Journal Of Cosmetic Dermatology[JOURNAL]
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200 papers
Umbilical Cord Mesenchymal Stem Cell-Derived Exosomes Preserve Melanocyte Stem Cell Integrity Under Acute Neurogenic Oxidative Stress via Activation of the Nrf2-ARE Pathway in C57BL/6J Mice.
Cui J, Duan L, Qu H … +3 more , Ning J, Li Z, Zhang H
J Cosmet Dermatol · 2026 Apr · PMID 42029421 · Full text
BACKGROUND: Stress-induced hair depigmentation is closely associated with neurogenic oxidative stress and dysfunction of melanocyte stem cells. Activation of antioxidant defense pathways, particularly the Nrf2-ARE pathwa...
BACKGROUND: Stress-induced hair depigmentation is closely associated with neurogenic oxidative stress and dysfunction of melanocyte stem cells. Activation of antioxidant defense pathways, particularly the Nrf2-ARE pathway, may protect melanocytes from oxidative damage. AIMS: To investigate whether exosomes derived from human umbilical cord mesenchymal stem cells (HUCB-MSC-Exo) preserve melanocyte stem cell integrity under acute neurogenic oxidative stress through activation of the Nrf2-ARE pathway. PATIENTS/METHODS: HUCB-MSC-Exo were characterized by transmission electron microscopy and the expression of exosomal markers CD63 and CD81. Melan-a cells were treated with exosomes at concentrations ranging from 0.50 × 10 to 2.0 × 10 particles/mL to assess cell proliferation. Nrf2 signaling and downstream antioxidant genes (HO-1, SOD-1, GR-1, and CAT) were evaluated using RT-PCR and western blotting, and intracellular calcium levels were measured. In vivo, acute neurogenic oxidative stress was induced in C57BL/6J mice using resiniferatoxin, followed by exosome treatment. Hair pigmentation, skin and follicle morphology, and antioxidant protein expression were assessed. RESULTS: HUCB-MSC-Exo promoted Melan-a cell proliferation in a dose-dependent manner, with increases of 53% and 94% at 1.5 × 10 and 2.0 × 10 particles/mL, respectively. Exosome treatment significantly upregulated Nrf2 and its downstream antioxidant genes and activated a calcium-dependent signaling pathway. In vivo, HUCB-MSC-Exo reduced stress-induced hair depigmentation, increased dermal thickness, lengthened hair shafts, improved follicular morphology, and enhanced antioxidant protein expression. CONCLUSIONS: HUCB-MSC-Exo alleviates acute neurogenic oxidative stress and preserves melanocyte function by activating the Nrf2-ARE pathway, thereby mitigating stress-induced hair depigmentation in C57BL/6J mice.
The Use of Microneedling With Exosomes in Dermatology: A Systematic Review.
Dhaliwal NK, Moothathamby T, Sokhal BS … +1 more , Gkini MA
J Cosmet Dermatol · 2026 Apr · PMID 42027180 · Full text
BACKGROUND: Microneedling combined with exosome therapy has growing clinical relevance in dermatology. This systematic review will critically evaluate current evidence on the combined use of microneedling and exosomes in...
BACKGROUND: Microneedling combined with exosome therapy has growing clinical relevance in dermatology. This systematic review will critically evaluate current evidence on the combined use of microneedling and exosomes in a number of dermatological diseases. METHOD: A systematic literature search was conducted using terms related to exosomes and microneedling using 3 databases in accordance with the Preferred Reporting Items for Systematic Reviews and synthesis (PRISMA) without meta-analyses (SWiM) guidelines. Studies were appraised using the JBI (Joanna Briggs Institute) Critical Appraisal tool. RESULTS: Two hundred and fifty-six unique references were identified, and after screening, 10 studies were eligible for quality appraisal, after which 8 studies were selected for inclusion in the final narrative synthesis. Sample size of the studies ranged from 3 from 60 participants. The efficacy and side effect profiles of exosomes and microneedling were evaluated in the following dermatological conditions: androgenetic alopecia, skin aging, hyperpigmentation, active scarring, and enlarged pores. CONCLUSION: Microneedling and exosomes hold great promise in a range of dermatological conditions. This study highlights that more evidence is required before we can ascertain the safety profile and efficacy profile of microneedling and exosomes. Further investigation with longer follow-up periods and larger sample sizes is necessary to determine the long-term safety profile and effectiveness of this treatment.
Correction to "Classification of High Curl Pattern Hair: A Systematic Review and Clinical Perspective".
J Cosmet Dermatol · 2026 Apr · PMID 42024626 · Full text
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Long-Term Persistence of Hyaluronic Acid Fillers: A Clinical Illustration and Implications for Practice.
Prager M, Lusher J
J Cosmet Dermatol · 2026 Apr · PMID 42015410 · Full text
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Efficacy and Safety of Calcium Hydroxylapatite for Nasal Augmentation: A 12-Month Prospective Study in a Chinese Population.
Wang J, Wei W, Chen J … +3 more , Zhang A, Jin P, Guo Y
J Cosmet Dermatol · 2026 Apr · PMID 42015409 · Full text
BACKGROUND: Calcium hydroxylapatite (CaHA) is a biostimulatory material that induces collagen neogenesis, but its long-term volumetric dynamics following nasal injection remain insufficiently characterized. This study ai...
BACKGROUND: Calcium hydroxylapatite (CaHA) is a biostimulatory material that induces collagen neogenesis, but its long-term volumetric dynamics following nasal injection remain insufficiently characterized. This study aimed to evaluate the efficacy and safety of CaHA gel for nasal augmentation in a Chinese population. METHODS: In this prospective study, 24 female patients received CaHA injections for nasal augmentation. Efficacy was assessed with three-dimensional (3D) facial scanning at 0 (immediately after injection), 1, 3, 6, 9, and 12 months. Patient satisfaction was evaluated using the Global Aesthetic Improvement Scale (GAIS). Safety was assessed by the Numerical Rating Scale (NRS) for injection-related pain and recording of injection site adverse reactions. RESULTS: All 24 patients completed the 12-month follow-up. 3D volumetric analysis revealed a transient reduction from Month 0 to Month 1 (p < 0.05), followed by a modest numerical increase from Month 1 to Month 6 that did not reach statistical significance (p > 0.05). At Month 12, the volume was 0.94 ± 0.45 mL, representing a significant decline compared with Months 6 and 9 (p < 0.05). The GAIS responder rate (subjects rating "Much improved" or "Very much improved") was 79% at Month 3 and 58% at Month 9. Injection-related pain was mild (mean NRS at 0 min: 1.29) and resolved within 60 min. Adverse events were transient, primarily swelling (60.5%) and tenderness (21.1%), resolving spontaneously within 1 week. No serious complications occurred. CONCLUSIONS: CaHA injection is an effective and safe treatment for nasal augmentation, providing durable volumetric improvement and high patient satisfaction over 12 months.
Evaluation of the Efficacy of Plasma Shower and 585 Nm Q-Switched Laser in the Treatment of Mild to Moderate Acne Vulgaris.
Bakircioglu CA, Turkmen D, Altunisik N … +3 more , Kanat Z, Sener S, Colak C
J Cosmet Dermatol · 2026 Apr · PMID 42011134 · Full text
OBJECTIVE: The aim of this study is to comparatively evaluate the clinical efficacy, safety profiles, and effects on different clinical components of plasma shower and 585 nm Q-Switch laser in the treatment of mild to mo...
OBJECTIVE: The aim of this study is to comparatively evaluate the clinical efficacy, safety profiles, and effects on different clinical components of plasma shower and 585 nm Q-Switch laser in the treatment of mild to moderate acne vulgaris. MATERIALS AND METHODS: A total of 47 patients with mild to moderate acne vulgaris were prospectively enrolled and allocated to either plasma shower (n = 24) or 585 nm Q-Switch laser (n = 23) treatment groups. Acne severity was assessed using the Global Acne Grading System (GAGS) at three time points: Baseline, week 2, and week 4. Repeated measures ANOVA and independent samples t-test were used for statistical analysis. RESULTS: An average improvement of 42.5% in GAGS scores was observed in the plasma shower group at the fourth week, while this rate was 32.2% in the 585 nm Q-Switch laser group. This difference between the two groups was statistically significant (p = 0.007). Clinical observations revealed that the plasma shower provided faster and more pronounced regression in inflammatory papules and pustules, while the 585 nm Q-Switch laser was more effective on post-inflammatory erythema. Both methods were found to be safe and well-tolerated by patients. CONCLUSION: Plasma shower appears to be more effective than the 585 nm Q-Switch laser in the treatment of mild to moderate acne vulgaris, particularly in reducing active inflammatory lesions. The 585 nm Q-Switch laser is a valuable treatment option for the removal of post-inflammatory erythema. Clinicians may choose between these modalities or develop combined protocols based on the predominant clinical component of acne.
Comparison of Compound Lidocaine Cream and Lidocaine-Prilocaine Cream for Pain Management in Facial Rejuvenation: A Randomized Controlled Trial.
Liu L, Zhang F, Han C … +4 more , Yuan C, Han M, Zhang C, Li L
J Cosmet Dermatol · 2026 Apr · PMID 42003110 · Full text
BACKGROUND: Effective pain management is essential for enhancing patient satisfaction and treatment compliance during facial rejuvenation procedures. Compound lidocaine cream and lidocaine-prilocaine cream are commonly u...
BACKGROUND: Effective pain management is essential for enhancing patient satisfaction and treatment compliance during facial rejuvenation procedures. Compound lidocaine cream and lidocaine-prilocaine cream are commonly used topical anesthetics in clinical practice; however, high-quality randomized controlled trials directly comparing their analgesic efficacy and safety in facial rejuvenation remain limited. OBJECTIVE: This study aimed to compare the analgesic efficacy and safety of compound lidocaine cream and lidocaine-prilocaine cream in patients undergoing facial rejuvenation procedures. METHODS: This single-center, prospective, randomized controlled trial enrolled 100 patients undergoing facial rejuvenation between January 2024 and June 2025. Participants were randomly assigned to receive either compound lidocaine cream (n = 47) or lidocaine-prilocaine cream (n = 53). The primary outcome was procedural pain intensity, assessed using a 10-point visual analog scale (VAS). Secondary outcomes included the incidence of adverse reactions, patient satisfaction, and treatment compliance. RESULTS: Baseline characteristics were comparable between the two groups (p > 0.05). The mean pain score was significantly lower in the compound lidocaine cream group than in the lidocaine-prilocaine cream group (2.51 ± 1.80 vs. 3.75 ± 1.74; t = -3.48, p < 0.001). Adverse reactions occurred in 4.3% (2/47) of patients in the compound lidocaine cream group and 11.3% (6/53) in the lidocaine-prilocaine cream group, with no statistically significant difference between groups (χ = 1.89, p = 0.169). CONCLUSION: Compound lidocaine cream demonstrated superior analgesic efficacy in this clinical comparison; however, differences in anesthetic concentration, application technique, and lack of participant blinding should be considered when interpreting these findings. Larger studies with standardized dosing and blinding are warranted.
Topical Minoxidil and Low-Dose Oral Minoxidil in Onychodystrophy: A Proposed Treatment Algorithm.
Gupta AK, Talukder M, Lipner SR
J Cosmet Dermatol · 2026 Apr · PMID 42003048 · Full text
BACKGROUND: Onychodystrophy includes diverse nail disorders that may impair function and quality of life. Because nails grow slowly, adjunctive therapies that promote nail growth are of increasing interest. AIM: This rev...
BACKGROUND: Onychodystrophy includes diverse nail disorders that may impair function and quality of life. Because nails grow slowly, adjunctive therapies that promote nail growth are of increasing interest. AIM: This review examines the evidence for minoxidil in nail growth and nail disorders and proposes a treatment algorithm for its adjunctive use in onychodystrophy. METHOD: A structured search of PubMed and Google Scholar was conducted on December 10, 2025, using terms related to minoxidil and nails. Records were deduplicated, screened, and appraised by full-text review using the Oxford Centre for Evidence-Based Medicine 2009 levels. RESULTS: A potential adjunctive treatment algorithm is proposed, emphasizing treatment of the underlying nail disorder first. Topical minoxidil (2% or 5% solution or foam, applied once or twice daily to the proximal nail fold) or low-dose oral minoxidil (LDOM; 0.625-2.5 mg/day in females and 1.25-5 mg/day in males) may then be considered, with appropriate monitoring and discontinuation criteria. Safety data for topical use indicate predominantly local irritation, whereas LDOM has been associated with tachycardia, edema, and other systemic adverse effects. Minoxidil may support nail growth through KATP channel-mediated vasodilation and growth factor signaling, with downstream activation of the Wnt/β-catenin pathway. CONCLUSION: Minoxidil shows potential as an adjunct to support nail growth, but nail-disorder-specific evidence remains limited. Controlled trials are needed to define efficacy, optimal regimens, and safety in onychodystrophy.
Postbiotic_Loaded Hyalurosome: Investigating Their Potential as Antimicrobial and Antioxidant Agents.
Morakabi SF, Shahraky MK, Ahmadian G … +1 more , Asl RM
J Cosmet Dermatol · 2026 Apr · PMID 41999161 · Full text
BACKGROUND: The skin microbiota supports skin health by defending against pathogens and regulating immunity, while its imbalance can lead to disorders. With rising interest in natural ingredients, postbiotics (bioactive...
BACKGROUND: The skin microbiota supports skin health by defending against pathogens and regulating immunity, while its imbalance can lead to disorders. With rising interest in natural ingredients, postbiotics (bioactive metabolites from probiotic fermentation) are emerging as natural antimicrobial and antioxidant agents. AIMS: This study evaluates the antibacterial and antioxidant properties of cell-free supernatants (CFS) from four lactic acid bacteria (LAB) (Lacticaseibacillus rhamnosus [LGG], Limosilactobacillus reuteri [LR], Limosilactobacillus fermentum [LF], and Weizmannia coagulans [WCO]) and encapsulates the two most potent samples (one with the highest antibacterial and the other with the strongest antioxidant activity) into hyaluronic acid-based nanoparticles (hyalurosome) for enhanced topical delivery. METHODS: Growth curve analysis, supernatant preparation, antibacterial assays (determination of minimum inhibitory concentration [MIC], minimum bactericidal concentration [MBC], and inhibition zone), antioxidant assay (measuring the scavenging activities of 2,2-diphenyl-1-picrylhydrazyl [DPPH assay]), nanoparticle synthesis and characterization, and cytotoxicity testing were performed. RESULTS: LGG demonstrated potent, broad-spectrum antibacterial activity, showing the highest efficacy against Micrococcus luteus (M. luteus) (30 mm inhibition zone, MIC/MBC of 5/7.5% v/v). In contrast, WCO exhibited superior antioxidant capacity, with an IC₅₀ of 17.48 μg/mL in the DPPH assay, outperforming ascorbic acid (IC₅₀ = 32.50 μg/mL). The optimized hyalurosomes were spherical, monodisperse (80-200 nm, PDI < 0.7), and retained the bioactivity of the postbiotics. LGG-hyalurosomes achieved complete eradication of M. luteus and Staphylococcus aureus (S. aureus) within 48 h, demonstrating sustained release, while WCO-hyalurosomes maintained strong antioxidant activity (IC₅₀ = 37.63 μg/mL). Crucially, encapsulation significantly reduced cytotoxicity, increasing human dermal fibroblast viability from 60% (free CFS) to over 90% at a 6.25% (v/v) concentration. CONCLUSION: These results position LAB-derived postbiotics delivered via hyalurosomes as a potent and safe dual-function strategy, addressing both microbial dysbiosis and oxidative stress in advanced skincare.
High Curl Pattern Hair and Scalp Care Considerations to Mitigate Seborrheic Dermatitis.
Callender V, Burgess C, Harvey VM … +5 more , Heath C, Mitchell H, Woolery-Lloyd H, Andriessen A, McMichael A
J Cosmet Dermatol · 2026 Apr · PMID 41998807 · Full text
BACKGROUND: High-curl-pattern hair has unique structural characteristics that increase its susceptibility to breakage and to seborrheic dermatitis (SD). AIMS: The paper discusses the challenges in effectively treating pa...
BACKGROUND: High-curl-pattern hair has unique structural characteristics that increase its susceptibility to breakage and to seborrheic dermatitis (SD). AIMS: The paper discusses the challenges in effectively treating patients with high-curl-pattern hair and SD, and the role of ceramide-containing products in improving the condition. METHODS: Following a systematic literature review, a panel of dermatologists developed five consensus statements on the relationship between SD and scalp barrier health in hair with a high curl pattern. RESULTS: Certain hair care practices common among individuals with high-curl-pattern hair may contribute to the development or exacerbation of SD, leading to considerable psychological distress. These statements reflect expert opinion and highlight key treatment challenges in this population. CONCLUSION: Further research is needed to better understand racial and ethnic variations in SD and to support individualized, culturally sensitive approaches to its treatment and management.
A Psychological Guide to Lower Face Botulinum Toxin Injections: Baseline Emotional Functions of Facial Expressions.
Hopf AGM, Buchheim A, Hopf M … +1 more , Eilert DW
J Cosmet Dermatol · 2026 Apr · PMID 41992522 · Full text
BACKGROUND: The lower face conveys critical interpersonal signals and is central to how patients are emotionally evaluated by others. As botulinum toxin type A (BoNT-A) is increasingly used in the perioral and mandibular...
BACKGROUND: The lower face conveys critical interpersonal signals and is central to how patients are emotionally evaluated by others. As botulinum toxin type A (BoNT-A) is increasingly used in the perioral and mandibular region, there is a growing need to understand how such procedures may influence both aesthetic outcomes and the dynamics of emotional communication and social perception. AIMS: This narrative review outlines the baseline emotional functions of lower-face expressions and supports clinicians in integrating emotional and interpersonal considerations into BoNT-A treatment planning. METHODS: A narrative literature review was conducted using PubMed and Scopus, combining the search terms 'botulinum toxin', 'lower face', 'facial expression', 'emotion', 'mimicry', and 'psychology'. Relevant evidence from psychology and neuroscience was synthesized to identify emotional and social signaling functions of key lower-face Action Units (AUs). Additional insights were integrated through citation tracking and clinical experience. RESULTS: Lower-face BoNT-A targets, such as the depressor anguli oris, platysma, masseter, mentalis, and orbicularis oris, are part of distinct AUs that contribute to emotion expression and interpersonal signaling. Their modulation through BoNT-A potentially alters cues linked to socially relevant emotions such as sadness and contempt, and social dimensions, including dominance and approachability, thereby affecting how patients are perceived in social contexts. CONCLUSIONS: Understanding the psychological and communicative functions of the lower face helps anticipate how BoNT-A treatments may influence emotional signaling and social perception. Incorporating these insights into aesthetic consultations supports transparent counseling and strengthens awareness of how aesthetic interventions contribute to nonverbal communication.
Dermatologists' Way of Informative Content on Dermatology and Cosmetology on Social Media.
Zulfiqar K, Anjum AF, Nurie IM
J Cosmet Dermatol · 2026 Apr · PMID 41987007 · Full text
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Study on the Potential Molecular Mechanism of Keloid Disease Associated With Single Cell Combined Mendelian Randomization.
Wu HH, Meng YX, Liu JH … +3 more , Luo DQ, Chen MK, Zhao YK
J Cosmet Dermatol · 2026 Apr · PMID 41986576 · Full text
BACKGROUND: Keloids are pathological scars with incompletely understood pathogenesis. This study aims to identify the key genes and regulatory networks potentially involved in keloid formation by integrating single-cell...
BACKGROUND: Keloids are pathological scars with incompletely understood pathogenesis. This study aims to identify the key genes and regulatory networks potentially involved in keloid formation by integrating single-cell transcriptomics (scRNA-seq), protein quantitative trait loci (pQTL), Mendelian randomization (MR) analyses, colocalization, and comprehensive functional characterization. METHODS: Single-cell RNA sequencing data (GSE181297, GSE163973) and bulk transcriptomic data (GSE145725) were obtained from the GEO database. These datasets, which included both keloid lesions and normal scar samples from distinct individuals, were subjected to rigorous quality control and cell annotation. Intercellular communication was analyzed using CellChat, and co-expression networks were constructed via hdWGCNA. To identify potential causal genes, MR analysis was performed by integrating pQTL data from the deCODE database with GWAS summary statistics (GCST90018874), followed by colocalization, sensitivity analysis, and reverse validation. Further functional characterization of potential key genes was conducted through Gene Set Enrichment Analysis (GSEA), immune infiltration analysis, transcription factor (TF) regulatory network inference, and pseudotime trajectory analysis. RESULTS: 92 659 high-quality cells were retained, revealing seven major cell types with fibroblasts showing the most extensive intercellular interactions. Mendelian randomization identified 11 genes causally linked to keloid risk, with genetically determined downregulation of SSR1 and SRA1 associated with increased susceptibility. SRA1 was enriched in cell cycle, nucleocytoplasmic transport, and ribosome biogenesis in eukaryotes, while SSR1 was implicated in complement/coagulation cascades, the NOD-like receptor signaling pathway, and viral protein interaction with cytokine and cytokine receptors. Immunoinfiltration, TF network and motif analysis, and pseudotime analysis further characterized their regulatory roles in immune microenvironment modulation and cell differentiation. CONCLUSIONS: This multi-omics study identifies SRA1 and SSR1 as potential key protective genes in keloid pathogenesis. These genes may contribute to inhibiting disease progression through modulation of cell proliferation, the immune microenvironment, and cellular signaling pathways. These findings provide novel mechanistic insights and potential immunotherapeutic targets for keloids.
Improved Skin Quality with a Novel Topical Body Serum: Distal Thighs and Back of Hands.
Wang JV, Makino ET, Kadoya K … +3 more , Cheng T, Huang P, Geronemus RG
J Cosmet Dermatol · 2026 Apr · PMID 41981821 · Full text
BACKGROUND: Intrinsic and extrinsic factors contribute to the loss of dermal extracellular matrix (ECM), which can result in a decline of skin quality and clinical signs of aging skin. OBJECTIVE: This randomized, double-...
BACKGROUND: Intrinsic and extrinsic factors contribute to the loss of dermal extracellular matrix (ECM), which can result in a decline of skin quality and clinical signs of aging skin. OBJECTIVE: This randomized, double-blinded, split-body, vehicle-controlled, 12-week study evaluated the efficacy of a skin body firming serum (BFS) that targets ECM renewal to improve skin quality on the distal thighs and back of hands. METHODS: Adults with mild-to-moderate skin crepiness applied either BFS or vehicle twice daily to their assigned treatment side. Clinical investigator assessments, digital imaging, and participant self-assessments were performed. Skin biopsies were taken from a limited number of participants for histologic analysis. RESULTS: Participants were divided into 2 groups: treatment on the distal thighs (N = 11) and treatment on the back of hands (N = 12). Significant improvements in distal thigh firmness, texture, crepiness, and fine lines/wrinkles were observed from BFS treatment at weeks 4 and 12 over vehicle treatment and baseline. Firmness and texture on the back of hands significantly improved at weeks 8 and 12 of BFS treatment relative to baseline, with crepiness significantly improving at weeks 2 and 12. Significant improvements were seen in body skin texture (distal thighs), firmness (back of hands), and crepiness (back of hands) at week 12, and fine lines/wrinkles (distal thighs) at week 8, with vehicle treatment in comparison to baseline. Participants reported higher satisfaction with BFS than vehicle through week 12. Exploratory histologic assessments showed induction of collagen and elastic fibers. CONCLUSIONS: BFS significantly improved skin quality in both the distal thighs and back of hands, suggesting that BFS enhances body skin quality.
Assessing the Utility of a Cosmetic Dermatology Journal Club.
Chang J, Alvi S, Zhang E … +11 more , Smith SS, Gullapalli T, Lazaro-Camp VJ, Dragovic D, Ahmed A, Carter DC, Mills DE, Henderson AA, El-Khateeb H, Kang BY, Alam M
J Cosmet Dermatol · 2026 Apr · PMID 41975526 · Full text
BACKGROUND: Journal clubs provide opportunities for discussion of new and evolving practices and technologies. OBJECTIVE: We sought to evaluate the utility and effectiveness of a monthly web-based cosmetic dermatology jo...
BACKGROUND: Journal clubs provide opportunities for discussion of new and evolving practices and technologies. OBJECTIVE: We sought to evaluate the utility and effectiveness of a monthly web-based cosmetic dermatology journal club facilitated by faculty, residents, and medical students. RESULTS: From May 2025 to September 2025, 16 articles were discussed and 41 responses were recorded (response rate: 60%). Most respondents found the journal club was an appropriate length, engaging, and very useful. Relevance, frequency, and likelihood to participate in the future varied significantly by participant type. Medical students and residents collectively considered the journal club too infrequent (p = 0.03) and reported it had less relevance to their practice (p < 0.001). CONCLUSION: A monthly web-based cosmetic dermatology journal club was generally positively received by respondents.
Calcium Hydroxylapatite-Carboxymethylcellulose as a Treatment for Forearm Dermatoporosis: A Prospective, Delayed-Start, Contralateral Case Series.
de Almeida ART, de Sousa Marins Barbosa MC, Michalany A … +1 more , McCarthy AD
J Cosmet Dermatol · 2026 Apr · PMID 41968542 · Full text
BACKGROUND: Dermatoporosis is a chronic cutaneous fragility syndrome marked by dermal thinning, collagen loss, and recurrent purpuric lesions. Effective treatments remain limited. Calcium hydroxylapatite-carboxymethylcel...
BACKGROUND: Dermatoporosis is a chronic cutaneous fragility syndrome marked by dermal thinning, collagen loss, and recurrent purpuric lesions. Effective treatments remain limited. Calcium hydroxylapatite-carboxymethylcellulose (CaHA-CMC) is a regenerative biostimulator with demonstrated skin extracellular matrix-restorative effects, but its usefulness in forearm dermatoporosis has not been established. OBJECTIVES: To evaluate the efficacy, durability, and safety of hyperdiluted CaHA-CMC for reducing lesion burden, increasing dermal thickness, and enhancing collagen density in dermatoporotic forearms. METHODS: In this prospective, delayed-start, contralateral case series, six patients with bilateral dermatoporosis received a single treatment of 1:2 CaHA-CMC. The more clinically affected arm was treated at Day 0, and the contralateral arm served as a 45-day untreated control before receiving identical treatment. Lesion coverage was quantified from standardized photographs using an ImageJ-based workflow. Dermal thickness was measured by high-frequency ultrasound, and collagen content was assessed from Masson's Trichrome-stained punch biopsies. Early effects (Day 0-45) were evaluated using paired testing and a subject-level difference-in-differences (DiD) estimator. Durability was assessed by aligning post-treatment follow-ups by time-since-treatment (TST), focusing on TST45 and an ~1-year window (320-365 days). RESULTS: From Day 0 to Day 45, lesion coverage decreased in treated forearms from 5.60% ± 4.47% to 1.92% ± 2.07% (p = 0.041), while changes in untreated contralateral forearms were not significant. In pooled participant-level analyses aligned by post-treatment timing, lesion coverage decreased from 4.27% ± 1.88% at baseline to 1.16% ± 1.10% at TST45 (p = 0.0313) and remained reduced at the ~1-year window (1.14% ± 0.68%, p = 0.0313), corresponding to a 73.4% reduction at ~1 year. Collagen area increased by 69.7% at 45 days post-treatment (p = 0.0009), and dermal thickness increased by 36.05% (p = 0.0007). Treatment was well tolerated; one transient nodule resolved with massage. CONCLUSIONS: A single session of hyperdiluted CaHA-CMC produced rapid and durable clinical, histologic, and ultrasonographic improvement in forearm dermatoporosis. Findings warrant further evaluation in larger controlled trials.
Global Pharmacovigilance of Aesthetic Botulinum Toxin Type A: Analysis of Adverse Event Reports From the USA, Europe, Canada, and Australia.
Zargaran A, Zargaran D, Pirayesh A … +2 more , Woollard A, Mosahebi A
J Cosmet Dermatol · 2026 Apr · PMID 41968501 · Full text
BACKGROUND: Monitoring of adverse events for aesthetic BoNT-A (BoNT-A) through pharmacovigilance databases provides critical insight into real-world safety profiles. Previous analyses suggested substantial underreporting...
BACKGROUND: Monitoring of adverse events for aesthetic BoNT-A (BoNT-A) through pharmacovigilance databases provides critical insight into real-world safety profiles. Previous analyses suggested substantial underreporting, yet comprehensive international multi-database analysis remains absent. METHODS: Adverse event reports for aesthetic BoNT-A indications were extracted from FDA FAERS, EMA EudraVigilance, Health Canada MedEffect, and TGA DAEN databases from 2002 to 2025. Reports were filtered for cosmetic indications using procedure codes, anatomical sites, and indication descriptions. Events were categorized by clinical manifestation and severity using MedDRA classification. RESULTS: Analysis identified 43,809 adverse event reports across four databases. FDA FAERS contributed 38,321 reports (87.5%), EudraVigilance 3,526 (8.0%), Health Canada 1,835 (4.2%), and TGA DAEN 127 (0.3%). Effectiveness issues comprised 57.3% of reports (n = 25,092), followed by local injection-site reactions (19.7%, n = 8,611), facial paresis/ptosis/asymmetry (9.9%, n = 4,348), and headache (6.0%, n = 2,650). Peak reporting occurred in 2018 for FAERS (1,375 reports) and 2020 for Health Canada (242 reports). Among FAERS reports with brand attribution, onabotulinumtoxinA accounted for 86.8%, abobotulinumtoxinA 9.7%, and incobotulinumtoxinA 2.4%. Co-reported adverse event analysis revealed drug ineffective with therapeutic response decreased as the most frequent pairing (n = 2,947), followed by drug ineffective with off-label use (n = 1,102). CONCLUSIONS: The predominance of effectiveness issues over traditional safety concerns distinguishes aesthetic BoNT-A pharmacovigilance from typical pharmaceutical surveillance. Geographic concentration of reporting in the United States despite global market distribution indicates systematic underreporting internationally. These findings suggest current pharmacovigilance systems inadequately capture aesthetic medicine adverse events, with direct implications for patient safety and regulatory oversight.
Evaluation of Transparent Pressure Masks in Reducing Hypertrophic Scars: A Comparison Across Facial Zones.
Ao M, Chen N, Lu B … +1 more , Tan J
J Cosmet Dermatol · 2026 Apr · PMID 41968483 · Full text
BACKGROUND: Facial burn scars are challenging to treat due to complex contours, and data on site-specific efficacy of transparent pressure masks are limited. AIMS: To evaluate the effectiveness of transparent pressure ma...
BACKGROUND: Facial burn scars are challenging to treat due to complex contours, and data on site-specific efficacy of transparent pressure masks are limited. AIMS: To evaluate the effectiveness of transparent pressure masks on six facial zones in treating post-burn hypertrophic scars. PATIENTS/METHODS: We retrospectively analyzed 22 patients with post-burn facial hypertrophic scars across six zones (mid-forehead, bilateral zygomatic arches, bilateral cheeks, chin). Patients were treated with transparent masks and followed for 6 months. Scar assessment included Vancouver Scar Scale (VSS), thickness, hardness, coloration, pruritus, pain, and satisfaction. RESULTS: We found that the VSS scores of the middle of forehead and bilateral zygomatic arches were significantly improved compared with scores before mask application. In the objective assessment, a significant difference in thickness of the scar was observed in the middle of forehead and chin compared with the scores before mask application. Similarly, the hardness of the scar in the chin was significantly different from that before mask application. The value of color L of the scar in the middle of forehead, left zygomatic arch, right cheek and chin was significantly different between baseline scores and after 6 months of wearing a transparent mask. The patients were very satisfied with the therapeutic effect. The percentage of wearing transparent mask adverse effects was 36.36%, including redness, oozing, blistering, and rash. CONCLUSIONS: Transparent pressure masks effectively improve facial burn hypertrophic scars, particularly in the mid-forehead of forehead and bilateral zygomatic arches, and can be applied within 1 month.
Comparative Efficacy of Photodynamic Therapy Versus Cryotherapy for Actinic Keratosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Aldraibi S, Alharbi M, Alzubaidi K … +6 more , Turkistani O, Kassim AB, Almutairi D, Alhammadi M, Makhtoum J, Alghamdi F
J Cosmet Dermatol · 2026 Apr · PMID 41964358 · Full text
BACKGROUND: Photodynamic therapy and cryotherapy are treatment options for actinic keratosis; however, their efficacy and safety remain debated. AIMS: To perform a high-quality systematic review and meta-analysis explori...
BACKGROUND: Photodynamic therapy and cryotherapy are treatment options for actinic keratosis; however, their efficacy and safety remain debated. AIMS: To perform a high-quality systematic review and meta-analysis exploring the efficacy and safety of photodynamic therapy and cryotherapy in actinic keratosis. METHODS: A systematic search was performed applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched PubMed, Web of Science, Cochrane, Science Direct, Ovid, EBSCO, Wiley, and Google Scholar for randomized controlled trials. RESULTS: A total of seven studies with 1233 patients were identified. PDT and cryotherapy showed similar success in clearing lesions (RR, 1.02; 95% CI, 0.92-1.13; p = 0.74). While both treatments performed comparably on the head and face (RR, 1.10; 95% CI, 0.94-1.28; p = 0.24), data from one trial suggested cryotherapy might be more effective for lesions on the arms and legs (RR, 0.88; 95% CI, 0.82-0.94; p < 0.05). However, more research is needed to confirm this finding. Cosmetic outcomes were significantly better for PDT (74.62% vs. 49.11%: RR, 1.52; 95% CI, 1.4-1.65; p < 0.00001) than cryotherapy. Similarly, PDT was superior to cryotherapy in patient satisfaction though the overall difference was not statistically significant (RR, 1.43; 95% CI, 0.91-2.25; p = 0.12). PDT was associated with a significantly higher risk of burning sensations and pain (RR, 1.95; 95% CI, 1.27-3.02; p = 0.002), whereas cryotherapy more frequently led to vesicles and blisters. CONCLUSION: Lesion clearance may depend on location. It is comparable for head and face lesions, while data from one trial suggests cryotherapy may be better for extremity lesions. PDT is associated with a higher occurrence of pain/burning, while cryotherapy leads to more vesicles/blisters. Future research should focus on standardized protocols, including blinded post-treatment assessments to improve reliability and minimize bias.
Procedural Treatments as Adjuncts in the Management of Acne Vulgaris: A Narrative Review.
Beutler K, Nowicka D, Gold MH … +1 more , Chilicka-Hebel K
J Cosmet Dermatol · 2026 Apr · PMID 41958307 · Full text
BACKGROUND: Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit and one of the most prevalent dermatological conditions globally. Its multifactorial pathogenesis and variable clinical presentation...
BACKGROUND: Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit and one of the most prevalent dermatological conditions globally. Its multifactorial pathogenesis and variable clinical presentation necessitate a multimodal therapeutic approach. While pharmacological interventions remain first-line therapy, cosmetic and dermatologic procedures are increasingly utilized as adjunctive strategies to enhance clinical outcomes. This narrative review synthesizes current evidence on four commonly employed cosmetic modalities in acne management: chemical peels, mechanical peels, light-based therapies, and radiofrequency-assisted microneedling. AIM: The aim of this study is to evaluate the role of procedural treatments as adjunctive options in the management of acne vulgaris. METHODS: A literature search was performed in PubMed, Web of Science, and Scopus with no time restrictions, focusing on patients with acne vulgaris and adjunct cosmetic/procedural interventions. RESULTS: Given the narrative scope, this was a non-comprehensive, non-exhaustive evidence synthesis, with treatment options organized thematically. Overall, these cosmetic procedures can provide meaningful adjunctive benefits when integrated into individualized acne treatment plans. However, variability in study designs, procedural parameters, and outcome measures limits direct comparison across modalities. Further high-quality randomized controlled trials are necessary to establish standardized protocols and to determine long-term safety and efficacy. CONCLUSIONS: Procedural treatments can serve as valuable adjuncts in the management of acne vulgaris by enhancing therapeutic outcomes and addressing treatment-resistant cases. However, individualized treatment selection and further high-quality studies are needed to optimize their use and long-term benefits.
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