Hand rejuvenation: a systematic review of techniques, outcomes, and complications
An increasingly popular medical aesthetic procedure for hand atrophy and ageing is hand rejuvenation.
The main objective of this study was to evaluate the techniques, outcomes and complications that are associated with hand rejuvenation treatments.
To carry out this study, the authors used a systematic review using a computerised search. Publication descriptors, methodological details, techniques, outcomes and complications were obtained. The authors assessed the articles by using the MINORS and Cochrane instruments.
A total of 31 studies were included. Most were prospective case series that were published within the past 5 years. Furthermore, the average age of patients was 56 years, while the average mean sample size was 47.
The study found that the most common treatments were Radiesse (32.2%) and fat grafting (32.2%). There were no serious complications seen in any of the studies; however, minor and temporary complications were observed, including oedema and pain. The authors noted that injection techniques varied, but the proximal to distal fanning technique and cannula use was associated with a lower risk of complications. Both Radiesse and fat grafting had long-term aesthetic results.
In conclusion, the authors stated that hand rejuvenation is a safe and efficacious intervention used to reduce dorsal hand atrophy. They noted that further studies are needed to compare the long-term results of common interventions.
Ireland has the highest per capita use of fake tan in the world: effect on dermatology clinics
It has been noted that Ireland has the highest per capita users of fake tan in the world. The authors of this study noted that they have witnessed the full effect of this in their dermatology clinics.
To carry out this study, they evaluated the number of patients presenting with fake tan to their pigmented lesion clinics. This resulted in unnecessary rescheduling of appointments, which also lead to further patient anxiety and a delay in diagnoses. This, in turn, has also increased patient waiting lists.
In this study, the authors have included images of the effect that wearing fake tan has on dermoscopy and in vivo confocal microscopy, complicating their ability to diagnose.
The authors have implemented a change in their practice regarding wearing fake tan to appointments and are hopeful that this will improve the situation in the future.
Prevalence of most common skin diseases in Europe: a population-based study
When planning health policies, the assessment of the prevalence of diseases is of the utmost importance. To date, there is no available data on the prevalence of skin diseases across European countries.
The aim of this study was to estimate the prevalence of the most frequent skin conditions or diseases in 27 European countries, including Norway, Switzerland and the UK.
To conduct this study, the authors carried out a population-based study on samples of the general population who were aged 18 years or older in each of the 27 countries studied. The participants were chosen using stratified, proportional sampling with a replacement design. The data was then gathered using an online survey. All participants were asked to fill in an online questionnaire and declare if they have had one or more skin conditions or diseases during the past 12 months.
A total of 44689 participants from the 27 countries included in this study; 21887 were men and 22802 were women. Just over 43% of these reported having at least one dermatological condition or disease during the past 12 months.
From the results of this study, the authors estimated that over 94 million Europeans had uncomfortable skin sensations, such as itching, burning, or dryness. The most frequent conditions found were fungal skin infections, acne and atopic dermatitis or eczema. Alopecia, acne, eczema, and rosacea were the most common conditions found in women, while men were more likely to have psoriasis and sexually transmitted infections.
The authors concluded that skin diseases are an significant public health concern. Their high incidence must be taken into account when planning access to dermatological care to address the needs of patients.
The association between frontal fibrosing alopecia, sunscreen, and moisturizers: a systematic review and meta-analysis
Frontal fibrosing alopecia (FFA) is a progressive cicatricial alopecia. Although the pathogenesis is still not clear, previous articles have considered a link between skincare products and FFA.
The aim of this study was to carry out a quantitative synthesis of the published accounts examining the relationship between FFA, sunscreens and moisturisers.
To carry out this study, the authors conducted a systematic review using PubMed, Embase and Web of Science databases from 1960 to August 2021. The authors used a mixture of the following search terms: ‘frontal fibrosing alopecia’, ‘scarring alopecia’, ‘FFA’, ‘sunscreen’, sun protection factor’ and ‘skincare products’. The authors only included controlled studies that researched a relationship between FFA and sunscreen and/or skincare products.
The authors initially found 87 articles, but only nine of these met the inclusion criteria. The value of the studies was measured using the Newcastle Ottawa scale, which yielded scores ranging from 5 to 7, suggestive of moderate quality.
A total of 1248 patients with FFA and 1459 controls were included. Controls included participants without a dermatologic condition and/or those with androgenic alopecia. All nine studies that were included evaluated the relationship between FFA and sunscreen.
The results suggested that sunscreen use is associated with a 2.21 times higher probability of developing FFA, while the use of moisturisers is associated with a 2.09 times higher probability of developing FFA.
The authors noted that, while the exact mechanism is not clear, there are suggested mechanisms regarding the role of sunscreen in the progress of FFA, including an immune lichenoid reaction, generation of reactive oxygen species, hormone disruption and attenuation of immunomodulatory effects of ultraviolet radiation. They also noted that the role of allergic contact dermatitis in the pathogenesis of FFA is debatable. They also found that oxybenzone, an organic filter used in sunscreens, and other preservatives in moisturisers, such as quaternium-15 and hydantoin, are understood to cause allergic reactions.
In conclusion, the authors agreed that this study has some limitations and stated that all the included studies were retrospective with self-reported data compiled from surveys. They also suggested that there is a possibility of selection bias, as patients with dermatologic conditions are more likely to use skincare products more frequently than those without skin or hair conditions. Taking these limitations into consideration, the authors suggested that their results highlight the substantial link between sunscreen and moisturiser use and FFA. They also stated that more in-depth epidemiologic studies are required to further investigate the causal relationship between FFA and skincare products.