Review of topical vitamins in photoaging skin

Cheuk Hung Lee(Cheuk Hung Lee),Kar Wai Alvin Lee(Kar Wai Alvin Lee),Kwin Wah Chan(Kwin Wah Chan),Kar Fai Victor Lee(Kar Fai Victor Lee),Kar Wai Phoebe Lam(Kar Wai Phoebe Lam ) 대한미용의학회 2022 대한미용의학회지 Vol.6 No.2

Photoaging is a process of normal skin architecture damage caused by ultraviolet radiation. Topical vitamins have been used to treat these conditions. The authors aimed to understand the mechanism and level of evidence of topical vitamins used to treat photodamaged skin. A range of topical vitamins has been used in cosmetic medicine for many years to treat photodamaged skin. This review article compares their efficacy and level of evidence. This study was a systematic review to evaluate the efficacy of different topical vitamins. Keywords including “Photoaging,” “Botanicals,” “Peptides,” “Retinoids,” “Vitamins” were searched on Ovid, PubMed, MEDLINE for relevant studies published on photoaging treatment. There is a wealth of Level I evidence supporting the use of topical retinoic acid, vitamins B and C. There is evidence supporting the use of topical vitamin E although it is mainly drawn from Level IV studies of the evidence hierarchy. Topical vitamins can effectively treat photodamaged skin. Level of Evidence: I

Treatment of acne fulminans with intense pulsed light: a case report

Cheuk Hung Lee(Cheuk Hung Lee),Kar Wai Alvin Lee(Kar Wai Alvin Lee),Kwin Wah Chan(Kwin Wah Chan),Kar Wai Phoebe Lam(Kar Wai Phoebe Lam ) 대한미용의학회 2022 대한미용의학회지 Vol.6 No.2

Acne fulminans is a severe form of acne that has a considerable psychosocial impact. Acne scarring is a potential complication of this condition. The treatment of acne fulminans includes conventional topical antibiotics, systemic antibiotics, hormonal therapy, isotretinoin, and light therapy. Intense pulsed light can have marked effects on acne fulminans. We aimed to describe the treatment of acne fulminans with intense pulsed light. This article is a case report together with a literature review to demonstrate how intense pulsed light can be used to treat acne fulminans. Pre-treatment and post-treatment clinical photographs are provided to show the effects of intense pulsed light therapy on acne fulminans. No comparisons were made with the other treatment modalities; nevertheless, this study provides an alternative treatment option for acne fulminans. Our case report revealed that intense pulse light using multiple filters at certain energy levels can effectively treat acne fulminans. Current evidence suggests that ablative CO2 and Er:YAG lasers provide the best curative effect on acne scars on all skin types. Potential complications with intense pulsed light include pain, burns, and post-inflammatory hyperpigmentation. Intense pulsed light is an effective treatment modality for acne fulminans. However, more cases of acne fulminans treated with intense pulsed light need to be documented in order to affirm intense pulsed light as one of the best options for treating this severe form of acne.

Review of chemical peeling in photoaging skin

Cheuk Hung Lee(Cheuk Hung Lee),Kar Wai Alvin Lee(Kar Wai Alvin Lee ),Lisa Kwin Wah Chan(Lisa Kwin Wah Chan ),Kar Fai Victor Lee(Kar Fai Victor Lee ) 대한미용의학회 2023 대한미용의학회지 Vol.7 No.1

Photoaging is a process in which ultraviolet radiation damages the normal skin architecture. Topical chemical peeling is used to treat this condition. The authors aimed to understand the mechanism and level of evidence of the different depths of chemical peeling used to treat photoaging. Various topical chemical peelings have been used in cosmetic medicine for many years to treat photodamaged skin. This review compares the efficacy and the level of evidence. This systematic review evaluates the efficacy of different chemical peeling methods. Keywords included “Photoaging,” “Alpha-hydroxy acid,” “Lipo-hydroxy acid,” “Trichloroacetic acid,” “Jessner’s solution,” and “Phenol” were typed on Ovid, PubMed, MEDLINE for relevant studies published on photoaging treatment. There is a wealth of Level I evidence supporting the use of topical retinoic acid, vitamin B, and vitamin C. The evidence behind the use of topical vitamin E exists but is mainly drawn from studies from the Level IV of the evidence hierarchy. Topical vitamins can effectively treat photodamaged skin. Level of Evidence: I

Case report: treating vitiligo with intense pulsed light

Cheuk Hung Lee(Cheuk Hung Lee),Kar Wai Alvin Lee(Kar Wai Alvin Lee ),Kwin Wah Chan(Kwin Wah Chan ) 대한미용의학회 2023 대한미용의학회지 Vol.7 No.1

Erythematotelangiectatic rosacea is a common, longstanding inflammatory skin disorder with unclear origin. It is characterized by facial erythema involving mainly the central face (malar areas, the chin, nasal area and forehead region) with a range of clinical presentations varying from hyperactivity of the blood vessels to sebaceous gland hyperplasia. It can lead to considerable psychosocial impact. Intense pulsed light (IPL) treatment can potentially have dramatic results on severe erythematotelangiectatic Rosacea. This is a case report of treating severe erythematotelangiectatic rosacea with IPL treatment. Pre-treatment and post-treatment clinical photos were provided to show the effect of IPL therapy on severe erythematotelangiectatic rosacea. This article is a case report together with literature review to explore the view of researchers on erythematotelangiectatic rosacea with IPL. No comparison is made with other treatment modalities. Nevertheless, it provides an alternative treatment option for patients with severe erythematotelangiectatic rosacea. Our case report shows that IPL at certain energy levels using multiple filters, can effectively treat severe erythematotelangiectatic rosacea. We believe with more treatment sessions patient can enjoy longer and persistent result. IPL is an effective treatment for erythematotelangiectatic rosacea. However, more erythematotelangiectatic rosacea cases treating with IPL will be required to consolidate IPL as one of the best treatment options in treating erythematotelangiectatic rosacea. Potential complications with IPL include post-inflammatory hyperpigmentation, burn and pain.

Treatment of severe erythematotelangiectatic rosacea with intense pulsed light: a case report

Cheuk Hung Lee(Cheuk Hung Lee),Kar Wai Alvin Lee(Kar Wai Alvin Lee ),Kwin Wah Chan(Kwin Wah Chan ) 대한미용의학회 2023 대한미용의학회지 Vol.7 No.1

Erythematotelangiectatic rosacea is a common, long-standing inflammatory skin disorder of unclear origin. It is characterized by facial erythema involving mainly the central face (malar areas, chin, nasal area, and forehead region), with a range of clinical manifestations varying from blood vessels hyperactivity to sebaceous glands hyperplasia. These can have a considerable psychosocial impact on the patients. Intense pulsed light treatment can have significant effects on severe erythematotelangiectatic rosacea. We aimed to describe the treatment of severe erythematotelangiectatic rosacea with intense pulsed light. This article is a case report together with a literature review to explore the views of researchers on the treatment of erythematotelangiectatic rosacea with intense pulsed light. Pre-treatment and post-treatment clinical photographs are provided to show the effects of intense pulsed light therapy on severe erythematotelangiectatic rosacea. No comparisons were made with the other treatment modalities; nevertheless, this study provides an alternative treatment option for patients with severe erythematotelangiectatic rosacea. Our case report revealed that intense pulsed light using multiple filters at certain energy levels can effectively treat severe erythematotelangiectatic rosacea. We believe that, with more treatment sessions, patients can enjoy longer and more persistent results. Intense pulsed light is an effective treatment for erythematotelangiectatic rosacea. However, more erythematotelangiectatic rosacea cases treated with intense pulsed light will be required to consolidate intense pulsed light as one of the best treatment options for erythematotelangiectatic rosacea. Potential complications with intense pulsed light include post-inflammatory hyperpigmentation, burns, and pain.

Re: Pilot study on efficacy and patient satisfaction with 1,450-nm laser boosting treatment after a thread lift procedure

Kar Wai Alvin Lee,Kwin Wah Chan,Cheuk Hung Lee 대한미용의학회 2023 대한미용의학회지 Vol.7 No.2

Laser resurfacing in acne scarring: a review

Lee Cheuk Hung,Lee Kar Wai Alvin,Chan Kwin Wah,Lam Kar Wai Phoebe,Wong Tin Hau 대한미용의학회 2022 대한미용의학회지 Vol.6 No.1

Scarring can complicate acne vulgaris and lead to considerable psychosocial implications. Resurfacing and collagen regeneration treatments for acne scars include cryotherapy, chemical peeling, lasers and lights, and radiofrequency. Lasers have become popular among these options. A range of lasers with varying designs, wavelengths, and fractional technologies have become available as treatment choices for acne scars. This review compares the efficacy and adverse effects of these treatments. This is a literature review to determine whether the use of a combination of laser treatments yields superior outcomes compared to a single-device method in the management of acne scars. Our literature review revealed that patient factors, including Fitzpatrick skin phenotype and acne scar subtype, are essential determinants of outcome success in acne treatment with laser. Evidence suggests that ablative CO2 and Er:YAG lasers provide the best curative effects on acne scars in all skin types. Both non-fractional and fractional techniques can effectively treat atrophic acne scars. However, when using a pulse-dye laser to treat hypertrophic scars, the outcomes are variable. Potential complications of ablative lasers include acne flares, infections, and scarring.

Outcome of mid- and lower face lifting using bidirectional cone sutures at 6 months and 1 year

Phoebe Kar Wai Lam,James Yui Lam,Alvin Kar Wai Lee,Clyde Wang Lung Luk,Paul Man Kei Tam,Cheuk Hung Lee 대한미용의학회 2021 대한미용의학회지 Vol.5 No.1

Soft tissue ptosis occurs with age, leading to loss of facial volume. The facial retaining ligamentous system is an intricate network of fibrous tissues connecting the whole face, restraining soft tissues from gravitational forces, and opposing facial movements. With proper positioning and anchorage within the ligamentous grid and superficial fat repositioning, lifting the mid-face and adjacent areas (e.g., jowl) is likely to occur. We aimed to determine whether inserting 3 pairs of bidirectional cone sutures can effectively improve the nasolabial fold (mid-face) and jowl (lower face) in Asian patients with mild to moderate mid-face laxity at 6 months and 12 months. Ten healthy volunteers with mild to moderate facial laxity received 3 pairs of bidirectional cone threads, inserted in a straight parallel technique. Based on validated evaluation parameters: facial laxity rating scale (FLRS) and the wrinkle severity rating scale, a total of 7 independent reviewers, among which 3 assessed the change in mid-face laxity (nasolabial fold), and the other 4 reviewers evaluated the change in jowl or lower face contour based on FLRS at 6 months and 12 months. All reviewers were experienced esthetic doctors. According to the reviewers’ evaluation based on the validated parameters, there was a linear improvement in the mid-face laxity/nasolabial fold and lower face laxity/jawline contour self-reporting patients’ satisfaction at 6 months and 12 months compared to baseline in all 10 patients. There was continuous improvement in mid-face laxity and lower face laxity from baseline, 6 months, and 12 months after treatment. The evaluation results among the reviewers were similar, apart from reviewer 7. All patients gave their best rating at 12 months, and their satisfaction almost doubled compared to that before treatment.

Twenty-four months long-term follow-up report on the effect of poly lactic-co-glycolic acid suspension suture in Asian with mild-moderate face laxity

Lam Phoebe Kar Wai,Fung Chi Pun,Lam James Yui,Luk Wang Lung,Lee Alvin Ka Wai,Lee Cheuk Hung,Tam Paul Man Kei,Lau Edwin Kwan Chark 대한미용의학회 2022 대한미용의학회지 Vol.6 No.1

Background: There was evidence of improvement in mid-face laxity using three pairs of suspension sutures in mid-face lifting in our early and mid-term follow-up. Objective: This 24-month prospective follow-up study aimed to determine the efficacy of mid-face lifting and lower jawline contouring using poly lactic-co-glycolic acid (PLGA) sutures in Asian patients. Methods: Ten healthy volunteers received three pairs of 8-cones bidirectional cones sutures at the mid-face. One of the ten volunteers lost to follow-up, and all remaining patients followed up for 24 months. Our primary outcome measure is the change in the facial laxity rating scale (FLRS), an “improvement” defined as at least “one-grade change” in FLRS. Other assessment parameters include the severity of the nasolabial fold (NLF), assessed on the wrinkle severity rating scale (WSRS). The secondary outcome measures were the self-satisfaction rating scale (SSRS) and global aesthetic improvement scale (GAIS), rated by participants at each follow-up interval. Results: A linear improvement in the mid-face was observed almost immediately after treatment, with progressive improvement up to at least 12 months following the intervention and no deterioration by 24 months. This improvement was significant (p<0.05), and the differences between before and after treatment at each follow-up interval were large (Cohen’s d>0.8). Contour improvement for the lower face followed a similar trend, except for a delay in the observable differences at three months (Cohen’s d=0.29, 0.8 at six weeks and three months, respectively). The differences in the level of patient satisfaction were significant (p<0.05) from 6 weeks to 24 months, peaking between 12 and 18 months, based on both the GAIS and SSRS ratings. No observed complications. Conclusion: Mid-facing lifting in Asian patients with mild-to-moderate laxity is safe and effective with PLGA bidirectional cone sutures, with concurrent improvement in the lower face contour and elevated patient satisfaction over the 24-month follow-up period.

New method to immediate reconstitute Sculptra to create a more homogenous mixture for immediate use in year 2023

Arthur Yu,Cheuk Hung Lee,Kar Wai Alvin Lee,Lisa Kwin Wah Chan 대한미용의학회 2023 대한미용의학회지 Vol.7 No.2

Background: To create a sterile, non-pyrogenic solution, Sculptra must first be reconstituted with 5 ml sterile water for injection. This reconstitution process has evolved, has become the norm, and has been recommended for use across the globe since it was marketed to the public for aesthetic reasons. The granuloma formation problem of Sculptra Aesthetic is troublesome to some injectors. It can appear anywhere that you injected and is erratic. According to some patients, the inappropriate mixing of Sculptra microparticles with sterile water or the inability of the microparticles to fully dissolve into the solution are to blame for the development of granulomas. Objective: This article aimed to demonstrate a new reconstitution method (with images) for mixing Sculptra with normal saline. Methods: In the new reconstitution method, we attached a 21G sterile needle to a sterile, single-use 5 ml syringe. Thereafter, we withdrew 2.5 ml normal saline into the 5 ml syringe. The 21G sterile needle was then introduced into the stopper of the vial, and we slowly added all normal saline into the vial. The vial was shaken vigorously to ensure the full hydration of the content. After shaking, the physician could then add any volume of normal saline. Results: A homogenous mixture of Sculptra can be achieved using this new reconstitution method. The mixture is ready to use after the immediate reconstitution of Sculptra. Conclusion: This novel reconstitution technique for Sculptra will result in less unpleasant treatment and less foam wastage on the part of the physician.