Novelli G, Piza Moragues AJ, Filippi A
… +2 more, Maino C, Sozzi D
J Cutan Aesthet Surg
· 2023 · PMID 37554684
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Pressure garment therapy is frequently used to prevent pathologic scarring, especially in burns. Less common is its use for the treatment of facial wounds. Pathologic scarring can create functional and aesthetic problems...Pressure garment therapy is frequently used to prevent pathologic scarring, especially in burns. Less common is its use for the treatment of facial wounds. Pathologic scarring can create functional and aesthetic problems, which can have psychological implications. The aim of this study is to report our experience in the treatment of traumatic facial wounds using an elastic custom facial mask.
Kumar R, Bhatnagar AK, Kumar M
… +2 more, Mitra D, Talukdar K
J Cutan Aesthet Surg
· 2023 · PMID 37554683
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There is an increasing interest in procedures to improve skin quality in acne patients with a short downtime. Off late, carbon peel laser technique which uses topical carbon suspension combined with Q-switched Nd:YAG las...There is an increasing interest in procedures to improve skin quality in acne patients with a short downtime. Off late, carbon peel laser technique which uses topical carbon suspension combined with Q-switched Nd:YAG laser treatment has gained popularity. The main advantages of this procedure are easy to perform and it requires less than 30 minutes.
J Cutan Aesthet Surg
· 2023 · PMID 37554682
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BACKGROUND: Safe donor area (SDA) in hair transplant surgery had been categorized by various studies. We designed a study to profile the occipital donor area in our population and devise a grading scale the donor area. A...BACKGROUND: Safe donor area (SDA) in hair transplant surgery had been categorized by various studies. We designed a study to profile the occipital donor area in our population and devise a grading scale the donor area. AIM: To profile and grade the pattern of receding hair over the occipital donor area among men in the age group of 50-55 years with androgenetic alopecia (AGA). MATERIALS AND METHODS: A total of 681 men with AGA (grade 3 and above Norwood scale, diffuse unpatterned AGA, and retrograde AGA) in the age group between 50 and 55 were included in the study group. Their occipital donor area was analyzed and photographed with the head in the sagittal plane. A team of two dermatologists graded the hair loss and the pattern of the receding hair over the occipital donor area and devised a grading scale and profiled the donor area. RESULTS: Grades 1, 2, and 3 occipital donor area constituting 76.05% of the subjects analyzed, fulfilled the standard SDA criteria and 22.31% of the subjects did not fit well into the standard SDA widely followed. Diffuse thinning and reverse thinning of the occipital donor area was observed among the subjects. CONCLUSION: There is no clear cut defined SDA. There are lot of individual variations in SDA. SDA selection should be always conservative and over harvesting of the occipital donor region should be avoided.
Mysore V, Kumaresan M, Dashore S
… +1 more, Venkatram A
J Cutan Aesthet Surg
· 2023 · PMID 37554681
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Management of androgenetic alopecia is a challenge because of its long course, need for continuous treatment, and potential adverse effects of the therapies. In order to enhance efficacy, minimize side effects, and ensur...Management of androgenetic alopecia is a challenge because of its long course, need for continuous treatment, and potential adverse effects of the therapies. In order to enhance efficacy, minimize side effects, and ensure patient compliance, the authors propose a scheme for using combination treatments with a rotational scheme, based on current evidence for efficacy, pharmacokinetic properties, convenience of administration over long term, side effect profile, and patient acceptance.
Gehlawat T, Karia UK, Shah SR
… +4 more, Vyas HR, Parghi MB, Doshi YJ, Shah BJ
J Cutan Aesthet Surg
· 2023 · PMID 37554680
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BACKGROUND: Nonhealing leg ulcers are challenging to manage and cause significant patient morbidity. To promote healing, newer techniques focus on delivering/enhancing dermal matrix components. AIM: The aim of this study...BACKGROUND: Nonhealing leg ulcers are challenging to manage and cause significant patient morbidity. To promote healing, newer techniques focus on delivering/enhancing dermal matrix components. AIM: The aim of this study was to compare the therapeutic efficacy of autologous platelet-rich plasma (PRP), autologous platelet-rich fibrin matrix (PRFM), recombinant human epidermal growth factor (rhEGF), and collagen particles in treating nonhealing leg ulcers. MATERIALS AND METHODS: Open, randomized prospective study was conducted in a single tertiary center over 2 years where after fulfilling the criteria, randomization was done into four groups. Group A: Autologous PRP (double spin, manual method, weekly); Group B: Autologous PRFM (weekly); Group C: rhEGF (daily application); and Group D: Collagen particles (weekly) along with cleansing, debris removal, and wound dressing. Treatment endpoints were complete healing/6 months of treatment, whichever was earlier. Follow-up was done two weekly by clinical assessment, photographs, and measurement of the ulcer area. Epi info 7 software was used for statistical analysis. RESULTS: A total of 48 patients completed the study, 12 in each group, with mean age: 42.37 ± 4.56 years and male-to-female ratio 2.6:1. Underlying etiology was varicosities (43.75%), traumatic (25%), diabetes (22.91%), and leprosy (8.34%). At baseline, all groups were comparable in terms of patient and ulcer characteristics. Complete healing was seen in 79.17% at the end of 12 weeks: 91.67% of patients from Groups A and B each, and 66.67% from Groups C and D each. The mean time to complete healing was 6.9 ± 2.5 weeks, the least in Group B (4.73 ± 2.3 weeks). Differences between excellent (≥75%) ulcer healing across all groups were statistically significant at the end of 8 weeks where Group B showed maximum improvement. No major adverse events were seen. CONCLUSION: PRFM resulted in relatively faster ulcer healing compared with other modalities.
Eyuboglu AA, Isken TM, Demir A
… +1 more, Kurklu M
J Cutan Aesthet Surg
· 2023 · PMID 37554679
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Vascular malformations can be treated using sclerotherapy agents like alcohol, polidocanol, or sodium tetradecyl sulfate foam and embolization treatments. These endovascular treatments may cause severe complications as p...Vascular malformations can be treated using sclerotherapy agents like alcohol, polidocanol, or sodium tetradecyl sulfate foam and embolization treatments. These endovascular treatments may cause severe complications as pulmonary embolism and thrombosis. 980-nm diode lasers (DLs) are common devices used by many specialties as plastic surgeons, dermatologists, and vascular surgeons. Laser energy is excellently absorbed in water and hemoglobin, which makes it ideal for adipose tissue and deep lesions. We treated our patient using a DL. Our surgical approach allowed total excision of the arteriovenous malformation (AVM), which decreased the size of the tumor allowing a smaller incision and eased the dissection plane. We believe that lasers will be used more frequently on AVM treatments.
J Cutan Aesthet Surg
· 2023 · PMID 37554678
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Intralesional therapy is a common treatment for keloid. However, because of some follicular openings and comedones on the surface of the keloid on the hairy chest and acne keloidalis, there is a risk of drug leakage, and...Intralesional therapy is a common treatment for keloid. However, because of some follicular openings and comedones on the surface of the keloid on the hairy chest and acne keloidalis, there is a risk of drug leakage, and sometimes ejection of drugs like a jet spray leads to therapy being ineffective. The authors describe a novel and effective method for preventing drug loss from follicular openings during intralesional therapy. To prevent drug loss during intralesional injection, cyanoacrylate glue is applied to the follicular and comedone openings on the keloid's surface.
Omidvar S, Ebrahimi F, Amini N
… +4 more, Modir H, Kia MK, Rahmaty B, Zarei A
J Cutan Aesthet Surg
· 2023 · PMID 37554677
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BACKGROUND: Emergence agitation (EA) is an important clinical problem that occurs during the initial period of recovery from anesthesia. This study aimed to determine the effects of ketamine and lidocaine administered on...BACKGROUND: Emergence agitation (EA) is an important clinical problem that occurs during the initial period of recovery from anesthesia. This study aimed to determine the effects of ketamine and lidocaine administered on agitation level, postoperative pain, and hemodynamic changes in adults after rhinoplasty. MATERIALS AND METHODS: Totally 72 patients scheduled to undergo elective rhinoplasty were enrolled in this prospective study. Patients were randomly divided into three groups including control group ( = 24), ketamine group ( = 24), and lidocaine group ( = 24). Twenty minutes before surgery completion, 1 ml saline was administered intravenously to the saline group, while 0.5 mg/kg ketamine or 1.5 mg/kg lidocaine was administered to two other groups. The emergence agitation level of the patients was evaluated using the Richmond Agitation-Sedation Scale just after extubation and in the post-anesthesia care unit (PACU). Postoperative pain was evaluated by Numerical Rating Scale that scored (from 0 to 10) every 10 min until the patients were discharged from PACU. RESULTS: There was a significant difference between EA level between ketamine ( = 0.049) and lidocaine ( = 0.019) groups compared to the control group, and there was a significant difference between pain level between the ketamine ( = 0.008) and lidocaine ( = 0.035) groups compared the to control group, while there was no significant difference between the level of agitation ( = 0.922) and level of pain ( = 0.845) after extubation between the ketamine and lidocaine groups. CONCLUSION: Ketamine and lidocaine are highly effective in preventing EA and pain control. Further studies with a greater sample size and longer follow-up period are needed to confirm the current findings.
J Cutan Aesthet Surg
· 2023 · PMID 37554676
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INTRODUCTION: Difficult-to-heal or recalcitrant palmoplantar warts are notoriously resistant to treatment, making treatment difficult and challenging. To improve the outcome and overcome the difficulties, various treatme...INTRODUCTION: Difficult-to-heal or recalcitrant palmoplantar warts are notoriously resistant to treatment, making treatment difficult and challenging. To improve the outcome and overcome the difficulties, various treatment options have been tried, but none is gold standard. Many comparative studies have been undertaken to assess the efficacy of various drugs; however, none of them are standardized, and no single treatment is effective. Various comparative efficacy studies have been conducted but, to the best of our knowledge, no study has been conducted comparing intralesional (IL) injection (inj) vitamin D3 (Vit D3) with the chemotherapy drug IL inj Bleomycin for difficult-to-heal palmoplantar warts. We conducted a trial to evaluate the efficacy of IL inj Vit D3 versus IL inj Bleomycin in the treatment of difficult-to-heal palmoplantar warts. The purpose of this study was to compare the efficacy of IL inj vitamin D3 versus IL inj Bleomycin as biological response modifier therapy in difficult-to-heal palmoplantar warts. MATERIALS AND METHODS: A cohort of 48 patients with difficult-to-heal warts were consecutively assigned to one of two groups: Group 1 IL inj Vit D3 (0.2-0.5 mL inj vitamin D3 600,000 IU solution 15 mg/mL) or Group 2 IL inj Bleomycin (0.2-0.4 mL of 1 U/mL solution) for a maximum of four treatments spaced 2 weeks apart, with a maximum of five warts treated at each visit for both groups. Warts were measured at baseline and at each subsequent visit. Wart's resolution was measured as 1-25%, 2-50%, 3-75%, and 4-100% reduction. Patients were followed-up for 3 months after treatment. RESULTS: All the 48 patients completed the study, with 26 receiving IL inj Vit D3 with complete resolution in 88.5%, partial resolution in 11.5%, and side effects in 6.2%. In 22 patients receiving IL inj Bleomycin, 95.5% had complete resolution, 4.5% had partial resolution, and 8.2% had side effects. Maximum resolution was observed in the third session. We found no recurrence after 3 months. CONCLUSION: IL inj Vit D3 and IL inj Bleomycin are both safe and effective in treating difficult-to-heal palmoplantar warts with better outcomes and patient satisfaction. IL Bleomycin was significantly more effective than IL Vit D3, although the difference was not statistically significant.
J Cutan Aesthet Surg
· 2023 · PMID 37554675
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Injury to the skin provides a difficult challenge, as wound healing is a complex and dynamic process. Wound healing process recruits three different phases: inflammation, proliferation, and maturation. The sequence of ev...Injury to the skin provides a difficult challenge, as wound healing is a complex and dynamic process. Wound healing process recruits three different phases: inflammation, proliferation, and maturation. The sequence of events involved in wound healing can be affected by numerous disease processes, resulting in chronic, non-healing wounds that give significant discomfort and distress to the patients while draining the medical fraternity of enormous resources. Wound tissue never reaches its pre-injured strength and multiple aberrant healing states can result in chronic non-healing wounds. There is a growing concern about the usage of correct materials for wound dressings. The development of new and effective treatments in wound care still remains an area of intense research. There are a number of wound dressings available in the market. The objective of the article is to enhance knowledge about characteristics of an ideal wound dressing and guide in finding the correct dressing material. It also provides a detailed classification of traditional and modern wound dressings.
Dheemant M, Harikishan KY, Naveen S
… +1 more, Belliappa PR
J Cutan Aesthet Surg
· 2023 · PMID 37554673
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BACKGROUND: Trophic ulcers remain the most common reason for hospitalization in patients with Hansen's disease. With the introduction of new therapeutic regimens, leprosy can now be cured. However, complications of the d...BACKGROUND: Trophic ulcers remain the most common reason for hospitalization in patients with Hansen's disease. With the introduction of new therapeutic regimens, leprosy can now be cured. However, complications of the disease, such as sensory loss, muscle palsy, absorption of extremities, and recurrent ulcers, still lead to substantial morbidity. The management of patients with trophic ulcers and their consequences is difficult, because it is a recurrent and recalcitrant problem. AIMS: To evaluate the efficacy of autologous smashed follicular dermal graft and epidermal cell suspension (ECS) in the treatment of chronic nonhealing trophic ulcers in patients with Hansen's disease and to compare its efficacy with normal saline dressing. MATERIALS AND METHODS: A total of 46 chronic nonhealing trophic ulcers were randomized into two groups (23 ulcers in each): Ulcers in Group A were treated with autologous smashed follicular dermal graft and ECS; ulcers in Group B were treated with normal saline dressings. Ulcers were assessed based on the rate of ulcer size reduction at every week till 12 weeks and then once a month till the sixth month. RESULTS: All 23 (100%) ulcers in Group A had healed within the study period of six months, whereas only 14 (60.9%) ulcers had healed in Group B. Nine (39.1%) ulcers in Group B had not healed even at the end of six months. All 23 (100%) ulcers in Group A had healed within eight weeks, which was statistically significant, value <0.05. CONCLUSION: Trophic ulcers heal faster by autologous smashed follicular dermal graft and ECS, with good results of re-epithelialization of the ulcer bed than by normal saline dressing.
Singh B, Phulware RH, Baishya P
… +5 more, Singh A, Durgapal P, Kumar A, Hazarika N, Kishore S
J Cutan Aesthet Surg
· 2023 · PMID 37554672
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BACKGROUND: An epidermoid cyst is a benign keratin-filled cyst, commonly located in the face, scalp, neck, and trunk. Although it is a common benign cystic neoplasm, large series of analyses in English literature are sti...BACKGROUND: An epidermoid cyst is a benign keratin-filled cyst, commonly located in the face, scalp, neck, and trunk. Although it is a common benign cystic neoplasm, large series of analyses in English literature are still scarce. To comprehend the clinical and pathological variation of epidermoid cysts in the sub-Himalayan region of India, as well as their clinical implications for late diagnosis, a retrospective study on epidermoid cysts was conducted. MATERIALS AND METHODS: This was a retrospective observational study conducted on 217 cases of epidermoid cyst subjected for fine-needle aspiration cytology over a period of 3.6 years (from 2018 to 2021). The clinical details and other epidemiological data were archived from the pathology requisition forms. RESULTS: It showed slight male preponderance with head and neck site as the most common area. Most patients were adults. Few uncommon sites were also seen namely breast, parotid, epididymis, and tonsils. Few large lesions were identified measuring up to 10 cm. The skin changes were seen in 5.5% cases, 0.9% cases show extreme ulceration, and 4.1% cases show foreign body giant cell reactions. Due to the province's steep terrain and limited access to medical services, the majority of patients arrived at out patient department (OPD) late. CONCLUSION: The findings suggest that fine-needle aspiration can be used as a quick diagnostic test even in remote areas by the general practitioner who can send the slides for evaluation to a pathologist. Many times, clinically looking epidermoid cyst can reveal certain challenging entities such as a biphasic fibroepithelial tumor with cystic squamous metaplasia and proliferating pilar tumor in our series. The study of this lesion is also needed for early diagnosis as long-standing lesion may rupture and cause requirement of extensive treatment followed cosmetic impairment.
J Cutan Aesthet Surg
· 2023 · PMID 37554671
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Pincer nail is a deformity characterized by excessive transverse curvature of nail, progressively increasing along its longitudinal axis. The curvature is greatest at the distal end, leading to an ingrown nail, producing...Pincer nail is a deformity characterized by excessive transverse curvature of nail, progressively increasing along its longitudinal axis. The curvature is greatest at the distal end, leading to an ingrown nail, producing pain, discomfort, and significant cosmetic alteration. It is a severe variant of ingrown nail, often attributed to causes such as anatomical variation of nail plate axis, tight footwear, gait abnormalities, and so on. Correspondingly, its management involves the removal of the lateral ingrowing nail plate or the lateral hypertrophic nail folds. We report a young male who presented with symptomatic pincer nail deformity. However, on exploration there was a midline onychomatricoma, leading to the thickening of the central part of the nail plate, causing incurving of the lateral nail plate and discomfort. The report serves to highlight the need for a comprehensive evaluation of pincer nails, to assess for matrix disease as well, because the surgical approach will differ accordingly.
Nayak CS, Kura MM, Banerjee G
… +6 more, Patil SP, Deshpande A, Sekar S, Sharma A, Pathak R, Sarma P
J Cutan Aesthet Surg
· 2023 · PMID 37383981
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BACKGROUND: Phototherapy in its different forms, is mainstay of vitiligo management. Combining treatment modalities like topical calcipotriol (for quicker, more intense repigmentation), Low dose azathioprine with PUVA ha...BACKGROUND: Phototherapy in its different forms, is mainstay of vitiligo management. Combining treatment modalities like topical calcipotriol (for quicker, more intense repigmentation), Low dose azathioprine with PUVA have proven to be beneficial in management of vitiligo due to different mechanisms of repigmentation and their synergistic effects. Topical bFGF-related decapeptide (bFGFrP) application followed by sun exposure/ UVA phototherapy yields effective repigmentation. bFGFrP has shown to aid the targeted phototherapy in smaller lesions and its combinations with other treatment modalities have been very promising. However, there is paucity of studies on combination treatments; especially oral PUVA along with bFGFrP. This study was aimed at evaluating safety and efficacy of combination of bFGFrP with Oral PUVA in vitiligo (larger body surface area 20% or more). MATERIALS AND METHODS: Phase IV, randomized, multicentre study ( 120) in adult patients with stable vitiligo of 6 months treatment period with monthly follow up visits. Psoralen (Tab. Melanocyl) dosage 0.6 mg/kg orally 2 h before exposure to UVA phototherapy. Oral PUVA therapy, initially, at an irradiation dose 4 J/cm (PUVA group), followed by increments 0.5 J/cm every four sittings if tolerated for twice weekly. Primary end point was improvement in extent of repigmentation (EOR) in target lesion (at least 2 cm × 2 cm in greatest dimension, without leukotrichia), while secondary endpoints were improvement in patient global assessment (PGA) and safety at end of 6 months of treatment period in bFGFrP + oral PUVA combination group and Oral PUVA monotherapy group. RESULTS: End of 6 months, significantly greater EOR >50%) was achieved in 61.8% (34 patients, 55) from combination group while 30.2% (16 patients, 53) from the oral PUVA monotherapy group ( 53). Regarding Grade of repigmentation (GOR), complete repigmentation was observed 5.5% (3 patients, 55) in combination group whereas no patient showed complete repigmentation in monotherapy group ( 0.05), PGA showed significant overall improvement in combination group ( 0.05); 6 patients (10.9%) from combination group Vs one (1.9%) showed complete improvement. During treatment period, there were no reported adverse events. CONCLUSIONS: Addition of bFGFrP to oral PUVA therapy resulted in intense and faster induction of repigmentation than oral PUVA monotherapy with favorable safety profile.
J Cutan Aesthet Surg
· 2023 · PMID 37383980
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Nodular hidradenoma is a rare skin adnexal tumor of eccrine differentiation with predominant site being scalp and axillae. Due to its variable locations and unusual clinical presentation and no definite radiological crit...Nodular hidradenoma is a rare skin adnexal tumor of eccrine differentiation with predominant site being scalp and axillae. Due to its variable locations and unusual clinical presentation and no definite radiological criteria, histopathology seems to be the mainstay in diagnosing these tumors. Most of the lesions present as a cystic swelling and was clinically thought to be a sebaceous cyst/metastasis/carcinoma/sarcoma. In our study, we have included 37 cases and compared its varied clinical and radiological presentation.
J Cutan Aesthet Surg
· 2023 · PMID 37383978
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BACKGROUND: The management of nonhealing ulcers has been a major challenge clinically. Current therapies include debridement, offloading, etc., which show a poor response. Newer modalities include stem cells, platelet-de...BACKGROUND: The management of nonhealing ulcers has been a major challenge clinically. Current therapies include debridement, offloading, etc., which show a poor response. Newer modalities include stem cells, platelet-derived growth factors, and fibrin glues, which reduce healing time. Platelets play a major role in wound healing through the secretion of growth factors, chemokines, etc. and have been an area of interest as a modality in regenerative medicine. AIMS AND OBJECTIVE: The aim was to study the comparative efficacy of autologous platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) as a regenerative medicine strategy for chronic cutaneous ulcers. MATERIALS AND METHODS: Forty-four ulcers of duration greater than six weeks were enrolled for a comparative study comprising two groups, each divided either into group A receiving PRF dressings or group B receiving PRP dressing for six weeks. The ulcer evaluation was performed at baseline, each weekly dressing, and a two-week follow-up. RESULTS: Primary efficacy was assessed by the percentage reduction in the volume of ulcers and re-epithelization at eight weeks. In total, 95.2% of ulcers in group A and 90.4% of ulcers in group B showed complete re-epithelization. One ulcer in group A and two ulcers in group B developed an infection. The recurrence of the ulcer was seen in four ulcers in the PRF group and three ulcers in the PRP group. CONCLUSION: Dressings done with PRF and PRP showed similar efficacy in the percentage reduction in the volume and re-epithelization of chronic cutaneous ulcers. Both dressings were associated with similar complications. PRF and PRP dressings provide a safe, efficacious, and inexpensive regenerative medicine strategy in the healing of chronic cutaneous ulcers.
J Cutan Aesthet Surg
· 2023 · PMID 37383977
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Venous lakes (VLs) are fairly common vascular lesions caused by dilatation of the localized vessels on sun-damaged skin. They are usually asymptomatic; however treatment is opted to improve psychological distress caused...Venous lakes (VLs) are fairly common vascular lesions caused by dilatation of the localized vessels on sun-damaged skin. They are usually asymptomatic; however treatment is opted to improve psychological distress caused by cosmetic disfigurement and occasionally to prevent bleeding. Multiple treatment modalities such as cryosurgery, carbon dioxide laser, pulse dye laser, sclerotherapy, and electrocoagulation have been mentioned in literatures with varying degrees of success and specific complications. Hereby, we present a case of a 40-year-old female with VL on upper eyelid treated successfully with surgical excision with better cosmesis.
Shah FY, Shah AA, Tasaduq I
… +5 more, Bhat MA, Rather AY, Dar UK, Shah SA, Hassan I
J Cutan Aesthet Surg
· 2023 · PMID 37383976
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INTRODUCTION: Follicular unit extraction (FUE) is a safe and effective procedure in the hands of an expert. Side effects, particularly those which can lead to significant morbidity or mortality, are unacceptable as the p...INTRODUCTION: Follicular unit extraction (FUE) is a safe and effective procedure in the hands of an expert. Side effects, particularly those which can lead to significant morbidity or mortality, are unacceptable as the procedure is done purely for cosmetic reasons. Any modification that decreases the risk associated with the procedure should be promoted. AIM AND OBJECTIVE: The study was conducted to determine whether FUE can be carried out effectively with the elimination of nerve blocks and bupivacaine from the procedure. MATERIALS AND METHODS: The study was conducted in 30 patients suffering from androgenetic alopecia. The donor areas was anesthetized using lignocaine with adrenaline just below the area to be harvested. The anesthetic was injected intradermally resulting in the development of wheals in continuity, forming a linear line. From our previous experience, we found intradermal administration of lignocaine to give better anesthetic effect as compared to subcutaneous administration, although the former is more painful. This was followed by injection of tumescent into the donor area and donor harvesting, which lasted for a couple of hours. The recipient area was anesthetized using a similar technique of linear injection of anesthetic just ahead of the proposed hair line. RESULTS: The total amount of lignocaine with adrenaline consumed during the surgery ranged from a minimum of 6.1 ml to 8.5 ml, with an average of 7.6 ml. The average duration of the entire surgery was 6.5 h, ranging from 4.5 to 8.5 h. None of the patients experienced any pain during the entire surgery, and there were no significant side effects related to anesthetic administration in any patient. DISCUSSION: We found lignocaine with adrenaline to be a very safe and effective anesthetic agent for field block anesthesia in FUE. The exclusion of bupivacaine and nerve blocks from the procedure of FUE can further increase the safety of the procedure, particularly for beginners and in cases where the area to be covered is not extensive (Norwood-Hamilton grades 3, 4, and 5).