraviolet-induced photodamage in human skin
Protective effects of a topical antioxidant
mixture containing vitamin C, ferulic acid,
and phloretin against ultraviolet-induced
photodamage in human skin. Journal of
cosmetic dermatology. 2008;7(4):290-7.
Dermatologic surgery : official publication for American Society for Dermatologic Surgery
- G J Goodman
- J A Baron
Goodman GJ, Baron JA. Postacne
scarring: a qualitative global scarring
grading system. Dermatologic surgery :
official publication for American Society
for Dermatologic Surgery [et al].
2006;32(12):1458-66.
Topical L-ascorbic acid: percutaneous absorption studies. Dermatologic surgery : official publication for American Society for Dermatologic Surgery
- S R Pinnell
- H Yang
- M Omar
- N Monteiro-Riviere
- H V Debuys
- L C Walker
Pinnell SR, Yang H, Omar M, Monteiro-Riviere N, DeBuys HV, Walker LC, et al.
Topical L-ascorbic acid: percutaneous
absorption studies. Dermatologic surgery :
official publication for American Society
for Dermatologic Surgery [et al].
2001;27(2):137-42.