Laser hair removal is the treatment of choice for reducing unwanted hair in hirsute patients. However, preventing hair regrowth remains a challenge. This study aimed to evaluate the combined effect of laser and enzymatic hair removal. Fifty-nine Greek women with facial hirsutism were divided into 2 groups. Group I was treated with combination of Alexandrite laser and iontophoresis of chymotrypsin and papain solutions. Group II was treated with laser alone. Outcomes included trichoscopic hair counts and patient-reported hair-free intervals (HFIs). Hair reduction from baseline was significantly higher in group I than in group II both after the 10th session (83.88 ± 10.63% vs 44.56 ± 23.52%) and at follow-up (80.28 ± 11.56% vs 25.68 ± 29.97%). The increase in HFI from the 1st to the 10th session was significantly higher in group I (38.05 ± 24.47% vs 19.82 ± 12.42%). Combination of Alexandrite laser and iontophoresis of proteolytic enzymes led to greater hair reduction, better early maintenance of the achieved result and longer HFIs than laser alone.

Steatocystoma multiplex (SM) is a benign adnexal disorder characterized by multiple dermal cysts arising from the pilosebaceous unit. Although various treatment modalities have been reported, recurrence and scarring remain challenging issues. This report aims to present a minimally invasive treatment approach using Er:YAG laser therapy. A 24-year-old man presented with numerous asymptomatic, dome-shaped, skin-colored papules (3-8 mm) on the lumbar and gluteal regions, which appeared following rapid weight loss. Histopathologic examination confirmed the diagnosis of SM. Given the extensive number of lesions, Er:YAG laser therapy was selected as a minimally invasive approach. The laser was applied using a 2-mm spot size and fluence of 7 J/cm2 in micro-short pulse mode until cyst contents were expelled. Topical mupirocin and a short course of oral azithromycin were prescribed post-procedure. The patient tolerated the procedure well. At six months, complete lesion resolution was achieved without scarring or recurrence. Cosmetic outcomes were good with minimal postinflammatory erythema. Er:YAG laser treatment may represent a safe and effective option for the management of SM with excellent cosmetic outcomes and minimal recurrence, particularly in cases with numerous lesions where surgical excision is impractical.

Vascular anomalies commonly affect the head and neck region and may result in functional and aesthetic impairment when involving the oral cavity Minimally invasive therapies, such as photocoagulation, have emerged as promising alternatives. Thus, the aim of this case series was to evaluate the efficacy of high-power diode laser (808 nm) photocoagulation in the treatment of oral vascular anomalies (OVA). This study included 12 patients presenting 13 OVA treated using diode laser photocoagulation (808 nm) with power settings ranging from 1.5 to 2.0 W in continuous mode. A 400-µm optical fiber was positioned perpendicular to the lesion in a non-contact technique, approximately 2 mm from the tissue. Clinical data regarding demographics, lesion characteristics, treatment sessions, complications, and follow-up were collected to assess clinical outcomes. Most patients were female (n = 9; 75%), and the lower lip was the most frequently affected site (n = 7; 53.8%). Lesion size ranged from 0.6 to 7.0 cm. Most lesions were successfully treated in a single session (n = 11; 84.2%). Postoperative ulceration occurred in all cases. Lesion reduction was predominantly classified as excellent. High-power diode laser photocoagulation is a safe and effective minimally invasive treatment for OVA, promoting significant clinical improvement.

Pyogenic granuloma may recur when an underlying vascular anomaly remains untreated. We report a case of recurrent pyogenic granuloma of the finger pulp associated with a deep venous malformation successfully treated using sequential dual-wavelength pulsed dye laser (PDL, 585-595 nm) and Nd:YAG laser (1064 nm). Four sessions were performed at three-month intervals (PDL 6 J/cm2; Nd:YAG 50 J/cm2; 10-mm spot; long delay sequential mode) with integrated cooling. Complete clinical resolution was achieved without adverse effects or recurrence after five years. Sequential PDL-Nd:YAG therapy represents an effective etiologic approach for complex vascular lesions involving both superficial and deep components.

Energy-based devices play a crucial role in aesthetic medicine for treating facial skin aging. Non-ablative thermolifting improves skin firmness and elasticity. This randomized trial evaluates Zaffiro® infrared technology and microfocused ultrasound (MFU) on dermal thickness and facial skin rejuvenation. Thirty healthy women were randomized (1:1) into two groups: Zaffiro® (N = 15) and MFU (N = 15). Each received a single treatment session and was evaluated at 30, 60, and 90 days. High-frequency ultrasound imaging assessed dermal thickness. Wrinkle severity (Fitzpatrick Wrinkle Scale), Subject Global Aesthetic Improvement Scale (SGAIS), patient satisfaction, and treatment tolerance were recorded. Both groups showed a ~ 40% increase in dermal thickness. Wrinkle reduction reached 52.8% in Zaffiro vs 40.5% in MFU. At 30 days, 62% of Zaffiro patients reported significant improvement vs 15% in MFU. Satisfaction was 85% (Zaffiro) and 61% (MFU) at 30 days; 92.5% in both groups at 90 days. Both technologies improved dermal thickness and wrinkle severity. Zaffiro demonstrated earlier and greater improvements in aesthetics and comfort, making it a favorable noninvasive treatment.

Same-day multimodal aesthetic treatments may optimize patient convenience, but concerns remain regarding possible thermal degradation of botulinum toxin type A (BoNT-A) when combined with energy-based devices. To preliminarily evaluate the feasibility and clinical outcomes of a single-session protocol combining Q-switched (QS) 1064 nm laser, incobotulinumtoxinA, and laser-assisted drug delivery (LADD) of polydeoxyribonucleotide (PDRN) and retinoic acid. This pilot case series included five patients. The protocol consisted of carbon-assisted QS 1064 nm laser treatment (2 J/cm), immediately followed by intramuscular BoNT-A injections and topical application of 5% PDRN and 10% retinoic acid. Outcomes were assessed 15 days post-treatment using the Modified Fitzpatrick Wrinkle Scale (MFWS) and Global Aesthetic Improvement Scale (GAIS). Clinical follow-up was performed for up to 6 months. Mean MFWS scores improved from 1.96 ± 0.46 to 0.88 ± 0.39 (p < .001). All patients were rated as "Much Improved" or "Very Much Improved" on GAIS. No serious adverse events occurred. BoNT-A efficacy was clinically preserved throughout follow-up. This multimodal protocol appears to be a feasible and well-tolerated strategy for same-session facial rejuvenation without clinically compromising BoNT-A efficacy.

This study investigated the dermatological outcomes of a transferosomal gel encapsulating Niacinamide and Co-enzyme Q10 compared with a conventional base gel in healthy female volunteers over a 12-week period, with a particular focus on key biophysical and aesthetic skin parameters. Before human use, both formulations underwent primary skin irritation testing on rabbit skin, followed by a patch test on healthy volunteers to establish safety. A randomized split-face study design was implemented. Skin hydration, elasticity, melanin, erythema, sebum content, pore size, spots, and wrinkle indices were systematically assessed. Sensory evaluation and appropriate statistical analyses complemented the biophysical measurements. Irritation and patch-test assessments confirmed the nonirritant, well-tolerated nature of both formulations. The transferosomal gel demonstrated significantly higher efficacy (p < .05) across multiple parameters, including hydration, elasticity, melanin, erythema reduction, and sebum regulation. Improvements in pore size, spot reduction, and wrinkle were also more substantial and became evident as early as week 2, with continual enhancement observed throughout the 12-week study. Transferosomal delivery of Niacinamide and Co-enzyme Q10 demonstrates improved topical efficacy compared with conventional formulation, as evidenced by the performance outcomes. It offers a safe, noninvasive delivery strategy for improving skin-related parameters within the study conditions.

Aging impacts all facial layers, leading to aesthetic concerns such as lines, folds, and furrows. Injectable dermal fillers are commonly employed to address these changes, with polycaprolactone (PCL) emerging as a widely used and innovative option. Images from before and after PCL injection were analyzed from 31 medical records (n = 31). The treatment points were 11. Images were processed in GIMP, and the selection of the facial area was in Adobe Photoshop, and the selected area was calculated in ImageJ. Associations between measurement variations before and after the procedure were tested concerning the increase and decrease in projections and shadows in the places where PCL was injected. The margin of error was 5% (p = .05) in the Bootstrap test (n = 300), Tukey's post hoc test, and ANOVA. There was no statistically significant difference in the zygomatic (p = .093), angle and ramus of the mandible (p = .07), and labiomental sulcus (p = .3559). In all other areas, there was a reduction in the shadow area, which was associated with an increase in the projection/prominence of the regions adjacent to the injection. PCL proved effective in full-face use in most areas tested (eight out of 11): Mean percentage reductions were: infraorbital margin (-8.3%, p = .021), palpebromalar groove (-7.4%, p = .006), piriformis fossa (-11.9%, p = .000), nasolabial fold (-9.5%, p = .002), oral commissure (-5.5%, p = .002), mentolabial groove (-9.0%, p = .001), pre-jowl area (-6.9%, p = .001), and chin (-6.9%, p = .001).

Neurogenic rosacea (NR) poses a therapeutic challenge due to its resistance to conventional treatments. This study explores the efficacy of pulsed-dye laser (PDL) therapy in managing NR. We present two cases of NR with severe facial discomfort and photoaging, treated with PDL alongside oral medications. Remarkably, PDL significantly alleviated pain and improved skin appearance in both cases, with sustained relief for over 2 years. Mechanistically, PDL may modulate neuropeptides and nerve fiber density implicated in NR pathogenesis. Our findings suggest PDL as a promising therapeutic avenue for NR, warranting further investigation and consideration in clinical practice.

Minimally invasive treatments such as fractional lasers are well-established options for addressing the aging skin in the periorbital region. Among energy-based devices, radiofrequency microneedling (RFMN) has emerged as a potential alternative. To evaluate the effectiveness and safety of RFMN for periorbital rejuvenation. In this prospective, evaluator-blinded clinical study, patients with periorbital wrinkles and fine lines received 1-3 RFMN sessions at 6-8-week intervals. Follow-up occurred 6 months after the final treatment. Outcomes were assessed using automated imaging software and a 5-point numeric rating scale (1 = very much improved; 5 = worsened) by two blinded, board-certified dermatologists. Adverse events (AEs) were documented. In total, 25 patients were included. Imaging analysis showed mean wrinkle reduction of 25.3 ± 40.4% in the infraorbital area and 37.3 ± 64.0% in the crow's feet region. Blinded evaluators reported a mean clinical score of 3.21 ± 0.98, reflecting variable improvement. All patients experienced transient erythema and edema, resolving within days. No severe AEs occurred. RFMN appears to be a promising option for periorbital rejuvenation with minimal downtime. Larger comparative studies are needed to confirm efficacy and define its role relative to established treatments.

Severe acne, left untreated, lead to permanent scarring and facial deformities, causing significant physical and psychological distress. Traditional ablative lasers, while effective for treating facial atrophic acne scars, are often limited by long recovery times and complications such as erythema, hyperpigmentation, and scarring. This study aims to compare the efficacy of fractional carbon dioxide (CO2) laser treatment with and without subcision for improving facial acne scars, seeking a more effective treatment with minimal recovery time. A total of 30 patients (18-40 years) with facial atrophic scars, attending the Dermatology OPD of a tertiary hospital, allocated into Group A (Fractional CO2 with subcision) and Group B (Fractional CO2 without subcision). The study used Goodman and Baron's quantitative and qualitative acne scar grading system for objective assessment and patients provided feedback using a 5-point Likert scale to gauge satisfaction. The scar improvement was better in Group A compared to Group B (p-value = .007), which was statistically significant. Patients receiving Fractional Carbon Dioxide Laser with subcision were more satisfied with the treatment outcome compared to those receiving Fractional Carbon Dioxide Laser alone. Keywords: Facial acne scars, Fractional carbon dioxide laser, Subcision.

Evaluate safety and aesthetic outcomes of combining lower eyelid skin pinch blepharoplasty with full-field erbium:YAG resurfacing for lower eyelid rejuvenation. Retrospective case series of 25 consecutive patients undergoing simultaneous lower eyelid skin pinch excision and full-field erbium:YAG resurfacing as part of a standardized lower-eyelid rejuvenation protocol that also included tear trough/lid-cheek autologous microfat grafting with blunt orbital retaining ligament release; transconjunctival fat removal and canthopexy were performed as indicated. Two masked oculoplastic surgeons graded standardized photos using the Barton Tear Trough Scale (0-3). MRD2 was measured to assess lid position. Complications and clinically evident lower lid tightening were recorded. Barton scores were compared with Wilcoxon signed-rank testing and MRD2 with paired t-testing. Mean Barton scores improved from 2.88 ± 0.33 to 0.52 ± 0.51 (p < .0001), with improvement in all patients. All patients had Fitzpatrick skin types I - III. Mean MRD2 was unchanged (3.75 ± 0.79 mm vs 3.71 ± 0.53 mm; p = .65), indicating preserved lid position. Lower lid tightening was noted in 21/25 patients. No ectropion, lower lid retraction, new scleral show, or vision-threatening complications occurred. Transient chemosis occurred in 6 patients and prolonged erythema in 2, all resolving with conservative care. Combined lower eyelid skin pinch surgery and full-field erbium:YAG resurfacing, within a comprehensive lower-eyelid rejuvenation protocol, significantly improved tear trough appearance and wrinkles while preserving lid position, with mostly transient complications.

This study aimed to evaluate pain levels, patient satisfaction, and preferences for different anesthetic techniques during the cosmetic application of botulinum toxin A in the upper third of the face. A randomized, double-blind, split-face clinical trial was conducted with 100 women undergoing esthetic procedures for facial wrinkle reduction. Patients were assigned to three groups: vibratory anesthesia versus placebo (Group I), topical anesthesia versus placebo (Group II), and vibratory anesthesia versus topical anesthesia (Group III). Pain levels were assessed using the visual analog scale (VAS). Patients identified the side with better pain control, expressed satisfaction, and provided recommendations for each technique. Group I (vibration 5.02 ± 2.56 vs. placebo 6.00 ± 2.75, p = .034), Group II (topical anesthetic 4.69 ± 2.45 vs. placebo 5.50 ± 2.38, p = .039), and Group III (topical anesthetic 4.89 ± 2.29 vs. vibration 6.06 ± 2.22, p = .048). While satisfaction levels showed no statistically significant differences between techniques, topical anesthesia in Group III received the highest recommendations (p = .010). This study suggests that topical anesthesia and vibratory stimulation both offer small-to-medium analgesic benefits over placebo during BoNT-A injections. Despite comparable satisfaction scores, patients preferred topical anesthesia for future use.

The retrograde approach to mid-face thread lift, utilizing reverse temporal vectors, offers an innovative advancement in minimally invasive facial rejuvenation. This study evaluates its efficacy and safety in 20 female patients aged 30-60 years presenting with moderate midface ptosis but minimal jowling and neck laxity. The technique involves inserting poly L-lactide-co-ε-caprolactone bi-directional threads into anchor points near the zygomatic body, leveraging the structural support of ligaments and minimizing neurovascular risks. Immediate post-procedure results revealed significant improvements, with lateral mouth angles elevated by 0.3-0.5 cm and medial cheek points by 0.2-0.3 cm. Patient satisfaction scores (PSS) were consistently high (2-3). During the one-month follow-up, additional gains of 0.1-0.2 cm were noted at the same points, alongside enhanced skin quality and firmness. At six months, outcomes remained stable for patients without adjunctive procedures, maintaining high PSS scores (2-3). The study reinforces the retrograde reverse-vector method as a safe, effective option for midface rejuvenation. Future research should explore its long-term benefits, optimization for varying patient profiles, and integration with other aesthetic modalities for enhanced results. This innovation exemplifies progress in minimally invasive solutions for age-related facial concerns.