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Platelet-rich plasma (PRP) contains autologous growth factors, which could act synergistically with growth factors induced by skin needling in order to enhance the wound-healing response. The com- bination of treatments, carried out by using skin needling and PRP application, should enhance both efficacy of skin needling and PRP application. The objective of this study is to establish the effectiveness of the combined use of skin needling and PRP application in acne scarring treatment. Twelve patients affected with rolling acne scars were enrolled. Each patient underwent 2 sessions of treatments, each consisting of skin needling followed by PRP application on the right side of the face and skin needling alone on the left side of the face. Digital photographs of all patients were taken. Photographic data were analyzed by using the Sign Test (a,.05). The study showed that the scars severity grade in all patients was greatly reduced on all of the face, but the improvement was more efficient on the side treated with both skin needling and PRP. Our study showed that the combined use of skin needling and PRP is more effective than skin needling alone in improving acne scars.

Introduction: Periorbital wrinkles are very common cutaneous folds, that develop on the periocular area. The treatment for wrinkles varies with the degree of severity. A relatively new treatment, termed Collagen Induction Therapy (CIT) seems to be appropriate for the treatment of periorbital wrinkles. Objective: To confi rm the usefulness of CIT in periorbital wrinkles treatment. Patients and methods: In total, 20 patients (12 females, 8 males; between 50-65 years of age) with periorbital wrinkles were included. Each patient was treated with a specifi c tool in two sessions. Using digital cameras, photos of all patients were taken to evaluate wrinkles’depth and silicone rubber was used to make a microrelief impression of the wrinkles. The photographic data were analysed by using the sign test statistic (α < 0.05). Cutaneous casts’ data were analysed by computerized image analysis. Results: Analysis of the patient photographs, supported by the sign test, and of the degree of irregularity of the surface microrelief, suppo rted by Fast Fourier Transform and by wrinkle’s image processing, showed that, after only two sessions, the wrinkles’ severity grade in most patients was greatly reduced. Conclusion: The present study suggests that CIT can be a suitable technique to improve periorbital wrinkles.

Background: Photodynamic therapy (PDT) with aminolevulinic acid (ALA) has been shown to be an effective treatment for acne. However, the effect of ALA PDT on comedo formation has never been objectively evaluated. Cyanoacrylate follicular biopsy (CFB), a noninvasive procedure, has been proposed as the most reliable tool for studying follicular casts. Objective: To determine the possible effect of ALA and red light (550–700 nm) on macro- and microcomedones in acne patients. Patients and Methods: 10 patients with mild-to-moderate facial and/or chest/back acne resistant to conventional therapies received ALA PDT at 2-week intervals in 3 sessions. The severity of acne had been estimated by a system of points, the Global Acne Grading System. The patients underwent PDT utilizing ALA 10% (face) or 15% (back/chest) and red light (15 J/cm2 each session). CFBs were performed. Results: Four weeks after their last PDT session, the patients showed an average global score reduction of 50%. CFBs demonstrated a reduction in the total area, the average area and the density of macrocomedones. Conclusion: The results obtained in this study using CFB evaluation demonstrate that ALA PDT exerts an action on the comedogenic phase as well.

BACKGROUND: Acne vulgaris is a complex, chronic, and common skin disorder of pilosebaceous units. The major pathogenic factors involved are ductal hyperkeratinization, obstruction of sebaceous follicles resulting from abnormal keratinization of the infundibular epithelium, stimulation of sebaceous gland secretion by androgens, and microbial colonization of pilosebaceous units by Propionibacterium acnes, which promotes perifollicular inflammation. AIM: The aim of the study was to investigate the therapeutic effects of resveratrol, a natural phytoalexin produced by some spermatophytes, such as grapes and other plants, on acneic skin. METHODS: Resveratrol was incorporated in a carboxymethylcellulose-based gel. The chemical stability of resveratrol after storage at 4°C for 30 days was investigated by high-performance liquid chromatography (HPLC). The resveratrol-containing hydrogel was administered to 20 patients affected by acne vulgaris enrolled in this single-blind study. The resveratrol-containing formulation was applied daily as a solo treatment on the right side of the face for 60 days, while the hydrogel vehicle was applied to the left side of the face as a control. To objectively evaluate the results, a digital photographic database was used to collect images. The number and type of lesions were recorded for each patient, to compare the Global Acne Grading System (GAGS) score before treatment with that obtained at the end of the study. Moreover, with the innovative technique of follicular biopsy, areas of acneic skin were prepared for histopathology. The average area occupied by microcomedones at baseline was compared with that at the end of treatment. RESULTS: HPLC analysis demonstrated that resveratrol, upon incorporation into the gel, did not convert to its cis-isomer when stored at 4°C for 30 days. All patients were satisfied with the active treatment and none experienced adverse effects. Clinical evaluation showed a 53.75% mean reduction in the GAGS score on the resveratrol-treated sides of the face compared with 6.10% on the vehicle-treated sides of the face. These data were supported by histologic analysis, which showed a 66.7% mean reduction in the average area of microcomedones on the resveratrol-treated sides of the face. The comparison with the vehicle-treated side of the face (9.7% reduction) showed a clinically relevant and statistically significant decrease of lesions in areas treated with resveratrol-containing hydrogel. CONCLUSION: This pilot study showed positive results for resveratrol gel in acne, and should be considered a valid starting point for further testing of the effectiveness of this molecule in different concentrations and formulations and in a larger group of patients.

Melasma is a common hypermelanotic disorder affecting the facial area which has a considerable psychological impact on the patient. Managing melasma is a difficult challenge that requires long-term treatment with a number of topical agents, such as rucinol and sophora-alpha. Aims. We aim to compare the combined treatment of skin needling and depigmenting serum with that using depigmenting serum alone in the treatment of melasma, in order to evaluate the use of microneedles as a means to enhance the drug’s transdermal penetration. Methods. Twenty patients were treated with combined skin needling and depigmenting serum on one side of the face and with depigmenting serum alone on the other side. The outcome was evaluated periodically for up to two months using the Melasma Area Severity Index score and the Spectrocolorimeter X-Rite 968. Results. The side with combined treatment (skin needling + depigmenting serum) presented a statistically significant reduction in MASI score and luminosity index (L) levels compared to the side treated with depigmenting serum alone, and clinical symptoms were significantly improved. Conclusions. Our study suggests the potential use of combining skin needling with rucinol and sophora-alpha compounds to achieve better results in melasma treatment compared to rucinol and sophora-alpha alone.

Skin scars remain a therapeutic challenge to dermatologists. Over the past several decades, numerous surgical techniques have been used to improve the appearance of scarring. The objective of this study is to evaluate the efficacy of a local application of a (50%) concentration of trichloroacetic acid (TCA) for the treatment of atrophic acne scars (grade 3 in Goodman classification), as opposed to the higher (90%) TCA concentration used in previous studies, in order to reduce adverse local effects. The primary goal was the resolution of acne or chickenpox scars. Secondary goals were physician and subject assessments of scar improvement. Fifty percent TCA was applied locally to atrophic scars in five patients. Three patients had treated scars on the face and two patients had treated scars on the back. Wooden applicators were used to apply TCA locally and the treatment was repeated at 4-week intervals for a total of three sessions. Digital photographic analysis of lesions supported clinical observations. Histologic examination was performed only on two samples of patients with treated scars on the back. Clinical examination revealed cosmetic improvements in both depth and appearance of skin scars. We believe that the 50% TCA CROSS can be an effective technique for the treatment of atrophic scars.