The topical calcineurin inhibitors (TCIs), tacrolimus (Protopic) and pimecrolimus (Elidel), were approved in the early 2000s and were widely used as a nonsteroid treatment for atopic dermatitis (AD) in adult and pediatric populations. In 2005, the addition of a boxed warning was mandated for TCIs based on a potential risk of malignancy, and there was subsequently a substantial decline in their use. Since then, evidence has mounted to support the safety of this class of medications and suggests that the increased risk of malignancy remains theoretical. This review aims to dispel some of the common myths surrounding the safety of TCIs by evaluating the key evidence regarding their safety and tolerability in adult and pediatric populations. Four major themes are addressed in a practical question-and-answer format: the risk of harm associated with TCIs including common and serious adverse events; warnings and precautions for their use including the risk of systemic absorption, immunosuppression, and malignancy; the comparative safety of TCIs; and suggestions for counselling patients about the risk of harm with TCIs. Based on the available evidence, international professional dermatological organizations and regulatory authorities have concluded that the benefits of TCIs outweigh their potential risks when used in the appropriate patient populations for the recommended duration of time.
Objective This study compared an antiaging treatment with two currently marketed cosmetic antiaging products for the treatment of lateral canthal lines ("crow's feet"). Methods Healthy female volunteers (72) aged of 54.6 years (mean) having fine‐to‐moderate wrinkles in the lateral canthal areas were randomized to one of three treatments applied daily over 28 days: Group A (Purgenesis™ Day Cream, Purgenesis™ Eye Cream, and Purgenesis™ Night Cream); Group B (Prevage® Eye Lotion, Prevage® Day Cream, and Prevage® Night Cream); or Group C (La Mer® Eye Balm, Crème de La Mer®, and La Mer® Night Cream). The effects on anti‐wrinkle properties and for sensory attributes and general performance were evaluated on Days 1, 7, and 28. Results Skin hydration improved significantly at all time points in Groups A and B, and at Day 28 in Group C. Group A patients experienced significant improvements in measured skin elasticity parameters at Day 28; extensibility and maximum amplitude were significantly better at Day 28 in Groups B and C. Benefits were also seen in profilometric parameters with statistical significance only in Group A Volunteer tolerance was good with all three treatments, although moderate and high levels of adverse events were numerically higher in Group B than in Groups A or C, and levels of slight discomfort were significantly more prevalent in Group B. Conclusion The Purgenesis™ antiaging treatment significantly improved skin hydration, elasticity, and profilometry parameters during a 28‐day study. This therapy was found to be well tolerated and effective in countering the cutaneous signs of aging.
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