Wound healing effect of adipose-derived stem cells: a critical role of secretory factors on human dermal fibroblasts

Aging is a complex, multifactorial process resulting in several functional and esthetic changes in the skin. These changes result from intrinsic as well as extrinsic processes, such as ultraviolet radiation. Recent advances in skin biology have increased our understanding of skin homeostasis and the aging process, as well as the mechanisms by which ultraviolet radiation contributes to photoaging and cutaneous disease. These advances in skin biology have led to the development of a diversity of treatments aimed at preventing aging and rejuvenating the skin. The focus of this review is the mechanism of photoaging and the pathophysiology underlying the treatments specifically designed for its prevention and treatment. Learning objectives At the conclusion of this learning activity, participants should be familiar with the mechanism of photoaging, the treatments for photoaging, and the data that supports the use of these treatments.

Photoaging: Mechanisms and repair

The drive to attain cosmetic facial enhancement with minimal risk and rapid recovery has inspired the field of nonsurgical skin rejuvenation. Laser resurfacing was introduced in the 1980s with continuous wave carbon dioxide (CO 2 ) lasers; however, because of a high rate of side effects, including scarring, short-pulse, high-peak power, and rapidly scanned, focused-beam CO 2 lasers and normal-mode erbium-doped yttrium aluminium garnet lasers were developed, which remove skin in a precisely controlled manner. The prolonged 2-week recovery time and small but significant complication risk prompted the development of non-ablative and, more recently, fractional resurfacing in order to minimize risk and shorten recovery times. Nonablative resurfacing produces dermal thermal injury to improve rhytides and photodamage while preserving the epidermis. Fractional resurfacing thermally ablates microscopic columns of epidermal and dermal tissue in regularly spaced arrays over a fraction of the skin surface. This intermediate approach increases efficacy as compared to nonablative resurfacing, but with faster recovery as compared to ablative resurfacing. Neither nonablative nor fractional resurfacing produces results comparable to ablative laser skin resurfacing, but both have become much more popular than the latter because the risks of treatment are limited in the face of acceptable improvement. Learning objectives At the completion of this learning activity, participants should be familiar with the spectrum of lasers and light technologies available for skin resurfacing, published studies of safety and efficacy, indications, methodologies, side effects, complications, and management.

The spectrum of laser skin resurfacing: Nonablative, fractional, and ablative laser resurfacing

Advances in laser technology have progressed so rapidly during the past decade that successful treatment of many cutaneous concerns and congenital defects, including vascular and pigmented lesions, tattoos, scars, and unwanted hair-can be achieved. The demand for laser surgery has increased substantially by patients and dermatologists alike as a result of the relative ease with which many of these lesions can be removed, combined with a low incidence of adverse postoperative sequelae. Refinements in laser technology and technique have provided patients and practitioners with more therapeutic choices and improved clinical results. In this review, the currently available laser systems with cutaneous applications are outlined, with primary focus placed on recent advancements and modifications in laser technology that have greatly expanded the cutaneous laser surgeon's armamentarium and improved overall treatment efficacy and safety.

Lasers in dermatology: four decades of progress.

Background: Autologous platelet-rich plasma has attracted attention in various medical fields recently, including orthopedic, plastic, and dental surgeries and dermatology for its wound healing ability. Further, it has been used clinically in mesotherapy for skin rejuvenation. Objective: In this study, the effects of activated platelet-rich plasma (aPRP) and activated platelet-poor plasma (aPPP) have been investigated on the remodelling of the extracellular matrix, a process that requires activation of dermal fibroblasts, which is essential for rejuvenation of aged skin. Methods: Platelet-rich plasma (PRP) and platelet-poor plasma (PPP) were prepared using a double-spin method and then activated with thrombin and calcium chloride. The proliferative effects of aPRP and aPPP were measured by [ 3 H]thymidine incorporation assay, and their effects on matrix protein synthesis were assessed by quantifying levels of procollagen type I carboxy-terminal peptide (PIP) by enzyme-linked immunosorbent assay (ELISA). The production of collagen and matrix metalloproteinases (MMP) was studied by Western blotting and reverse transcriptase-polymerase chain reaction. Results: Platelet numbers in PRP increased to 9.4-fold over baseline values. aPRP and aPPP both stimulated cell proliferation, with peak proliferation occurring in cells grown in 5% aPRP. Levels of PIP were highest in cells grown in the presence of 5% aPRP. Additionally, aPRP and aPPP increased the expression of type I collagen, MMP-1 protein, and mRNA in human dermal fibroblasts. Conclusion: aPRP and aPPP promote tissue remodelling in aged skin and may be used as adjuvant treatment to lasers for skin rejuvenation in cosmetic dermatology. (Ann Dermatol 23(4) 424∼431, 2011)

/pdf/can-platelet-rich-plasma-be-used-for-skin-rejuvenation-47qzex057f.pdf

Can Platelet-rich Plasma Be Used for Skin Rejuvenation? Evaluation of Effects of Platelet-rich Plasma on Human Dermal Fibroblast

BACKGROUND: Interest in the reversal of facial photodamage has increased significantly among patients and physicians in the past decade Though surgical procedures may be very effective, the associated healing time and potential risks have spurred the development of non‐surgical treatments There has also been an increasing depth of knowledge regarding wound healing and its control by growth factors as well as its modulation by the topical application of growth factors Bioengineered tissue cultures have resulted in the ability to collect naturally occurring human growth factors in their tissue concentrationsOBJECTIVE: The objective of this study is to determine if the twice daily application of a combination of multiple growth factors to photodamaged facial skin results in any evidence of improvement after 60 daysMETHODS: Fourteen patients applied a gel containing a mixture of eight different growth factors (Nouricel‐MD) to photodamaged facial skin twice daily Prior to the study and at 60 days there w

Reversal of photodamage with topical growth factors: a pilot study

Background. A new generation of highly selective short-pulsed lasers has emerged in recent years for the treatment of tattoos. Several studies (including reports by the present investigators) have proven the efficacy of each of the three commercially available, FDA approved devices; namely, the Q-switched alexandrite, Q-switched Nd:YAG and Q-switched ruby lasers. Considerable differences among the three have been reported in relation to the rate of clearing of the tattoo ink particles, tissue effects, beam profile, wound healing, and side effects.



Objective. This study was primarily conducted to examine and compare the clinical response of patients with blue-black tattoos simultaneously treated with three different Q-switched lasers (alexandrite, Nd:YAG, ruby) with a focus on the percentage of tattoo lightening/clearance and the occurrence or non-occurrence of pigmentary change as a side effect.



Methods. A total of forty-two blue-black tattoos seen at two laser centers (Massachusetts General Hospital Dermatology Laser Center and Laser and Skin Surgery Center of La Jolla) were simultaneously treated with three types of Q-switched lasers: a Candela Q-switched alexandrite laser (755nm 50-100 nanoseconds, 3.0mm spot size, 6-8 J/cm2); a Continuum Biomedical Q-switched Nd:YAG laser (1064nm, 10-20 nanoseconds, 3.0mm spot size, 5-10 J/cm2); and a Spectrum Q-switched ruby laser (694nm, 25-40 nanoseconds, 5.0mm spot size, 4-10 J/cm2). Paired t-tests and McNemar tests were used to compare the treatment outcome and pigmentation side effects between sites per tattoo, with each site representative of one of the three lasers. The statistical significance level was set at p < .05.



Results. Overall, the Q-switched ruby laser had a significant difference in tattoo lightening versus the Q-switched Nd:YAG and Q-switched alexandrite lasers. An increase in the number of treatments paralleled a statistically significant increase in tattoo clearance for all three Q-switched lasers.



Conclusion. The Q-switched ruby laser had the highest clearance rate in blue-black tattoos and the highest incidence of longlasting hypopigmentation. The Nd:YAG had no incidence of hypopigmentation.

Comparison of the Q-Switched Alexandrite, ND:YAG, and Ruby Lasers in Treating Blue-Black Tattoos

BACKGROUND: Nonablative laser resurfacing with various lasers and light sources can improve skin texture and fine lines. The 595 nm pulsed dye laser has been reported to improve rhytides through nonablative mechanisms, minimizing the side effects and recovery period associated with traditional ablative resurfacing techniques. OBJECTIVE: The purpose of this study was to investigate the efficacy of the long pulse flashlamp pumped pulsed dye laser (LPDL) in improving rhytides and stimulating collagen synthesis and dermal remodeling. METHODS: The cheeks of 15 women with moderate to severe photoaging were treated on one side with a series of four monthly LPDL treatments, while the contralateral cheek was treated with cryogen coolant only. Clinical grading was performed at monthly intervals for up to 3 months after the fourth LPDL treatment. Skin biopsy before treatment and at 4-6 weeks was also performed for histologic evaluation and staining for type I procollagen. RESULTS : Eleven of 15 patients demonstrated...

A double-blind, side-by-side comparison study of low fluence long pulse dye laser to coolant treatment for wrinkling of the cheeks.

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Reversal of photodamage with topical growth factors: a pilot study

Comparison of the Q-Switched Alexandrite, ND:YAG, and Ruby Lasers in Treating Blue-Black Tattoos

A double-blind, side-by-side comparison study of low fluence long pulse dye laser to coolant treatment for wrinkling of the cheeks.