Jeffrey S Dover's research while affiliated with Alpert Medical School - Brown University and other places
Publications (310)
Objectives:
To evaluate skin barrier and hydration effects of a new rebalancing moisture treatment (TRMT) and to assess efficacy and tolerability in subjects with photodamaged skin.
Methods:
In an epidermal skin model, tissues (n = 5/group) were topically treated with 25 µL of TRMT, 25 µL of a market-leading moisturizer (MLM), or untreated for 6...
Background:
A range of monophasic dermal fillers made of high-molecular-weight hyaluronic acid (HA) chains with reduced cross-linking was developed for aesthetic procedures.
Objective:
The efficacy, durability, and safety of 2 of these resilient HA (RHA) fillers, and their noninferiority to an effective HA comparator available in the United Stat...
Background:
The number of patients receiving minimally and noninvasive cosmetic procedures is increasing. Often, patients turn to online review forums to gain and share advice regarding cosmetic procedures. Understanding and discussing patient-reported outcome data can help align physician and patient expectations and ultimately help improve the p...
Background:
Perioral rhytides are a common complaint among dermatologic patients and can be notoriously stubborn and resistant to therapy.
Objective:
We aimed to assess the safety of fractional ablative laser-assisted delivery of topical poly-L-lactic acid (PLLA) suspension in the treatment of upper cutaneous lip rhytides.
Materials and methods...
The realm of scar therapeutics is constantly changing. Several factors need to be considered when developing a comprehensive treatment plan for scar rehabilitation, including those related to the patient and the nature of the scar. Scar characteristics can be divided by color, scar type and thickness, and body location. Many agents including topica...
Background:
ATX-101 (deoxycholic acid injection) is approved for reduction of moderate or severe submental fat (SMF).
Objective:
To evaluate the efficacy and safety of ATX-101 in subjects with mild or extreme SMF.
Patients and methods:
Adults with mild or extreme SMF (based on clinician assessment) were randomized to receive ≤6 treatments with...
Background:
The inherent subjectivity of pain perception makes pre-procedural pain counseling especially challenging. Setting the wrong pain expectations will negatively impact the patient's experience and affect their physiologic and emotional state. Best practices for sourcing pain related information about a given procedure, however, remains un...
Background:
Picosecond pulse duration lasers (PS) have altered the field of dermatology. PS were initially used in tattoo removal, to optimize efficacy and reduce side effects with nanosecond domain lasers. More recently, they have been demonstrated to be effective in the treatment of pigmentary disorders, acne scarring, and photoaging.
Objective...
Objectives
Measure the sound levels produced by various lasers commonly used during routine outpatient cosmetic surgery to determine whether or not their use exceeds exposure levels set forth by the US National Institute for Occupational Safety and Health (NIOSH) and the US Occupational Safety and Health Administration (OSHA).
Materials and Method...
Background:
Robust and long-term data on true incidence of delayed-onset nodules and immune tolerance of hyaluronic acid (HA) fillers are lacking.
Objective:
To characterize the incidence of delayed nodules in Vycross (VYC) HA fillers compared with previously reported FDA and non-FDA data of all HA fillers.
Methods and materials:
The incidence...
Objective
This retrospective study compares subject‐reported pain levels and expectations set forth by industry and treating physicians during a clinical trial of an energy based device. The physiologic and emotional aspects of pain expectations are discussed and recommendations are made for strategic patient counseling.
Materials and Methods
Aver...
Pigmented lesions were initially treated with destructive non-selective lasers.
Objective: Noninvasive fat reduction has become increasingly popular. This study evaluated the outcomes of multiple treatments with a nonthermal focused ultrasound device for the noninvasive removal of excess abdominal fat. Design: Participants underwent a total of three pulsed, focused ultrasound treatments spaced two weeks apart. Setting: This st...
Importance
Despite the growing popularity of cosmetic procedures, the sociocultural and quality-of-life factors that motivate patients to undergo such procedures are not well understood.
Objective
To estimate the relative importance of factors that motivate patients to seek minimally invasive cosmetic procedures.
Design, Setting, and Participants...
Background:
Persistent facial erythema is a clinically challenging feature of rosacea.
Objective:
To evaluate persistent erythema reduction on the first day of treatment from pooled data from two pivotal trials of topical oxymetazoline cream 1.0% (oxymetazoline) in persistent facial erythema of rosacea.
Methods:
In two identically designed, ph...
Background:
Rosacea is a chronic dermatologic condition with limited treatment options.
Objective:
This phase 2 study evaluated the optimal oxymetazoline dosing regimen in patients with moderate to severe persistent facial erythema of rosacea.
Methods:
Patients were randomly assigned to oxymetazoline cream, 0.5%, 1.0%, or 1.5%, or vehicle, adm...
Keratosis pilaris (KP) is a common skin finding that presents as follicular hyperkeratotic papules on the proximal extremities in patients with a propensity for atopy. Although often asymptomatic, the stippled appearance is cosmetically disturbing to patients and difficult to treat as current therapies are limited in availability and efficacy. Nitr...
Background and objective:
Noninvasive fat reduction appears effective, but there are various methods for quantifying changes. The objective of this review is to assess comparative utility measures of subcutaneous fat.
Study design/materials and methods:
Articles describing noninvasive fat reduction were searched using MEDLINE, EMBASE, CINAHL and...
The realm of scar management is constantly changing. Many factors need to be considered when developing a comprehensive treatment plan, including the nature of the scar and the patient. Scar characteristics can be divided by color, scar type and thickness, and body location. Topical and intralesional agents and light- and laserbased treatments can...
Background:
Several formulations of Botulinum toxin serotype A (BoNT-A) for aesthetic indications are available, with numbers likely to increase. Preparations are not interchangeable, based on dose unit comparisons.
Objective:
Numerous myths and misconceptions regarding the use of BoNT-A for aesthetic indications have arisen, which this review a...
In this issue of JAMA Dermatology, Mervak et al¹ describe the rare condition of erosive pustular dermatosis (EPD) that presented in a series of patients after undergoing fully ablative carbon dioxide laser resurfacing or deep chemical peel. Several weeks to months after the procedure, the patients exhibited facial nonhealing erythematous plaques wi...
Importance
The notion that systemic isotretinoin taken within 6 to 12 months of cutaneous surgery contributes to abnormal scarring or delayed wound healing is widely taught and practiced; however, it is based on 3 small case series from the mid-1980s.
Objective
To evaluate the body of literature to provide evidence-based recommendations regarding...
Background:
The numbers of minimally invasive cosmetic procedures performed in the United States have steadily increased each year. Concurrently, the rates of filler complications have also increased. Delayed filler reactions and granulomas have recently been attributed to biofilm infections.
Objective:
The biology and pathogenesis of biofilms,...
Background:
Currently, the isotretinoin (13-cis-retinoic acid) package insert contains language advising the discontinuation of isotretinoin for 6 months before performing cosmetic procedures, including waxing, dermabrasion, chemical peels, laser procedures, or incisional and excisional cold-steel surgery. It is common practice to follow this stan...
Background:
Reports of poor wound healing in the setting of isotretinoin treatment have created a conservative standard of care in which laser and phototherapy treatment of patients receiving isotretinoin is relatively contraindicated.
Objective:
A survey of 220 nationally recognized experts in cutaneous laser surgery was conducted to evaluate p...
Background:
ATX-101 (deoxycholic acid injection; Kythera Biopharmaceuticals, Inc., Westlake Village, CA [an affiliate of Allergan plc, Dublin, Ireland]) was recently approved for submental fat (SMF) reduction in the United States (Kybella) and Canada (Belkyra). The pivotal trials supporting these approvals revealed that ATX-101 is associated with...
Background:
The American Council of Graduate Medical Education, which oversees much of postgraduate medical education in the United States, has championed the concept of "milestones," standard levels of achievement keyed to particular time points, to assess trainee performance during residency.
Objective:
To develop a milestones document for the...
Studies using a 755 nm picosecond laser with a focus lens array have been reported to be effective for facial wrinkles and pigmentation. This study reports the safety and efficacy using a shorter interval of 2–3 weeks between treatments. Nineteen female subjects and one male subject, primarily Fitzpatrick skin types II and III (one skin type I), wh...
Background:
Patients presenting for appearance-related concerns are often perceived as being more difficult (ie, more needy, more difficult to satisfy) than patients presenting for medical dermatologic problems. While the reasons for this perception are many, some hypothesize that this may be related to a higher rate of anxiety, depression, or bod...
The realm of scar therapeutics is constantly changing. Many factors need to be considered when developing a comprehensive treatment plan, including those related to the patient and the nature of the scar. Scar characteristics can be divided by color, scar type, and body location. Many agents including topical, intralesional, light- and laser-based...
Propionibacterium acnes is a key pathogenic factor in the development of acne. Antibiotics are the first choice of treatment for mild-to-moderate, mixed, papular/pustular, and moderate nodular acne, and an alternative choice in severe, nodular/conglobate acne. The emergence of resistance to the currently available antibiotics poses a serious set-ba...
Background:
Aging effects, such as facial flatness, increased tissue laxity, and soft tissue descent and deflation, contribute to midface deficiency.
Objective:
To evaluate whether large gel particle hyaluronic acid with lidocaine (LGP-HAL) is more effective in the treatment of midface deficiencies than no treatment.
Materials and methods:
Sub...
Disseminated superficial actinic porokeratosis (DSAP) is an inherited disorder of keratinization readily diagnosed through clinical and histologic examination. While generally benign in nature, the lesions can have profound psychosocial implications for patients. Although no cure exists, a number of treatment modalities, from topical medications to...
Background:
Hyaluronic acid gels are increasingly used for augmentation of the lips.
Objective:
To assess the safety and effectiveness of Juvéderm Ultra XC, a 24 mg/mL hyaluronic acid gel containing 0.3% (wt/wt) lidocaine (HYC-24L), for augmentation of the lips.
Methods:
This ongoing, multicenter, single-blind study randomized 213 subjects to...
Background:
A polymethylmethacrylate-collagen filler is generally believed to give long-term benefits, but the risk of granuloma formation over time remains unclear.
Objective:
To determine the incidence of granuloma formation and response to treatment and assess the degree of patient satisfaction over 5 years.
Materials and methods:
Adults se...
How delegation of procedures varies among cosmetic specialties in the United States is not well described.
To better describe current practices in delegation of procedures to nonphysicians among physicians of different cosmetic specialties in the United States.
An Internet-based survey was administered to physician members of the American Society f...
Treating posttraumatic lower extremity wounds can be challenging, especially in elderly patients. Recently, the use of fractional carbon dioxide laser has been shown to improve wound healing in scar-related wounds. We used this treatment modality in posttraumatic wounds that were slow to heal in 3 elderly patients.
Each wound underwent one fraction...
To compare the safety and effectiveness of small particle hyaluronic acid plus lidocaine (SPHAL) versus no treatment for lip augmentation and perioral rhytides.
Adults scoring 1 (very thin) to 2 (thin) on the Medicis Lip Fullness Scale (MLFS) for upper and lower lips were randomized (3:1) to SPHAL or no treatment. Treatment success was an MLFS incr...
Chronic, nonhealing ulcers are a frustrating therapeutic challenge and investigation of innovative therapies continues to be an important research pursuit. One unique and newly applied intervention is the use of ablative fractional lasers. This technology has recently been employed for the treatment of hypertrophic, disfiguring and function-limitin...
Although millions of aesthetic procedures are performed annually, few patient-reported outcome (PRO) measures have been used in this setting.
To evaluate the impact of onabotulinumtoxinA treatment for crow's feet lines (CFL) on relevant psychological variables and self-perception of age/appearance in subgroup populations.
Facial Lines Outcomes (FLO...
Facial skin laxity is a bothersome sign of aging. In the past, the only option for treating laxity was surgery. While surgical lifting remains the gold standard, there has been a growing demand among patients for less invasive techniques. Patients are increasingly seeking procedures with little to no downtime, lower risk profiles, and a more natura...
Importance
Common noninvasive to minimally invasive cosmetic dermatologic procedures are widely believed to be safe given the low incidence of reported adverse events, but reliable incidence data regarding adverse event rates are unavailable to date.Objective
To assess the incidence of adverse events associated with noninvasive to minimally invas...
Article Information
Accepted for Publication: June 12, 2014
Corresponding Author: Heather K. Hamilton, MD, Waldorf Dermatology & Laser Associates, PC, 57 N Middletown Rd, Nanuet, NY 10954 (heatheraklein@yahoo.com).Published Online: October 8, 2014. doi:10.1001/jamadermatol.2014.1838.
Conflict of Interest Disclosures: None reported.
Stretch marks are common skin disorders that are dermal scars with associated epidermal atrophy. They are of significant concern or psychological concern to many. This manuscript describes the use of multipolar radiofrequency with pulsed magnetic fields that was successfully used to diminish these lesions in 16 subjects undergoing a series of treat...
Background:
High-intensity focused ultrasound (HIFU) is a noninvasive alternative to traditional invasive body sculpting procedures.
Objective:
To assess the effectiveness and tolerability of HIFU treatment using high and low fluence settings with 2 treatment techniques, grid repeat (GR) and site repeat (SR).
Materials and methods:
Two multice...
Rhinophyma is a progressive and disfiguring proliferative disorder of the nose, which is related to chronic rosacea. Many different treatment modalities have been utilized both alone and in combination including: loop cautery, CO2 laser, argon laser, dermabrasion, cryotherapy, radiotherapy, full-thickness excision, skin graft, flap reconstruction,...
Das ablative Resurfacing kann in Abhängigkeit vom verwendeten Gerät zu weitreichenden Verbesserungen bei Aknenarben, tiefen Falten im Gesicht und Pigmentstörungen führen. Dabei werden die beschädigte Epidermis sowie die obere (papilläre) Dermis durch neues Gewebe ersetzt. Nichtablatives Resurfacing umfasst eine große Bandbreite an Behandlungen zum...
Because abobotulinumtoxinA treatment for glabellar lines must be repeated regularly to prevent recurrence, understanding the safety and effectiveness of long-term, repeated administration of abobotulinumtoxinA is important.
To report the long-term safety and efficacy of abobotulinumtoxinA in patients with moderate to severe glabellar lines.
Abobotu...
The potential for bruising is a frequent concern for patients undergoing minimally invasive procedures, particularly injection-based soft tissue fillers and botulinum toxin type A. Decreasing the risk of this side effect with good technique and careful patient selection is key, but interventions that quicken the resolution of bruising are also help...
Combination laser treatments can potentially increase the effectiveness of treatment without the additional downtime associated with another procedure.
To assess the effectiveness and safety of combining non-ablative fractional treatments with optimized intense pulsed light.
Ten subjects (Group A) received full face treatments with a non-ablative f...
There is a lack of consensus regarding appropriate nomenclature for drugs and devices used in surgical and cosmetic dermatology.
To develop a rules-based system for naming drugs and devices commonly used in dermatologic surgery that generates identifiers and modifiers that are clear, complete, and brief.
Using an iterative modified consensus proces...
Background:
Moderate to severe acne vulgaris is often treated with a combination of an oral antibiotic, topical antibiotic/retinoid, and benzoyl peroxide (BP), but data are limited on the efficacy of this and other combination regimens that incorporate both oral and topical therapies.
Methods:
Patients were required to be aged 12-30 years with m...
A Multicenter, Randomized, Double-Blind Phase 2B Study of ATX-101 in the Reduction of Submental Fat Using Investigator, Subject, and Magnetic Resonance Imaging Assessments
Goals/Purpose:
To evaluate the efficacy and tolerability of ATX-101, an investigational-stage injectable drug for the reduction of submental fat (SMF). Excess submental fat co...
Goals/Purpose: An open-label extension study of 4 phase 3 clinical trials was conducted to assess the long-term safety of repeat injections with abobotulinumtoxinA for the treatment of glabellar lines.
Methods/Technique: Patients were eligible for enrollment in this extension study based on their participation in 4 phase 3 studies; they were aged...
Safe and effective laser treatments are crucial, especially in darker-skinned individuals. Herein, we report our experience treating Fitzpatrick skin types IV to VI with a long-pulsed, 1,064-nm neodymium-doped yttrium aluminum garnet laser. With the right treatment settings, darkly pigmented individuals can undergo laser hair removal effectively....
BACKGROUND: Many devices used in dermatology lack generic names. If investigators use commercial device names, they risk the appearance of bias. Alternatively, reliance on ad-hoc names and abbreviations may confuse readers who do not recognize these. OBJECTIVE: To develop a system for assigning abbreviations to denote devices commonly used in derma...
Laser skin resurfacing (LSR) has evolved over the past 2 decades from traditional ablative to fractional nonablative and fractional ablative resurfacing. Traditional ablative LSR was highly effective in reducing rhytides, photoaging, and acne scarring but was associated with significant side effects and complications. In contrast, nonablative LSR w...
Quality-switched (QS) lasers and their applications have evolved greatly since the ruby laser's effect on tattoo ink was first reported in the 1960s. The 1983 description of selective photothermolysis explained the efficacy of QS lasers for the treatment of cutaneous pigmented lesions and tattoos and cemented their status as the gold standard for t...
BACKGROUND: The fractionated nonablative 1440-nm laser creates microscopic thermal wounds within the epidermis and the dermis and is used clinically to improve tone, texture, and color of skin. OBJECTIVE: We sought to investigate the use of this device to treat facial pores and to improve skin texture. METHODS: Twenty patients received 6 treatments...
Objective To study a picosecond 755-nm alexandrite laser for the removal of tattoos to confirm the efficacy of this therapy, focusing on the effect of therapy on the target lesion as well as the surrounding tissues and quantifying the number of necessary treatments.
Design Fifteen patients with tattoos were enrolled. Treatments were scheduled appro...
Fractionated technology has revolutionized laser therapy. With the success of initial devices, several fractionated lasers have appeared on the market. Claims of superiority have made device choice difficult for physicians and patients.
Twelve subjects were treated with fractionated ablative lasers (10,600-nm carbon dioxide and 2790-nm yttrium scan...
To assess the effectiveness and safety of small gel particle hyaluronic acid (SGP-HA) for lip augmentation.
Adults (n = 180; aged 18-65) scoring 1 (very thin) to 2 (thin) on the 5-point validated Medicis Lip Fullness Scale (MLFS) for the upper or lower lip were randomized (3:1) to SGP-HA (≤1.5 mL/lip) or no treatment. Co-primary effectiveness end p...
Scarring is a challenge that every procedural dermatologist encounters. It affects patients of all ages and all demographics. Left untreated, scars never go away, and rarely improve spontaneously. Even with treatment, complete resolution is near impossible. It is difficult to find another complaint that is so tied to the patient’s emotional well-be...
The term cellulite is derived from the French word cellule, literally meaning “small cell.” It describes the dimpled appearance of skin created by pebbly subcutaneous fat that occurs in nearly all postpubertal women, most commonly on the buttocks, hips, and thighs (Fig. 25.1). Although, cellulite can appear on any area of the body with subcutaneous...
Citations
... There is controversy regarding this and procedures such as elective surgery, dermabrasion, chemical abrasives, CO 2 laser, and fractionated radiofrequency: some practitioners delay such procedures until more than 6 months 55 after stopping oral isotretinoin, and others wait 20 to 30 days, the normal time required for the drug to be eliminated. Two recent reviews 78,79 concluded that mechanical dermabrasion and fully ablative laser were not recommended, 78 but that there was insufficient evidence to delay manual or microdermabrasion, superficial chemical peels, cutaneous surgery, fractional ablative and fractional nonablative laser resurfacing for patients currently or recently (6-12 months) exposed to isotretinoin. 78,79 Our current practice is to wait for around 2 months after stopping isotretinoin before starting such procedures. ...
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... 6 Matrix metalloproteinases have been implicated in chronic wounds, and have been cited sparingly with EPDS. 7 Reports of successful treatment with infliximab for superficial granulomatous pyoderma, a similar trauma-induced chronic wound condition, suggest a possible role of tumor necrosis factor in chronic scalp wound pathogenesis. 7 Additionally, follicular destruction caused by this patient's LI likely prevented stem cell production, resulting in impaired wound healing. ...
... Despite this, re-epithelialization can occur within a day after treatment [2,22], which reduces infection and other risks. The wavelength of carbon dioxide lasers has a much lower absorption coefficient for water, which results in significant collateral thermal injury such as charring and scar formation but also improves hemostasis [23]. The energy of the laser was controlled in our study, and the minimum energy and density were selected. ...
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... In addition, many cosmetic indications have been known for botulinum toxin for eliminating crow's feet, vertical and horizontal lines around the eyes and lips, and scar management. [1][2][3] BTX-A inhibits the exocytosis of acetylcholine on cholinergic nerve endings of motor nerves and blocks the release of acetylcholine by the neuron. This effectively weakens the muscle for a period of three to four months. ...
... 14 Study 143 (N = 474) had similar response rates for onabotulinumtoxinA 40 U versus placebo for Items 1 (70.2% vs 13.0%), 4 (66.7% vs 9.9%), and 5 (69.5% vs 14.4%). 15 Among studies that assessed response to FLO-11 items 2, 5, and 8 (N = 1,362), an evaluation of onabotulinumtoxinA 44 U (CFL: 24 U; GL: 20 U) 22 found that on Day 30, response rates were generally higher for subjects aged 50 years or younger versus those older than 50 years; 75% versus 64% for Item 2, 68% versus 54% for Item 5, and 62% versus 54%, respectively. A small study (N = 175) 23 comparing onabotulinumtoxinA 30 U or 40 U injected to the frontalis and glabellar complex showed response rates at Day 30 of approximately 90% for Item 8 and more than 90% for Items 2 and 5. ...
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... In a similar trial with a 1,550-nm laser, all 10 patients displayed some level of improvement in acne scarring at a 6-month follow-up visit [21]. When implementing a six-session 1,440-nm NAFL regimen to improve skin appearance in 20 patients, Saedi et al. [22] noted a mean overall improvement score of 2.75 AE 0.2 measured on a 4-point scale. ...
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... Collateral tissue heating and associated adverse events are minimized owing to the lower fluences required. 39 As a result, potentially all skin types may be treated with this device. A 3-to 5-mm spot size and 1.5 to 2.83 J/ cm 2 fixed fluence are favored. ...
Reference: Dark Circles
... A five-point Pigment Improvement Scale (0 ¼ No improvement, 1 ¼ Trace to mild improvement of some lesions, 2 ¼ Moderate response: some lesions lighter, 3 ¼ Good response: most lesions much lighter, 4 ¼ Excellent response: most or all lesions much lighter or gone) was used by both the investigator and subjects to assess pigmentation improvement of the face and hands at follow-up visits [18]. The primary efficacy endpoint was pigmentation improvement in the face and hands at the 1-month follow-up visit. ...
... Egyre elterjedtebben használják a lézereket is a porokeratosisok terápiájában. Kedvező eredményeket közöltek Q-kapcsolt rubin lézer, CO2 lézer, Erbium és Neodymium YAG lézer, frakcionált 1927 nm-es thulium fiber lézer, pulzáló festéklézer, valamint fraktionált fototermolízis alkalmazásával (23,34,36,37,39,40). A fentieken túl egy esetben sikeres kezelésről írnak egy DSAP-ban szenvedő betegnél röntgensugárzás használatakor is (41). ...
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... Não tivemos complicações sérias na nossa amostra. Alam et al. 5 relataram que a hiperpigmentação é a principal complicação desses procedimento, mas é incomum e costuma resolver espontaneamente, o que está de acordo com nossa ...
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