Stretch marks (striae distensae) are common dermal scarring associated with weight gain, overweight, and pregnancy. Scarring is caused by overstretching of the skin\'s dermis with permanent structural alteration of the collagen network fibers. Some individuals have naturally weak connective tissue and may develop major stretch marks without being overweight. Stretch marks can develop during puberty and after physical exercise with rapid muscle growth. Cortisone treatment and anabolic steroids often cause stretch marks. Stretch marks are of major cosmetic concern to many. They are red and swollen in the early sate and white and irregular in texture in the later stage. Many men and women suffer from poor self-esteem caused by stretch marks. Medical tattooing of stretch marks, also known as microneedling, can correct the skin pigmentation color in the normal direction, but not the actual textural change. However, abnormal texture may be modified by microneedling, by nonablative laser treatment, or by microdermabrasion. Treatments can also be combined, e.g., initial use of a method to flatten the skin, followed by tattooing to correct the color. Treatment options and strategies are reviewed.

UNASSIGNED: Melasma is a common disorder of hyperpigmentation mainly affecting the face. It is difficult to treat and is a cause for great cosmetic concern for the patient. So, we did this research to compare the therapeutic efficacy of tranexamic acid (TXA) through oral route versus its transepidermal administration with a dermaroller in melasma.
UNASSIGNED: This was a hospital-based, interventional study carried over a span of 1 year on 40 patients with facial melasma. The enrolled patients were randomly divided into 2 groups of 20 patients each. Group A patients received oral tablet TXA in a dose of 250 mg twice daily for 12 weeks and Group B patients were given TXA solution transepidermally into the melasma lesions using a dermaroller at 2 weekly interval for 12 weeks. Thereafter, all patients were followed up for improvement in Melasma Area and Severity Index (MASI) score, adverse effects and relapse at 4 weekly intervals till 24 weeks. All the patients were evaluated for therapeutic outcome both objectively (by MASI) and photographically at 4, 8, 12, 18, and 24 weeks. Grading of improvement was done by assessing percentage reduction in MASI score.
UNASSIGNED: Majority of the patients, 24 (60%) in our study had centrofacial pattern of melasma followed by malar pattern seen in 16 (40%) patients. The baseline MASI score was 11.98 (± 5.47) in Group A and 12.13 (± 3.16) in Group B. The mean MASI score in Group A at the end of 4, 8, 12, 18, and 24 weeks was 9.75 (±4.83), 6.09 (±3.64), 4.21 (±2.48), 2.56 (±1.95), and 3.10 (±3.38) while these values were 9.73 (±3.32), 6.06 (±2.75), 4.55 (±1.89), 2.94 (±1.36), and 3.09 (±1.32) for Group B. At the end of 24 weeks follow-up period, good (51%-75% improvement) and very good (>75% improvement) response occurred in 5 (25%) and 14 (70%) patients in Group A and 11 (55%) and 9 (45%) patients in Group B, respectively. However, the final reduction in MASI score was similar in both the groups. Relapse was uncommon and occurred at 24 weeks in 1 patient from Group A.
UNASSIGNED: The major limitation was small sample size due to time limitation and long follow-up period.
UNASSIGNED: Oral and transepidermal TXA appear equally effective suggesting that the efficacy of TXA is perhaps independent of its route of administration. Oral therapy is convenient for the patient. Transepidermal therapy of TXA has the advantage of local action, hence systemic side effects are avoided, but it is slightly painful and the time period between consecutive microneedling sessions is left to the prerogative of the treating doctor, hence a proper quantification is lacking. Moreover, scheduling of maintenance sessions is necessary as melasma is prone for recurrence.

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UNASSIGNED: Microneedling therapy is one of the recent advances in treating acne facial scars.
UNASSIGNED: To evaluate the efficacy of microneedling therapy in the treatment of atrophic acne facial scars.
UNASSIGNED: A total number of 10 patients between the age group of 20 and 40 years (8 women and 2 men) who complained of acne scars from November 2012 to August 2014 were selected for the study.
UNASSIGNED: Microneedling therapy was performed following the application of the Eutectic Mixture of Local Anesthetics in an interval of 2 months. All patients underwent three sessions. A follow-up of 2 months after the last sitting was carried out.
UNASSIGNED: Cochran\'s Q-paired test, Kendall\'s W-test, and Pearson\'s correlation were used for statistical analysis.
UNASSIGNED: Patients in our study had three forms of acne scars: box-scar, icepick form, and rolling scars. Patients were told to rate the outcome of the treatment at the end of the follow-up. Three observers randomly selected were shown the pre- and postoperative photographs of the patients to rate the treatment outcome. Statistically there was no interobserver bias. Ninety percent reduction in number of scars and depth of scars was noted at the end of three sittings. The improvement in pigmentation was insignificant. Seventy percent improvement in the skin texture was noted. Nine patients suffered from transient postinflammatory erythema and six patients had postoperative swelling.
UNASSIGNED: Microneedling therapy is a safe and effective method of treating acne scars.

Physical drug delivery enhancement in skin has been shown to enhance cosmeceutical actives efficacy. Among the physical drug delivery enhancement technologies, microneedle is the most commercially successful technology. However, there are pros and cons like other physical enhancement technologies including variabilities in penetration depth and lack of efficacy. In this study, three physical topical dug delivery enhancements, elongated microparticles, microneedles and dermaroller, were applied to ex vivo pig skin and compared. The model topical drug that was used is 5-Aminolevulinic acid, the most commonly used photosensitiser prodrug. The skin was pre-treated before mounting on to Franz cell diffusion apparatus. Transdermal epidermal water loss was measured, and receptor fluids were collected at 7 time points for HPLC analysis. The results show that all three technologies disrupted the skin surface. All microporation pre-treatments significantly enhanced mALA cumulative permeation over 8 h (p < 0.001), with the 24x dermaroller significantly greater than 12x dermaroller (p < 0.001) and both dermaroller treatments significantly greater than microneedles and elongated microparticles (p < 0.05). The microporation pre-treatments all significantly increased mALA deposition in the stratum corneum and deeper skin tissues compared to passive administration, with deposition increases ranging from 3.6x to 15.1x that of passive administration. The DR pretreatment showed highest enhancement ratios (amount 5-Aminolevulinic acid in skin at 8 h following pretreatment v passive) with the following order of enhancement: 24x dermaroller > 12x dermaroller > microneedles > elongated microparticles. In conclusion, physical enhancement tools such as microneedles, dermarollers and elongated microparticles demonstrated significant penetration and retention of mALA through/into piglet skin. Further study is needed to determine the cost, dose and patient compliance.

UNASSIGNED: Melasma is a commonly acquired, chronic, and relapsing disorder that results in symmetrical, brownish facial pigmentation. It is more common in women than in men, which generally starts between 20 and 40 years of age, and it can lead to considerable embarrassment and distress. Managing melasma is a difficult challenge that requires long-term treatment with a number of topical agents. Microneedling has been described as a new technique to enhance the drug\'s transdermal penetration, and has also been reported to result in sustained long-term improvement of recalcitrant melasma.
UNASSIGNED: The aim of this article was to compare the therapeutic efficacy and safety of combined treatment of skin microneedling and depigmenting cream versus depigmenting cream alone in the treatment of melasma.
UNASSIGNED: A prospective study was conducted with a sample size of 40 patients, with twenty in each of the treatment arms; 20 patients were treated with combined skin needling and depigmenting cream and 20 with depigmenting cream alone. The outcome was evaluated periodically for up to 2 months using the modified Melasma Area and Severity Index (MASI) score.
UNASSIGNED: Significant reduction was observed in modified MASI score in the combined treatment, with P value <0.05.
UNASSIGNED: Combining microneedling with Kligman\'s regimen gives better results in melasma treatment compared to topical treatment alone.

Androgenetic alopecia (AGA) is an androgen-dependent hereditary trait resulting in hair miniaturization. It is the most common type of alopecia in men and women. During the last years, multiple treatment modalities have been studied, but only topical minoxidil and finasteride have been approved by the US Food and Drug Administration. Microneedling (MN) is a minimally invasive technique that induces collagen formation, as well as growth factors production and neovascularization. Even though not many studies of MN in alopecia have been performed, it remains a favorable treatment modality; however, no standardized protocol for MN in hair loss has been proposed yet. Current evidence is not sufficient to allow a direct comparison with other therapies, but it shows promises to increase hair density, thickness, and quality of hair, especially when combined with other treatments or when used as a drug delivery system. This article aims to summarize the available literature regarding the use of MN alone or associated with other therapies for the treatment of androgenetic alopecia.

OBJECTIVE: Microneedles (MNs) create micropunctures and deliver drugs or nutrients deep into skin layer. We demonstrated that MNs, coated with electrosprayed nanoparticles loaded with functional molecules, are useful for transdermal delivery.
METHODS: Electrospraying was utilised to generate drug-loaded nanoparticles and to create uniform coating on MNs. Process parameters and release kinetics were evaluated in vitro. The in vivo efficacy of insulin-coated MNs was investigated using diabetic rats.
RESULTS: Electrosprayed micro/nanoparticles loaded with dye or insulin were coated on MNs with particle size of 515 ± 286 and 522 ± 261 nm, respectively. Optimally coated MNs resulted in >70% transfer rate into porcine skins. Insulin-coated MNs were applied to diabetic rats resulting in reduction of blood glucose levels fluctuations, compared to subcutaneous injections.
CONCLUSIONS: Electrospraying is shown to be an effective method to coat MNs with drug-loaded nanoparticles. Coated MNs provide a promising platform for cosmetic, drug and protein delivery applications.

BACKGROUND: The use of stem cells derived growth factors is representing a novel treatment modality in facial rejuvenation. Nowadays, skin needling is considered a very famous treatment of skin aging. However, the addition of such derived products, augments its therapeutic efficacy in the management and delay of skin aging.
OBJECTIVE: Comparing the effect of amniotic fluid mesenchymal stem cell derived conditioned media (AF-MSC-CM) combined with skin needling versus the needling alone in the management of facial aging.
METHODS: Both sides of the face of ten volunteers, suffering from facial aging, were treated with five sessions of skin needling, 2 weeks apart. After skin microneedling, AF-MSC-CM was added topically to the right side only. Clinical, histological, and morphometrical assessment of the treated skin was done at 1 month after the last session.
RESULTS: The percentage of improvement of aged skin increased significantly on the combined treated side (AF-MSC-CM and dermaroller [DR]), when compared with the other side (DR only) (P < .001). Remodeling of the dermal structures was observed mainly on the combined side. Meanwhile, histometry of the epidermis revealed a significant increase in the epidermal thickness on both treated sides.
CONCLUSIONS: AF-MSC-CM combined with skin needling was more efficient in managing facial aging than skin needling alone.