Weekly Cosmetic Research Analysis
This week’s cosmetic-focused literature shows decisive comparative effectiveness results and methodological advances that will influence clinical practice and regulatory evaluation. A randomized split-face trial establishes surgical excision as superior to 70% TCA for localized xanthelasma with better clearance and cosmesis. A PROSPERO-registered meta-analysis supports combined fractional CO2 plus pulsed dye laser as superior to monotherapy for pathological scars. Multimodal ultrasound diagnosti
Summary
This week’s cosmetic-focused literature shows decisive comparative effectiveness results and methodological advances that will influence clinical practice and regulatory evaluation. A randomized split-face trial establishes surgical excision as superior to 70% TCA for localized xanthelasma with better clearance and cosmesis. A PROSPERO-registered meta-analysis supports combined fractional CO2 plus pulsed dye laser as superior to monotherapy for pathological scars. Multimodal ultrasound diagnostics demonstrated near-perfect accuracy for carpal tunnel syndrome and objective postoperative monitoring, illustrating broader momentum toward quantitative, noninvasive tools and exposure-informed safety science for cosmetic ingredients.
Selected Articles
1. Efficacy and safety of surgical excision versus 70% tricholoroacetic acid (TCA) topical application in xanthelasma palpebrarum: a split face randomized trial.
In a prospective split-face randomized trial of bilateral limited xanthelasma palpebrarum, surgical excision achieved 100% complete clearance at 12 weeks versus 22.2% with up to three sessions of 70% TCA. Excision yielded superior median area reduction (100% vs 69.2%), better cosmetic outcomes, less dyschromia, and higher patient satisfaction; papulonodular morphology and younger age predicted poorer TCA response.
Impact: First randomized head-to-head evidence showing surgical excision is decisively more effective and cosmetically superior to commonly used 70% TCA for localized xanthelasma, directly informing first-line therapeutic choice.
Clinical Implications: Offer surgical excision as first-line therapy for localized xanthelasma (≤1/3 palpebral area) due to single-session predictable clearance and better cosmetic outcomes; counsel patients on higher dyschromia and lower clearance with TCA, especially for papulonodular lesions.
Key Findings
- Complete clearance at week 12: 100% (36/36) with excision vs 22.2% (8/36) with 70% TCA (P<0.001).
- Median area reduction: 100% for excision vs 69.2% for TCA; dyschromia more frequent with TCA (75% vs 41.7%).
2. Combined Fractional CO
A PRISMA-compliant, PROSPERO-registered meta-analysis of nine studies (n=247) found that combining fractional CO2 and pulsed dye lasers significantly improves scar outcomes across validated scales (POSAS MD −18.09; OSAS MD −19.44; VSS MD −3.80) compared with monotherapy, with an acceptable safety profile. Benefits spanned thickness, vascularity, pliability, and pigmentation.
Impact: Synthesizes multi-study evidence supporting dual-laser protocols for pathological scars, providing a foundation for standardized treatment protocols and patient selection to improve functional and aesthetic outcomes.
Clinical Implications: Consider fractional CO2+PDL combination for hypertrophic/keloid and mixed-etiology scars to target vascularity and remodeling; emphasize the need for protocol standardization (fluence, density, intervals) and long-term follow-up.
Key Findings
- Pooled improvements across POSAS, OSAS, and VSS with combined CO2+PDL vs monotherapy (POSAS MD −18.09; OSAS MD −19.44; VSS MD −3.80).
- Benefits observed in thickness, vascularity, pliability, and pigmentation with a favorable safety profile.
3. Multimodal Ultrasound Imaging for Pre- and Postoperative Evaluation of Carpal Tunnel Syndrome.
A prospective cohort (50 CTS patients, 35 controls) combined high-frequency ultrasound, sound touch elastography, and ultramicro angiography to measure CSA, SWV, and CPP at the carpal tunnel inlet. The combined panel achieved AUC 0.990 (96.2% sensitivity, 98.6% specificity) for CTS diagnosis and all metrics significantly decreased 3 months after carpal tunnel release, supporting noninvasive diagnostic and short-term monitoring utility.
Impact: Demonstrates near-perfect diagnostic accuracy using a multimodal ultrasound panel and provides objective postoperative biomarkers, which could streamline CTS pathways and reduce need for invasive or time-consuming tests.
Clinical Implications: Adopt combined high-frequency ultrasound, elastography, and microvascular imaging to enhance early CTS diagnosis, severity stratification, and objective postoperative follow-up; pursue multicenter validation and protocol standardization.
Key Findings
- CSA, SWV, and CPP were significantly elevated in CTS vs controls (all P < 0.001).
- Combined CSA+SWV+CPP achieved AUC 0.990 with 96.2% sensitivity and 98.6% specificity; all parameters decreased significantly 3 months post-op.