Glass-laser in skin resurfacing

Following our survey, we can appreciate that a variety of laser platforms exist to rejuvenate the skin by resurfacing the outer layer of the skin as well as heating the lower layers of the dermis. Based on reliable clinical effectiveness and a limited side effect profile, we can confirm that non-ablative fractionated technologies greatly improve the appearance of lentigines, rhytids, eliminate sun damage, attenuate scarring due to acne and other causes and treat hyper-pigmentation. The Fraxel® (Solta Medical) laser system delivers pulses across a wide range of density and energy levels. We determined that when increasing the pulse energy this led to an increase in thermolysis micro zone (MTZ) depth and width without damaging the surrounding tissue. Due to its performance and various clinical applications, Fraxel® Laser can be optimally considered to be the gold-standard for skin rejuvenation.

Using platelet-rich plasma for skin rejuvenation

The skin is the largest organ of the body, and it is affected by both intrinsic and extrinsic ageing factors. Platelet-rich plasma is an effective treatment for skin ageing, whether as a standalone treatment or in combination with other treatment modalities. The results depend on the skin quality of the patient, compliance and aftercare. Other factors to consider include the platelet-rich plasma kits and centrifuge used by the practitioner, as well as whether it is activated or not. In this article, Claudia McGloin will discuss skin ageing and the use of platelet-rich plasma for skin rejuvenation.

Transcriptomic analysis of human skin wound healing and rejuvenation following ablative fractional laser treatment

Ablative fractional laser treatment is considered the gold standard for skin rejuvenation. In order to understand how fractional laser works to rejuvenate skin, we performed microarray profiling on skin biopsies to identify temporal and dose-response changes in gene expression following fractional laser treatment. The backs of 14 women were treated with ablative fractional laser (Fraxel®) and 4 mm punch biopsies were collected from an untreated site and at the treated sites 1, 3, 7, 14, 21 and 28 days after the single treatment. In addition, in order to understand the effect that multiple fractional laser treatments have on skin rejuvenation, several sites were treated sequentially with either 1, 2, 3, or 4 treatments (with 28 days between treatments) followed by the collection of 4 mm punch biopsies. RNA was extracted from the biopsies, analyzed using Affymetrix U219 chips and gene expression was compared between untreated and treated sites. We observed dramatic changes in gene expression as early as 1 day after fractional laser treatment with changes remaining elevated even after 1 month. Analysis of individual genes demonstrated significant and time related changes in inflammatory, epidermal, and dermal genes, with dermal genes linked to extracellular matrix formation changing at later time points following fractional laser treatment. When comparing the age-related changes in skin gene expression to those induced by fractional laser, it was observed that fractional laser treatment reverses many of the changes in the aging gene expression. Finally, multiple fractional laser treatments, which cover different regions of a treatment area, resulted in a sustained or increased dermal remodeling response, with many genes either differentially regulated or continuously upregulated, supporting previous observations that maximal skin rejuvenation requires multiple fractional laser treatments. In conclusion, fractional laser treatment of human skin activates a number of biological processes involved in wound healing and tissue regeneration.

Adipose Collagen Fragment: A Novel Adipose-Derived Extracellular Matrix Concentrate for Skin Filling

Background Skin filler is an option for treatment of skin aging and wrinkle formation; however, currently used fillers are limited by poor biocompatibility, rapid degradation, and possible hypersensitivity reactions. However, autologous adipose tissue-derived products have been recognized as promising options for skin rejuvenation. Objectives This study aimed to develop a novel adipose-derived product for skin filling. Methods Adipose collagen fragment (ACF) was prepared through pulverization, filtration, and centrifugation. The macrography, structure, types of collagen, and cell viability of ACF were evaluated by immunostaining, Western blotting, and cell culture assays. ACF, nanofat and phosphate-buffered saline (9 spots/side, 0.01 ml/spot) were intradermally injected in the dorsal skin of 36 female BALB/c nude mice; then, the skin filling capacity and collagen remodeling process were investigated. Twenty-one female patients with fine rhytides in the infraorbital areas were enrolled and received ACF treatment as clinical applications. Therapeutic effects and patients’ satisfaction scores were recorded. Results The ACF yield from 50 ml of Coleman fat was 4.91 ± 0.25 ml. ACF contained nonviable cells and high levels of collagen I, collagen IV, and laminin. Fibroblasts and procollagen significantly increased in ACF and ACF-treated dermis (p < 0.05). 85.7% of patients were satisfied with the therapy results, and no infections, injection site nodules, or other unwanted side effects were observed. Conclusions ACF significantly improved dermal thickness and collagen synthesis and may serve as a potential autologous skin filler.