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OBJECTIVES Melasma is a chronic acquired condition characterized by grayish-brown macules and patches with a distinct border on the face. Although various treatments methods have been suggested for treating melasma, none has been completely successful. The aim of the study was to compare the efficiency of erbium: yttrium-aluminum-garnet (Er:YAG) laser and 4% hydroquinone (HQ) with the effects of intradermal tranexamic acid (TA) and 4% HQ for the treatment of refractory melasma. METHODS The study included 31 female patients with refractory melasma. The left or right side of the patient's face was chosen randomly to receive laser therapy with topical HQ on the one side (i.e., the laser side) and intradermal injection of TA plus topical HQ on the other side (i.e., the mesotherapy side). Digital photography was performed at baseline, at the end of the treatment, and three months after the treatment as follow-up. Two independent dermatologists evaluated the modified Melasma Area and Severity Index (mMASI) score according to the pictures. Overall, 27 patients completed the study and went through the clinical evaluation. RESULTS Treatment using HQ in combination with either Er:YAG laser therapy or intradermal injection of TA significantly improved the hemi-mMASI and resulted in higher patient satisfaction. While the improvement was not significantly different between the two regiments after the treatment and upon follow up and both were equally efficient in the treatment of refractory melasma (p = 1.308), recurrence rate was higher after treatment with Er:YAG laser than TA (12% vs 34%). CONCLUSION This study confirmed the comparable efficacy of TA plus topical HQ versus Er:YAG laser plus topical HQ for the treatment of refractory melasma. Both groups improved significantly and no subject left the treatment because of adverse effects.

BACKGROUND:Migraine is a prevalent disabling primary headache disorder that is classified into two major types: migraine without aura and migraine with aura. New therapeutic methods to reduce migraine headaches in the emergency department (ED) include intradermal mesotherapy.OBJECTIVE:Compare the efficacy of intradermal mesotherapy versus a systemic therapy in pain control in patients with headache related to migraine without aura.DESIGN:Prospective parallel-group randomized controlled trial.SETTING:University hospital in Turkey.PATIENTS AND METHODS:Patients 18 years of age and older who were admitted to the ED over a 15-month period with headache related to migraine without aura were eligible for inclusion if they had a VAS score of 4 or above. Patients were randomly allocated to one session of mesotherapy or intravenous dexketoprofen. Changes in pain intensity were measured by the score on a visual analog scale (VAS) at 30, 60, and 120 minutes and 24 hours after treatment. Efficacy was also assessed by the need for use of an analgesic drug within 24 hours, by readmission with the same complaint to the ED within 72 hours, and by adverse effect rates.MAIN OUTCOME MEASURE:Pain intensity on the VAS scale.SAMPLE SIZE:148 patients (154 enrolled and treated; 1 patient in the mesotherapy and 5 patients in the systemic therapy group lost to follow up).RESULTS:Pain intensity on the VAS scale decreased from a median score of 8 to 4 in the mesotherapy group and from 8 to 5 in the systemic therapy group. These differences were statistically significant from baseline for all time intervals (P=.001 to 30 minutes,P=.004 to 60 minutes,P=.005 to 120 minutes, andP=.002 to 24 hours). The need to use analgesics and the rate of readmission to the ED were higher in the systemic therapy group (P=.013 andP=.030, respectively). Adverse effect rates were minimal and similar in the study groups during the one-week follow-up period.CONCLUSIONS:Mesotherapy is more efficacious than intravenous dexketoprofen in the management of acute attack of migraine without aura in the ED.LIMITATIONS:Unblinded. Valid for assessing short-term pain relief, but not sufficient to predict long-term efficacy. Not generalizable because single center and small sample size.CONFLICT OF INTEREST:None.REGISTRATION:ClinicalTrials.gov(NCT04519346)

Background Treatment options for erythematotelangiectatic rosacea (ETR) are still scarce. Tranexamic acid (TXA) is an antifibrinolytic drug that was recently used for the treatment of ETR. Aims to evaluate the efficacy and safety of intradermal microinjections of TXA for ETR. Patients/methods This was a retrospective study enrolling patients, treated with TXA intradermal microinjections for ETR, from January 2019 to February 2020. Response to treatment was assessed based on subjective symptoms, clinical photographs and the Investigator Global Assessment of Rosacea Severity Score (IGA-RSS). Results Six patients were included. The mean number of monthly intradermal TXA microinjections was 5.1±1.3. The mean decrease of IGA-RSS was 2.4±0.5. Local side effects, mainly transient erythema and swelling, were noticed in three cases. No systemic effects were noted. Clinical improvement, in respondent patients, lasted after 3 months of follow-up. Conclusion Intradermal TXA microinjections is a safe and effective treatment option for ETR. The optimal number of monthly sessions has yet to be determined.

Introduction Corticosteroid-induced rosacea-like dermatitis (CIRD) is one of the cutaneous side effects of long and excessive application of topical corticosteroids, resembling rosacea that can present with a series of cutaneous manifestations. Most patients with CIRD undergo a variety of long-term treatments before their symptoms are relieved as there is no accepted standard therapy. We gave each of seven patients two sessions of platelet-rich plasma (PRP) mesotherapy before the routine treatment to restore their skin barrier function, and we were surprised to find that the patients’ symptoms and appearance were significantly improved without any further treatments. Here we report this unexpected finding in dealing with CIRD. Case Presentation Seven patients, one male and six female, who had history of applying topical corticosteroids on the face for more than 3 months continuously or intermittently for various reasons were diagnosed with CIRD, showing varying degrees of erythema, telangiectasia, and papules, with dry skin, pain, and burning or stinging sensation. We intended to use the restorative effect of PRP to restore the skin barrier function of the patients for further treatment such as tacrolimus ointment, intense pulsed light (IPL), or pulsed dye laser (PDL), so they were treated twice with PRP intradermal injections using a mesogun injector machine. We used the VISIA skin detector to photograph and compare the changes after the treatments. Clinical efficacy was also assessed by the Global Aesthetic Improvement Scale (GAIS). Patients’ assessments were recorded using three-point scale questionnaires. After two sessions of PRP treatment, before any further treatment, we were surprised to find that the patients' symptoms had improved significantly, as confirmed by VISIA skin detector and GAIS. All of the patients were satisfied with the outcomes, considering that mesotherapy was not painful and their appearance and symptoms had much improved. Conclusions PRP mesotherapy may mitigate sensitivity and inflammation in patients with CIRD by reducing erythema, telangiectasia, and papules. It is worth conducting large randomized controlled trials to verify its safety and efficacy in treating corticosteroid-induced rosacea-like dermatitis and maybe rosacea.

Intradermal injection of autologous platelet-rich plasma (PRP) is a non-surgical cosmetic therapy to rejuvenate the periorbital area pathologies of wrinkles, periorbital hyperpigmentation (POH), and photoaging. The past decade has seen the adoption of this novel therapy around the world. This is the first systematic review and meta-analysis evaluating PRP treatment of periorbital pathologies. This is a PRISMA compliant review that includes a comprehensive search of the databases Cochrane Library, Ovid Medline, Ovid Embase, and clinicaltrials.gov. The search was performed in June 2019 to obtain all peer-reviewed articles published in English that describe the application of PRP to periorbital pathologies. A meta-analysis of patient satisfaction was performed for randomized controlled trials. Nineteen studies treating 455 patients (95% female, age range 28–60) were included. Studies were categorized based on reported outcomes: wrinkles (11 studies), POH (7 studies), and photoaging (6 studies). Patients were treated a mean of 3 times (range 1–8) in mean intervals of 23 days (range 14–56 days). Follow-up averaged 3 months (range 1–6 months). Meta-analysis of 3 randomized controlled clinical trials (RCTs) shows that patients treated with PRP have increased satisfaction above controls of saline, platelet-poor plasma, mesotherapy, and as an adjunct to laser therapy (overall effect p = 0.001, heterogeneity I2 = 64%). PRP treatment of periorbital area pathologies results in histologic improvements of photoaging, subjective satisfaction score increases, and blind evaluator assessments of rejuvenated skin appearance. Future studies are needed to address limitations of the current literature and should include long-term follow-up, delineation of the POH etiology that is treated, RCTs with low risk of bias, and be absent conflicts of interest or industry sponsors. Trial registration: Prospero Systematic Review Registration ID: CRD42019135968

Introduction. The sufficiency of vitamin D is important for slowing down the aging of the skin, maintaining its hydration, elasticity and the ability to regenerate. Biologically active forms of vitamin D (including alfacalcidol) promote the activation of genes whose function is directly related to the maintenance of the structure of the skin, subcutaneous tissue, fascia and muscle fibers.The aim of the work was to assess the prospects for the inclusion of alfacalcidol (“Alpha D3”, 0.25 μg, 1 caps/day) in the rehabilitation programs of patients with age-related ptosis of the face (n = 40, age 47 ± 5 years).Materials and methods. 4 groups of patients with age-related facial ptosis (n = 40, average age 47 ± 5 years) were observed for 60 days; measurements were made before and after clinical trials. Group 1A (first treatment, n = 12) received the daily dose of Alpha D3, 0.25 mg, in the morning, for 60 days, during this period the patients received 4 cosmetic procedures (2 plastic face massages and 2 stimulation current therapies). Group 1B (first control, n = 8) received only 4 cosmetic procedures over 60 days (2 plastic face massages and 2 stimulation current therapies). Group 2A (second treatment, n = 12) received the daily dose of ALFA D3, 0.25 mg, for 60 days, during this period the patients received 4 DMAE (diethylaminoethanol) mesotherapy procedures. Group 2B (second control, n = 8) only received 4 DMAE (diethylaminoethanol) mesotherapy procedures.Results. Alfacalcidol intake significantly increased the concentrations of 25 (OH) D (from 17 ± 5 ng/ml to 27 ± 8 ng/ml, P = 0.001) and calcium (from 86 ± 10 mg/L to 96 ± 6 mg/L, P = 0.01) in serum. The positive dynamics of the concentrations of 25 (OH) D and calcium when taking alfacalcidol corresponded to an increase in the total bone mineral density (+ 0.03 ± 0.03 g/cm3, control: + 0.006 ± 0.03, P = 0.016) and T-criterion (+0.4 ± 0.5, control: -0.07 ± 0.2, P = 0.0002), which indicates compensation for vitamin D deficiency and an improvement in bone metabolism. An increase in the levels of 25 (OH) D and calcium when taking alfacalcidol was accompanied by a positive trend in skin condition according to bioimpedance measurements. Taking the drug significantly increased the moisture content of the facial skin (from 17 ± 14 points to 29 ± 14 points, P = 0.055, without changes in the control) and increased the amplitude of the muscle motor response to the stimulus (+ 0.24 ± 0.22, P < 0.02).Conclusions. Within the framework of a randomized design, it was shown that the addition of massage, microcurrent therapy, mesotherapy with alfacalcidol led to a significant increase in serum 25 (OH) D levels, an increase in skin elasticity and hydration, a decrease in visceral fat according to bioimpedance measurements, and an improvement in indicators of muscle contractility and neuromuscular signal transmission according to electromyography data and an increase in bone mineral density.

Hand eczema is a recurrent and resistant disease that seriously affects the quality of life of patients; currently, there are no ideal treatments for hand eczema. Here, we describe two patients who presented with hand eczema to illustrate the potential efficacy of mesotherapy with snake venom pharmacopuncture (SVP). A 23-year-old woman (Case 1) and a 47-year-old woman (Case 2) presented to the clinic with symptoms of pruritic rash, blis-ters, and itchiness on both the hands and the left hand, respectively. Both patients were diagnosed with hand eczema based on the physical examination of blisters and redness only on the hands. The patients underwent 1 month (Case 1) and 1 week (Case 2) of mesotherapy with SVP. After treatment, the lesions completely improved and did not recur at 1 year of follow-up. These outcomes suggest that mesotherapy with SVP may be effective for the resolution of hand eczema; however, further research is needed to confirm these findings.

Background Achilles tendinopathy (AT) is considered the commonest tendon pathology, occurring mainly in athletes. Different conservative treatment options have been introduced but with short-term effects; however, extracorporeal shockwave therapy (ESWT) and mesotherapy (MT) injections were claimed to provide longer effects and could be used in cases failure of response to conservative treatments. The objective of our prospective 12-week study was to compare the effect of ESWT and MT on chronic Achilles tendinopathy in athletes by both clinical and ultrasonographical assessment. Results Forty patients with chronic AT diagnosed clinically and with high-resolution ultrasound (US) randomly allocated in two groups first received weekly ESWT session, and the other group underwent weekly MT sessions for 4 consecutive weeks. Both groups improved during the treatment and follow-up period. The mean visual analogue score (VAS) decreased in both the ESWT group and the MT group. Mean American Orthopedic Foot and Ankle Society (AOFAS) hindfoot score and VAS scores were not significantly different between ESWT and MT groups at the 4th and the 12th week of follow-up. However, US assessment significantly improved after 12 weeks in the ESWT group (as regards tendon thickness, calcifications, and Doppler signal), and for the mesotherapy group, there was the only improvement of tendon thickness. Conclusion ESWT showed improvement of pain and inflammation and calcifications of AT than MT injections, which was documented by US improved findings at week 12 follow up.

This study was aimed at evaluating the efficacy of Tranexamic Acid (TA) mesotherapy versus cysteamine 5% cream in the treatment of melasma. This single-blind, randomized clinical trial was conducted among 54 subjects between 2018 and 2019. Cysteamine 5% cream group was instructed to apply the cream on the melasma lesions 30 min before bed for 4 consecutive months. Conversely, 0.05 mL (4 mg/mL) TA mesotherapy was performed by a physician every 4 weeks until 2 months. The severity of melasma was evaluated using both Dermacatch® device and the modified Melasma Area Severity Index (mMASI). The most remarkable improvement rate was observed in the TA group at the third visit based on mMASI and Dermacatch® values at 47% and 15% in turn. The mMASI scores were substantially improved in both groups at the second visit (cysteamine vs TA 8.48 ± 2.34 and 7.03 ± 3.19; P = 0.359) and third visit (cysteamine vs TA 6.32 ± 2.11 and 5.52 ± 2.55; P = 0.952) as compared to baseline (cysteamine vs TA: 11.68 ± 2.70 and 10.43 ± 2.69). Dermacatch® values were significantly declined at the second and third visits (cysteamine vs TA 42.54 ± 12.84 and 38.75 ± 9.80, P = 0.365; 40.74 ± 12.61 and 36.17 ± 10.3, P = 0.123, respectively) compared with baseline (cysteamine vs TA 45.76 ± 13.41 and 42.41 ± 10.48), although the improvement rates between two groups were not significantly different. Findings suggest that none of the cysteamine and TA mesotherapy treatments measured by both mMASI and Dermacatch® methods have substantial advantages over the other; however, complications are less in the cysteamine than the TA mesotherapy group.

Introduction. Knee osteoarthritis (KOA) is one of the most common degenerative diseases that lead to pain and disability. Oral NSAIDs are effective drugs used to alleviate symptoms in patients with KOA, but they have several important complications, especially in the elderly. In this study, we evaluated the effectiveness of mesotherapy on pain reduction and improvement of functioning in patients with KOA. Methods. Sixty-two patients with KOA, grade 2-3 of the Kellgren–Lawrence scale, were randomized into two groups: the mesotherapy group, in which two injections were applied with piroxicam at a 10-day interval, and the oral group, in which piroxicam was prescribed for 10 days. The patients were evaluated before the treatment and 2, 4, and 8 weeks after it using the Visual Analogue Scale (VAS), Oxford Knee Scare (OKS), and Western Ontario McMaster University Osteoarthritis Index (WOMAC, Persian version). Results. There was no significant difference in demographic characteristics and baseline pain and function scores between the two groups. After 2, 4, and 8 weeks of follow-up, VAS, WOMAC, and OKS scores significantly improved in both groups (in the mesotherapy group: p value p value p value p value p value p value Conclusion. Mesotherapy is an effective and safe treatment modality in patients with mild-to-moderate KOA in the short term. This trial is registered with IRCT2017052434113N1.

Pain evaluation during local injections is a complex process. Injections cause patient's distress, especially when the target is a sensitive area such as scalp. Nonpharmacological methods as vibration before and during the procedure have been used to reduce pain. Mesotherapy has become a popular nonsurgical procedure for nonscarring alopecia, such as androgenetic alopecia (AGA) and alopecia areata (AA). Vibration has been successfully used in dermatological procedures, pediatrics, and dentistry. No study was found on vibration anesthesia during scalp mesotherapy. To analyze the effect of a vibration anesthetic device (VAD) during scalp mesotherapy on the patients' comfort.This is a randomized split-scalp study; thirty patients received mesotherapy with or without VAD on half of their scalp. Numerical rating scale (NRS) was used to measure self-reported pain. To test difference in means and medians in comparing device use and by treatment (AGA or AA), Student's t tests and Wilcoxon signed rank tests were used. Overall mean pain score on the no vibration-assisted side was 8.0 ± 1.0 while pain score for the vibration side was 2.3 ± 1.5, for AGA (P < .001) and 7.4 ± 1.2 and 2.1 ± 1.3, respectively, for AA (P < .001). Findings were similar for medians. No complications were found following procedure. To the best of our knowledge, this is the first study analyzing the effect of VAD in patients undergoing scalp mesotherapy. The VAD technique was found to be safe, effective, simple, and suitable for scalp procedures.

Background: Fibromyalgia is the second most common disease encountered in rheumatology practice Aim: This study designed to assess the potential effect of mesotherapy in treatment of tender points in primary fibromyalgia (PFM) patients. Methods: Thirty PFM patients who fulfilled the American Colleague of Rheumatology 1990 criteria, joined this study. They were divided into 2 groups randomly according to the treatment program received; Injection mesotherapy group (Group I: No=15 patients) who received a mixture of 2 ml of Ketoprofen (100mg/2ml) added to 3 ml of Saline Solution, once cession per week for a total of 6 successive weeks and other 15 patients (Group II) who received Ketoprofen 100 mg Extended- Release capsules once daily for 2 successive weeks which represent the control group. Patients‟ pain severity, quality of life and depression were assessed using visual analogue scale (VAS), fibromyalgia impact questionnaire (FIQ) and the Hamilton Rating Scale (HDRS) respectively before treatment and after the 3rd & the 6th cession then data were recorded and compared. Results: We found significant improvements (p

Atrophic scars, a permanent complication of severe acne, have negative effect on psychology in adolescent. The treatment of atrophic scar is depended on types of scar and it is difficult to improve by a single treatment. Mesenchymal stem cell is a scientific approval for surgery scar treatment and wound healing. We present a case report of female presented with atrophic acne scar distributed on both cheeks. The case aims to prove that the combination of MSCs and aqueous human placenta extract (RGF&#174) contained bioactive therapeutic molecules obviously promoted the improvement of skin scar to reach the optimal outcomes. We first found that MSCs-contained human placenta extract solution combination subcision improves the atrophic acne scar and skin complexity by enhancement of skin cell regeneration.

Introduction Vitiligo is one of the most common hypomelanoses. Current treatments include ultraviolet, topical corticosteroids, calcineurin inhibitors. Orally administered vitamins, acting as anti-oxidants and in combination with ultraviolet light have also demonstrated skin re-pigmentation. In our pilot study of seven patients, we injected skin affected with vitiligo intra-dermally with a complex of vitamins and minerals and assessed the outcome. Aim The aim of this study was to evaluate a novel treatment modality for vitiligo. Methods We present a pilot study of seven patients; each having been diagnosed with generalized progressive vitiligo. In all cases, multiple therapies had been previously attempted. All patients were subjected to intradermal injections of biorevitalizant NCTF 135 (3 mls) in the hypo-pigmented areas of skin, once a week for 5 weeks. A 30Gx13 mm needle was used for the 0.025 mls intradermal injections to create micro-papules with a 1 cm distance between the injection sites. The results were assessed at 2 weeks and 5 weeks and were considered successful if partial or complete repigmentation was achieved. Results Partial or complete skin re-pigmentation post-treatment was observed in vitiligo macules of all patients (100%). No significant side effects, or exacerbation of vitiligo were observed during or after treatment with NCTF 135 in the following 6 months (five patients) and 12 months (two patients). Discussion Increasing the armamentarium of new treatments of vitiligo is important. Previous studies showed the effectiveness of oral and intramuscularly injected multivitamins in the treatment of vitiligo, explaining the results by the antioxidative qualities of the above. Our study demonstrated that intradermal mesotherapy injections of NCTF135, rich with vitamins and other antioxidants are well tolerated and effective in achieving significant re-pigmentation of de-pigmented skin in all patients studied, including five who had been resistant to previous standard therapies.

“Injection lipolysis” or “mesotherapy” is done for introducing various substances into deeper layers of the skin with the aim to dissolve subcutaneous fat. However, the safety profile of these chemicals is poorly regulated. Therefore, they may cause side effects or long-term sequelae that can be disastrous for the patient. We present such a case that required surgical management to salvage it and to give an aesthetically acceptable result.

Microneedling can accelerate skin repair through numerous complex processes triggered by micro-injuries it produces on the skin surface with very thin needles. The current growth in the application of microneedling in the treatment of cutaneous diseases can be explained by its numerous effects on the skin as reported in the literature. Despite the numerous studies conducted on the application of microneedling in the treatment of skin lesions, its effects on pigmented skin lesions have remained relatively unexplored. The present review comprises an examination of the evidence for the application of microneedling in skin diseases in general and a comprehensive review of the applications of microneedling in pigmentation disorders. The review involved a search of all clinical studies, including trials, case reports, and case series, in the databases MEDLINE/PubMed and Google Scholar using the following keywords: "microneedling", "dermal needling", "percutaneous collagen induction", "skin needling", "dermaroller", and "dermatology disorder". Pertinent data were extracted from all relevant articles published from 1990 to April 2021, and focused on the application of microneedling in the treatment of pigmented skin lesions. Despite the limited number of available studies, evidence suggests the effectiveness and safety of microneedling in treating vitiligo, melasma, and periorbitalhypermelanosis. It is noteworthy that the combination of any type of non-aggressive needing technique with other effective therapies (especially topical agents and mesotherapy) yields more promising therapeutic results than single therapy for melasma, dark cycles and vitiligo as the prototype of pigmentary disorders. However, single needling therapy is significantly effective, too. This article is protected by copyright. All rights reserved.

BACKGROUND Melasma is a common hyperpigmentation disorder. This study aimed to compare the efficacy of Nd-Yag fractional 1064 plus microinjection of tranexamic acid versus Nd-Yag fractional 1064 plus oral tranexamic acid in patients with melasma. MATERIALS AND METHODS This is a prospective, randomized study with a sample size of 40 patients, 20 in each treatment arm, which was done six times with 2-week intervals. Twenty patients were administered localized microinjections (4 mg/ml) of tranexamic acid and Q-switched 1064 laser every 2 weeks in one arm, while in the other arm, 20 were given oral tranexamic acid 250 mg three times a day and Q-switched 1064 laser every 2 weeks per visit. RESULTS Twenty-one patients with mean SD 40.52+-4.95 y/o were treated with oral tranexamic acid, and 20 patients with 43.3+-5.87 y/o treated with microinjection of tranexamic acid were analyzed. There was no statistically significant difference between the two groups in terms of demographic and clinical characteristics at the baseline (p > 0.05). The patients MASI score and ∆E decrease over the study period in both treatments significantly (p

A 28-year-old white female patient presented with multiple erythematous-to-violaceous, painful, suppurative nodules on the buttocks and thighs that appeared after two weeks of mesotherapy with deoxycholate, caffeine, sunflower liposomes, and sinetrol for localized fat. She was treated for atypical mycobacteriosis, but with no satisfactory response after antibiotic therapy. Bacterial, mycobacterial, and fungal culture were all negative. Histopathologic examination of the biopsy showed noninfectious suppurative panniculitis. It resolved after treatment with methotrexate, prednisone, and hydroxychloroquine. This report highlights the rarity of this complication, the importance of its early recognition, and differentiation with atypical fast growing mycobacterioses.

Background Mesotherapy can be included as an ancillary treatment in the management of localized pain in rehabilitation, but there are no definitive treatment protocols for this approach. Objectives The purpose of this review was to examine new indications for more standard protocols of mesotherapy in rehabilitation. Materials and methods This systematic review was performed using the following resources: PubMed, Cochrane, PEDro, Scopus, and Google Scholar. The following algorithm was developed, based on the PICO acronym, to evaluate the effects of mesotherapy, with pain as the primary outcome (MESH terms): [mesotherapy AND pain], [mesotherapy AND musculoskeletal], [mesotherapy AND musculoskeletal disorder], [intradermal therapy AND pain], and [intradermal therapy AND musculoskeletal disorder]. Results Seven articles (N=7) satisfied the inclusion criteria and were considered in the review: two of them treated osteoarthritis of the knee (3 sessions) and pes anserine (9 sessions) emphasizing a good efficacy of mesotherapy. Five studies analyzed spine diseases (specifically, two was about chronic and nonspecific neck pain, two about acute low back pain and one about chronic spinal pain): the results of mesotherapy treatment are encouraging both for the resolution of acute and chronic musculoskeletal vertebral pain from one to five sessions. Conclusion Mesotherapy showed a good effect to reduce acute and chronic musculoskeletal pain and, also, it is a well-tolerated treatment. Nonetheless future randomized controlled trials should be desirable for more uniform treatment protocols.

Any cosmetic procedure, which is accompanied by damage to the skin barrier, carries the risk of attaching not only bacterial, but also fungal or viral infections. According to a number of authors, most often these complications occur after intradermal injections, mesotherapy, ablative laser procedures, tattooing, and account for about 5 % of the total number of manipulations. Objective: to evaluate the effectiveness and safety of using Tetraderm® cream in patients with infectious and inflammatory complications after various cosmetic procedures. Material and methods. The study included 28 patients (24 women and 4 men) aged from 18 to 65 years with infectious and inflammatory complications (excluding herpes infection) after various procedures performed according to indications: involutive skin changes, acne, rosacea, hyperpigmentation, scarring of the skin All patients received Tetraderm cream 2 times a day - 7 days. Performance evaluation was carried out taking into account the index DISHC, VAS, DIQoL. Results. The DISHC index decreased by 83.5 %, from 12.7 ± 1.3 points to 2.1 ± 0.3 points (p ® cream is highly effective, tolerable and comfortable to use.

Background: Chronic low back pain is a common painful medical problem which has significant socioeconomic impact. Conventional pharmacological therapy usually associated with adverse effects. Mesotherapy is the injection of active substances into the surface layer of the skin. This method allows a slower spread, higher levels, and longer lasting effects of drugs in the tissues underlying the site of injection compared with those following intramuscular injection. This technique is useful when a local pharmacological effect is required and relatively high doses of drug in the systemic circulation are not. Objective: The aim of this study was to compare mesotherapy versus conventional systemic administration of NSAIDs in chronic low back pain with sciatica (radicular pain). Patients and Methods: Fifty patients were randomized to receive anti-inflammatory therapy according to the following protocols: group I had received ketoprofen 100 mg (2 ml) + 2% lidocaine (1 ml) + saline (2 ml) for 4 injections. Group II had received: 100 mg ketoprofen orally twice daily. Results: After receiving treatment (After one and three months; As regarding VAS, repeated measure of the mean VAS score for each group separately showed statistically significant reduction (P < 0.01), and statistically highly significant higher percentage regarding sever grade of disability in group II (57.1% and 72.7%; respectively) compared with group I (42.9% and 27.3%; respectively) (P < 0.05). Conclusion: It could be concluded that the administration of NSAIDs via mesotherapy technique provides better therapeutic benefit than that induced by oral drug administration. That beside the lower drug amounts administered to patients undergoing mesotherapy and the low frequency of administration.

Hyperpigmentation is a common skin problem in a woman. Prolonging topical use of skin whitening may cause hyperpigmentation such as ochronosis whose condition is a challenge for treatment. An aqueous human placenta extract (RGF&#174) contains bioactive therapeutic molecules. There is evidence of human placenta extract showing that melanin synthesis is inhibited by placenta extract in melanocytes. We first reported the case of the hyperpigmentation improvement following face skin mesotherapy human placenta extract treatment.

Objectives To conduct a systematic review of randomized controlled trials about the safety (number and severity of adverse events) and efficacy (pain reduction and functional improvement) of mesotherapy in musculoskeletal disorders, and to compare them with other therapeutic options, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Methods A search of PubMed, Cochrane Library and Scopus database resulted in an initial total of 16,253 records. A total of 931 articles were included in the study. A final total of 7 articles, published from 1 Jan 1999 until 30 Apr 2020 were selected. Two independent reviewers selected potentially relevant studies based on the inclusion criteria for full-text reading. They evaluated the methodological quality of each study and included only studies of high methodological quality, according to the Physiotherapy Evidence Database scale. Results Seven studies were included in the meta-analysis, and visual analogue scale scores before and after mesotherapy were considered. A statistically significant reduction in visual analogue scale score in the mesotherapy group was reported in comparison with the control group in all except 1 of the trials. Mesotherapy was found to be a safe procedure with mild and temporary side-effects, such as nausea, fatigue, numbness, sweating, headache, ecchymosis, bleeding, pain and local reaction at the injection site. Conclusion Mesotherapy proved to be more effective than systemic therapy in the treatment of local pain and functional limitations caused by a variety of musculoskeletal conditions. However, because of the heterogeneity of the analysed studies in terms of injected drugs, administration technique, associated treatments, frequency and total number of sessions, more randomized controlled trials are needed, comparing a standardized mesotherapy protocol with a systemic treatments.

BACKGROUND Cosmetic injection-induced nodules are tricky to handle in the clinic. AIMS We reported a case of injection-induced nodule receiving the experimental treatment of hyperbaric oxygen therapy (HOT). PATIENT A woman presented with multiple red solid nodules on the neck after receiving mesotherapy conducted by syringe. Ultrasound examination showed multiple thickened inflammatory skin tissues on the neck. Pathological biopsy results showed epithelioid granulomas in the dermis, within which there were degenerative necrosis and foreign bodies in the center and multinucleated giant cells around. The bacteria tests remained negative. Diagnosed with foreign body granuloma, the patient rejected the resection or steroids, but willingly took the experimental treatment of HOT instead. After one month, the patient's ultrasound examination showed that the lesion's local hardness got significantly reduced, and the local blood flow increased, indicating the condition improved. RESULTS Although the patient's nodule has not been eliminated, some improvements have been achieved. So far there has no case report on HOT treating injection-induced nodules in the literature. CONCLUSION HOT may be considered as a potential alternative when other treatment options cannot be implemented. More research is needed in this field.

Androgenetic alopecia (AGA) with its precursor miniaturization of anagen phase (MA) and telogen effluvium (TE) represent nonscarring hair loss diseases which causes moderate to severe aesthetic and psychologic discomfort in affected people. Several therapeutic approaches have been tested through the latest decades, with different degree of success. In this study we aim to analyze the efficacy and outcome of an innovative therapeutic protocol, named TRICHOBIOLIGHT, a combination of active principles conveyed by mesotherapy directly on the scalp with a subsequent photobiostimulation session with LED light (630 nm). About 107 patients (49 women, 58 men, mean age 45-year-old) with clinical and trichoscopic diagnosis of MA, AGA, and TE have been enrolled at Skin Center of L'Aquila, Avezzano and Pescara (Italy) and subsequently treated with the TRICHOBIOLIGHT protocol. 4 patients dropped out at the beginning of the study: 2 patients because of an histological diagnosis of scarring alopecia and lichen scleroatrophicus, and 2 patients dropped out because of adverse reaction to the treatment. Excellent to good outcome have been reached in the 82.5% of patients (85/103), 9 patients (8.7%) reached a sufficient result while 7 patients (6.8%) partially respond to the treatment. Two patients (2%) did not respond at all. TRICHOBIOLIGHT is a promising protocol, working through the combined action of the active principles and the photobiostimulation, that lead to a strengthening and thickening of the residual hair, giving an optical thickening effect that provides high quality aesthetic results and, consequently, appreciable psychological results.

Melasma is a recalcitrant pigmentary disease with a complex pathogenesis. Monotherapy often results in unsatisfactory results with high recurrence rate. In this review article, we evaluate efficacy of energy-based devices combination therapy for melasma. We reviewed published literature since 2010 up to November 2020 regarding adjuvant therapy of energy-based devices with other treatment modalities in the treatment of melasma. After final selection, we assessed 49 articles. Energy-based devices include lasers, non-coherent lights, radiofrequency, iontophoresis, sonophoresis, microneedling, and microdermabrasion. Adjuvant therapies other than energy-based devices were lightening agents, chemical peels, platelet rich plasma (PRP) and mesotherapy. Combination of Q-switched neodymium-doped: yttrium, aluminum, and garnet (QSNY) with either intense pulsed light therapy (IPL) or pulsed-dye laser (PDL) are recommended in recalcitrant melasma in patients with light skin photo types and with dilated skin vessels (especially with PDL). Combination of fractional microneedling radiofrequency or microneedling with QSNY leads to promising results and is a safe treatment modality, especially in darker skin types. Application of topical lightening agents in combination with laser therapy leads to higher efficacy with less adverse effects (post-inflammatory hyperpigmentation) and rebound of melasma. Combination of ablative techniques with QSNY is not recommended, due to the high risk of permanent adverse effects such as guttate hypopigmentation and exacerbation of melasma.

Mesotherapy is a convenient, safe and relatively painless non-surgical procedure. It has found its way into the aesthetic world and is employed for various indications such as lipolysis, skin rejuvenation, pigmentation and hair loss. The procedure involves delivery of mixture or cocktail of different compounds (plant extracts, nutrients, enzymes, homeopathic agents, pharmaceuticals, vitamins, amino acids and other bioactive substances) into the dermis or subcutaneous layer. A variety of techniques have been employed. The newer no-needle and micro-needle techniques are less invasive. Ingredients of the chosen mesococktail depend on the indication and play a major role in the outcome. Despite its popularity, mesotherapy has a scarcity of large scale studies on its efficacy and safety profile. Nevertheless, the choice of the mesoproduct and technique must be done with great detail to achieve the best desired effect.

Platelet-rich plasma (PRP) showed positive results in the improvement of skin aging. Lyophilized PRP can be interesting in clinical practice due to the facility to obtain many samples in a single blood collection and can be used in multiple injections. To evaluate the effect of lyophilized PRP in the treatment of skin aging, through a Phase II pilot study. Nineteen women (54 years ± 7 years) with Glogau photoaging II and III types were select for this non-randomized, split-face controlled study. They received monthly intradermal injections of lyophilized PRP and saline solution (as control) into the facial skin, during a period of 2 months. The evaluation was performed by imaging method, histological techniques, and multiphoton microscopy. Although lyophilized PRP presented 10 times the platelet baseline value (P .0001) and growth factors in adequate levels, only saline solution showed an increase of dermis thickness (p = .0009). Collagen pre and post-application remained the same for both types of treatments. The use of lyophilized PRP by mesotherapy showed no improvement on skin aging. TRIAL REGISTRATION APPROVAL: RBR-3n9wxw, UTN U1111-1226-6093-retrospectively registered.

Objectives: To compare the efficacy of tranexamic acid mesotherapy versus 0.9% normal saline for melasma by split-face study. Methods: It was a non-randomized clinical trial performed at the Dermatology ward of JPMC from September 2018 to June 2019 after getting approval from the Ethical Committee. A total of sixty patients were recruited in the study, who had symmetrical melasma on their faces. Both halves of the face were treated by Injection Tranexamic Acid (TA) with a dose of 4mg/ml and Normal Saline (NS) two weekly for twelve weeks. Hemi Modified Melasma Area and Severity Scoring (H-mMASI) was calculated at the start and end of the study. Analyses were done by SPSS version 23. P < 0.05 was taken as significant. Results: Mean of H-mMASI score was compared on both sides at the end of study, which showed significant reduction in mean score from 3.19 ±2.57 to 1.52 ± 1.2 (P < 0.05) on A side as compared to decline in scores on NS side from 3.46 ± 2.7 to 3.45 ± 2.6 (P > 0.05). Erythema, swelling, and burning were documented as temporary side effects on both sides. Conclusion: Tranexamic Acid (TA) mesotherapy can be considered as the most cost-effective, safe and directly observed therapy for melasma which showed significant improvement when old prior therapies have failed. doi: https://doi.org/10.12669/pjms.36.5.2379 How to cite this:Kaleem S, Ghafoor R, Khan S. Comparison of efficacy of Tranexamic Acid Mesotherapy versus 0.9% normal Saline for Melasma; A split face study in a Tertiary Care Hospital of Karachi. Pak J Med Sci. 2020;36(5):930-934. doi: https://doi.org/10.12669/pjms.36.5.2379 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Female androgenetic alopecia is one cause of alopecia in women, although the ideal treatment for this condition remains far from defined. The objective of this study was to evaluate the efficacy and safety of intradermal injections with 0.5% minoxidil for the management of female androgenetic alopecia in a randomized, placebo-controlled trial. A total of 54 women diagnosed with female androgenetic alopecia were divided into two groups: one group received intradermal injections of 0.5% minoxidil, and the other received 0.9% saline. Biopsy, trichogram, Trichoscan (Tricholog GmbH, Freiburg, Germany), and self-assessment findings were used to evaluate the outcomes of treatment with minoxidil. In the treated group, there was a significant increase in the terminal-to-vellus hair ratio (P < .001) and in the percentage of anagen hairs (P = .048) and an improvement in hair loss and volume (P = .021 and P = .028, respectively). These results show that intradermal injections with minoxidil were more effective than placebo (P < .001) in the treatment of female androgenetic alopecia with a good safety profile.

Background Melasma is a common, multifactorial, and recurring disease which is not easy to treat. Aims The purpose of this study is to evaluate the efficacy of microneedling in combination with Q-switched neodymium-doped yttrium aluminum garnet laser (QsNd-YAG laser) for treatment of melasma. Patients/methods Fifteen female patients with epidermal or mixed-type melasma on the face were included in the study. Patients were first treated with QsNd-YAG laser, and then with microneedling containing mesotherapy products of biomimetic peptides, at the same session. Modified Melasma Area Severity Index (mMASI) scores were calculated before the first session and again 2 weeks after the last session. The same treatment protocol was repeated every 2 weeks for five sessions within period of 3 months of therapy. The evaluation was performed according to the before and after photographs taken from three angles including 90-degree front and 45 degrees from left and right with the VISIA device. Results Of the 15 patients included in the study, the mean mMASI scores before and after treatment were 9.2 ± 5.7 (3.8-23.1) and 3.6 ± 4.0 (0.6-16.8), respectively. mMASI scores were significantly reduced after completion of the protocol. Six (40%) patients had "very good response," 4 (26.7%) patients had "good response," and 5 (33.3%) patients were "unresponsive." Six (40%) patients were followed up for 1 year, and only 1 patient had a recurrence (6.7%). Conclusions In addition to the use of photoprotective measures, multimodality treatment including QsNd-YAG laser and microneedling with mesotherapy products containing biomimetic peptides is effective to treat melasma and they work synergistically.

Androgenetic alopecia is the most common cause of hair loss [Br J Dermatol. 2011 Jan;164(1):5–15]. Finasteride and minoxidil are the only approved treatments [J Am Acad Dermatol. 2008 Oct;59(4):547–8 and J Eur Acad Dermatology Venereol. 2018 Jan;32(1):11–22]. Dutasteride is more potent than finasteride due to its ability to inhibit both 5-α-reductase type I and II [Our Dermatol Online. 2017 Sep;9(1):75–9] though its adverse effects and long half-life contribute to the reluctance on its oral use. Mesotherapy could be a feasible alternative to avoid systemic exposure and side effects [J Pan-Arab League Dermatologist. 2009 Feb;20(1):137–45]. We aim to perform a systematic review to analyze scientific literature with the purpose of comparing efficacy and adverse effects of both administration routes. Five clinical trials using oral route and 3 intralesional in comparison with placebo met criteria for inclusion. Regarding intralesional dutasteride, only one study [Clin Dermatol. 2001 Mar;19(2):149–54] reported the mean change in hair count. Although both interventions favor over placebo, there are not enough data to reliably compare outcomes obtained between both routes. Mean increase in hair count observed with oral dutasteride was higher (MD: 15.92 hairs [95% CI: 9.87–21.96]; p = I2 = 90%) compared to intralesional dutasteride in Abdallah’s study (MD: 7.90 hairs [95% CI: 7.14–8.66]; p =

Background: Lipomas are benign adipocytic tumours. Surgical excision is the gold standard for treating such lipomas, but it results in unaesthetic scarring. Methods: A total of 126 patients were randomised into two groups. The patients in Group A underwent mesotherapy (n = 66) and those in Group B underwent surgery (n = 60). The patients in Group A group received six sessions of mesotherapy treatment at 2-week intervals. Both groups were followed up for 12 weeks, during which they were assessed for complications arising from treatment, reduction of the size of the lipoma and cosmetic outcomes. Results: The overall mean age of the patients was 32.93 (± 10.1) years old and the mean volume of the lipomas was 2.29 (± 3.8) mL. A 55.86% (P = 0.0032) mean reduction in the volume of lipomas was noted in the patients who received mesotherapy, while one patient showed a gain of 16% by volume. The patients in Group A (cosmetic score ≥ 4: 63%) were happier with the treatment than those in Group B (cosmetic score ≥ 4: 21%). Conclusion: Our findings indicate that mesotherapy modestly reduces the volume of lipomas with very few and minor complications and excellent cosmetic outcomes.

Mesotherapy is sometimes responsible for dermal and subcutaneous infections caused by nontuberculous mycobacteria. Mycobacterium chelonae, M abscessus, and M fortuitum are usually involved. We present two cases of deep skin infections caused by M chelonae following mesotherapy. A review of the literature is included.

Background Cryolipolysis is a fairly popular procedure performed in North America, Europe, and many other countries. Although it is considered a rather safe procedure, there are underreported side effects such as paradoxical adipose hyperplasia (PAH), contour irregularities, skin and soft tissue atrophy, and asymmetries. Our knowledge regarding the prevalence and treatment of such complications is limited. Objectives We hereby report a case series of 5 patients treated for various complications of cryolipolysis, including PAH, that persisted for more than 12 months after their last treatment. Methods Five patients with various complications of cryolipolysis (4 patients with PAH and 1 with atrophy and indentations) presented in our private office between 2015 and 2018. Three of the 4 patients with PAH were treated at other facilities with ultrasonic liposuction, laser lipolysis, and radiofrequency skin tightening devices respectively. The fourth patient developed PAH after liposuction at another facility. The fifth patient developed several areas of indentations and atrophy and received mesotherapy and lymphatic massages at another facility. All 5 patients were subsequently treated in our office by means of a customized approach specific to their underlying complications. Results Near-normal results were achieved in all 5 patients. None of our patients showed any recurrences of their initial complication for which they were treated. All 5 patients were extremely satisfied with their results. Conclusions Cryolipolysis, just like any other form of lipolysis, has certain specific adverse effects associated with it, including but not limited to PAH. Complications of cryolipolysis must be individually recognized and treated accordingly. Level of Evidence: 4

We report six cases of female patients who, after the application by mesotherapy with platelet-rich plasma, as well as of an intradermal filler material of unknown origin, developed infection at the injection sites associated to Mycobacterium massiliense, as well as granuloma with reaction to foreign body. Although the cultures were negative, the identification of the microorganism was achieved by extraction of soft tissue DNA obtained by biopsy and sequencing the obtained product, with which the therapy was redirected against the particular species. Due to the great similarity in the culture between M. massiliense with the related species M. abscessus, to the required time for its growth, and to the different therapeutic response of each strain, molecular diagnostic techniques are a real option to consider to administer in an early way the appropriate treatment against the pathogen and prevent infection progression.

Objective To evaluate the feasibility and effectiveness of mesotherapy in dogs compared with a positive control group. Study design Experimental, randomized, blinded study. Animals Fifteen working police dogs with chronic back pain. Methods Animals were divided randomly into control (CG; n = 5) and treatment groups (TG; n = 10). A combination of 140 mg lidocaine, 15 mg dexamethasone and 20 mg thiocolchicoside was administered to group TG along with a 70-day course of a placebo, administered as if it was carprofen. Carprofen was administered to Group CG for 70 days, at a dose adjusted to their weight. On day 0, an intradermal injection of Ringer’s lactate was also administered. Both groups were rested for 3 days and resumed normal activity over a 5-day period. Response to treatment, measured by the Canine Brief Pain Inventory (CBPI) and the Hudson Visual Analogue Scale (HVAS), was evaluated before treatment (T0), after 15 days (T1) and 1 (T2), 2 (T3), 3 (T4), 4 (T5) and 5 (T6) months. Results were compared using a Mann–Whitney test or a paired samples t test. Results When comparing CBPI results, no differences were found between groups TG and CG at T0 through T3 and in T6 and T7. Differences were observed in CBPI sections after the discontinuation of carprofen: at T4 [p = 0.02 for Pain Interference Score (PIS) and p = 0.03 for Pain Severity Score (PSS)] and T5 (p = 0.16 for PIS and p = 0.03 for PSS), with group TG having overall better results. Individual treatment results were considered successful in one dog of group CG (20%), whereas in group TG, success was higher (ranging from 78% at T1 to 22% at T7). No significant differences were registered with the HVAS. Conclusions and clinical relevance Mesotherapy may be a promising treatment option for canine musculoskeletal-related pain. Further studies are required.

Introduction. The questions of treatment of chronic skin purulent infections are extremely important due to their wide spread, severe clinical course of some nosological forms, development of resistance to the traditional means, and growth of undesirable side effects of antibiotic therapy. Chronic suppurative skin diseases connected with skin appendages are disorders of common occurrence and a major constituent of pyodermas. They still remain a problem due to their chronic character and difficulty of treatment, as well as its large impact on patients’ quality of life. Due to the chronic course of the disease, treatment is long lasting, and often ineffective because of resistance to antibiotics therefore it is desirable to provide the treatment with effective alternatives to commonly used antibiotics to reduce the resistance and obtain a highly specific agent which is able to destroy bacteria effectively. In the same time across the world a growing number of scientists are noting the promising positive results of phage therapy and its advantages, especially in the treatment of chronic cases. The aim of this communication, which is a continuation of previously presented research, is to report the data and results of treatment of some common chronic suppurative skin disease with phages. Materials and methods. In the present investigation were included 87 males aged 18 to 56 with chronic folliculites (n=52), syccosis (n=30) and folliculitis et perifolliculitis capitis abscendens et suffodiens, Hoffmann (n=5), in all cases was approved prevalence of staphylococcal flora and all of them were treated before with antibiotics, but unsuccessfully. The treatment was provided with pyophages produced by Giorgi Eliava Institute (Tbilisi, Georgia) which include Staphylococcus aureus, Streptococcus (different cultures), Escherichia coli (different serotypes), Psedomonas aeruginosa, Proteus vulgaris, mirabilis. Taking into consideration deep locations for treatment was chosen mesotherapy technique – phage solution was injected by dermal nappage, papula and point by point technique in all damaged areas. In each case the frequency of procedures was usually once in 3-4 days until healing, the process took about one month. In patients with folliculitis full recovery was achieved in all cases, but they were still under observation up to 2 months in order to avoid relapses. In the cases of folliculitis et perifolliculitis capitis abscendens et suffodiens Hoffmann treatment was started with М. Jessner’s peeling followed by intralesional injections into buggy nodules and sinus tracts and dermal nappage, papula and point by point technique in all damaged areas. Patients were treated within three weeks once in three days with following break of 7 days, after the course was repeated. In all 5 cases the final results were positive. The cosmetic defect in the form of a fibroid growth was still present, but after the course of treatment the laboratory data confirmed the absence of pathogenic flora in correlation with marked clinical improvement. Conclusions. Рhage therapy has a long history and phages potential for treating infectious diseases has been pursued since their discovery, but still there are many important questions that must be decided before their wide therapeutic use in different clinical fields. Their benefits are undeniable, this therapy may replace or augment the conventional antibiotic therapy, help eliminate antibiotic resistance of bacterial strains and they give a real chance for patients suffering from chronic infections caused by antibiotic-resistant bacteria. The experience in phage therapy may become very important with the rapidly-increasing spread of antibiotic-resistance bacterial infections which are difficult to treat now. There is a need to develop phage therapy of purulent skin diseases, but more research is needed to understand the bacteria-bacteriophage interactions in the skin community to obtain comprehensive knowledge on different pathogenic flora.

Current data on the acne pathogenesis are given. According to the authors, dermatosis is becoming more prevalent among women of mature age. Issues related to the clinical picture, effect of exogenous and endogenous factors on the course of acne, and psychosocial characteristics of delayed acne manifestations in women are described in detail. The essential role of medical and cosmetic products for the complex therapy of acne is discussed. The authors describe their own experience of treating delayed acne using the Hyseac line of medical and cosmetic products in a combination with microdermabrasion and no-needle mesotherapy using the vitaPeel/vital О2 device.

Background Achieving a satisfying quality of life for a patient by applying individually matched therapy is, simultaneously, a great challenge and a priority for contemporary medicine. Patients with visible dermatological ailments are particularly susceptible to reduction in the general quality of life. Among the dermatological diseases, acne causes considerable reduction in the quality of life and changes in self-perception that lead to the worsening of a patient's mental condition, including depression and suicidal thoughts. As a result, difficulties in contact with loved ones, as well as social and professional problems are observed, which show that acne is not a somatic problem alone. To a large extent, it becomes a part of psychodermatology, becoming an important topic of public health in social medicine practice. Pharmacological treatment of acne is a challenge for a dermatologist and often requires the necessity of cooperating with a cosmetologist. Cosmetological treatments are aimed at improving the condition of the skin and reduction or subsiding of acne skin changes. Aim The aim of this study was to assess the influence of selected cosmetological treatments on the general quality of life of patients with acne. Materials and methods The study group consisted of 101 women aged 19-29 years ([Formula: see text] years, SD =2.3 years). All subjects were diagnosed with acne vulgaris of the face. In the study group, the acne changes occurred over the course of 3-15 years ([Formula: see text] years, SD =2.7 years). Selected cosmetological treatments (intensive pulsing light, alpha-hydroxy acids, cavitation peeling, needle-free mesotherapy, diamond microdermabrasion and sonophoresis) were performed in series in the number depending on the particular patient's chosen treatment, after excluding contraindications. General quality of life of the patients was estimated using the Skindex-29 and Dermatology Life Quality Index (DLQI) questionnaires, before and after the cosmetological treatment. Results Statistical analysis of the data obtained from the Skindex-29 questionnaire in areas (emotions, symptoms and physical functioning) and DLQI questionnaire in areas (daily activities, leisure, work and school, personal relations and treatment) showed great improvement in the general quality of life after applying a series of cosmetological treatments. The results are statistically relevant at P Conclusion The cosmetological treatment significantly improved the general quality of life of patients with acne vulgaris and their skin condition, which was evaluated by the Hellgren-Vincent scale. It was proven that therapy performed in cosmetological clinics may become an integral part of or complete dermatological treatment.

Cellulite affects the majority of women and is an unacceptable cosmetic defect. Therefore, effective methods for cellulite reduction are being sought. Intradermal mesotherapy is one of such methods.The aim of the study was to assess the efficacy of intradermal mesotherapy in cellulite reduction, using conventional and high-frequency ultrasound.Twenty-one women with cellulite underwent a series of intradermal mesotherapy procedures. The following parameters were assessed: thickness of epidermis, dermis and hypodermis, echogenicity of dermis and the surface area of serrated hypodermis-dermis junction. Furthermore, the thigh circumference was measured; body mass index and cellulite severity were assessed based on photographs using Nürnberger-Müller's scale.Intradermal mesotherapy reduced severity of cellulite. The surface area of serrated hypodermis-dermis junction and hypodermis thickness decreased significantly as compared to baseline. Cellulite reduction was also confirmed by palpation, decreased thigh circumference and the Nürnberger-Müller's grade. There were no statistically significant changes in epidermis or dermis thickness, body weight and the BMI.Intradermal mesotherapy offers effective cellulite reduction. It is a simple and safe treatment, which makes it popular. Further research in mesotherapy is essential due to a limited number of published studies. Ultrasound is a useful method to monitor intradermal mesotherapy and assess its efficacy.

Numerous skin lesions have been commonly observed in individuals with diabetes mellitus. The common skin manifestations of diabetes mellitus are erythrasma, xanthomatosis, xanthelasma, phycomycetes and cutaneous infections like furuncolosis, candidiasis, carbuncle, dermatophytosis, etc. Diabetic dermopathy is the most common skin lesion found in patients with diabetes. It is typically seen in men aged above 50 years. In low-level laser therapy (LLLT), the entire lower limb was illuminated with the frequency of 20 Hz and wavelength of 830 nm for 9 min, and the treatment was divided into four parts. With the continued sessions of LLLT, the skin manifestations and neuropathy conditions improved drastically. On the 21st day, the skin colour was found to be normal. Also, there were significant changes in clinical findings for diabetic peripheral neuropathy. LLLT with specific exercises can promote healing of skin manifestations in individuals with type 2 diabetes mellitus. It can be used as an effective treatment modality for treating diabetic dermopathy.