Daily Cosmetic Research Analysis

Chronic prurigo (CP) is a distressing dermatological condition lacking effective topical therapies. This randomized, double-blind, vehicle-controlled trial evaluated the efficacy and safety of Cryosim-1, a TRPM8 agonist cream, in 30 adults with CP. Participants were assigned to apply Cryosim-1 0.1%, 0.5%, or vehicle cream 3 times daily for 4 weeks. Both active formulations significantly reduced Prurigo Activity Score (PAS) compared with vehicle, with 0.1% Cryosim-1 showing a mean PAS reduction of -7.3 (p < 0.001). Significant improvements were observed in 24-h itch intensity, quality of life (DLQI), transepidermal water loss, and stratum corneum hydration. While both concentrations were effective, the 0.1% formulation showed superior tolerability with fewer reports of stinging and erythema. These findings support the potential of TRPM8-targeted therapy in managing CP through dual mechanisms of itch inhibition and skin barrier restoration.

INTRODUCTION: Glabellar wrinkle patterns, a visible manifestation of facial dynamics and ageing, result from complex interactions between anatomical and functional variables such as muscle interdigitation density, skin elasticity, and subcutaneous tissue characteristics. The standard injection pattern for botulinum toxin type A (BoNTA) is widely used but assumes uniformity in these factors, potentially overlooking individual anatomical and demographic variability. This study evaluates whether the standard injection pattern adequately addresses these differences. METHODS: Advanced biomechanical modelling and machine learning were employed to analyse the interactions between glabellar muscles, skin, and subcutaneous tissue. AI frameworks, including convolutional neural networks and long short-term memory networks, were trained on 3D facial scan data capturing dynamic expressions. Bayesian modelling quantified demography-specific predictors, while finite element analysis simulated wrinkle patterns under varying biomechanical conditions. RESULTS: The hybrid cohort included 600 participants (300 males, 300 females), evenly distributed across Caucasian (n = 150), African American (n = 150), Asian (n = 100), Hispanic (n = 100), and Middle Eastern (n = 100) ethnicities, aged 18-65 years. Significant predictors of wrinkle patterns were age (β = -0.64, p < 0.001), elasticity (β = 0.48, p < 0.01), and BMI (β = -0.52, p < 0.01). Within our cohort, higher interdigitation density was observed in Asian and African American participants, producing narrower wrinkle configurations ("11", "V"), while lower densities in Caucasian and Hispanic groups allowed broader patterns ("omega", "converging arrows"). AI models achieved >90% accuracy, demonstrating significant variability in wrinkle morphology and the need to reassess the universal applicability of the standard injection pattern. CONCLUSION: This study underscores the limitations of the standard injection pattern, advocating for anatomically precise, personalised treatment protocols to better accommodate demographic and anatomical diversity in clinical practice. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

BACKGROUND: Botulinum toxin type A (BoNT-A) has become an established treatment for upper facial rejuvenation; however, its use in the lower face and neck is less explored and presents anatomical challenges. This study evaluates the long-term efficacy and safety of BoNT-A injections for lower facial rejuvenation, emphasizing potential cumulative effects and muscle modulation. METHODS: A retrospective single-centre analysis was conducted on 400 patients (380 females and 20 males; aged 35-85 years) treated between January 2018 and December 2024. Patients received, during a full face treatment, BoNT-A injections targeting the mentalis, depressor anguli oris, platysmal bands, and masseter muscles, with standardized doses ranging from 120 to 160 units per session every 6 months. Patients underwent a minimum of three sessions over a follow-up period of 24-60 months. Outcomes were assessed using the Merz Aesthetic Scale (for platysmal bands) and a 5-point Visual Analogue Scale (VAS) based on standardized pre-treatments photographic and video documentation reviewed by two independent plastic surgeons. RESULTS: The mean Merz score reported these results baseline (pre-first treatment): 4.2 ± 0.6, after first cycle: 2.1 ± 0.4 (p < 0.01), and after third cycle: 1.8 ± 0.3 (p < 0.001 compared to baseline). Independent VAS ratings confirmed significant improvements in contour and soft tissue balance Global improvement score: pre-treatment 1.5 ± 0.7 → post-treatment 4.1 ± 0.4 (p < 0.001). Notably, patients maintained results longer than the expected pharmacological effect window, supporting the hypothesis of functional muscle retraining. Mild adverse events occurred in less than 12% of patients, mainly localized bruising and discomfort, with no serious complications. CONCLUSIONS: In this large cohort of 400 patients, BoNT-A injections for lower facial rejuvenation produced significant aesthetic improvements with progressive and sustained benefits over time. The concept of cumulative neuromodulation offers new insight into long-term lower face aesthetic management. Our results support BoNT-A as a safe, effective, and minimally invasive treatment option in expert hands. LEVEL OF EVIDENCE II: This journal requires that authors 43 assign a level of evidence to each article. For a full 44 description of these Evidence-Based Medicine ratings, 45 please refer to the Table of Contents or the online 46 Instructions to Authors http://www.springer.com/00266 .