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Background: Acne vulgaris often results in permanent scars, with atrophic scars being the most common type and posing a significant therapeutic challenge due to their prevalence and impact on patients' quality of life. Various treatment options exist, including the use of poly‐d,l‐lactic acid delivered via different methods. Objective: This study aimed to assess the efficacy and safety of poly‐d,l‐lactic acid delivered via laser‐assisted needle‐free microjet injection for treating atrophic scars. Methods: Five Korean participants with atrophic facial scars were recruited. Poly‐d,l‐lactic acid solution was administered via the Mirajet system in five sessions, with clinical assessments conducted at baseline, before each session, and at 12‐week and 22‐week follow‐ups. Outcome measures included the Global Aesthetic Improvement Scale and patient satisfaction scores. Results: Positive results were observed at the 12‐week and 22‐week follow‐ups, with high patient satisfaction and improvements in atrophic scars and skin texture. Mild discomfort and transient side effects were reported, with no adverse events observed during the follow‐up period. Conclusion: Poly‐d,l‐lactic acid delivered by a laser‐assisted needle‐free microjet injector was judged to be effective for improving atrophic the facial area. Further research, particularly through randomized controlled trials, is needed to validate these findings and assess the longer‐term safety and sustainability of outcomes. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Discussion Conclusion Striae distensae (SD), or stretch marks, result from rapid stretching of the skin due to various factors. Conventional treatments often yield unsatisfactory results, leading to the exploration of alternative methods. Laser‐induced microjet technology offers a promising approach for drug delivery to target areas. This study investigates the efficacy of using a microjet injector with poly‐d,l‐lactic acid for treating SD.Four female participants with SD were treated with poly‐d,l‐lactic acid solution using a microjet injector over five sessions. Patients were assessed based on severity scales before and after treatment. Topical anesthetics were applied to minimize discomfort. Injection techniques were optimized to reduce side effects such as bleeding and pain.All patients showed significant improvement in SD appearance after 5–7 treatments. Assessment scales indicated positive outcomes both immediately after treatment and at the 32‐week follow‐up. Minimal side effects, primarily petechiae, were observed.Laser‐induced microjet technology offers several advantages, including rapid drug delivery and mechanotransduction effects, promoting skin regeneration. Poly‐d,l‐lactic acid injections demonstrated effectiveness in treating SD, particularly when delivered via microjet injectors. Patients expressed high satisfaction due to the procedure's minimal invasiveness and quick recovery.Utilizing a needleless microjet injector with poly‐d,l‐lactic acid shows promise as a treatment for SD, typically requiring 5–7 sessions for optimal results. Mild petechiae may occur as a common side effect. This approach offers an effective and minimally invasive alternative for addressing this common cosmetic concern. [ABSTRACT FROM AUTHOR]

Background: Skin aging is characterized by wrinkles, rough skin texture, pigmentation, facial erythema, and telangiectasia through structural and functional changes in the epidermis and dermis. Recently, injectable poly(D, L‐lactic acid), a biodegradable polymer, has been used widely for skin rejuvenation. Aims: This study aims to assess the efficacy and safety of injectable dermal poly D, L‐lactic acid) for skin rejuvenation. Patients/Methods: A total of 16 patients who desired skin rejuvenation were included. All participants received two or three procedure sessions with a 4 weeks interval between sessions. Clinical and three‐dimensional images at baseline, before each procedural session, and follow‐up visits were obtained. Therapeutic effects were assessed by evaluating signs of aging skin and overall improvement by dermatologists and patients. Histologic examinations with special stains were performed on the posterior auricular areas of consenting patients at baseline and follow‐up visits after injecting poly D L‐lactic acid into the postauricular area as in the face. Results: Overall, statistically significant differences were observed in all signs of aging skin, such as fine wrinkles, skin texture, irregular pigmentation, telangiectasia, and facial erythema before and after treatments. Half (50%) of patients responded that there was more than 50% overall improvement. There were no severe adverse events. Histologic examination demonstrated increases in collagen and elastic fibers in the dermis. Conclusions: Results of this preliminary study suggest that injectable dermal poly D, L‐lactic acid can significantly affect skin rejuvenation without causing any serious adverse events. [ABSTRACT FROM AUTHOR]

This article discusses the delayed occurrence of foreign body reactions caused by poly-L-lactic acid (PLLA) fillers, which are commonly used for tissue augmentation and cosmetic purposes. The article presents a case study of a 52-year-old woman who developed granuloma formation over 100 months after receiving PLLA injections in the nasolabial fold. The article emphasizes the importance of healthcare providers recognizing the potential adverse effects of PLLA fillers and informing patients about these risks. It also highlights the effectiveness of intralesional steroid therapy in managing complications associated with PLLA injections. [Extracted from the article]

Angiogenesis promotes rejuvenation in multiple organs, including the skin. Heat shock protein 90 (HSP90), hypoxia-inducible factor-1 alpha (HIF-1α), and vascular endothelial growth factor (VEGF) are proangiogenic factors that stimulate the activities of phosphoinositide 3-kinase (PI3K), protein kinase B (AKT), and extracellular signal-regulated kinase 1/2 (ERK1/2). Poly-D,L-lactic acid (PDLLA), polynucleotide (PN), and calcium hydroxyapatite (CaHA) are dermal fillers that stimulate the synthesis of dermal collagen. However, it is not yet known whether these compounds promote angiogenesis, which leads to skin rejuvenation. Here, we evaluated whether PDLLA, PN, and CaHA stimulate angiogenesis and skin rejuvenation using H2O2-treated senescent macrophages and endothelial cells as an in vitro model for skin aging, and we used young and aged C57BL/6 mice as an in vivo model. Angiogenesis was evaluated via endothelial cell migration length, proliferation, and tube formation after conditioned media (CM) from senescent macrophages was treated with PDLLA, PN, or CaHA. Western blot showed decreased expression levels of HSP90, HIF-1α, and VEGF in senescent macrophages, but higher expression levels of these factors were found after treatment with PDLLA, PN, or CaHA. In addition, after exposure to CM from senescent macrophages treated with PDLLA, PN, or CaHA, senescent endothelial cells expressed higher levels of VEGF receptor 2 (VEGFR2), PI3K, phosphorylated AKT (pAKT), and phosphorylated ERK1/2 (pERK1/2) and demonstrated greater capacities for cell migration, cell proliferation, and tube formation. Based on the levels of 4-hydroxy-2-nonenal, the oxidative stress level was lower in the skin of aged mice injected with PDLLA, PN, or CaHA, while the tumor growth factor (TGF)-β1, TGF-β2, and TGF-β3 expression levels; the density of collagen fibers; and the skin elasticity were higher in the skin of aged mice injected with PDLLA, PN, or CaHA. These effects were greater in PDLLA than in PN or CaHA. In conclusion, our results are consistent with the hypothesis that PDLLA stimulates angiogenesis, leading to the rejuvenation of aged skin. Our study is the first to show that PDLLA, PN, or CaHA can result in angiogenesis in the aged skin, possibly by increasing the levels of HSP90, HIF-1α, and VEGF and increasing collagen synthesis. [ABSTRACT FROM AUTHOR]

Background: Indocyanine green (ICG) exhibits robust absorption near 800 nm. Aims: To examine the clinical effects of combining ICG with a 785 nm picosecond laser for treating photo‐aged skin. Patient/Methods: A 785 nm 600 picosecond laser was used on the facial area of 16 female patients with Fitzpatrick skin type III and IV (mean age: 58.44 ± 5.24 years) after applying 0.0125% ICG cream. A total of 3000 shots were administered in diffractive optical element mode at a pulse energy of 200 mJ and frequency of 10 Hz. Hyperpigmented lesions were treated using the Zoom handpiece set at a spot size of 3–4 mm, pulse energy of 60–120 mJ, and frequency of 3–7 Hz. Patients underwent five sessions of treatment at intervals of 1–2 weeks. Wrinkles, pores and pigmented lesions were assessed at the initial assessment and 4 weeks after the final treatment using the Modified Fitzpatrick Wrinkle Scale and 10‐point visual analog scale, respectively. Skin biopsy of the postauricular area was performed on two consenting patients. Results: Significant improvements in wrinkles (p = 0.02), pores (p = 0.034), and hyperpigmentation (p = 0.036) were observed, along with increased patient subjective improvement. Adverse effects were transient and well‐tolerated. Hematoxylin and eosin and Masson's trichrome staining revealed increased and thickened dermal collagen fibers. Immunohistochemical staining revealed increased expression of collagen I and III throughout the papillary and upper reticular dermis, along with diffuse increase of STRO‐1 in the dermis. Conclusions: The combined application of a 785 nm picosecond laser and ICG yielded promising clinical outcomes for treating photo‐aged skin in Asian patients with Fitzpatrick skin type III and IV. [ABSTRACT FROM AUTHOR]

BACKGROUND: Treatment with filler injections using a microneedle fractional radiofrequency (MFRF) device is a promising modality with proven efficacy for acne scar treatment. OBJECTIVE: To investigate the efficacy and histologic differences of intradermal injection of a filler (poly- d , l -lactic acid, PDLA) using an MFRF device for the treatment of acne scars. METHODS: Patients with acne scars on both cheeks were included. Poly- d , l -lactic acid was injected via the MFRF device every 4 weeks for a total of 4 sessions. Patients were evaluated using the grading system for acne scars before each session, as well as personal satisfaction. For histologic evaluation, 2 patients (who consented) underwent a skin biopsy from the upper arm before and after the same single session. RESULTS: After the final session, the acne scar grading (échelle d'évaluation clinique des cicatrices d'acné) scale and visual analog scale for evaluation of satisfaction showed improvement compared with initial assessment (36.99% and 79.65% respectively [ p <.001, respectively]). For histologic evaluation, biodegradation of PDLA materials and increase in collagen and elastic fibers were observed after 5 months of treatment. CONCLUSION: Intradermal injection of PDLA using the MFRF device could be used as an effective treatment with fewer side effects in acne scar patients with Fitzpatrick skin type III-IV. [ABSTRACT FROM AUTHOR]

Photoaging pigmentation conditions such as senile lentigo and melasma show epidermal melanogenic activity and dermal abnormalities, including collagen degradation. A dermal rejuvenation strategy with skin‐lightening therapy directly acting on melanocytes is suggested for photoaging pigmentation. This study investigates whether collagen biostimulation can result in skin lightening of photoaging skin. A split‐face clinical trial was conducted, involving 40 subjects with facial melasma and senile lentigo. Subjects received a poly‐DL‐lactic acid (PDLLA) treatment on one side of their face, whereas the contralateral side received a treatment of normal saline as a control. Assessments were scheduled every month after completing treatments for up to 3 months. Pigmentation was evaluated using the L* value as measured with a chromameter and by investigator global assessment scores (IGA). Subjects reported different outcomes in terms of overall skin quality, including pigmentation, wrinkles and elasticity. Skin biopsies were obtained before the treatment and 4 weeks after completing the treatment. Fontana‐Masson, Masson‐Trichrome and Verhoeff‐van Gieson staining, and fibroblast‐specific protein 1 (FSP1) immunostaining were conducted. The PDLLA treatment demonstrated significant improvements in the L* values and IGA scores from 8 weeks after the subject completed their treatments. These improvements were sustained over a 12‐week assessment period. The subjects reported substantial reductions in both pigmentation and wrinkle severity and elasticity throughout the assessment period. Fontana‐Masson staining showed a marked decrease in pigmentation upon a PDLLA injection compared to the baseline values. Increased immunogenicity of FSP1 and increases in collagen and elastic fibre staining were observed. This study demonstrated remarkable improvements in photoaging pigmentation along with collagen production with a collagen biostimulator. Thus, collagen biostimulators represent a promising therapeutic approach for addressing photoaging signs associated with melasma and senile lentigo. (ClinicalTrials.gov Identifier: NCT05913102). [ABSTRACT FROM AUTHOR]

Postinflammatory hyperpigmentation (PIH) and erythema are the most common adverse effects associated with laser treatment, particularly in dark-skinned individuals. Several methods have been used to prevent or minimize these adverse effects; however, to date, no definitive precautions/strategies are known to prevent post-laser PIH and erythema. We investigated whether the topical application of the α-adrenergic receptor agonist brimonidine could reduce laser treatment-related complications such as erythema and PIH. [ABSTRACT FROM AUTHOR]

Since the advent of the theory of selective photothermolysis, the importance of targeting the chromophore and minimizing the surrounding damage has been extensively discussed. Picosecond‐domain laser (ps‐laser) treatment with a wide range of wavelengths is an emerging option for various pigmented lesions; however, no definitive treatment choice has been confirmed. The authors aimed to investigate the efficacy and safety of a ps‐laser with a 785‐nm wavelength for the treatment of facial pigmented lesions in Asians. Three Korean patients with facial pigmented lesions were recruited for the study. A 785‐nm ps‐laser with a fractionated and an unfractionated handpiece was utilized to administer the treatment. The clinical outcome was evaluated by a clinician by comparing pre‐ and post‐treatment photographs. All patients exhibited a significant improvement in pigmented lesions including freckles, lentigines, and melasma, after three to four sessions of treatment. No adverse events, including post‐inflammatory hyperpigmentation or hypopigmentation were observed. In conclusion, this novel 785‐nm Ti:sapphire ps‐laser may be an effective and safe modality for treating pigmented lesions in skin of color. [ABSTRACT FROM AUTHOR]

Cryotherapy (or cryosurgery) has been performed to treat various skin lesions in the field of dermatology; however, to the best of our knowledge, no study has investigated its efficacy and safety for benign pigmented lesions. Therefore, we conducted a split‐face study to evaluate the efficacy and safety of cryotherapy in the treatment of benign pigmented lesions. A total of five subjects were included. Picosecond laser therapy was performed to treat the whole face and cryotherapy for half the face. Four weeks after completing the treatment sessions, patients showed more clinical improvement on the laser and cryotherapy combination treatment side than on the laser‐only side, with no adverse events. Our study demonstrated that cryotherapy is a potential adjuvant therapeutic modality for benign pigmented lesions. [ABSTRACT FROM AUTHOR]