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Objectives: Microneedling and injectable platelet-rich fibrin (i-PRF) have been proposed as relatively less invasive alternatives to surgical procedures for augmentation of thin periodontal phenotype. The present study was conducted to evaluate the effect of microneedling and i-PRF alone on gingival thickness in thin periodontal phenotype individuals. Method and materials: Systemically healthy individuals with thin periodontal phenotype in mandibular anterior teeth (n = 21) were treated with microneedling on one side and i-PRF on the contralateral side. Assessment of gingival thickness, keratinized tissue width, and periodontal parameters was done at baseline, and at 1, 3, and 6 months. Results: In intergroup comparison, a statistically significant increase in gingival thickness was observed with microneedling as compared to i-PRF at 6 months (P < .02). Intragroup comparison from baseline to 6 months showed a statistically significant increase in gingival thickness within both the groups: microneedling from 0.78 ± 0.12 mm to 1.00 ± 0.14 mm (P < .000), and i-PRF from 0.77 ± 0.10 mm to 0.93 ± 0.12 mm (P < .000). Intragroup comparison showed a statistically significant increase in keratinized tissue width in the microneedling group (P < .000). A statistically significant decrease in periodontal parameters was observed on intragroup comparison (P < .000). Conclusion: Considering the higher gain in gingival thickness and the added advantage of eliminating need for autologous blood withdrawal, microneedling is potentially better than i-PRF for phenotype modification in thin periodontal phenotype individuals. [ABSTRACT FROM AUTHOR]

A simple and rapid method that is not based on race and ethnicity for classifying people with skin of color is of paramount importance in dermatology. The currently used Fitzpatrick classification of sun-reactive skin types is inadequate. Newer scales that have been used in immigration surveys and sociology studies are not applicable in the office setting. A new, non-racial and non-ethnic, colorimetric scale for skin of color has recently been proposed that is simple to perform. The scale has five colors: very light beige (skin color type 1), light brown (skin color type 2), medium brown (skin color type 3), dark brown (skin color type 4) and very dark brown (skin color type 5); an individual with white skin, such as in albinism, would have a skin color type 0 in this classification. In conclusion, the colorimetric scale enables the rapid classification of individuals with skin of color and allows for accurate assessment of skin cancer risk, more appropriate management of cosmetic dermatologic procedures and aesthetic devices, and enhanced ability for focused counseling regarding hair products, skin care interventions, and color-targeted makeup based on the person's skin tone.

Introduction: Striae distensae (SD), linear scars of derma, caused by disproportionate skin stretching, which indicates a cosmetic problem and even endangers individuals' psychosocial health. Microneedling, representing a relatively new procedural therapy, has shown brightening but diverse results in the remedy of SD. Our study systematically investigates and further evaluates the efficacy of microneedling for SD. Method: This study was conducted following the PRISMA guidelines. According to the preplanned search strategy, four electronic databases were comprehensively searched for eligible clinical controlled studies. Standardized mean difference (SMD) and odd ratio (OR) with 95% confidence intervals were calculated for continuous data and dichotomous data, respectively. Results: According to the predetermined criteria, eleven eligible articles of six RCTs and five non-RCTs were included. Concerning clinical improvement, a significant difference was observed in the microneedle radiofrequency treatment subgroup (SMD: 0.57, 95% CI 0.20−0.94, P = 0.003). The pooled result of the second subgroup revealed that microneedling and lasers producing almost comparable effectiveness for treating SD with no significant difference (P = 0.35). The analysis result of the third subgroup of microneedling versus non-laser therapy indicated significant difference at the 5% significance level (SMD:1.01, 95% CI 0.51−1.51, P < 0.0001). With regard to patient satisfaction, the pooled estimate concluded that participants' satisfaction with therapeutic effect between MRF and laser group was comparable (P = 0.26), whereas microneedling exhibited significant superiority than both laser (P = 0.04) and non-laser treatments (SMD: 0.95, 95% CI 0.52–1.38, P < 0.0001). Occurrence of post-inflammatory hyperpigmentation (PIH) was not obvious in microneedling therapy compared to other treatments, and a statistically difference was observed (P = 0.0003). Microneedling treatment caused significant pain compared with laser therapy (P < 0.00001). Conclusion: This systematic review and meta-analysis has provided initial evidence of the efficacy and safety of microneedling technology for SD. Level of Evidence II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Introduction: Post-burn hypertrophic scars are an important cause of physical discomfort, limitation of movements, psychological disorders, low self-esteem and reduced quality of life. Treatment for this condition is complex and involves several options. Microneedling, also known as minimally invasive percutaneous collagen induction, is an affordable minimally invasive option that can be combined with other treatments, including ablative ones. Objective: The goal of this study was to present our microneedling approach for the treatment of hypertrophic scars after burns. Method: A prospective study of 15 patients with post-burn hypertrophic scars was conducted between October 2016 and June 2022. All patients were treated with microneedling and drug delivery of triamcinolone. Scars were evaluated using Vancouver Scar Scale (VSS), Burn Scar Assessment Scale (BSAS) and angle measurement for amplitude of movement evaluation of joints. Results: A significant improvement in the VSS score was obtained after microneedling (8.8 ± 0.44 to 4.1 ± 0.98; p = 0.012), especially in the acute group (less than 1 year after burns): 9.3 ± 0.49 to 3.5 ± 1.36; p = 0.041. There was a significant and progressive improvement of the scars throughout the treatment sessions in all criteria evaluated and in the ranges of joint movement (p = 0.012). Conclusion: Our microneedling protocol promoted a significant improvement of post-burn scars, especially in acute hypertrophic scars, and in the amplitude of joint motion. Sequential treatments provided progressive improvement. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Introduction Materials and Methods Results Discussion An increasing interest in minimally invasive procedures hassled to a demand for an effective local anesthetic algorithm. The scalp presents a challenge in achieving effective anesthesia due to the presence of hair shafts. This study aims to evaluate the efficacy of different methods during a microneedling procedure, including 25 mg lidocaine and 25 mg prilocaine cream, skin spray with 10% lidocaine, and cold gel compresses.Sixty‐two men aged between 20 and 50 years underwent three microneedling treatments, each using a different method of anesthesia. The treatment area was divided into two equal parts, with one part exposed to a specific anesthetic method. Patients were asked to rate their pain on a 0–10 verbal analog scale. An attempt was made to objectify the results using algometry.A negative correlation was observed between the algometry results and the VAS score after the application of the cream and cold compresses.When choosing monotherapy, it is recommended to use cold gel compresses for scalp microneedling after considering the advantages and disadvantages of different methods. [ABSTRACT FROM AUTHOR]

Background Aim Methods Conclusions Lasers and other energy‐based devices are increasingly becoming popular in aesthetic practice. Many centers employ doctors or technicians to perform these procedures where treating doctor and operating doctor may be different. Hence the need for standard operative protocols, to be followed while performing these procedures to avoid mistakes, complications and to get optimum results. In the current review article, group of doctors who have worked with these energy‐based devices over many years worked together and suggested the protocols to be followed for the most commonly used energy‐based procedures.To provide Standard operating protocols for the operator and staff to ensure, efficacy, safety, for the patient and for the devices.The following protocols have been drafted based on the best practices followed by the authors in their clinics and reflect their consensus opinion. The objective is to provide operating protocols in a standard format, which can be of use by practicing dermatologists and their staff. The protocols include both general guidelines for the laser room and specific protocols for different machines. The draft follows the following schema: General instructions for all the energy‐based devices. Specific protocols for different devices: Laser hair removal, fractional lasers, Q‐switched lasers, fractional microneedling radiofrequency and cryolipolysis. The protocols proposed help to maintain the uniformity and avoid complications. However, these instructions are generalized and not machine or lesion specific. There may be variations in the protocols depending on the treatment lesion and treating doctor as well as machine. [ABSTRACT FROM AUTHOR]

Vitiligo is considered an autoimmune disease, and its treatment is challenging. We assessed and compared the effect of fractional erbium:yttrium–aluminum–garnet (Er:YAG) laser-assisted delivery of platelet-rich plasma versus microneedling (Mn) with platelet-rich plasma (PRP) in enhancing skin repigmentation in localized stable vitiligo patients. In total, 40 patients with localized stable vitiligo were selected in a random manner into two similar groups (20 each). Group (A) was subjected to fractional Er:YAG laser combined with platelet-rich plasma and Group (B) was subjected to microneedling combined with platelet-rich plasma. The procedure was repeated every 2 weeks for up to 6 months. Each individual was assessed clinically utilizing Vitiligo Area Scoring Index (VASI). Fractional Er:YAG + PRP group achieved better pigmentation100% (excellent 30%, very good 15%, good 30% and satisfactory 25%) which is comparable to Mn + PRP where 80% of cases demonstrate repigmentation (20% very good, 10% good and 50% mild). When comparing the VASI scores for both groups after therapy to the baseline VASI, there was a statistically significant decrease [p = 0.001 for group(A) and 0.003 for group(B)]. Regarding the treatment side effects, there was significantly (p = 0.048) side effects among cases treated with microneedling group(B) (25%) than those fractional Er:Yag laser therapy group(A) (5%). Both forms of therapy demonstrated induction of repigmentation of vitiligo, but fractional Er:YAG laser efficacy is greater when combined with platelet-rich plasma. Clinical trials.gov identifier: NCT05511493. [ABSTRACT FROM AUTHOR]

Background: TikTok is one of the fastest‐growing social media platform, and its short‐form videos have become a widely used source of health information. "Dermarolling" is a form of roller microneedling often practiced at home, and patients may be using TikTok to inform their decision to pursue this treatment and their practice of it. Aims: This study assessed the informational content quality, source, and engagement of TikTok dermarolling videos to highlight potentially harmful social media trends. Methods: On a predetermined date, "dermarolling" was searched on TikTok. The top 75 results were screened. Number of views, creator type, type of video, and whether risks were discussed were recorded. Information quality was assessed using the DISCERN tool. The data were stratified by creator type, and statistical analysis was performed using R version 4.3.2. Median viewership and DISCERN scores were compared using Kruskal–Wallis tests with post hoc pairwise Wilcoxon tests. Fisher's exact test was used to compare rates of risk discussion between groups. Results: Sixty‐one of the reviewed videos met the inclusion criteria. Influencer videos engaged the largest overall audience and had higher median viewership than other creators. Physicians, primarily dermatologists, created exclusively educational content and influencers created mostly experience‐based content. Overall content quality was generally low‐moderate, with a median (IQR) DISCERN score of 30.5 (26.5–33.5). Physician content had higher median DISCERN scores than influencers (p = 0.004) and others (p = 0.004). Physicians were more likely to discuss risks compared to influencers (p = 0.02). Conclusions: TikTok content on "dermarolling" was of relatively low quality, and nonphysicians command a large viewership. Physician‐created content is often of higher informational quality, and dermatologists should escalate their efforts to engage patients in this space to mitigate the effects of potential misinformation. [ABSTRACT FROM AUTHOR]

Melasma is a challenging skin condition which involves both structural and functional skin alterations. Despite the availability of various treatment options, the management remains complex. This is the first study to investigate topical application of Rosa damascena stem cell exosomes when used concomitantly with microneedling in women and men with facial melasma. We recruited 20 subjects with Fitzpatrick skin types I-III, exhibiting melasma of varying severity. The modified Melasma Area and Severity Index (mMASI) and Global Aesthetic Improvement Scale (GAIS) were utilized to evaluate treatment response. The treatment protocol involved microneedling followed by exosome application over four or five sessions, at 4-week intervals. Ninety percent of subjects demonstrated a significant improvement in mMASI scores, while only 10% showed no change. GAIS assessment further supports overall improvement, with just 10% categorized as "not changed". Tolerability was favorable, with mild, transient side effects. Our findings suggest promising outcomes with this combined therapy, underscoring its potential as a safe and effective approach for treating melasma, particularly in severe and moderate cases. However, further research with larger sample sizes and control arms is warranted to validate these findings and explore long-term efficacy. [ABSTRACT FROM AUTHOR]

Androgenetic alopecia, the most common cause of hair loss affecting both men and women, is typically treated using pharmaceutical options, such as minoxidil and finasteride. While these medications work for many individuals, they are not suitable options for all. To date, the only non-pharmaceutical option that the United States Food and Drug Administration has cleared as a treatment for androgenetic alopecia is low-level laser therapy (LLLT). Numerous clinical trials utilizing LLLT devices of various types are available. However, a myriad of other physical treatments for this form of hair loss have been reported in the literature. This review evaluated the effectiveness of microneedling, pulsed electromagnetic field (PEMF) therapy, low-level laser therapy (LLLT), fractional laser therapy, and nonablative laser therapy for the treatment of androgenetic alopecia (AGA). It also explores the potential of multimodal treatments combining these physical therapies. The majority of evidence in the literature supports LLLT as a physical therapy for androgenetic alopecia. However, other physical treatments, such as nonablative laser treatments, and multimodal approaches, such as PEMF-LLLT, seem to have the potential to be equally or more promising and merit further exploration. [ABSTRACT FROM AUTHOR]

Melasma is a chronic pigmentary disorder that results in hyperpigmented patches in sun-exposed areas. Tranexamic acid (TXA) and microneedling are potential treatment options for individuals with melasma. The objective of our systematic review was to review 12 randomized controlled trials and clinical trials on the use and efficacy of TXA with microneedling for melasma. The combination of TXA and microneedling was found to be more effective at improving melasma lesions than either treatment alone; TXA alone was equally effective at reducing melasma lesions vs the standard treatment of hydroquinone. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of microneedling plus Tacrolimus with narrow band UVB versus tacrolimus with narrow band UVB in the treatment of vitiligo. Study Design: Randomized Controlled Trial. Setting: Department of Dermatology, Madinah Teaching Hospital, Faisalabad. Period: 05-06-2023 to 5-12-23. Methods: Enrolled 28 patients with stable Vitiligo for the last 3 months, aged 15 to 60 years. Patients were assigned to group A and B, treated with microneedling plus topical tacrolimus 0.1% with narrow band UVB and tacrolimus ointment twice a day. The study focused on evaluating the repigmentation response during subsequent follow-up visits, using a comprehensive four-grade scale. The results were analyzed using SPSS 26. Results: The study involved 34 patients with face lesions. Six patients lost follow-up and were excluded. The study included 16 males and 12 females, with a mean age of 29.4 + 11 years. After the treatment, the first follow-up visit showed significant improvement in 17 of 28 patients (60.7%) in group A (microneedling pus Tacrolimus with narrow band UVB) compared to 32.1% in group B (Tacrolimus with narrow band UVB). The efficacy was categorized into five levels: 'excellent' in 25% cases in group A and 21.4% in group B, and very good' in 35.7 vs 10.7%. At 12 weeks, overall efficacy was seen in 71.4% in group A and 39.3% in group B. The study's findings suggest that microneedling plus tacrolimus with narrow band UVB may be a more effective treatment for vitiligo. Conclusion: Microneedling, a technique using delicate needles to puncture the dermis, has been shown to promote collagen synthesis and enhance the absorption of tacrolimus, a drug used for immunosuppression, potentially aiding in vitiligo repigmentation, but further localized studies are needed. [ABSTRACT FROM AUTHOR]

Background: Microneedles are tiny needles, typically ranging from tens to hundreds of micrometers in length, used in various medical procedures and treatments. The tested medical device named "CELLADEEP Patch" a dissolvable microneedle therapy system (MTS), made of hyaluronic acid and collagen. And the iontophoresis technique is also applied in the system. The study aimed to evaluate the effectiveness of the "CELLADEEP Patch" in skin improvement. Methods: Ex vivo human‐derived skin tissue models were used in this study and they were divided into three different groups, namely, the Untreated Group, the Negative Control Group, and the Test Group respectively. The Untreated Group received no treatment measures, the Negative Control Group was exposed to ultraviolet B radiation (UVB) irradiation, and the Test Group was exposed to UVB irradiation and treated with "CELLADEEP Patch". Skin moisture content, transdermal water loss, and skin elasticity were evaluated by three clinical devices. Additionally, histological staining and related mRNA expression levels were also analyzed. Results: The results of skin moisture content, transdermal water loss, and skin elasticity evaluation consistently illustrated that the application of "CELLADEEP Patch" led to remarkable skin improvement. And the analysis of histological staining images also confirmed the effectiveness of the "CELLADEEP Patch", especially for increasing collagen density. Moreover, the upregulation of Collagen type 1 a (COL1A1) and hyaluronan synthase 3 mRNA expression and the decrease of Matrix metalloproteinase 1 (MMP‐1) and Interleukin‐1 beta (IL‐1β) mRNA expression reflected its wrinkle improvement, moisturizing and anti‐inflammation function. Conclusion: "CELLADEPP Patch", the MTS combined with the iontophoresis technique, exhibits its effectiveness in moisturizing, skin elasticity improvement, and anti‐inflammatory function when applied to ex vivo human‐derived skin tissue models in experiments. The study has contributed to the understanding of the "CELLADEPP Patch" and laid the foundation for subsequent animal experiments and clinical trials. [ABSTRACT FROM AUTHOR]

Purpose: Alopecia significantly affects the appearance and psychology of patients, and pharmacological therapies and hair transplantation are the main treatments for alopecia, but both have limitations. This review aimed to summarize the non-pharmacological therapies that promote hair growth and regeneration. Patients and Methods: This is a non-systematic review. Multiple databases was searched with relevant data published between 1997 and 2024. Searching and screening followed the PRISMA guidelines. Results: Novel therapeutic modalities, such as gas molecules, platelet-rich plasma, laser, and microneedling, can change the microenvironment of hair follicles, activate hair follicle stem cells, and promote hair growth and regeneration. Conclusion: This paper reviews research on the application of non-pharmacological therapies in alopecia treatment and hair regeneration, with a view to providing an important basis for future research on alopecia treatment and the postoperative treatment of patients after hair transplantation. [ABSTRACT FROM AUTHOR]

Background: Acne is a common skin condition that is prevalent in 90% of the adolescent population. Inflammatory lesions of acne may lead to scarring. Various treatment modalities such as subcision, punch excision, chemical peels, microdermabrasion, and fractional lasers have been tried for acne scars but with unsatisfactory results. Purpose: The aim of the present study is to compare the efficacy of microneedling with Jessner’s plus 35% trichloroacetic acid (TCA) peel versus the efficacy of microneedling with platelet-rich plasma (PRP) therapy for the management of atrophic acne scars. Methods: Sixty patients having atrophic scars due to acne were segregated into two groups each containing 30 patients. On Group A, patients microneedling was performed at weeks 0, 6, and 12 and Jessner’s plus 35% TCA peel was performed at weeks 3, 9, and 15. On Group B, patients microneedling and intradermal PRP were performed sequentially at weeks 0, 3, and 6. Patients were followed at the outset of the procedure and 24 weeks after the procedure using the Echelle d’Evaluation Clinique des Cicatrices d’acne (ECCA) score. Results: The difference in the mean ECCA score at the outset of the procedure and 24 weeks after the procedure was more in Group B as compared to Group A (47.8 ± 13.6 vs. 39.1 ± 11.4). Conclusion: The efficacy of the combination of microneedling with PRP was higher than the combination of microneedling with Jessner’s plus 35%TCA peel for the treatment of atrophic acne scars.

This study aimed to analyze the efficacy and safety of microneedling (MN), both alone and in combination with other treatments, to refine the approach for treating acne scars using MN. We systematically searched Pubmed, Cochrane Library, Embase, and Web of Science for randomized controlled trials examining MN or its combinations in patients with acne scars. All statistical analyses were performed using Stata 18 software. A total of 24 studies involving 1546 participants were included. The analysis revealed that MN combined with chemical peels (CP) exhibited the best results in terms of degree of improvement, patient satisfaction, and treatment efficacy compared to other treatments examined, including MN alone, MN with hyaluronic acid (HA), MN with botulinum toxin‑A (TA), MN with platelet-rich plasma (PRP), PRP alone, CP, and laser therapy. The results for MN combined with additional treatments were obviously better than for MN alone. Side effects such as erythema, pain, and post-inflammatory hyperpigmentation showed no significant differences across all treatments assessed. [ABSTRACT FROM AUTHOR]

Introduction: Severe acne breakouts often lead to atrophic acne scars, which affect millions of people worldwide and can significantly affect a person's self‐confidence and self‐image. Given the difficulty in treating atrophic acne scars, this study aims to investigate the efficacy of topical phenytoin in the treatment of atrophic acne scars. Method: This split face clinical trial on 25 patients between the ages of 18 and 40 involved the application of microneedling on one side of the face, with three sessions taking place over the course of a month. On the other side, a 1% phenytoin cream was administered three times daily for 1 week following the microneedling procedure. Baseline information was collected for all patients, and follow‐up assessments were conducted during the treatment sessions and 2 months after the last session. The assessments included evaluating the number and area of pores and spots, determining scar severity, assessing patient satisfaction, and recording any potential complications. Results: Among patients, 20 individuals (80%) were females, and the average age of the participants was 35.96 ± 9.23. In terms of the fine pore area, despite the fine pore count, both groups showed improvement over time (p: 0.03 vs. 0.06). Also, regarding large pore count and area, and the count and area of spots, both groups showed improvement over time (p: 0.001). However, there were no significant differences between the two groups (p > 0.05). On the other hand, when it comes to acne scar grade and patients' satisfaction, the phenytoin group outperformed the control group in all follow‐up sessions and this difference was found to be significant (p: 0.001). It is worth noting that no complications were observed among any of the patients. Conclusion: It appears that combining phenytoin cream with microneedling has a more effective therapeutic outcome in enhancing atrophic acne scars, when compared to microneedling alone, and this method can be regarded as a viable alternative in treating these types of scars. [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]

Acne scarring is common and can occur even with effective acne management. In addition, patients with acne scarring suffer from significant psychosocial morbidity, including depression and suicidality. Despite the availability and advancement of therapeutic modalities, treatment for acne scarring is not always optimized and often overlooked in patients with acne encounters. Using acne scarring assessment tools and identifying specific acne scar subtypes allows for a tailored therapeutic approach. Part I of this continuing medical education series covers the pathophysiology and morphology of textural and pigmented acne scars, scarring assessment tools, and medical treatment options. The principles reviewed will aid in approaching and initiating acne scar treatment in the outpatient setting. [ABSTRACT FROM AUTHOR]

Pigmentary disorders of the face present a significant challenge in dermatology, impacting the confidence and well-being of affected individuals. Various approaches have been developed to address these concerns, including microneedling and topical vitamin C products. This study involved 15 participants undergoing three treatment sessions over 12 weeks, assessing the efficacy of a combined microneedling and CE Ferulic® serum approach. Clinical evaluation and statistical analysis were conducted before and after the intervention. Significant improvement of akin hyperpigmentation was observed, particularly on the side treated with microneedling and CE Ferulic® serum compared to microneedling alone. The integrated treatment protocol demonstrated a synergistic effect in improving skin texture and appearance. Integrated treatment protocols, such as combining microneedling with CE Ferulic® serum, show promise in managing facial hyperpigmentation disorders. Further research with larger cohorts is warranted to validate these findings and optimize treatment strategies, highlighting the potential of combined therapeutic modalities for achieving optimal clinical outcomes in pigmentary disorder management. [ABSTRACT FROM AUTHOR]

Hair loss is a common cause of presentation to dermatology outpatient clinics and an important disorder affecting the quality of life of patients. Alopecia with cicatricial and non-cicatricial subtypes is a common cause of cosmetic problems. Interest in the use of microneedling as an independent and adjunctive treatment for hair loss disorders has been increasing recently. Microneedling is a minimally invasive procedure that uses multiple needles to create micro punctures in the skin. The penetration of the microneedles produces a controlled skin injury with minimal epidermal damage and stimulates dermal wound healing, hence neovascularisation and the release of growth factors. In hair loss, the stimulation of hair growth by microneedling is related to the wound healing process that occurs in response to the trauma it creates. Microneedling therapy has been shown to stimulate hair growth through the release of various growth factors, stimulation of dermal papilla stem cells and various mechanisms. Although evidence suggests that microneedling may improve hair loss, clinical data are relatively limited. There is not yet a standardised needle length and procedure consensus for treatment and clinical data are relatively limited. With more participants and multi-centre experimental studies, microneedling may become a basic or adjunctive procedure in US Food and Drug Administration (FDA)-approved hair loss treatments. In this review, the mechanism of action of microneedling, the procedure of use with the data in the literature, and its effectiveness in androgenetic alopecia, alopecia areata, telogen effluvium and other hair loss types will be discussed in detail. [ABSTRACT FROM AUTHOR]

Background: Vitiligo is an inveterate disease of great aesthetic concern presenting with depigmented macules and patches. It is often incorrigible to medical treatment. Aim: To study the clinical profile of vitiligo patients and evaluate the effect of 5% 5‑fluorouracil (5‑FU) cream with microneedling. Materials and Methods: This observational analytical study was conducted from November 2019 to July 2021. A total of 33 adult vitiligo patients were treated with oral mini‑pulse (dexamethasone) therapy and topical corticosteroid (clobetasol propionate 0.05%). Patient’s total number of vitiligo lesions with <10‑cm size were counted and half of the lesions were treated with 5‑FU + microneedling (Group A), while a remaining number of lesions were not treated with 5‑FU + microneedling (Group B). In the case of the odd number of lesions, the total number of lesions minus one was considered and then divided into equal numbers for treatment. The procedure was performed every 2 weeks for 3 months. Clinical improvement was assessed monthly till 6 months by serial clinical photographs and grading scores. Results: Initiation of repigmentation started in the first month in Group A, whereas in Group B, it was seen in the second, which was statistically significant (P < 0.0001). Excellent improvement (>75% repigmentation) was noted in Group A as compared to Group B at the end of 6 months (P < 0.0001). Conclusions: Needling with 5% 5‑FU appears to be a simple, safe, and effective treatment in vitiligo. It can be used in poor responders to conventional therapy. [ABSTRACT FROM AUTHOR]

Objective: To provide dermatologists with more clinical experience in treating androgenetic alopecia, we evaluated the effect and safety of combined microneedling therapy for androgenetic alopecia. Method s : Studies on combined microneedling for hair loss were comprehensively searched by us in PubMed, Excerpta Medica Database, and the Cochrane Library Database. The literature search spanned the period from 2012 to 2022. Inclusion and exclusion criteria were developed, and the literature was screened according to this criteria. The Cochrane Risk of Bias Tool was used to assess the quality of the studies. The researcher applied Revman 5.3 and Stata 15.1 software to analyze the data after extracting information from the data. Results: Finally, 13 RCTs involving 696 AGA patients were included to compare the clinical effectiveness and adverse events of combined MN therapy with single MN therapy or single drug therapy for AGA. The results of meta‐analysis showed as follows: (1) Hair density and diameter changes: The combined MN group was significantly better than any single treatment group, and the differences were statistically significant (MD = 13.36, 95% CI = [8.55, 18.16], Z = 5.45, p < 0.00001; MD = 18.11, 95% CI = [13.70, 22.52], Z = 8.04, p < 0.00001; MD = 13.36, 95% CI = [8.55, 18.16], Z = 5.45, p < 0.00001; MD = 2.50, 95% CI = [0.99, 4.02], Z = 3.23, p = 0.001); (2) the evaluation of satisfaction for efficacy: The doctor satisfaction rating of the combined MN group was significantly higher than that of any single treatment group, with statistical difference (RR = 2.03, 95% CI = [1.62, 2.53], Z = 6.24, p < 0.00001). The difference between the two groups regarding patients satisfaction was not significant (RR = 3.44, 95% CI = [0.67, 17.59], Z = 1.49, p = 0.14). (3) Safety: There was no statistical difference in the incidence of adverse reactions between combination therapy and monotherapy (RR = 0.83, 95% CI = [0.62, 1.12], Z = 1.22, p = 0.22). Conclusion: The combined MN group showed statistically significant improvement in hair density and diameter, and good safety compared with monotherapy. [ABSTRACT FROM AUTHOR]

Background: Rosacea is a prevalent chronic dermatological condition marked by facial inflammation and erythema, significantly compromising the quality of life for affected individuals. Current treatment methods for rosacea are not considered ideal because of the complex etiology of the disease. Mussel adhesive protein (MAP) is a glycoprotein derived from the foot gland of mussels. The protein exhibits anti‐inflammatory properties, relieves skin itching, and promotes wound healing. Aims: We aimed to explore the feasibility of using MAP administered via microneedle delivery for treating rosacea and the potential molecular mechanism involved. Materials and Methods: The therapeutic effect and mechanism of MAP microneedle delivery in an LL‐37‐induced rosacea‐like mouse model were observed using morphological and histological methods. Twenty‐seven patients with erythematotelangiectatic rosacea (ETR) underwent treatment once every 1 month, with three treatments constituting one treatment course. The therapeutic effect was evaluated by comparing the clinical images taken at baseline, after the first treatment course, and after the second treatment course. The red value, CEA, and GFSS score were also calculated. Results: In response to the microneedle delivery of MAP, innate immunity, inflammatory infiltration, and abnormal neurovascular regulation improved significantly in rosacea‐like mice. In the clinical experiments, the microneedle delivery of MAP significantly improved the symptoms of erythema, flushing, and telangiectasia in patients with ETR, and no obvious adverse reactions were observed. Conclusions: MAP delivered by microneedling is effective and safe for treating ETR. [ABSTRACT FROM AUTHOR]

Background: Microneedling (MN) and microcoring (MCT) are both methods used for percutaneous collagen induction. This minimally invasive technique involves creating controlled damage in cutaneous tissue to induce neocollagenesis and neoelastogenesis. MN utilizes solid microneedles and is commonly combined with radiofrequency (RF) to add thermal energy, while MCT involves hollow microneedles capable of removing excess tissue without inducing scar formation. Aims: The purpose of this review was to summarize recent literature for MN and MCT, with the goal of assisting clinical decision making regarding the use of these technologies. Methods: PubMed search was conducted for relevant articles published within the last 10 years. Scoping literature review was then performed with pertinent findings reported. Results: Existing literature investigating MCT is sparse. Limited data on in vivo, human effects of this technology exist. Two out of 14 studies in this review pertained to MCT. Conclusion: Additional high‐powered clinical studies are needed to guide future cosmetic treatments with MN and MCT. [ABSTRACT FROM AUTHOR]

Background: Microneedling is a technique of repeated puncturing or drilling of the skin to induce repair and collagen induction. There are many reported important factors determining the efficacy of microneedling treatment. The extent of injury needed to produce the desired effect in each condition is one of these important factors. Objectives: We designed the present split‐face comparative study to evaluate the use and effectiveness of two different depths of penetration of Dermapen needles in the management of atrophic postacne scars. Patients and methods: The present study involved 14 subjects with atrophic postacne scars. In each patient, both sides of the face were treated with six sessions of microneedling, using Dermapen at 2‐week intervals. A split‐face study design was performed. The right (Rt) side of the face was treated with Dermapen using 2.5 mm needle length, while the left (Lt) side was treated using 1.5 mm needle length. Results: There was a significantly better percentage of improvement of acne scars on the Rt side of the face compared to the Lt side (P = 0.02) after six sessions. Both sides of the face showed improvement of collagen bundles and elastic fibers characteristics after six sessions. Conclusions: The use of 2.5 mm depth proved to be more effective both clinically and histologically in the management of atrophic postacne scars. [ABSTRACT FROM AUTHOR]

Although patients with refractory melasma have been treated using various methods, there is still no precise definition or summary of the therapies. To define refractory melasma and conduct a review of the treatments, we searched for relevant publications in PubMed, Web of Science, and the Cochrane Library, and a total of 35 references were obtained. Refractory melasma can be roughly defined as an ineffective treatment for melasma, including topical bleaching agents, chemical peels, laser therapy, microdermabrasion for more than six months, or chemical peels treated more than six times. Meanwhile, physicians should be careful when treating patients with darker skin and dermal or mixed types of melasma since these individuals do not respond well to treatment. Lasers combined with other methods, especially different types of lasers or topical agents, are considered more effective than monotherapy. Oral tranexamic acid (TXA) is a prospective cure for refractory melasma. Other methods include a combination of chemical peels, microneedling, or injections with additional therapies. In conclusion, we were able to provide a rough definition of refractory melasma and list the available therapies. According to the literature, the most prevalent treatment is laser combination therapy. However, laser treatment should be considered only after topical agents and chemical peeling have failed. Considering its side effects, efficacy, and safety, oral TXA may be a better option, but more research is needed to make a firm conclusion. Moreover, maintenance therapy is required after treatment. [ABSTRACT FROM AUTHOR]

Objective To determine the efficacy of micro-needle knife therapy versus placebo (sham microneedle knife) for cervicogenic headache. Method A total of 60 eligible patients with cervicogenic headache were assigned to two groups with 30 cases in each group by using a random number table. Treatment group received micro-needle knife therapy and placebo group received sham micro-needle knife. Results After 4 weeks of intervention, the pain index score was significantly lower in the treatment group (1.27 ± 0.583) than that of the placebo group (3.37 ± 0.765); the cervical range of motion was significantly lower in the treatment group A (1.20 ± 0.407) than that of the placebo group (2.47 ± 0.681); the headache duration was significantly lower in the treatment group (3.33 ± 0.661) than that of the placebo group (5.30 ± 0.988); the headache frequency was significantly lower in the treatment group (1.50 ± 0.682) than that of the placebo group (2.73 ± 0.691), and the differences in the data of the two groups were statistically significant. The duration of headache (3.93 ± 0.739) and frequency of headache (1.96 ± 0.556) were significantly lower in the treatment group than that of the placebo group at follow-up, and the difference was statistically significant (P < 0.05). The occurrence of adverse reactions was not statistically significant in the two groups (P > 0.05) Conclusions Micro-needle knife therapy could effectively improve the pain level of cervicogenic headache patients, reduce the headache duration and headache frequency, and improve the mobility of cervical spine. Acupuncture-related adverse events during treatment were infrequent in both groups and it's safe for cervicogenic headache. [ABSTRACT FROM AUTHOR]

Aim: The aim of this clinical study was to explore the effects of thumb-tack needling combined with sporting (TTNS) therapy on the improvement of pain and joint function in older adult patients with knee osteoarthritis (KOA). Methods: A total of 120 older adult patients with KOA were randomly assigned to receive TTNS therapy or medicine treatment (Med group) only for 1 month. The patients were followed up for 3 months and clinical efficacies were evaluated using a visual analog scale to assess pain, the Lequesne scoring system to assess motor function, and the Western Ontario and McMaster University Osteoarthritis Index to assess KOA severity. Blood was collected to measure the levels of interleukin-6 and tumor necrotic factor-alpha using enzyme-linked immunosorbent assay. Results: The data suggested that TTNS therapy resulted in a significantly higher clinical efficacy (P = 0.012). Visual analog scale score, Lequesne index, and Western Ontario and McMaster University Osteoarthritis Index of the TTNS group at the time of post-treatment (1 month) and post-follow-up (3 months) were also lower compared with the Med group. Patients in the TTNS group also showed lower levels of serum tumor necrotic factor-alpha and interleukin-6. Conclusions: TTNS therapy is more efficacious than pharmacological treatment in improving the clinical outcomes of patients with KOA, which suggests its clinical utility in the management of KOA. [ABSTRACT FROM AUTHOR]

Background: Hair cycle arrest (HCA) is a chronic alopecic disorder in dogs. Clinical responses vary and are often insufficient. Microneedling (MN) has been used as a successful treatment for HCA in dogs; ideal protocols have not yet been established. Objectives: The objective of the study was to compare the efficacy and safety of three needle lengths for MN in dogs with HCA. Animals: Six unrelated client‐owned dogs, including five Pomeranians and one mixed‐breed dog, diagnosed with HCA. Materials and Methods: Individual alopecic sites were divided into three sections. For each section, different lengths of needles (1, 2 and 3 mm) were used. Efficacy and safety were evaluated at 1, 3 and 6 months. Treated sections were monitored for 20 months. Results: Three months after treatment with 3 mm needles, all sections showed hair regrowth. There was no hair regrowth in two of six sections treated with 2 mm needles, and four of six sections did not show a response to treatment with 1 mm needles. Two dogs developed transient pruritus. Five of six dogs had recurrent hair loss between 5 and 16 months of follow‐up. Conclusion and Clinical Relevance: Microneedling using longer needles stimulated better hair regrowth in dogs with HCA. Alopecia relapsed in most dogs and minor pruritus occurred in some dogs. [ABSTRACT FROM AUTHOR]

Context: Scarring is a biological process of wound repair which leads to a difference in the normal structure and function of the skin and manifests as a depressed or raised area. Treatment of scars is challenging. A number of therapeutic approaches like surgical techniques and non-surgical techniques are performed to improve scarring. Aims and Objectives: The aim of this study was to compare the outcome of subcision followed by microneedling versus subcision followed by microneedling and topical platelet-rich plasma (PRP) in atrophic scars. Materials and Methods: A comparative prospective study was conducted at a tertiary care hospital in North India to compare the efficacy of subcision followed by microneedling versus subcision followed by microneedling and topical PRP. A total of 40 cases were taken and were randomly divided into two groups, A and B of 20 patients in each group. Topical PRP was applied as an additional therapy in Group B in the same sitting. Minimum three sittings were done in each patient at an interval of 4 weeks and results were assessed after 1 month of the third session. The statistical software used is Microsoft Excel and SPSS software program, version 24.0 for analysis of data and Microsoft Word to generate graphs and tables. Results: Improvement in scar grading was more in Group B as compared to Group A with statistically significant difference (P = 0.032). There was an improvement in scar grading from grade 4 scar to grade 2 in 15% and 30% patients of Groups A and B, respectively, with improvement in skin texture and pigmentation more in Group B. Conclusion: PRP proved to add to the improvement of grade of atrophic scars when combined with subcision and microneedling. [ABSTRACT FROM AUTHOR]

Background: Severe post-acne scarring has been implicated as a cause of considerable psychological distress, mainly among adolescents. Subcision and microneedling are cutting-edge treatment options available nowadays. Aim: In this study, we aimed to compare the efficacy of microneedling with platelet-rich plasma (PRP) against subcision with PRP in treating atrophic post-acne scars in a split-face study design. Materials and Methods: Fifty patients with atrophic post-acne facial scars were included in this prospective interventional study. Group A included the left side of the face managed by microneedling with PRP and group B included the right side of the face that was subjected to subcision with PRP. Results were assessed based on Goodman and Baron qualitative and quantitative grading. Results: In our study, at the end of the treatment, on the left side, 5 (10%) had 1 grade of improvement showing good response, 35 (70%) had 2 grades of improvement showing very good response, and 10 (20%) had 3 grades of improvement showing excellent response. On the right side, 1 (2%) patient had no improvement in acne grade showing poor response, 9 (18%) had 1 grade of improvement showing good response, 25 (50%) had 2 grades of improvement showing very good response, whereas 15 (30%) had 3 grades of improvement showing excellent response. Conclusion: Till date, apart from ours no other study has compared the two modalities head-to-head with adjuvant PRP in both groups. Although both modalities showed statistically significant results individually, there was no significant difference in qualitative improvement of acne scars between the two groups. [ABSTRACT FROM AUTHOR]

BACKGROUND: Acanthosis nigricans is a common hyperpigmentation disorder with a profound aesthetic impact. The primary concern of most patients is the cosmetic improvement, that is way there is a continuous search for the most effective cosmetic therapeutic option. METHODS: 40 acanthosis nigricans patients were included, lesions are split into equal halves; right side treated with TCA 15% peel and left side was treated with microneedling followed by TCA 15% peel, both sides were treated monthly for three months. Response to treatment was assessed by acanthosis nigricans grade improvement along with the percentage of improvement in texture and pigmentation individually. RESULTS: There was statistically signiffcant improvement in acanthosis nigricans grade after treatment in both sides. The combination side showed more improvement in terms of texture and pigmentation. CONCLUSION: Both TCA 15% alone or combined with microneedling were effective in improving acanthosis nigricans with superior results in combination modality. [ABSTRACT FROM AUTHOR]

Objective: Alopecia areata (AA) is often characterized by sudden onset of patchy hair loss. Topical corticosteroid injection is the most common treatment. This study retrospectively observed the clinical efficacy of microneedle minoxidil combined with triamcinolone acetonide in the treatment of AA. Methods: A total of 230 patients with AA were selected. The experimental group (n = 120) received physician training and home microneedle treatment with minoxidil combined with triamcinolone acetonide once a week. Topical minoxidil and triamcinolone acetonide were used twice daily at other times. The control group (n = 110) was treated with minoxidil combined with triamcinolone acetonide, twice a day. Cure rate, response rate, SALT, dermatological Quality of Life Index (DLQI), visual analogue (VAS), and cost were assessed at weeks 4 and 12. Results: Treated group SALT score(Severity of Alopecia Tool) remarkable lower than control group after treated 4 and 12 weeks. After 12 weeks treatment, DLQI score of the treated group (1.8 ± 1.67) were significantly lower than those of the control group (2.45 ± 1.88) (p < 0.05). VAS score and adverse reaction between two group showed no significant different (p = 0.823, p = 0.484 respectively). The total cost was 53.93 ± 15.85 in the treatment group and 53.26 ± 11.51 in the control group. There was no significant difference between the two groups (p = 0.72). In the treated group, the complete response rate (CR: 78.33%) and total effective rate (CR+PR: 95%) were significantly higher than those in the control group (CR: 40.91% and CR+PR: 51.82%), with statistically significant differences (p < 0.001). Conclusion: Microneedle introduction of minoxidil and triamcinolone acetonide in the treatment of AA is a safe, effective, economical, and convenient method, with few adverse reactions, and has a good application prospect. [ABSTRACT FROM AUTHOR]

Background: Microneedling has emerged as a promising technique for transdermal drug delivery, offering a minimally invasive method to enhance the permeation of topical medications. Despite its increasing application in dermatological treatments, comprehensive reviews of its mechanisms, advantages, and therapeutic uses are scarce. Objective: This review aimed to provide a comprehensive overview of microneedling as a mode of delivery for topical medications, encompassing its mechanism of action, advantages, disadvantages, and applications in cosmetic and therapeutic delivery. Methods: An extensive literature search was conducted across multiple databases, including PubMed, Scopus, and Web of Science, to identify studies related to microneedling and its applications in drug delivery. The review focused on articles published in the last two decades. Documents in languages other than English were disqualified due to lack of translation-related sources. Conclusion: Microneedling represents a versatile and effective method for transdermal drug delivery, with a wide range of applications in both cosmetic and therapeutic contexts. Ongoing research and technological advancements are expected to further enhance its efficacy and safety, solidifying its role in modern dermatological treatments. [ABSTRACT FROM AUTHOR]

Background: There are many post‐procedural treatments touted to improve comfort and decrease downtime, but very few prospective randomized studies. Aims: To analyze the safety and efficacy of a post‐procedural biotech cellulose mask. Patients/Method: Fifteen patients undergoing either a microneedling with radiofrequency (n = 5), non‐ablative fractional (n = 5), or full erbium:YAG resurfacing (n = 5) treatment were randomized to receive a biotech cellulose mask on one side of the face for 30 min after the procedure and for 2 h a day until healed. Standardized photos and thermal images were taken 30 min after the procedure and daily until healed. The investigator and blind evaluators reviewed the photos, and subjects answered daily questionnaires. Results: An analysis of the thermal images showed a significant reduction in facial temperature on the biotech cellulose mask side as compared to the control side in all groups with an average of 2.2 (range 0.2–6.5) degree Celsius reduction across all 15 subjects. All subjects reported less pain and heat immediately upon application of the mask. Thirty minutes after application, 13/15 continued to report less pain and heat, and 11/15 reported less erythema and swelling on the mask side while blind evaluators were able to choose which side had the mask 80% of the time. On average, subjects also reported significantly less swelling on Day 1 and Day 2. Conclusion: The biotech cellulose mask decreased patient's facial temperature, feelings of heat and pain, as well as downtime without any side effects for the subjects in this study undergoing a variety of treatments. [ABSTRACT FROM AUTHOR]

Background: Tranexamic acid (TA) is a new and promising drug for the treatment of melasma. Objectives: This network meta‐analysis aims to compare the efficacy and safety of various ways of administration of TA on melasma. Methods: We collected researches from PubMed, EMBASE, Cochrane Library and Web of Science. Melasma area severity index (MASI) is used to evaluate the severity of melasma. After treatment with different TA administration methods, a difference in MASI is named ΔMASI. We evaluate the curative effect by comparing the ΔMASI of different TA administration methods at a certain time point. Results: At the Weeks 4, 8, and 12 and the last follow‐up, the ΔMASI of oral TA combined with routine topical agents (oTA + RTA) was higher than that of intradermal TA (iTA), topical TA (tTA) as well as microneedling TA (MNsTA), with statistical significance. At the 8th week, the ΔMASI of oTA was higher than that of iTA, with statistical significance. Compared with placebo, oTA showed statistically significant differences at Week 4, while tTA, iTA, and MNsTA showed statistically significant differences starting from Week 8. Conclusions: Among various ways of administration of TA, oTA + RTA has the best effect on melasma. In the short term, the curative effect of oTA is better than that of iTA, and the onset time of oTA is faster than that of tTA, iTA and MNsTA. In the long run, the curative effect of TA alone has nothing to do with the mode of administration. [ABSTRACT FROM AUTHOR]

Microneedling, also known as percutaneous collagen induction, using microneedling devices and fabricated microneedle patches, has been widely employed in cosmetic applications for acne scar treatment, skin care, hair loss, melasma, skin rejuvenation, and skin cancer. The micro-channels formed by microneedling through the stratum corneum facilitate the delivery of cosmetic agents and stimulate collagen and elastin production by inducing the wound-healing cascade, keeping the skin shiny and wrinkle-free. Several cosmetic agents, such as ascorbic acid, hyaluronic acid, retinoids, niacinamide, and peptides, have been delivered by microneedling. This review aims to highlight the use of microneedling devices and fabricated microneedle patches in facilitating the delivery of cosmetic agents through the skin layers. Moreover, the differences between the microneedling devices, commonly used alone or in combinational treatments with topical formulations, are explored. Furthermore, the safety of microneedling in terms of skin irritation, pain sensation, skin or systemic infection, and chemical and biological materials used in the fabrication of microneedles is discussed. [ABSTRACT FROM AUTHOR]

Background: Stretch marks, or striae distensae (SD), are a common dermatological issue caused by skin stretching and subsequent dermal damage. Various treatments, including laser therapy and microneedling, have been explored for SD. This study evaluates and compares the effectiveness of Fractional CO2 laser and microneedling with platelet-rich plasma (PRP) for treating SD. Method: A randomized controlled trial was conducted over a year at Rohilkhand Medical College and Hospital. Ninety-eight patients aged 18-40 were enrolled and divided into two groups: Group A (Fractional CO2 laser) and Group B (microneedling with PRP), each receiving four sessions at three-week intervals. Patients' histories, including demographics and striae characteristics, were documented. The effectiveness of treatments was assessed using the Visual Analogue Score (VAS) and Patient Satisfaction Scale (PSS) at multiple follow-ups. Side effects were also recorded. Result: Group A (Fractional CO2 laser) had 49 patients with a mean age of 25.9 years, and Group B (microneedling with PRP) had 49 patients with a mean age of 26.4 years. Group A showed a significant reduction in striae width and length compared to Group B. By Week 12, 48.80% of Group A reported Excellent Improvement in VAS scores, compared to 12.80% in Group B. Patient satisfaction was significantly higher in Group A, with more patients reporting Very Satisfied and Extremely Satisfied outcomes. Side effects such as erythema and hyperpigmentation were more common in Group A. Conclusion: Fractional CO2 laser therapy is more effective than micro needling with PRP in reducing the appearance of stretch marks, with higher patient satisfaction and significant improvements in VAS scores. Despite a higher incidence of side effects, the CO2 laser provides better overall outcomes.

Introduction: Post-acne scars are a prevalent cosmetic complaint that usually requires multi-modality treatment to achieve accepted results. Objectives: The target of this research was to evaluate and compare the efficacy and safety of microneedling with topical insulin against microneedling with non-cross-linked hyaluronic acid in atrophic post-acne scars treatment. Methods: The current comparative split-face research included 30 patients with atrophic facial acne scars. Each patient received 6 sessions of microneedling with topical insulin on one side of the face and microneedling with non-cross-linked hyaluronic acid on the other side. Sessions were done 3 weeks apart and digital photographs were taken before and 3 months after the last treatment session. Goodman and Baron qualitative and quantitative grading system was used to evaluate the improvement across both sides of the face, along with patient satisfaction. Results: After 3 months of the last session, a statistically significant improvement in qualitative acne scars grading on both sides of the face (p-value

Abstract Vitiligo is a chronic disease which manifests as patchy loss of skin pigmentation. It can be classified into two main types: segmental and nonsegmental. The condition can result in significant negative psychosocial effects, especially in skin of colour patients. These implications are particularly important in the social development of children and adolescents. As such, rapid‐acting, effective therapeutic options should be pursued when treating these patients. Topical ruxolitinib is the only approved drug for the treatment of vitiligo. Other procedural therapeutic options have also been explored including microneedling both alone and in conjunction with topical agents. Microneedling is thought to stimulate repigmentation through the induction of cytokines and growth factors which activate melanocytes and their precursors as well as through the creation of microchannels which allow for enhanced topical drug delivery. Its efficacy has been described in nonsegmental vitiligo cases, but its utility in segmental vitiligo has not been consistently characterised in the literature. We describe the first case of segmental vitiligo treated with combined microneedling and topical ruxolitinib in a skin of colour adolescent patient and review the purported mechanism of action of treatment.

Acne scars can greatly impact patient quality of life. While treatment options have included mi- croneedling, the recent addition of platelet-rich plasma (PRP) to this regimen has led to an increased popularity of combination treatment. Here, we aimed to review the efficacy of microneedling and PRP therapies and review the literature on combination treatment for acne scars.

Abstract Background Striae distensae is a disfiguring atrophic skin condition that impairs the body’s aesthetic image. Despite the variety of conducted studies, there is controversy regarding the best modalities. Human mesenchymal stem cells are considered a rich source for scar treatment. Skin needling is among the most efficient and safe aesthetic and therapeutic devices. This study aimed to evaluate the efficacy of the combination of needling and intradermal injection of mesenchymal stem cells compared to skin needling alone for treating striae distensae. Method This study was a randomized, double-blind clinical trial involving 10 women aged 18–60. Each striae lesion was divided into two parts, with one side receiving needling and intradermal injection of conditioned medium, while the other side received needling and intradermal injection of normal saline. This treatment was administered in three sessions with three-week intervals. Patients were evaluated before the first intervention and three months after the final session. Three months after the completion of the intervention, patients’ lesions were evaluated using biometric criteria, physician evaluation, and patient self-assessment. Results The results demonstrated a significant improvement in dermal and complete thickness and skin density in patients treated with microneedling. All skin ultrasound parameters improved significantly in patients receiving the combination of needling and conditioned medium. When comparing the two groups, significantly higher physician and patient satisfaction was observed in the combination group. However, the comparison of biometric indices improvement wasn’t significant between these groups. Conclusion The combination of human mesenchymal stem cells with microneedling could be considered a novel effective option for stretch marks.

Background: Striae distensae is a disfiguring atrophic skin condition that impairs the body's aesthetic image. Despite the variety of conducted studies, there is controversy regarding the best modalities. Human mesenchymal stem cells are considered a rich source for scar treatment. Skin needling is among the most efficient and safe aesthetic and therapeutic devices. This study aimed to evaluate the efficacy of the combination of needling and intradermal injection of mesenchymal stem cells compared to skin needling alone for treating striae distensae. Method: This study was a randomized, double-blind clinical trial involving 10 women aged 18–60. Each striae lesion was divided into two parts, with one side receiving needling and intradermal injection of conditioned medium, while the other side received needling and intradermal injection of normal saline. This treatment was administered in three sessions with three-week intervals. Patients were evaluated before the first intervention and three months after the final session. Three months after the completion of the intervention, patients' lesions were evaluated using biometric criteria, physician evaluation, and patient self-assessment. Results: The results demonstrated a significant improvement in dermal and complete thickness and skin density in patients treated with microneedling. All skin ultrasound parameters improved significantly in patients receiving the combination of needling and conditioned medium. When comparing the two groups, significantly higher physician and patient satisfaction was observed in the combination group. However, the comparison of biometric indices improvement wasn't significant between these groups. Conclusion: The combination of human mesenchymal stem cells with microneedling could be considered a novel effective option for stretch marks. [ABSTRACT FROM AUTHOR]

BACKGROUND Patients with darker skin phototypes self-report less facial aging than their lighter-skinned counterparts. However, the association of skin phototype with the type of cosmetic procedures received, is yet to be established in a Canadian context. OBJECTIVE To compare the pattern of nonsurgical cosmetic procedures performed on people with different Fitzpatrick SPTs. MATERIALS AND METHODS Cross-sectional study of patient encounters from October 2020--April 2022. Charts and photographs were reviewed and analyzed for age, sex, SPT, and procedure type. Participants were stratified by SPT into 2 cohorts: SPT I--III and SPT IV--VI. SPTs were collapsed into groups based on definitions of "skin of color" (SPT IV--VI) in previous literature. RESULTS We analyzed 350 patients with mean age 43.4, of whom 320 (91%) were female and 30 (9%) were male. The SPT I--III cohort was older (mean age 45 vs 38.5 years, p, .0001) and more frequently underwent neuromodulator injection. The SPT IV--VI cohort more frequently underwent microneedling, platelet-rich plasma, or electrodessication. CONCLUSION There are distinct patterns of cosmetic procedures performed. The SPT I--III cohort more commonly received procedures to manage facial aging. The SPT IV--VI cohort was younger and more commonly underwent procedures to manage hyperpigmentation. [ABSTRACT FROM AUTHOR]

INTRODUCTION Acne is a long-lasting inflammatory condition of the skin's hair follicles and oil glands. It is identified by comedones, inflammatory papules, pustules, and occasionally, nodules and cysts. Scarring that occurs as sequelae, is permanently disfiguring, both physically as well as psychologically. Multiple techniques are often required in combination to achieve the best results for managing acne scars, as there is no single ideal procedure or set algorithm. So, we decided to undertake this study to evaluate acne scar patients and compare the results of the existing two modalities, Fractional Carbon Dioxide Laser and Microneedling, in treating acne scars. AIM To observe and compare the efficacy and safety of fractional carbon dioxide laser and micro needling in the treatment of atrophic acne scars MATERIALS AND METHODS The patients were randomly allocated to the following two regimens: Group A: Treated with Fractional Carbon Dioxide Laser (4 sittings) [25 patients] Group B: Treated with Microneedling (4 sittings) [25 patients] Each sitting was done at 4-week intervals. * Pre-treatment and post-treatment Goodman Barron score was recorded. Patients were followed up regularly every 3 weeks for 3 months and then monthly for another 3 months. RESULTS Among the 50 patients, the most common age group was 21-30 years (78%) and males exceeded females (1.77:1). Majority of patients (46%) had acne scars for 4+ years with cheeks being the predominant site followed by temples. Predominantly rolling and boxcars were present in all the patients. In patients treated with fractional carbon dioxide laser, the preprocedure Goodman Baron score was 3.6 while the post-procedure was 2.72 whereas in the other group, the change in the score was from 3.56 to 2.84. P value was highly significant when comparing the pre-and post-procedure scores but nonsignificant when comparing the 2 modalities. CONCLUSION In conclusion, we can infer that clinical improvement in both groups is almost the same and their difference is statistically insignificant. Among other factors, age, type, and duration of scars, impact the final outcome while the grade of scars at presentation does not affect the outcome, according to my study. [ABSTRACT FROM AUTHOR]

Background: Atrophic scars are white, dermal depressions, caused by the destruction of collagen fibers and decrease in epidermal cells, following inflammation after different types of trauma. They lead to significant physical, aesthetic and psychological barriers and their treatment remain a therapeutic challenge for dermatologists. Microneedling has been shown to improve scars by stimulating angiogenesis and neocolagenesis and the combination of anti‐fibrotic drugs could potentialize the results. Methods: We present 8 cases of patients with linear scars, successfully treated with two sessions of a new Microneedling technique, using a tattoo machine, associated with drug delivery of 5‐FU. Results: A marked improvement in scar pigmentation and texture were noted by patients and doctors, 6 months following the sessions of MMP and drug delivery with 5‐FU, in different body sites. We also showed that the assessment scores of at least one of the professionals with those of the patient had significant correlations with each other, which shows consistency between the qualitative assessment instruments. We also showed that the cause of the injury can influence joint assessment scores (physicians plus patient) or those exclusive to professionals trained for the assessments, generating evidence that the cause of the injury can influence the treatment outcome itself. Conclusions: We present an inexpensive and promising approach that can be easily done as an in‐office procedure. Larger, multicenter studies are needed to validate this technique among the first line therapies for acne scar treatment. [ABSTRACT FROM AUTHOR]

Background: Acne scar (AS) is a frequent sequela in patients with acne. In addition to advanced treatment methods, microneedling (MN) is still used as an effective option in the treatment of AS. However, similar to most diseases in dermatology, there is no objective tool to determine the severity of AS and to evaluate the treatment outcome. Objectives: In the current study, we aimed to evaluate skin elasticity in AS patients who have undergone MN therapy. Furthermore, other purposes were to determine the relationships between the history of isotretinoin use, demographic data, and changes in skin elasticity. Methods: In order to evaluate the skin elasticity of 20 patients with AS, shear wave elastography (SWE) was performed before and after MN treatment. The physician's clinical assessment was evaluated with quantitative AS severity scale. In order to show that SWE is a consistent method, three repeated measurements were performed on 24 healthy participants. Results: A significant increase was found between the shear‐wave velocity (SWV) values that were measured baseline and after treatment in the patient group (P = 0.033). In the control group, there was no significant difference between the three repeated measurements (P > 0.05). A statistically significant decrease was also detected in the AS severity scores (P < 0.005). Conclusions: In AS patients who underwent MN treatment, a significant increase was found in skin elasticity compared to the baseline. We argued that SWE is a method that can be useful to evaluate skin elasticity before and after similar cosmetic procedures and dermatological diseases. [ABSTRACT FROM AUTHOR]