María Enríquez-Molina, Nuria Blazquez-Sanchez, Juanjo Reyes-Luján, Sergio Vañó-Galván, Agustín Buendía-Eisman, Salvador Arias-Santiago
{"title":"Sun Exposure and Photoprotection Knowledge, Habits, and Attitudes Among Spanish Military Personnel.","authors":"María Enríquez-Molina, Nuria Blazquez-Sanchez, Juanjo Reyes-Luján, Sergio Vañó-Galván, Agustín Buendía-Eisman, Salvador Arias-Santiago","doi":"10.1111/phpp.70119","DOIUrl":"10.1111/phpp.70119","url":null,"abstract":"<p><strong>Background and objectives: </strong>The incidence of skin cancer continues to rise, with ultraviolet (UV) radiation exposure representing its main modifiable risk factor. Military personnel constitute a particularly vulnerable population due to the combination of occupational and recreational sun exposure, together with operational constraints related to uniforms and working conditions. The aim of this study was to assess knowledge, habits, and attitudes related to sun exposure and photoprotection among Spanish military personnel, and to explore differences in photoprotective practices according to sociodemographic and professional variables.</p><p><strong>Materials and methods: </strong>A cross-sectional observational study was conducted using a validated self-administered questionnaire in a sample of 500 active-duty Spanish military personnel from different ranks. Data collected included sociodemographic and phenotypic characteristics, knowledge, habits, and attitudes. Descriptive analyses and bivariate inferential analyses using non-parametric tests were performed.</p><p><strong>Results: </strong>Most participants reported frequent sun exposure in both occupational and leisure settings, with longer daily exposure during leisure time; 81.6% reported exposure of ≥ 3 h per day. Overall, 73.4% experienced at least one sunburn in the previous year. Sunglasses and sunscreen were the most commonly adopted photoprotective measures, whereas avoidance of peak sun hours and use of protective clothing were infrequent. Knowledge of UV radiation risks was generally high, although misconceptions persisted regarding shade protection and vitamin D exposure. Photoprotective practices were significantly poorer during leisure time than during occupational activities (p < 0.01).</p><p><strong>Conclusions: </strong>Spanish military personnel demonstrate adequate knowledge and positive attitudes toward photoprotection but insufficient protective practices, particularly outside the occupational setting. These findings highlight the need to strengthen health education and integrate photoprotection into military training and operational environments.</p>","PeriodicalId":20123,"journal":{"name":"Photodermatology, photoimmunology & photomedicine","volume":"42 5","pages":"e70119"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796826","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":"Photothermal-Activated Platelet-Rich Plasma Versus Conventional Platelet-Rich Plasma for Melasma: A Split-Face, Double-Blind Randomized Controlled Trial.","authors":"Rueangrit Siriphanit, Nattachar Ranoppawan, Sasin Charoensuksira, Wilai Thanasarnaksorn, Atchima Suwanchinda, Jitlada Meephansan","doi":"10.1111/phpp.70122","DOIUrl":"10.1111/phpp.70122","url":null,"abstract":"<p><strong>Background: </strong>Melasma is a common acquired pigmentary disorder that predominantly affects women with darker skin types and substantially impairs quality of life. Current treatments are limited by variable efficacy, adverse effects, and frequent recurrence. Platelet-rich plasma (PRP) has emerged as a potential regenerative treatment through growth-factor-mediated modulation of melanogenesis. Photothermal activation, which combines photobiomodulation with controlled hypothermic conditioning, has been hypothesized to promote a more sustained growth-factor release than conventional PRP. This study compared the efficacy and safety of photothermal-activated PRP (PT-PRP) and conventional PRP (C-PRP) for melasma treatment.</p><p><strong>Methods: </strong>This split-face, double-blind, randomized controlled trial included 26 women with epidermal or mixed-type melasma. Each participant received three monthly sessions of intradermal PRP, with PT-PRP and C-PRP injected into opposite facial sides. Outcomes were assessed at weeks 0, 4, 8, and 12 using the modified Melasma Area and Severity Index (mMASI), Mexameter melanin and erythema indices, patient satisfaction, overall improvement, and adverse events.</p><p><strong>Results: </strong>Both treatments significantly reduced mMASI by week 12, with no significant between-group differences at any time point. C-PRP showed significant mMASI improvement from week 4, whereas PT-PRP reached significance from week 8. For the melanin index, PT-PRP produced a significant within-group reduction at week 12, while C-PRP did not. At week 12, PT-PRP showed a significantly lower melanin index than C-PRP. Mild injection-site bruising was the only adverse event.</p><p><strong>Conclusion: </strong>PT-PRP and C-PRP produced comparable clinical improvement, but PT-PRP achieved greater objective melanin reduction at week 12. PT-PRP may represent a safe alternative treatment for melasma.</p><p><strong>Trial registration: </strong>Thai Clinical Trials Registry: TCTR20260318004.</p>","PeriodicalId":20123,"journal":{"name":"Photodermatology, photoimmunology & photomedicine","volume":"42 5","pages":"e70122"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956293","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}
Kholoud Almahzoum, Waleed Alfailakawi, Abdullah M Alharran, Omar W Alrumaih, Retaj N Hazaa, Dalal Ali Al-Mutairi, Abdulrahman Talal Alqallaf, Bader N Almutawaa, Merwi S Alhadeyah, Abdulaziz Abdullah Alenezi, Fanr F Alraqum, Ebraheem Albazee
{"title":"Comparative Efficacy and Safety of Needling-Based Therapies Versus Ablative Fractional Lasers for Scar Management: A Systematic Review and an Exploratory Meta-Analysis.","authors":"Kholoud Almahzoum, Waleed Alfailakawi, Abdullah M Alharran, Omar W Alrumaih, Retaj N Hazaa, Dalal Ali Al-Mutairi, Abdulrahman Talal Alqallaf, Bader N Almutawaa, Merwi S Alhadeyah, Abdulaziz Abdullah Alenezi, Fanr F Alraqum, Ebraheem Albazee","doi":"10.1111/phpp.70121","DOIUrl":"10.1111/phpp.70121","url":null,"abstract":"<p><strong>Background: </strong>Needling-based therapies and ablative fractional lasers are widely used for scar management, but their efficacy and safety remain uncertain. In this systematic review, we aimed to assess the safety and efficacy of both needling-based therapy and ablative fractional laser therapy.</p><p><strong>Methods: </strong>This review followed PRISMA 2020 and the Cochrane Handbook. PubMed, Scopus, Web of Science, and Cochrane were searched from inception to 9 April 2026 without restrictions. Studies enrolling patients with scars of any etiology and comparing a needling-based therapy with an ablative fractional laser were included. Randomized controlled trials (RCTs), non-randomized trials, and cohort studies were eligible. Risk of bias was assessed using RoB 2, ROBINS-I, and the Newcastle-Ottawa Scale. Because of heterogeneity, findings were synthesized narratively, with exploratory random-effects meta-analysis where data were sufficiently comparable.</p><p><strong>Results: </strong>Twenty-seven studies involving 1137 participants were included, comprising 17 RCTs, 2 non-randomized comparative trials, and 8 cohort studies. Most studies evaluated atrophic or hypertrophic acne scars (18 studies; 870 patients), while fewer studies assessed striae (4 studies; 87 patients), burn or postburn scars (3 studies; 105 patients), and traumatic scars (2 studies; 75 patients). Both treatment categories improved scar appearance. In many comparisons of atrophic acne scars, ablative fractional lasers, particularly fractional CO<sub>2</sub> and, in some studies, Er:YAG systems, suggested greater improvement than microneedling. However, needling-based therapies were associated with shorter downtime, better tolerability, and fewer pigmentary adverse effects. Microneedling radiofrequency appeared to provide efficacy closer to that of ablative lasers in several individual studies and demonstrated a more favorable safety profile. Recent combination regimens appeared promising.</p><p><strong>Conclusion: </strong>Available evidence suggests that both modalities can improve scars. Ablative fractional lasers may offer greater efficacy, whereas needling-based therapies may provide better tolerability and pigment safety. These conclusions should be interpreted cautiously because of clinical heterogeneity and the sensitivity of the exploratory pooled estimate to individual studies. Treatment selection should remain individualized according to scar type, patient priorities, and acceptable downtime.</p><p><strong>Trial registration: </strong>The protocol was registered in PROSPERO (CRD420261383840).</p>","PeriodicalId":20123,"journal":{"name":"Photodermatology, photoimmunology & photomedicine","volume":"42 5","pages":"e70121"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Beyond UV: Visible Light and Pigmentation.","authors":"Edric Ip, Thierry Passeron, Michelle Rodrigues","doi":"10.1111/phpp.70125","DOIUrl":"10.1111/phpp.70125","url":null,"abstract":"<p><strong>Background: </strong>Melasma and post-inflammatory hyperpigmentation (PIH) are common dermatologic conditions disproportionately affecting individuals with darker skin phototypes, carrying substantial psychosocial burden and reduced quality of life. Emerging evidence increasingly implicates visible light (VL), particularly high energy visible (HEV) light, as a significant but underappreciated driver of disease appearance and progression.</p><p><strong>Aims and methods: </strong>This narrative review integrates mechanistic and clinical evidence to examine VL's pathogenic role in melasma and PIH, synthesising data on opsin-mediated melanocyte activation, clinical trial outcomes of VL protective interventions and patient adherence barriers to photoprotection strategies.</p><p><strong>Results and discussion: </strong>HEV (400-450 nm) activates opsin-3 on melanocytes, triggering calcium-dependent signaling that increases melanogenesis in a wavelength-specific manner. Clinical studies confirm that blue-violet light induces dose-dependent hyperpigmentation whereas red light produces none. Notably, pigmentation induced by high-energy visible (HEV) light can be substantial and persist over time. Protection against VL significantly enhances melasma treatment outcomes: melasma patients using iron oxide-containing sunscreen achieved 15% greater Melasma Area and Severity Index (MASI) improvement, 28% greater lightening on colorimetry and 4% greater histologic reduction in melanin than patients using an otherwise similar UV-only sunscreen. VL also seems to be involved in PIH, as suggested by a suction blister PIH model in which light-blocked sites healed without hyperpigmentation by Day 29, unlike ambient light-exposed sites that showed colorimetric and histologic darkening. Adherence to photoprotection in general remains suboptimal. Fewer than two-thirds of patients with hyperpigmentation use sunscreen and fewer than 10% reapply appropriately, with worse habits observed in skin of color, the population at greatest risk. Shade incompatibility of tinted formulations represents a key additional barrier to the use of VL-specific photoprotection.</p><p><strong>Conclusion: </strong>This review establishes VL as a clinically significant driver of melasma and PIH pathogenesis. Standardising VL photoprotection metrics and integrating these into sunscreen development is essential. Incorporating VL protective strategies into treatment recommendations is critical to improving outcomes, particularly in darker skin individuals where disease burden is greatest and treatment most challenging.</p>","PeriodicalId":20123,"journal":{"name":"Photodermatology, photoimmunology & photomedicine","volume":"42 5","pages":"e70125"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Willem Izak Visser, Husna Moola, Susanna Kannenberg, Bianca Tod, Henry W Lim
{"title":"Beyond Tint: Active Ingredient Strategies for Post-Inflammatory Hyperpigmentation due to Visible Light in Skin of Color.","authors":"Willem Izak Visser, Husna Moola, Susanna Kannenberg, Bianca Tod, Henry W Lim","doi":"10.1111/phpp.70112","DOIUrl":"10.1111/phpp.70112","url":null,"abstract":"<p><strong>Background: </strong>Post-inflammatory hyperpigmentation (PIH) is among the most burdensome sequelae of inflammatory dermatoses in skin of color (SOC), and reduction of visible pigmentation represents the primary clinical outcome of interest. Tinted sunscreens containing iron oxides and/or pigmentary titanium dioxide are currently the best-evidenced strategy for preventing visible light-driven PIH in SOC. However, cosmetic unacceptability-including white cast, poor shade match, and texture incompatibility with acne-prone skin-significantly limits real-world adherence. This concept paper proposes a clinical reframing: when pigment-based visible light filters are not tolerated, pigmentation reduction may be achievable through proactive topical actives with direct anti-pigmentation activity.</p><p><strong>Methods: </strong>This commentary synthesizes the mechanistic and clinical literature on high-energy visible light (HEVL)-driven pigmentation in SOC, with particular focus on the opsin-3-MITF-melanogenesis axis and topical actives with demonstrated anti-pigmentation activity against HEVL-induced melanogenesis. Evidence is presented to support a proposed clinical reframing and pragmatic algorithm.</p><p><strong>Results: </strong>HEVL activates opsin-3 on melanocytes, upregulating MITF and promoting formation of stable, autophagy-resistant melanosomes-a mechanism distinct from UVA-driven photooxidation and particularly relevant in darker phototypes. Four prototypical actives with direct clinical or preclinical evidence against HEVL-induced pigmentation are reviewed.</p><p><strong>Conclusion: </strong>Pigmentation reduction-rather than the mechanism by which it is achieved-should be recognized as the primary clinical endpoint in photoprotection for PIH in SOC. When pigment-based visible light filters containing iron oxides and/or pigmentary titanium dioxide are cosmetically unacceptable, a strategy combining broad-spectrum UVA1 photoprotection with a topical active with anti-pigmentation activity represents a rational, evidence-informed alternative that keeps the clinical goal firmly in focus.</p>","PeriodicalId":20123,"journal":{"name":"Photodermatology, photoimmunology & photomedicine","volume":"42 4","pages":"e70112"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593196","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":"Epidermal Permeability Barrier Dysfunction Influences Acute and Chronic Skin Responses to UVA and UVB Radiation.","authors":"Pan Wu, Piyan Hua, Qiuyan Yao, Zhenghui Yang, Ying Tu, Hua Gu","doi":"10.1111/phpp.70108","DOIUrl":"10.1111/phpp.70108","url":null,"abstract":"<p><strong>Background: </strong>The epidermal permeability barrier is crucial for skin homeostasis and defending against ultraviolet radiation. While it's known that barrier dysfunction is a feature of many dermatoses, how different degrees of barrier dysfunction affect acute and chronic responses to UVA and UVB remains unclear. This study compared erythema and pigmentation responses in skin with different levels of barrier dysfunction.</p><p><strong>Methods: </strong>Forty-nine healthy female subjects (Fitzpatrick skin types III-IV) were enrolled. Barrier-impaired models were created on one volar forearm by tape stripping; the contralateral forearm served as a control. Both sites received graded doses of UVA and UVB. Skin color was assessed using a spectrophotometer to obtain L* (lightness) and a* (redness) values. Changes (△L, △a) were compared between barrier-impaired and normal skin immediately, 24 h, and 2 weeks after irradiation.</p><p><strong>Results: </strong>The influence of skin barrier integrity on UVA-induced immediate pigment darkening varies with UVA dose: a more compromised barrier correlates with a stronger response at low doses, whereas normal skin exhibits a more pronounced reaction at higher doses. Moderate-to-severe barrier damage led to more pronounced persistent pigment darkening and delayed tanning after UVA. Following UVB exposure, severely impaired skin exhibited more pronounced delayed erythema and post-inflammatory hyperpigmentation than normal skin.</p><p><strong>Conclusion: </strong>An intact epidermal permeability barrier contributes to protecting the body from UV-induced damage. Therefore, restoring and maintaining an intact epidermal barrier should be considered a fundamental strategy in photoprotection and the clinical management of disorders associated with barrier dysfunction.</p>","PeriodicalId":20123,"journal":{"name":"Photodermatology, photoimmunology & photomedicine","volume":"42 4","pages":"e70108"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13382186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520748","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}
Frederick Hartung, Julien Dairou, Samhita Ramamoorthy, Katharina M Rolfes, Stephan Meller, Thomas Haarmann-Stemmann
{"title":"Erlotinib and Leflunomide Disrupt 6-Formylindolo[3,2-b]Carbazole Metabolism and Sensitize Keratinocytes to UVA Radiation-Induced Apoptosis.","authors":"Frederick Hartung, Julien Dairou, Samhita Ramamoorthy, Katharina M Rolfes, Stephan Meller, Thomas Haarmann-Stemmann","doi":"10.1111/phpp.70099","DOIUrl":"10.1111/phpp.70099","url":null,"abstract":"<p><strong>Background/purpose: </strong>Phototoxicity is a common adverse effect triggered by systemic or topical drug treatments. It is mainly caused by drug-induced sensitization to UVA radiation, arising from either the drug's inherent photosensitizing potential or its interference with the metabolism of endogenous photosensitizers. A potent endogenous UVA sensitizer is 6-formylindolo[3,2-b]carbazole (FICZ), a tryptophan photoproduct formed in UVB-irradiated epidermal cells. By sequentially activating the aryl hydrocarbon receptor signaling pathway and inducing cytochrome P450 (CYP) 1A1 expression, FICZ induces its own degradation. Recently, we reported that the BRAF inhibitor vemurafenib interferes with CYP1A1 activity and sensitizes keratinocytes to FICZ/UVA-induced phototoxicity. Herein, we screened 12 clinical drugs, known to exhibit phototoxicity in patients, for their potential to interfere with the metabolism of (exogenous) FICZ and sensitize HaCaT keratinocytes to UVA-induced phototoxicity.</p><p><strong>Methods: </strong>The UV-VIS absorption of the drugs was determined, and their effect on CYP1A1 activity and FICZ/UVA-triggered apoptosis was assessed in immortalized and primary human keratinocytes using 7-ethoxyresorufin-O-deethylase (EROD) and caspase-3 activity assays. Moreover, the impact of the candidate drugs on the metabolic degradation of FICZ in cells (LC analysis) as well as on the generation of oxidative stress (MitoSOX assay, qPCR analyses) was investigated.</p><p><strong>Results: </strong>We identified two drugs, erlotinib and leflunomide, to sensitize human keratinocytes to FICZ/UVA-induced apoptosis by inhibiting CYP1A1 activity. Moreover, both drugs attenuated the metabolic breakdown of FICZ, enhanced the FICZ/UVA-triggered formation of mitochondrial superoxide anions, and increased heme oxygenase-1 (HMOX1) transcript levels, indicative of antioxidant defense activation.</p><p><strong>Conclusion: </strong>Disruption of FICZ metabolism may contribute to the phototoxicity of drugs.</p>","PeriodicalId":20123,"journal":{"name":"Photodermatology, photoimmunology & photomedicine","volume":"42 4","pages":"e70099"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}