Journal of Cosmetic Dermatology最新文献

{"title":"Facial Lifting and Skin Rejuvenation Using a Dual-Wavelength Picosecond Nd:YAG Laser in Asian Skin: A Prospective Pilot Study","authors":"Yoon Hwan Lee,&nbsp;Sin Woo Sung,&nbsp;Ji Yeon Hong,&nbsp;Kui Young Park","doi":"10.1111/jocd.71206","DOIUrl":"https://doi.org/10.1111/jocd.71206","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Fractional picosecond lasers promote nonablative skin rejuvenation by inducing dermal remodeling through photomechanical effects. However, prospective clinical evidence regarding dual-wavelength picosecond Nd:YAG laser systems remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the efficacy and safety of a dual-wavelength picosecond Nd:YAG laser for facial laxity and skin quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective, single-arm pilot study, 20 adults underwent three treatments at 4-week intervals using sequential 1064- and 532-nm picosecond laser. Outcomes included Cutometer parameters (R2, R5, R7), melanin index (MI), erythema index (EI), imaging analysis, physician-assessed GAIS, participant satisfaction, and adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All participants completed the study. R5 and R7 improved from Week 4 onward, while R2 improved significantly at Weeks 8 and 12. MI and EI decreased significantly at Week 12. Imaging analysis showed significant improvements in pores, wrinkles, pigmentation, skin tone, and gloss. Week-12 GAIS and participant satisfaction scores were 4.70 ± 0.57 and 4.50 ± 0.76, respectively. Adverse events were limited to transient erythema and transient worsening of preexisting malar melasma in two participants, which resolved spontaneously.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Dual-wavelength picosecond Nd:YAG laser treatment progressively improved skin elasticity, skin tone, and overall skin quality with a favorable safety profile, supporting its potential for nonablative facial lifting and skin rejuvenation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 10","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.71206","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149047856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Sterile Folliculocentric Acneiform Eruption Mimicking Infection After Hair Transplantation: Clinical Pattern Recognition and a Proposed FUE Epidermal Cap–Angle Mechanism","authors":"Jae Hyun Park","doi":"10.1111/jocd.71209","DOIUrl":"https://doi.org/10.1111/jocd.71209","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acneiform eruption following hair transplantation is frequently encountered in clinical practice but remains incompletely characterized. Because these pustular eruptions may resemble postoperative infection, they often lead to unnecessary antibiotic use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To characterize the clinical pattern of a sterile folliculocentric acneiform eruption after hair transplantation and to propose a hypothesis-based mechanistic model integrating graft morphology and implantation geometry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients/Methods</h3>\u0000 \u0000 <p>In this retrospective observational cohort study, 76 consecutive patients who developed acneiform eruption were analyzed. Clinical features, eruption timing, anatomic distribution, graft composition, and microbiologic findings were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean onset occurred at postoperative day (POD) 3.1 (SD 1.1), with 84% of cases presenting between POD 2–4. Eruptions were predominantly observed in multi-hair graft areas following FUE procedures and were strictly confined to the transplanted recipient zone. Among 35 affected patients who also received lateral acute-angle single-hair grafts, those lateral zones were spared in 91.4% (32/35), an intra-individual comparison supporting an angle-dependent pattern. Wound cultures (<i>n</i> = 8) showed no pathogenic bacterial growth. Lesions were confined to the transplanted recipient area and resolved with conservative management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This sterile folliculocentric eruption appears to represent a technique-associated inflammatory reaction that may mimic infection in the early postoperative period. To our knowledge, this is the first characterization of this discrete, early-onset sterile entity as distinct from previously described post-transplant folliculitis, supporting a non-antibiotic, stewardship-oriented management approach. The proposed epidermal cap–angle mechanism is presented as a testable hypothesis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 10","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.71209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149047857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Target Treatment Zones: A Zone-Based Clinical Framework for Skin Quality Improvement Using Non–Cross-Linked Hyaluronic Acid and Glycerol","authors":"Vorapot Siramangkhalanon,&nbsp;Harirak Artamnuayvipas,&nbsp;Kran Sophonpatima","doi":"10.1111/jocd.71191","DOIUrl":"https://doi.org/10.1111/jocd.71191","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Aesthetic medicine has progressively shifted from volume toward skin quality as a key determinant of perceived age and facial attractiveness. Although non–cross-linked hyaluronic acid–based injectables are widely used to improve skin hydration and appearance, clinical application remains largely technique-driven, and structured decision-making frameworks addressing skin texture and visual skin quality as distinct therapeutic objectives remain limited.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To introduce target treatment zones (TTZs), a skin quality-first, anatomy-guided decision-making framework within the visual aesthetic (VA) methodology, designed to support selective dermal intervention for texture refinement and patient-perceived improvement in skin quality without altering facial volume or contour.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Evidence on skin quality as a foundational aesthetic parameter was reviewed alongside the rationale for dermal texture refinement using non–cross-linked hyaluronic acid combined with glycerol. The TTZ framework integrates anatomical zoning, zone-specific clinical relevance, and biologically appropriate dermal depth selection. Illustrative clinical cases from routine aesthetic practice are included to demonstrate clinical feasibility, practical application, and conceptual understanding rather than objective efficacy.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The illustrative cases supported the practical application of the TTZ framework for identifying clinically relevant treatment zones and selecting localized dermal intervention while seeking to minimize overtreatment. Serial clinical observations suggested possible improvements in hydration, surface texture refinement, and visual skin quality without volumetric change or contour distortion, while changes in skin texture homogeneity, fine superficial lines, pore appearance, and perceived skin brightness were observed. No formal efficacy analysis was performed.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;TTZs are proposed as a conceptual clinical framework that may support the incorporation of skin quality enhancement as a structured planning step rather than as a solely technique-dependent intervention. As an extension of the VA methodology, TTZs are intended to complement structural rejuvenation strategies and support natural, skin-centered aesthetic outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 ","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 10","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.71191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consumer Perceptions of Glycation-Induced Facial Skin Aging and the Role of Skincare Products","authors":"Sharon Shi,&nbsp;Kelly Chua,&nbsp;Bee Leng Lua","doi":"10.1111/jocd.71203","DOIUrl":"https://doi.org/10.1111/jocd.71203","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Glycation is a biological process known to exacerbate undesirable skin aging parameters such as yellowing, dullness, wrinkles and reduced elasticity. This study aimed to better understand consumer perceptions of glycation on facial skin and consumer expectations of anti-glycation skincare.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Focus group discussions (FGDs) with 24 female participants and an online survey with 800 female participants were conducted in China. Participants were 20–50 years old. The FGDs and survey aimed to determine facial skin qualities consumers associated with glycation and to link these qualities to commonly perceived skincare efficacies. Total unduplicated reach and frequency (TURF) and principal component analyses (PCA) were performed on data collected from the online surveys.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The main expected efficacies of anti-glycation skincare were reduced dullness and yellowness, and increased radiance and brightness. These efficacies were associated with the skincare descriptive categories “nourishing”, “repairing” and “skin and spot lightening”. TURF analysis showed that the descriptive category “nourishing” had an estimated 50% consumer reach, highlighting that this skincare feature was highly valued in the management of glycation. The descriptive category with the second highest consumer reach was “skin and spot lightening”, however, among women who identified glycation as a skin concern, “repairing” had a greater estimated reach than “skin and spot lightening”.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Female Chinese skincare users mainly associate the descriptive categories “nourishing”, “repairing”, and “skin and spot lightening” with anti-glycation effects. To combat glycation, women expect to see reduced skin dullness and yellowness and improved skin radiance and brightness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 10","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.71203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Evaluation of Video Recording, Tangential, and Room Light Photography in Acne Scar Severity Assessment","authors":"Esra Duzdemir,&nbsp;Eda Karaismailoglu,&nbsp;Gulsen Akoglu","doi":"10.1111/jocd.71161","DOIUrl":"https://doi.org/10.1111/jocd.71161","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Accurate assessment of acne scarring is essential for diagnosis, treatment planning, and outcome evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the Global Skin Assessment (GSA), Physician's Assessment of Skin Surface Roughness (PSSR), and Échelle d'évaluation clinique des cicatrices d'acné (ECCA) scores of patients' images recorded by room light photography (RLP), tangential light photography (TLP), and video recording (VR) with dermatological examination (DE) which was accepted as the reference standard method for further analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Medical and imaging records of 27 patients (48.1% female; mean age 25.2 ± 5.3 years) were reviewed. Agreement for GSA and PSSR was analyzed using weighted kappa coefficients. Intraclass correlation coefficients (ICC) were calculated for continuous ECCA scores. Bland–Altman analyses were performed to evaluate systematic bias and limits of agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For GSA, RLP demonstrated weak-to-moderate agreement (κ ≈ 0.59), TLP showed strong agreement (κ ≈ 0.88–0.91), and VR achieved almost perfect agreement (κ up to 1.000) with DE. Similar findings were observed for PSSR, with minimal agreement for RLP (κ = 0.285) and strong to almost perfect agreement for TLP (κ = 0.863) and VR (κ = 0.965). ICC values for ECCA scores indicated poor agreement for RLP (0.365), good agreement for TLP (0.852), and excellent agreement for VR (0.975). Bland–Altman analysis revealed the lowest bias and narrowest limits of agreement for VR (−2.96), compared with TLP (−12.59) and RLP (−50.19).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>For patients with acne scars, obtaining video recordings to capture images that most closely resemble DE findings would be the most appropriate approach before treatment and during follow-up. If video recording is not feasible, photographing under tangential light should be preferred as an alternative.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 9","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.71161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148942827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Featured Cover","authors":"","doi":"10.1111/jocd.71182","DOIUrl":"https://doi.org/10.1111/jocd.71182","url":null,"abstract":"<p>The cover image is based on the article <i>Pretarsal Augmentation With PLLA-b-PEG/HA Filler: Anatomical Plane and Safety Considerations</i> by Chuan-Yuan Lin and Jui-Yu Lin, https://doi.org/10.1111/jocd.71099.\u0000\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </p>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 9","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.71182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148942532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Next-Generation Dual 1550-nm Erbium Glass Fiber and 1927-nm Thulium Fiber Non-Ablative Fractional Laser System: Provider and Patient Perspectives","authors":"Ashish C. Bhatia,&nbsp;Jeffrey S. Dover,&nbsp;Paul M. Friedman,&nbsp;Anne Chapas,&nbsp;Jill Waibel,&nbsp;Mitchel P. Goldman,&nbsp;Suzanne L. Kilmer,&nbsp;Su Yong Choi,&nbsp;Abby Jacobson","doi":"10.1111/jocd.71115","DOIUrl":"https://doi.org/10.1111/jocd.71115","url":null,"abstract":"&lt;p&gt;The next-generation dual 1550-nm erbium glass fiber and 1927-nm thulium fiber non-ablative fractional laser system (Fraxel FTX system; Solta Medical, Bothell, WA) was launched in 2025. Compared with the previous-generation Fraxel DUAL system, enhancements include a lighter and more ergonomic handpiece, integrated tubing with directed cooling, a redesigned treatment tip, an enhanced user interface, and an updated optical tracking system. The system operates at the same wavelengths that, in a previous study, were associated with a quartile clinical improvement score of 1.9 (1 = 1%–25% improvement; 2 = 26%–50% improvement) for photodamage and pigmentation after ≤ 4 sessions [&lt;span&gt;1&lt;/span&gt;]. The 1550-nm laser coagulates the epidermis and dermis with ≤ 1.6-mm depth of penetration, addressing severe sun damage, wrinkles, acne scars, and surgical scars. The 1927-nm laser coagulates the epidermis and superficial dermis with ≤ 0.3-mm depth of penetration, addressing mild-to-moderate sun damage, pigmented lesions, skin texture, and actinic keratosis [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;A beta-testing survey was conducted among 22 providers who treated 97 patients with the next-generation device. Reflecting real-world clinical practice, treatment protocols and posttreatment regimens were not standardized, enabling providers to customize treatments according to their own clinical experience and judgment, patient tolerability, skin condition, Fitzpatrick skin type, and body area. Providers assessed efficacy via Investigator Global Aesthetic Improvement Scale (I-GAIS; 1 = worse; 5 = significant improvement) and quartile improvement scores (0 = no improvement; 4 = 76%–100% improvement), monitored safety, and answered questions about user experience. Patients completed surveys about comfort and satisfaction immediately after treatment (&lt;i&gt;n&lt;/i&gt; = 85), during the healing process (7–14 days after treatment; &lt;i&gt;n&lt;/i&gt; = 65), and 3–8 weeks after treatment (&lt;i&gt;n&lt;/i&gt; = 38) and rated esthetic improvement via Patient Global Aesthetic Improvement Scale (P-GAIS). Outcomes were analyzed on an as-observed basis.&lt;/p&gt;&lt;p&gt;Patients were predominantly female (89%) and White (73%), with most having a Fitzpatrick skin type of II (53%). Common treatment objectives were dyschromia and fine lines and wrinkles. Patients were treated with the 1550-nm laser (14%), 1927-nm laser (40%), or both (45%).&lt;/p&gt;&lt;p&gt;The average I-GAIS score after treatment was 3.4 (slight-to-moderate improvement), and the average quartile improvement score was 2.1 (26%–50% improvement; Figure 1A). No unexpected skin reactions or serious adverse events were reported. Most providers were “satisfied” or “very satisfied” with the system (91%) and noted it was “easy” or “very easy” to use (95%). Most providers (73%–96%) reported improvements in cable bundling, ergonomics, and tip design (Figure 1A). Additionally, 50% of providers noted that the new tracking system reduced treatment time by up to 20%.&lt;/p&gt;&lt;p&gt;Most patients (74%) rat","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 9","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.71115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148942068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal Rehabilitation of Extensive Post-Burn Scarring: A Case Report of Sequential Treatment With IPL, Microneedling + PRP, Ablative Fractional CO2 and Non-Ablative Er,Yb:Glass","authors":"Carina Nogueira Garcia,&nbsp;Corinna Herz,&nbsp;Lidia Poppe","doi":"10.1111/jocd.71172","DOIUrl":"https://doi.org/10.1111/jocd.71172","url":null,"abstract":"&lt;p&gt;Hypertrophic scarring develops in up to 70% of survivors of significant burn injury and remains the greatest unmet challenge in burn care [&lt;span&gt;1&lt;/span&gt;]. Deep burns rarely produce a uniform scar: a single territory typically contains hypertrophic ridging, atrophic depression, telangiectasia and dyspigmentation, reflecting regional variation in burn depth and inflammatory load [&lt;span&gt;2&lt;/span&gt;]. Among 1034 people living with scars, the 119 with burn scarring reported more symptoms and greater psychological difficulty than those with other etiologies [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;No single modality addresses this heterogeneity, so multimodal protocols have become the pragmatic standard. What remains undefined is sequencing. A meta-analysis of seven studies and 467 patients found that laser therapy begun within 12 months of injury outperformed later intervention (standardized mean difference −1.97, 95% CI −3.08 to −0.87, vs. −0.59, −1.10 to −0.07), with vascularity the most timing-sensitive subscale [&lt;span&gt;4&lt;/span&gt;]. Timing and order are therefore determinants of outcome, not administrative detail.&lt;/p&gt;&lt;p&gt;The available modalities act on complementary targets. Intense pulsed light (IPL) permits selective photothermolysis of oxyhemoglobin and melanin, with reported use in hypertrophic scarring and post-inflammatory dyschromia [&lt;span&gt;5&lt;/span&gt;]. In a cohort of 20 patients with burn scar dyschromia, 16 improved [&lt;span&gt;6&lt;/span&gt;]. Because hypervascularity sustains fibroproliferation, vascular and collagen targets are mechanistically linked [&lt;span&gt;7&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Ablative fractional CO&lt;sub&gt;2&lt;/sub&gt; laser (AFCL) ablates microcolumns while preserving tissue bridges. In mature burn scars it improved collagen architecture and shifted the Type I:III ratio [&lt;span&gt;8&lt;/span&gt;], and pooled data across 14 studies show a mean Vancouver Scar Scale (VSS) reduction of 3.01 points (95% CI −3.79 to −2.22) [&lt;span&gt;9&lt;/span&gt;]. Early intervention in acute burns produced 63% improvement on the Manchester Scar Scale [&lt;span&gt;10&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Evidence for combining light devices is weaker than assumed: a 2025 review admitted only two studies to quantitative synthesis and found no advantage of combination over pulsed dye laser alone [&lt;span&gt;11&lt;/span&gt;]. Hybrid platforms delivering ablative CO&lt;sub&gt;2&lt;/sub&gt; and non-ablative 1570 nm Erbium glass from one device are a newer option. In 51 patients this pairing improved pigmentation, vascularity, and elasticity alongside itch, pain, and tension [&lt;span&gt;12&lt;/span&gt;]. Platelet-rich plasma (PRP) supplies PDGF, VEGF, TGF-β, and IGF-1 [&lt;span&gt;13&lt;/span&gt;], and adding PRP to microneedling nearly tripled the odds of &gt; 50% improvement across 14 controlled studies (OR 2.97; 95% CI 1.96–4.51) [&lt;span&gt;14&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;We describe a phased 10-session protocol in which IPL and microneedling with PRP preceded AFCL, and in which each laser session served as a delivery window for same-session mesotherapy. The report follows the CARE guidelines [&lt;span&gt;15&lt;/span&gt;].&lt;/p","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 9","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.71172","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148942062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety Evaluation of a Novel Low-Fluence, High-Frequency Approach for Unwanted Hair Removal","authors":"Alejandra Fernández Santos,&nbsp;Leticia Huergo Zapico,&nbsp;Susana Valero Freitag","doi":"10.1111/jocd.71138","DOIUrl":"https://doi.org/10.1111/jocd.71138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>High-fluence laser hair removal procedures have provided permanent solutions for unwanted hair growth. However, their association with uncomfortable sessions and adverse effects has prompted the evaluation of new hair removal techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study compares the efficacy and safety of a new laser method (linear FDHR; low fluence, high frequency, and controlled movements) with the traditional technique (DHR; high fluence and low frequency), using the Eneka PRO laser device (Termosalud Inc., Gijón, Spain).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Thirteen body areas (skin phototypes II–IV) were treated 8 times at 2-month intervals. DHR mode was applied to one side of the treatment area, whereas linear FDHR mode was delivered on the contralateral side. Efficacy was evaluated 2 months after the final session by digital photographs and hair counts. Safety was assessed during the treatment period and at 6-month follow-up visit. Participant satisfaction was assessed via a customized questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At the follow-up, hair clearance rates of the linear FDHR and DHR method (83% and 91%, respectively) were significant (<i>p</i> &lt; 0.05) and comparable (<i>p</i> &gt; 0.05). Common adverse effects were detected through the treatments and no unexpected adverse effects or long-term adverse effects occurred. Linear FDHR method was associated with less discomfort (31%) when compared to DHR (54%) (<i>p</i> &lt; 0.05). 62% of the participants reported no difference in satisfaction levels between the 2 modes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The linear FDHR technique is a noninvasive, effective, safe, and well-tolerated alternative to the traditional method for the removal of unwanted hair.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 9","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.71138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148942061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Links Between Body Dysmorphic Concerns and Acceptance of Cosmetic Surgery: The Role of Internal and External Shame as Mediators","authors":"Gabrielle Victoria Topalian,&nbsp;Georges-Alain Al Tekle,&nbsp;Katia Iskandar,&nbsp;Pascal Lahoud,&nbsp;Feten Fekih-Romdhane,&nbsp;Souheil Hallit,&nbsp;Sahar Obeid","doi":"10.1111/jocd.71083","DOIUrl":"https://doi.org/10.1111/jocd.71083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cosmetic surgery has become increasingly normalized in many societies, including Lebanon, where appearance enhancement is often associated with identity, social acceptance, and social mobility. Body dysmorphic concerns (BDC) and shame have both been associated with attitudes toward cosmetic surgery; however, the emotional processes underlying these associations remain insufficiently explored. The purpose of this study is to assess the mediating role of shame in the relationship between BDC and acceptance of cosmetic surgery in Lebanese adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional study, 399 Lebanese participants aged 18 years and older were enrolled. Measures used were the Acceptance of Cosmetic Surgery Scale (ACSS), the Dysmorphic Concern Questionnaire (DCQ), a screening measure of subclinical dysmorphic concerns, and the External and Internal Shame Scale (EISS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Indirect associations statistically consistent with partial mediation models involving total, internal, and external shame were observed between BDC and acceptance of cosmetic surgery. Higher BDC was significantly associated with higher shame and directly associated with higher acceptance of cosmetic surgery. Higher shame was significantly associated with lower acceptance of cosmetic surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These results indicate that the role of shame in crafting attitudes toward cosmetic surgery is rather complicated as an emotional variable. BDC and shame can be screened for during preoperative consultations by clinicians to determine which patients are at risk of having psychological concerns. Applying mental health care to the perspective of aesthetic medicine can increase patient satisfaction and result in an ethical, patient-centered approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"25 9","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocd.71083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}