Changes in clinical condition and quality of life of patients with involutional changes of facial skin and metabolic syndrome after the course of treatment with therapeutic physical factors

Abstract

BACKGROUND: The presence of concomitant chronic non-infectious diseases, which significantly increase in probability and severity with age, contributes to the intensity of external manifestations of involutional processes. This is absolutely true for the metabolic syndrome, which is confirmed to be associated with involutional changes in the skin and soft tissues of the face through systemic mechanisms of comorbidity, determining mutual additive influences. AIM: The aim of the study was to evaluate the clinical efficacy of the combined use of transcranial magnetic field therapy, oxygen bar therapy, and laser phoresis of hyaluronic acid for the treatment of involutional skin changes in patients with metabolic syndrome. MATERIALS AND METHODS: Using a simple randomization technique, patients with involutional skin changes associated with metabolic syndrome (n=120) were divided into 4 groups of 30 subjects each. Subjects in group 1 (control group) received only laser phoresis of hyaluronic acid; subjects in group 2 (comparator group 1) received one course of transcranial magnetic therapy; subjects in group 3 (comparator group 2) received one course of oxygen bar therapy; subjects in group 4 (experimental group) received one course of combined treatment (laser phoresis of hyaluronic acid + transcranial magnetic therapy + oxygen bar therapy). Results were evaluated based on changes in the severity of key clinical and functional signs of age-related skin changes. In addition, the quality of life of the patients was evaluated using the Dermatologic Index, and the overall aesthetic improvement was evaluated using the Global Aesthetic Improvement Scale (GAIS). RESULTS: The comorbidity of chronoaging with metabolic syndrome is associated with subjectively more severe major clinical manifestations of facial skin aging and indicative changes in its morphological and functional parameters. A comparative analysis of the effectiveness of using different monotherapy regimens showed the most significant regression of clinical manifestations with the laser phoresis of hyaluronic acid. The total subjective score of major clinical manifestations of age-related skin changes decreased by 39.8% on a visual analog scale (VAS), and the quality of life increased by 61.7%. The GAIS score was 2.48. Visual analog scale scores were largely consistent with changes in objective skin parameters. In the transcranial magnetic therapy and oxygen bar therapy groups, the effect was weaker and almost equal. The highest efficacy was reported in the experimental group: regression of clinical manifestations of skin chronoaging and restoration of objective dermal parameters were reliable and exceeded the level of the control group after the treatment. CONCLUSION: The combined treatment shows a significant increase in clinical efficacy due to the pathogenetic effect on the metabolic syndrome. Sinergy of therapeutic physical factors is achieved by different modalities, sites of treatment, and mechanisms of biological potential.