Journal of Applied Cosmetology

Early Cervical Nodule Formation Following Poly-D,L-Lactic Acid Injection: Ultrasound Findings, Technical Considerations, and Practical Lessons From Clinical Practice

Mohammad Ghazzawi — 2026-05-27

Poly-D,L-lactic acid (PDLLA) is increasingly used as a collagen-stimulating injectable with a favorable safety profile. However, reports of nodules associated with PDLLA remain limited, particularly in anatomically sensitive areas such as the neck. We report a case of early, asymptomatic cervical nodules occurring after PDLLA injection, characterized clinically and by high-resolution ultrasound. The case is discussed in the context of injection technique, anatomical considerations, and real-world procedural factors that may predispose to product accumulation. This report highlights that early nodules following PDLLA injection may reflect technical deposition rather than inflammatory or granulomatous reactions. Awareness of neck anatomy, careful handling of PDLLA suspensions, and the use of ultrasound can aid in accurate diagnosis and prevention of similar events.

Predictive Analysis of Cosmetic Formulations: A Multi-Vector INCI Mapping Methodology for Objective Product Assessment

Rusana Plonsak — 2026-05-27

EU regulation requires that cosmetic products be safe and that claims not mislead consumers. It does not require that claims be compositionally grounded. A product marketed as "barrier-restoring" need not contain barrier lipids at any particular concentration. Practitioners who want to check whether formulation composition supports a declared function have no standardised procedure for doing so from the label alone. To develop a structured, label-based methodology - the Multi-Vector Functional Mapping (MVFM) - for analysing cosmetic formulations from their INCI composition without laboratory data or proprietary tools. The MVFM locates the first regulated preservative or fragrance marker in the INCI list and uses its position as a segmentation boundary. Ingredients above that boundary are scored on three functional vectors - Hydration (H), Lipid (L), Structural (S) - on a 0–3 scale. Three commercial products with different declared functions were used as a test case. Segmentation worked without ambiguity in all three products. Products A and C returned vector profiles consistent with their label claims. Product B - marketed as anti-aging - scored H=4, L=7, S=6: a lipid-dominant profile more consistent with a texture-focused cream than with a bioactive-driven anti-aging formula. Two fragrance allergens regulated under Commission Regulation (EU) 2023/1545 were identified in the functional zone of Product B. The MVFM converts the INCI list into a reproducible functional profile. Three products tested by one evaluator show it functions as designed. Larger-scale validation and inter-rater reliability testing remain to be done.

Efficacy and Safety of a Multimodal Laser, Injectable, and Topical Protocol for the Treatment of Skin Hyperpigmentation: A Prospective Pilot Study

Nabil Elmahdawi — 2026-07-03

Skin hyperpigmentation disorders are common, chronic, and often refractory to monotherapy. Multimodal strategies addressing pigmentation, dermal quality, and epidermal barrier simultaneously may improve outcomes. To evaluate the efficacy and safety of a combined protocol using accelerated non-ablative fractional diode laser therapy (LaserMe®), injectable non-cross-linked calcium hydroxyapatite-hyaluronic acid (CaHA-HA), and adjunctive topical retinoid and ascorbic acid in patients with facial hyperpigmentation. Five participants with Fitzpatrick skin types I-IV (including melasma, post-inflammatory hyperpigmentation, age-related pigmentation, and photodamage-associated dyschromia) were enrolled in a prospective, open-label pilot study. The protocol included three laser sessions over four weeks, injectable CaHA-HA at weeks 0 and 4, daily stabilised ascorbic acid, alternate-night retinoid application, and broad-spectrum SPF 50 photoprotection. The primary outcome was the change in pigmentation severity assessed by the modified Melasma Area and Severity Index (mMASI). Secondary outcomes included transepidermal water loss (TEWL), standardised photographic assessment, and safety evaluation over 12 weeks. All participants demonstrated clinically meaningful improvement in pigmentation by week 12. Mean mMASI scores decreased from 14.0 at baseline to 7.0 at week 12, representing a 50.4% mean reduction. Four of five participants showed improved TEWL values, with mean TEWL decreasing from 19.0 to 14.4 g/m²/h. No serious adverse events occurred; mild transient erythema, swelling, and bruising resolved spontaneously. This pilot study suggests that a combined laser-injectable-topical protocol is safe, well-tolerated, and associated with consistent improvements in pigmentation severity and epidermal barrier function. Larger randomised controlled trials are warranted to confirm these findings.