This paper explores the impact of osteopathic medicine\'s principles and philosophy on dermatology conditions, focusing specifically on atopic dermatitis (AD), bullous pemphigoid (BP), and acne scars. The aim is to investigate how integrating osteopathic principles into dermatology can improve patient outcomes by addressing visible and internal health factors. The review was conducted through a literature search utilizing PubMed and Journal Storage. By focusing on the interconnectedness of mind, body, and spirit, osteopathic medicine could contribute to the effective treatment of AD. Stress management techniques have been found to significantly aid in the treatment of AD, as stress levels and social stress have a significant impact on the exacerbation of AD symptoms. Micro-needling is a promising treatment for atrophic acne scars, reducing scar severity scores by up to 68.3%. Combining micro-needling with trichloroacetic acid or non-ablative fractional laser technology further enhances treatment efficacy. The development of BP has been linked to alterations in the epidermis. Granzyme B has been identified as a contributing factor in dermal-epidermal junction separation and autoantibody formation, leading to BP. However, the specific link between osteopathic manipulation and Granzyme B levels in BP is not yet firmly established. Although osteopathic manipulation may impact the immune system and inflammation, further investigation is required to determine its precise effects on granzyme B and BP. Nonetheless, integrating osteopathic principles and philosophy into dermatology can improve patient outcomes by addressing visible and internal health factors. The benefits of such integration include improved patient-provider relationships, innovative treatments, better stress management, and individualized care plans. Practitioners should be educated on the significance of complete skin examinations for all patients, and future research should focus on exploring the benefits of osteopathic manipulation for dermatologic conditions. Further investigations into new dermatological treatment methods rooted in osteopathic principles are encouraged. The foundation of dermatology and osteopathic medicine share the importance of physical touch for diagnosis and treatment. An osteopathic approach to dermatology considers the link between cutaneous diseases and systemic health. This approach aligns with the four fundamental osteopathic beliefs: the body functions as a whole unit; a person is an integration of body, mind, and spirit that cannot be separated. The body can regulate itself, heal itself, and maintain its health. The body\'s structure and function are interdependent and work together. Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function.

The aim of this study is to compare needling (RF-needling, meso-needling, micro-needling) and ablative fractional lasers (CO2, erbium-YAG) in the treatment of atrophic and hypertrophic scars in a systematic review. The database was searched, and 10 articles were selected that were relevant in terms of content, topic, and purpose and met the inclusion criteria. Of all the articles reviewed in this study, there were 2 randomized split-face trials (20%), 1 controlled nonrandomized trial (10%), 1 controlled randomized phase III clinical trial (10%), 1 prospective trial (10%), 1 prospective nonrandomized open-label trial (10%), and 1 randomized comparative trial (10%), with the type of study not reported in 3 articles. We used Endnote X8 to review the articles and extract data. After review, the studies were analyzed and categorized. No statistically significant difference was found between the two methods, laser and micro-needling, in the treatment of atrophic and hypertrophic scars in 60% of the articles studied, and both showed significant improvement (70% or more improvement to complete response). Significant improvement was noted in 20% of the studies reviewed for the laser and micro-needling treatment methods. The results of this study show that needling and ablative fractional lasers are tolerable and safe procedures with no significant difference in the treatment of skin scars in sixty percent of the studies.

Although interest in aesthetic medicine is growing, the focus is often placed outside of the facial area, namely on the skin of the neck and cleavage. Exposure to the sun and muscle movements cause the prompt development of wrinkles that may appear there, even before they show up on the face. We conducted a literature review devoted to micro-needling to identify its role in anti-ageing treatments and to determine the gaps in current knowledge. A search in Medline identified 52 publications for neck and face micro-needling. Micro-needling is an anti-ageing procedure that involves making micro-punctures in the skin to induce skin remodelling by stimulating the fibroblasts responsible for collagen and elastin production. It can be applied to the skin of the face, neck, and cleavage. Two to four weeks should be allowed between repeated procedures to achieve an optimal effect. The increase in collagen and elastin in the skin can reach 400% after 6 months, with an increase in the thickness of the stratum granulosum occurring for up to 1 year. In conclusion, micro-needling can be considered an effective and safe aesthetic medicine procedure which is conducted at low costs due to its low invasiveness, low number of adverse reactions, and short recovery time. Little evidence identified in the literature suggests that this procedure requires further research.

Despite the rising trend for applying platelet-rich plasma (PRP) in the management of various types of scars, there is no convincing evidence supporting its use. This motivated us to review the randomized clinical trials that examine the effectiveness and safety of PRP, alone or in combination with other methods, for the management of atrophic or hypertrophic/keloidal scars. The Web of Science, Scopus, Google Scholar, and Cochrane Library databases were systematically searched until September 1st , 2020. Thirteen clinical trials were enrolled in the meta-analysis, and 10 more were reviewed for their results. The random effect meta-analysis method was used to assess the effect size of each outcome for each treatment type, and I2 was used to calculate the statistical heterogeneity between the studies. Patients treated with PRP experienced an overall response rate of 23%, comparable to the results seen with laser or micro-needling (22% and 23%, respectively) When used alone, moderate improvement was the most frequently observed degree of response with PRP (36%) whereas, when added to laser or micro-needling, most patients experienced marked (33%, 43%, respectively) or excellent (32% and 23%, respectively) results. Concerning the hypertrophic/keloid scars, the only study meeting the required criteria reported a better improvement and fewer adverse effects when PRP was added to the intralesional corticosteroids. Platelet-rich plasma appears to be a safe and effective treatment for various types of atrophic scars. In addition, when added to ablative lasers or micro-needling, it seems to considerably add to the efficacy of treatment and reduce the side effects.

BACKGROUND: Skin needling is a technique used to improve the appearance of acne scarring.
OBJECTIVE: To comprehensively review the medical literature regarding skin needling as a treatment for acne scarring.
METHODS: A literature search was performed using the PubMed, Medline, and Embase databases, in addition to reviewing the bibliographies of relevant articles.
RESULTS: Ten studies presented patients treated with skin needling alone, while eight studies discussed skin needling in combination with other treatments for acne scarring. All studies showed improvements in scarring after needling, with 12 reporting statistical significance. The median number of treatments when needling was used alone was three, the median duration between treatments was 4 weeks, and the median needle length used was 1.5 mm. Reported adverse events were infrequent and included post-inflammatory hyperpigmentation, \"tram track\" scarring, acne, and milia. There were no reports of bacterial infections.
CONCLUSIONS: The studies reviewed were heterogeneous in design and of variable validity, with some not reporting statistical significance.
CONCLUSIONS: There is moderate evidence to suggest that skin needling is beneficial and safe for the treatment of acne scarring. However, double-blinded, randomized controlled trials are required to make more definitive conclusions.