Laser and a topical containing human adipose tissue stem cell-derived exosomes. The 12-week prospective, double-blind, randomized, split-face investigative report was published on Oct. 19, 2020 in Acta Dermato-Venereologica.
The study included 25 patients (18 men and 7 women) between the ages of 19 and 54 with atrophic acne scars. Twelve of the patients had Fitzpatrick skin type 3 and 13 had Fitzpatrick skin type 4. Each patient received three consecutive treatment sessions of fractional CO
Laser to the entire face, with a follow-up evaluation and post-laser split face regimen, where one side of each patient's face was treated with an adipose tissue stem cell-derived exosome gel and the other side of the face was treated with a control gel. (The exosomes used in the study were acquired from human ASC-CM by ExoSCRT technology developed by ExoCoBio.)
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Findings showed that treatment sides of the face achieved a significantly greater improvement than the control sides at the final follow-up visit (32.5% versus 19.9%). In addition, treatment-related erythema was milder and post-treatment downtime was shorter on treatment side.
With a huge percentage of the world population struggling with this condition, the need for widening of therapeutic options was astoundingly clear, says Diane Duncan, MD, FACS. While ablative fractional carbon dioxide laser resurfacing has demonstrated clinical efficacy in acne scar treatments, patients have sustained side effects during post-procedural wound healing and had demanded improvement. The adjuvant application of adipose-derived stem cell conditioned medium with synergistic effects in augmenting treatment responses and reducing adverse effects through its potential to accelerate tissue rejuvenation is a victory for those suffering.
Research by Amplifica found that signaling by senescent melanocyte cell clusters caused epithelial hair stem cells in mice to exit quiescence and change their transcriptome and composition, potentially enhancing hair renewal.
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The research revealed that the decline of autophagy activity in skin adversely affects epidermal homeostasis and disturbs formation (cornification) of the stratum corneum, which functions as a barrier and retains hydration in the skin.This content was created by Everyday Health Media on behalf of an advertiser. More Information. Much of the Content on this page created or selected by the Everyday Health Media team is funded by an advertising sponsor. The content selected by the Everyday Health Media team conforms to its editorial standards for accuracy, objectivity, and balance. The sponsor may select the topic but does not edit the content. However, any content with the MedPage Today News: headline is not funded by an advertiser and was created independently by MedPage Today.
The legal ambiguity around minors' ability to consent without parental involvement to oral contraceptive pills (OCPs) for acne suggests that dermatologists err on the side of caution, according to researchers.
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Even when combined oral contraceptives (COCs) are clearly indicated for acne, dermatologists may hesitate to prescribe them, instead referring patients to primary care physicians or gynecologists, explained of Arielle Nagler, MD, of the New York University School of Medicine in New York City. Reasons for dermatologists' reluctance include the fact that many are uncomfortable discussing sexual health or are unwilling to spend time on such discussions, although OCP prescriptions for younger females necessitate doing so.
Combined oral contraceptives (COCs) provide an effective and usually very safe long-term therapeutic option. But we don't have a lot of data on who prescribes for our patients, particularly the COCs. That got me thinking about some of the challenges dermatologists may face when prescribing COCs for acne, Nagler said.
The impetus for the article in JAMA Dermatologycame from a data blind spot in the treatment of acne, particularly the use of hormonal therapies, four of which are FDA-approved for acne treatment.
And The Computer Plays Along
No less formidable an obstacle is the unclear nature of consent laws governing minors with respect to OCPs. By statute or default, all states require parental consent for treatment of minors except in matters related to reproductive and mental health. While 26 states and DC allow minors to consent to reproductive health treatments without parental consent or notification, the issue grows muddy regarding OCPs prescribed for acne.
On the one hand, the exception is carved out for matters related to reproductive health, and prescribing OCPs primarily for acne does not constitute a treatment related to reproductive health, Nagler and co-authors wrote. But then teens may wish to take OCPs for multiple reasons, including both acne treatment and pregnancy prevention, they pointed out.
Nagler said that the spirit of minor consent laws is to promote public health by allowing teens to make reproductive health decisions without parental involvement. Studies have shown that adolescents will more likely seek birth-control and treatment for sexually transmitted infections when parents will not be consulted or notified. Arguably, the treatment of acne also achieves the goal of improving public health, so allowing minors to consent to OCPs for acne is consistent with the spirit of the law, the authors noted.
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But to comply with the letter of minor consent law, Nagler's group recommend that dermatologists still seek parental consent when prescribing OCPs for acne management. Because the exception to parental consent applies only to reproductive health decisions, If a parent explicitly objects to OCP prescriptions, it would be prudent for the dermatologist to respect parental rejection of treatment. Legal precedent typically respects parental authority in such matters, they said.
Because some dermatologists use and may even prescribe OCPs for acne treatment, the authors add that to mitigate physician discomfort and support adolescent decision-making, dermatologists should be trained in counseling patients on OCP use.
Meanwhile, absent court decisions that would clarify whether minors need parental consent for OCPs for the primary indication of acne, Nagler's group recommend that dermatologists craft explicit policies for their own prescribing practices. Examples might range from requiring parental waivers regarding OCP consent to always obtaining parental consent. Policies also might stipulate when or if parents will be involved in conversations about OCPs.
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Some of the laws are ambiguous about what to do with minors with respect to prescribing COCs, which is inherently related to sexual health, but in the case of acne, may not be exclusively or at all related to sexual health. And because it's ambiguous whether or not parental consent is needed in many states, we believe it's better for dermatologists to have explicit policies when it comes to prescribing oral contraceptives to minors, Nagler said.
Rather than broad guidelines developed by the government or the American Academy of Dermatology, she said, We were thinking more on the individual level because laws vary by state, and because different practitioners may have a different level of comfort with prescribing OCPs for minors.
Having transparent policies, coupled with physician awareness of consent laws and resources for OCP counseling, will improve care for young women with acne, the authors said. Having clear practice guidelines may make dermatologists more comfortable discussing OCPs with minor patients, and patients may feel empowered knowing to what extent their parents will be involved in their care, and having access to reliable information about OCPs.
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Source Reference: Neuhaus CP, et al Teens, acne, and oral contraceptive pills: The need for greater clarity on when teens can consent JAMA Dermatol 2017; DOI:10.1001/jamadermatol.2016.5096.
Investigators recently published a worldwide assessment of the burden of 15 dermatological conditions measured between 1980 and 2013. See where skin disease ranks and what experts recommend to help decrease ongoing disability.
The 2016 American Academy of Dermatology Guidelines recommend re-evaluation of oral antibiotic treatment at 3 to 4 months and concomitant use with topical benzoyl peroxide or a retinoid, but it’s unclear if prescribing patterns for moderate and severe acne have really changed.
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