Daily Cosmetic Research Analysis

BACKGROUND: Given the rising demand for cosmetic Botulinum Toxins (BoNT) procedures in the UK, the potential for adverse outcomes, and a notable gap in evidence regarding how injector type, treatment location, and product choice influence risk, this study aims to investigate these associations in a large UK patient sample. METHODS: A cross-sectional observational survey was designed to gather data on individuals' (aged ≥18 years) experiences and adverse events with cosmetic BoNT injections across Great Britain and Northern Ireland. Data were collected on participants age, gender, injector role, treatment location, BoNT type, adverse events (AEs) and satisfaction. Binary logistic regression models were fitted for each adverse event to examine the association between the occurrence of the symptom (Yes/No) and injector role, treatment location and BoNT type. Ethical approval for the study was granted by Anglia Ruskin University Research Ethics Panel (Ethics ID: ETH2425-1930). RESULTS: The present sample included 919 participants. Receiving BoNT injections from a beautician was significantly associated with increased odds of some AEs, including pain, and eyelid ptosis. Interestingly, BoNT administered by pharmacists, was significantly associated with bruising and swelling, whereas BoNT administered by a doctor was associated with increased odds of nerve damage. Medical clinics outperformed all other environments, with patients reporting lower odds of complications across multiple AEs. By contrast, home-based injections carried significantly elevated odds of bruising and swelling. Participant reported unknown or undisclosed BoNT-A products had markedly poorer outcomes across multiple AEs. CONCLUSION: Findings from this cross-sectional study suggest that injectors operating from informal settings, particularly without disclosing the product used, pose a potential measurable and preventable risk. As public demand grows, safeguarding patient outcomes requires further legislative action.

BACKGROUND: Achieving adequate UV protection can be particularly challenging in patients with cutaneous immune-mediated inflammatory dermatoses (IMIDs), owing to the clinical characteristics and quality-of-life impact of these diseases. OBJECTIVES: To compare the UV protection habits and preferences of patients with cutaneous IMIDs, specifically considering expert recommendations for these diseases. METHODS: This pilot cross-sectional, observational and analytical cohort study recruited 120 participants (78 female, 42 male; mean age, 40.8 ± 15.39 years): 20 cases for each IMID (vitiligo, atopic dermatitis, alopecia areata, psoriasis and hidradenitis suppurativa) and 20 healthy controls. Study variables included eye and hair color, BMI, phototype, clinical severity scales for each IMID, the Dermatology Life Quality Index (DLQI) score and a study-specific questionnaire on photoprotection preferences. RESULTS: Daily photoprotection was reported by 40% of participants, with highest adherence (55%) in vitiligo patients. Hat use was generally low (24.17%), except among alopecia areata patients (40%). Overall, 63.3% of participants reported no sunburn in the last year, and 95% used an SPF > 15. Cream was the most commonly used SPF format, followed by spray. Oral photoprotection was known by 33.3% of participants, with highest use reported by vitiligo patients (45%). Compliance with UV protection recommendations for their specific disease was highest among vitiligo patients (70%), but did not exceed 10% for any other IMID. CONCLUSIONS: Educating patients with cutaneous IMIDs about appropriate UV protection, tailored to their specific skin disorder, treatments and preferences, is crucial to improve compliance and disease control.

Proximal renal tubular acidosis (RTA) results from impaired bicarbonate reabsorption in the proximal renal tubule, leading to a normal anion gap metabolic acidosis and electrolyte abnormalities. We report the case of a 16-year-old previously healthy female who presented with recurrent episodes of hypotension, dizziness, and generalized weakness over one month. Laboratory evaluation demonstrated severe hypokalemia, hyperchloremic metabolic acidosis with a normal anion gap, and glucosuria in the absence of hyperglycemia, with preserved renal function. Extensive evaluation for endocrine and autoimmune causes was unrevealing. A detailed review of medications and supplements identified recent initiation of high-dose biotin supplementation (2,500 µg daily) for cosmetic purposes. A strong temporal association was noted between biotin exposure and symptom onset, with rapid clinical and biochemical improvement following discontinuation. Two months later, inadvertent re-exposure to biotin resulted in recurrence of symptoms and laboratory abnormalities, which again resolved promptly after cessation of the supplement. The patient was managed with intravenous fluids, potassium supplementation, and avoidance of biotin, leading to sustained resolution of symptoms. At one-month follow-up, she remained asymptomatic with normal electrolyte levels and preserved renal function. This case identifies biotin as a rare, reversible cause of proximal RTA and underscores the importance of obtaining a thorough supplement history when evaluating patients with otherwise unexplained metabolic acidosis.