Acne fulminans is a severe form of acne that has a considerable psychosocial impact. Acne scarring is a potential complication of this condition. The treatment of acne fulminans includes conventional topical antibiotics, systemic antibiotics, hormonal therapy, isotretinoin, and light therapy. Intense pulsed light can have marked effects on acne fulminans. We aimed to describe the treatment of acne fulminans with intense pulsed light. This article is a case report together with a literature review to demonstrate how intense pulsed light can be used to treat acne fulminans. Pre-treatment and post-treatment clinical photographs are provided to show the effects of intense pulsed light therapy on acne fulminans. No comparisons were made with the other treatment modalities; nevertheless, this study provides an alternative treatment option for acne fulminans. Our case report revealed that intense pulse light using multiple filters at certain energy levels can effectively treat acne fulminans. Current evidence suggests that ablative CO 2 and Er:YAG lasers provide the best curative effect on acne scars on all skin types. Potential complications with intense pulsed light include pain, burns, and post-inflammatory hyperpigmentation. Intense pulsed light is an effective treatment modality for acne fulminans. However, more cases of acne fulminans treated with intense pulsed light need to be documented in order to affirm intense pulsed light as one of the best options for treating this severe form of acne.
Photoaging is a process of normal skin architecture damage caused by ultraviolet radiation. Topical vitamins have been used to treat these conditions. The authors aimed to understand the mechanism and level of evidence of topical vitamins used to treat photodamaged skin. A range of topical vitamins has been used in cosmetic medicine for many years to treat photodamaged skin. This review article compares their efficacy and level of evidence. This study was a systematic review to evaluate the efficacy of different topical vitamins. Keywords including "Photoaging," "Botanicals," "Peptides," "Retinoids," "Vitamins" were searched on Ovid, PubMed, MEDLINE for relevant studies published on photoaging treatment. There is a wealth of Level I evidence supporting the use of topical retinoic acid, vitamins B and C. There is evidence supporting the use of topical vitamin E although it is mainly drawn from Level IV studies of the evidence hierarchy. Topical vitamins can effectively treat photodamaged skin.
Soft tissue ptosis occurs with age, leading to loss of facial volume. The facial retaining ligamentous system is an intricate network of fibrous tissues connecting the whole face, restraining soft tissues from gravitational forces, and opposing facial movements. With proper positioning and anchorage within the ligamentous grid and superficial fat repositioning, lifting the mid-face and adjacent areas (e.g., jowl) is likely to occur. We aimed to determine whether inserting 3 pairs of bidirectional cone sutures can effectively improve the nasolabial fold (mid-face) and jowl (lower face) in Asian patients with mild to moderate mid-face laxity at 6 months and 12 months. Ten healthy volunteers with mild to moderate facial laxity received 3 pairs of bidirectional cone threads, inserted in a straight parallel technique. Based on validated evaluation parameters: facial laxity rating scale (FLRS) and the wrinkle severity rating scale, a total of 7 independent reviewers, among which 3 assessed the change in mid-face laxity (nasolabial fold), and the other 4 reviewers evaluated the change in jowl or lower face contour based on FLRS at 6 months and 12 months. All reviewers were experienced esthetic doctors. According to the reviewers' evaluation based on the validated parameters, there was a linear improvement in the mid-face laxity/nasolabial fold and lower face laxity/jawline contour self-reporting patients' satisfaction at 6 months and 12 months compared to baseline in all 10 patients. There was continuous improvement in mid-face laxity and lower face laxity from baseline, 6 months, and 12 months after treatment. The evaluation results among the reviewers were similar, apart from reviewer 7. All patients gave their best rating at 12 months, and their satisfaction almost doubled compared to that before treatment.
Background: There was evidence of improvement in mid-face laxity using three pairs of suspension sutures in mid-face lifting in our early and mid-term follow-up.Objective: This 24-month prospective follow-up study aimed to determine the efficacy of mid-face lifting and lower jawline contouring using poly lactic-co-glycolic acid (PLGA) sutures in Asian patients.Methods: Ten healthy volunteers received three pairs of 8-cones bidirectional cones sutures at the mid-face. One of the ten volunteers lost to follow-up, and all remaining patients followed up for 24 months. Our primary outcome measure is the change in the facial laxity rating scale (FLRS), an "improvement" defined as at least "one-grade change" in FLRS. Other assessment parameters include the severity of the nasolabial fold (NLF), assessed on the wrinkle severity rating scale (WSRS). The secondary outcome measures were the self-satisfaction rating scale (SSRS) and global aesthetic improvement scale (GAIS), rated by participants at each follow-up interval.Results: A linear improvement in the mid-face was observed almost immediately after treatment, with progressive improvement up to at least 12 months following the intervention and no deterioration by 24 months. This improvement was significant (p<0.05), and the differences between before and after treatment at each follow-up interval were large (Cohen's d>0.8). Contour improvement for the lower face followed a similar trend, except for a delay in the observable differences at three months (Cohen's d=0.29, 0.8 at six weeks and three months, respectively). The differences in the level of patient satisfaction were significant (p<0.05) from 6 weeks to 24 months, peaking between 12 and 18 months, based on both the GAIS and SSRS ratings. No observed complications. Conclusion:Mid-facing lifting in Asian patients with mild-to-moderate laxity is safe and effective with PLGA bidirectional cone sutures, with concurrent improvement in the lower face contour and elevated patient satisfaction over the 24-month follow-up period.
Scarring can complicate acne vulgaris and lead to considerable psychosocial implications. Resurfacing and collagen regeneration treatments for acne scars include cryotherapy, chemical peeling, lasers and lights, and radiofrequency. Lasers have become popular among these options. A range of lasers with varying designs, wavelengths, and fractional technologies have become available as treatment choices for acne scars. This review compares the efficacy and adverse effects of these treatments. This is a literature review to determine whether the use of a combination of laser treatments yields superior outcomes compared to a single-device method in the management of acne scars. Our literature review revealed that patient factors, including Fitzpatrick skin phenotype and acne scar subtype, are essential determinants of outcome success in acne treatment with laser. Evidence suggests that ablative CO 2 and Er:YAG lasers provide the best curative effects on acne scars in all skin types. Both non-fractional and fractional techniques can effectively treat atrophic acne scars. However, when using a pulse-dye laser to treat hypertrophic scars, the outcomes are variable. Potential complications of ablative lasers include acne flares, infections, and scarring.
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