Journal of Applied Cosmetology <p><sub>The JOURNAL OF APPLIED COSMETOLOGY is an international journal dedicated to publishing original papers, reviews and other material which represent a useful contribution to research on the skin and on cosmetics. It is aimed at cosmetic chemists, dermatologists, microbiologists, pharmacists, experimental biologists, toxicologists, plastic surgeons, and all other scientists working on products which will come into contact with the skin and its appendages. The Journal is published every 6 months in English. It is distributed to cosmetic chemists, dermatologists, plastic surgeons, medical and pharmaceutical schools, medical libraries, selected hospitals and research institutions through the world, and by subscription to any other interested individuals or organizations. Statements and opinions expressed are personal to the respective contributors and are not necessarily endorsed by the Editor(s), Advisers, Publishers of Distributors of this Journal.</sub></p> World Health Academy Publishing House en-US Journal of Applied Cosmetology 0392-8543 A randomized double-blind placebo-controlled clinical trial to evaluate the effect of an Annurca apple supplement formula in androgenic alopecia <p style="text-align: justify;"><strong>Androgenic alopecia is the most common form of hair loss, affecting men and women at different ages. The role of natural bioactive compounds has gained increasing recognition as a potential means to address hair loss. There is great interest in oligomeric procyanidins, particularly procyanidin B2, which have been shown to possess hair-growing activity. Annurca (<em>Malus pumila</em> Miller cv Annurca) apple fruits have one of the highest amounts of oligomeric procyanidins, specifically of procyanidin B2, compared to more common apple cultivars. In this study, randomized double-blind controlled parallel group trial was performed to compare the efficacy of the Annurca apple fruit extract as nutraceutical AT HAIR-FUL AA® food supplement with a placebo in hair growth. AT HAIR-FUL AA® procyanidin B2 whole fruit (peel and pulp) is characterized by a complex mixture of polyphenolic compounds, especially chlorogenic acid (400 - 600 μg/g) and procyanidin B2 (60-100 μg/g). The products were assigned to 80 enrolled subjects with alopecia, divided into 2 groups: 40 subjects took AT HAIR-FUL AA® food supplement and 40 subjects took the alternative treatment (PLACEBO). Each group of volunteers underwent 180 days of treatment, with the intake of 2 capsules per day. After that, volunteers took nothing for 30 consecutive days (follow up). The AT HAIR-FUL AA® food supplement significantly affected hair loss: hair density and weight significantly increased and hair loss significantly decreased over time (<em>p</em>&lt;0.001). Moreover, we observed a fairly good pleasantness and a good skin and gastro-intestinal tolerability of the product, confirming its compliance of use: the product did not have a significant effect on gastrointestinal disorder and stomach ache onset (<em>p</em>=0.41 and <em>p</em>=0.25, respectively). AT HAIR-FUL AA® food supplement could be used as potential agent to induce hair growth.</strong></p> Filomena De Biasio A. Ielpo L. Santarsiere L. Ivaldi R. Salamone D. Gorgoglione Copyright (c) 2023 Journal of Applied Cosmetology 2023-05-24 2023-05-24 41 2 28/46 28/46 10.56609/jac.v41i2.276 Agaric extract and colloidal silver promote skin health and wound repair <p style="text-align: justify;"><strong>Group D vitamins are a family of micronutrients essential for the health of numerous organs and systems. The family members come from different sources. In particular, UV irradiation forms ergocalciferol (vitamin D2) in some plants, predominantly in fungi. Differently, cholecalciferol (vitamin D3) is synthesised in the skin of animals by UV irradiation of 7-dehydrocholesterol. Consequently, humans synthesise vitamin D3 and introduce the same vitamin to foods of animal origin and vitamin D2 to foods of plant origin. The pre-hormonal forms, cholecalciferol and ergo cholecalciferol are converted to active compounds via a 2-step enzymatic dihydroxylation in the liver and kidney to synthesise the active form of vitamin D, calcitriol. It has recently been demonstrated that the skin possesses the hydroxylases responsible for activating vitamin D directly in the keratinocytes. We have previously demonstrated the effectiveness of vitamin D3 combined with silver nanoparticles in wound healing in vitro. The aim of the present work was to establish whether vitamin D2 could have a similar effect to vitamin D3. Therefore, we used the same combination of vitamin D+ silver nanoparticles by substituting vitamin D3 for vitamin D2. We demonstrated that the effect of vitamin D2 on wound repair is very similar to that of vitamin D3. Indeed vitamin D2 induces an even stronger effect suggesting the possible future use of the combination of vitamin D2 + silver nanoparticles for the repair of skin damage, not only repair of wounds, but also atopic dermatitis, irritative pathologies such as diaper area dermatitis, actinic dermatitis, minor burns, folliculitis, and other skin wounds such as umbilical stump care. Possible applications were discussed.</strong></p> G. Ruggiero S. Cataldi F. Fiorani M. Mandarano Elisabetta Albi Copyright (c) 2023 Journal of Applied Cosmetology 2023-07-12 2023-07-12 41 2 86/95 86/95 10.56609/jac.v41i2.291 Evaluation of the effectiveness of non-invasive methods of compressive microvibration and ablative sensory microvibration on local areas with excess fat deposits in volunteers of different age groups <p style="text-align: justify;"><strong>The aim of the study was the apparatus of compressive microvibration “Endospheres Therapy® Body” (Registration certificate RZN 2016/3863 of 29 December 2017) used in women with mild to moderate edematous fibrosclerosis (panniculopathy) of peri- and post-menopausal age.</strong> <strong>The purpose of the project is to evaluate the effectiveness of the non-invasive technique of compressive microvibration in volunteers of different age groups.</strong> <strong>The basis for the work is the agreement No. 002/2022-n between the GBUZ MO MONIKI named after M.F. Vladimirsky and ItalConsult, LLC of 01.03.2022</strong><strong>. </strong><strong>The main tasks were: form 3 cohort groups of volunteers in accordance with the criteria agreed with the Customer (mild or moderate edematous fibrosclerosis, as panniculopathy), aged 30 to 44 years old, 45 to 54 years old and 55-65 years old; ensure that all participants receive a course on procedures (12 procedures every other day) regularly and correctly; evaluate the effectiveness of the non-invasive method of compressive microvibration on local areas of excess fat deposits in volunteers of different age groups through subjective testing (with a questionnaire), objective results of laboratory tests (blood test with hormone levels) and instrumental studies (ultrasound examination of the skin of fat trap zones, in abdomen and thighs) and assessment of the microcirculation system.</strong> <strong>Hypothesis: compressive microvibration generated by the manipulator-cylinder, consisting of 50 spheres of hypoallergenic silicone that generates low-frequency vibrations, makes it possible to activate microcirculation, stimulate lymphatic drainage, increase muscle tone and improve skin trophism.</strong> <strong>For all study results, mean values (Mean), standard deviations (Std.Dev.), minimum (Minimum), maximum (Maximum) values, and SD confidence of all results were obtained. The difference between the mean values and the variation coefficients was tested using a two-sample Student’s t-test (considering the distribution’s normality).</strong> <strong>Our results have convincingly demonstrated the effectiveness of the Endospheres Therapy® procedures for treating cellulite, with the effect maintained for at least 60 days after the course of therapy. Instrumental studies confirmed a pronounced improvement in the skin’s condition, microcirculation, cellular metabolism activation, hypoxia reduction and tissue perfusion improvement. Endospheres Therapy® procedures are safe and effective in treating cellulite in the long term without side effects. Patients noted a high degree of satisfaction with the Endospheres Therapy® course, which indicates the quality of the procedures and the level of specialists.</strong></p> V. B. Metelin A. A. Fomicheva Z. Z. Kardashova Pier Antonio Bacci I. A. Vasilenko Copyright (c) 2023 Journal of Applied Cosmetology 2023-05-29 2023-05-29 41 2 60/85 60/85 10.56609/jac.v41i2.278 Fat tissue reduction by depurative diet and compressive microvibration with spheres of variable density <p style="text-align: justify;"><strong>Society is characterised by a substantial increase in overweight and obesity, with progressive diseases such as diabetes, lipolymphedema and lipoedema. Many experiences have demonstrated the sensitivity of the subcutaneous adipose tissue utilising non-invasive mechanical treatments. This study aims to study the sensitivity of the subcutaneous adipose layer of the abdomen using compressive microvibration treatments with spheres of variable density. Thirty patients were followed between the period from 10th January to the 30th May 2022. Fifteen patients were treated with twelve compressive microvibration sessions with variable density spheres, and the other fifteen with the same treatment associated with a nutritional purification program. All patients were studied with clinical/instrumental examinations and evaluations in compliance with ethical and deontological standards. </strong><strong>All patients showed improvements in the single treatment and the treatment associated with the nutritional program. The reduction of subcutaneous adipose tissue observed with the treatment of compressive microvibration with spheres of variable density indicates a direct stimulation of the biochemical and biophysical structures that regulate the cellular biology of adipose tissue, with metabolic action induced by the vibrations.</strong></p> B. Diffidenti S. Vannuccini G. Cavalletti P. L. Rossi E. Caradonna Pier Antonio Bacci Copyright (c) 2023 Journal of Applied Cosmetology 2023-07-11 2023-07-11 41 2 47/59 47/59 10.56609/jac.v41i2.290 Comparative Study to Evaluate the Efficacy of Two Microneedling Therapies for Acne Scar Treatment <p><strong>Microneedling is a minimally invasive procedure based on collagen induction therapy and helps reduce the appearance of acne scars. The aim of the present study is to evaluate and compare skin firmness, elasticity, and improvement of skin texture and reduction of facial erythema after sessions of microneedling procedure performed by using two different devices, i.e., the manual microneedle roller and automated microneedle stamp. </strong><strong>A randomized comparative clinical study was conducted. Research subjects in one group were applied with the manual microneedle roller, and those in the other group were applied with the automated microneedle stamp. They were subjected to four months of treatment (4 sessions with a microneedling procedure at 28-day intervals). Skin firmness and elasticity were performed by Cutometry measurement. Subjects were photographed for skin texture and erythema evaluation. It was observed that the microneedling procedure using both devices - microneedle roller and stamp- significantly improved skin firmness and elasticity. The treatment also promoted reductions in the intensity of </strong><strong>s</strong><strong>car and erythema, respectively. The devices promoted similar beneficial results without significant differences between them. The present study demonstrates that both the manual microneedle roller and automated microneedle stamp comparably resulted in an improvement of skin firmness, elasticity, reduction of facial scar, and erythema.</strong></p> Sangbum Han Copyright (c) 2023 Journal of Applied Cosmetology 2023-10-30 2023-10-30 41 2 96/105 96/105 10.56609/jac.v41i2.296 The Remarkable Benefits of Hyaluronic Acid in Full Facial Care: Skin, Oral Mucosa and Bone Health <p>.</p> Raffaele Borgia Copyright (c) 2023 Journal of Applied Cosmetology 2023-12-05 2023-12-05 41 2 155/160 155/160 Cosmetic Dentistry Luciano Zucchinelli Copyright (c) 2023 Journal of Applied Cosmetology 2023-12-05 2023-12-05 41 2 149/154 149/154 Case Series: Infrared Energy Device for the Treatment of Erythematotelangiectatic Rosacea <p style="text-align: justify;"><strong>Rosacea is a common chronic dermatosis which occurs mainly in middle-aged patients. The etiology of the disease remains unknown but immune and vascular factors are seen to play a crucial role.&nbsp; Diagnosis is established based on clinical manifestation. We present four case reports of rosacea therapy using a medical device emitting near-infrared light.&nbsp; </strong></p> Diogo Pereira Forjaz Copyright (c) 2023 Journal of Applied Cosmetology 2023-11-28 2023-11-28 41 2 142/148 142/148 10.56609/jac.v41i2.308 Characterization of Adipose-Derived Mesenchymal Stem Cells from tissue harvested with the guided SEFFI technique and co-cultured with calcium hydroxyapatite <p style="text-align: justify;"><strong>Increased interest in regenerative medicine in the last few years was registered. In parallel, a progressive increase in injectable calcium hydroxylapatite (CaHA) applications has been observed due to its applications in skin rejuvenation. This study combined micro fragmented fatty tissue (FAT) grafting with the CAHA filler procedure to observe the biological effect on FAT. Each sample of micro fragmented adipose tissue harvested using the guided </strong><strong>&nbsp;</strong><strong>Superficial Enhanced Fluid Fat Injection (guided SEFFI) technique were collected from 5 patients. The 5 samples were divided into aliquots to create two different experimental conditions: FAT and FAT combined with CaHA (FAT + R). Afterwards, the cellularity of mesenchymal phenotype and the in vitro differentiation capacity in mesenchymal lineages were assessed in both experimental conditions, FAT and FAT+R. Despite low cellularity observed for FAT+R compared to FAT, isolated cells could grow and expand in culture in both experimental conditions, thus proving their proliferative ability. Cells were proved to differentiate towards mesenchymal lineages, expressing mesenchymal markers by flow cytometry analysis. Combining emulsified harvested tissue prepared with guided SEFFI technique with CaHA products can be exploited to counteract the loss of volume and skin ageing of the human face and body. This approach to regenerative aesthetic treatment is a promising treatment for facial antiaging therapy.</strong></p> Fabrizio Melfa A. Gennai G. Carfagna B. Bovani D. Piccolo M. Colli M. Baldessin D. Siragusa Copyright (c) 2023 Journal of Applied Cosmetology 2023-06-22 2023-06-22 41 2 4/19 4/19 10.56609/jac.v41i2.288 Heat Influence on Different Hyaluronic Acid Fillers <p style="text-align: justify;"><strong>F</strong><strong>acial volume deficits, providing long-term facial aesthetic enhancement outcomes for the signs of aging and/or facial contouring. Numerous hyaluronic acid (HA) fillers seem to have similar characteristics, although their properties regarding rheology, viscoelasticity, heat resistance are different in many ways. The resistance heat degradation is important when hyaluronic acid fillers and energy-based devices are going to be used sequentially. Our objective was to determine the characteristics of HA gels in terms of heat resistance. Degradation of the gels was measured as a change of surface area of the sample. Five types of HA fillers, chosen from most common products on the market for temporary correction of congenital and acquired soft tissue deficits of the face via intradermal or subcutaneous injection: 20mg/ml HA-BDDE, 20mg/ml HA-BDDE, 20mg/ml HA-BDDE, 25 mg/ml HA-BDDE, 28mg/ml HA-PEG were tested in this study. Even though the three dermal fillers contained the same concentration of HA and were cross-linked with the same cross-linking agent, they were produced by different manufacturers using different technologies developed by individual companies. We tested <em>in vitro</em> resistance to heat degradation using Celltibator GT (Medikan Co., LTD, Seoul, Rep. of Korea) and Autoclave (Medotti 22L PRO, Poland). All of the HA fillers samples (0,3 ml) were placed on the petri dishes and put into the autoclave for 10 minutes (temp. 72,4°C). Three of the gels samples (20mg/ml HA-BDDE, 25mg/ml HA-BDDE, 28mg/ml HA-PEG) each 0,3ml were placed into Celltibator for 10 min, temp. 55,2°C degree, centrifugation: 30 RPM. Centrifugation was used to imitate the behaviour of the fillers under the conditions of forces acting on it in the tissue (stress under the influence of facial expressions, exercises, etc.). The temperatures used during this test correspond with commonly used heat-based devices, such as radio-frequency devices (about 45°C), infrared (about 55-65°C) and HiFU (about 70-75°C). Before and after each test pictures of the samples were taken. Heat degradation of the HA samples was measured by comparing (before and after) the changes of the surface area of samples on the petri dishes (on the graph paper). The 28-mg/ml HA-PEG gel filler demonstrated greater resistance to heat versus the 20- mg/ml and 25-mg/ml BDDE gel fillers. The 28-mg/ml HA-PEG, demonstrated in both test (celltibator with/without rotation and autoclave) greater resistance to heat in terms of deformation / thermal degradation and change of surface area. Selection of dermal filler with the right rheological properties is a key factor in achieving a natural-looking long-lasting desired aesthetic outcome. Hyaluronic acid fillers combined with energy-based devices are frequently used sequentially during the same session, however, in some cases it might cause thermal damage of HA. Caution is advised in using IR over recently injected filler (selection of dermal fillers is crucial in this case). Study limitations include use of <em>in vitro</em> model and lack of inflammatory response in an <em>ex-vivo</em> model.</strong></p> P. Kubik W. Gruszczyński Copyright (c) 2023 Journal of Applied Cosmetology 2023-11-08 2023-11-08 41 2 20/27 20/27 10.56609/jac.v41i2.305 PEGylated hyaluronic acid as tissue expander on a surgical compromised nose. A case study <p><strong>Our nose is a very important and sometimes an essential element of facial beauty. The nose, located in the centre of the face, should be in harmony with the other features of the face. Rhinoplasty is one of the most frequently performed aesthetic operations today. Below, we present the case of a 29-year-old patient with a complication after surgical rhinoplasty. The patient underwent surgical rhinoplasty twice - the first time (2011) with terrible results and the second time (2017) only with gentle improvements.</strong></p> <p style="text-align: justify;"><strong>&nbsp; Twelve years after the first surgery, the patient was still looking for a way to improve the outcome of her nose; we proposed the treatment plan with the use of novel PEG-cross-linked hyaluronic acid to improve the appearance of the nose area, with significant visual effect and no side effects.</strong></p> Diego Araya Bruna Copyright (c) 2023 Journal of Applied Cosmetology 2023-10-10 2023-10-10 41 2 114/119 114/119 10.56609/jac.v41i2.303 Safety and aesthetic outcomes of using fillers with different cross-linking agents. A case report. <p style="text-align: justify;"><strong>Of the several dermal fillers developed in recent decades, hyaluronic acid fillers have become the material of choice. They are safe, long-lasting, non-immunogenic, available to most patients, and can be removed with hyaluronidase. Unfortunately, early and delayed complications can also occur after HA filler injection. Below, we present the case of a 42-year-old patient who had complications after the aesthetic procedure using hyaluronic acid dermal fillers in the past. Surprisingly, the treatment performed with hyaluronic acid cross-linked with another cross-linking agent was without complications. The affected places were the chin and malar area. In 2021, after performing augmentation with hyaluronic acid in the chin area, a patient developed swelling, which subsided after using hyaluronidase (Hylase Dessau 300 I.E.) and corticosteroids. The patient repeated the procedure in 2022, where she was administered 2 ml of hyaluronic acid in July 2022. About 3 weeks after injection, oedema and nodules appeared at the injection site in the zygomatic/malar area; after using Prednisone, the changes subsided. In September 2022, 3 ml of PEG-cross-linked hyaluronic acid was successfully performed with no side effects. In the described case, an important role was played by the ability of the hyaluronic acid hydrogel to modulate human immunological functions, which was associated with a very low risk of immune-related side effects and accompanying cellulitic processes.</strong></p> Sophie Menkes Copyright (c) 2023 Journal of Applied Cosmetology 2023-08-29 2023-08-29 41 2 120/125 120/125 10.56609/jac.v41i2.297 Transcranial magnetic stimulation treatment for dermotillomania: a multidisciplinary approach focused on circuitries and neuroplasticity <p style="text-align: justify;"><strong>Dermotillomania in the Manual for Mental Disorders (DSM5- TR) is included in the chapter "Obsessive-Compulsive Disorders and Related Disorders". Dermotillomania is a disorder characterised by the compulsive damaging of skin tissue through repetitive behaviour. For this reason, patients suffering from this disabling condition are often referred to dermatologists claiming therapy or cosmetic remedies. Repetitive Transcranial Magnetic Stimulation has been approved for the treatment of Obsessive-Compulsive disorder. It has been recently reported to be a promising therapy in other compulsive spectrum disorders, such as trichotillomania and skin picking. According to the "Research Domain Criteria", a circuit-oriented approach targeting the dorsolateral prefrontal cortex to modulate reward and compulsivity circuitries and implied in dermotillomania. A recent report for Obsessive-Compulsive disorder Spectrum Disorders highlights the deleterious effect of inflammation on brain plasticity that affects neuroplasticity and the specific treatment. Given this, some laboratory testing for inflammation has been included in our assessment to reduce the contrast to the therapeutic mechanisms underlying neuroplasticity induced by the Repetitive Transcranial Magnetic Stimulation treatment; this is the first case reporting Repetitive Transcranial Magnetic Stimulation as effective in reducing the dermotillomania to remission. Further studies are needed to validate this proof-of-concept case and this multidisciplinary approach for these disorders, which are not so rare, targeting a brain area highly implicated in the Reward Circuitries. </strong></p> S. Pallanti G. P. Gasic N. Makris Torello Lotti S. Gerakaris Eleonora Grassi Copyright (c) 2023 Journal of Applied Cosmetology 2023-05-29 2023-05-29 41 2 126/132 126/132 10.56609/jac.v41i2.280 Isotretinoin-Induced Peripheral Neuropathy: An Enigma <p style="text-align: justify;"><strong>&nbsp; Isotretinoin, a first-generation nonaromatic retinoid, leads to numerous diseases including eye disorders and neurological, gastrointestinal, psychiatric, metabolic, connective tissue, and musculoskeletal diseases. The aim of this study was to investigate the effects of isotretinoin on peripheral nerve functions. </strong></p> <p style="text-align: justify;"><strong>&nbsp; The study included 30 patients that were started on isotretinoin due to nodulocystic acne. A thorough neurological and general examination was performed for each patient by a neurologist both at the beginning and end of the study. Laboratory investigations including complete blood count (CBC), serum biochemical analysis, vitamin B12 levels, thyroid function tests, and urine tests were performed to identify the other factors that may affect the functions of peripheral nerves. A neurophysiological examination was performed using an electroneuromyography (EMG) device.</strong></p> <p style="text-align: justify;"><strong>&nbsp; </strong><strong>The 30 patients comprised 7 (23.3%) men and 23 (76.7%) women, with a mean age of 21.9±3.56 years. No serious side effect occurred in any patient. No motor or sensory values suggestive of neuropathy were observed in any patient. However, significant differences were found between the pre-and post-treatment sensory and motor values of some nerves. </strong></p> <p style="text-align: justify;"><strong>&nbsp; Although it did not cause peripheral polyneuropathy, isotretinoin resulted in alterations in the latency, amplitude, and velocity values of peripheral nerves.</strong></p> A. Yılgor G. Ozaydin Yavuz I. H. Yavuz C. Boyvadoglu P. Korkmaz H. S. Inaloz Copyright (c) 2023 Journal of Applied Cosmetology 2023-09-18 2023-09-18 41 2 133/141 133/141 10.56609/jac.v41i2.301 Overview of hyaluronic acid and its development as dermal fillers gel <p style="text-align: justify;"><strong>Since the late 1990s, when the first commercially available hyaluronic acid-based tissue filler appeared, HA fillers have become the “product of choice” of soft tissue augmentation due to their favourable safety profile and minimally invasive nature of the treatment. Recent years have increased the popularity of HA fillers among doctors and patients and the number of available HA fillers and indications for aesthetic treatments. Due to the greater availability, and growing awareness among patients, HA filler treatments have become one of the most frequently performed cosmetic procedures worldwide. For several decades, we have been observing the development and progress of improving fillers to increase the safety and effectiveness of performed treatments.</strong></p> Nabil Elmahdawi Copyright (c) 2023 Journal of Applied Cosmetology 2023-08-01 2023-08-01 41 2 106/113 106/113 10.56609/jac.v41i2.294