BACKGROUND: Aging of the upper third of the face is characterized by dynamic forehead wrinkles and volume loss in the temporal region, resulting in a fatigued and aged appearance. Addressing both muscle hyperactivity and...BACKGROUND: Aging of the upper third of the face is characterized by dynamic forehead wrinkles and volume loss in the temporal region, resulting in a fatigued and aged appearance. Addressing both muscle hyperactivity and soft tissue atrophy is essential for effective rejuvenation. OBJECTIVE: To evaluate a combined injectable treatment protocol using Relabotulinum Toxin A for frontalis muscle modulation and NASHA™-based gel skinbooster for temporal skin quality enhancement. METHODS: Patients received intramuscular injections of Relabotulinum Toxin A targeting the frontalis muscle, followed by three monthly sessions of NASHA gel skinbooster injected subcutaneously into the temporal region using a blunt cannula technique. Dosages and injection points were individualized based on detailed anatomical and functional assessments. RESULTS: Preliminary clinical evaluations indicate that the protocol is minimally invasive and well-tolerated, producing progressive aesthetic improvements lasting beyond six months. Patients reported enhanced skin tone, elasticity, hydration, and a natural-looking lift of the eyebrow tail. Improvements in psychological well-being and patient satisfaction were also observed. CONCLUSION: This combined neuromodulation and skin quality improvement approach provides a comprehensive and synergistic strategy for upper facial rejuvenation. The ready-to-use liquid formulation of Relabotulinum Toxin A allows for precise application, rapid onset of results within 24-48 hours, and sustained improvement of forehead dynamic wrinkles for up to six months. The collagen-stimulating properties of NASHA gel deliver natural, long-lasting enhancement of the temporal region, contributing to high levels of patient satisfaction.  .
BACKGROUND: Skin aging results from intrinsic and extrinsic factors, including oxidative stress, ultraviolet (UV) radiation, and declining cellular functions. These factors lead to visible changes like rhytids, pigmentat...BACKGROUND: Skin aging results from intrinsic and extrinsic factors, including oxidative stress, ultraviolet (UV) radiation, and declining cellular functions. These factors lead to visible changes like rhytids, pigmentation, and loss of elasticity. Meanwhile, interest in plant-based skincare ingredients for skin aging has been increasing. OBJECTIVE: This systematic review investigates the anti-aging potential of Astragalus membranaceus, a botanical plant. The authors focused on its active components and their roles in dermal protection, antioxidant, anti-inflammatory, anti-aging properties, and telomere elongation. METHODS: A comprehensive PubMed search from 2015 to 2025 per PRISMA guidelines identified clinical and experimental studies assessing the anti-aging effects of Astragalus membranaceus. RESULTS: Bioactive compounds, including astragaloside IV, cycloastragenol, flavonoids, and polysaccharides, showed photoprotective effects, including reactive oxygen species (ROS) reduction, inflammatory signaling inhibition, mitochondrial preservation, and promotion of collagen synthesis. Elongation of telomeres under oxidative stress was also demonstrated with Astragaloside IV. Clinical trials showed improvements in skin hydration, tone, and wrinkle reduction. CONCLUSION: Astragalus membranaceus offers promise as a botanical anti-aging agent. Its effects on collagen, oxidative defense, and telomere preservation support its potential use in cosmeceuticals. However, further randomized trials are needed to confirm long-term efficacy and safety.  .
BACKGROUND: Although drugs are a common cause of hyperpigmentation, the pathogenesis is unclear and varies based on the offending agent. Classic medications associated with hyperpigmentation secondary to increased melani...BACKGROUND: Although drugs are a common cause of hyperpigmentation, the pathogenesis is unclear and varies based on the offending agent. Classic medications associated with hyperpigmentation secondary to increased melanin deposition include tetracyclines, prostaglandins, nicotine, and antimalarial medications. We report the case of a 70-year-old female who developed photodistributed hyperpigmentation due to increased melanin deposition following COVID-19 vaccination. CASE REPORT: A 70-year-old female presented with a one-year history of diffuse blue-grey hyperpigmentation in a photodistributed pattern. Eight months prior to onset, she received her third COVID-19 booster vaccine. The patient had never undergone therapy with medications classically implicated in the condition. A punch biopsy of the left cheek demonstrated brown pigment deposition with both superficial perivascular and deep focal interstitial and perivascular distribution. Fontana-Masson stain positivity in the setting of Prussian blue negativity was suggestive of increased melanin pigment deposition as the cause of her hyperpigmentation. Extensive laboratory workup was unremarkable. DISCUSSION: While the COVID-19 vaccine has been associated with a variety of cutaneous reactions, there is little evidence describing drug-induced hyperpigmentation after vaccination. Although we cannot definitively establish a causal relationship between the patient's COVID-19 vaccination and the development of her photoinduced hyperpigmentation, an in-office literature review suggested the correlation of these two events. The timing of the vaccine relative to the onset of pigmentary changes and the absence of other identifiable metabolic triggers elevate COVID-19 vaccination as a plausible offending agent. This report is intended to raise awareness of a rare but cosmetically disfiguring potential complication of COVID-19 vaccination.  .
BACKGROUND: Sunless tanners offer a safer alternative to ultraviolet (UV)-based tanning but may cause adverse skin reactions, including irritant and allergic contact dermatitis. This study examines the composition, effic...BACKGROUND: Sunless tanners offer a safer alternative to ultraviolet (UV)-based tanning but may cause adverse skin reactions, including irritant and allergic contact dermatitis. This study examines the composition, efficacy, safety, and reported side effects of commonly used sunless tanning products. METHODS: The top 50 sunless tanners on Amazon's Best Sellers list (March 2025) were reviewed. After excluding bundles, applicators, and non-self-tanning cosmetics, 37 products were included. Ingredient lists were analyzed, and customer reviews were screened for reports of skin reactions using predefined keywords. RESULTS: All products contained dihydroxyacetone (DHA), 38% included erythrulose, 11% contained melanin, and 5% included tyrosine derivatives. Only one product (3%) also contained sunscreen. On average, 1.96% of customer reviews mentioned skin reactions. DISCUSSION: DHA remains the predominant active ingredient, with erythrulose, melanin, and tyrosine derivatives used less frequently. Emerging or less common agents such as troxerutin, melanotan, and melanoidins raise safety and regulatory concerns. Reported adverse effects include contact dermatitis and pigmentary changes, which may complicate dermatologic assessments. CONCLUSION: While sunless tanners provide a UV-free tanning option, dermatologists should educate patients on ingredient safety, potential adverse effects, and proper application techniques. Given their minimal UV protection, patients should be advised to continue regular sunscreen use.
A 73-year-old woman with Fitzpatrick skin type V presented with a long-standing brownish-black, three-tone macule on the right anterior thigh that developed a sharply demarcated depigmented halo. She also exhibited depig...A 73-year-old woman with Fitzpatrick skin type V presented with a long-standing brownish-black, three-tone macule on the right anterior thigh that developed a sharply demarcated depigmented halo. She also exhibited depigmented patches on the buttocks, hands, and feet consistent with vitiligo. Horizontal excision with histopathology confirmed seborrheic keratosis (SK) without atypia. This case highlights that the halo phenomenon can occur in non-melanocytic lesions, including SK,1 a presentation that may mimic melanoma and complicate diagnosis in richly pigmented skin.2,3 We review halo SK, discuss dermoscopic–pathologic features that distinguish it from melanoma and adult-onset halo nevus, and summarize evidence-based therapies for coexisting vitiligo, including topical ruxolitinib 1.5% cream and narrowband UVB (NB-UVB).4,5  .
Many medications commonly used in dermatology come with package inserts that contain boxed warnings that are frequently not evidence-based. Boxed warnings are the most serious warnings that the US Food and Drug Administr...Many medications commonly used in dermatology come with package inserts that contain boxed warnings that are frequently not evidence-based. Boxed warnings are the most serious warnings that the US Food and Drug Administration (FDA) can issue for medications through various methods, like class labeling, despite the absence of factual, high-quality evidence. Currently, there are several medications labeled with these boxed warnings for which there is no evidence, and in many cases, there actually may exist refuting evidence. However, these warnings persist in the package inserts. This has led to much hesitancy in their use, contributing to the undertreatment, or even lack of treatment, of conditions for which these medications are efficacious. Furthermore, the negative physical and mental effects of the lack of effective treatment for patients with skin disorders are well-documented. The authors call for transparency regarding the evidence, or lack thereof, behind these boxed warnings on the part of the FDA.
As cancer prevalence continues to increase in Nordic countries, the amount of dermatological adverse events, termed cutaneous adverse events (cAEs), will also increase. The Nordic European Cutaneous Oncodermatology Manag...As cancer prevalence continues to increase in Nordic countries, the amount of dermatological adverse events, termed cutaneous adverse events (cAEs), will also increase. The Nordic European Cutaneous Oncodermatology Management (NECOM) group aims to provide evidence-based guidance on how to treat and manage cAEs with an emphasis on supportive skincare regimens to improve patients' quality of life. The presented real-world cases demonstrate the use of the previous 6 NECOM recommendations in clinical practice. Experts in supportive oncodermatology share real patient cases and cAE treatment plans to serve as a guide for future healthcare providers. The cases highlight the use of daily skincare regimens containing gentle cleansers, moisturizers, and sunscreen that help to protect the skin from severe skin toxicities and help repair the skin barrier. Patients who were prescribed a daily skincare regimen consisting of Lipikar Syndet AP+ cleanser, Lipikar Baume AP+M, Cicaplast baume B5+, and Anthelios UVMUNE SPF50+ sunscreen (La Roche-Posay) found that their cAEs were less severe and symptomatic. The products in the recommended skincare regimen have all been tested for tolerance on patients undergoing cancer treatment. NECOM advisors emphasize the importance of selecting the right skincare products that will best nourish and heal sensitive skin and encourage patients and clinicians to encourage a proactive approach to skincare before, during, and after cancer-targeted therapies.  .
BACKGROUND: Cutaneous hyperpigmentation, which includes melasma, post-inflammatory hyperpigmentation, and solar lentigines, significantly impacts patients' quality of life. The overproduction of melanin is mediated by ac...BACKGROUND: Cutaneous hyperpigmentation, which includes melasma, post-inflammatory hyperpigmentation, and solar lentigines, significantly impacts patients' quality of life. The overproduction of melanin is mediated by activation of the skin enzyme tyrosinase, leading to excess melanin deposition in the skin. Thiamidol (isobutylamido thiazolyl resorcinol) formulations have been previously shown to be effective in reducing the cutaneous pigmentation associated with this human skin enzyme. METHODS: A randomized study was performed with 90 subjects clinically presenting with facial hyperpigmentation (Thiamidol serum n=43; Thiamidol regimen n=47) as measured by colorimeter and individual typology angle (ITA0) to assess the efficacy of a Thiamidol-based serum (2X daily application; morning/night) or a Thiamidol-based regimen (day lotion with SPF 30 + serum in morning; night cream + serum at night) for 12 weeks with a 6-week regression period. RESULTS: A significant visible reduction in facial hyperpigmentation, assessed by increases in L* and ITA° values, along with an increase in skin radiance and shine, were observed as early as week 2, with continued improvement through week 12 in both the treatment groups relative to baseline. At week 12, changes in radiance and shine were trending toward enhancement in the regimen group compared with the serum group. DISCUSSION: This study demonstrates the clinical effectiveness of Thiamidol-containing formulations in the visible improvement of facial hyperpigmentation and in overall skin radiance and shine. CONCLUSION: These data support the use of Thiamidol-containing formulations as part of the overall management strategy for individuals affected by facial hyperpigmentation.  .
BACKGROUND: A novel gel-matrix moisturizer was designed to 1) deliver immediate, long-lasting hydration benefits in a lightweight, non-greasy, noncomedogenic formula that is suitable for use on dry, oily, acne-prone, and...BACKGROUND: A novel gel-matrix moisturizer was designed to 1) deliver immediate, long-lasting hydration benefits in a lightweight, non-greasy, noncomedogenic formula that is suitable for use on dry, oily, acne-prone, and sensitive skin; 2) reduce acne-related and acne medication–induced skin irritation and dryness; and 3) improve quality of life (QoL), when used as an adjunctive moisturizer by patients with acne using topical treatments. OBJECTIVE: To assess the biological effects of the gel-matrix moisturizer on key epidermal proteins of skin barrier function, and clinical improvements in skin attributes and tolerability in adults with acne undergoing topical treatment. METHODS: Preclinical and clinical studies evaluated the tolerability of the gel-matrix moisturizer and its effects on filaggrin and aquaporin-3 protein levels (markers of barrier function), skin texture, appearance, and QoL in the study population. RESULTS: In skin explant studies, the gel-matrix moisturizer demonstrated significant increases in levels of filaggrin (+36%) and aquaporin-3 (+102%) versus untreated controls (both P<0.05). Clinically, at week 4 compared with baseline, the gel-matrix moisturizer demonstrated significant improvements in visual skin smoothness, roughness, clarity, radiance, pore issues, and overall skin appearance (all P<0.01), as well as significant decreases in skin itching (P<0.01) and tightness (P<0.002). Patients with acne also using topical over the counter and prescription treatments reported significant improvements in QoL at week 4 (P<0.001). CONCLUSION: The gel-matrix moisturizer improved barrier function and skin attributes without exacerbating acne symptoms, offering suitable topical moisturization when used as an adjunctive moisturizer with acne treatments.  .
BACKGROUND: DFD-29 (minocycline hydrochloride extended-release capsules, 40 mg) has shown significant therapeutic benefit vs placebo and doxycycline in treating moderate-to-severe rosacea. However, the impact of its use...BACKGROUND: DFD-29 (minocycline hydrochloride extended-release capsules, 40 mg) has shown significant therapeutic benefit vs placebo and doxycycline in treating moderate-to-severe rosacea. However, the impact of its use on skin, vaginal, and gastrointestinal microbiota is unknown. METHODS: In this multicenter, randomized, double-blind, placebo-controlled trial, 60 healthy adults were randomized in a 2:1 ratio to receive either DFD-29 (40 mg) orally or a matching placebo once daily for 16 weeks. Microbiological samples were collected from the skin (forehead), vagina, and stool at baseline and weeks 4, 8, and 16 to evaluate changes in normal microbiota species (via culture and 16S rRNA sequencing), in the MIC90 of selected colonized microbial species, and in opportunistic microbiota with DFD-29 vs placebo. Safety was evaluated via analysis of adverse events, vital signs, and laboratory tests. RESULTS: Thirty-eight adults assigned to DFD-29 and 19 adults assigned to placebo were included in the microbiota evaluable population. There were no significant differences detected in the abundance of microbial species in the skin, stool, or vagina from baseline to week 16 between the DFD-29 and placebo groups. No significant differences were detected in resistance to minocycline between DFD-29 and placebo. There were also no significant differences in the presence of opportunistic microbiota at any time point. No significant safety issues were reported. CONCLUSION: Administration of DFD-29 for 16 weeks had no detectable effects on skin, GI tract, or vaginal microflora and was well tolerated in healthy adults, reinforcing its potential as a therapeutic option in moderate-to-severe rosacea.  .
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder associated with many comorbidities, including obesity, diabetes, cardiovascular risk factors, mental health issues, and many more disorder...BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder associated with many comorbidities, including obesity, diabetes, cardiovascular risk factors, mental health issues, and many more disorders. Current treatments including biologics, topicals, and surgical interventions often fall short in terms of patient satisfaction, demonstrating a need for additional innovative approaches that address HS-related comorbidities. OBJECTIVE: This review explores the novel application of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in HS treatment, particularly for patients with comorbid conditions such as metabolic syndrome, diabetes, and obesity. Emphasis is placed on combination therapy and the potential for GLP-1RAs to address both HS symptoms and associated comorbidities, with careful consideration of patient selection. METHODS: A review of emerging evidence and existing literature on GLP-1RAs and their applications for weight loss, metabolic regulation, and anti-inflammatory effects was conducted. FINDINGS: GLP-1RAs offer dual benefits for HS patients by modulating inflammatory pathways and addressing associated comorbid conditions. Case studies and preliminary data suggest that GLP-1RAs may reduce lesion severity, systemic inflammation, and morbidity, either as monotherapy or in conjunction with existing treatments. However, high-quality randomized controlled trials are indicated to confirm these findings. CONCLUSION: GLP-1RAs represent a promising adjunctive or standalone treatment choice for those with HS and its related comorbidities. Further research is needed to establish their safety and efficacy in HS treatment.  .
BACKGROUND: International Dermatology Outcome Measures (IDEOM) is a nonprofit organization committed to advancing the development and accessibility of evidence-based, consensus-driven outcome measures in dermatology. Thi...BACKGROUND: International Dermatology Outcome Measures (IDEOM) is a nonprofit organization committed to advancing the development and accessibility of evidence-based, consensus-driven outcome measures in dermatology. This mission is supported by a diverse group of stakeholders who collaborate to improve the research and treatment of dermatologic disease. SUMMARY: The 2024 IDEOM Annual Meeting was held on April 5-6, 2024. During the event, work groups in psoriatic disease, hidradenitis suppurativa, geriatric dermatology, connective tissue disease, vitiligo, itch, actinic keratosis, acne, and cutaneous T-cell lymphoma discussed research progress and conducted breakout sessions. This report summarizes each workgroup’s updates. KEY MESSAGES: This report outlines the key research advancements made by each IDEOM workgroup at the 2024 IDEOM Annual Meeting.  .
OBJECTIVE: Recognizing the risk of atherosclerotic cardiovascular disease (ASCVD) in patients is crucial in clinical practice. Recent studies suggest an association between inflammatory skin diseases and ASCVD. This stud...OBJECTIVE: Recognizing the risk of atherosclerotic cardiovascular disease (ASCVD) in patients is crucial in clinical practice. Recent studies suggest an association between inflammatory skin diseases and ASCVD. This study evaluates ASCVD risk in inflammatory skin disease patients using a standardized assessment model. METHODS: We used the TriNetX platform to analyze 10-year ASCVD risk in inflammatory skin conditions. Propensity score-matched (PSM) cohorts adjusted for confounders. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression. RESULTS: Inflammatory skin diseases were associated with elevated ASCVD risk. Hidradenitis suppurativa showed the strongest association (HR 1.32; 95% CI: 1.17-1.48). Elevated risks were also noted for psoriasis (HR 1.21; 95% CI: 1.14-1.28) and atopic dermatitis (HR 1.15; 95% CI: 1.04–1.26). These risks were lower than in diabetes mellitus (HR 2.57; 95% CI: 2.52-2.63). CONCLUSION: Patients with hidradenitis suppurativa, psoriasis, and atopic dermatitis exhibit increased ASCVD risk. While lower than in diabetes mellitus, findings highlight the role of dermatologists in ASCVD risk identification and management.  .
BACKGROUND: Acne pathophysiology and presentation may differ between pediatric/adolescent/young adult (9-24 years) and adult (≥25 years) patients. Fixed-dose clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide...BACKGROUND: Acne pathophysiology and presentation may differ between pediatric/adolescent/young adult (9-24 years) and adult (≥25 years) patients. Fixed-dose clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide 3.1% (CAB) gel demonstrated superior efficacy to vehicle and component dyads with good safety/tolerability in 3 clinical trials of acne. This post hoc analysis evaluated the efficacy/safety of CAB in pediatric/adolescent/young adult ("younger") vs adult participants. METHODS: In one phase 2 (NCT03170388) and two phase 3 (NCT04214652, NCT04214639) trials, participants aged greater than or equal to 9 years with moderate-to-severe acne were randomized to once-daily CAB or vehicle gel. Pooled data were analyzed for participants grouped by age: younger (9-24 years; n=515) and adult (greater than or equal to 25 years; n=142). Endpoints included the percentage of participants achieving treatment success (greater than or equal to 2-grade reduction from baseline in Evaluator's Global Severity Score and clear/almost clear skin) and least squares mean percent change from baseline in inflammatory/noninflammatory lesions at week 12. Treatment-emergent adverse events (TEAEs) were evaluated throughout. RESULTS: At week 12, approximately half of CAB-treated participants in both age groups achieved treatment success (9-24: 50.6%; greater than or equal to 25: 49.0%) vs less than one-fourth with vehicle (15.7%; 20.6%; P<0.01, both). Across groups, CAB yielded >70% reductions in inflammatory/noninflammatory lesions vs 45% to 62% with vehicle (P≤0.001, all). For all endpoints, CAB efficacy was similar across age groups. Most TEAEs with CAB were of mild-to-moderate severity, and there were no age-related trends in safety/tolerability. CONCLUSIONS: Fixed-dose, triple-combination CAB gel was efficacious and well tolerated in participants with moderate-to-severe acne, regardless of age. Approximately half of the participants achieved clear/almost clear skin, with >70% reductions in lesion counts.
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disease associated with obesity and metabolic dysregulation. Current therapies yield variable benefits and do not target metabolic drivers. Tirzepatide,...BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disease associated with obesity and metabolic dysregulation. Current therapies yield variable benefits and do not target metabolic drivers. Tirzepatide, a dual GLP-1/GIP receptor agonist, induces weight loss and exerts anti-inflammatory effects, offering a potential novel approach for the treatment of HS. OBJECTIVES: To evaluate the efficacy and safety of tirzepatide in adults with moderate-to-severe HS. METHODS: In this open-label, single-center, single-arm proof-of-concept study, 20 adults with moderate-to-severe HS (Physician's Global Assessment greater than or equal to 3; BMI greater than or equal to 27) received once-weekly tirzepatide, titrated to maximum tolerated dose, for 24 weeks, followed by an 8-week washout. The primary endpoint was Hidradenitis Suppurativa Clinical Response (HiSCR) at week 24. Secondary endpoints included changes in PGA, Dermatology Life Quality Index (DLQI), pain visual analog scale (VAS), and Hospital Anxiety and Depression Scale (HADS). Analyses were conducted using an intention-to-treat approach. RESULTS: At week 24, 16 of 20 participants (80.0%; P<0.00001) achieved HiSCR. Improvements were also observed in DLQI, VAS, and PGA scores, with some benefits persisting through week 32. Treatment was well tolerated, with high adherence and favorable metabolic effects. LIMITATIONS: Single-center, open-label design, modest sample size. CONCLUSIONS: Tirzepatide demonstrated promising efficacy and tolerability in patients with moderate-to-severe HS and obesity. Larger randomized trials are warranted to confirm efficacy, durability, and safety.  .
Psoriasis has profound negative impacts on quality of life (QOL), including stigmatization, discrimination, occupational challenges, and mental health concerns, which are correlated with disease severity. Effective, long...Psoriasis has profound negative impacts on quality of life (QOL), including stigmatization, discrimination, occupational challenges, and mental health concerns, which are correlated with disease severity. Effective, long-term symptom control can dramatically improve the psychological and social outcomes for patients with psoriasis, though certain mechanisms of action of biologic therapies may contribute to reduced or diminished efficacy, need for treatment switching, and reduced QOL. Brodalumab is the only approved biologic indicated for moderate-to-severe plaque psoriasis that binds to interleukin-17 (IL-17) receptor A rather than targets specific IL-17 cytokines, which may contribute to its high clinical efficacy among patients who have lost responses to other biologic therapies and may also lead to sustained improvements in QOL. In biologic-experienced and biologic-naive patients, brodalumab has demonstrated optimal efficacy and improvements in QOL in both clinical trials and real-world studies, including improvements over other biologic therapies. This has the potential to dramatically improve the mental and social burdens faced by patients with moderate-to-severe psoriasis.  .