Daily Cosmetic Research Analysis

OBJECTIVES: To achieve consensus among expert laser surgeons on standards for the prevention and management of adverse events from fully ablative laser resurfacing of the face. MATERIALS AND METHODS: Delphi study with two rounds of ratings and revisions until consensus was achieved. The draft set of statements was developed by a steering committee based on expert clinical experience. This was followed by two rounds of rating and revisions completed by an expert panel, then a virtual consensus meeting. In both rounds, respondents rated the draft statements on a 9-point Likert scale (1 = strongly disagree; 9 = strongly agree) and optionally provided comments. The consensus meeting was supplemented by the results of a systematic review of the literature (from 2000 to 2023). RESULTS: Two rounds of Delphi survey were completed by 34 participants across four countries. Represented specialties were dermatology, facial plastic surgery, plastic surgery, and oculoplastic surgery. The initial 105 statements from round 1 expanded to 112 in round 2, with 96 statements achieving consensus. These included possible adverse events (11 statements); absolute and relative contraindications to treatment (5 statements); preoperative care and antimicrobial prophylaxis precautions (16 statements); intraoperative precautions (17 statements); postoperative care (21 statements); monitoring for and management of infection (16 statements); management of pigmentation changes (6 statements); and management of scarring and incipient scarring (4 statements). CONCLUSION: An international consensus statement was developed for the prevention and management of complications associated with fully ablative laser resurfacing of the face. While expert practices vary, key factors for optimizing outcomes include careful patient selection, counseling, and meticulous pre- and postoperative care. Further research will improve our understanding of this treatment technique.

INTRODUCTION: Scalp seborrheic dermatitis (SD) can cause physical discomfort and social embarrassment in affected individuals. Mild-to-moderate scalp SD can be managed using topical products with antifungal, antiinflammatory, and keratolytic properties. METHODS: A two-phase, randomized, controlled study was conducted to evaluate the clinical efficacy of a newly formulated anti-SD shampoo containing two patented antifungal actives and to investigate the associated changes in the scalp microbiota. The intervention involved a 2-week intensive phase for the 42 subjects included in the study, consisting of the application of the anti-SD shampoo three times a week; a randomized [1:1], controlled, parallel-group 8-week maintenance phase consisting of the test group applying the study shampoo once a week alternately with a neutral shampoo twice a week; and the control group applying the neutral shampoo alone three times a week. RESULTS: Following the intensive phase, the scalp condition improved substantially, as evidenced by a significant decrease in the severity of dandruff, erythema, and pruritus, associated with an improvement of SD dysbiosis. These improvements were more sustained in the test group than in the control group during the maintenance phase. The rediversification of the scalp microbiota involved a significant increase in fungal and bacterial richness along with a decrease in the level of SD-predominant Malassezia fungi and Staphylococcus bacteria and an increase in the level of low-abundant fungi genera belonging to the Ascomycota phylum. CONCLUSIONS: The synergistic effects of antimycotic and antiinflammatory agents in the study shampoo likely contributed to rebalancing the fungal and bacterial ecosystem, thus improving scalp symptoms. GOV IDENTIFIER: NCT06578962 (retrospectively registered on 28 August 2024).

BACKGROUND: Since the approval of OnabotulinumtoxinA, the introduction of new botulinum toxin formulations has raised concerns regarding the potential development of neutralizing antibodies, diminished efficacy, and reduced duration of effect. However, long-term data on the safety of repeated cosmetic OnabotA treatments remain limited, particularly in real-world clinical practice. OBJECTIVE: To evaluate the long-term use and patient perceived age after consecutive cosmetic OnabotA injections. METHODS: Single-center, single-injector, retrospective cohort study evaluating the long-term use of consecutive OnabotA injections and assessing patient perceived age. RESULTS: Fifty patients (48 females, 2 males) were included, with a mean follow-up duration of 15.04 years (range: 8-26) and a total of 1,098 treatment cycles (8-67 cycles/patient). The cumulative OnabotA dose ranged from 332 to 3,684 units, with an average cumulative dose of 1,232 units/patient. When asked how old they perceived themselves compared to their current age, no patient reported feeling older than their chronologic age. Ninety-four percent stated appearing at least 2 years younger, while 76% perceived themselves to be between 5 and 12 years younger. CONCLUSION: In this cohort of 50 patients treated over an average of 15 years, OnabotA demonstrated no evidence of treatment failure or diminished duration of aesthetic outcomes.