BACKGROUND:Integrative skincare refers to a clinician-directed regimen that combines aesthetic procedures with appropriate post-procedure skincare. The novel phyto polydeoxyribonucleotides (PDRN) formulation combines the benefits associated with the antioxidant, soothing phyto botanical blend with the effects of PDRN, a regenerative ingredient for wound-healing with collagen-stimulating properties. The serum contains an 8% phyto botanical complex, ectoin, tripeptide-8, and a 9.7% hydrating complex (glycerin and hyaluronic acid), along with PDRN derived from Lactobacillus sakei, a bacterium isolated from the soil of fallen magnolia flowers. Together, these components are designed to reduce immediate post-procedure redness and erythema while providing skin-rejuvenating benefits with continued use. METHODS:Nine global expert medical doctors share their experience incorporating the serum into post-procedure care with the goal of optimizing patient outcomes and minimizing downtime. The phyto PDRN serum was evaluated in a split-face real-world protocol for post-procedure care. RESULTS:Eight cases were selected by the expert panel to demonstrate the use of the phyto PDRN serum in an integrative skincare treatment plan under real-world conditions. All cases demonstrated successful integration of the phyto PDRN serum into the post-procedure care of eight women with Fitzpatrick skin types II–IV and aged from 28 to 68. Patients underwent non-ablative fractional laser, Nd:YAG, microneedling, microneedling radiofrequency, and chemical peels to address their various skin concerns. CONCLUSION:The phyto PDRN serum was safe, well-tolerated, and a clinically useful adjunct to integrative skin care regimens following cosmetic procedures. The antioxidant and anti-inflammatory ingredients, combined with PDRN polymers, uniquely support post-procedure recovery and skin repair.
BACKGROUND:Delayed complications associated with hyaluronic acid (HA) fillers are a concern in aesthetic medicine. However, clinical strategies for mitigation remain inconsistent, and guidelines often make recommendations that may lack the support of robust evidence. To address this gap, a multidisciplinary expert safety council convened to develop evidence-based recommendations aimed at reducing the delayed complication risk of soft-tissue augmentation with fillers, noting which recommendations are uncertain due to lack of evidence. METHODS:A structured advisory board meeting was held with 8 United States-based experts in aesthetic injectables. Discussions were informed by a comprehensive literature review, pre-meeting surveys, and real-time polling, with consensus statements refined following the meeting. RESULTS:The council reached full consensus on 8 key recommendations across 4 risk factor categories: patient history, product characteristics, procedural technique, and postprocedure care. A consistent theme across all categories was the lack of robust clinical evidence supporting many current guidelines, underscoring the need for more evidence-based recommendations. CONCLUSION:This expert consensus highlights the need for evidence-informed approaches to HA filler safety. While definitive data remain limited, the panel offers a practical framework for minimizing delayed complications and identifying priorities for future research.  .
BACKGROUND:Eyebrows play an essential role in facial symmetry, communication, and aesthetic identity. Scarring eyebrow alopecia results from inflammatory, autoimmune, infectious, genetic, traumatic, and iatrogenic processes that irreversibly damage follicular stem cells and limit regrowth potential. Despite its clinical and psychosocial impact, evidence-based guidance for diagnosis and management remains limited. METHODS:A comprehensive PubMed search (1960–2025) was performed using terms related to "eyebrow alopecia," "eyebrow madarosis," and etiology-specific conditions. English-language original studies evaluating eyebrow involvement and reporting diagnostic or therapeutic outcomes were included. Review articles without original patient data and studies limited to scalp alopecia were excluded. RESULTS:Scarring eyebrow alopecia included autoimmune conditions such as discoid lupus erythematosus and localized scleroderma; infectious etiologies such as lepromatous leprosy; genetic disorders including keratosis follicularis spinulosa decalvans; and inflammatory dermatoses such as ulerythema ophryogenes. Additional causes included radiation therapy, trauma, and hematologic malignancies. Reported treatments included corticosteroids, calcineurin inhibitors, antimalarials, methotrexate, mycophenolate, retinoids, JAK inhibitors, phototherapy, and reconstructive approaches. Emerging therapies, including biologics and regenerative techniques, have shown limited but evolving benefit. CONCLUSION:Scarring eyebrow madarosis involves diverse irreversible etiologies. Early diagnosis and etiology-directed treatment are essential to limit progression, highlighting the need for standardized management algorithms and eyebrow-specific outcome measures.  .
BACKGROUND:Red light therapy (RLT) is a non-invasive modality that uses visible red wavelengths (approximately 620–700 nm) to modulate cellular activity. By stimulating mitochondrial cytochrome c oxidase, RLT increases adenosine triphosphate production, regulates reactive oxygen species, and activates downstream pathways involved in inflammation control, tissue repair, and collagen synthesis. RLT has rapidly expanded into cosmetic dermatology and consumer wellness markets with widespread direct-to-consumer marketing. This review synthesizes current evidence on the mechanisms and cosmetic applications with particular attention to discrepancies between peer-reviewed data and commercial claims. METHODS:The 6 most frequently targeted conditions were selected for analysis. A PubMed search was conducted to identify peer-reviewed studies evaluating RLT for cosmetic dermatologic indications. For each condition, the available evidence was synthesized and compared with claims made by leading commercial RLT devices. RESULTS:Evidence supports RLT as a safe adjunctive therapy for select indications, including acne, androgenetic alopecia, mild photoaging, and wound healing, where modest and gradual improvements are observed with consistent, maintenance-based use. In contrast, marketing materials frequently exaggerate the speed, magnitude, and durability of clinical benefit, portraying RLT as a universal or transformative solution. CONCLUSION:RLT represents a biologically plausible and low-risk adjunct in cosmetic dermatology, but current consumer-facing narratives often exceed the available evidence.
BACKGROUND:Facial paralysis (FP) produces functional deficits and facial asymmetry that may include neuromuscular discoordination with synkinesis, painful muscle contractions, disturbing facial spasms, and autonomic misdirection such as gustatory lacrimation. Although Botulinum toxin A (BTX-A) is widely used in dermatology for aesthetic indications, its therapeutic and functional role in facial paralysis is less commonly incorporated within a clinical unified framework. OBJECTIVE:To propose a neuroaesthetic framework that integrates functional restoration, therapeutic relief, and correction of facial asymmetry using Botulinum toxin A (BTX-A) in the management of facial paralysis. METHODS AND MATERIALS:A structured narrative review of PubMed Index literature was conducted to evaluate aesthetic and therapeutic applications of BTX-A and facial paralysis. Evidence was synthesized across domains of facial asymmetry, functional impairment, and neuromuscular dysregulation and organized into a clinically applicable neuroaesthetic framework for dermatologists and advanced clinicians to support a comprehensive approach. RESULTS:The reviewed literature supports BTX-A as an effective modality for reducing hyperkinesis and improving facial symmetry. Therapeutic benefit is also demonstrated for synkinesis, painful contractions, hemifacial spasms, and gustatory lacrimation. When applied using a comprehensive, integrated neuroaesthetic strategy, BTX-A enables concurrent management of functional deficits and therapeutic symptoms alongside aesthetic correction. CONCLUSIONS:This review introduces a neuroaesthetic framework that unifies aesthetic, functional, and therapeutic applications of BTX-A in facial paralysis and emphasizes its multi-systemic complexity. With appropriate knowledge and understanding of facial nerve dysfunction, dermatologists and clinicians experienced with neuromodulators are well positioned to deliver comprehensive function-guided treatments across the spectrum of facial paralysis-related sequelae.
BACKGROUND:Keloids are pathological scars characterized by persistent fibroblast activation and excessive extracellular matrix (ECM) deposition. Cardamonin (CARD), a natural chalcone compound, has demonstrated anti-fibrotic effects; however, its role in keloid-associated fibrosis remains unclear. This study aimed to investigate the effects of CARD on human keloid fibroblasts (KFs) and the underlying molecular mechanisms. METHODS:A human keloid fibroblast cell line (KEL FIB) was treated with increasing concentrations of CARD. Cell proliferation, clonogenic growth, apoptosis, migration, and invasion were assessed using CCK-8, colony formation, flow cytometry, wound healing, and Transwell assays. Myofibroblast markers and ECM-related proteins were analyzed by immunofluorescence, RT-qPCR, and western blotting. TGF-β1/Smad signaling was evaluated by assessing Smad2/3 phosphorylation. RESULTS:CARD inhibited KF proliferation, migration, and invasion in a dose-dependent manner and promoted apoptosis through modulation of the BAX/BCL2 ratio and activation of Caspase-3. CARD reduced α-SMA and vimentin expression and decreased collagen I, collagen III, and fibronectin expression. CARD also attenuated TGF-β1-induced Smad2/3 phosphorylation. CONCLUSION:Cardamonin exerts anti-fibrotic effects in human keloid fibroblasts by suppressing the TGF-β1/Smad signaling pathway, suggesting its potential as a pharmacological candidate for the treatment of keloids.
BACKGROUND:Antiaging skin treatments are continuously in development to meet the needs of an aging population and counteract cosmetic effects of glucagon-like peptide-1 receptor agonists. Peptide Facial Refining Concentrate (ST26-PF-F1) serum contains multiple bioactive peptides within a penetrative delivery system. A clinical study of ST26-PF-F1 assessed its effects on skin health/appearance and tolerability/usability. METHODS:This noncomparative 12-week study enrolled healthy females aged 45 years or older, Fitzpatrick phototypes I–VI, with evidence of skin aging. Participants applied ST26-PF-F1 twice daily. Efficacy (expert evaluation, instrumental measurements, confocal microscopy, and participant self-assessments) and tolerability/safety (dermatologist and participant reporting) were assessed at weeks 2, 4, 8, and 12. RESULTS:Statistically significant improvements from baseline were observed for expert evaluator global assessments of fine lines, skin elasticity and plumpness, and facial contour and facial sagging (all time points); and wrinkles and skin firmness (weeks 4, 8, and 12). Significant improvements were also observed in skin hydration and elasticity (all time points); wrinkle volume, depth, and skin texture (weeks 4, 8, and 12); and lifting effect and V-shape (week 12). Confocal microscopy showed statistically significant improvements in interkeratinocyte brightness, papilla morphology, and dermal collagen fibers at weeks 4 and 12 and surface uniformity and keratinocyte morphology at week 12. Participants reported skin improvements across multiple measures and overall product satisfaction. ST26-PF-F1 was well tolerated with no treatment-related stinging, itching, or discomforting sensations. CONCLUSION:Clinical, instrumental, and microscopy assessments of ST26-PF-F1 demonstrated wrinkle-modulating and filler-like effects, visibly more balanced-looking facial geometry, favorable tolerability, and user satisfaction.
BACKGROUND:Keloids and hypertrophic scars are fibroproliferative skin disorders characterized by excessive collagen deposition and high recurrence rates despite existing therapies. Emerging evidence implicates immune-mediated pathways, including Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling, in their pathogenesis. However, population-level data evaluating the association between JAK inhibitor exposure and keloid/hypertrophic scar risk are lacking. OBJECTIVE:To evaluate whether initiation of JAK inhibitors is associated with a reduced risk of incident hypertrophic scar or keloid formation. METHODS:Using a target trial emulation framework, we conducted a retrospective cohort study within the TriNetX US Collaborative Network. Adults without prior hypertrophic scar or keloid formation were classified as initiators of a JAK inhibitor or psoriasis comparators without JAK inhibitor exposure. Propensity score matching (1:1) balanced demographic characteristics, comorbidities, healthcare utilization, trauma history, and surgical exposure. The primary outcome was incident hypertrophic scar or keloid formation (ICD-10-CM L91.0) within 730 days. Risk ratios (RRs) and Cox proportional hazards models were used to estimate cumulative and time-to-event associations. RESULTS:After matching, 122,341 individuals were included in each group. Within two years, hypertrophic scar or keloid formation occurred in 0.14% of JAK inhibitor initiators versus 0.22% of comparators (RR 0.65, 95% CI 0.54-0.79; absolute risk difference -0.08%; P<0.001). JAK inhibitor initiation was also associated with a lower hazard of scar formation (HR 0.77, 95% CI 0.64-0.93). CONCLUSION:Initiation of JAK inhibitors was associated with a significantly reduced risk of incident hypertrophic scar or keloid formation. These findings support a potential role for JAK/STAT pathway modulation in keloid prevention and warrant prospective investigation.  .
BACKGROUND:The body contouring market has undergone a paradigm shift from invasive surgical procedures to advanced noninvasive treatments. Noninvasive fat-reducing devices based on nonfocused ultrasound waves induce lipolysis and ultimately reduce body fat, with minimal discomfort and downtime. METHODS:A dosimetry analysis was conducted on skin of domesticated pigs to increasing doses of low-intensity ultrasound, followed by histological analysis of skin biopsies collected up to 14 days post-treatment. The clinical impact of ultrasound was retrospectively assessed by comparing skin laxity in before-and-after photographs of abdominal and facial regions subjected to up to 8 treatment sessions, at 7- to 14-day intervals. Circumference reduction and patient-rated pain and satisfaction levels were extracted from patient records. RESULTS:Histological analysis of pig biopsy samples identified that treatment with ultrasound damages subcutaneous fat at cellular and tissue levels, without impact on neurovascular bundles, epidermal or dermal layers. Seventy-four (74) patients were treated in facial (2.3%) or abdominal, buttocks, or thigh (79.7%) areas, and followed up for 2 to 3 weeks after the last session. The ultrasound regimen induced a significant reduction in abdominal circumference (2.6±1.2 cm). Physician-rated improvements were significant in 57.9% of patients treated at the abdomen, trunk, or thighs, and 20.0% (3/15) of facial areas, with a positive correlation found between degree of improvement, number of sessions (rs=0.365, P=.002), and inter-session interval length (rs=0.257, P=.003). Treatment was highly tolerable, and patients were very satisfied with the outcomes. CONCLUSION:Nonfocused ultrasound is a safe and effective technology to reduce body fat, particularly in the abdominal area.  .
BACKGROUND:Dermatoporosis is a condition of fragile, aging skin that manifests as altered pH, wrinkles, laxity, easy bruising, and hyperpigmentation. This study evaluated efficacy, safety, and subject perception after the use of a novel cream, GC (Galderma Laboratories, LP, Fort Worth, TX), on subjects with mature, aging skin. METHODS:A 12-week multicenter, randomized, blinded, in-use study enrolled female and male subjects aged 40 to 60 years of all races, ethnicities, and Fitzpatrick skin types. Subjects were required to have a history of fragile skin and dry, crepey skin on the knees and thighs. GC cream was applied to knee and upper thigh skin twice daily. Assessments included clinical grading, digital photography, bioinstrumentation (skin texture, pH, and heatmap hydration), standard safety assessments, and satisfaction. RESULTS:Use of GC cream for 12 weeks resulted in significant improvements in skin crepiness, photodamage, and firmness, as well as decreased skin pH and early improvements in skin roughness and smoothness from baseline. Corneometer heatmapping documented improved skin hydration over baseline. No adverse events were reported; the GC cream was well tolerated, and subjects reported high satisfaction. CONCLUSION:Twice-daily application of the novel GC skin cream significantly improved the overall skin quality of mature, aging skin, including crepiness, photodamage, firmness, texture, pH, and hydration. GC cream was well tolerated with high subject satisfaction. These data are intended to help guide healthcare providers and patients in choosing an effective moisturizer that was specifically designed for patients with fragile, mature skin.
Cutis marmorata telangiectatica congenita (CMTC) is a rare congenital vascular disorder characterized by persistent, violaceous, reticulated skin changes that may be complicated by painful ulcerations. Although localized disease often improves with age, generalized CMTC can persist into adulthood and may be associated with limb asymmetry, ocular abnormalities, and neurologic sequelae. Diagnosis can be challenging in atypical adult presentations despite established major and minor criteria. We report a case of a 50-year-old woman with congenital livedo reticularis and Raynaud syndrome who presented with lifelong unilateral left lower-extremity hypoplasia and fixed lacy violaceous patches. Over the preceding decade, she developed recurrent, spontaneous, painful ulcerations exacerbated by cold exposure. Examination revealed a hypoplastic left leg with reticulated violaceous patches and tender, crusted erosions without venectasia; biopsy findings ruled out vasculitis, and the overall clinicopathologic picture met all three major and multiple minor Kienast-Hoeger criteria for CMTC. Multiple therapies targeting vasospasm and microvascular flow (including sildenafil, pentoxifylline, diosmiplex, nifedipine, and aspirin) failed to improve symptoms. Initiation of once-daily topical sirolimus (1 mg/mL) resulted in marked pain reduction within four weeks and cessation of new ulcerations, with visible improvement and healed erosions by two months. This case supports topical sirolimus as a promising off-label option for adult CMTC with chronic ulcerative disease.
BACKGROUND:Topical carboxytherapy, a transcutaneous carbon dioxide (CO2) delivery system, may support skin repair and regeneration, yet its role as an adjunct to fractional laser treatment remains underexplored. OBJECTIVE:To investigate the effectiveness and safety of topical CO2 mask (CO2Lift® Carboxy Gel, Lumisque Skincare) in supporting skin recovery and improving clinical outcomes following fractional CO2 laser resurfacing. METHOD:This 12-week randomized, placebo-controlled trial evaluated mild-to-moderate photoaging (n=6 females only). Participants received either topical carboxytherapy (n=4) or standard care (n=2). Assessments included VISIA-CR imaging, biophysical measurements, investigator ratings, and paired (baseline and 4-week) skin biopsies. RESULTS:Topical carboxytherapy accelerated recovery and was well-tolerated, with no major adverse events. VISIA-CR imaging showed accelerated erythema resolution, transepidermal water loss normalized more rapidly, and pH remained stable. Skin histology at week 4 revealed epidermal thickening and rete ridge formation with topical carboxytherapy vs placebo. Investigator ratings demonstrated significantly improved healing, global assessment, and global aesthetic improvement scale scores, with trends toward improvement in photodamage, rhytides, and pigmentation. CONCLUSION:Adjunctive topical carboxytherapy after fractional CO2 resurfacing accelerated healing, improved barrier recovery, and overall aesthetic outcomes. Larger studies are needed to confirm these findings.
