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Pharmaceutical based cosmetic serums
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Background: Acne is a chronic inflammatory skin condition that causes spots and pimples on the face due to excessive skin sebum.
Objectives: To evaluate efficacy and safety of Rosa T Mild Cleanser and Rosa T Serum in volunteers with mild to moderate facial acne lesions with oily skin/excessive skin sebum.
Methods: 37 subjects were randomized in a double-blind, two-arm, parallel study conducted in healthy males and females aged≥18 to≤35 years. Each subject applied Placebo Cleanser /Rosa T Mild Cleanser along with Rosa T Serum on face BID for 42 days.
Effect of Placebo Cleanser and Rosa T serum (Test Product 1) and RosaT Mild Cleanser and Rosa T Serum (Test Product 2)was evaluated for sebum level, skin hydration, cutaneous inflammatory and non-inflammatory acne lesions, skin pigment, acne severity and acne scars assessment.
Results: Combined usage of Rosa T serum along with the cleanser proved to be effective where a significant reduction in sebum level on cheek and forehead (p<0.001), cutaneous inflammatory (p<0.05) and non-inflammatory (p<0.01) acne lesions skin pigment (p<0.001), till Day 42, with sufficient skin hydration level (MS>40) and no apparent adverse event was observed.
Conclusions: Significant improvement in acne, overall skin condition with lowered sebum level, decrease in skin pigment, sufficient skin hydration, improved acne condition and reduction in acne scars. The botanical-based Rosa T Mild Cleanser and Rosa T Serum (Test Product 2) can be employed as a safer and effective substitute to the current change of synthetic topical anti-acne product in patients with acne severity grade II and III.
Keywords: acne vulgaris, adult acne, scar, post-inflammatory hyperpigmentation
Background: Vitiligo is a chronic disease of great cosmetic concern presenting with depigmented macules and patches. It is often recalcitrant to medical treatment. Aim: The aim of the study was to study the efficacy and safety of topical 5% 5-fluorouracil with needling versus topical 5% 5-fluorouracil alone in stable vitiligo. Materials and Methods: This interventional prospective study was conducted from July 2018 to June 2019. Total of 60 patients, with stable vitiligo of age older than 10 years, were randomly assigned into two groups of 30 patients each. Group A was treated with needling followed by topical 5% 5-fluorouracil over vitiligo patches. The procedure was performed every 2 weeks for 3 months. Group B was treated with topical 5% 5-fluorouracil alone. Clinical improvement was assessed monthly till 6 months by serial clinical photographs and grading score. Results: Initiation of repigmentation started at 1 month in 76 patches (65%) in Group A, whereas in group B, it was seen in 45 patches (38.7%), which was statistically significant (P = 0.0001). Excellent improvement (>75% repigmentation) was noted in 55 patches (47%) in Group A as compared to 5 patches (4.3%) in group B at the end of 6 months (P = 0.03). Conclusion: Needling with 5% 5-fluorouracil appears to be simple, safe, and effective treatment in vitiligo. It can be used in poor responders to conventional therapy.
Background: Hair fall is a widespread problem among all genders, ages, and ethnicity with both physical and psychological effects.
Objective: This clinical study was designed to evaluate the efficacy and safety of a hair serum formulation containing amla extract, freeze-dried coconut water, and the micronutrient selenium along with sandalwood odorant and peanut shell extract in healthy male and female volunteers with hair fall.
Methods: A total of 42 subjects were enrolled and completed the study and they used the test product daily for 90 days. TrichoScan® was used to evaluate the efficacy of the test product for improving hair growth rate, hair density, anagen hair, telogen hair, and the density of vellus and terminal hair. Hair thinning and hair fall reduction were compared to its basline by both dermatologists and subject self-assessment questionnaires.
Result and Discussion: After 90 days of test product application, there was a significant improvement in hair growth rate (< 0.0001), hair density (< 0.0001), vellus hair density (< 0.0001), and terminal hair density (< 0.0001) in comparison to baseline. There was a significant reduction in hair fall with bulb (< 0.0001) and without bulb (< 0.0001), and hair thinning (< 0.0001) compared to the baseline measurement. Adverse events were not recorded during the study. No skin intolerance was reported during the study, and the test product was considered dermatologically safe to use.
Microneedling was initially introduced for skin rejuvenation, however, this minimally invasive procedure is now being used for the treatment of multiple dermatological conditions. Recent reports have shown its efficacy in the treatment of vitiligo. This review analyzes the current literature on microneedling techniques, efficacy, and safety for vitiligo treatment. An extensive PubMed was done to identify literature on microneedling treatment for vitiligo. Case reports, case series, and clinical trials were included in this review. All 14 articles evaluated showed improvement of vitiligo lesions after microneedling treatment. The combination of microneedling and topical tacrolimus, 5-FU, topical calcipotriol and betamethasone, NB-UVB with or without PDT, and triamcinolone acetonide solution yielded more efficacy than microneedling monotherapy Microneedling is a safe and efficient technique in the treatment of vitiligo. Thus, it can be an alternative treatment for vitiligo especially when the latter is resistant to conventional therapies. This article is protected by copyright. All rights reserved.
Background:
Vitiligo is a chronic disease of great cosmetic concern presenting with depigmented macules and patches. It is often recalcitrant to medical treatment.
Aim:
The aim of the study was to study the efficacy and safety of topical 5% 5-fluorouracil with needling versus topical 5% 5-fluorouracil alone in stable vitiligo.
Materials and methods:
This interventional prospective study was conducted from July 2018 to June 2019. Total of 60 patients, with stable vitiligo of age older than 10 years, were randomly assigned into two groups of 30 patients each. Group A was treated with needling followed by topical 5% 5-fluorouracil over vitiligo patches. The procedure was performed every 2 weeks for 3 months. Group B was treated with topical 5% 5-fluorouracil alone. Clinical improvement was assessed monthly till 6 months by serial clinical photographs and grading score.
Results:
Initiation of repigmentation started at 1 month in 76 patches (65%) in Group A, whereas in group B, it was seen in 45 patches (38.7%), which was statistically significant (P = 0.0001). Excellent improvement (>75% repigmentation) was noted in 55 patches (47%) in Group A as compared to 5 patches (4.3%) in group B at the end of 6 months (P = 0.03).
Conclusion:
Needling with 5% 5-fluorouracil appears to be simple, safe, and effective treatment in vitiligo. It can be used in poor responders to conventional therapy.
A new cyclodextrin polypseudorotaxanes nail lacquer (Regenail®) containing biotin, methyl sulphonyl methane (MSM), and dimethylsilanediol salicylate was developed and evaluated in vitro and in vivo. The product was developed to improve nail status and diminish signs of pathological nail alterations. A reference product (Betalfatrus®) was used for comparative purposes. An in vitro permeation experiment in hooves showed high MSM and biotin absorption. The content of sulfur and silicon in hooves was also found to be higher compared with the reference product. MSM was tested in human keratinocytes, exhibiting a good cytotoxicity profile and anti-inflammatory activity by the reduction in IL-8 and TNF-α under LPS stimuli. A clinical study was performed to check product safety and efficacy against nail brittleness and alterations such as Beau’s lines and onychorrhexis. A reduction in both alterations and in surface roughness without alteration of nail structure was observed, with a good level of patient acceptance and satisfaction.
Geraniol is a monoterpenic alcohol with a pleasant rose-like aroma, known as an important ingredient in many essential oils, and is used commercially as a fragrance compound in cosmetic and household products. However, geraniol has a number of biological activities, such as antioxidant and anti-inflammatory properties. In addition, numerous in vitro and in vivo studies have shown the activity of geraniol against prostate, bowel, liver, kidney and skin cancer. It can induce apoptosis and increase the expression of proapoptotic proteins. The synergy of this with other drugs may further increase the range of chemotherapeutic agents. The antibacterial activity of this compound was also observed on respiratory pathogens, skin and food-derived strains. This review discusses some of the most important uses of geraniol.
Background:
Skin aging is characterized by slacking and loss of density, especially under ultraviolet (UV) radiation exposure.
Objective:
To investigate the beneficial effects of a combination containing bakuchiol (BK) and vanilla tahitensis extract (VTE) to prevent skin photoaging in vitro and to improve clinical outcomes for naturally aged skin.
Materials and methods:
Human dermal fibroblasts were treated with active compounds, exposed to an acute dose of UVA and analyzed by confocal microscopy: actin network for morphology, interleukin-8 (IL-8) for inflammation and p16 for senescence. Human skin was used to evaluate chronic UVA-induced glycosaminoglycan (GAG) loss and to assess the benefit of topical application of a BK+VTE serum (Alcian blue staining). An open-label clinical trial was conducted in women applying the serum twice daily for 56 days (n=43). Skin remodeling was assessed by FaceScan®. Firmness was evaluated through Dynaskin® and clinical scoring. Skin radiance was also rated on standardized full-face photographs.
Results:
UVA induced a significant increase in IL-8 and p16 expression and marked morphological changes in fibroblasts. Treatment with BK or VTE alone prevented both actin network alteration and IL-8 upregulation. Interestingly, BK+VTE demonstrated synergistic protection against IL-8 and p16 overexpression. Serum application prevented GAG loss at the dermo-epidermal junction and increased dermal GAG in UVA-exposed skin explants. In the clinical trial, face ptosis was reduced by 11% on average for 26 responsive subjects and up to 23%. Depth of skin deformation was also reduced by 24% on average for 30 responsive subjects and up to 30%. This firming effect was confirmed by clinical scoring. Radiance was significantly improved by 29% on average for 33 responsive subjects. The serum demonstrated good tolerance/safety.
Conclusion:
BK+VTE combination demonstrated anti-aging efficacy and might provide a substantial benefit in the daily care of naturally aged skin in women, through their synergistic effect on inflammaging and senescence.
Vitiligo is a skin disorder commonly acquired. Although different therapies are used, they are refractory to therapy in many cases. Trauma has been reported to cause hyperpigmentation by the pigment incontinence, which results in the build‐up of melanophages in the upper dermis after basal cell layer destruction. To detect the effectiveness of trichloroacetic acid (TCA) 70% in the treatment of non‐segmental vitiligo after skin micro‐needling by dermapen or intradermal injection of 5‐fluorouracil.
Patients and Methods
A prospective comparative study was enrolled with thirty‐ two patients with vitiligo who were assigned to two equal groups. Each containing 16 patients; group1 was treated by micro‐needling followed by TCA 70%, group 2 was treated by intradermal 5‐FU injection. This was done every 2 weeks for 2 months.
Results
According to the Physician's Global Assessment, there was no significant (P < 0. 05) difference in the therapeutic response between the two studied groups.
Conclusions
Both micro‐ needling plus TCA70% and 5‐FU intradermal injection are a simple means of treating vitiligo with cosmetically accepted repigmentation of all age groups, as well as a relatively safe alternative or additive method that can be used before (or in combination with) any of the well‐known and widely approved method for stable non‐segmented vitiligo treatment.
This article is protected by copyright. All rights reserved.
Human skin demonstrates a striking variation in tone and color that is evident among multiple demographic populations. Such characteristics are determined predominantly by the expression of the genes controlling the quantity and quality of melanin, which can alter significantly due to the presence of small nucleotide polymorphism affecting various steps of the melanogenesis process and generally linked to the lighter skin phenotypes. Genetically determined, constitutive skin color is additionally complemented by the facultative melanogenesis and tanning responses; with high levels of melanin and melanogenic factors broadly recognized to have a protective effect against the UVR-induced molecular damage in darker skin. Long-term sun exposure, together with a genetic makeup responsible for the ability to tan or the activity of constitutive melanogenic factors, triggers defects in pigmentation across all ethnic skin types. However, sun exposure also has well documented beneficial effects that manifest at both skin homeostasis and the systemic level, such as synthesis of vitamin D, which is thought to be less efficient in the presence of high levels of melanin or potentially linked to the polymorphism in the genes responsible for skin darkening triggered by UVR. In this review, we discuss melanogenesis in a context of constitutive pigmentation, defined by gene polymorphism in ethnic skin types, and facultative pigmentation that is not only associated with the capacity to protect the skin against photo-damage but could also have an impact on vitamin D synthesis through gene polymorphism. Modulating the activities of melanogenic genes, with the focus on the markers specifically altered by polymorphism combined with differential requirements of sun exposure in ethnic skin types, could enhance the applications of already existing skin brightening factors and provide a novel approach toward improved skin tone and health in personalized skincare.
p class="abstract">Glutathione is a potential antioxidant and its reduced form (GSH) has a good skin-whitening effect in humans through its tyrosinase inhibitory activity. Many physicians consider it as a Wonder drug for skin lightening and treatment of hyperpigmentation, especially with darker skin tones. Glutathione is available in topical, oral and injectable formulations. Topical and oral forms are considered to be safe. Intravenous form did not prove its safety and efficacy to till date. In this article, we shall review and discuss the current status of glutathione as a skin lightening agent and address the miscellaneous unanswered queries regarding the dosage, duration of use and longevity of accrued effects based on clinical evidence and recent insights into its antimelanogenic mechanism.</p
A multifunctional system comprised of hyaluronic acid microneedles was developed as an effective transdermal delivery platform for rapid local delivery. The microneedles can regulate the filling amount on the tip, by controlling the concentration of hyaluronic acid solution. Ultrasonication induces dissolution of the HA microneedles via vibration of acoustic pressure, and AC iontophoresis improves the electrostatic force-driven diffusion of HA ions and rhodamine B. The effect of ultrasound on rhodamine release was analyzed in vitro using a gelatin hydrogel. The frequency and voltage dependence of the AC on the ion induction transfer was also evaluated experimentally. The results showed that the permeability of the material acts as a key material property. The delivery system based on ultrasonication and iontophoresis in microneedles increases permeation, thus resulting in shorter initial delivery time than that required by delivery systems based on passive or ultrasonication alone. This study highlights the significance of the combination between ultrasonic waves and iontophoresis for improving the efficiency of the microneedles, by shortening the reaction duration. We anticipate that this system can be extended to macromolecular and dependence delivery, based on drug response time.
Aim of the study: Is to evaluate the effect of myrrh oil local application on the healing process of skin wounds histologically , histomorphometrically and , histochemically. Materials and methods:Twenty male white New Zealand rabbits were used in this study. An incisional wounds with full thickness depth and of 2 cm length were done on both sides of the cheek skin of each rabbit. The left sided incisions (the control group) were irrigated with distilled water (10µL). The right sided incisions (the experimental groups) were treated with myrrh oil (10µL). Each group was subdivided into 4 subgroups according to the healing interval into 1,3,7 and 14 days(5 rabbits for each group). Results: Histological findings of our current study showed a highly significant difference between the experimental and the control groups in count of the inflammatory cells which showed that mean values increased with time for the control and the experimental groups. The histomorphometrical findings had shown that the thickness of the epithelium was nearly completed at about 7 days for the experimental groups and at about 14 days for the control. The blood vessels count was recorded to have a highly significant difference between the groups at days 1 and 3 only. The histochemical findings had shown that the collagen fibers remodeling had recorded a highly significant difference between the control and the experimental groups at days 7 and 14. Conclusion: The current study had revealed that myrrh oil accelerates wounds healing in rabbits.
Background:
Skin aging has many manifestations such as wrinkles, uneven skin tone, and dryness. Both intrinsic and extrinsic factors, especially ultraviolet light-induced oxidative radicals, contribute to the etiology of aging. Human skin requires both water- and lipid-soluble nutrient components, including hydrophilic and lipophilic antioxidants. Vitamins C and E have important protective effects in the aging process and require exogenous supply. Raspberry leaf extracts contain botanical actives that have the potential to hydrating and moisturizing skin. Topical products with these ingredients may therefore combine to provide improved anti-aging effects over single ingredients.
Objectives:
To evaluate the anti-aging and brightening effects of an encapsulated serum containing vitamin C (20% w/w), vitamin E, and European raspberry (Rubus idaeus) leaf cell culture extract.
Methods:
Fifty female volunteers aged 30-65 years were allocated one capsule of serum for topical application on one side of the face for 2 months, in addition to self-use of facial skin products. Both test (treated) and contralateral (untreated) sides were dermatologically assessed after 4 and 8 weeks. Skin color (melanin index), elasticity, radiance, moisture, and water evaporation were measured by Mexameter MX18® , Cutometer® , Glossymeter GL200® , Corneometer CM825® , and Tewameter TM300® instruments, respectively (Courage + Khazaka Electronic GmbH). Skin microtopography parameters, smoothness (SEsm), roughness (SEr), scaliness (SEsc), and wrinkles (SEw), were measured by Visioscan® VC98 USB (Courage + Khazaka Electronic GmbH), and gross lifting effects were measured by VECTRA® H1 (Canfield Scientific), and adverse reactions and satisfaction were also assessed.
Results:
Skin color, elasticity, and radiance were significantly improved. The smoothness, scaliness, and wrinkles were also revealed significant improvement. Mild adverse reactions were tingling and tightness.
Conclusions:
The vitamin C, vitamin E, and raspberry leaf cell culture extract serum has anti-aging and brightening effects of skin.
Grapefruit essential oil has been proven to have wide range of bioactivities. However, bioactivity of its molecular distillate has not been well studied. In this study, a light phase oil was obtained by molecular distillation from cold-pressed grapefruit essential oil and GC-MS was used to identify its chemical composition. The antimicrobial activity of the light phase oil was tested by filter paper diffusion method, and the anticancer activity was determined by the Cell Counting Kit-8 (CCK-8) assay. Twenty-four components were detected with a total relative content of 99.74%, including 97.48% of terpenes and 1.66% of oxygenated terpenes. The light phase oil had the best antimicrobial effect on Bacillus subtilis, followed by Escherichia coli, Staphylococcus aureus and Salmonellaty phimurium. DPPH and ABTS assays demonstrated that the light phase oil had good antioxidant activity. The CCK-8 assay of cell proliferation showed that the light phase oil had a good inhibitory effect on the proliferation of HepG2 liver cancer cells and HCT116 colon cancer cells.
Introduction:
Photoaging is a complex process that is chiefly the result of oxidative stress caused by ultraviolet (UV)-generated reactive oxygen species. To counter this process, we developed a 3-in-1 night facial serum (3-in-1 NFS) containing a combination of direct and indirect antioxidants and polyphenols that is designed to attenuate UV-generated free radicals and stimulate dermal protein synthesis. In clinical trials 3-in-1 NFS improved the appearance of photoaged skin. In this study we sought to identify some of the main histologic changes responsible for this.
Methods:
We performed an immunolabeling analysis of some of the salient epidermal and dermal proteins in 3-in-1 NFS-treated primary epidermal keratinocytes (HEKs) and dermal fibroblasts (HDFs) in vitro, and in UV-exposed skin explants ex vivo. Numbers of apoptotic sunburn cells following exposure of 3-in-1 NFS-treated skin explants to UV radiation were also determined.
Results:
We demonstrate that 3-in-1 NFS increases levels of filaggrin and aquaporin 3 in HEKs, and levels of collagen I and collagen III in HDFs in vitro. Levels of precursor procollagen type I and tropoelastin were increased in ex vivo skin explants. Numbers of apoptotic sunburn cells were significantly reduced in UV-exposed skin explants. These effects were only observed with the combination of ingredients in 3-in-1 NFS, suggesting that they have a synergistic effect on photoaged skin biology.
Conclusion:
Our results show that some of the histological hallmarks of photoaging are improved with the use of 3-in-1 NFS.
The dermal-epidermal junction (DEJ) provides a physical and biological interface between the epidermis and the dermis. In addition to providing a structural integrity, the DEJ also acts as a passageway for molecular transport. Based on the recently reported importance of the DEJ in skin aging, novel peptide derivatives have been tested for their effects on basement membrane (BM) protein expressions in cultured human epidermal keratinocytes. As a result, protein expressions of collagen XVII, laminin and nidogen were stimulated by the test peptide and peptides complex. Further ex vivo evaluation using excised human skin, confirmed that the topical application of the peptides complex significantly increased dermal collagen expression, as well as expressions of collagen XVII and laminin. Interestingly, while the origin of the laminin protein is epidermal keratinocytes, the immunohistochemical staining of skin showed that laminin was only detected in the uppermost layer of the dermis, which suggests a tight assembly of laminin protein onto the dermal side of the DEJ. These results suggest that a peptide complex could improve the structural properties of the DEJ through its ability to stimulate BM proteins. In order to evaluate the anti-wrinkle benefits of the peptide complex in vivo, a clinical study was performed on 22 healthy Asian female volunteers older than 40 years. As a result, significant improvements in skin wrinkles for all of the five sites were observed after two weeks, as assessed by skin topographic measurements. Collectively, these results demonstrate the anti-aging efficacy of the peptides complex.
Background: Collagen induction therapy is a form of microneedling. It is cheap and effective and has less side effects than other alternative therapies. Purpose: It is done using dermaroller for the treatment of scars, wrinkles, stretch marks, hair growth, and transdermal delivery of substances like lipopeptides and antiaging products. Methods: It acts by stimulating collagen production, produces microwounds and thus release of various inflammatory mediators. It also increases electric potential, thus inducing cellular activity with release of cytokines and growth factors leading to wound healing with collagen induction. Results: There are various new modified instruments, and combination with other modalities of treatment increases its utility in different dermatological and cosmetic conditions. Conclusions: Microneedling is a simple, inexpensive procedure with no down time and good results in acne scars, hair loss and wrinkles.
Background
Melasma is a chronic pigmentary condition that can have significant negative effects on quality of life. Vitamin C can be effective in the treatment melasma, but its delivery often proves to be challenging due to instability of the drug and subsequent cutaneous irritation at higher concentrations.
Aim
In this prospective, open‐label, evaluator‐blinded study, we aimed to assess the efficacy and tolerability of twice‐daily application of a novel, highly potent, non‐irritating 30% tetrahexyldecyl (THD) ascorbate serum in combination with 100% mineral‐based sunscreen in the treatment of melasma during the summer months.
Patients/Methods
Ten female subjects of ages ranging from 18 to 60 years underwent twice‐daily application of 30% THD ascorbate serum in combination with an anti‐aging 100% mineral tinted broad‐spectrum protection SPF 45 sunscreen moisturizer for 12 weeks during the summer months (July to September). Two blinded evaluators scored baseline and post‐treatment photographs using the Griffiths’ 10‐point scale and global aesthetic improvement scale.
Results
All subjects showed an improvement in hyperpigmentation with an average improvement of 33.7%. Seventy percent of subjects showed an improvement in skin tone evenness (redness), and among those subjects, the average improvement was 33.3%. The median global aesthetic improvement score was 2.0 (very much improved).
Conclusion
Our study demonstrated efficacy and safety in treating the pigmentary as well as vascular components of melasma with a novel 30% THD ascorbate serum and a purely mineral‐based tinted moisturizing sunscreen.
Gaultheria longibracteolata (Ericaceae) has been traditionally used by different linguistic groups in Yunnan Province, China, but it has not been well studied. Through our ethnobotanical study in Lüchun County of Yunnan, we found that this species has multiple traditional uses including food, medicine, and worship. The essential oils from the root, stem, and leaf were investigated by both GC–MS and anti-bacterial assays. The GC–MS study showed that methyl salicylate is the main (>90%) component of the essential oil, and the oil composition extracted from different plant parts showed some similarities. The oil of G. longibracteolata displayed antimicrobial activity against Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus, which is likely due to its methyl salicylate content. Gautheria longbracteolata appears to be a useful natural wintergreen oil substitute, but further studies are needed to develop this product.
BACKGROUND: Due to both intrinsic and extrinsic damage, the skin is where easily noticable signs of aging manifest. OBJECTIVE: We sought to assess the effects of two complex novel topical formulations, L'Unique Miracular Facial Serum (LMFS) and L'Unique Skin Essence (LSE) (Nourishing Biologicals LLC, St. Augustine, Florida) on hydration, firmness, elasticity, wrinkling, and pore size of facial skin after initial application and then after four, eight, and 12 weeks of use. METHODS: An open-label study was conducted on subjects (N=32) between the ages of 45 and 65 years (mean: 57 years). Subjects were treated with a twice-daily application of LMFS and LSE for a total of 12 weeks following a one-week washout period. The test products were gently applied in a circular motion to the face each morning and evening. Measurements of skin hydration, transepidermal water loss (TEWL), and skin elasticity and firmness and three-dimensional skin surface evaluations were performed at each visit. Skin lift and pore size assessments were also completed using clinical photography. Subjective outcomes were assessed by a posttreatment product efficiency survey at the end of each visit. RESULTS: Objective instrumental measurements showed statistically significant improvements in skin hydration (20.19%), TEWL (25.96% at 15 minutes), firmness (24.77%), skin elasticity (11.40%), and skin lift (5.41%) with product use. Improvements in pore size and wrinkle depth were not statistically significant. CONCLUSION: Use of the test products produced significant improvements in skin hydration, TEWL, firmness, and skin elasticity with associated improvements in facial skin appearance.
Melasma, a common cause for seeking dermatologic care, is a chronic condition of skin hyperpigmentation. With a poorly understood pathogenesis, and no universal cure, melasma is a challenge for many dermatologists. For decades, there has been investigation into the role of oxidative stress in melasma. In this literature review, we introduce the role of oxidative stress in melasma and discuss the function of various topical and oral antioxidant therapies for patients suffering from melasma. Numerous studies have shown efficacy of various antioxidant therapies for treatment of hyperpigmentation, and in this review, we focus primarily on those with less widespread use. Vitamin E, niacinamide, polypodium leucotomos, pycnogenol, grape seed extract, amino fruit acids, phytic acid, zinc, silymarin, Korean red ginseng powder, plant extracts, and parsley all have well‐demonstrated evidence of antioxidant properties, and these substances have been studied in the context of skin hyperpigmentation. Although there is conflicting evidence of their therapeutic efficacy, the use of these naturally occurring substances is promising for patients and medical providers seeking alternative therapeutic options.
Background
The use of stem cells derived growth factors is representing a novel treatment modality in facial rejuvenation. Nowadays, skin needling is considered a very famous treatment of skin aging. However, the addition of such derived products, augments it’s therapeutic efficacy in the management and delay of skin aging.
Objective
Comparing the effect of amniotic fluid mesenchymal stem cell derived conditioned media (AF‐MSC‐CM) combined with skin needling versus the needling alone in the management of facial aging.
Methods
Both sides of the face of ten volunteers, suffering from facial aging, were treated with 5 sessions of skin needling, 2 weeks apart. After skin microneedling, AF‐MSC‐CM was added topically to the right side only. Clinical, histological and morphometrical assessment of the treated skin was done at 1 month after the last session.
Results
The percentage of improvement of aged skin increased significantly on the combined treated side [AF‐MSC‐CM and dermaroller (DR)], when compared with the other side (DR only) (P<0.001). Remodeling of the dermal structures was observed mainly on the combined side. Meanwhile, histometry of the epidermis revealed a significant increase in the epidermal thickness on both treated sides.
Conclusion
AF‐MSC‐CM combined with skin needling was more efficient in managing facial aging than skin needling alone.
Background
Skin needling, also called “collagen induction therapy”, is a novel non‐pharmacological treatment modality that has been increasingly utilized for the treatment of acne scars.
Aims
To review the medical literature and to select the most significative and recent studies regarding skin needling as a treatment for acne scarring, used alone or combined with other treatments.
Methods
A literature search was performed using the PubMed, Medline, and Embase databases, in addition to reviewing the bibliographies of relevant articles.
Results
Almost all the articles evaluated showed improvement of acne scars severity after microneedling treatment. When combined with other treatments such as autologous platelet‐rich plasma (PRP), chemical peels, filler injections or laser treatment, a greater improvement was reported. Needling technique is well‐tolerated with erythema and dryness representing the most frequent adverse events.
Conclusions
Microneedling is a useful treatment for ance scarring. Further studies are needed to evaluate its efficacy and safety and to create a standardized protocol to adopt for each patient according to the severity of acne scars.
Iontophoretic transdermal delivery uses a small electric current to push charged molecules into the skin under an electrode of same polarity and offers an attractive option to facilitate the delivery of macromolecules or hydrophilic molecules and to improve patient compliance. This technique has been used in physical therapy clinics for several decades, though the science was not always there to support claims of clinical effectiveness. Recently, this modality of treatment has undergone more systematic and rigorous investigations to withstand the scrutiny of regulatory authorities. In recent years various drugs have gained FDA approval for iontophoretic patches. This technique is gaining recognition due to better compliance rates, non-invasive drug delivery leading to fewer side effects, and sustained release of the drug. Furthermore, programmed delivery and bolus delivery systems have helped with customizing the drug dosage and frequency of dosage based on the patient's need.
Background
Skin‐lightening products are used worldwide to treat persistent pigmentation disorders that impact our quality of life and self‐confidence. However, consumers of cosmetic and over‐the‐counter skin lighteners struggle to find products that perform to their expectations. New, safe, and effective bioactives are needed to fill this gap.
Objective
To investigate the safety and skin‐lightening performance of a new topical tranexamic acid derivative, that is, cetyl tranexamate mesylate.
Methods
The test material was a facial serum containing 2.0% (w/w) of the new bioactive. Safety was evaluated by a modified Human Repeat Insult Patch Test with 54 subjects of either sex. Performance was objectively assessed based on the improvement of melanin and erythema indexes through time, and also subjectively by photographs and self‐perception questionnaires. Thirty‐five female subjects applied the serum twice a day for 8 weeks.
Results
No questionable adverse reactions were observed. Melanin and erythema indexes improved significantly and continuously from the baseline to the end of the study (−16.9% and −34.3%, respectively). Photographs further support instrumental data. On average, after 2 weeks, the subjects already noticed an improvement in skin tone (79.3%), a reduction in dark spots (78.6%), and an improvement in facial redness (77.1%).
Conclusion
A topical serum containing cetyl tranexamate mesylate was well‐tolerated and successfully improved the overall facial skin tone, as well as the appearance of dark spots and redness.
Background: Tranexamic acid is a promising drug for melasma treatment, but its topical formulation has limited efficacy. Its use as liposome based cream or in combination with other modalities might help to achieve better results.
Objective: Comparing efficacy of topical tranexamic acid 5% in liposome base alone versus its combination with intradermal platelet rich plasma (PRP) for melisma treatment.
Methods: Forty female patients with melasma were divided randomly into 2 equal groups who were treated with topical tranexamic acid 5% cream twice daily for 12 weeks and group B received additional intradermal injections of PRP every 3 weeks throughout the treatment period. Evaluation was done through modified MASI score and patient satisfaction after one month from the end of treatment.
Results: Both groups showed significant improvement of modified MASI score after treatment. Significantly better treatment response and patient satisfaction were detected in patients of group B (p = .024, .029). The side effects of PRP were mild and tolerable and tranexamic acid was well tolerated.
Conclusion: 5% topical tranexamic acid in liposome base is thought to be safe and effective modality for treatment of melasma. PRP is advisable as an autologous safe elixir which boosts the therapeutic effect of tranexamic acid.
Today, about 50% of men and 15-30% of women suffer from hair loss as well as the associated psychological impact. Drug therapy, especially through topical administration, is the main treatment strategy for stimulating hair regrowth. However, challenges exist due to the skin barrier that hinders drug penetration. To this end, many efforts have been made to enhance drug penetration efficiency. This review focuses on the advancement of the transdermal drug delivery strategies for hair loss therapy reported in the last five years, especially those via nanoformulations for topical administration and microneedles for transdermal delivery. In addition, physical or chemical penetration enhancers are also introduced, which are often applied with the drug delivery systems to achieve a synergy effect.
Cosmeceuticals are the latest addition to the healthcare industry. There are a number of topical cosmeceutical products used for various conditions related to the skin such as wrinkles, hyperpigmentation, and aging. Nanotechnology is one of the major advancements in the personal care industry and is considered as safe for targeted delivery of active medicaments. A significant number of novel formulations are used in personal care with consumer-perceptible benefits, resulting in economic benefits to the cosmetics industry. Nanomaterial-based cosmeceuticals are advantageous in a variety of products due to enhance penetration and increased bioavailability of active ingredients. This chapter outlines the different types of nanomaterials like liposomes, nanoemulsion, nanosponges, solid lipid nanoparticles, nanopigments, dendrimers, etc., along with their applications and also provides patent data and regulatory perspectives. Toxicity and safety of nanocosmeceuticals need to be kept in mind while exploring various nanomaterials for cosmetics.
This is a brief history of the beginnings of skin needling (collagen induction therapy) and Part 1 covers the original clinical work which was then validated by research primarily by Matthias Aust and team at Hanover Medical School, Germany. Skin needling became the very first medical procedure that induces regeneration instead of scar formation because it employs transforming growth factor‐β3 (TGF‐β3) and interleukin‐10 (IL‐10). We essay into methods to optimise the effects of skin needling. First by the depth of penetration into the skin which will depend on the condition treated. Wrinkles stretch marks, and so on only require 1.0 mm whereas burns scars acne scars, and so on require deeper penetration, that is, approximately 3.0 mm. In Part 2, we need to consider the use of topicals both before and after skin needling. Vitamins A and C are scientifically proven to almost quadruple the effects of needling. Selected peptides seem to further enhance results. Hyaluronic acid is best induced naturally but may be used topically for comfort. Finally, we examine the rationale of the intervals between needling. The best clinical results seem to come from treatments at 4 to 10 days intervals to take advantage of raised titres of TGF‐β3 and IL‐10. Other modalities such as red and infrared LED, platelet‐rich plasma and mild peeling are gaining appeal to give better results. Skin needling is the safest and most effective method to treat photoaging, lax skin, stretch marks, acne scars, and burn scars.
A 42-year-old woman with phototype V, presented a 9-year history of refractory centrofacial melasma to topical bleaching agents and peelings, untreated for the last 90 days. One session of microneedling with 1.5 mm needles was performed with hydroquinone 4% sterile serum drug delivery; after 3 days, modified Kligman's formula (hydroquinone 4% + fluocinolone acetonide 0.01% + tretinoin 0.05%) and broad-spectrum sunscreen SPF 70 were introduced for daily use. After 30 days, a significant improvement was observed in the clinical outcome (Figure 1) and the quality of life of the patient. These parameters were measured using Melasma Area and Severity Index (MASI) scale, with an 82.5% decrease, and Melasma Quality of Life Scale - Brazilian Population (MELASQoL-BP), with a 60% decrease. Dermatoscopic analysis (polarized videodermatoscopy x20) of the glabellar region revealed lighting of the pseudoreticular pigment network, diffuse light to dark brown background, and reduction in vascularity and telangiectasias (Figure 2). At the 5-month follow-up, there had been no relapse. The patient continued to use a broad-spectrum sunscreen along with the topical regiment.
Onychomycosis is one of the most prevalent and severe nail fungal infection, which is affecting a wide population across the globe. It leads to variations like nail thickening, disintegration and hardening. Oral and topical drug delivery systems are the most desirable in treating onychomycosis, but the efficacy of the results is low, resulting in a relapse rate of 25-30%. Due to systemic toxicity and various other disadvantages associated with oral therapy like gastrointestinal, hepatotoxicity, topical therapy is commonly used. Topical therapy improves patient compliance and reduces the cost of treatment. However, due to poor penetration of topical therapy across the nail plate, research is focused on different chemical, mechanical and physical methods to improve drug delivery. Penetration enhancers like Thioglycolic acid, Hydroxypropyl-β-cyclodextrin (HP-β-CD), Sodium lauryl sulfate (SLS), carbocysteine, N-acetylcysteine etc. have shown results enhancing the drug penetration across the nail plate. Results with physical techniques such as iontophoresis, laser and Photodynamic therapy are quite promising, but the long-term suitability of these devices is in need to be determined. In this article, a brief analysis of the treatment procedures, factors affecting drug permeation across nail plate, chemical, mechanical and physical devices used to increase the drug delivery through nails for the onychomycosis management has been achieved.
Age-related changes in the dermis can be due both to intrinsic factors and to the consequence of environmental damage, such as ultraviolet (UV) radiation. There are several treatments available for skin aging. Among these treatment modalities, the very promising and innovative is microneedling, which is able to increase the penetration of many topical antiaging substances. Microneedling is a simple, safe, and minimally invasive procedure that uses fine needles to puncture the epidermis, stimulating the release of growth factors, and induce collagen production. The indications for microneedling therapy have grown significantly, and it is becoming a more widely used treatment in dermatology. Its efficacy when performed alone or in combination with other techniques. In experienced hands, microneedling is a very useful and promising aesthetic dermatology technique, because it is well accepted by the patient with a very short recovery time and with good results.
Background:
Changes induced by intrinsic and extrinsic photoaging result in signs of skin aging including altered pigmentation and wrinkles. A 3-in-1 night facial serum (NFS) was developed to treat skin aging by antioxidative and retinoid-like mechanisms.
Objective:
To determine the clinical and histological effects of the 3-in-1 NFS on signs of skin aging, clinically and histologically.
Methods & materials:
Twenty-four subjects applied serum nightly for 12 weeks, and 12 subjects continued an extension study to 24 weeks. Clinical assessment of skin quality was performed by dermatologists. Skin biopsy was performed at 12 weeks to assess histological changes.
Results:
There was a global aesthetic improvement over the duration of the study: +1.21 points at 12 weeks; +1.25 at 24 weeks. Skin texture, pigmentation, erythema, skin tone, complexion, lines, and wrinkles all significantly improved (P < .05). There was also a significant reduction in photodamage, hyperpigmentation, and wrinkle scores, most notably horizontal forehead expression lines, and marionette lines (P < .05 for all). Dermal and epidermal thickness increased without reaching statistical significance.
Conclusion:
The 3-in-1 NFS had clinically and statistically significant effects on signs of skin aging after 12 weeks, which became more pronounced after 24 weeks.
Background:
Combination therapies have reported to augment the repigmentation in vitiligo. Microneedling (Mn) facilitates drug delivery across the skin barrier.
Objective:
To evaluate and compare the efficacy and safety of Mn combined with tacrolimus vs Mn alone or tacrolimus 0.1% ointment for treatment of localized and stable vitiligo.
Patients and method:
Ninety patients with vitiligo were randomized into three groups: group I received microneedling with tacrolimus, group II microneedling only both at 2 weeks interval for twelve sessions, and group III applied tacrolimus ointment 0.1% twice daily for 6 months. Skin biopsies were taken at baseline and after treatment.
Results:
The overall improvement (76.6%) was significantly higher in the combined group compared with other groups. Repigmentation was excellent in 66.6 of group I vs 33.3% in the other two groups (P .03). A highly significant improvement of the extremities was observed in the combined group than in the other groups (P < .001). A fewer number of sessions have reported in the combined group (I) than in the microneedling group (II; P < .001). Immunohistochemical results showed a significantly higher expression of HMB-45 in group I than in other two groups (P .04). Side effects were mild and tolerable in all groups.
Conclusion:
The combination group has shown promising results over the other two groups.
Introduction: Alopecia is a common clinical complaint for patients and often a source of significant psychological distress. The goal of therapy is to stop hair loss and encourage regrowth. Many treatment modalities are available and novel drug delivery approaches are needed to maximize results and minimize potential side effects.
Areas covered: Many novel drug delivery approaches for the management of hair loss have been developed in recent years. This review summarizes all therapeutic modalities used to enhance drug penetration into the scalp including microneedling, laser-assisted, radio-frequency, sonophoresis, iontophoresis. Advantages and developments in nanoparticles drug delivery approaches are also discussed.
Expert opinion: When considering novel drug delivery approaches for alopecia, physicians should consider the intended target and etiology of hair loss.
Introduction:
The standardized litchi extract had been revealed on phytochemical actives, in vitro and cellular activities against aging and darkening of skin. However, a formulation containing the extract has never been developed as per clinical evaluated.
Materials and methods:
The litchi serum was developed, safety and efficacy were clinically evaluated in human volunteers. The stable and none irritated 0.05 and 0.1% litchi serums were randomized-single blind placebo control clinical applied on the inner forearm of 29 volunteers for a consecutive 112 days and monitored by Mexameter® MX18, Cutometer® MPA 580 and Visioscan® VC 98.
Results:
Skin lightening efficacy of the 0.1% and 0.05% litchi serum was significantly (P<0.001 and P<0.05) higher than the placebo. Skin elasticity and wrinkle reduction was significantly (P<0.05 and P<0.005) achieved by the 0.1% litchi serum. The efficacy of litchi serums was confirmed by a split-face, randomized, single-blind controlled that the 0.1% litchi serum was significantly (P<0.05) better than the 0.05% one of all examined parameters.
Conclusion:
Safety and efficacy of litchi extract are clinically confirmed for hyperpigmentation and aging of skin treatments.