The Journal Of Clinical And Aesthetic Dermatology[JOURNAL]
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200 papers
Aesthetic Improvement, Facial Harmony, and Patient Satisfaction after Lower Face Treatment with a Hyaluronic Acid Filler: A Randomized Post-Marketing Study to Evaluate Two Different Stepwise Injection Approaches.
Dayan SH, Hartman CL, Di Gregorio C … +4 more , Avelar L, Haddad A, Andriopoulos B, Bromée T
J Clin Aesthet Dermatol · 2025 Oct · PMID 41416028
OBJECTIVE: The authors sought to evaluate a flexible, hyaluronic acid (HA) filler, Restylane® Defyne™ (HA) (Galderma), for combined treatment of chin, nasolabial folds (NLFs), and marionette lines (MLs), in a predefined...
OBJECTIVE: The authors sought to evaluate a flexible, hyaluronic acid (HA) filler, Restylane® Defyne™ (HA) (Galderma), for combined treatment of chin, nasolabial folds (NLFs), and marionette lines (MLs), in a predefined stepwise order, comparing Down-up (ie, chin first) versus Top-down (NLFs and MLs first) treatment approaches. This postmarketing study complements prior pivotal investigations that demonstrated the safety and effectiveness of HA treatments of the lower face, by providing a standardized treatment algorithm for combining several treatment areas in the lower face. METHODS: HA was injected at Day 1 in the first treatment area and at Week 3 in the second area (randomized to either Down-up or Top-down order), with optional touch-up (any area) at Week 6. Assessments included Global Aesthetic Improvement Scale (GAIS), skin firmness, facial harmony, patient satisfaction, and safety until Week 9. RESULTS: Both approaches achieved similar, favorable results at Week 9, with 100% of patients in both groups (Down-up, n=31; Top-down, n=29) demonstrating aesthetic improvement on the GAIS, improved skin firmness and facial harmony, and natural-looking results. Of patients seeking aesthetic improvement of the submental area, 95% in the Top-down group and 100% in the Down-up achieved improvement. Patient-reported endpoints supported these results, with high satisfaction throughout the study. HA was well tolerated throughout the study. LIMITATIONS: The results should be considered indicative rather than definitive given the post-marketing design of the study. CONCLUSION: Both stepwise approaches may be used for administering HA when treating the combined areas of chin, NLFs, and MLs.
Impact of Oral DFD-29, a Low-Dose Formulation of Minocycline, on Quality of Life in Patients with Rosacea: Results of Two Phase 3 Randomized Controlled Trials.
Gold LS, Yamauchi P, Dirschka T … +3 more , Tsianakas A, Dhawan S, Sidgiddi S
J Clin Aesthet Dermatol · 2025 Oct · PMID 41416027
OBJECTIVE: DFD-29 is a low-dose modified formulation of minocycline 40mg that has demonstrated efficacy and safety in patients with rosacea. We report the effect of DFD-29 on patient-reported assessments of disease sever...
OBJECTIVE: DFD-29 is a low-dose modified formulation of minocycline 40mg that has demonstrated efficacy and safety in patients with rosacea. We report the effect of DFD-29 on patient-reported assessments of disease severity and quality of life (QoL) from two clinical trials in patients with moderate-to-severe rosacea. METHODS: MVOR-1 (NCT05296629) and MVOR-2 (NCT05343455) were 16-week, randomized, double-blind, active- and placebo-controlled Phase III trials that compared the impact of oral DFD-29 (EMROSI, Journey Medical Corporation), doxycycline 40mg, and placebo in adults aged 18 years or older with moderate-to-severe rosacea. Changes in QoL were exploratory endpoints that were evaluated at baseline and Weeks 2, 4, 8, 12, and 16 using the Rosacea-Specific Quality of Life (RosaQoL) questionnaire and the Dermatology Life Quality Index (DLQI). RESULTS: Among randomized subjects, 288 completed MVOR-1 (DFD-29, n=117; doxycycline, n=98; placebo, n=73) and 296 completed MVOR-2 (DFD-29, n=115; doxycycline, n=113; placebo, n=68). In both trials, DFD-29 significantly improved QoL versus placebo (<0.05) as assessed by RosaQoL and DLQI over 16 weeks. In MVOR-2, DFD-29 was also significantly superior to doxycycline in improving least squares mean RosaQoL scores at Week 12 (=0.034). In MVOR-1, patients reported superior improvements in DLQI scores with DFD-29 versus doxycycline (<0.05) at Weeks 4, 8, and 12. LIMITATIONS: RosaQoL and DLQI were exploratory endpoints. CONCLUSION: These data suggest that DFD-29 may be useful in improving QoL in patients with moderate-to-severe rosacea.
Fecal Microbiota Transplantation as a Potential Treatment for Pediatric Atopic Dermatitis.
Wan L, Park A, Lio P
J Clin Aesthet Dermatol · 2025 Oct · PMID 41416026
Abstract loading — click title to view on PubMed.
Regression Rate of Basal Cell Carcinoma in a Veteran Population: A Study of 317 Cases at the Kansas City Veterans Affairs Medical Center.
Stoieva M, Mettman D
J Clin Aesthet Dermatol · 2025 Oct · PMID 41416025
OBJECTIVE: This study aims to assess the regression rate of basal cell carcinoma (BCC) in excision specimens following diagnostic biopsies obtained from patients in a veterans affairs facility. METHODS: A retrospective r...
OBJECTIVE: This study aims to assess the regression rate of basal cell carcinoma (BCC) in excision specimens following diagnostic biopsies obtained from patients in a veterans affairs facility. METHODS: A retrospective review of biopsy-proven BCC excision cases was conducted. All included biopsy and corresponding excision reports were reviewed to determine the margin status of specimens. Proportion of residual carcinoma cases and regression rate of the tumor were determined. RESULTS: Regression rate of BCC was estimated to be 47%. The most prevalent subtype was nodular BCC (46%), and the most prevalent location was the head. Tumors located on the trunk and upper extremities were more likely to regress, and those on the head were less likely to regress (<0.05). Punch biopsy technique was associated with significantly lower regression rate (<0.01). The time interval between the biopsy and excision and age were not significantly different between regressed and non-regressed tumors. Neither of sexes and neither of tumor subtypes had significantly different regression rates as compared to the general study population. LIMITATIONS: The limitation of our study is that the data may not be generalizable due to our unique study population. CONCLUSION: BCC is a tumor with the potential to regress. However, definitive management resides in complete surgical excision, which will most likely remain the mainstay of treatment in the near future.
IL-17 Class Inhibitors and Plaque Psoriasis: Not All Biologics Relapse Equally.
Issa NT, Al-Tariq K, Bunick CG
J Clin Aesthet Dermatol · 2025 Oct · PMID 41416024
OBJECTIVE: In patients with moderate-to-severe plaque psoriasis, recent meta-analyses compared efficacies among biologics and time to relapse after treatment withdrawal; however, there was notable heterogeneity in the cl...
OBJECTIVE: In patients with moderate-to-severe plaque psoriasis, recent meta-analyses compared efficacies among biologics and time to relapse after treatment withdrawal; however, there was notable heterogeneity in the clinical trials and their criteria used to define relapse. Furthermore, while biologics are effectively grouped into treatment classes based on their mechanisms of action (ie, anti-interleukin (IL)-23 class, anti-IL-17 class), not all biologics should necessarily be grouped into a class effect. For example, the anti-IL-17 class is heterogeneous in their mechanisms of action due to the variety of cytokines and receptors antagonized along with their accompanying gene expression changes in psoriatic disease. Therefore, we performed an in-depth assessment of biologics comprising the anti-IL-17 class and their associated pharmacokinetics (PK). We identified differences in PK parameters that may augment our understanding of how these biologics differ in function and explain variations in time to relapse of psoriatic disease after treatment withdrawal. METHODS: A PubMed literature search was performed and articles screened to only include double-blind, randomized, placebo or comparator-controlled trials. The remaining articles were screened to ensure inclusion of a treatment withdrawal period and to confirm they investigated and defined relapse. RESULTS: We identified five unique randomized controlled trials that examined time to relapse after treatment discontinuation for anti-IL-17 biologics. Brodalumab, an IL-17RA antagonist, consistently demonstrated the quickest time to relapse, whereas bimekizumab, the first-in-class dual IL-17A and IL-17F antagonist, demonstrated the longest time to relapse. LIMITATIONS: There is heterogeneity in both the criteria for treatment success prior to undergoing treatment withdrawal as well as relapse criteria. The only relapse datapoints shared by all four anti-IL-17 class biologics examined were median time to loss of PASI-75 and PASI-90. CONCLUSION: Differences in time to relapse after treatment discontinuation following treatment success can be attributed to both differences in biologic PK properties and mechanisms of action. These results warrant further investigation into the role of IL-17F in the pathogenesis of plaque psoriasis, as targeting this isoform appears to confer synergistic therapeutic benefit compared to targeting the IL-17A isoform alone. Furthermore, the classic understanding of IL-17RA blockade with brodalumab must be revisited as IL-17F was found to partially bind and signal through IL-17RA despite the presence of brodalumab.
From the Masterclasses in Dermatology 2025 Meeting: Practical Approaches to Cutaneous and Systemic Lupus for Dermatologists.
Childs B, Merola JF
J Clin Aesthet Dermatol · 2025 Oct · PMID 41416023
Cutaneous lupus erythematosus (CLE) may occur independently or in association with systemic lupus erythematosus (SLE). When systemic disease is present, CLE is the first manifestation in nearly one-third of cases. This p...
Cutaneous lupus erythematosus (CLE) may occur independently or in association with systemic lupus erythematosus (SLE). When systemic disease is present, CLE is the first manifestation in nearly one-third of cases. This positions dermatologists as key stakeholders in early detection of systemic disease, underscoring the importance of appropriate screening among this population. Various CLE subtypes carry distinct risks of systemic progression, with acute CLE closely tied to active SLE, subacute CLE conferring moderate risk, and most chronic subtypes (eg, localized discoid lupus) remaining limited to the skin. This review provides a practical, dermatology-focused framework for risk stratification, screening, and comanagement of patients with CLE. To support clinical decision-making and expand awareness, we introduce the "LABS FOR" SLE mnemonic to guide laboratory evaluation and propose an updated visual algorithm that illustrates screening and monitoring practices. We synthesize evidence-based and expert-informed recommendations, including serologic, demographic, clinical, and genetic predictors of systemic involvement. The 2019 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria-requiring antinuclear antibody (ANA) positivity and weighted domain scoring-are reviewed and compared to other diagnostic aids. Additionally, we highlight appropriate ANA testing, the importance of symptom review, and targeted second-line labs. Finally, we discuss collaborative management strategies with rheumatology, including organ-specific therapeutic considerations. By adopting a structured, CLE-informed approach to systemic screening and follow-up, dermatologists can play a critical role in improving outcomes for patients across the lupus spectrum.
The Noncompete Agreement: The Current Ordeal and a Possible Solution.
Ajegwu A, Blalock TW
J Clin Aesthet Dermatol · 2025 Aug · PMID 40843241
Abstract loading — click title to view on PubMed.
Ultraviolet-Induced Fluorescence Dermoscopy: Game Changers.
Nazir HI, Daly KE, Seiverling EV … +2 more , Navarrete-Dechent C, Buchanan KL
J Clin Aesthet Dermatol · 2025 Aug · PMID 40843240
Ultraviolet-induced fluorescence dermoscopy (UVFD) is a novel diagnostic and visualization technique that enhances visualization of skin dermatoses with ultraviolet (UV) light. UVFD has been used to diagnose dermatoses i...
Ultraviolet-induced fluorescence dermoscopy (UVFD) is a novel diagnostic and visualization technique that enhances visualization of skin dermatoses with ultraviolet (UV) light. UVFD has been used to diagnose dermatoses including bacterial and fungal infections, pigmentary disorders, and skin neoplasms. We present five cases-pitted keratolysis, porokeratosis, molluscum, biopsy site identification, and lentigo maligna-where UVFD alone, compared to traditional polarized dermoscopy (PD) or the unaided clinical exam, served as a "game-changer" in diagnosis and management. Polarized and UV images were captured using a DL5 dermatoscope coupled to a smartphone. In the cases of pitted keratolysis, porokeratosis, and molluscum, we highlight distinct patterns of fluorescence that were readily visualized with UVFD and aided efficient diagnosis, in contrast with more subtle features that were seen under PD. We also demonstrate the utility of UVFD in identification and confirmation of a prior biopsy site in a patient who presented for excision of a skin cancer. Finally, we describe the advantage of UVFD in presurgical margin delineation in a patient with lentigo maligna. In these cases, we show that UVFD facilitates prompt and accurate diagnosis, streamlines appropriate treatment, and has the capacity to reduce the need for unnecessary biopsies. Given the convenience and practicality of a dermatoscope equipped with a UV light, we propose that clinicians would benefit from the use of UVFD as a supplementary tool alongside conventional dermoscopy, rather than as a substitute.
Large Basal Cell Carcinoma Treated with Combination Topical Therapy.
Al-Tariq K, Abdin R, Issa NT
J Clin Aesthet Dermatol · 2025 Aug · PMID 40843239
Basal cell carcinoma (BCC) is the most common skin cancer in the United States. Common treatment approaches for superficial, small, and/or low grade BCCs include topical therapy or curettage plus electrodesiccation and c...
Basal cell carcinoma (BCC) is the most common skin cancer in the United States. Common treatment approaches for superficial, small, and/or low grade BCCs include topical therapy or curettage plus electrodesiccation and cryotherapy. For larger, high-grade, and/or certain subtypes of BCC, surgical therapy is typically pursued, occasionally under anesthesia for large lesions. While surgical therapy provides good clearance rates, it is not feasible for all patients. Therefore, it is important for physicians to understand alternative, less invasive approaches to treating BCC in order to provide patients with the best possible evidence-based care. In this case, we describe a combination topical treatment approach for a large nodular BCC in an elderly patient in a tough to excise inguinal region.
Comparison of Colony-forming Units of . in Patients with Atopic Dermatitis with and without Response to Systemic Treatment.
Sánchez-Cárdenas CD, Aldrete LG, Guzmán ZR … +5 more , Sánchez DCV, Viveros MIC, Díaz NP, Arenas R, Moreno-Coutiño G
J Clin Aesthet Dermatol · 2025 Aug · PMID 40843238
INTRODUCTION: It has been proposed that some cases of refractory atopic dermatitis are caused by an overgrowth of spp. This study aimed to compare the colony-forming units of spp. in patients with AD who were grouped b...
INTRODUCTION: It has been proposed that some cases of refractory atopic dermatitis are caused by an overgrowth of spp. This study aimed to compare the colony-forming units of spp. in patients with AD who were grouped based on their responsiveness to systemic treatment. METHODS: This prospective, cross-sectional, and comparative study was conducted in patients with AD who were treated with prednisone, cyclosporine, and methotrexate, and separated in two groups, those with and those without response to their treatments, and who had not received treatment with antifungals (topical or systemic) within the prior six months. Scoring Atopic Dermatitis (SCORAD) was determined to evaluate disease severity and therapy response. A sample of epidermal cells from the glabellar region was obtained by scraping for direct examination with methylene blue and m-Dixon agar culture in search of colony-forming units. Fisher's exact test and Mann-Whitney U test were performed to compare the groups. RESULTS: A total of 15 patients were included in each group. The majority of the group who were refractory to treatment were women (60%), while the non-refractory group were predominantly men (66.7%). In addition, 73.3 percent of subjects with therapeutic resistance presented fungal growth in the cultures compared to 40 percent in the non-resistant group. A significant difference was found between direct examination (=0.000) and colony-forming units of spp. (=0.016) in patients with AD resistant to systemic treatment. CONCLUSION: Patients with AD resistant to systemic treatment had a higher count of colony-forming units of spp. Therefore, we propose intentionally seeking this fungus in patients with therapeutic failure to eliminate its overpopulation.
Real-world Efficacy of Sodium Hypochlorite Body Wash in Managing Hidradenitis Suppurativa.
Omole I, Brooks B, Pham T … +2 more , Chovatiya R, Daveluy S
J Clin Aesthet Dermatol · 2025 Aug · PMID 40843237
Hidradenitis suppurativa (HS) is a chronic skin condition characterized by nodules, abscesses, and tunnels that may develop in various parts of the body, particularly in the axillary, gluteal, and inguinal regions. Treat...
Hidradenitis suppurativa (HS) is a chronic skin condition characterized by nodules, abscesses, and tunnels that may develop in various parts of the body, particularly in the axillary, gluteal, and inguinal regions. Treatment for HS varies based on clinical presentation and disease progression and encompasses antibiotics, hormonal therapy, biologics, topical treatments, and surgical procedures. Despite the array of available treatment options, patients typically require multiple treatment modalities to alleviate symptoms, which can include antimicrobial cleansers and washes, though there is limited evidence regarding their effectiveness in managing HS. Here, we evaluated real-world patient-assessed efficacy of sodium hypochlorite body wash in the management of hidradenitis suppurativa. Of the 165 participants enrolled, 145 completed a four-week study evaluating daily use of sodium hypochlorite body wash for hidradenitis suppurativa (HS), representing all Hurley stages and a wide range of disease durations. Significant improvements were observed across key symptoms, with the greatest reduction in pain (3.52 to 1.62, <0.001), and over 60 percent of participants reported fewer and shorter flares. Most participants found the wash beneficial, with 88.8 percent recommending it, and there was strong support for the dab method among those who used it. These data support clinical utility of hypochlorite washes in the chronic management of HS.
Managing Advanced Squamous Cell Carcinoma: A Guide for the Dermatology Clinician.
Burshtein J, Schlesinger T
J Clin Aesthet Dermatol · 2025 Aug · PMID 40843236
OBJECTIVE: Cutaneous squamous cell carcinoma (cSCC) is the second most common form of skin cancer. Advanced cSCCs encompass locally advanced cSCC (laCSCC), including primary or recurrent tumors that are not amenable to c...
OBJECTIVE: Cutaneous squamous cell carcinoma (cSCC) is the second most common form of skin cancer. Advanced cSCCs encompass locally advanced cSCC (laCSCC), including primary or recurrent tumors that are not amenable to curative surgery or radiation therapy, and metastatic (locoregional or distant) cSCCs (mCSCC). With the development of immunotherapies (eg, PD-1 inhibitors), there may be an enhanced opportunity to effectively treat advanced cSCC. We aim to review the current literature on therapeutic options and outline treatment strategies to optimize care for patients with advanced cSCC. METHODS: A comprehensive literature search was completed using the keywords "advanced cutaneous squamous cell carcinoma," "treatment," "surgery," "radiotherapy," "immunotherapy," "PD1-inhibitor," "cemiplimab," and "pembrolizumab". The authors reviewed all studies and included those which addressed the topic of the review. RESULTS: Advanced cSCCs may not be amenable to surgery or radiotherapy due to size, location, and other aggressive features. Identifying advanced cSCCs and managing patients with multiple tumors and/or those with high tumor burden can be challenging and utilizing current evidence-based guidelines and staging systems can help selection of appropriate therapeutic options. Systemic immunotherapies such as cemiplimab and pembrolizumab have growing evidence for use as a first-line treatment for advanced cSCCs. It is important to understand the adverse event profile of these immunotherapies as utility may be limited by adverse events. LIMITATIONS: This is a review article and is limited by the information available in the published literature. In addition, comparison between studies is limited as varying methodologies were used. CONCLUSION: Advanced cSCCs can be difficult to manage and involving a multidisciplinary team is essential. For laCSCCs and mCSCCs not amenable to surgery or radiotherapy, cemiplimab and pembrolizumab can be effective therapeutic options.
Enhanced Clinical Outcomes and Treatment Adherence in Patients Using Compounded Topical Minoxidil to Treat Androgenetic and Traction Alopecia.
Wyche J, Aguh C
J Clin Aesthet Dermatol · 2025 Aug · PMID 40843235
INTRODUCTION: This study highlights the experiences and clinical outcomes of Black women treated with compounded topical minoxidil (CTM), containing a steroid and retinoid, compared to over the counter (OTC) minoxidil. M...
INTRODUCTION: This study highlights the experiences and clinical outcomes of Black women treated with compounded topical minoxidil (CTM), containing a steroid and retinoid, compared to over the counter (OTC) minoxidil. METHODS: A retrospective chart review included 66 Black women treated at Johns Hopkins Hospital between 2020 and 2024. Patients previously used OTC minoxidil and were currently using CTM. Data collected included patient demographics, formulation, side effects, follow-up visits, and patient-reported outcomes. Adherence was assessed at follow-up appointments based on self-reported CTM use. RESULTS: Of the 66 patients, 33.3 percent had traction alopecia (TA), 37.9 percent had androgenetic alopecia (AGA), and 28.8 percent had combined AGA and TA. Side effects from OTC minoxidil were reported by 21.2 percent of patients, with scalp irritation being the most common. Only 10.6 percent of patients reported side effects while using CTM, with 4.5 percent reporting scalp irritation and four reporting hypertrichosis. After receiving treatment with CTM for at least six months, patients had an overall adherence rate of 84.7 percent, compared to only 44.7 percent of patients who adhered to OTC minoxidil (<0.001). Clinical improvement was reported by 69.6 percent of patients using CTM, compared to 45.0 percent of patients using OTC minoxidil (<0.001). DISCUSSION: CTM was associated with higher adherence, fewer side effects, and clinical improvement in majority of patients treated with CTM compared to their previous OTC minoxidil use. LIMITATIONS: This is a single institution study. CONCLUSION: When treating AGA or TA in Black women, special consideration should be taken when selecting minoxidil formulation, as it may have an impact on adherence and efficacy.
Can the Pursuit of an Ageless Face Redefine Medicine? Exploring Dermatology's Role in the Quest for Immortality.
Cheng A, Shawa H, Uttke Z … +1 more , Cotter DG
J Clin Aesthet Dermatol · 2025 Aug · PMID 40843234
Recent years have witnessed significant growth in aging research due to groundbreaking discoveries in gerotherapeutics and an ever-increasing interest in longevity. Such advances beg the question, what if the physical an...
Recent years have witnessed significant growth in aging research due to groundbreaking discoveries in gerotherapeutics and an ever-increasing interest in longevity. Such advances beg the question, what if the physical and functional declines we associate with aging were no longer inevitable, but instead treatable through the next frontier of medical innovation? In this article, we explore the broader social and ethical implications of advancing healthspan and mitigating age-related decline. We also highlight dermatology's unique role as a catalyst of aging research, serving as a model for integrating aesthetic and functional innovations. Finally, we discuss the curious role and the ethical challenges of the aesthetic dermatology industry in the healthspan debate.
Impact of Microencapsulated Benzoyl Peroxide on the Skin Microbiome and Clinical Outcomes in Rosacea: An Update on a Randomized, Double-blind, Crossover, Vehicle-controlled Clinical Trial.
Nong Y, Sugarman J, York JP … +6 more , Levy-Hacham O, Nadora D, Mizrahi R, Galati A, Gallo RL, Sivamani RK
J Clin Aesthet Dermatol · 2025 Aug · PMID 40843233
OBJECTIVE: We sought to evaluate changes in skin microbiome biodiversity and correlation with rosacea improvement of microencapsulated benzoyl peroxide (E-BPO) versus vehicle cream in rosacea patients in a 12-week crosso...
OBJECTIVE: We sought to evaluate changes in skin microbiome biodiversity and correlation with rosacea improvement of microencapsulated benzoyl peroxide (E-BPO) versus vehicle cream in rosacea patients in a 12-week crossover study with a no-treatment period of four weeks (Week 16). METHODS: This was a randomized, double-blind, single-center, crossover, vehicle-controlled evaluation of E-BPO on the skin microbiome in rosacea. Thirty-one participants had facial rosacea with global severity of 3 or 4 on the Investigator's Global Assessment (IGA) scale. Participants were randomly assigned to two groups. The E-BPO/vehicle group applied E-BPO for eight weeks, then vehicle for four weeks. The vehicle/E-BPO group applied vehicle for eight weeks, then E-BPO for four weeks. Clinical assessments were performed using IGA, inflammatory rosacea scale, and erythema scale. Determination of change in skin microbiome was based on facial swab sampling. RESULTS: Shifts in the microbiome correlated with improvements in IGA, inflammatory rosacea, and erythema. At Week 8, similar bacterial species diversity profiles were observed among all participants. After crossover of the vehicle/E-BPO group at eight weeks to E-BPO, the relative abundance of was markedly lowered, and the relative abundance of was slightly increased. In the E-BPO/vehicle group, the relative abundance of and at Weeks 12 and 16 remained at the level observed at Week 8. LIMITATIONS: The study had a short duration, which may not fully capture the long-term effects and durability of E-BPO in real-world clinical practice. CONCLUSION: Even after withdrawal at 16 weeks, efficacy and shifts in the skin microbiome were maintained over the duration of the study period with demonstrated clinical improvement and a well-tolerated safety profile.
Field Therapy for Actinic Keratosis: One Nurse Practitioner's Perspective on Evolving Approaches and Patient-centered Care.
Caldwell A
J Clin Aesthet Dermatol · 2025 · PMID 40842512
BACKGROUND: Actinic keratosis (AK) is a common dermatologic condition that can progress to squamous cell carcinoma if left untreated. Field therapy plays a critical role in managing both visible and subclinical lesions w...
BACKGROUND: Actinic keratosis (AK) is a common dermatologic condition that can progress to squamous cell carcinoma if left untreated. Field therapy plays a critical role in managing both visible and subclinical lesions within sun-damaged skin. OBJECTIVE: The author sought to provide one nurse practitioner's perspective on the evolving role of field therapy in AK management, emphasizing patient-centered care, real-world challenges for all advanced practice providers (APPs), and personal experience. METHODS: This commentary reflects clinical observations, patient interactions, and the author's own experience undergoing multiple field therapies, including topical 5-fluorouracil, imiquimod, tirbanibulin, and photodynamic therapy. Emphasis is placed on treatment selection, education, and adherence strategies. RESULTS: Field therapy is effective when personalized to the patient's lifestyle, skin type, and preferences. Empathetic counseling and tailored treatment regimens improve outcomes and satisfaction. Newer therapies such as tirbanibulin and daylight photodynamic therapy offer promising options with improved tolerability. CONCLUSION: APPs are uniquely positioned to lead in early AK treatment and prevention. Combining clinical expertise with patient education and empathy enhances the impact of field therapy. The author's dual perspective as a provider and patient offers valuable insight into the real-world application of evidence-based dermatologic care.
Hidradenitis Suppurativa: Beyond Skin Concerns to Focus on Cardiovascular Considerations.
Flynn J, Harrison K, Le V
J Clin Aesthet Dermatol · 2025 · PMID 40842511
INTRODUCTION: Hidradenitis suppurativa (HS) is a poorly recognized chronic skin condition that presents with inflamed recurring painful nodules, abscesses, and subcutaneous tunnels, mainly impacting intertriginous areas....
INTRODUCTION: Hidradenitis suppurativa (HS) is a poorly recognized chronic skin condition that presents with inflamed recurring painful nodules, abscesses, and subcutaneous tunnels, mainly impacting intertriginous areas. Although extensively studied for its dermatological implications, recent research suggests a potential correlation between HS and cardiovascular disease. Studies reveal a heightened prevalence of cardiovascular risk factors, such as obesity, metabolic syndrome, and smoking, in individuals with HS. Most researchers attribute HS's elevated cardiovascular risk to these coexisting factors. OBJECTIVE: This review aims to identify whether or not HS's underlying chronic inflammatory nature can contribute to atherosclerosis development, thereby elevating the risk of cardiovascular events and, specifically, major adverse cardiovascular events (MACE). Recognizing the association between HS and cardiovascular disease is crucial for comprehensive patient care. METHODS: A PubMed search was performed to locate clinical trials, systematic reviews, and clinical reviews published to date concerning this topic. RESULTS: This review consolidates existing literature on the topic, summarizing key findings and emphasizing the need for further research to clarify the mechanisms linking HS and cardiovascular conditions and delineating best clinical practices to mitigate risk. LIMITATIONS: Many publications attribute the increase in cardiovascular disease to comorbid risk factors. Despite limited research on cardiovascular (CV) risk in patients with HS, emerging evidence indicates an increased risk of adverse CV outcomes in this population, consistent with data from other chronic inflammatory diseases indicating that the inflammatory nature of the disease itself is elevating cardiovascular events. More clinical research is needed to strengthen this hypothesis and improve patient outcomes. CONCLUSION: An integrated, multidisciplinary approach combining dermatological and cardiovascular perspectives is vital for optimizing patient care and navigating the complexities of managing HS and its associated cardiovascular comorbidities.
The Need for Regulated Training and Certification for Providers Entering into Aesthetic Medicine.
Gaskell A, Brondstater K
J Clin Aesthet Dermatol · 2025 · PMID 40842510
The growing demand for aesthetic procedures leads to an influx of providers entering the field, many of whom lack formal training in aesthetic medicine. The absence of standardized education and certification poses signi...
The growing demand for aesthetic procedures leads to an influx of providers entering the field, many of whom lack formal training in aesthetic medicine. The absence of standardized education and certification poses significant risks to patient safety, including improper technique, adverse complications, and unethical practice. Without clear regulatory oversight, nonmedically trained individuals and inadequately trained healthcare professionals offer aesthetic treatments, leading to inconsistent outcomes and diminished public trust in the field. This article examines the urgent need for regulated training and certification to establish competency benchmarks and ensure patient safety. A tiered education model provides foundational, intermediate, and expert-level training, with standardized curricula covering anatomy, injection techniques, complication management, ethics, and legal considerations. Professional organizations and regulatory bodies play a key role in accrediting training programs, defining the scope of practice, and enforcing licensure requirements. Legislative measures, including mandatory certification, continuing education, and enforcement mechanisms, maintain high standards in aesthetic medicine. Implementing a structured training framework enhances provider competency, reduces adverse events, and reinforces ethical practice. Standardized regulation safeguards patient well-being and preserves the credibility and integrity of the aesthetic medicine industry.
Effectiveness and Safety of Intradermal Tranexamic Acid Injection as an Adjunctive Treatment for Melasma in Skin Type IV-V: A Double-blind Randomized Controlled Trial.
Hosfiar VA, Sitohang IBS, Rahmayunita G
J Clin Aesthet Dermatol · 2025 Jul · PMID 40778014
OBJECTIVE: Melasma is an acquired pigmentary disorder for which tranexamic acid (TA) injection has shown promising results in earlier studies. This study aimed to evaluate the effectiveness and safety of intradermal TA a...
OBJECTIVE: Melasma is an acquired pigmentary disorder for which tranexamic acid (TA) injection has shown promising results in earlier studies. This study aimed to evaluate the effectiveness and safety of intradermal TA as an adjuvant therapy for melasma in individuals with Fitzpatrick Skin Type IV-V. METHODS: We conducted a double-blind, randomized, split-face controlled trial of 34 female patients with melasma. All subjects were randomized to receive either 10mg of intradermal TA or placebo injection on the right or the left side of their face. The primary outcome was improvement of melasma lesions assessed by modified Melasma Area and Severity Index (mMASI) score and mexameter examination which includes Melanin Index (MI) and Erythema Index (EI). Measurements were done at baseline and every two weeks for 12 weeks. Additionally, side effects of therapy and subject satisfaction assessment with patient global assessment (PtGA) were also documented. RESULTS: This study showed the reduction of mMASI score was larger and faster in intervention group compared to control group whereas the reduction of MI and EI was not significantly different between both groups. The majority of subjects did not experience any serious side effects. The subjects in the treatment group also reported significantly higher proportion of very good response compared to control group. LIMITATIONS: This was a single-center study with a small sample size and the inability to control confounding variables. CONCLUSION: Based on our results, intradermal TA injection appears to be an effective and safe adjuvant therapy for melasma in individuals with Fitzpatrick Skin Type IV-V.
Experiences of Social Media Users with Over the Counter Red Light Therapy Devices.
Ilyas EN, Barna AJ, Arza A … +1 more , Giordano C
J Clin Aesthet Dermatol · 2025 Jul · PMID 40778013
The rising popularity of over-the-counter red-light therapy (RLT) devices has sparked interest in their efficacy and consumer behavior, particularly as they are increasingly promoted on social media. This cross-sectional...
The rising popularity of over-the-counter red-light therapy (RLT) devices has sparked interest in their efficacy and consumer behavior, particularly as they are increasingly promoted on social media. This cross-sectional study analyzed responses from a survey of 226 participants, with 88.5 percent identifying as female and 83.6 percent of Hispanic or Latino origin. The majority (60.4%) reported learning about RLT devices through social media, and 90.0 percent were willing to purchase one, with most respondents willing to spend between $101 to $300 USD (48.9%). The top motivations for use included anti-aging (50.2%), improving skin texture (37.9%), and reducing dark spots (30.8%). Significant associations were found between Hispanic ethnicity, male gender, and increasing age with a higher likelihood of considering RLT devices (<0.001). Respondents were also skeptical of the value of higher-priced devices, with 58.8 percent doubting their superior efficacy. These findings highlight significant demographic influences on the interest in RLT devices, emphasizing the need for transparent product information and realistic consumer expectations to ensure satisfaction and trust in the technology.
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