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Skin scarring can result from burns, injuries, stretch marks and acne, leading to cosmetic and functional difficulties. Treatments for burn scars encompass a range of options, such as lasers, corticosteroid injections, surgery and regenerative techniques such as platelet‐rich plasma (PRP). Hyaluronic acid‐based products offer skin hydration and shield against aging effects. A study is being conducted to evaluate how effective PRP injection, hyaluronic acid and their combination improve burn scars and their effects on quality of life and potential disabilities. In our study, PRP and non‐cross‐linked hyaluronic acid treatments were compared in 10 individuals with burn scars between 2022 and 2023. Patients received CO2 fractional laser treatment followed by injections in scar areas. Evaluations included the Vancouver scar scale (VSS), biometric assessments, ultrasounds and satisfaction ratings. Two therapy sessions were conducted at 1‐month interval, and assessments were done before treatment, 1 month after the first session, and 3 months after the first session. Biometric assessments showed significant improvements in various parameters (tewametry, corneometry, erythema index, melanin index, cutometry, thickness and density) in the intervention groups compared to the placebo group (p <0.05). PRP‐non‐cross‐linked hyaluronic acid, PRP and non‐cross‐linked hyaluronic acid treatments exhibited the best clinical responses with significant differences between groups (p <0.05). Dermal thickness did not show significant improvement during treatment sessions, and changes among subjects were not significantly different. The colorimetry parameter improved in all groups except the placebo group, with no significant difference between intervention groups. The VSS significantly decreased in all treatment groups except the placebo group. PRP, non‐cross‐linked hyaluronic acid and especially the combination of these two treatment options are very effective in treating burn scars.

Background Female androgenetic alopecia (FAGA) is a condition that affects women and involves the gradual loss of terminal hair in specific areas of the scalp. The limited treatment options for FAGA necessitate the development of new strategies. This study aimed to evaluate the potential benefit of using a combination therapy composed of autologous platelet‐rich plasma (PRP) and a non‐cross‐linked hyaluronic acid (HA) compound in the treatment of FAGA. Methods This was a retrospective, case‐series study, which enrolled nine female patients with FAGA between September 2021 and December 2022. The non‐cross‐linked HA compound (Hearty®, Imeik Technology Development Co., Ltd.) and PRP were implanted into the areas of hair loss over four treatment sessions separated by 4‐week intervals. Patients were monitored for overall improvement in their hair loss, hair count, treatment satisfaction, and adverse events at 1, 3, and 6 months follow‐up. Results The improvement rates, subjectively evaluated by the study physician, were 88.89% at the 1‐month and 100% at the 3‐month follow‐up, relative to baseline. Moreover, the quantitative evaluation results showed that the FAGA patients' hair density increased by 54.51% at the 1‐month and by 77.25% at the 3‐month follow‐up. Conclusion The combination of PRP and non‐cross‐linked HA compound appeared to be a certain positive effective procedure for FAGA without serious adverse event. We envisage that this work will contribute to the development of new treatment options for women suffering from this condition.

Introduction Acne vulgaris is a common skin condition that affects a significant percentage of adolescents, with scarring being one of its permanent complications. This study aims to compare the efficacy and safety of using botulinum toxin type A (BTA) in combination with cross‐linked and non‐cross‐linked hyaluronic acid (HA) for the treatment of atrophic acne scars. Method Our study is a randomized, double‐blind clinical trial conducted on 16 patients with atrophic acne scars. The patients were randomly assigned to one of two groups: one group received a single session of BTA and crossed link HA combination, while the other group received two sessions of BTA and non‐crossed link HA, 1 month apart. The patients were followed up at 3 and 6 months after baseline to evaluate the number and area of fine and large pores and spots, scar grading, patient satisfaction, and complications. Results The mean age of individuals in both the cross‐linked HA and non‐cross‐linked HA groups was 32.75 ± 4.26 and 31.50 ± 8.48 years, respectively (p = 0.71). In terms of gender, three (37.5%) and seven (87.5%) individuals in the cross‐linked and non‐cross‐linked HA groups were female, respectively (p = 0.11). There were no significant differences in the count and area of fine and large pores and spots between the two groups at baseline and the first follow‐up session. However, in the second follow‐up session, the non‐cross‐linked HA group had significantly better results than the cross‐linked HA group in terms of large pores count and area (p = 0.01). In terms of changes over time, the non‐cross‐linked HA group showed significantly better improvements in the count and area of large pores compared to the cross‐linked HA group (p = 0.03). Additionally, both groups experienced a significant decrease in the count and area of fine pores over time (p = 0.001), but the amount of changes was not statistically significant between the two groups (p = 0.06). Concerning acne grade, initially, 62.5% and 12.5% of cases in the cross‐linked HA and non‐cross‐linked HA groups, respectively, had severe grades. However, in the last session, these percentages significantly decreased to 0% for both groups (p = 0.002 and 0.005, respectively). In terms of treatment complications, none of the patients experienced any adverse effects. Conclusion The study demonstrated that both cross‐linked HA and non‐cross‐linked HA were effective in reducing acne severity and improving the appearance of pores and spots. The treatments had similar effects on fine pores, spots, and overall acne severity. However, non‐cross‐linked HA appeared to have a better result on large pores compared to cross‐linked HA.

Background Post‐acne erythema (PAE) is one of the most common inflammatory sequelae of acne. Although various therapeutic approaches are currently available, many are limited by suboptimal efficacy, poor tolerability, or high costs. This trial aims to evaluate the clinical efficacy and safety of non‐cross‐linked hyaluronic acid (HA) mesotherapy for the treatment of PAE. Methods A total of 25 patients aged 18–35 years with clinically diagnosed PAE and bilaterally symmetrical facial lesions were enrolled. Three treatment sessions were performed at 4‐week intervals. The primary outcome was the Clinician Erythema Assessment Scale (CEAS) score assessed at baseline and week 12. Secondary endpoints included the Dermatology Life Quality Index (DLQI), Patient Self‐Assessment (PSA), VISIA skin analysis (red areas, pores, texture), CK measurement parameters (erythema index, melanin index, skin hydration, transepidermal water loss), dermoscopic imaging, adverse effects, and relapse. Results Finally, 23 patients completed all treatment sessions. By week 12, the mesotherapy group showed significantly lower CEAS scores compared to the control group. In addition, patients in the mesotherapy group reported higher satisfaction levels. Improvements in red areas, pores, texture, erythema index, skin hydration, transepidermal water loss, and dermoscopic imaging were also more marked in the mesotherapy group. There was a significant change in the DLQI score, too. No serious adverse events or erythema flares occurred during the study. Among the 23 patients who completed the trial, only one experienced acne relapse. Conclusion According to the results of this study, non‐cross‐linked HA mesotherapy is a promising and useful therapeutic option for PAE.

Background Tear trough‐eye bag deformities may appear in young Asian patients due to the weak support of their facial skeletons. For these patients with better periorbital skin elasticity, the injection may be more suitable than surgery for treating tear trough‐lower eyelid bag deformity. Aims Identify the clinical efficacy and safety of non‐cross‐linked HA in the treatment of tear trough‐lower eyelid bag deformity. Methods In this study, we analyzed pre‐ and postinjection photographs of 55 patients treated with non‐cross‐linked hyaluronic acid (HA) for tear trough‐lower eyelid bag deformity. Results The mean [SD] scores of modified Goldberg score suggested that the most significant improvement of preoperative and postoperative scores was in tear trough depression, followed by infraorbital triangular depression, orbital fat prolapse, loss of skin elasticity, and skin transparency. Only transient localized complications were observed, including bruising, swelling, and erythema. There were no serious complications, such as skin necrosis or visual impairment. Conclusions Our study confirmed the beneficial efficacy and minor complications of composite non‐cross‐linked HA for the treatment of tear trough‐lower eyelid bag deformity.

Background Tear trough deformities are indicative of aging, progressively manifesting as pronounced infraorbital hollows. Although hyaluronic acid (HA) dermal fillers are favored for their safety and efficacy, quantifiable evidence of their effect of action still remains insufficient. Aims To investigate the efficacy of non‐cross‐linked HA compound in tear trough enhancement. Methods Twenty‐one subjects with moderate to severe infraorbital hollows underwent a single treatment including subcutaneous to supraperiosteal injections of a non‐cross‐linked HA compound. The effectiveness was assessed through Allergan Infraorbital Hollows Scale (AIHS), satisfaction rates, the Global Aesthetic Improvement Scale (GAIS), and quantitative analyses via Canfield VECTRA 3D imaging and MRI measurements during the 6‐month follow‐up. Results A total of 0.67 ± 0.31 and 0.77 ± 0.42 mL of the non‐cross‐linked HA compound were injected into the left and right suborbital regions, respectively. Substantial improvements in AIHS were observed in 85.71% and 80.95% of subjects at 6 months posttreatment, as assessed by blinded evaluators and treating investigators, respectively. 3D imaging showed volume increases of 0.87 ± 0.32 (left) and 0.99 ± 0.45 mL (right). MRI analysis provided closely aligned results to the 3D analysis. The GAIS and satisfaction rate were 85.71%, 90.48% for treating investigators and were 90.48% and 95.24% for subjects 6 months posttreatment. Conclusions The non‐cross‐linked HA filler demonstrated a safe and efficacious profile for the correction of infraorbital hollows with significant patient satisfaction and sustained outcomes up to 6 months posttreatment. These results support their clinical value in periorbital rejuvenation and reduction of infraorbital hollowing.

To evaluate the efficacy and safety of an injectable non-cross-linked hyaluronic acid (NCHA) solution in improving facial skin appearance. This prospective, multicenter, randomized, no‑treatment-controlled, assessor-blinded, superiority clinical trial was conducted from December 2023 to July 2024 with 448 adults (224 per arm). The treatment group received full-face intradermal injections of NCHA (4 mL/session) at baseline, day 28, and day 56; the control group followed routine skincare and underwent the same injection protocol after day 84. The treatment group underwent skin hydration measurement, elasticity measurement (two objective assessments), global aesthetic improvement scale, skin roughness score, and fine line score (three subjective assessments) at baseline; day 28 and 56; and 7/14/28 days after the last injection (day 63/70/84). The control group completed the same assessments at baseline, 28, 56, 63, 70, and 84 days after randomization. In the treatment group, 212 subjects (94.64%) completed the study, compared to 209 (93.3%) in the control group. Hydration increased steadily in the treatment group, exceeding that of the control at all post-treatment time points (P<0.001). Elasticity improvements at 7/14/28 days after the final injection were significantly greater than those in the control group (P<0.05). GAIS, ASRS, and AFLS all favored the treatment arm. Serious adverse events were not observed. Full‑face intradermal NCHA improved skin hydration, elasticity, texture, and fine lines with a favorable safety profile. ChiCTR2300078169.

Background Keratosis pilaris (KP) is a prevalent benign dermatological condition characterized by small bumps at the hair follicles alongside surrounding redness, significantly impacting both aesthetics and mental well‐being. Objective This study investigated the potential benefits of a non‐cross‐linked hyaluronic acid (HA) compound for treating KP. Methods A split‐body, investigator‐blinded, randomized, intraindividual comparative clinical trial was conducted. The non‐cross‐linked HA compound was injected into KP‐affected regions on both upper arms. The treatment was delivered across four sessions scheduled at 4‐week intervals. Blinded physicians and patients assessed differences in erythema, skin roughness, and overall scores between treated and control areas at the final follow‐up visit. At the 12th and 24th weeks post‐treatment, a four‐point scale was utilized to assess subjects' perceived treatment efficacy. Additionally, dermoscopic images, histological alterations, and adverse events were monitored. Results Physician assessments revealed a significant reduction in roughness and overall scores for treated areas compared to controls. Patient self‐assessments also reflected improvements in roughness, redness, and overall scores for treated sides at the final visit, with 35.71% of patients demonstrating sustained improvement in redness and 71.43% reporting persistent improvements in roughness at 24th weeks post‐treatment. The dermatoscopic examinations revealed a notable enhancement in both the quantity of follicular plugs and the extent of erythema among the subjects in the treatment group. Histopathological outcomes also demonstrated improvement. Conclusion This study suggests that the non‐cross‐linked HA compound effectively improves skin roughness and promotes hair shaft growth in KP treatment, demonstrating a favorable safety profile. These findings position it as a potentially viable alternative therapy in clinical practice.

Background Horizontal neck wrinkle formation is gaining more attention among cosmetic practitioners and clients. To date, hyaluronic acid products are one of the most common treatment options for this aesthetic concern. However, different therapeutic strategies should be given to solve the problem due to multiple etiological reasons. Given that oxidative damage plays a critical role in neck wrinkle formation, anti-oxidative compounds are now considered by physicians when making a treatment plan. Aims To evaluate the efficacy and safety of a non-cross-linked hyaluronic acid filler in combination with L-carnosine in treating horizontal neck wrinkles. Methods Thirteen patients with a Wrinkle Assessment Scale (WAS) of 2–5 for horizontal neck wrinkles were treated with L-carnosine-containing non-cross-linked hyaluronic acid. Participants were followed-up for 3 months after treatment. The post-treated WAS scores evaluated by physicians were collected when patient satisfaction was surveyed. Any post-treatment adverse events were recorded. Results With a single injection of the above filler, the physician-evaluated WAS scores improved by at least one score at one month and the improvement kept consistent as far as three months after injection. According to the last follow-up visit, 11/13 patients were satisfied with the treatment effect of their neck wrinkle. Moreover, adverse events were rare after filler injection, except for local complications that were considered common reactions to the filler injection procedure. Conclusion The non-cross-linked hyaluronic acid filler containing L-carnosine is safe and effective for treating horizontal neck wrinkles.Level of Evidence IV 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.

Reconstruction of complex abdominal wall defects is challenging. The use of prosthetic mesh can be associated with surgical site infection, fistula formation, and adhesions. This study presents our experience using a non–cross-linked porcine dermal scaffold (NCPDS) in abdominal wall reconstruction. Patients undergoing abdominal wall reconstruction with NCPDS between May 2006 and January 2008 underwent a retrospective chart review. Demographics, indications for NCPDS placement, surgical technique, complications, and follow-up data were evaluated. Sixteen patients were identified in whom NCPDS was implanted into complex abdominal wall defects. These included 13 planned and 3 emergency surgeries. Indications for surgery included delayed reconstruction of giant ventral hernia secondary to decompressive laparotomy and open management of abdominal trauma, recurrence of large incisional hernia, temporary coverage of open abdomen secondary to intra-abdominal catastrophes, and open abdominal closure owing to compartment syndrome secondary to necrotizing fasciitis. In all, NCPDS was positioned in a subfascial underlay technique. Forty-four percent required a combination of components separation and NCPDS insertion. At a mean follow-up period of 16.5 months, the majority had desirable outcomes. Complications included seroma (21%), superficial wound dehiscence (7%), recurrence (7%), and infection (7%). Two patients died from multiorgan failure unrelated to NCPDS placement. The material only had to be removed in 1 patient because of wound infection and superficial wound dehiscence. NCPDS seems to be a safe and effective alternative to prosthetic mesh in the reconstruction of complicated abdominal wall defects.