Update on avoiding and treating blindness from fillers: a recent review of the world literature
The sudden loss of vision following dermal filler procedures is rare; however, it can happen and can have catastrophic results. The aim of this study was to provide an update on the published cases of blindness following dermal filler injection that have occurred following a review of 98 cases since 2015, and to discuss strategies for prevention and management of this outcome.
In order to conduct this study, a literature review was carried out to identify all cases of visual complications caused by dermal filler injections between January 2015 and September 2018.
The results showed that there were 48 new published cases of partial or complete vision loss following dermal filler injections since January 2015.
The areas of the face that were at highest risk for visual loss were the nasal region (56.3%), glabella (27.1%), forehead (18.8%), and nasolabial fold (14.6%). In 81.3% of these cases, Hyaluronic Acid dermal filler was used.
The most common symptoms experienced by patients included in this study were vision loss, pain, ophthalmoplegia and ptosis. In addition, skin changes were observed in 43.8% of cases and complications associated with the central nervous system were recorded in 18.8% of cases.
Of these complications, only 10 cases experienced complete recovery of vision and 8 cases experienced only partial recovery. It was noted that the management of these complications varied greatly, and there were no treatments that were shown to be consistently successful in managing this complication.
In conclusion to this study, although the risk of blindness from dermal fillers is rare, it is imperative that practitioners who inject dermal filler have a thorough knowledge of this complication, including prevention and management strategies.
The role of oral vitamins and supplements in the management of atopic dermatitis: a systematic review
Atopic dermatitis is a chronic, inflammatory skin disorder that is characterised by disruption of the epidermal barrier function and immune response to antigens.
The current available therapies focus on symptom management by restoring epidermal barrier function with emollients and reducing inflammation. However, patients are often dissatisfied with this approach to treatment, so further research to establish possible alternatives is required.
The purpose of this review was to evaluate the evidence for various oral vitamins and supplements for the treatment of atopic dermatitis.
The authors conducted a literature search from February 2018 in MEDLINE, EMBASE, and Cochrane databases. The authors also included studies of clinical trials and meta-analyses on the oral supplementation of vitamins and supplements for the treatment or prevention of atopic dermatitis.
In total, over 300 articles were found and 37 of these were included in the final review.
The results of conclude that the treatments with the most robust evidence for treatment of atopic dermatitis are supplementation with vitamins E and D. Probiotics may play a role in the prevention of infantile atopic dermatitis. The researchers found preliminary evidence that fatty acids, such as docosahexaenoic acid and hempseed oil can help to decrease AD severity, but further research in the form of randomised controlled trials is required.
In conclusion to this review, the authors state that more studies are needed to better inform medical professionals and patients about the role of these treatments in the management of Atopic dermatitis..
Association of indoor tanning exposure with age at melanoma diagnosis and BRAF V600E mutations
The authors of this article suggest that there is limited information available on how indoor tanning (sunbeds) promotes the development of melanoma in the skin.
The authors investigated indoor tanning use in patients with melanomas in sun-exposed skin, and studied the clinicopathological and molecular characteristics in relation to indoor tanning exposure. The study looked at patients from December 2013 to May 2015.
The results showed that 114 patients who had used indoor tanning were ounger at diagnosis than the 222 patients who did not use indoor tanning. There were no more melanomas in intermittently sun-exposed skin than non-users of indoor tanning.
In conclusion, indoor tanning may promote melanomas that arise in skin with low-chronic sun-induced damage through BRAF V600E-mediated melanomagenesis.
How hormones may modulate human skin pigmentation in melasma: an in vitro perspective
Melasma is a common hyperpigmentary disorder which occurs primarily in photo-exposed areas and mainly affects women of childbearing age.
This study examined the role of sex hormones in melasma. To do so, the authors reviewed the effects f sex hormones on cutaneous cells in the presence or absence of UV.
The findings of this study showed that sex steroid hormones, particularly oestrogen, can modulate in vitro pigmentation by stimulating melanocytes and keratinocyte pro-pigmentary factors, but not via fibroblast or mast cell activation.
The authors of this study conclude that in predisposed people, sex steroid homrones initiate hyperpgmenation in melasma by amplifying the effects of UV on melanogenesis via direct effects on melanocytes or indirect effects via keratinocytes, and on the transfer of melanosomes. The authors also conclude that sex steroid hormones help to sustain hyperpigmentation by increasing the number of blod vessels nd the level of endothelin-1.
Sunscreen use could lead to better blood vessel health
According to this press release from the American Physiological Society, a soon-to-be-published study suggests that using sunscreen protects the skin's blood vessel function from harmful ultraviolet radiation (UVR) exposure by protecting dilation of the blood vessels. The authors found that perspiration on the skin may also protect the skin's blood vessels from sun damage, to some extent.
The fact that ultraviolet radiation (UVR) from the sun is a contributing factor to skin cancer and premature skin ageing is well documented and recognised. UVR has also been found to reduce nitric oxide-associated dilation of skin blood vessels (vasodilation) by reducing the amount of nitric oxide available in the skin. Nitric oxide is a compound essential for blood vessel health. Vasodilation of the skin's blood vessels plays an important role in regulating body temperature and responding to heat stress.
A team of researchers from Pennsylvania State University studied the effect of UVR exposure with either sunscreen or sweat on the ability of nitric oxide to promote vasodilation of skin blood vessels.
The study looked at healthy young adults with light to medium skin tone who were exposed to UVR on one arm, while the other arm served as a control and was not exposed to any UVR.
The UVR applied was roughly equivalent to spending an hour outside on a sunny day, but without the reddening of sunburn.
A random study of 3 sites on the UVR-exposed arm of each participant were assigned one of three treatments:
Results showed that on the UVR-only site it was found to have less nitric oxide-associated vasodilation than in the control arm, but the sunscreen- and sweat-treated sites did not show these reductions in nitric oxide-associated vasodilation.
The findings will be presented at the American Physiological Society's (APS) annual meeting at Experimental Biology 2019, and will be published thereafter.
The impact of airborne pollution on skin
The effects of airborne pollution on respiratory and cardiac health and diseases have been widely researched in recent years, and are now generally well understood. However, the impact of airborne pollution on the skin remains poorly understood.
The skin is one of the main targets of pollutants, which reach the superficial and deeper skin layers by transcutaneous and systemic routes. This review shows the outcomes of clinical research studies monitoring pollutant levels in human tissues including the skin and hair.
The skin is one of the main targets of airborne pollutants, which can reach the superficial and deeper skin layers by transcutaneous and systemic routes. The authors of this review set out to report the outcomes of several basic and clinical research studies monitoring pollutant levels in human tissues, including the skin and the hair.
The authors reviewed the available literature to report the clinical effects of pollutants on skin health and skin ageing, and their impact on some chronic inflammatory skin diseases. The authors of this study also discuss the potential interactions of airborne pollutants with ultraviolet radiation and human skin microbiota, and their specific impact on skin health.