A retrospective evaluation of subsurface monopolar radiofrequency for lifting of the face, neck, and Jawline

BACKGROUND Subsurface monopolar radiofrequency (SMRF) has emerged as a new method for reducing skin laxity via the controlled delivery of thermal energy below the skin using a radiofrequency probe. OBJECTIVE To evaluate the overall efficacy of the treatment and satisfaction ratings of subjects who underwent a single SMRF treatment to the face, neck, or jawline (or some combination). MATERIALS AND METHODS A retrospective, single-center study was conducted in which data were obtained via subject follow-ups at 90 and 180 days posttreatment. RESULTS A total of 35 subjects, 6 men and 29 women, underwent a single SMRF treatment. Overall, 77% of subjects reported improvement, and 64% reported satisfaction with the treatment site at Day 180 posttreatment. CONCLUSION Subsurface monopolar radiofrequency represents an effective modality to achieve skin tightening of the face, neck, and jawline. The data suggest that there is an energy delivery threshold, above which a higher percentage of subjects report satisfaction. Analysis of treatments parameters suggests an optimal treatment time and tissue temperature that should be achieved to maximize results. © 2016 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc

The Efficacy and Safety of Radiofrequency Microneedling Versus a Nonablative Fractional 1,550-nm Erbium:Glass Laser for the Rejuvenation of the Neck

BACKGROUND: Radiofrequency microneedling (RFMN) and nonablative fractional 1,550-nm erbium:glass lasers (NAFLs) have been reported to be used with success in neck rejuvenation. There are no head-to-head trials to compare these modalities. OBJECTIVE: The purpose of the study was to compare the efficacy and safety of radiofrequency microneedling and nonablative fractional 1,550-nm erbium:glass lasers for the rejuvenation of the neck. METHODS: This was a single-center, randomized, investigator-blinded clinical trial. A total of 21 subjects were randomized into 2 groups, NAFL and RFMN; subjects received 3 treatments 4 weeks apart and were followed up 12 weeks after last treatment. RESULTS: Subjects in NAFL and RFMN groups showed 42.1% and 8.6% improvement in the Fitzpatrick-Goldman Wrinkling Score, respectively, 41.3% and 16.3% improvement in the elastosis score, respectively. Subjects in the NAFL 1,550-nm erbium:glass group showed significantly better blinded investigator Fitzpatrick-Goldman Wrinkling and Elastosis scores; subjects in the RFMN groups showed a more significant reduction in the Horizontal Neck Wrinkle Severity Score. There was a trend for higher patient satisfaction with the NAFL. CONCLUSION: This study showed that both treatments resulted in significant improvement in wrinkling and elastosis scores; the NAFL treatment was associated with significantly better blinded investigator Fitzpatrick-Goldman Wrinkling and Elastosis scores and better subject satisfaction

"A retrospective evaluation of subsurface monopolar radiofrequency for lifting of the face, neck, and Jawline"

"BACKGROUND Subsurface monopolar radiofrequency (SMRF) has emerged as a new method for reducing skin laxity via the controlled delivery of thermal energy below the skin using a radiofrequency probe. OBJECTIVE To evaluate the overall efficacy of the treatment and satisfaction ratings of subjects who underwent a single SMRF treatment to the face, neck, or jawline (or some combination). MATERIALS AND METHODS A retrospective, single-center study was conducted in which data were obtained via subject follow-ups at 90 and 180 days posttreatment. RESULTS A total of 35 subjects, 6 men and 29 women, underwent a single SMRF treatment. Overall, 77% of subjects reported improvement, and 64% reported satisfaction with the treatment site at Day 180 posttreatment. CONCLUSION Subsurface monopolar radiofrequency represents an effective modality to achieve skin tightening of the face, neck, and jawline. The data suggest that there is an energy delivery threshold, above which a higher percentage of subjects report satisfaction. Analysis of treatments parameters suggests an optimal treatment time and tissue temperature that should be achieved to maximize results. © 2016 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc.

Extension Phase of a Multi-Center, Randomized, Blinded Clinical Study Evaluating the Efficacy and Safety of a Novel Topical Product for Facial Dyschromia.

BackgroundDyschromia can be associated with increased production and/or reduced clearance of pigmentation in the skin. Multiple pathways are involved in causality. A novel topical product was recently developed, which contains actives that have been validated through in-vitro and clinical studies to counteract pigmentation related to photodamage, PIH, and melasma. This study further evaluates the safety and efficacy of this product for facial dyschromia during an additional 3-month extension period following the completion of the previous 12-week multi-center trial.  Study Design: Subjects from the previous multi-center trial with mild to severe facial dyschromia at baseline were eligible to participate in this 3-month extension study upon completion of that trial. This extension study evaluated the continued use of the novel topical product with PATH-3 Technology (Alastin Skincare, Carlsbad, CA) over a 3-month period. Subjects who were previously randomized to the novel topical product continued using it and for those previously randomized to hydroquinone 4% discontinued its use. Both cohorts continued daily sunscreen use. Blinded investigators assessed subjects at follow-up visits at 16, 20, and 24 weeks.ResultsTwenty-six (26) subjects completed the extension phase of the pivotal trial, with 13 subjects in each of the AL and HQ-BREAK cohorts. Significant improvements were seen within the AL cohort from weeks 12 to 24 for facial dyschromia (P=0.0158) and skin tone/clarity/evenness (P=0.0067), while there were no significant improvements seen in the HQ-BREAK cohort. The HQ-BREAK cohort had more subjects who worsened with facial dyschromia and skin tone/clarity/evenness. For the mMASI, the HQ-BREAK cohort demonstrated regression at week 24 compared to week 12, while the AL cohort instead experienced continued improvement. This difference was found to be significant (P=0.02). No study-related adverse events were reported for either cohort.  Conclusion: A novel topical product designed to counteract various steps in pigmentation pathways using PATH-3 Technology has been demonstrated to be safe and effective in treating facial dyschromia on a long-term basis. In contrast to the significant rebound experienced by subjects with HQ, the AL cohort continued to demonstrate ongoing improvement. J Drugs Dermatol. 2024;23(1):1266-1270.     doi:10.36849/JDD.7622

Estrogen-deficient skin: The role of topical therapy

Menopause is a major turning point in a woman’s life that is characterized by declining ovarian function and decreased serum estrogen levels. The resulting hormonal changes particularly affect the skin, with postmenopausal symptoms such as loss of structural architecture and increased propensity to damage becoming rapidly noticeable. Interestingly, studies have shown that estrogen deprivation in postmenopausal conditions accelerates many skin changes, including dryness, atrophy, fine wrinkling, and poor wound healing. Thus, the effects of low estrogen on the skin are an important endogenous cause of aging skin in women, yet topical treatment strategies that target cutaneous symptoms are limited. The goal of this article is to provide an overview of the role of estrogen in the skin and changes associated with estrogen deficiency, as well as review alternatives to systemic estrogen therapy and describe the effects of these interventions on cutaneous aging in postmenopausal skin. Specifically, clinical studies that utilize topical estrogens and topical isoflavones, which are soy-derived compounds that interact with estrogen receptors, are discussed. Keywords: Topical estrogen, topical isoflavone, genistein, menopause, post-menopause, ski

Photodynamic Therapy: A Clinical Consensus Guide

BACKGROUND: The American Society of Dermatologic Surgery (ASDS) periodically develops consensus documents for its members concerning various aspects of dermatologic surgery. Advances in photodynamic therapy (PDT) have been many and PDT use has been established in a variety of skin conditions. OBJECTIVE: The ASDS board of directors proposed a committee of experts in the field to develop consensus documents on different treatments. An expert panel reviewed the literature on PDT and discussed the findings. The consensus was reached with evidence-based recommendations on different clinical applications for PDT. PATIENTS AND METHODS: This consensus document includes discussions regarding PDT, including different photosensitizers and various light source activators, historical perspective, mechanism of action, various therapeutic indications and expected outcomes, pre- and post-care, and management of adverse outcomes. RESULTS: Photodynamic therapy is highly effective for pre-cancerous lesions, superficial nonmelanoma skin cancers, inflammatory acne vulgaris and other conditions. New protocols including laser mediated PDT significantly improve results for several indications. CONCLUSION: The ASDS consensus document on PDT will be helpful for educating members on safe and effective PDT for a variety of indications