Melasma is a common hyperpigmentary disorder over the sun-exposed areas of the face which affect mostly women with Fitzpatrick skin type III-V. 1,2 Various factors may exacerbate this condition including sun exposure, hyperestrogenic states like pregnancy, oral contraceptive pills, hormone replacement therapy, other medications (eg, antiepileptic and phototoxic drugs), and disorders (eg, autoimmune thyroid disease). 3 Melasma is a clinical result of the melanogenesis pathway overactivity leading to increases in melanin deposition within the epidermis, dermis, or both layers of the affected skin. 4 The treatment of melasma is difficult, and it has a significant negative impact on patients' quality of life. 5 Numerous treatment modalities are available for treatment of melasma including topical preparations, chemical peels, microdermabrasion, laser, and lights along with restrict avoidance of exacerbating factors such as sun exposure. 2 Nevertheless, none of these remedies are able to achieve complete clearance of

The PERSIAN Kavar cohort study (PKCS) aims to investigate the prevalence, trends, and relevant prognostic risk factors of non-communicable diseases in participants aged 35–70 years living in the urban area of Kavar County. Kavar County is located at the center of Fars province in the southwest of Iran. Overall, 5236 adults aged 35–70 years old were invited to participate in the PKCS. From whom, 4997 people comprising 2419 men and 2578 women met the inclusion criteria and were recruited in the study (participation rate: 95.4%). This study is aimed to follow participants for at least 10 years; it is designed to perform all procedures similar to the primary phase including biological sampling, laboratory tests, physical examinations, and collecting general, nutritional, and medical data at the 5th and 10th years of follow-up. In addition, participants are annually followed-up by phone to acquire data on the history of hospitalization, any major diagnosis or death. At the enrollment phase, trained interviewers were responsible for obtaining general, nutritional, and medical data utilizing a 482-item questionnaire. The results of the baseline phase of this study show that the overweight category was the most prevalent BMI category among the registered participants (n = 2005, 40.14%). Also, almost one-third of Kavar adult population suffered from metabolic syndrome at the baseline phase (n = 1664, 33.30%). The rate of eighteen-month follow-up response was 100% in the PKCS. Hypertension (n = 116, 2.32%), cardiovascular outcomes (n = 33, 0.66%), and diabetes (n = 32, 0.64%) were the most prevalent new-onset NCDs during eighteen months of follow-up in the participants.

Background: Microneedling and fractional lasers have been used in facial rejuvenation with acceptable results and low adverse effects. Aims: To compare the efficacy of microneedling with fractional Er:YAG in facial skin rejuvenation. Patients/Methods: This study was planned as a split-face clinical trial. Volunteers were randomly allocated to receive three monthly treatments on each side of the face, one with fractional Er:YAG laser and one with microneedling. The assessments included investigating clinical outcomes by two blinded dermatologists accompanied by measuring skin biophysical characteristics including cutaneous resonance running time (CRRT) and transepidermal water loss (TEWL). Moreover, possible adverse effects, downtime, and patients' satisfaction were recorded at baseline, 1 month after each treatment, and 3 months after the last treatment session. The protocol was approved by the Iranian Registry of Clinical Trials (IRCT20160820029436N3).Results: Of the 32 selected volunteers, 24 subjects completed the study. The clinical assessment showed a significant improvement of the face appearance along with a significant reduction in dyschromia, and periorbital wrinkling (P-value < .05), with both procedures without any considerable difference between two methods. Moreover, the patients showed substantial satisfaction with both modalities with no statistically significant difference. Mean TEWL and CRRT values also decreased significantly in both groups with no considerable difference. The downtime was significantly shorter in the microneedling-treated side. There were no long-lasting or severe adverse effects after treatment with both methods. Conclusion:Microneedling and fractional Er:YAG laser have comparable efficacy in facial rejuvenation, but little downtime of the former makes it preferable for many patients. K E Y W O R D S facial rejuvenation, fractional Er:YAG laser, microneedling, wrinkle How to cite this article: Robati RM, Hamedani B, Namazi N, Niknejad N, Gheisari M. Efficacy of microneedling versus fractional Er:YAG laser in facial rejuvenation. J Cosmet

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