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Experience of using intense pulsed light safely and effectively, with cases sharing of treating postinflammatory hyperpigmentation with different origins

Cheuk Hung LEE ; Kar Wai Alvin LEE ; Kwin Wah CHAN

Journal of Cosmetic Medicine.2024;8(1):66-71. doi:10.25056/JCM.2024.8.1.66

This article aims to share our experience of using intense pulsed light (IPL) technology safely and effectively in our clinic. We aimed to provide valuable insights for other cosmetic practitioners interested in incorporating IPL technology into their practices. In this article, we elaborate on the various challenges faced while using IPL technology, such as ensuring the safety of clients and educating them on proper aftercare. We will explain the precautions taken, such as conducting a thorough consultation and patch testing, to mitigate the risk of adverse side effects. We also describe several interesting cases where IPL was used to treat post-inflammatory hyperpigmentation of different origins. We also explain how we tailor our treatments to suit individual clients’ needs and provide them with detailed instructions on how to care for their skin after treatment. In conclusion, IPL technology is a safe and effective way to treat various cosmetic concerns and improve the overall appearance of the skin. With proper safety measures and tailored treatments, we hope that our experience and insights will be valuable to other cosmetic practitioners.

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Impact of coated phycocyanin and phycoerythrin on antioxidant and antimicrobial activity of soap, anti-acne face wash and hand sanitizer gel

Bahareh NOWRUZI ; Hossein HASHEMI

Journal of Cosmetic Medicine.2024;8(1):18-33. doi:10.25056/JCM.2024.8.1.18

Background: The use of natural ingredients in skincare products has become a topic of interest in contemporary society. The adverse effects and environmental risks of synthetic compounds have prompted studies on the use of photosynthetic organisms as sustainable and ecofriendly sources of effective ingredients. Natural extracts have gained attention in the cosmetic industry, especially those derived from plants, algae, and cyanobacteria. Cyanobacteria have gained prominence in the cosmetic industry because of their low culture requirements, rapid growth rates, and capacity to produce different bioactive metabolites. As a result, cyanobacteria are economically viable and sustainable resources. Objective: We aimed to determine the effect of coating with natural phycocyanin and phycoerythrin pigments from two cyanobacterial species, Spirulina platensis and Nostoc sp., on the properties of three cosmetic products: soap, anti-acne face wash, and hand sanitizer gel. Methods: After cyanobacterial culture, the pigments were extracted, purified, and coated with the stabilizer, chitosan. Thereafter, cosmetic products were formulated with phycocyanin and phycoerythrin, and their viscosity, pH, stability, and antioxidant and antibacterial properties against bacteria were evaluated using the appropriate assays. Results: The anti-acne wash gel and soap had better properties when coated with both pigments and phycocyanin alone, whereas the hand sanitizer gel had better properties when coated with phycoerythrin alone and both pigments. Conclusion Overall, three coated and stable cosmetic products can be produced using cyanobacterial pigments owing to their high fortifying capacity.

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Quantum mechanics principle and other physics principles involved in light and laser therapy

Cheuk Hung LEE ; Kar Wai Alvin LEE ; Kwin Wah CHAN

Journal of Cosmetic Medicine.2024;8(1):1-7. doi:10.25056/JCM.2024.8.1.1

Laser and light therapies have revolutionized the field of cosmetic medicine because of their ability to treat a range of dermatological conditions safely and effectively. However, the theoretical principles underlying these modalities have often been overlooked. To explore the key principles of quantum mechanics and physics involved in laser and light therapy. We, a team of doctors who are quantum mechanics enthusiasts, discuss the concept of wave particle duality, wherein a photon can exist in two states simultaneously, allowing for its emission and absorption during laser and light therapy. Moreover, we examined the concepts of the Pauli exclusion principle, superposition, emission mechanism, and different reactions from the absorption of light energy by skin tissue. Although these concepts are not taught in medical schools, it would be interesting to understand them. Understanding the principles of quantum mechanics and physics is vital for optimizing the clinical outcomes of laser and light therapy. Combining these fundamental principles with empirical observations and clinical experience can enhance the efficacy and safety of laser- and lightbased cosmetic interventions and pave the way for further advancements in this field.

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Exploring the psychological and social motivations for aesthetic treatments in the post-COVID era

Emmaline ASHLEY ; Anika PARMAR ; Shonnelly NOVINTAN ; Lara WATSON ; Priyanka CHADHA

Journal of Cosmetic Medicine.2024;8(1):34-40. doi:10.25056/JCM.2024.8.1.34

Background: Minimally invasive injectable aesthetic treatments have seen a surge in popularity, particularly in the post-COVID era.However, our understanding of the psychological and social factors that influence patients’ choices when seeking these treatments is still lacking. Objective: This study explored whether the COVID-19 pandemic influenced patients’ motivations and perceptions regarding the above-mentioned treatments. Methods: A comprehensive survey was conducted among 147 patients who had received injectable aesthetic interventions at Acquisition Aesthetics, a leading UK training academy in aesthetic medicine. The survey included questions regarding motivation for treatment initiation, ongoing drivers for continuing treatment, desired outcomes, main concerns about treatment, post-treatment feelings, and the psychological impact of skin aging. Descriptive analysis was performed to explore the patterns of patient responses. Results: This findings revealed that the primary motivation for seeking aesthetic treatment was to improve confidence and address concerns about aging. Patients expressed a strong desire for natural-looking results and reported the significant psychological effects of skin aging, including feelings of self-consciousness and anxiety. After treatment, patients reported increased confidence and satisfaction with their appearance, and reduced self-consciousness. Conclusion This study revealed that although the core motivations for improving confidence and addressing aging remain central to patients seeking aesthetic treatments, the post-COVID era saw a subtle shift toward heightened concerns about social acceptance and maintaining appearances. Understanding these subtle shifts can allow aesthetic practitioners to tailor their approaches to meet patients’ holistic needs.Level of Evidence: Level V, descriptive study

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Unfolding Mycobacterium abscessus outbreak: a case study of mesotherapy-associated Mycobacterium abscessus infection

Phoebe Kar Wai LAM ; Alvin Kar Wai LEE ; Lisa Kwin Wah CHAN

Journal of Cosmetic Medicine.2024;8(1):62-65. doi:10.25056/JCM.2024.8.1.62

This article explores the clinical manifestations, diagnostic processes, and management strategies for Mycobacterium abscessus infections following mesotherapy and includes a literature review on M. abscessus incidence, diagnostic challenges, and therapeutic difficulties. A woman who presented to our clinic with redness and swelling across multiple sites 3 months following mesotherapy in a beauty shop was ultimately diagnosed with M. abscessus-induced skin and soft tissue infection (SSTI). Concurrently, Hong Kong’s Department of Health reported 19 similar cases, all linked to mesotherapy sessions at a particular beauty center from June to August 2023. Diagnosis involved analyzing pus samples, including acid-fast bacilli smear and culture. A literature review was conducted on M. abscessus infections, causality, treatment strategies, antibiotic susceptibility tests, advanced diagnostics such as polymerase chain reaction and matrix-assisted laser desorption ionization time-of-flight mass spectrometry, and newer treatment modalities. Nineteen patients exhibited SSTIs that manifested as rashes and abscesses at the injection sites. Diagnosis is hindered by the slow growth of M. abscessus, which necessitates advanced testing. Our patient underwent 2 to 3 months of intravenous antibiotics (combination therapy) as an inpatient at a public hospital, together with repeated surgical curettage and drainage of the infected areas. This report highlights the surge in M. abscessus infections related to cosmetic procedures and the immediate requirement for stringent infection control measures in aesthetic practices. The M. abscessus outbreak emphasizes its emergence as a significant pathogen, the intricacies of managing its antibiotic resistance and biofilm production, and the need for a comprehensive treatment approach that incorporates personalized medicine, innovative therapeutics, and surgical interventions. The literature review underscores the importance of continuous research on strain-specific treatments, development of advanced diagnostic and therapeutic techniques to effectively tackle this antibiotic-resistant pathogen, and infection control.

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A case of surgical treatment for patients with symptoms similar to empty nose syndrome using a columella widening

Dong Won JUNG ; Young Jae LEE ; Ji-Yun CHOI

Journal of Cosmetic Medicine.2024;8(1):50-53. doi:10.25056/JCM.2024.8.1.50

This study aimed to address a unique case of external nasal valve insufficiency characterized by subjective symptoms of excessive air entry into the nose and throat discomfort despite the absence of apparent anatomical abnormalities or underlying diseases. We focused on devising a novel surgical approach to alleviate patient symptoms and highlighted the importance of considering the structural and functional aspects of nasal airflow in diagnosis and treatment. Paranasal sinus computed tomography and acoustic rhinometry were used to evaluate the anatomical and functional abnormalities. The nose scale was used to assess the subjective symptoms. The patient experienced significant improvement in breathing comfort following surgical intervention. Imaging revealed a widened columella, and the subjective symptoms were alleviated. Acoustic rhinometry measurements within the nasal cavity showed no substantial changes, likely due to the surgical focus on the external nasal valve. This case highlights the complexity of diagnosing and treating external nasal valve insufficiency without traditional anatomical abnormalities. Successful symptomatic management using this novel surgical technique highlights the need to consider structural and functional factors in nasal airway assessments.Further research is encouraged to refine the diagnostic tools and validate the effectiveness of innovative interventions for external nasal valve insufficiency in larger cohorts.

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Effects of beauty college student’s appearance management behavior on self-esteem after COVID-19

Chae Yeon HAN ; You Jeong KIM

Journal of Cosmetic Medicine.2024;8(1):41-49. doi:10.25056/JCM.2024.8.1.41

Background: The concept of beauty has gained widespread attention, heightening expectations for external health and attractiveness. Although physical appearance has become a significant social asset, the COVID-19 pandemic, marked by the normalization of mask wearing and reduced outdoor activities, has led to a decline in focus on appearance. Objective: This study aims to analyze the correlation between appearance management behaviors and self-esteem among beauty major college students in the post-COVID-19 era. Methods: This study conducted a survey targeting beauty major college students, and the data were analyzed using SPSS 25.0, which was validated at a significance level of 0.05. Results: Analysis of appearance management behaviors among college students revealed that, for males, hair care behavior (M=3.66) was the most prevalent, while for females, makeup management behavior (M=3.61) was the most prevalent. Additionally, students majoring in makeup exhibited high levels of appearance management behaviors (M=3.61) and self-esteem (M=3.86). Examination of the impact of the independent variables indicated statistically significant positive influences. Conclusion Beauty majors showed higher self-esteem and increased engagement in hair, skin, makeup, and apparel management behaviors. However, the generalization of the findings may be limited to this specific group, emphasizing the need for ongoing research across various majors and age groups.

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Levobupivacaine as a substitute for lignocaine during reconstitution of Ellanse M

Larry WU ; Sandeep ROHILLA ; Anuj JAIN

Journal of Cosmetic Medicine.2024;8(1):58-61. doi:10.25056/JCM.2024.8.1.58

This study highlights the use of levobupivacaine as a substitute for lignocaine in the treatment of two patients with documented adverse reactions to lignocaine. Lignocaine, the most widely used local anesthetic, can trigger allergies and other adverse effects.Allergic reactions can be mild, ranging from urticaria, erythema, and pruritus, to severe reactions in the form of angioedema and bronchospasm. In patients with a documented allergy to lignocaine, options for analgesia during nonsurgical rejuvenation include other amide-based local anesthesia, light sedation, or general anesthesia. Two patients with documented allergies to lignocaine underwent nonsurgical rejuvenation with levobupivacaine as the local anesthetic and reconstitution agent for Ellanse M. Levobupivacaine, chosen for its lower central nervous system and cardiovascular toxicity compared to those of racemic bupivacaine, has dual functions: local anesthesia and reconstitution of Ellanse. Ellanse is a collagen stimulator composed of polycaprolactone microspheres embedded in carboxymethylcellulose (CMC) gel distributed by Sinclair Pharmaceutical. It produces a natural aesthetic result through collagen stimulation. The 2 patients tolerated levobupivacaine as the choice of local anesthesia, with no adverse events. The reconstituted Ellanse was treated using a 27 G needle as well as a 25 G 50 mm cannula. The extrusion force was uniform and no needle or cannula jams were found. During 1-month assessment, the injected Ellanse volume decreased owing to resorption of the CMC gel, and during 3-month assessment, neocollagenesis was observed. Levobupivacaine is a suitable alternative to lignocaine as it enables patients with lignocaine allergies to undergo nonsurgical facial rejuvenation with Ellanse. Levobupivacaine offers comparable efficacy and safety profiles, making it a valuable option for anesthesia and reconstitution in such cases.Level of Evidence: Level V (Case Series)

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Immediate improvement of alar drooping and nostril shape by hyaluronic acid filler injection into the perialar regions: a case study

So-Eun KIM ; Saowanee CHANGYONGSUWAN ; Jaeran HONG ; Kyoungjin KANG

Journal of Cosmetic Medicine.2024;8(1):54-57. doi:10.25056/JCM.2024.8.1.54

After the augmentation rhinoplasty, the unnatural nasal contour is commonly happened in the patient who had premaxillary and perialar depression. In this study, the authors would like to introduce an interesting outcome that the unnatural nasal contour such as alar drooping and a spindle-shaped nostril was significantly improved by hyaluronic acid filler injection into the perialar and nasolabial fold regions in the case of perialar depression with premaxillary protrusion. The hyaluronic acid filler was injected into the perialar region first and then injected into nasolabial folds region using a 22-gauged blunt cannula through the entry site located at the central perialar region. Approximately 70% of the total filler volume (about 9.5 ml) was placed on the nasal process of the maxillary bone(attached) or in the deep fat layer (injected), while 20%–30% of the filler volume was injected into the superficial fat layer. No fatplaced under the dermal layer at the perialar region, and 10% volume was injected under the dermis at the central crease of the folds.The patient’s satisfaction was a great. The improved droopy alar, and the change of the nostril from the spindle shaped to the triangular shaped were observed. The morphological changes were corresponded to the change of measurements as follow that the angle of nostril axis and the columellar height were decreased, on the other hand, interaxial angle and the alar base width were increased. From the above result, the filler injection can be used as a reliable and non-invasive technique for the correction of alar drooping with a spindle-shaped nostril by augmentation of the perialar depression.

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Facial aesthetic preferences among ethnicity in Malaysia

Adibah Hanim ISMAIL ; Muhammad Farhan Abdul RASHID ; Ungku Mohd Shahrin Mohd ZAMAN ; Noor Shahirah SUPARJI ; Nur Izzati Mohd SHAHROL ; Ernieda Md HATAH ; Qi Hao LOOI

Journal of Cosmetic Medicine.2024;8(1):8-17. doi:10.25056/JCM.2024.8.1.8

Background: Malaysians, known for their diverse ethnicities, exhibit unique aesthetic features influenced by cultural nuances.Research indicates that factors including ethnicity, culture, and personal experiences affect how people perceive beauty. Objective: This study aims to address the lack of data on the preferred facial aesthetics among women from different ethnic groups in Malaysia. Methods: A questionnaire was administered to 290 Malaysian women, covering multiple regions and dimensions of facial aesthetics, including facial shape, forehead height and slope, cheekbone height, chin shape, eye region features (eyebrow shape, eyelid creases, and inner eye fold), nose (nose bridge shape, nasolabial angle, and nose width-length ratio), and lip thickness. Edited images of Asian models were used as references for facial aesthetic criteria in this study. Results: The survey revealed that the majority of participants were of Malay ethnicity (71.0%) and employed in the private sector (39.3%). The average age of the participants was 31.6±9.2 years, and most of them (66.9%) have not undergone aesthetic procedures before. Furthermore, a significant association was observed between ethnicity and women’s facial aesthetic preferences for facial shape and nasal width-length ratio (p<0.05). Oval facial shape was preferred by Malay (40.3%, n=83), Chinese (41.4%, n=12), and Indian (41.3%, n=19) women, due to its long, narrow, and rounded chin. For nasal width-length ratio, Malay (44.2%, n=91) and Chinese (37.9%, n=11) women preferred a ratio <1, whereas Indians (39.1%, n=18) favored a ratio >1. However, no significant association was found between ethnicity and other facial aesthetic criteria assessed in the study. Conclusion This study identified that Malaysian women’s preferences for facial shape and nasal width-to-length ratio are associated with ethnicity. These findings can serve as a valuable reference for aesthetic practitioners, emphasizing the importance of preservation and enhancement of unique ethnic features, customized according to the suitability of each ethnicity, rather than conforming to prevailing beauty standards.

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