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Background: Melasma is a challenging, acquired hyperpigmentary disorder. The gold standard treatment is Kligman's formulation, which contains hydroquinone, tretinoin, and dexamethasone, but its long-term use is limited by the risk of exogenous ochronosis. Cysteamine, a tyrosinase inhibitor, reduces melanocyte activity and melanin production, showing strong depigmenting effects in patients resistant to Kligman's formulation. Nonetheless, clinical studies have yielded inconsistent efficacy results. This meta-analysis aimed to assess the efficacy of cysteamine in treating melasma and to identify potential factors that may impact its therapeutic outcomes. Methods: A systematic search of PubMed, Embase, Web of Science, and CENTRAL, from the earliest record until August 2024, was conducted. Randomized controlled trials and quasi-randomized design studies related to topical cysteamine on melasma patients were included. The primary outcome was MASI or mMASI assessment after treatments. The current meta-analysis was conducted with a random-effects model. Subgroup analyses and meta-regressions were performed based on baseline MASI, disease duration of melasma, patient age, and sample size of the included studies. Funnel plots and Duval and Tweedie's trim and fill method were adopted to assess the publication bias. Results: Eight studies were included for quantitative analysis. The analysis of MASI after topical cysteamine demonstrated a significant decrease compared to the placebo (p = 0.002). Compared to other melasma treatments, cysteamine did not show superior efficacy in mMASI (p = 0.277). The treatment efficacy of hydroquinone, modified Kligman's formula, and tranexamic acid mesotherapy for melasma was not statistically different when compared to cysteamine (p = 0.434). Further analyses showed no benefit when allowing extended cysteamine application time (p < 0.0001). The meta-regression revealed the efficacy of cysteamine decreased as the duration of melasma increased (coefficient = 0.38, p = 0.0001, R2 = 0.99). The funnel plot displayed some asymmetry. The trim and fill method suggested the adjusted effect size was 0.607 (95% CI = −0.720 to 1.935). Conclusions: Cysteamine exhibited efficacy in treating melasma patients; however, its depigmentation effect was comparable to hydroquinone-based regimens, tranexamic acid mesotherapy, and modified Kligman's formula. Using cysteamine in patients with a short duration of melasma may result in better efficacy. [ABSTRACT FROM AUTHOR]

Background: Periorbital hyperpigmentation (POH) is a common cosmetic problem with a negative impact on the patient's self‐confidence, leading to a decrease in the quality of life. Current treatments include topical agents and mesotherapy, but research remains limited. Aims: Due to the undesirable effect of the available treatments, the present study was designed to compare the effectiveness of platelet‐rich plasma (PRP) injection and intradermal injection of tranexamic acid plus vitamin C mesotherapy as a therapeutic method to treat POH. Methods: Patients received an intradermal injection of PRP randomly on one side and an intradermal injection of tranexamic acid + vitamin C on the other side of their face, for three sessions with an interval of 3 weeks. Digital photography was taken, and data were assessed based on physician global assessment (PGA) and patient satisfaction. Results: Eighteen patients were studied. Among all, 12 patients had a positive family history, 2 had asthma, and 4 had a history of atopic dermatitis. Even though patient satisfaction was higher in the PRP group than in mesotherapy, it was not statistically significant. Both groups showed similar rates of improvement. However, improvement rates did not significantly differ based on various factors including gender, skin type, family history, or medical history. Age and the age of disease onset also did not significantly affect the improvement rates. Conclusion: Both methods revealed successful results in the reduction of POH. Comparing the efficacy of these two methods showed that both treatments had similar improvements. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the effectiveness of different mesotherapy techniques applied at various dermal depths on pain, functional status, and quality of life in patients with non-specific neck pain. Methods: A total of 43 patients who received mesotherapy for non-specific neck pain were retrospectively analyzed. Patients treated with the point-by-point technique (n=21) and the napaj technique (n=22) were recorded. A mixture of 2 mL lidocaine and tenoxicam was used as the mesotherapy solution. Pain was assessed using the visual analog scale (VAS), functional status was assessed using the neck disability index (NDI), and quality of life was assessed using the Nottingham health profile before (T0), after (T1), and 3 months after (T2). Results: In both groups, which were homogeneous in terms of demographic data, statistically significant changes were observed in T1 and T2 values compared with T0 for all evaluation parameters (p=0.001). While both groups demonstrated improvement in all parameters, the posttreatment VAS and NDI score in the point-by-point group was slightly better than that in the napaj group (p=0.042), (p=0.043) but this difference disappeared in the 3-month evaluation. Conclusions: Mesotherapy using a lidocaine-tenoxicam mixture with both the point-by-point and napaj techniques is an effective and safe treatment method for nonspecific neck pain. Both techniques were found to be effective in improving pain, functional status, and quality of life, but neither technique was found to be superior to the other. [ABSTRACT FROM AUTHOR]

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Today, musculoskeletal pain is frequently seen in the working population. Analgesic drugs are frequently used in the treatment of this chronic pain. However, analgesic drug treatment causes various side effects. Mesotherapy is an application method that aims to heal by injecting a small amount of medication under the skin. In this method, less medication is used compared to systemic treatment and a similar effect is achieved. Although mesotherapy has a wide range of uses, it does not yet have a standard protocol. For these reasons, every study conducted in the field of mesotherapy is quite valuable. It was aimed to contribute to the literature by evaluating the mesotherapy results of three sisters from the same family who applied to our center with various pain complaints. The pain of the sisters, aged 44, 47 and 50, was evaluated with the Visual Analog Scale (VAS) before and after mesotherapy. The pain levels, which were 10/10, 8/10 and 10/10, decreased to 7/10, 4/10 and 3/10 after three sessions of mesotherapy, respectively. In addition, all of them reported an increase in their quality of life. The decrease in pain in these patients with similar genetic and sociodemographic characteristics, consistent with previous studies, can be interpreted as significant. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aims Patients/Methods Results Conclusions Eyebrows significantly influence facial aesthetics and are often linked to attractiveness and personality. Eyebrow loss and alopecia impact physical and psychological well‐being. Several treatments, including mesotherapy (MT), aim to enhance eyebrow density and quality. Despite the availability of MT for hair growth, its application in eyebrow revitalization is less explored.This study evaluates clients' perceptions and satisfaction with eyebrow MT (EB MT) using AQ skin solutions' growth factor‐based MT cocktail serum.Thirty‐two healthy women (ages 21–55) with thin or weakened eyebrows underwent three EB MT sessions spaced 2–4 weeks apart. Exclusion criteria included chronic diseases, allergies, and conditions like pregnancy. Each session lasted about 40 min, and “point by point” and “nappage” techniques were employed. Satisfaction and pain levels were assessed through a Numeric Rating Scale for Satisfaction (NRSS) and Pain scale, while photographic analysis and the Global Aesthetic Improvement Scale (GAIS) evaluated effectiveness.The average GAIS score was 8.28, while the NRSS satisfaction score was 8.06. Pain levels were moderately low, averaging 4.0. A high majority (90.6%) were satisfied and willing to continue treatment, with 100% recommending EB MT to others. Notable improvements in overall appearance were reported by participants.EB MT demonstrated high satisfaction and low pain levels, with significant improvements in eyebrow density and appearance. This treatment is a practical option for eyebrow enhancement with a strong safety profile, motivating further clinical application. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aims Methods Conclusion The demand for aesthetic procedures aimed at restoring and preserving a youthful appearance is growing. While numerous non‐surgical facial rejuvenation techniques are available, there is a need for a comprehensive review of clinic‐based procedures targeting non‐facial body parts.This review aims to describe and evaluate clinic‐based techniques for rejuvenating the neck, chest, and hands, focusing on various types of fillers and other non‐invasive procedures.In this first part of this review, we conducted an extensive literature review on PubMed, reporting the effectiveness of different fillers, detailing their preparation, required volume per area, injection methods, durability, and any associated side effects. We also discuss the use of mesotherapy, microneedling, chemical peeling, and Profhilo in these specific body areas.The review synthesizes the latest data on the effectiveness and safety of these procedures, highlighting the advancements in filler technology and the growing popularity of non‐invasive techniques for body rejuvenation. This article serves as a valuable resource for practitioners and patients interested in non‐surgical body rejuvenation, providing insights into the best practices. [ABSTRACT FROM AUTHOR]

Upper Crossed Syndrome (UCS), described by Vladimir Janda, is characterized by postural changes involving the cervical spine and trunk, leading to biomechanical limitations and cervicoscapulobrachial pain. This study proposes a mesotherapy protocol, termed the 8:1 block, to address cervicoscapulobrachialgia by targeting the scapulae and associated musculature. The scapula, central to shoulder girdle kinematics, often exhibits dyskinesis and muscular imbalances, notably the pattern referred to as scapular upper trapping (SUT). SUT involves scapular elevation, medial rotation, and shoulder protraction, contributing to cervicobrachial pain. The protocol includes a comprehensive assessment of muscle tone changes and biomechanical considerations, highlighting the importance of the scapula in upper limb movement and posture. Key anatomical changes involve tightened upper trapezius, levator scapulae, and pectoralis minor muscles, with weakened middle trapezius and serratus anterior. The mesotherapy approach targets these imbalances through specific injection points to alleviate muscle tension and correct postural deviations. Case studies from our clinic demonstrate the protocol's effectiveness in reducing pain and restoring scapular biomechanics. Patients reported significant improvements in pain relief and functional outcomes, underscoring the clinical utility of the 8:1 block in treating cervicoscapulobrachialgia. This protocol offers a feasible, cost-effective intervention that enhances the efficacy of traditional therapeutic exercises by addressing underlying muscular and biomechanical dysfunctions. In conclusion, the 8:1 block mesotherapy protocol provides a novel approach to managing cervicoscapulobrachial pain by focusing on scapular biomechanics and muscle tension. Further studies are needed to validate these findings and refine the protocol for broader clinical application. [ABSTRACT FROM AUTHOR]

Background: The exact pathogenesis of melasma is not yet known, and its treatment remains challenging. Mesotherapy with tranexamic acid (TXA) and vitamin C was both reported to have certain effects on melasma. In spite of that several articles have compared the efficacy and safety of the two drugs on melasma, most of them were clinical study with small sample size. Aims: To evaluate the efficacy and safety of mesotherapy with TXA versus vitamin C in treating melasma through meta‐analysis and systemic review. Methods: The authors searched PubMed, Web of Science, Springer, and ScienceDirect for studies that compared mesotherapy with TXA versus vitamin C as a treatment for melasma. Primary outcomes were change in melasma area and severity index (MASI) before and after the treatment. Results: Finally, five studies with a total of 127 patients were included in the systematic review. There was no statistic difference in the change in MASI score between the TXA and vitamin C groups (mean difference, 0.16; 95% CI, −0.79 to 1.11). Conclusions: Mesotherapy with both TXA and vitamin C is safe and effective in the treatment of melasma. [ABSTRACT FROM AUTHOR]

This article presents a case series of hair system-induced alopecia in six White women. The patients experienced exacerbated hair loss in areas where the hair system was attached. Trichoscopy revealed features of both traction alopecia and pressure alopecia, suggesting a combined mechanism of action. The study highlights the need for dermatologists to be aware of this complication and familiar with trichoscopy to differentiate it from other conditions. However, the study has limitations, including a small sample size and lack of histopathological studies. [Extracted from the article]

Background: Androgenetic alopecia (AGA) is a common skin disease characterized by gradually miniaturized hair follicles, which manifests as progressive hair thinning and produces a bald appearance. Currently, finasteride is approved by the Food and Drug Administration (FDA) for the treatment of AGA, but its efficacy remains poor in some patients. Summary: Compared to finasteride, oral dutasteride has better efficacy and similar tolerability, and most adverse events are mild and reversible, making it an effective option for AGA, but its sexual adverse events and potential psychiatric risks still need to be concerned. Mesotherapy with dutasteride and microneedling combined with dutasteride solution can reduce adverse events caused by oral medication and exhibit certain efficacy, but standardized treatment protocols and large-scale clinical trials are still needed in the future. Liposomes or nanoparticles of dutasteride are under development and may become an efficient topical formulation. Key Messages: We have summarized the efficacy and AEs of dutasteride in treating AGA under different administration methods and the promise of novel topical drug carriers. [ABSTRACT FROM AUTHOR]

The Brazilian market holds the second position globally in the beauty sector, poised to surpass the USD 50 billion mark in the upcoming years. Aesthetic procedures encompass a spectrum, ranging from non-invasive ones, such as drainage, radiofrequency, ultrasound, and cryolipolysis, to more invasive techniques, including fillers, botulinum toxin, microneedling, micropigmentation, carboxytherapy, and enzyme application. This wide array of treatments has yielded satisfactory cosmetic results for individuals who opt out of surgical procedures. However, despite being categorized as having low complexity, they still carry inherent risks. These risks are often exacerbated by the breach of the skin barrier, the exposure of organs and spaces, or the presence of implantable devices. Among the bacteria most isolated concerning this matter are non-tuberculous Mycobacteria. This study presents descriptive case reports involving three patients under the care of the Infectious Diseases Department at General Hospital of Roraima (HGR). These patients were diagnosed with Mycobacterium abscessus infections subsequent to undergoing enzyme application procedures. Although these cases involve the same microorganism, they exhibit varying degrees of severity, ranging from the development of locally nodular formations to a progression towards sepsis. These cases provide an opportunity to delve into the diagnostic subtleties and clinical implications of these infections while also prompting a critical evaluation of therapeutic strategies. Additionally, the report underscores the potential risks associated with routine aesthetic procedures.

This article explores the clinical manifestations, diagnostic processes, and management strategies for Mycobacterium abscessus infections following mesotherapy and includes a literature review on M. abscessus incidence, diagnostic challenges, and therapeutic difficulties. A woman who presented to our clinic with redness and swelling across multiple sites 3 months following mesotherapy in a beauty shop was ultimately diagnosed with M. abscessus-induced skin and soft tissue infection (SSTI). Concurrently, Hong Kong’s Department of Health reported 19 similar cases, all linked to mesotherapy sessions at a particular beauty center from June to August 2023. Diagnosis involved analyzing pus samples, including acid-fast bacilli smear and culture. A literature review was conducted on M. abscessus infections, causality, treatment strategies, antibiotic susceptibility tests, advanced diagnostics such as polymerase chain reaction and matrix-assisted laser desorption ionization time-of-flight mass spectrometry, and newer treatment modalities. Nineteen patients exhibited SSTIs that manifested as rashes and abscesses at the injection sites. Diagnosis is hindered by the slow growth of M. abscessus, which necessitates advanced testing. Our patient underwent 2 to 3 months of intravenous antibiotics (combination therapy) as an inpatient at a public hospital, together with repeated surgical curettage and drainage of the infected areas. This report highlights the surge in M. abscessus infections related to cosmetic procedures and the immediate requirement for stringent infection control measures in aesthetic practices. The M. abscessus outbreak emphasizes its emergence as a significant pathogen, the intricacies of managing its antibiotic resistance and biofilm production, and the need for a comprehensive treatment approach that incorporates personalized medicine, innovative therapeutics, and surgical interventions. The literature review underscores the importance of continuous research on strain-specific treatments, development of advanced diagnostic and therapeutic techniques to effectively tackle this antibiotic-resistant pathogen, and infection control.

Skin aging is associated with both intrinsic and extrinsic aging, with extrinsic aging caused by environmental factors and overlaying the effects of chronological aging. The main aim of this study was to evaluate the effect of preparations containing Helix aspersa snail mucus on skin regeneration with photoaging features. Before and 3 months after the series of treatments, skin biopsy specimens from the right preauricular region of the face were taken from six women. Histological, morphometric, and immunohistochemical analyses were performed. Positive changes, indicating a reduction in photoaging related to the reduction in epidermis thickness 3 months after the end of the treatments, were noted in each group. A statistically significant increase in the thickness of the collagen fiber bundles was also observed in the patients 3 months after a series of micro-needle mesotherapy treatments with snail mucus and 0.9% NaCl. There was a significant increase in the immuno-expression of Ki-67 and PCNA in the dermis. The aforementioned significance applies to patients in whom snail mucus was introduced with the use of micro-needle mesotherapy and needle-free mesotherapy. Moreover, a statistically significant increased area with the immunoexpression of MMP-2 in the dermis was observed in the above-mentioned groups of patients, who were treated with the preparation containing snail filtrate. The results of the study suggest that the use of snail mucus preparations for skincare, as well as its introduction by micro-needle and needleless mesotherapy, had a beneficial effect on the condition of the skin. [ABSTRACT FROM AUTHOR]

The study aimed to evaluate the efficacy of percutaneous dilatational tracheostomy (PDT) combined with adjuvant therapies in preserving vocal function in amyotrophic lateral sclerosis (ALS) patients. Methods: We performed a retrospective analysis of 47 ALS patients who underwent PDT at the Rodem Hospital from 2021 to 2023. Post-operatively, these patients were provided with a comprehensive treatment plan that included regenerative injection therapy, low-frequency electrical stimulation, respiratory rehabilitation, and swallowing rehabilitation therapy. Additionally, a balloon reduction program was implemented for effective tracheostomy tube (T-tube) management. The preservation of vocal functions was evaluated 4 weeks following the procedure. Results: While some patients maintained or slightly improved their ALSFRS-R speech scores, the overall trend indicated a decrease in speech scores post-PDT. This suggests that PDT in combination with adjuvant therapies may not universally improve vocal function, but can help maintain it in certain cases. Conclusions: Our findings indicate that PDT combined with mesotherapy, low-frequency electrical stimulation, and swallowing rehabilitation therapy may play a role in maintaining vocal function in limb type ALS patients, though further research is needed to optimize patient management and to validate these results. [ABSTRACT FROM AUTHOR]

The Brazilian market holds the second position globally in the beauty sector, poised to surpass the USD 50 billion mark in the upcoming years. Aesthetic procedures encompass a spectrum, ranging from non-invasive ones, such as drainage, radiofrequency, ultrasound, and cryolipolysis, to more invasive techniques, including fillers, botulinum toxin, microneedling, micropigmentation, carboxytherapy, and enzyme application. This wide array of treatments has yielded satisfactory cosmetic results for individuals who opt out of surgical procedures. However, despite being categorized as having low complexity, they still carry inherent risks. These risks are often exacerbated by the breach of the skin barrier, the exposure of organs and spaces, or the presence of implantable devices. Among the bacteria most isolated concerning this matter are non-tuberculous Mycobacteria. This study presents descriptive case reports involving three patients under the care of the Infectious Diseases Department at General Hospital of Roraima (HGR). These patients were diagnosed with Mycobacterium abscessus infections subsequent to undergoing enzyme application procedures. Although these cases involve the same microorganism, they exhibit varying degrees of severity, ranging from the development of locally nodular formations to a progression towards sepsis. These cases provide an opportunity to delve into the diagnostic subtleties and clinical implications of these infections while also prompting a critical evaluation of therapeutic strategies. Additionally, the report underscores the potential risks associated with routine aesthetic procedures. [ABSTRACT FROM AUTHOR]

In this study, scalp tissues from Korean adults between 20 and 80 without skin disease were used. Scalp tissues were processed, and hair follicles were isolated and cultured with different treatments (including Bioscalp, Ultra Exo Booster, and Ultra S Line Plus) from Ultra V company. Over 12 days, observations and measurements of hair follicle characteristics were recorded at intervals (Days 0, 3, 6, 9, and 12). The study assessed the impact of these substances on hair follicle growth and morphology. Bioscalp, combined with Ultra Exo Booster and Ultra S Line Plus, showed significant hair elongation in ex vivo. Preservation of hair bulb diameter was observed, indicating potential for sustained hair growth by exosome‐based products. The hair growth cycle analysis suggested a lower transition to the catagen stage in test products from Ultra V compared to non‐treated groups. The research findings indicated that the tested formulations, especially the combination of Bioscalp, Ultra Exo Booster, and Ultra S Line Plus, demonstrated significant effectiveness in promoting hair growth, maintaining the integrity of the hair bulb, and reducing the transition to the catagen stage. The study suggests promising alternative treatments for hair loss, illustrating results that were as good as those of the conventional testing product groups. [ABSTRACT FROM AUTHOR]

Intradermal injection of bioactive compounds is used to reduce the effects of aging skin. The aim of this work is to study the response of facial injection of a hyaluronic acid complex supplemented with amino acids and antioxidant vitamins on skin rejuvenation. A total of 40 healthy adult subjects were recruited to whom this complex was injected into the facial skin, three consecutive times every two weeks. Together with assessing the degree of skin hydration, the level of skin microcirculation, wrinkles, skin color, and skin biomechanical parameters were evaluated. Using the GAIS scale, the degree of satisfaction of the participants was assessed. At 42 days (D42), there was an 11–12% increase in skin hydration and viscoelasticity, a 23% increase in skin density, a 27% increase in skin microcirculation, and a significant lightening and whitening of skin color, but without causing changes in skin wrinkles. A value between 1 and 3 on the GAIS scale was observed between 70 and 92% of the participants, and 87% of subjects found their skin more beautiful, 85% would recommend this treatment, and more than 50% found their face rejuvenated. In summary, the intradermal treatment tested suggests skin rejuvenation, with a good degree of safety. [ABSTRACT FROM AUTHOR]

Objective: Injectable skin fillers offer a wider range of options for cutaneous anti-aging and facial rejuvenation. PLLA microspheres are increasingly favored as degradable and long-lasting fillers. The present study focused solely on the effect of PLLA on dermal collagen, without investigating its impact on the epidermis. In this study, we investigated the effects of PLLA microspheres on epidermal stem cells (EpiSCs). Methods: Different concentrations of PLLA microspheres on epidermal stem cells (EpiSCs) in vitro through culture, and identification of primary rat EpiSCs. CCK-8 detection, apoptosis staining, flow cytometry, Transwell assay, wound healing assay, q-PCR analysis, and immunofluorescence staining were used to detect the effects of PLLA on EpiSCs. Furthermore, we observed the effect on the epidermis by injecting PLLA into the dermis of the rat skin in vivo. Results: PLLA microspheres promote cell proliferation and migration while delaying cell senescence and maintaining its stemness. In vitro, Intradermal injection of PLLA microspheres in the rat back skin resulted in delayed aging, as evidenced by histological and immunohistochemical staining of the skin at 2, 4, and 12 weeks of follow-up. Conclusion: This study showed the positive effects of PLLA on rat epidermis and EpiSCs, while providing novel insights into the anti-aging mechanism of PLLA. [ABSTRACT FROM AUTHOR]

Sedentary lifestyles, work overload, and lack of regular physical activity are risk factors for spinal pain syndrome. In everyday medical practice, spinal pain syndrome of a muscular or myofascial, or non-neurogenic, nature is diagnosed. This problem affects a large group of patients and reaches about 70–80% of spinal pain cases. Usually, one of the primary treatments is with NSAIDs (Non-steroidal Anti-Inflammatory Drugs). In this case, one treatment method that is safe and has no side effects is spinal mesotherapy. This method consists of performing multi-point intradermal microinjections with the administration of drugs or medical devices. Based on a new perspective on the treatment of spinal pathology—the so-called three-stage treatment concept—it is necessary to deal with the risk factor(s) of spinal pain syndrome and reduce or at least modify them (stage I). This is followed by a broadly understood medical therapy, in this case spinal mesotherapy (stage II), which aims to relax tense tissues, improve mobility in the spine and thus reduce pain. As a result, conditions are created for the necessary process, which is rehabilitation in the broadest sense (stage III). Movement therapy, which is crucial in spinal pain syndrome, is performed with less pain, after obtaining better patient mobility. The purpose of this article is to evaluate the role of rehabilitation of patients after spinal mesotherapy in terms of the three-stage treatment concept for spinal pathology. [ABSTRACT FROM AUTHOR]

Introduction: Vitiligo is a skin pigmentation disorder caused by the selective degradation of melanocytes. This study investigates the therapeutic effects of microneedling with and without N‐acetylcysteine (NAC) in patients with persistent and limited vitiligo. Method: This research employed a clinical trial design with double‐blind randomization. Individuals affected by vitiligo and seeking treatment at Rasool Akram Medical Complex were divided into two separate treatment groups. In the intervention group, 24 affected areas underwent meso‐microneedling using 5% NAC ampoules over six sessions, in addition to the application of 4.7% NAC cream once daily on the specified area. Conversely, the control group, consisting of 22 lesions, underwent microneedling using distilled water during six sessions. The severity of lesions and the extent of repigmentation were gauged using the Modified VETI Score. Assessment of treatment efficacy was determined through both physician evaluations and patient feedback. Results: Twenty patients with a mean age of 36.4 years were recruited. The mean percentage of lesions and their intensity were significantly improved 2 weeks after the third session and 1 month after the end of the treatment (p < 0.01). There was no statistically significant difference between the intervention and control groups. Gender, age, family history, duration of disease, duration of disease stability, and history of hypothyroidism had no statistically significant relationship with patients' treatment outcomes (p > 0.05). Conclusion: Microneedling with or without the application of NAC appears to be an effective treatment option for persistent vitiligo lesions. However, despite the higher improvement rate with the application of NAC, the difference was not significant. [ABSTRACT FROM AUTHOR]

Antioxidants (including Vitamin C, ferulic acid, and phloretin) are among the compounds used in skincare products. The purpose of this study was to evaluate the effect of a combination containing L-ascorbic acid, ferulic acid, and phloretin. The delivery of active substances was facilitated by micro-needle mesotherapy and sonophoresis. The study was completed by 22 volunteers. The study resulted in a significant reduction of erythema and an improvement in skin hydration. According to participants, the therapy yielded visible anti-aging effects. The combination of up to three antioxidant-active ingredients and the use of transdermal application methods proved to be both safe and effective. [ABSTRACT FROM AUTHOR]

Proposed as a non-invasive alternative to address a variety of patient concerns including cellulite, body sculpting, weight reduction and skin rejuvenation, mesotherapy remains a controversial therapy, with some arguing that it is ineffective at best and potentially dangerous at worst. However, other practitioners and researchers swear by its efficacy. Francesca Ramadan dives into the current evidence base, safety profile and applications of mesotherapy. [ABSTRACT FROM AUTHOR]

Background: Mesotherapy is a popular cosmetic procedure for localized delivery of substances. However, due to the lack of standardized processes, there are potential risks of adverse reactions. Granulomas formation is one of the chronic reactions which impose significant physical and mental burdens on patients. Objectives: The aim of this analysis is to evaluate the safety and feasibility of combining intense pulsed light (IPL) with intralesional corticosteroids for treating noninfectious granulomas after mesotherapy. Methods: This retrospective observational case series included patients who suffer from noninfectious granulomas after mesotherapy and received combination of IPL and intralesional corticosteroids treatment between October 2021 and December 2022 at Peking University Shenzhen Hospital, Shenzhen, China. The process and effect were analyzed and summarized. Results: Among the seven patients, five expressed extreme satisfaction with the efficacy, while two was slightly satisfied. The physicians believed that all patients had shown significant improvement. No adverse reactions or recurrences were observed during follow‐up. Conclusion: Based on this analysis, the application of the combined treatment in patients suffering from noninfectious granuloma due to mesotherapy demonstrates good clinical efficacy and safety, making it worth considering as a treatment option. [ABSTRACT FROM AUTHOR]

People with Neurofibromatosis Type 1 (NF1) suffer disfigurement and pain when hundreds to thousands of cutaneous neurofibromas (cNFs) appear and grow throughout life. Surgical removal of cNFs under anesthesia is the only standard therapy, leaving surgical scars. Effective, minimally-invasive, safe, rapid, tolerable treatment(s) of small cNFs that may prevent tumor progression. Safety, tolerability, and efficacy of 4 different treatments were compared in 309, 2-4 mm cNFs across 19 adults with Fitzpatrick skin types (FST) I-IV: radiofrequency (RF) needle coagulation, 755 nm alexandrite laser with suction, 980 nm diode laser, and intratumoral injection of 10 mg/mL deoxycholate. Regional pain, clinical responses, tumor height and volume (by 3D photography) were assessed before, 3 and 6 months post-treatment. Biopsies were obtained electively at 3 months. There was no scarring or adverse events > grade 2. Each modality significantly (P <.05) reduced or cleared cNFs, with large variation between tumors and participants. Alexandrite laser and deoxycholate were fast and least painful; 980 nm laser was most painful. Growth of cNFs was not stimulated by treatment(s) based on height and volume values at 3 and 6 months compared to baseline. Intervention was a single treatment session; dosimetry has not been optimized. Small cNFs can be rapidly and safely treated without surgery. [ABSTRACT FROM AUTHOR]

Introduction: Nowadays, a lot of body contouring devices and methods are introduced all over the world. The object of the present narrative review was to update and classify existing evidence on these methods and devices. Methods: We searched databases including PubMed, Cochrane, and Google Scholar for 11 essential keywords, including cryolipolysis, high-intensity focused ultrasound (HIFU), shock wave, low-level laser therapy (LLLT), radiofrequency (RF), capacitive resistive electrical transfer (TECAR), high-intensity focused electromagnetic (HIFEM), electromyostimulation (EMS), carboxytherapy, mesotherapy, and acupuncture and their abbreviations, in addition to obesity, overweight, cellulite, subcutaneous fat, and body contouring. Results: Totally 193 references were used in 11 main topics. Conclusion: In order to help physicians with finding the best evidence in different methods, the data were summarised in 11 topics. Furthermore, FDA-approved devices, side effects and common protocols were described in each section. Level of Evidence I: This journal requires that authors 39 assign a level of evidence to each article. For a full 40 description of these Evidence-Based Medicine ratings, 41 please refer to the Table of Contents or the online 42 Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Antony de Paula Barbosa, Isabela Espasandin, Lucas Pinheiro de Lima, Caroline de Souza Ribeiro, Lara Raquel Silva, Thalita Faria Quintal, Evenny Nascimento Lima, Láila Catarina Duarte Vieira, Thaina Ribeiro Soares, Anna Raphaella Autran Colaço Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210 BrazilCorrespondence: Antony de Paula Barbosa, Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Marco Aurélio de Miranda Street, 406/1104, Buritis, Belo Horizonte, Minas Gerais, 30575-210, Brazil, Email drantonybarbosa@gmail.comAbstract: Body Harmonization (BHA) is an innovative concept in aesthetics area based on a set of advanced injectable techniques that have shown promising results for body shaping. This is based on procedure combinations indicated to treat body aesthetic dysfunctions, such as localized fat, stretch marks, blemishes, flaccidity, buttocks remodeling, lean mass gain and muscle definition. This study aims to define the clinical concept of BHA, its applications and the main protocols used based on injectable pharmacotherapy. For this purpose, we performed a retrospective review of proven efficient injectable procedures with advanced results for the treatment of body aesthetic disorders, in addition to relying on data obtained from previous clinical experiences. Based on these data, we describe how different compounds can act for treatment of the main body aesthetic dysfunctions, such as lipolytic compounds and collagen biostimulators. In addition, the main application techniques and treatment protocols for each of these dysfunctions were defined. Minimally invasive injectable procedures offer an effective therapeutic option for patients who do not intend to undergo surgical interventions.Keywords: body harmonization, BHA, aesthetic dermatology, injectable pharmacotherapy, aesthetic dysfunctions, mesotherapy, bioestimulating fillers, thread

Abstract Background Physiologic gingival hyperpigmentation is a common esthetic concern that affects individuals of various ethnicities, and can have a significant impact on individual’s self-confidence and overall quality of life. Thus, this study aimed to clinically assess the effectiveness of intra-mucosal injection of vitamin C versus 980 nm diode laser for the management of physiologic gingival hyperpigmentation. Methods Twenty-six healthy non-smoker individuals with physiologic gingival hyperpigmentation were randomly assigned to two groups. Group I received intra-mucosal injection of vitamin C (L-Ascorbic acid 1000 mg/5 ml), and group II was managed using diode laser (980 nm, 1.5 W, continuous wave mode). Clinical evaluation of pigmentation intensity and distribution was performed preoperatively, and at 1, 2 and 3 months postoperatively using two different color assessment indices; Dummett-Gupta Oral Pigmentation Index (DOPI), and Gingival Pigmentation Index (GPI). Additionally, the study assessed pain intensity and patients’ satisfaction. Results Pigmentation scores decreased significantly between pre-operative visit and different follow-up visits for both treatment modalities (p

Objective: to assess the dynamics of the immune system functioning when using mesotherapy with peptide complexes. Materials and methods: the observation group consisted of 26 women (from 35 to 55 years old) who received a course of mesotherapy with preparations containing peptides for the first time. Injections were carried out in a course of 5 procedures with an interval of 14 days. The exclusion criteria were the absence of same manipulations in the past, hormone replacement therapy, combined oral contraceptives, pregnancy, lactation, acute infections, somatic pathologies. The parameters of innate and adaptive immunity were studied before the course of procedures, right after it, 3 and 6 months after the course. Skin quality changes were assessed using the Aramo Smart Lite 300 dermatoscope. Results: improved skin quality, decreased skin creases, increased skin moisture. The obtained clinical improvements last for three months after the end of the course and there is a tendency for the effects to decrease after six months. In the functioning of the immune system, there is a redistribution of lymphocytes population in the peripheral bloodstream immediately after the course of mesotherapy. In addition, an increase in peripheral T-regulatory lymphocytes responsible for intraimmune suppression was documented. The activation of spontaneous oxygen-producing activity was noted. 3 months after the procedure, no significant changes in immunological parameters were found. 6 months after the course of procedures, a decrease in the level of T-lymphocytes with an increase in the expression of markers of early T-cell activation was recorded. In the humoral link, an increase in circulating B-lymphocytes was documented. In the parameters of innate immunity, there is a decrease in the spontaneous oxygen-producing activity of neutrophils. Conclusion: as a result of the study, a positive persistent clinical effect is documented, simultaneously with the mobilization of factors of innate and adaptive immunity. It is important to note the fact that the immune response restores completely within 6 months after a course of mesotherapy with peptide complexes, with still noticeable clinical results.

Numerous scientific papers have compared different treatment options in the management of myofascial pain syndrome. This study evaluated the efficacy of Extracorporeal ShockWave Treatment (ESWT) and mesotherapy in patients with Myofascial Pain Syndrome (MPS) in terms of improvement in pain, functional capacity, and quality of life. A case–control study was conducted on 54 patients, who were randomized into 2 groups: group A, consisting of 27 patients, who were treated with 5 sessions of focal ESWT on a weekly basis; and group B, consisting of 27 patients, who underwent 5 sessions of mesotherapy with Thiocolchicoside fl 4 mg/2 mL and Mepivacaine fl 10 mg/1 mL on a weekly basis. Patients were evaluated at enrollment (T0), after 5 weeks, at the end of rehabilitation treatment (T1), and at a follow- up 30 days after the end of treatment (T2), by administering rating scales (Numeric Rating Scale (NRS) - Pressure Pain Threshold (PPT) – Short Form-36 (SF-36)). The results showed that focal ESWT and Mesoterapy are two valid and effective treatment options in reducing algic symptoms and improving short- and long-term quality of life. However, the use of ESWTs, despite being mildly painful but tolerated, has been shown to be superior to mesotherapy in terms of pain reduction and increased functional capacity.

Abstract Objective To determine whether intra-mucosal injection of injectable platelet-rich fibrin (i-PRF) can promote healing after Diode Laser Gingival Depigmentation (DLGD). Methodology A total of 20 arch sites of hyperpigmented gingiva of 10 patients underwent DLGD. For each patient, two arch sites were randomly assigned for either intra-mucosal injection of i-PRF (G1-i-PRF) (n=10 sites) or no treatment (G2-Control): (n=10 sites). Wound Healing Score (WHS), patient satisfaction, and Pigmentation Index (DOPI) were measured at 1 week and 1 and 3 months postoperatively. Histological assessment of tissue specimens was performed at baseline and 1 week. Results The percentage change in WHS at 1 week was significantly higher in G1 (58.34±15.43) compared to G2 (37.50±11.79). At day 1, 50% of patients in G1 were pain free compared with 75% in G2, who had mild pain. Mean DOPI decreased significantly at 3 months in both groups (P-value

Background: Low back pain syndrome is associated with muscular and myofascial pain and is linked with muscle overstrain or a lack of regular physical activity as well as a habitual bad posture, which cause the overload of perispinal soft tissues. One of the forms of therapy of LBP is the mesotherapy of the spine, which consists of multi-point micro-injections of drugs or medicine mixtures, which include preparations of collagen type I. The aim of the study was to assess the efficacy and safety of mesotherapy with collagen type I. Methods: A retrospective analysis of the results of the treatment of patients with chronic low back pain syndrome using mesotherapy was performed. A total of 130 patients (83 women and 47 men; mean age: 51 ± 14 years) were divided into two groups: group I (n = 65), treated with collagen type I, and group II (n = 65), treated with lignocaine 1%. Mesotherapy was performed weekly over five weeks. Patients were assessed using the following scales: the VAS, Laitinen Scale, and Revised Oswestry Low Back Pain Disability Scale before the start of the treatment, after five treatments, and at the three-month follow-up visit. Results: A statistically significant improvement was observed after the use of spinal mesotherapy both with collagen type I and lignocaine, with the collagen treatment having better results at the three-month follow-up visit. No adverse effects were observed after the procedures. Conclusions: Spinal mesotherapy using collagen type I and lignocaine seems to be an effective method in the treatment of chronic LBP. Collagen mesotherapy gives better results in the long term. Mesotherapy is a safe form of therapy. [ABSTRACT FROM AUTHOR]

Objective: Microneedling with topical tranexamic acid (TXA) is a novel treatment option for melasma; however, the efficacy and safety of this combined administration therapy is in controversial. This study is conducted to address this issue of this technique in melasma. Methods: An extensive literature review was performed to identify relevant trials, including randomized split‐face studies, randomized controlled trials and prospective non‐randomized split‐face studies, comparing microneedling plus topical TXA to routine treatments or placebo. The primary outcomes were changes of the Melasma Area Severity Index (MASI)/modified MASI (mMASI)/hemi MASI between before and after treatment, as well as the changes between a particular treatment and microneedling plus TXA. The mean differences (MDs) and 95% confidence intervals (CIs) were calculated for the reduction of melasma severity scores from baseline to each time point. In contrast, the standard mean differences (SMDs) and 95% CIs were calculated for the differences in reduction in melasma severity scores between the experimental and control groups at each time point. Results: A total of 16 trials were included in the systematic review and data synthesis. The pooled analysis demonstrated that MASI, mMASI, and hemiMASI scores decreased significantly at 4 weeks (MD = 1.85; 95% CI = 1.15–2.54), 8 weeks (MD = 3.28; 95% CI = 2.31–4.24), 12 weeks (MD = 4.73; 95% CI = 2.79–6.50), 16 weeks (MD = 3.18; 95% CI = 1.50–4.85), and 20 weeks (MD = 3.20; 95% CI = 1.95–4.46) after treatment when compared with baseline. The reduction in melasma severity scores of microneedling with TXA group at 4 weeks was more significant than the routine treatment group (SMD = 0.97; 95% CI = 0.09–1.86), while insignificant at 8 weeks (SMD = 1.21; 95% CI = −0.17 to 2.59), 12 weeks (SMD = 0.63; 95% CI = −0.03 to 1.29), 16 weeks (SMD = 0.61; 95% CI = −2.85 to 4.07), or 20 weeks (SMD = 1.04; 95% CI = −1.28 to 3.36). Conclusion: Despite the high heterogeneity across these studies, the current findings indicated that microneedling with topical TXA is an alternative treatment option for melasma treatment; and more well‐designed studies are needed to confirm it. [ABSTRACT FROM AUTHOR]

This case series evaluated use of injectable platelet rich fibrin (termed i-PRF+) for the treatment of female pattern hair loss (FPHL). Eleven individuals underwent 3-monthly intradermal injections of i-PRF+ using a mesotherapy gun. The mean number of hair follicles containing hairs per unit area improved at 3- and 6-months follow-up (p <.001), and all participants had a negative hair pull test. Hair volume and thickness, and patient-reported outcome scores also improved at follow-up (p <.001). Adverse effects were minor and self-limited. A series of three i-PRF+ injection sessions were effective for the treatment of FPHL, as shown by improved hair analysis parameters and patient self-assessment scores. [ABSTRACT FROM AUTHOR]

Background: Mesotherapy is a procedure or a process of injecting drugs into the skin. This technique can help decrease the total drug dose due to its drug-sparing effect on the systemic route and can be utilized to treat nonspecific neck pain that occurs in the lateral and posterior neck. Methods: Ten patients with bilateral cervicobrachial pain were recruited and evaluated at T0 before treatments, T1 at the end of the treatment (42 days after T0), and T2 (72 days after T0). Assessments consisted of performing the Visual Analogue Scale (VAS) to evaluate pain evolution; a range of movement (ROM) and Bilateral trapezius' tone, elasticity, and dynamic stiffness mensuration were performed using MyotonPro®. All patients underwent mesotherapy treatment in the trapezius muscles with 1 cc of Diclofenac Sodium and 1 cc of lidocaine diluted in 3 cc of saline for a total of 6 weeks. Results: VAS value statistically decreased at T1 and T2; ROM of neck flexion statistically increased at T1 and T2, and miometric tone and stiffness value statistically improved at T1 and T2. Conclusion: mesotherapy with Diclofenac Sodium reduced pain intensity and improved functional outcomes, with no significant adverse effects in patients with myofascial pain syndrome of cervicobrachial localization. [ABSTRACT FROM AUTHOR]

Pressure-induced alopecias (PAs) are an infrequent group of scarring and nonscarring alopecias that occur after ischemic obstruction of capillaries that leads to circumscribed areas of hair loss. Initially described after prolonged surgeries or immobilization, type 1 PA occurs after sustained external pressure to the skin, mainly the scalp prominences. Alopecia induced by cosmetic procedures, referred in this review as type 2 PA, is reported with increased frequency in literature and predominantly emerges from pressure exerted by the volume of injectables. It is important to differentiate type 2 PA from vascular occlusion-induced alopecia because they represent distinct entities. Clinically, PA may present with erythema, swelling, and tenderness; however, alopecia might be the sole manifestation. Crusts and ulceration are associated with a worse outcome and a higher risk of scarring alopecia. Prompt diagnosis is paramount to prevent complications. Trichoscopy, although considered nonspecific, may provide relevant clues for an accurate diagnosis. Hair regrows in most cases, but prognosis depends on ischemia severity and timely treatment with reperfusion therapies or mobilization. Treatment of hair loss is usually not necessary because the disease in most cases is self-limited and reversible. The role of topical minoxidil and corticosteroids remains unknown. [ABSTRACT FROM AUTHOR]

Background: Peri orbital hyperpigmentation (POH) is a common presentation in dermatological outpatient departments and has multiple causes. Finding an appropriate treatment for POH can be challenging and requires a case-based approach. The objective of this research was to study the effect of Biofiller vs. PLATELET-RICH plasma meso-therapy in the treatment of Peri-orbital hyperpigmentation. Our hypothesis was "Biofillers are better than platelet-rich plasma therapy in the treatment of peri-orbital hyperpigmentation". It was a double-blinded randomized Control Trial (IRCT20230816059168N1) carried out in the Dermatology OPD of a tertiary care hospital in Rawalpindi over 4 months, i.e., 10.07.23 to 10.10.23. Methods: Forty-two patients meeting the inclusion criteria were included in the study after taking informed consent. Sampling was done by non-probability randomized sampling using the lottery method. 21 patients were treated with Bio fillers and another 21 with platelet-rich plasma therapy (PRP). Sessions with a 2-week interval were done in each case and results were analyzed by peri-orbital photo-metric pigmentation scale and clinical grading improvement scale rated by a physician. Patient satisfaction and complications were also recorded. Results: Statistically significant difference in results of Group A as compared to Group B, regarding improvement in photo numeric scale, evaluation of efficacy by a blinded dermatologist and patient satisfaction, i.e., p= 0.001, 0.014 and 0.001 respectively. In group A, pain was reported by 3 (14.3%), bruising by 1 (4.76%) and lumps by 2 (9.5%). PRP treated group had more side effects, i.e., 9 (42.8%) reported pain, 6 (28.6%) bruising and 4 (19%) more than one complaint (p-0.001). Conclusion: Biofillers are better than PRP in the treatment of POH. [ABSTRACT FROM AUTHOR]

Ultrasonography is a well-tolerated procedure that aids in the targeted esthetic therapies of special cutaneous regions, as well as in the prevention (vascular mapping, identification of previous filler, and others) and management of potential complications (vascular occlusion, external vascular compression, product misplacement or migration, inflammatory reactions, and others). It has lately been promoted as the first-line imaging tool to address injectables. In this article, we aim to review the evolving role of ultrasonography in cosmetic filler procedures, from the fundamental ultrasound characterization of cosmetic fillers to the ultrasound-enhanced detection and management of cosmetic filler complications, including ultrasound's role in hyaluronidase-guided injections for cosmetic filler dissolution. Furthermore, the paper explores the integral role played by ultrasound in enhancing the precision, efficacy, and safety of additional minimally invasive aesthetic techniques such as mesotherapy, radiofrequency, cryolipolysis, and polydioxanone procedures. [ABSTRACT FROM AUTHOR]

Body Harmonization (BHA) is an innovative concept in aesthetics area based on a set of advanced injectable techniques that have shown promising results for body shaping. This is based on procedure combinations indicated to treat body aesthetic dysfunctions, such as localized fat, stretch marks, blemishes, flaccidity, buttocks remodeling, lean mass gain and muscle definition. This study aims to define the clinical concept of BHA, its applications and the main protocols used based on injectable pharmacotherapy. For this purpose, we performed a retrospective review of proven efficient injectable procedures with advanced results for the treatment of body aesthetic disorders, in addition to relying on data obtained from previous clinical experiences. Based on these data, we describe how different compounds can act for treatment of the main body aesthetic dysfunctions, such as lipolytic compounds and collagen biostimulators. In addition, the main application techniques and treatment protocols for each of these dysfunctions were defined. Minimally invasive injectable procedures offer an effective therapeutic option for patients who do not intend to undergo surgical interventions. [ABSTRACT FROM AUTHOR]

The article discusses the importance of recommendations and guidelines for the practice of hair loss (Androgenetic Alopecia). It emphasizes that guidelines are based on extensive studies and provide an overview of therapies and active ingredients. However, there is a gap between theory and practice in certain treatments such as mesotherapy and PRP due to the lack of standards. The authors emphasize the importance of statistical insights from practice to complement recommendations. It also reports on a new tablet that blocks the cytokine IL-23 and represents a promising treatment option for chronic inflammatory diseases such as psoriasis vulgaris. [Extracted from the article]

Mesotherapy is a popular novel therapeutic modality that delivers intradermal or subcutaneous microinjections of pharmaceutical compounds. Although this novel treatment method is used commonly in aesthetic dermatology, there is little information about the details of injections, efficacy, and side effects of mesotherapy in melasma. In this review, we evaluated the efficacy of various types of anti-pigmentation agents used with mesotherapy in the management of melasma. [ABSTRACT FROM AUTHOR]