Background: Centella asiatica, a medicinal plant, has been used traditionally to promote wound healing. Its efficacy on promoting postlaser resurfacing wound healing is lacking.Methods: Thirty individuals with facial acne scars underwent a treatment with 2940 nm Er:YAG laser. Half side of the face was randomized to receive 0.05% w/w ECa 233 gel, a standardized extract of C. asiatica, and the other half a placebo gel. The gels were applied four times daily for 7 days then twice daily for 3 months. Erythema, melanin, and texture index (TI) from Antera3D, Ò and skin biophysics were obtained at baseline, days 2, 4, and 7, then every 2 weeks for the first month, and every month for 3 months. Three blinded dermatologists assessed the photographs and provided a grading scale of wound appearances.Results: The ECa 233 treated side exhibited significantly less erythema index over total follow-up by 0.03 U (coefficient = -0.03 [95% CI -0.06 to -0.0006]; p = 0.046). In keeping with the physicians' assessment that showed significantly higher improvements in skin erythema at days 2, 4, and 7 ( p = 0.009, 0.0061, 0.012), crusting at days 2 ( p = 0.02), and general wound appearance at days 2, 4, and 7 ( p = 0.008, 0.001, 0.044), TI showed a trend toward better outcome in the ECa 233 group. Skin biophysics did not differ between the two groups.Conclusion: ECa 233 might be an option for postlaser treatment to improve wound appearance.
Background Seborrhea is linked to several medical and mental conditions. Although it is common, effective agents and the standardized sebum level for seborrhea are not elucidated. Aims To determine the efficacy of chitosan particles (CP) formulation on controlling sebum secretion, its extended effects on skin redness and texture after combining with proretinal nanoparticles (CP‐PRN), and a correlation of the clinical grading with sebum levels that affect mental health. Patients/Methods A four‐week clinical trial with forty subjects was conducted. Subjects applied either CP formulation or CP‐PRN during nighttime. Objective measurements including sebum levels, transepidermal water loss (TEWL), skin corneometry, skin redness, and texture were analyzed. Subjects completed a self‐assessment clinical grading of skin oiliness at every visit. Results Both CP and CP‐PRN significantly decreased sebum levels (P ≤ .01) at week 4 compared to baseline. CP also resulted in significant decreases in TEWL (P ≤ .05) and skin corneometry (P ≤ .05) throughout the study. A significant improvement in skin redness was observed with CP‐PRN (P ≤ .01). A moderate correlation between the clinical grading and sebum levels was detected (coefficient of 0.5, P ≤ .001), with a sebum level of 106 μg cm‐2 indicating emotional discomfort. One subject experienced local irritation with the CP‐PRN. Mild pruritic symptoms were reported in both groups. Conclusions Chitosan particles exhibited an interesting anti‐sebum effect. It could be combined with PRN to extend benefits without losing the sebum controlling effect. The clinical grading may be useful in practice due to a modest correlation with sebum levels.
Background Skin signs observed in morbid obesity may change as the weight reduces, especially post-bariatric surgery (BaS). Data concerning the skin findings exclusively in post-BaS patients remain limited. Methods Seventy post-BaS patients were examined for cutaneous abnormalities. The patients were divided into those with successful weight loss (% excessive body weight loss (EBWL) of at least 50%) and a non-successful group (%EBWL < 50%). Results Forty-six patients with successful weight loss demonstrated a significantly lower prevalence of acanthosis nigricans on the neck, axillae and inguinal areas, keratosis pilaris (KP) and pebble fingers. However, a higher prevalence of alopecia was observed. After adjustment with patients’ factors, KP (adjusted odds ratio (aOR) = 0.21, 95%CI 0.06–0.74, p = 0.02) and pebble fingers (aOR = 0.09, 95%CI 0.01–0.89, p = 0.04) remained significantly less likely in patients with successful weight loss. Laboratory results comparing pre- and post-surgery values revealed significant decreases in fasting plasma glucose, hemoglobin A1c, and triglyceride and an increase of high-density lipoproteins in both groups. However, significant decreases of liver aminotransferases (AST and ALT) were observed only in the successful group (p = 0.04, 0.003). Nonetheless, a decrease in vitamin B12 (p = 0.01) was observed in the successful group. Conclusion Weight loss after BaS provided an improvement for metabolic profiles. Successful weight reduction resulted in better skin improvement. However, nutritional supplements may be necessary. Trial registration Thai Clinical Trials Registry TCTR20171003002. Registered October 3. 2017, retrospectively registered.
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