Chemical peels are widely used to treat various skin diseases and photoaging. Their rational, effective, and safe use has become an important issue in clinical practice. To standardize the clinical use of chemical peels, a group of experts developed this consensus based on the latest research and discussions. This consensus provides specific guidance to clinicians on chemical peels with respect to their classification, peeling agents, mechanisms, indications, contraindications, peeling techniques, and complications.

Acne scars are caused by inflammatory reactions, infections, and improper handling of acne lesions. Such scars have a high incidence and are difficult to treat. There are many methods currently used to treat acne scars, including medications, photoelectric technology, surgery, filling, chemical peeling, traditional Chinese medicine, biotherapy, and microneedle therapy, and many new methods are constantly emerging. However, there are still many issues, such as the lack of high-quality clinical studies, non-uniform treatment methods, and unsatisfactory therapeutic effects. The selection of appropriate methods for the comprehensive treatment of different types of acne scars at different stages in clinical practice remains challenging and is a research topic of great interest. From the perspective of evidence-based medicine, this consensus aims to provide a reference for the treatment of acne scars in clinical practice.

Objective:We aimed to evaluate the efficacy and safety of the 1,565 nm non-ablative fractional laser (NAFL) in combination with isotretinoin and pricking blood therapy (PBT) for treatment of AV. Methods:A retrospective analysis of 60 patients with moderate-to-severe AV was performed. Four groups (n = 15) were evaluated: 1,565nm NAFL alone, oral isotretinoin alone, double therapy (NAFL + isotretinoin) and triple therapy (NAFL + isotretinoin + PBT). Results:The triple therapy showed the highest improvement rate of inflammatory papules and boxcar atrophic scars. The patients receiving oral isotretinoin alone, double or triple therapy showed a significant decrease in volume of boxcar atrophic scars. The NAFL alone, double or triple therapy significantly decreased index of hemoglobin. Furthermore, the triple therapy significantly decreased indexes of hemoglobin and red areas as compared to the other three treatments. All four treatments significantly decreased indexes of pore sizes and wrinkles. Conclusion:This study showed that the triple therapy is effective for treatment of AV, which is worthy of further evaluation and investigation.

Botulinum toxin (BTX) is produced by a gram-positive anaerobic bacterium called Clostridium botulinum. BTX is among the deadliest natural substances known to humans with an estimated lethal dose of 1 ng/kg.1,2 There are 7 types of this neurotoxin- BTX-A, -B, -C1, -C2, -D, -E and -F. Human botulism is caused mainly by types A, B, E, and rarely F.3 BTX can cleave the presynaptic protein snap-25, inhibit acetylcholine release, and block the neuromuscular junction.4,5 BTX was first used in humans to treat strabismus in 1973, and later its applications were extended to many other conditions such as neurogenic detrusor overactivity, chronic migraine, muscle spasticity, axillary hyperhidrosis, and blepharospasm.

Background: Acral vitiligo often responses poorly to treatments. Objective: To observe whether pretreatment with ablative fractional CO2 laser aiding penetration of compound betamethasone solution plus NB-UVB could improve the response of refractory acral vitiligo. Methods: Subjects with symmetrical and stable acral vitiligo were enrolled in this study. The symmetrical lesions were randomly allocated to experimental and control sides in a subject. The experimental side underwent five sessions, one month apart, of ablative fractional CO2 laser followed by once of a topical painting of compound betamethasone solution, the control side applied topical betamethasone cream once a day; both sides underwent NB-UVB three times per week. The assessment was performed one month following each of the 1st, 2nd, 3rd, and 5th treatment sessions. Results: Two hundred eighty-nine subjects entered the clinical trial and 126 subjects completed the study. The experiment side showed better improvement in repigmentation. Overall response rate (repigmentation percentage ≥10%) of experiment sides was 51.6%, in contrast, that of control side was 35.8%. There were no severe adverse events in all subjects during the trial. Conclusions: A triple method of ablative fractional CO2 laser, topical compound betamethasone solution plus NB-UVB provided an alternative choice for acral vitiligo with remarkable safety profile. Cinical trial registration: This clinical trial has been registered at Chinese Clinical Trial Registry (Registration number: ChiCTR-TRC-12002593).