Weekly Cosmetic Research Analysis
This week’s cosmetic-related literature prioritized high-quality randomized trials and mechanistic safety studies. A multicenter RCT showed nonoperative casting was noninferior to surgery for displaced pediatric medial epicondyle fractures at 12 months, challenging rising surgical rates. Procedural dermatology evidence found scissor snip excision superior to a 532 nm LBO laser for skin-tag removal, favoring simpler care. Preclinical toxicology identified macrophage iron‑recycling disruption from
Summary
This week’s cosmetic-related literature prioritized high-quality randomized trials and mechanistic safety studies. A multicenter RCT showed nonoperative casting was noninferior to surgery for displaced pediatric medial epicondyle fractures at 12 months, challenging rising surgical rates. Procedural dermatology evidence found scissor snip excision superior to a 532 nm LBO laser for skin-tag removal, favoring simpler care. Preclinical toxicology identified macrophage iron‑recycling disruption from ZnO nanoparticles, raising safety flags for ZnO use in topical products.
Selected Articles
1. Casting vs Surgical Treatment of Children With Medial Epicondyle Fractures: A Randomized Clinical Trial.
Multicenter noninferiority RCT (n=72) found long-arm casting noninferior to open reduction and internal fixation for displaced pediatric medial epicondyle fractures at 12 months by QDASH, with casting showing superior cosmetic scores despite a much higher radiographic nonunion rate (68.6% vs 2.7%). No crossovers occurred and functional outcomes were excellent in both groups at 1 year.
Impact: High-quality randomized, registered, multicenter evidence that challenges increasing operative management and supports conservative care with informed counseling about radiographic nonunion.
Clinical Implications: Offer long-arm casting as a first-line option for displaced medial epicondyle fractures in children with shared decision-making; counsel families on high radiographic nonunion rates but low short-term functional detriment, and monitor long-term outcomes.
Key Findings
- Casting noninferior to surgery for 12-month QDASH (mean difference −0.98; noninferiority confirmed).
- Cosmetic VAS favored casting (between-group difference −8.9 points).
- Radiographic nonunion much higher with casting (68.6% vs 2.7%) but without short-term functional loss; no crossovers.
2. Removal of skin tags: scissor excision versus non-ablative 532nm-LBO-laser in a randomized intraindividual controlled observer-blinded clinical trial : Laser is not always better.
Randomized intraindividual, observer‑blinded trial in 68 patients (1,257 lesions) comparing scissor snip excision with non‑ablative 532 nm LBO laser for skin tags. At 12 weeks scissor excision had higher complete healing (85% vs 71%), lower pain scores, and greater patient preference; laser was faster and bloodless but caused more erythema and pigmentary changes.
Impact: Provides robust within-patient RCT evidence that challenges the default use of lasers for benign cosmetic lesions and supports low‑cost, high‑value procedural choices.
Clinical Implications: Prefer scissor snip excision for pedunculated skin tags as first-line; inform patients that lasers may be faster but have higher pigmentary/erythematous side effects and lower healing rates in this study.
Key Findings
- Complete healing at 12 weeks: 85% (scissor) vs 71% (532 nm LBO laser), p=0.00001.
- Lower pain scores and higher patient preference for scissor excision (63% preferred scissor).
- Laser was ~39% faster but had more erythema and hyper-/hypopigmentation.
3. ZnO Nanoparticle Exposure Disrupted Iron-Sulfur Protein Functions to Increase Macrophage Erythrophagocytosis and Disturb Systemic Iron Recycling.
Preclinical mouse study showing ZnO nanoparticle exposure causes anemia via disrupted splenic iron metabolism: macrophage metabolic reprogramming increased erythrophagocytosis, ferroportin response was blunted, and iron‑sulfur protein dysfunction led to iron retention and impaired systemic iron recycling.
Impact: Mechanistically links a widely used cosmetic ingredient (ZnO nanoparticles) to systemic hematologic toxicity, prompting reconsideration of safety testing paradigms for topical nanomaterials.
Clinical Implications: Regulatory and safety assessments for ZnO-containing products should include endpoints for reticuloendothelial iron handling and chronic exposure hematologic effects; clinicians should be aware of potential systemic risks from repeated nanoparticle exposure.
Key Findings
- ZnO NP exposure induced overt anemia in mice linked to disrupted splenic iron metabolism.
- Macrophage metabolic reprogramming increased erythrophagocytosis while ferroportin responsiveness was blunted, causing iron retention.
- Iron–sulfur protein dysfunction implicated as mechanistic mediator of impaired macrophage iron recycling.