Background Various devices are used for facial wrinkle treatment, but comparative data on their efficacy and safety are limited. Objective To compare the efficacy and safety of a temperature-controlled bipolar fractional radiofrequency microneedling device (Profound) with a skin treatment system (EndyMed Pro) for facial wrinkle treatment. Methods A prospective, randomized controlled trial was conducted at three sites in China from February 2022 to May 2023. A total of 140 healthy adults (age >= 20, Fitzpatrick skin Type III-IV) were randomized to receive either a single Profound treatment or three EndyMed Pro treatments. Results No significant differences in wrinkle scores (Fitzpatrick, crow's feet, and nasolabial folds) were observed between the two groups at 24 weeks. However, Profound showed superior results for wrinkles at the corner of the lips and the mandibular margin at 20 and 24 weeks (p < 0.05). Conclusion Profound provided similar or superior improvements in wrinkle reduction compared to EndyMed Pro, particularly for wrinkles at the corner of the lips and the mandibular margin.

Melasma is a persistent and recurrent condition that remains difficult to manage effectively. Both fractional 1064 nm picosecond Nd:YAG (PSNY) and low-fluence Q-switched Nd:YAG (QSNY) lasers have been applied in treatment, yet there is currently insufficient data to compare their efficacy and safety. This retrospective study evaluated 99 female patients with melasma, including 54 treated with PSNY laser and 45 with QSNY laser. Each patient received two to five laser sessions at 2-4-week intervals. Clinical efficacy was evaluated by the modified Melasma Area and Severity Index (mMASI) at baseline, as well as four weeks following the second and fifth treatment sessions, with adverse events carefully documented. The PSNY laser produced a mean mMASI reduction of 23.7% and 40.7% after two and five sessions, respectively, while QSNY treatment achieved reductions of 9.8% and 29.5%. Although both modalities were safe and effective, PSNY laser demonstrated faster clinical improvement and required lower energy fluence. Post-inflammatory hyperpigmentation occurred in 7.4% of PSNY-treated patients and 13.3% of QSNY-treated patients, with no significant difference between groups. In conclusion, fractional PSNY laser therapy provides a rapid, safe, and effective alternative to QSNY laser for managing melasma.

Photobiomodulation therapy (PBMT) is a safe and effective option for multiple skin diseases. To promote standardized clinical use, this expert consensus was developed by 35 dermatology experts through 2 rounds of Delphi surveys and addressed 19 clinical questions with a consensus degree of over 80.0%. This consensus summarizes current evidence on PBMT’s mechanisms of action, indications, contraindications, treatment parameters, and adverse event management. Although encouraging outcomes have been observed regarding acne vulgaris, photoaging, alopecia, and other dermatologic conditions, considerable variability in treatment protocols and the scarcity of high-quality, large-scale clinical trials continue to limit broader clinical adoption. This consensus provides evidence-based and practical guidance to support the safe and effective incorporation of PBMT into dermatologic practice in China.

Background:Vitiligo is an acquired depigmentary disorder caused by the loss of functional melanocytes. Increasing evidence suggests that competing endogenous RNA (ceRNA) interactions participate in this process, yet their global architecture in vitiligo remains unclear. Objective:To delineate a long non-coding RNA (lncRNA)-microRNA (miRNA)-mRNA ceRNA network associated with vitiligo and to identify blood-borne RNA markers with diagnostic potential. Methods:miRNA, mRNA, and lncRNA expression data from vitiligo patients and healthy controls were obtained from the GEO database (GSE141655 and GSE186928). Differentially expressed (DE) mRNAs, miRNAs and lncRNAs were screened (|log2 FC| > 0.5, adj. p< 0.05). Functional enrichment, STRING-based protein-protein interaction (PPI) mapping, and lncRNA-mRNA co-expression analysis (Pearson r > 0.9) was performed. miRNA-mRNA pairs were predicted with miRWalk 3.0, and miRNA-lncRNA pairs with miRanda v3.3a (score ≥ 140, energy ≤-20 kcal mol-¹). Triplets that shared the same miRNA, displayed positive lncRNA--mRNA correlation, and showed inverse expression relative to the miRNA were combined into a ceRNA network; hub nodes were ranked by degree centrality. Candidate lncRNAs were validated by RT-qPCR in peripheral blood from 20 vitiligo patients and 20 matched controls. Results:A total of 454 DE-mRNAs (341 down-, 113 up-regulated), 22 DE-miRNAs (6 down-, 16 up-regulated), and 281 DE-lncRNAs (112 down-, 169 up-regulated) were identified. Enrichment analysis highlighted pathways linked to melanogenesis, oxidative stress, PI3K-Akt, JAK-STAT and IL-17 signalling. The ceRNA network comprised 33 lncRNAs, 12 miRNAs and 58 mRNAs; SLC32A1, GRIA2, PRKACG and WNT1 were top hub proteins in the PPI sub-network. Blood validation confirmed up-regulation of CASC19, NUCB1-AS1 and LINC01485 and down-regulation of VAV3-AS1, SPATA13-AS1, ZNF350-AS1 and LINC00677 (all p< 0.05). Conclusion:Our findings map a vitiligo-related ceRNA landscape and pinpoints seven circulating lncRNAs with diagnostic promise. The results provide a foundation for probing non-coding RNA-mediated mechanisms and developing targeted therapies for vitiligo.

Several studies have demonstrated the inhibitory effect of metformin on pigmentation. However, the effect of metformin on melanosome transfer remains unknown. The goals of this study were to elucidate the effects of metformin on melanogenesis and melanosome transfer and explore the related mechanisms. We determined that, compared with those in the control zebrafish, the area occupied by pigment granules, melanin content, tyrosinase activity, and the expression levels of melanogenesis genes and melanosome transfer-related genes were reduced in metformin-treated zebrafish. In human primary melanocytes, MNT1 cells/B16F10 cells, metformin also plays a negative role in melanin synthesis regardless of health status and α-MSH-induced pigmentation. Unlike arbutin, metformin inhibited the formation of dendrites and filopodia-like structures and suppressed melanosome transfer. After treatment with metformin, the cAMP content was reduced, the expression of MITF and downstream molecules was downregulated, and the expression of Rho GTPases was changed. Metformin partially abrogated the changes in genes regulating melanin synthesis, melanosome transfer and the cytoskeleton induced by a cAMP activator. Furthermore, the Nrf2 expression was decreased upon metformin intervention, and metformin partially abrogated the changes in genes regulating melanogenesis caused by a Nrf2 activator. Our study revealed that metformin can serve as a candidate depigmentation agent.

Artificial intelligence (AI) has profoundly impacted various medical fields, including dermatology, which is to a large extent an image-based discipline. Initially applied in general dermatology, AI has expanded into aesthetic dermatology, where it assists in integrating objective approaches with the aesthetic judgment of dermatologists. This review explores the role of AI in aesthetic dermatology, focusing on skin condition assessment, diagnosis, treatment optimization, and patient education, as well as the challenges and future directions in this evolving field.

Post-inflammatory hyperpigmentation represents an acquired pigmentation anomaly frequently observed as a common sequela following acute or chronic skin inflammation, which often poses a challenge for treatment. We report a patient who developed persistent, mottled pigmentary macules all over her face subsequent to mesotherapy treatment. The patient was treated with a picosecond 1064 nm Nd:YAG laser in a two-step procedure way combined with a large- spot size, low-fluence mode and a fractional mode. After two treatment sessions, considerable improvement in her pigmentary lesions was observed, with no exacerbation or other complications.

To characterize midfrontal erythema and evaluate the clinical efficacy of 595 nm pulsed dye laser treatment for this condition. A total of 85 patients presenting with vascular lesions in the midfrontal area were analyzed who received the pulsed dye laser treatment between 2018 and 2023. The efficacy and safety of the treatment was assessed. The total effective rate of pulsed dye laser treatment for midfrontal erythema was 96.4

To evaluate the efficacy and safety of the combination of the long-pulse 1064 nm neodymium-doped yttrium aluminum garnet (LP1064 nm) laser and picosecond 755 nm alexandrite (P755 nm) laser with a diffractive lens array (DLA) in improving skin photoaging. This prospective, randomized, split-face trial was conducted between April 2024 and February 2025 at two centers. A total of 22 healthy volunteers with facial photoaging symptoms aged 30–65 years were enrolled. The full face was treated with the LP1064 nm laser, and one side was treated with the P755 nm laser with DLA for three sessions at 1-month intervals. Efficacy and safety were assessed before each treatment and 1, 3, and 6 months after treatment. The primary outcome was the Global Aesthetic Improvement Scale (GAIS) score. A total of 21 patients completed the study. The combined treatment side demonstrated further improvement in GAIS scores compared with the monotherapy side at 3 (85.7

A retrospective analysis was performed to characterize the clinical features and distribution patterns of acquired bilateral naevus of Ota-like macules (ABNOMs) in paediatric patients. Paediatric ABNOMs exhibit early-onset, female-predominant characteristics. Lesions almost always involve the bilateral zygomatic area and frequently extend to the cheek, with one in five displaying asymmetry.

BACKGROUND:Picosecond lasers have been increasingly applied to the treatment of acquired bilateral nevus of Ota-like macules (ABNOMs), and proved safe and effective for adult patients. But there has been limited data concerned with their use in children. OBJECTIVE:To analyze the efficacy, safety, and correlative influencing factors of a 755 nm picosecond alexandrite laser in treating ABNOMs in children. METHODS:We retrospectively analyzed children with ABNOMs from January 2017 to July 2023 who received the treatment using a 755 nm picosecond alexandrite laser. Treatment parameters used were as follows: 750 ps pulse duration, 2.34-4.07 J/cm² fluence, and 2.5-3.3 mm spot size. The mean treatment interval was 7 months. The efficacy was evaluated based on a five-point scale according to the percentage of pigmentation clearance. RESULTS:A total of 49 pediatric patients were included in this retrospective study. The average age at the beginning of treatment was 16.87 months old (range of 4 months to 59 months). These patients received an average of two treatments, achieving an average of 76% pigment clearance, which corresponded to excellent improvement (75%-94%). After the first treatment, six cases reached clinical clearance, and an average of pigment clearance was 61%. The initial efficacy was positively correlated with Fitzpatrick type (p < 0.05). Patients with Fitzpatrick III skin type responded better than patients with Fitzpatrick IV skin type. Besides, the initial efficacy was negatively correlated with the first treatment age and disease duration (p < 0.05). Eight cases developed postinflammatory hyperpigmentation, accounting for 16.3% of the cases. CONCLUSION:The 755 nm picosecond alexandrite laser is safe and effective in treating ABNOMs in children. Being younger at the initial treatment, having Fitzpatrick III skin type, and experiencing a shorter disease duration are beneficial for initial efficacy.

Background Alopecia areata (AA) places a considerable burden on patients. While intralesional glucocorticoid injection is an important therapy, it can cause severe pain. Objective To compare the efficacy and pain levels of microneedle transdermal delivery of compound betamethasone versus traditional intralesional injection in mild-to-moderate AA. Methods We conducted a randomized controlled trial in AA patients with a Severity of Alopecia Tool (SALT) score <50. Both groups received monthly compound betamethasone injections: group A via intralesional injections and group B via transdermal microneedle delivery. The primary outcome was the reduction in SALT score after 3 months. Results With 80 patients enrolled, baseline SALT scores were similar between group A (9.250 ± 5.300) and group B (10.65 ± 9.445). After 3 months, the mean SALT reduction was 7.000 ± 4.5017 in group A and 8.075 ± 8.014 in group B, with no statistical difference. Remission rates for SALT30/50/75/90 were 92.50/90.00/57.50/42.50% in group A and 95.00/87.50/72.50/40% in group B, with no significant difference. Group B had a significantly lower visual analog scale pain score than group A (4.000 ± 1.174 vs 5.281 ± 2.098, P = .0047). Limitations The study focused on mild-to-moderate patchy AA, limiting insights into severe cases. Conclusion Microneedle transdermal delivery of compound betamethasone in mild-to-moderate patchy AA demonstrates efficacy comparable to traditional intralesional injection with reduced pain.

Traumatic scars negatively impact the patient’s quality of life. Fractional 1064 nm Nd: YAG picosecond laser improves scars. However, the effect varies among individuals. This study aimed to evaluate the treatment of traumatic scars with fractional 1064 nm Nd: YAG picosecond lasers and the factors associated with its prognostication. We conducted a retrospective study with 161 patients with traumatic scars. All scars were treated using fractional 1064 nm Nd: YAG picosecond lasers. Efficacy was determined based on blinded visual evaluation using the Manchester Scar Scale (MSS) and 5-point Global Assessment Scale (GAS). The mean MSS values before and after treatments was 17.4 ± 2.7 and 13.6 ± 2.6 (P < 0.001), respectively. Color, radiance, contour, and distortion of the traumatic scars improved. (all P < 0.001). The course, location, and height of the scars, and the number of treatments and energy densities, were related to treatment responses (P < 0.05). Fractional 1064 nm Nd: YAG picosecond laser is effective for treating traumatic scars. Clinicians can predict the prognosis using multiple factors.

BackgroundFew reports have confirmed whether exosomes derived from fibroblasts can regulate the process of melanogenesis. We wondered whether exosomes derived from fibroblasts could have a potent regulatory effect on melanogenesis and explored the underlying mechanisms.ObjectiveThis study aimed to find the role of fibroblasts in melanocytes and revealed the related mechanisms.MethodsRT-qPCR, Western blot analysis were conducted to measure the RNA and protein expression level of various related genes. miRNA sequencing, mass spectrum analysis and subsequent bioinformatics analysis were employed to find the underlying targets. Zebrafish were employed to measure the melanin synthesis related process in vivo. Furthermore, electron microscopy, ROS measurement and dual-luciferase reporter assay were adopted to investigate the relationship between these processes.ResultsWe found that exosomes derived from human primary dermal fibroblasts were internalized by human primary melanocytes and MNT1 cells and that the melanin content and the expression of melanin synthesis-related proteins TYR and MITF was inhibited by exosomes derived from UVB-induced human primary dermal fibroblasts. The miRNA expression profile in secreted exosomes changed significantly, with miR-25-5p identified as capable of regulating TSC2 expression via the CDS region. The miR-25-5p-TSC2 axis could affect the melanin content through subsequent cellular organelle dysfunction, such as mitochondrial dysfunction, endoplasmic reticulum stress and dysregulation of lysosomal cysteine proteases.ConclusionWe unveiled a novel regulatory role of fibroblasts in melanocytes, facilitated by the secretion of exosomes. miR-25-5p within exosomes plays a pivotal role in regulating melanogenesis via TSC2-induced cellular organelle dysfunction.

Background: The picosecond alexandrite laser has been safely and effectively used to treat the nevus of Ota in adults. However, limited data are available for children. Objective: To investigate the efficacy, safety, and correlative influencing factors of a 755nm picosecond alexandrite laser in the treatment of nevus of Ota in children. Methods: We retrospectively analyzed Chinese children with nevus of Ota who received a 755nm picosecond alexandrite laser treatment in a tertiary dermatological hospital. Result: A total of 305 pediatric patients received an average of two treatments achieving an average of 79% pigment clearance. After the first treatment, 22 patients achieved complete clearance (95%-100%), and 72 patients achieved excellent response (75%-94%), with an average initial efficacy of 63% lesion clearance. Treatment at an early age achieved better initial efficacy (0- to 12-month group >1- to 6-year group, 6- to 12-year group). And 0- to 12-month group achieved better final efficacy. More treatment sessions also increased the final efficacy. Both initial efficacy and final efficacy were better when treating a darker lesion. The incidence of complications was 12.1%, with 10.8% being post-inflammatory hyperpigmentation and 1.3% being hypopigmentation. The rate of recurrence was 6.6%. Limitation: Retrospective study. Conclusion: A 755nm picosecond alexandrite laser is safe and effective in treating nevus of Ota in children. Younger to initiate treatment, darker lesions, and more treatments are positively associated with better pigmentation clearance.

BACKGROUND:Melasma is a common and chronic pigmentary disorder with complex pathogenesis, and the relationship between melasma and metabolic syndrome remains elusive. Thus, metabolomics might contribute to the early detection of potential metabolic abnormalities in individuals with melasma. OBJECTIVE:The present study aims to analyze changes in plasma metabolites of female melasma patients and identify disease markers as well as explore potential therapeutic targets. METHODS:Plasma samples from 20 female patients with melasma and 21 healthy female controls that were comparable in terms of age and body mass index were collected for untargeted metabolomics investigations. Ultra-high performance liquid chromatography-mass spectrometry was used to analyze metabolites in the plasma. Metabolic pathway analyses were employed to identify significantly differentially expressed metabolites in melasma patients. Receiver operating characteristic curves were constructed, and correlation analyses were performed using the modified Melasma Area and Severity Index and oxidative stress levels. RESULTS:In contrast to healthy subjects, melasma patients showed significant alterations in 125 plasma metabolites, including amino acids, lipids, and carbohydrate-related metabolites. KEGG pathway analysis suggested that primary pathways associated with the development of melasma include tryptophan metabolism, as well as the biosynthesis of phenylalanine, tyrosine, and tryptophan. Importantly, based on receiver operating characteristic curves and correlation analyses, several metabolites were identified as robust biomarkers for melasma. CONCLUSION:Collectively, this study identified significant changes in plasma metabolites in melasma patients, providing new insights into the pathogenesis of melasma and opening novel therapeutic avenues.

PURPOSE:This split-face randomized study compared the efficacy and safety between 1064-nm picosecond laser with fractionated microlens array (MLA) and 1565-nm nonablative fractional laser to treat enlarged pores. METHODS:Participants with enlarged facial pores were enrolled and underwent three consecutive sessions at 2-week intervals with either a 1064-nm picosecond laser with MLA or a 1565-nm nonablative fractional laser. Images were captured at each visit. Objective (pore number) and subjective assessments, including patient self-evaluations and quartile improvement scales, were used to evaluate the treatment efficacy. The pain levels and adverse effects were recorded at each subsequent visit. RESULTS:The participants were 3 men and 22 women with enlarged facial pores. At the initial and 2-month checkups after the last treatment, the pore numbers were significantly decreased bilaterally for both lasers. The respective quartile improvement scale scores for the 1064-nm picosecond and 1565-nm fractional lasers were 2.22 ± 1.06 and 2.14 ± 1.11, while those for patient self-assessment were 3.72 ± 0.74 and 3.68 ± 0.75. The pore number, quartile improvement scale score, and patients' self-assessments did not differ significantly between the two lasers. Treatment with the 1064-nm picosecond laser better reduced pain compared with the 1565-nm nonablative fractional laser (4.11 ± 1.33 vs. 4.83 ± 1.17). The occurrence of pigmentation did not differ significantly between the lasers. CONCLUSION:Both the 1064-nm picosecond laser with MLA and the 1565-nm nonablative fractional laser are viable options for treating enlarged pores, and showed comparable respective efficacies; however, the former was less likely to cause hyperpigmentation and was better tolerated.

The role of fractional picosecond-domain lasers in scar remodeling is being increasingly recognized. In this study, we aimed to evaluate the efficacy of a fractional 1064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) picosecond laser for treating early-stage traumatic and surgical scars in an Asian population. Thirty-seven patients with 49 early-stage traumatic and surgical scar lesions were enrolled. Participants underwent three treatment sessions with a fractional 1064-nm Nd:YAG picosecond laser at 4–8-week intervals. Two non-involved dermatologists evaluated the treatment response using the Vancouver Scar Scale (VSS) and Global Aesthetic Improvement Scale (GAIS). After treatment, the early-stage traumatic and surgical scars significantly improved. The treatment effects differed markedly according to the number of treatment sessions (F=219.71, P<0.001). The VSS scores were 5.56 ± 2.17 and 3.85 ± 2.02 in the postoperative period after one (P<0.001) and three (P<0.001) sessions, respectively, compared with the baseline VSS score (6.94 ± 1.85). After three treatment sessions, 69.39 www.springer.com/00266 .

Background . Becker’s nevus (BN) severely affects a patient’s appearance and can lead to depression, especially when it involves the face or neck. Currently, there is no effective treatment. Laser therapy has become popular, but its efficacy has not been confirmed. We evaluated the efficacy and safety of lasers in treating BN. Methods . This retrospective study involved 49 patients exposed to different laser treatments who completed at least one treatment session and follow-up. Results . The patients treated with the 755-nm alexandrite picosecond laser and Q-switched 694-nm ruby laser gained relatively good results: 3.07 ± 1.09 and 2.87 ± 1.14 on the five-point scale and 3.47 ± 0.73 and 3.40 ± 0.85 on the GAIS, respectively. However, the results of the 755-nm alexandrite picosecond laser with a diffractive focus lens array and the fractionated 1064-nm neodymium-doped: yttrium aluminum garnet picosecond laser were poor. Furthermore, there were marked differences between the number of treatment sessions and treatment effects, both for the five-point grading score for pigment clearance ( F = 15.246, p < 0.001) and GAIS ( F = 15.469, p < 0.001). Concerning different lasers and efficacy, there were no marked differences between the five-point grading scale and the GAIS ( p > 0.05). Conclusions . Although the efficacy of various lasers for BN is not satisfactory and there are no marked differences between picosecond and Q-switched lasers, they can help in selecting an appropriate laser for slight-to -moderate pigment removal. The 755-nm alexandrite picosecond laser is a new option, whereas nonablative fractional picosecond lasers for BN are not recommended. Increasing the number of treatment sessions can improve the curative effect slightly.