Alopecia areata (AA) is a common inflammatory, non-cicatricial hair loss. At present, it is considered that its pathogenesis is an autoimmune disease specific to hair follicle organs mediated by T cells under the combined action of genetic and environmental factors. Treatment is challenging for children with severe AA who are resistant or intolerant to conventional treatment.Here, we treated a 3-year-old child with severe AA with microneedling combined with compound betamethasone. After 6 months of treatment, the patient\'s condition was significantly improved, and most of the primary hair loss areas had hair regeneration.

UNASSIGNED: Microneedling is a common non-invasive procedure used for a variety of dermatologic conditions. It is associated with a low rate of adverse events which are typically temporary. Hypersensitivity reactions, including granuloma formation, are a rare adverse event, with only 10 cases previously reported.
UNASSIGNED: We report a case of a 49-year-old female who presented with asymptomatic edematous erythematous annular plaques on her left cheek following a microneedling procedure in which a Vitamin C cosmeceutical was applied to the skin beforehand. Skin biopsy confirmed non-necrotizing granulomatous dermatitis with negative tissue cultures. Systemic workup for sarcoidosis was negative.
UNASSIGNED: Delayed facial granulomatous reaction is an uncommon adverse event following microneedling. Increased risk may be related to peri-procedure use of cosmeceuticals such as Vitamin C. Given the popularity of microneedling, and that it is an unregulated procedure, it is important for dermatologists to be aware of this possible sequela in order to counsel patients appropriately and understand management options.

Spider vein is mostly seen in patients with liver disease, although the underlying problem is sometimes unknown. If spider vein appears on the face, it can affect the self-esteem and self-image of patients. Particularly, females are more vulnerable to these complications. Spider nevi are mostly left untreated since they are considered a cosmetic matter; in case of treatment, the procedure is costly with limited satisfaction. Therefore, this study reports the successful treatment of a spider vein case using a microneedling procedure.

BACKGROUND: Microneedling in combination with the use of growth factors can help with a range of indications, including skin rejuvenation. There is an increase in request for safe minimally invasive procedures with no-to-minimal downtime. This procedure offers regeneration and is becoming popular as part of the regenerative, minimally invasive era.
OBJECTIVE: To examine the efficacy of a course of two sessions of growth factor-induced therapy using propriety preparation of AQ recovery serum.
METHODS: Thirty women with various ethnic backgrounds (Chinese, Caucasian and Latino) with an average age of 38 years old participated and mild-moderate visual facial aging signs Two sessions with 2-week intervals were completed using a derma stamp (transdermal drug delivery method) and 2 mL of growth factor serum (AQ Skin Solution recovery serum-contain a mixture of contains a mix of transforming growth factor beta (TGF-β), granulocyte monocyte-colony-stimulating factor, and platelets-derived growth factor with patented technology for extraction and composition at each session. The procedures were carried out for anti-aging and skin rejuvenation. Clinical assessment, VISIA photography, independent assessment of before and after photographs baseline and six weeks by two clinicians and two laypersons were carried out. The participants used FACE-Q questionnaire (outcome satisfaction) and scored changes in terms of their skin texture, radiance, pore size, wrinkles, pigmentation, tightness and overall skin appearance.
RESULTS: Physician\'s global assessment revealed growth factor-induced therapy resulted in skin rejuvenation in all races with 95% confidence, and this increased to 98% confidence for Latinos and Caucasians within the six weeks. Participants\' subjective rating revealed improvement of overall skin appearance with 95% confidence. Most noted improvements were in brightness, skin texture, and tightness.
CONCLUSIONS: This study revealed improvement in overall skin appearance, brightness, skin texture, and tightness. The treatment is non-invasive, safe, with no or minimal downtime and resulted in high participant satisfaction.

BACKGROUND: Acne is a common condition that often results in scarring. Current treatment options, such as chemical peels, laser therapy, radiofrequency, subcision, and microneedling, all have some efficacy in the treatment of acne scars. Results can vary based on the type of scarring and the treatment modality used. OBJECTIVE: We propose a novel treatment of acne scarring using a multimodal approach comprising chemical reconstruction of skin scars, subcision, and microneedling. METHODS: A retrospective chart review was conducted from January 2017 to December 2018 of all patients with acne scars treated with a triple combination approach in an outpatient cosmetic dermatology practice. Patients presenting with acne scarring who were 18 years of age or older and treated with the triple combination technique were eligible for inclusion. Each patient was treated with a combination of three procedures: 1) chemical reconstruction of skin scars (CROSS), mainly with carbolic acid; 2) blunt bi-level cannula subcision; and 3) microneedling. RESULTS: A total of 139 patients were treated, of whom 89 (64%) had Fitzpatrick Skin Types IV to VI. Shadow-lit before and after photos and patient feedback on side effects and satisfaction level were used to assess changes. On average, patients received a total of two treatments each (range: 1-4 treatments). This triple approach to treating acne scars resulted in consistently high satisfaction among patients and photographic evidence of improvements. CONCLUSION: The triple combination of CROSS (to stimulate neocollagenesis), subcision (to release dermal connective tissue tethering), and microneedling (to stimulate neocollagenesis) appears to be effective for the treatment of acne scars. Randomized, controlled clinical trials with larger patient numbers are needed to support these observations.

BACKGROUND: Androgenetic alopecia (AGA) is the most common type of alopecia. Currently, various methods have been tried to treat male AGA, but the outcomes are often unsatisfactory, especially for elderly persons.
OBJECTIVE: We report a case of an elderly man with a severe long-standing AGA, which was successfully managed with microneedling and minoxidil.
METHODS: The patient was a 70-year-old Japanese man with family history of AGA, showed no abnormality in physical and laboratory examinations, and had received no treatment. We did monotherapy with 5% minoxidil twice daily to the right half of the scalp, while on the left half topical minoxidil was combined with weekly microneedling using an automated microneedling pen.
RESULTS: After 14 weeks of treatment, negligible hair growth was observed on the monotherapy side. On the combined-therapy side, however, hair growth was obvious and the density of hairs determined under trichoscope was significantly increased compared with the monotherapy side (P < .001). Only transient pain, erythema, and pinpoint bleeding were observed as adverse effects.
CONCLUSIONS: Although we need further clinical trials to assess the efficacy and safety and to standardize the method, microneedling combined with topical minoxidil could be a treatment option for severe AGA in elderly patients.

Radiofrequency (RF) microneedling has been used to reduce skin laxity, due to aging, on the face and neck. Our objective for this case study was to evaluate the use of RF in combination with microneedling to nonsurgically improve skin laxity, a result of significant weight loss, on the thighs of a 39-year-old woman. Two sessions of subcutaneous RF microneedling were performed five months apart on the patient\'s bilateral medial thighs. Laxity was graded before the first session and two months following the second session using the Hexsel and Dal\'Forno Severity Scale of Cellulite. Upon visual evaluation, the appearance of cellulite and skin laxity was improved, with a five-point improvement on the Hexsel and Dal\'Forno scale at two months after the second treatment. Laxity and depth of depressions showed the most improvement. Our patient reported satisfaction with the results. RF microneedling might offer an effective alternative to surgical correction of skin laxity. Further research is needed to explore the expanding applications of RF microneedling in aesthetic medicine.