Journal Of Cosmetic Dermatology[JOURNAL]
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200 papers
Fascia-Level Temperature Kinetics During Multi-Wavelength Diode Laser Irradiation: A Cadaveric Study.
Yi KH, Park Y, Cartier H … +2 more , Garson S, Ascher B
J Cosmet Dermatol · 2026 May · PMID 42141819 · Full text
BACKGROUND: Thermal energy-based technologies are widely used for noninvasive body contouring; however, quantitative characterization of fascia-level heat propagation in body tissues during multi-wavelength diode laser i...
BACKGROUND: Thermal energy-based technologies are widely used for noninvasive body contouring; however, quantitative characterization of fascia-level heat propagation in body tissues during multi-wavelength diode laser irradiation remains limited. OBJECTIVE: To assess fascia-level temperature kinetics and regional differences in deep-plane heating during stacking delivery of a multi-wavelength diode laser (Fortra, Classys Inc., Korea) in human cadaver tissues. METHODS: Three fresh-frozen human cadavers underwent laser irradiation at the abdomen, anterior thigh, and lateral upper arm. Subcutaneous fat thickness was measured by ultrasonography. A single thermocouple was inserted to the muscle fascial plane to record fascia-level temperature over time, and infrared thermography of the exposed measurement field was performed after tissue exposure to identify the local thermographic peak. Deep fascial arrival time, peak fascial temperature, exposed-field thermographic peak temperature, and fascia-level cumulative equivalent minutes at 43°C (CEM43) were evaluated. Regional comparisons were descriptive, with exploratory nonparametric testing. RESULTS: Heat reached the muscle fascia fastest in the anterior thigh (4.9 ± 0.4 s), followed by the lateral upper arm (5.3 ± 0.5 s), and slowest in the abdomen (6.6 ± 0.6 s). These values represent mean ± SD of cadaver-level means. Regional differences in fascial arrival time were exploratory but reached significance (Friedman test, p = 0.049). Exposed-field thermographic peak temperatures were highest in the anterior thigh (70°C-72°C), followed by the lateral upper arm (68°C-71°C), and lowest in the abdomen (65°C-68°C). CONCLUSIONS: Under non-perfused ex vivo conditions, fascia-level thermal behavior during multi-wavelength diode laser irradiation varied by anatomical region. Greater subcutaneous fat thickness was associated with slower fascial heat arrival, but did not fully explain regional variation. These findings are descriptive and do not establish volumetric heat distribution, histologic injury, or in vivo safety thresholds.
Combination Therapy With AOPT Intense Pulsed Light (Dual-Band Vascular Filter) and 1064 nm Nd:YAG Laser for Solitary, Superficial Infantile Hemangioma: A Retrospective Study.
Jiang Z, Jiang P, Ran F … +6 more , Li S, Xu Y, Yang Y, Liang L, Yang L, Wei C
J Cosmet Dermatol · 2026 May · PMID 42136054 · Full text
OBJECTIVE: This study evaluated the efficacy and safety of a sequential protocol for treating solitary, superficial infantile hemangioma (IH). The protocol combined an Advanced Optimal Pulse Technology (AOPT) intense pul...
OBJECTIVE: This study evaluated the efficacy and safety of a sequential protocol for treating solitary, superficial infantile hemangioma (IH). The protocol combined an Advanced Optimal Pulse Technology (AOPT) intense pulsed light system, which was equipped with a novel dual-band vascular filter, with a subsequent long-pulsed 1064 nm Nd:YAG laser. We compared this sequential approach to treatment with a long-pulsed Nd:YAG laser alone. METHODS: In this retrospective cohort study, 257 treatment-naïve children with solitary, superficial IH were included. Patients were divided into two groups based on a chronological cutoff following the introduction of a new AOPT intense pulsed light device in March 2024. The combination therapy group (n = 113) received treatment with the AOPT intense pulsed light system immediately followed by the Nd:YAG laser. The monotherapy group (n = 144) was treated with the Nd:YAG laser alone. The primary efficacy endpoint was the overall improvement rate. Time to improvement was analyzed using Cox proportional hazards regression, and safety was assessed by the incidence of adverse events. RESULTS: The combination therapy group achieved a significantly higher overall response rate (92.9% vs. 82.6%, p = 0.014). Cox regression analysis confirmed that combination therapy significantly accelerated the time to improvement (hazard ratio = 1.43, 95% CI: 1.08-1.88, p = 0.011). The final complete cure rate and the overall incidence of adverse events were comparable between the two groups. CONCLUSION: For solitary, superficial IH, the sequential treatment protocol using an AOPT intense pulsed light system with an integrated dual-band vascular filter, followed by long-pulsed Nd:YAG laser, is a safe and effective local strategy. It significantly accelerates lesion regression and improves the treatment response rate compared to Nd:YAG laser monotherapy.
Hyaluronidase Reverses the Effect of Hyaluronic Acid Without Destroying Normal Skin Structure.
Yin B, Jiang Z, Shi J … +3 more , Wang H, Wang P, Jia C
J Cosmet Dermatol · 2026 May · PMID 42136041 · Full text
BACKGROUND: Dermal fillings based on hyaluronic acid have been widely used in facial rejuvenation. A number of studies have reported the beneficial effect of hyaluronidase in saving the complications of hyaluronic acid....
BACKGROUND: Dermal fillings based on hyaluronic acid have been widely used in facial rejuvenation. A number of studies have reported the beneficial effect of hyaluronidase in saving the complications of hyaluronic acid. However, the effects of hyaluronidase on dermal matrix, skin structure, and fibroblast function are unknown. METHOD: In this study, hyaluronic acid and hyaluronidase were injected into rat skin, skin samples were collected at multiple time points, and the changes of skin structure, fibroblast function, and extracellular matrix gene and protein expression were detected. RESULT: The results in vivo showed that hyaluronidase can effectively degrade exogenously injected hyaluronic acid in rats without causing significant changes in dermal matrix and skin structure. The results in vitro showed that hyaluronidase had no significant effect on proliferation, apoptosis, and collagen synthesis of fibroblasts. CONCLUSION: This study provided a theoretical basis for the clinical application of hyaluronic acid and hyaluronidase. In vivo and in vitro experiments confirmed that hyaluronidase can degrade exogenous hyaluronic acid without damaging the skin structure, dermal matrix, and fibroblast function.
Structural Characteristics of Facial Sagging: A Quantitative Analysis Linking Visual Assessment to Dermal, Fat, and Muscle Properties.
Oya M, Takeuchi Y, Touma Y … +1 more , Yamazaki K
J Cosmet Dermatol · 2026 May · PMID 42136004 · Full text
BACKGROUND: Facial sagging is associated with changes in underlying facial structures, including the dermis, subcutaneous fat, and muscle layers. However, previous studies have focused primarily on surface appearance, an...
BACKGROUND: Facial sagging is associated with changes in underlying facial structures, including the dermis, subcutaneous fat, and muscle layers. However, previous studies have focused primarily on surface appearance, and quantitative evaluations linking sagging to individual internal structures remain limited, making it difficult to identify key determinants of sagging and to optimize intervention targets. OBJECTIVE: This study aimed to clarify, using statistical analyses and predictive models, the contributions of quantitative structural parameters of the dermis, subcutaneous fat, and muscle to facial sagging, and to obtain fundamental insights for individualized evaluation and intervention optimization. METHODS: A total of 220 women aged 20-79 years were enrolled. Facial sagging was assessed using the Merz Scale. Dermal properties were quantitatively measured. The thickness and echogenicity of subcutaneous fat and muscle layers were evaluated using high-resolution ultrasound. Skin displacement and volume increase associated with postural changes were calculated as dynamic sagging indices. Associations between structural characteristics and sagging indices were analyzed using correlation and multiple regression analyses. RESULTS: Sagging appearance was significantly correlated with dermal viscoelasticity, subcutaneous fat thickness, and zygomaticus major muscle thickness. Regression analysis indicated that sagging was jointly influenced by dermal, fat, and muscle characteristics, with relative structural contributions varying by facial site and age. Dynamic sagging indices were significantly correlated with age and Merz scores. CONCLUSION: This study demonstrated that facial sagging is not attributable to aging of a single layer but results from overlapping changes in the dermis, subcutaneous fat, and muscle layers, highlighting the necessity of integrated structural evaluation. TRIAL REGISTRATION: UMIN Clinical Trials Registry: UMIN000060199.
Correction to "Comparative Efficacy of Photodynamic Therapy Versus Cryotherapy for Actinic Keratosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials".
J Cosmet Dermatol · 2026 May · PMID 42133540 · Full text
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Non-Surgical Cosmetic Treatment Modalities for Interdental Papilla Reconstruction "Black Triangles": An Evidence-Based Review.
Elhaj A, Shatta B, Nguyen S … +2 more , Novo Pereira I, Hassan H
J Cosmet Dermatol · 2026 May · PMID 42130077 · Full text
BACKGROUND: The interdental papilla plays a vital role in dental and facial aesthetics, as the loss of papilla manifests as unesthetic "black triangles". In recent years, non-surgical approaches such as hyaluronic acid i...
BACKGROUND: The interdental papilla plays a vital role in dental and facial aesthetics, as the loss of papilla manifests as unesthetic "black triangles". In recent years, non-surgical approaches such as hyaluronic acid injections, autologous platelet concentrates, laser therapy, and microneedling with vitamin C have emerged as alternatives to technically demanding and unpredictable surgical reconstruction. AIM: To evaluate the effectiveness, patient satisfaction, and safety of cosmetic non-surgical treatment modalities for the correction of black triangles. MATERIALS AND METHODS: A comprehensive literature search was conducted using the PubMed, Cochrane Library, Scopus, and Embase databases, from January 2013 to January 2024. All case series, cohort studies, and randomized controlled trials with relevant outcomes were included. The BestBETs methodology was used, and the risk of bias was assessed using the "Quality Assessment Tool for Quantitative Studies." RESULTS: A total of 19 human studies met the inclusion criteria. Of these, six studies were classified as level II evidence, while the remaining 13 were categorized as level III or level IV evidence. Based on level II evidence, hyaluronic acid injections were effective and safe for correcting the black triangles and improving the smile. Evidence on non-surgical modalities such as autologous platelet concentrates, photobiomodulation therapy, and microneedling with vitamin C remains limited. Based on level II to level IV evidence, these conservative treatments are recommended as clinically effective for filling black triangle spaces, demonstrating high patient satisfaction and minimal adverse events. CONCLUSION: Non-surgical cosmetic treatments offer a promising alternative for reconstructing interdental papilla deficiencies, with benefits including reduced complications and favorable aesthetic outcomes. However, the current evidence remains limited, and findings should be interpreted with caution. Further well-designed, standardized clinical trials are required to establish the effectiveness, long-term stability, and patient-centred outcomes of these interventions.
The Neuromuscular Junction Distribution in the Upper Face: An Anatomy-to-Practice Review to Inform Botulinum Toxin Type A Treatment Planning.
Magacho-Vieira FN
J Cosmet Dermatol · 2026 May · PMID 42130073 · Full text
BACKGROUND: Upper-face botulinum toxin treatment planning often relies on surface landmarks and standardized injection patterns, yet neuromuscular junctions are distributed in muscle-specific motor zones that vary in top...
BACKGROUND: Upper-face botulinum toxin treatment planning often relies on surface landmarks and standardized injection patterns, yet neuromuscular junctions are distributed in muscle-specific motor zones that vary in topography, depth, and overlap. Injecting near an optimal motor zone has been associated with greater clinical effect, suggesting that mapping these patterns may refine anatomy-guided targeting and reduce variability. AIMS: To synthesize anatomical evidence on micro-innervation and neuromuscular junction clustering in the frontalis, corrugator supercilii, orbicularis oculi, procerus, and depressor supercilii. METHODS: A clinician-oriented "anatomy-to-practice" narrative review was conducted. Studies with extractable human, muscle-level micro-innervation mapping were synthesized qualitatively, emphasizing cluster location, depth, and distribution. RESULTS: Neuromuscular junctions were nonuniformly distributed, forming muscle-specific distribution patterns, ranging from more discrete, clustered territories to diffuse fields. They tended to concentrate in the mid- to upper-frontalis belly along the deep fascial surface; in the corrugator supercilii, predominantly within the medial portion and at greater depth, centrally and inferiorly along the orbital rim in the depressor supercilii; and inferiorly near the nasion in the procerus. In the orbicularis oculi, neuromuscular junctions were diffusely distributed across the muscle. Given heterogeneous and often proxy-based mapping, these territories are best interpreted as probabilistic fields. CONCLUSIONS: Micro-innervation and neuromuscular junction distribution represent a complementary anatomical layer that may inform upper-face botulinum toxin treatment planning alongside dynamic assessment, clinical judgment, and established safety considerations.
PDGF In Aesthetics: Hype Outpacing the Evidence?
Torres MAA, Gold MH, Bruce AJ
J Cosmet Dermatol · 2026 May · PMID 42130063 · Full text
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Advancing the Evidence on Glabellar Contraction Patterns-A Prospective Multicenter Study on Its Clinical Relevance for Glabellar Neuromodulator Injections.
Germani M, Munoz-Lora VRM, Geroldo AM … +11 more , Hayashida H, Inácio L, Vitale S, Bulhões V, Thiesen V, Davidovic K, Escobar S, Rodrich R, Gold MH, Bravo C, Cotofana S
J Cosmet Dermatol · 2026 May · PMID 42130059 · Full text
BACKGROUND: Glabellar neuromodulator injections are frequently guided by skin surface contraction patterns, assuming that visible rhytids reflect underlying muscular anatomy. However, emerging anatomical and imaging evid...
BACKGROUND: Glabellar neuromodulator injections are frequently guided by skin surface contraction patterns, assuming that visible rhytids reflect underlying muscular anatomy. However, emerging anatomical and imaging evidence has questioned the clinical relevance of pattern-based treatment adaptations. OBJECTIVE: To prospectively evaluate whether different glabellar contraction patterns influence clinical and patient-reported outcomes when a standardized, anatomy-based, FDA-approved 5-point injection algorithm is applied. METHODS: This prospective, multicenter clinical study enrolled 125 patients treated across five independent centers. Patients were classified into five previously described glabellar contraction patterns (V-shape, U-shape, converging arrows, omega, and inverted omega) based on standardized photographs during maximal frowning. All patients received neuromodulator injections following the same standardized 5-point technique using either onabotulinumtoxinA or abobotulinumtoxinA with dose equivalence. Clinical outcomes were assessed using the Glabellar Line Severity Scale (GLSS) at baseline, 15 days, and 90 days, while patient-reported outcomes were evaluated with the Global Aesthetic Improvement Scale (GAIS) at 90 days. Statistical analyses included non-parametric group comparisons and multivariate ordinal logistic regression. RESULTS: A total of 119 patients completed the study. A significant improvement in GLSS was observed at 15 days (p < 0.001), followed by partial regression at 90 days (p < 0.001 vs. baseline). No statistically significant differences in GLSS or GAIS were identified between contraction pattern groups at any time point (all p > 0.05). Multivariate analysis demonstrated that age and body mass index significantly influenced treatment outcomes, whereas glabellar contraction patterns and Fitzpatrick skin type did not. Mild, transient local adverse events were observed and resolved spontaneously. CONCLUSION: Glabellar contraction patterns do not significantly affect clinical or patient-reported outcomes when neuromodulator injections are performed using a standardized, anatomy-based 5-point technique. These findings support prioritizing muscular anatomy and patient-specific biological factors over surface rhytid patterns in glabellar neuromodulation.
Efficacy and Safety of Cryotherapy Combined With Intralesional Steroid for Keloid and Hypertrophic Scar: A Systematic Review and Meta-Analysis.
Feng X, Zou X, Jiang S … +3 more , He X, Deng Y, Xie J
J Cosmet Dermatol · 2026 May · PMID 42130027 · Full text
OBJECTIVE: Intralesional steroid injection is the first-line therapy for scars. Emerging evidence indicates that combining intralesional steroid injection with cryotherapy yields promising therapeutic outcomes for scar m...
OBJECTIVE: Intralesional steroid injection is the first-line therapy for scars. Emerging evidence indicates that combining intralesional steroid injection with cryotherapy yields promising therapeutic outcomes for scar management. However, a consensus on the efficacy and safety of this combined regimen has not yet been reached. Consequently, the present meta-analysis aimed to assess the efficacy and safety of this combination compared with control groups. METHODS: A full-scale literature retrieval was performed across a range of databases to identify eligible randomized controlled trials (RCTs) and prospective non-randomized studies that evaluated the efficacy and safety of cryotherapy plus intralesional steroid injection against control treatments for keloids or hypertrophic scars. Key outcome data, including the mean percentage change in scar improvement, the excellent clinical response rate (defined as ≥ 75% reduction in scar volume), and the incidence of adverse events, were extracted. Meta-analyses were performed using a fixed- or random-effects model based on the heterogeneity assessment results. RESULTS: Thirteen studies involving 1012 cases were included in this meta-analysis. The pooled results exhibited that cryotherapy combined with intralesional steroid injection yielded a significantly higher efficacy rate than various control interventions (including intralesional steroid monotherapy, cryotherapy alone, bleomycin/verapamil treatment, laser plus steroid, and surgical excision plus radiotherapy) (risk ratio [RR] = 1.19, 95% confidence interval (CI): 1.03-1.36; p = 0.01). However, no statistically significant differences were detected between the experimental and control groups in either the mean percentage change in scar improvement (standard mean difference (SMD) = 0.14, 95% CI: -0.39 to 0.68; p = 0.60) or the overall incidence of adverse events (RR = 1.35, 95% CI: 0.99-1.83; p = 0.06). CONCLUSIONS: Cryotherapy combined with intralesional steroid injection is a viable alternative to other first-line treatments for keloids and hypertrophic scars. Clinical recommendations should be made cautiously based on specific patient and scar conditions. Further well-designed, large-scale RCTs are required to validate the long-term efficacy and safety of this combined regimen.
Safety and Tolerability of Fractional CO Lasers for Facial Rejuvenation Across Fitzpatrick Skin Phototypes I-IV: Retrospective Cohort Study.
Oloruntoba AI, Rodrigues M
J Cosmet Dermatol · 2026 May · PMID 42121348 · Full text
BACKGROUND: Fractional CO laser is an effective treatment for skin rejuvenation, although pigmentary complications remain a clinical consideration. Newer generation fractional CO laser systems include pulse modes such as...
BACKGROUND: Fractional CO laser is an effective treatment for skin rejuvenation, although pigmentary complications remain a clinical consideration. Newer generation fractional CO laser systems include pulse modes such as HighPulse (HP), which deliver high energy over a shortened dwell time, reducing the duration of energy delivery per microbeam with the aim of limiting thermal diffusion beyond the ablation zone. METHODS: We conducted a single-center retrospective study of 38 patients (Fitzpatrick skin phototypes I-IV) treated with fractional CO laser using HP mode for facial rejuvenation. Pain scores and adverse events were recorded, stratified by skin type and anesthetic use. RESULTS: Mean pain score was 4.8, with no statistically significant difference between patients who received topical anesthetic (LMX4) and those who did not. Pain scores did not differ significantly across skin phototypes I-IV. Erythema occurred in 50% of patients and edema in 24%, all of which were transient. No cases of blistering, post-inflammatory hyperpigmentation, or scarring were documented in routine clinical records, although the true incidence may be underestimated. Erythema rates did not differ significantly by anesthetic use. CONCLUSIONS: In this preliminary cohort, the HP fractional laser was associated with transient short-term adverse effects and no documented pigmentary complications among patients with Fitzpatrick skin types I-IV. These findings are descriptive and are not generalizable to Fitzpatrick phototypes V-VI, which were not represented.
Efficacy and Safety of Fractional Laser Therapy for Androgenetic Alopecia: A Systematic Review and Meta-Analysis.
Chen C, Wang S, Bi D … +2 more , Wei AC, Guo S
J Cosmet Dermatol · 2026 May · PMID 42121331 · Full text
OBJECTIVE: To systematically evaluate the efficacy and safety of fractional laser therapy in the treatment of androgenetic alopecia. METHODS: A comprehensive literature search was conducted in PubMed, Web of Science, Emb...
OBJECTIVE: To systematically evaluate the efficacy and safety of fractional laser therapy in the treatment of androgenetic alopecia. METHODS: A comprehensive literature search was conducted in PubMed, Web of Science, Embase, the Cochrane Library, and China National Knowledge Infrastructure (CNKI) from inception to November 2025. Eligible studies were selected according to the PICOS framework. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias tool. Meta-analysis was performed using R software. RESULTS: A total of 15 studies involving 1097 patients were included. Meta-analysis demonstrated that fractional laser therapy significantly improved hair density compared with control interventions (mean difference [MD] = 13.88, 95% confidence interval [CI]: 6.87-20.90, p < 0.001). Subgroup analysis revealed no significant difference in efficacy between ablative and non-ablative fractional lasers (p = 0.7792), nor between different wavelengths (1565 nm, 1550 nm, 1927 nm; p = 0.7014). Combination therapy with laser and other treatments (e.g., minoxidil) showed a certain advantage over other treatments alone (MD = 9.74, p = 0.001). Adverse events were predominantly mild to moderate, including erythema, pain, and pruritus, all of which resolved spontaneously. CONCLUSION: Fractional laser therapy demonstrates marked therapeutic efficacy and a favorable safety profile in the treatment of androgenetic alopecia, making it a viable clinical treatment option. Future high-quality studies are warranted to further validate its long-term effectiveness and optimal treatment parameters.
A Multicenter Trial of an Enhanced Serum Comprised of 13 Plant-Based Adaptogens Targeting Skin Quality in Females Impacted by Hormonal Decline.
Draelos ZD, Moradi A, Smathers A
J Cosmet Dermatol · 2026 May · PMID 42117281 · Full text
OBJECTIVES: To assess the effectiveness and tolerability of a serum comprised of plant-based adaptogens (MYS-REV) for visible improvements in skin changes caused by hormonal fluctuations associated with perimenopause and...
OBJECTIVES: To assess the effectiveness and tolerability of a serum comprised of plant-based adaptogens (MYS-REV) for visible improvements in skin changes caused by hormonal fluctuations associated with perimenopause and postmenopause in women. STUDY DESIGNS: A 16-week open-label multicenter study evaluated the efficacy and tolerability of twice-daily application of MYS-REV in females, aged ≥ 46 years, Fitzpatrick skin type (FST) I-VI, with fine-to-moderate depth lines and wrinkles, mild-to-moderate elastosis, and crepey skin. Investigators assessed improvements in depth and number of lines/wrinkles, elastosis, and crepey skin. Additionally, investigators assessed improvements in appearance of skin dullness, skin roughness/texture, erythema, uneven pigmentation, and pore size, along with objective changes in skin hydration and transepidermal water loss (TEWL), all over 16 weeks. Tolerability and subject self-assessment were assessed over 16 weeks. RESULTS: At 16 weeks, twice-daily use of MYS-REV demonstrated mean percent improvements in elastosis/crepey skin, lines/wrinkles, skin hydration, and TEWL, and in erythema, dullness, texture/roughness, pore size, and uneven pigmentation (all p < 0.0001). All AEs were mild with no study discontinuations owing to any AE. Subjects reported high levels of satisfaction with MYS-REV beginning as early as 4 weeks and continuing through Week 16. CONCLUSIONS: This study demonstrated that twice-daily application of MYS-REV visibly improves skin affected by menopause-related hormonal fluctuations.
Efficacy of a Topical Formulation on Skin Hydration and Barrier Function in Individuals With Xerosis: A 28-Day Randomized, Split-Leg, Untreated-Controlled Trial.
Morgado-Carrasco D, Balado-Simó P, Vivancos Cuadras F … +2 more , Furmanczyk M, Delgado Ojeda J
J Cosmet Dermatol · 2026 May · PMID 42108609 · Full text
BACKGROUND: Xerosis cutis is characterized by impaired epidermal barrier function, increased transepidermal water loss (TEWL), reduced hydration, and symptoms such as pruritus. AIMS: To evaluate the efficacy, tolerabilit...
BACKGROUND: Xerosis cutis is characterized by impaired epidermal barrier function, increased transepidermal water loss (TEWL), reduced hydration, and symptoms such as pruritus. AIMS: To evaluate the efficacy, tolerability, and subjective perception of a topical formulation containing panthenol, niacinamide, and dipotassium glycyrrhizate in improving skin hydration and barrier function in subjects with dry, sensitive skin. METHODS: In this randomized, intra-individual, split-leg clinical trial, subjects with xerosis applied the test emollient twice daily for 28 days to one pretibial area. The contralateral leg remained untreated as control. Assessments were performed at baseline (T0), 30 min, 24 h, 48 h, day 7 and day 28. Primary outcomes were corneometric stratum corneum hydration and TEWL. Secondary outcomes included deep skin conductance ("deep moisturization"), desquamation index, surface microrelief regularity (SEr), scaliness (SEsc), dermatologist-rated clinical signs, and participant self-assessment. RESULTS: Thirty-five participants (31 women; mean age 47.3 ± 2.0 years) were included. Compared with baseline (hydration: 21.3 ± 1.0 c.u., 95% CI: 19.3-23.3; TEWL: 9.2 ± 0.3 g/h/m, 95% CI: 8.6-9.8) and untreated control, the treated leg showed greater corneometric hydration at all time points: 66.2% (33.9 ± 1.4 c.u., 95% CI: 31.1-36.7) at day 7 and 74.1% (35.2 ± 1.2 c.u., 95% CI: 32.8-37.6) at day 28 (all p < 0.001). TEWL decreased by 11.3% (8.2 ± 0.2 g/h/m, 95% CI: 7.8-8.6) and 13.5% (7.9 ± 0.2 g/h/m, 95% CI: 7.5-8.3), respectively (all p < 0.05). Deep moisturization increased by 5.7% (39.5 ± 0.9 μS at day 7, 95% CI: 37.7-41.3) and 7.3% (41.1 ± 0.8 μS at day 28, 95% CI: 39.5-42.7) (p < 0.05). The desquamation index decreased by 13.0% (29.50% ± 1.67% at day 7, 95% CI: 26.1-32.9) and 15.8% (26.77% ± 1.25% at day 28, 95% CI: 24.2-29.3), SEr increased by 46.9% (3.38 ± 0.15 a.u. at day 7, 95% CI: 3.08-3.68) and 54.2% (3.47 ± 0.15 a.u. at day 28, 95% CI: 3.17-3.77), and SEsc decreased by 67.0% (0.81 ± 0.12 a.u. at day 7, 95% CI: 0.57-1.05) and 76.3% (0.51 ± 0.07 a.u. at day 28, 95% CI: 0.37-0.65), respectively (all p < 0.05). Dermatologist assessments at all time points showed significant clinical improvement in dryness and pruritus in all participants (p < 0.001). Complete resolution was observed in all participants according to the 5-point scale, though this may reflect a floor effect given mild baseline scores. CONCLUSIONS: The topical formulation appeared to be an effective and well-tolerated emollient; however, the absence of a vehicle control precludes attribution of effects specifically to the active ingredients. Patient-reported outcomes should be interpreted with caution due to the unblinded design.
Neuroaesthetics: Evolutionary Thinking in Facial Aesthetic Medicine.
Dayan S, Fabi S
J Cosmet Dermatol · 2026 May · PMID 42108601 · Full text
BACKGROUND: Facial aesthetic medicine has traditionally emphasized proportion, symmetry, and structural harmony based on anatomic and cultural ideals. However, rigid adherence to these principles may contribute to overco...
BACKGROUND: Facial aesthetic medicine has traditionally emphasized proportion, symmetry, and structural harmony based on anatomic and cultural ideals. However, rigid adherence to these principles may contribute to overcorrected, unnatural outcomes, challenging perceptions of authenticity. Although patients frequently request to "look natural," this concept remains poorly defined and is not systematically addressed in training. OBJECTIVE: To distinguish beauty, attractiveness, and naturalness and to propose neuroaesthetics as a framework for improving patient-centered outcomes in aesthetic medicine. METHODS: Narrative synthesis of interdisciplinary literature integrating neuroscience, evolutionary psychology, and aesthetic medicine, with a focus on neural mechanisms underlying attractiveness, reward processing, and social perception. RESULTS: Perceptions of attractiveness and naturalness are mediated by neural systems involved in reward valuation, rapid first-impression formation, and embodied simulation. Overreliance on static structural ideals may overlook dynamic cues critical to social and emotional evaluation. Neuroaesthetic principles provide a biologically informed framework for aligning aesthetic interventions with perceptual and psychosocial responses. CONCLUSIONS: Incorporating neuroaesthetics represents a shift from structural optimization toward outcomes that prioritize authenticity, emotional resonance, and social perception. As patient expectations evolve, aesthetic providers should integrate these principles to achieve more natural and meaningful results.
Clinical Efficacy of Local Injection of Compound Betamethasone Versus Triamcinolone Acetonide in the Treatment of Hypertrophic Scars: A Retrospective Analysis of 126 Patients.
Mao J, He M
J Cosmet Dermatol · 2026 May · PMID 42108543 · Full text
BACKGROUND: Hypertrophic scars (HTS) are common complications of wound healing characterized by excessive fibroblast proliferation and collagen deposition. HTS causes local elevation, pruritus, and pain, significantly im...
BACKGROUND: Hypertrophic scars (HTS) are common complications of wound healing characterized by excessive fibroblast proliferation and collagen deposition. HTS causes local elevation, pruritus, and pain, significantly impacting aesthetics and quality of life. While triamcinolone acetonide (TA) and compound betamethasone (CB) are standard treatments, direct comparative studies regarding their efficacy and recurrence rates remain limited. OBJECTIVE: To evaluate the clinical efficacy, safety, and recurrence rate over 6 months of local injection of TA and CB monotherapy in the treatment of HTS. METHODS: We retrospectively analyzed 126 patients with HTS who received intralesional injection therapy at our hospital between December 2021 and December 2024. Patients were divided into the TA group (n = 63) and the CB group (n = 63) based on the injected drug. All patients were observed during treatment and followed for at least 6 months to monitor adverse reactions and recurrence. Scar assessment was performed using the Vancouver Scar Scale (VSS), combined with high-frequency ultrasonography to measure scar thickness changes. Clinical efficacy was evaluated based on the percentage reduction in VSS scores. RESULTS: Baseline characteristics were not significantly different between the two groups. Both CB and TA significantly reduced VSS scores and ultrasonographically measured scar thickness in patients with HTS; however, the CB group exhibited greater reductions in both VSS scores and scar thickness compared with the TA group. Evaluation of clinical efficacy revealed a total effective rate of 93.65% in the CB group versus 80.95% in the TA group. The incidence of adverse reactions was similar between the two groups, primarily consisting of local skin atrophy, pigmentation changes, and telangiectasia. The 6-month recurrence rate was significantly lower for CB (3.17%) than for TA (15.87%, p = 0.015). CONCLUSION: Both CB and TA intralesional injections are effective in improving VSS scores, reducing scar thickness, and achieving high clinical efficacy rates in patients with HTS. However, CB demonstrates superior therapeutic outcomes and a significantly lower recurrence rate compared with TA, supporting its wider clinical application.
Setting the Standard for Peer-Reviewed Published Studies on Regenerative Products in Aesthetic Medicine and Post-Procedure Wound Care.
Gold MH, Keaney TC, Fitzgerald R
J Cosmet Dermatol · 2026 May · PMID 42093170 · Full text
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The Tracy Technique: A Systems-Based Paradigm Shift in Upper Face Neurotoxin Treatment.
Tracy B, Moe K
J Cosmet Dermatol · 2026 May · PMID 42087527 · Full text
BACKGROUND: The Tracy Technique is a novel systems-based method for upper face neurotoxin treatment. It challenges the traditional area-based model by approaching the frontalis, glabella, and orbicularis oculi as a singl...
BACKGROUND: The Tracy Technique is a novel systems-based method for upper face neurotoxin treatment. It challenges the traditional area-based model by approaching the frontalis, glabella, and orbicularis oculi as a single dynamic complex. OBJECTIVE: To describe the anatomical rationale and clinical application of the Tracy Technique and its ability to produce natural, balanced aesthetic outcomes. METHODS: Patients were treated with onabotulinumtoxinA reconstituted with 2.5 mL bacteriostatic saline per 100 U vial (4 U per 0.1 mL). Injections were performed intramuscularly using a 32-gauge, ½ inch needle at a 30-degree angle, targeting the lower one-third of the frontalis with lateral extension into the orbicularis oculi while sparing the middle third and minimizing treatment in the upper third. Clinical photographs were taken using the Alma IQ photo system under standardized conditions. RESULTS: Three representative cases demonstrated effective rhytid reduction and maintenance of natural brow position without heaviness or ptosis. Both injectors and patients reported balanced, comfortable outcomes. CONCLUSION: The Tracy Technique reframes upper face neurotoxin treatment as a dynamic force balancing system. By treating both elevator and depressor muscles simultaneously, it optimizes aesthetic results and may establish a foundation for future evidence-based refinement.
International Expert Consensus on Integrated Skincare Active Ingredients for Pretreatment and Posttreatment Use With Medical Aesthetic Procedures to Enhance Skin Benefits.
Bjerring P, Draelos ZD, Fabi SG … +13 more , Goodman GJ, Hau KC, Haus A, Heydenrych I, Kim J, Lin LC, Sayed K, Sundaram H, Tsubouchi R, Wu Y, Brieva P, Choudhary H, Xiang LF
J Cosmet Dermatol · 2026 May · PMID 42087526 · Full text
BACKGROUND: Integrated skincare (ISC) combines dermocosmetics with medical aesthetic procedures to improve outcomes. However, guidance on selecting appropriate active ingredients across different procedure types and phas...
BACKGROUND: Integrated skincare (ISC) combines dermocosmetics with medical aesthetic procedures to improve outcomes. However, guidance on selecting appropriate active ingredients across different procedure types and phases remains limited. AIMS: To provide international guidance on appropriate ISC actives for use with aesthetic procedures. METHODS: In a simplified Delphi study, 14 experts evaluated 44 actives for use across four procedure categories (ablative energy-based, non-ablative energy-based, non-energy-based procedures with or without skin barrier disruption) at four time points (pretreatment, peri-treatment, aftercare, and follow-up ≥ 1 week post-procedure). The panelists also ranked their top five preferred actives for each procedure category and time point. RESULTS: Ceramides, cholesterol, hyaluronic acid, niacinamide, and peptides were deemed appropriate across all procedure categories and all time points. Azelaic acid, benzoyl peroxide, cysteamine, glycolic acid, hydroquinone, lactic acid, retinoids, and salicylic acid were identified as unsuitable for use on treatment day. Ceramides and hyaluronic acid were highly ranked for pre-treatment, peri-treatment and aftercare, while retinoids and ferulic acid were highly ranked for pretreatment and followup. Vitamin C was ranked in the top 5 across all procedure categories and time points, except at pretreatment for non-energy-based without skin barrier damage. CONCLUSIONS: Safety and tolerability are primary considerations when selecting ISC actives. Ingredients with higher irritation potential, such as retinoids and acids, should be avoided during the healing phase (on treatment day and during short-term aftercare) due to risk of irritation, as well as post-inflammatory hyperpigmentation in skin of color.
Stem Cells in Cosmetic Applications: Advancements, Challenges, and Future Directions.
KarkonShayan F, Saderi N, Morshedi I … +2 more , Ghamari B, KarkonShayan S
J Cosmet Dermatol · 2026 May · PMID 42087492 · Full text
BACKGROUND: Biotechnology has significantly impacted the cosmetics industry, particularly through the incorporation of plant stem cells, which possess regenerative properties beneficial for skincare. AIMS: This review ai...
BACKGROUND: Biotechnology has significantly impacted the cosmetics industry, particularly through the incorporation of plant stem cells, which possess regenerative properties beneficial for skincare. AIMS: This review aims to evaluate the potential benefits and challenges of using plant stem cells in cosmetics, while discussing future directions for their application in skin care products. PATIENTS/METHODS: The review synthesizes existing literature on the regenerative capabilities of plant stem cells, their role in combating aging, promoting skin repair, and providing protection against ultraviolet damage. It also examines biotechnological methods such as plant cell cultures that mitigate issues associated with raw plant materials. RESULTS: Plant stem cells demonstrate self-renewal and differentiation capabilities, crucial for tissue regeneration and skin healing. Despite their advantages, the cosmetic industry faces hurdles including inconsistent terminology, regulatory challenges, high production costs, and the prevalence of marketing strategies lacking clinical validation. CONCLUSIONS: While plant stem cell technology offers promising advancements in skincare, the cosmetic industry must address regulatory and validation concerns to ensure consumer safety and product efficacy. Future research should focus on establishing standardized practices and clinical trials to substantiate the claims of stem cell-based products in cosmetics.
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