Skin resurfacing procedures: new and emerging options

Loesch, Mathew; Somani, Ally Khan; Kingsley, Melanie; Travers, Jeffrey B.; Spandau, Dan F.

doi:10.2147/ccid.s50367

Cited by 25 publications

(19 citation statements)

References 67 publications

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“…There has long been an interest in the use of cosmetic dermal rejuvenation approaches to create more youthful-appearing skin [ 152 , 153 ]. These rejuvenation methods are diverse and include approaches such as dermabrasion and fractionated laser resurfacing [ 154 ]. These skin rejuvenation therapies are thought to induce a wounding response in dermal fibroblasts that ultimately stimulates the production of new collagen synthesis by fibroblasts in the skin.…”

Section: Dermal Wounding As a Preventive Approach For Nmscmentioning

confidence: 99%

Impact of Age and Insulin-Like Growth Factor-1 on DNA Damage Responses in UV-Irradiated Human Skin

2017

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The growing incidence of non-melanoma skin cancer (NMSC) necessitates a thorough understanding of its primary risk factors, which include exposure to ultraviolet (UV) wavelengths of sunlight and age. Whereas UV radiation (UVR) has long been known to generate photoproducts in genomic DNA that promote genetic mutations that drive skin carcinogenesis, the mechanism by which age contributes to disease pathogenesis is less understood and has not been sufficiently studied. In this review, we highlight studies that have considered age as a variable in examining DNA damage responses in UV-irradiated skin and then discuss emerging evidence that the reduced production of insulin-like growth factor-1 (IGF-1) by senescent fibroblasts in the dermis of geriatric skin creates an environment that negatively impacts how epidermal keratinocytes respond to UVR-induced DNA damage. In particular, recent data suggest that two principle components of the cellular response to DNA damage, including nucleotide excision repair and DNA damage checkpoint signaling, are both partially defective in keratinocytes with inactive IGF-1 receptors. Overcoming these tumor-promoting conditions in aged skin may therefore provide a way to lower aging-associated skin cancer risk, and thus we will consider how dermal wounding and related clinical interventions may work to rejuvenate the skin, re-activate IGF-1 signaling, and prevent the initiation of NMSC.

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Section: Dermal Wounding As a Preventive Approach For Nmscmentioning

confidence: 99%

Impact of Age and Insulin-Like Growth Factor-1 on DNA Damage Responses in UV-Irradiated Human Skin

2017

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“…Technological advancements and new methodologies are ushering in new therapies with promising results which may be increasing consumer demand for device‐driven procedures [24–27]. Thus, market forces may also be increasing demand for operators who are not well‐trained on these devices [28–30].…”

Section: Discussionmentioning

confidence: 99%

Dermatologic Device Clearance Within the Food and Drug Administration's 510(k) Pathway

et al. 2020

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Background and Objectives: Device innovation in dermatology is increasing. Medical devices identified as "substantially equivalent" to predicate ones by the United States Food and Drug Administration (FDA) may be exempt from premarket approval through the 510(k) pathway. The 510(k) pathway has been criticized for having less stringent clinical data requirements, and implications of dermatologic device clearance via this pathway are incompletely described. The objective of this study is to characterize dermatologic device clearance via the 510(k) pathway. Study Design/Materials and Methods: We performed a retrospective review of the FDA's 510(k) database between January 1, 1996 and December 31, 2018. Dermatologic devices were included based on product code and classified by the application. Approval pathways and decision characteristics were compared among dermatologic device categories. Results: Of the 76,607 records screened, 4,637 met inclusion criteria. Laser/thermal devices comprised the largest category (64.2%), followed by wound (24.0%) and light-based devices (5.8%). The majority of 510(k) pathway submissions were traditional (89.2%) compared with alternative (10.8%) submission types (P = 0.003). Devices that were deemed substantially equivalent without limitations (98.5%) were the most common among all device categories. Rates of device clearance over the study period increased for all categories except laser/ thermal devices. Conclusions: Dermatologic devices are increasingly cleared via the FDA's 510(k) pathway through "substantial equivalence" with minimal requirements for premarket clinical data. Lasers Surg. Med.

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“…Thus, wounding therapy has the potential to achieve an efficacious and long-term chemo-preventative effect, which allays the rising healthcare burden and morbidity associated with NMSC (21-23, 52, 77). In addition, these skin rejuvenation modalities are able to attain both cosmetic and cancer prophylactic effects (8,78). Our group has identified four viable wounding therapies: dermabrasion, fractionated laser resurfacing (FLR), microneedling, and chemical peeling (19,(21)(22)(23)63).…”

Section: Wounding Therapies For Rejuvenationmentioning

confidence: 99%

“…Microneedles are reported to be both effective and versatile devices due to its relatively painless penetration, affordability, and ability to deliver transdermal medicinal applications (88). The basic theory behind its mechanism of action is percutaneous collagen induction (78,87). Histological studies exhibit increased collagen and elastin after use of a microneedling device, which introduces small zones of dermal injury and subsequent wound healing processes (87).…”

Section: Microneedlingmentioning

confidence: 99%

Wounding Therapies for Prevention of Photocarcinogenesis

et al. 2022

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The occurrence of non-melanoma skin cancer (NMSC) is closely linked with advanced age and ultraviolet-B (UVB) exposure. More specifically, the development of NMSC is linked to diminished insulin-like growth factor-1 (IGF-1) signaling from senescent dermal fibroblasts in geriatric skin. Consequently, keratinocyte IGF-1 receptor (IGF-1R) remains inactive, resulting in failure to induce appropriate protective responses including DNA repair and cell cycle checkpoint signaling. This allows UVB-induced DNA damage to proliferate unchecked, which increases the likelihood of malignant transformation. NMSC is estimated to occur in 3.3 million individuals annually. The rising incidence results in increased morbidity and significant healthcare costs, which necessitate identification of effective treatment modalities. In this review, we highlight the pathogenesis of NMSC and discuss the potential of novel preventative therapies. In particular, wounding therapies such as dermabrasion, microneedling, chemical peeling, and fractionated laser resurfacing have been shown to restore IGF-1/IGF-1R signaling in geriatric skin and suppress the propagation of UVB-damaged keratinocytes. This wounding response effectively rejuvenates geriatric skin and decreases the incidence of age-associated NMSC.

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Skin resurfacing procedures: new and emerging options

Cited by 25 publications

References 67 publications

Impact of Age and Insulin-Like Growth Factor-1 on DNA Damage Responses in UV-Irradiated Human Skin

Impact of Age and Insulin-Like Growth Factor-1 on DNA Damage Responses in UV-Irradiated Human Skin

Dermatologic Device Clearance Within the Food and Drug Administration's 510(k) Pathway

Wounding Therapies for Prevention of Photocarcinogenesis

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