Fatemeh Mokhtari

Background: Androgenetic alopecia (AGA) is the most common type of hair loss in men and can impose a significant psychosocial burden, reducing self‐esteem and quality of life. Current standard treatments include topical minoxidil and oral finasteride; however, there is no definitive or fully satisfactory treatment. Carboxytherapy increases blood flow and enhances the delivery of oxygen and nutrients to hair follicles. It may also facilitate transdermal drug delivery and improve the response to standard therapy. Methods: Forty‐six male patients aged 18–50 years with moderate‐to‐severe androgenetic alopecia (AGA) were allocated into two groups. The intervention group received topical minoxidil 5%, oral finasteride 1 mg, and carboxytherapy. A total of six sessions were administered at 2‐week intervals over approximately 12 weeks. The control group received topical minoxidil 5% and oral finasteride 1 mg alone. Outcomes were assessed at baseline, 3 months, and 24 weeks post‐treatment using standardized photography, dermoscopy, and patient satisfaction based on a 7‐point grading scale. Results: At 24 weeks post‐treatment, both groups showed statistically significant improvements in patient satisfaction and photography‐dermoscopy scores. However, the intervention group achieved significantly higher dermoscopy‐photography scores than the control group ( p = 0.006). Conclusion: Adding carboxytherapy to standard therapy (topical minoxidil and oral finasteride) resulted in greater clinical improvement and higher patient satisfaction compared with standard therapy alone.

Background: Melasma is a common hyperpigmentation disorder primarily affecting women, influenced by ultraviolet exposure, hormones, and genetics. Kligman's formula is a first‐line therapy, but emerging evidence suggests that topical metformin, an antidiabetic with antimelanogenic effects, may enhance treatment outcomes. The objective of this study is to compare the efficacy and safety of Kligman's formula with and without 30% topical metformin in bilateral facial melasma. Methods: In this randomized, double‐blind, split‐face clinical trial, 31 patients with symmetrical facial melasma applied Cream A (Kligman's formula + 30% metformin) to one side and Cream B (Kligman's formula alone) to the other for 2 months. Outcomes included MASI scores, repigmentation grading, patient satisfaction via Visual Analog Scale (VAS), and side effect profiles assessed at baseline, post‐treatment, and 2 months after discontinuation. Results: Both treatments significantly reduced pigmentation and improved homogeneity. Cream B showed a slightly greater reduction in darkness, while Cream A led to more stable repigmentation and fewer cases of post‐inflammatory hyperpigmentation. No significant differences were found between post‐treatment and follow‐up scores. VAS scores indicated high patient satisfaction across both groups. Conclusion: Adding 30% topical metformin to Kligman's formula is safe and comparably effective in melasma treatment, offering potential benefits in pigment stability and reduced PIH. Although differences were not statistically significant, clinical trends support further investigation through larger, long‐term studies. Trial Registration: ClinicalTrials.gov identifier: IRCT20150706023081N2

Melasma is a chronic acquired condition characterized by grayish-brown macules and patches with a distinct border on the face. Although various treatments methods have been suggested for treating m...

Periorbital hyperpigmentation (POH) is a common aesthetic condition causing people referring to dermatology clinics. Although the therapeutic approach is steeply dependent to the etiology of POH, the gold standard approach of treatment is still a question. The current study is designed to compare the use of carboxytherapy vs platelet‐rich plasma (PRP) for the treatment of POH. In the current clinical trial, number of 21 patients with POH underwent carboxytherapy in one side of the face and PRP therapy on the other side. SPSS software version 22 was used with independent T‐test, Chi‐square, and ANOVA for analytics. Carboxytherapy was performed by intradermal injection of 5 cc carbon‐dioxide gas once weekly for six weeks. The PRP treatment was performed by intradermal injection of PRP in periorbital space using an insulin syringe every two weeks for three times. The periorbital darkness was assessed using visual analogue scale (VAS) preoperatively and within 8 weeks postoperatively by the patients and the dermatologists. Automatic assessments of skin vascularity and pigmentation were assessed using a digital camera. The patients represented significant darkness improvement postoperatively for both of the approaches (P‐value: 0.84, P‐value: 0.87), while the comparison of the two groups revealed insignificant postoperative changes by dermatologists assessments (P‐value = 0.59, P‐value: 0.61), the patients' assessments (P‐value = 0.85), the digital camera skin vascularity and pigmentation assessments (P‐value>0.05). Conclusion: Although insignificant changes following both of the approaches were found, it may have occurred due to the technique, quality of material, or inadequate treatment sessions due to the type of Iranian skin; therefore, more evaluations considering particular entities such as vascularity for longer duration of follow‐up and new design are strongly recommended.

Vitiligo is a prevalent destructive melanocyte skin disease that negatively affects the patients' life in terms of self‐esteem. Suction blister and dermabrasion plus 5‐fluorouracil are effective treatments for vitiligo. The present study was conducted to compare the outcomes of these two techniques. The present clinical trial was conducted on 36 patients with persistent refractory vitiligo which defined as the lack of any new or progressed lesion during the previous year as well as no responding to conventional therapies of vitiligo including topical treatments and phototherapy. Individuals with two vitiligo patches, with similar baseline Vitiligo Area Severity Index (VASI) scores were randomly allocated to dermabrasion plus 5‐fluorouracil or suction blister treatments. VASI and repigmentation scores were measured and compared at the baseline, four, and 12 weeks after performing the procedures. Both of the approaches accompanied with significant improvement in both entities of VASI and repigmentation scores ( P value < .05) at the end of the study, besides the trend of VASI and repigmentation scores between the two groups revealed insignificant difference ( P > .05). The short‐term follow‐up of the patients was the limitation of this study. The present findings suggested that both surgical techniques of dermabrasion plus 5‐fluorouracil and suction blister posed acceptable outcomes within 12‐week follow‐up.

Objective. Vitiligo is a common, autoimmune disease that results in the destruction of the melanocytes and manifests as depigmented macules on various areas of the skin. Numerous treatment options have been proposed for vitiligo. The purpose of this study was to compare the efficacy of microneedling plus topical pimecrolimus 1% versus the sole use of topical pimecrolimus 1% for the treatment of vitiligo. Methods. This clinical trial was conducted on 30 skin lesions on 15 Al‐Zahra hospital patients. Each patient had two similar lesions in the limb area, and each lesion was considered a separate treatment group. The left or right side of the patient’s lesion was randomly assigned to receive microneedling plus topical pimecrolimus for three months, while the other side received only topical pimecrolimus 1%. As part of the follow‐up, digital photography was taken at the baseline and biweekly for three months after treatment and six months’ follow‐up. The following methods were used to evaluate the results: DLQI questionnaires, patient satisfaction questionnaires, and two independent dermatologists comparing the improvement rate for each group. Results. Topical pimecrolimus 1% treatment led to unsatisfactory results, whereas the combination of microneedling and topical pimecrolimus1% treatment produced a more favorable overall outcome (P < 0.001). Conclusion. This study established that combination therapy results in more significant patient improvement. Additionally, one patient experienced mild skin irritation as a side effect of topical pimecrolimus.

Background: Microneedling has shown to have positive therapeutic effects in treatment of androgenetic alopecia (AGA); however, the best microneedling protocol is still controversial.Aims: Investigating effect of microneedling with 2 different depths of penetration on promoting hair growth in patients with AGA.Methods: Sixty patients, in the age of 18‐45 years old with moderate and severe AGA, were allocated into 3 groups of control: treatment with minoxidil 5% lotion; group A: treatment with minoxidil 5% lotion and biweekly microneedling with a depth of 1.2 mm and group B: treatment with minoxidil 5% lotion and biweekly microneedling with a depth of 0.6 mm during 12 weeks. Efficacy parameters including change of hair count and hair thickness from baseline and assessment of hair growth by patient and investigator were evaluated.Results: Compared with the baseline, a significant increase in hair count and hair thickness was observed in all three groups after completion of the treatment course (P < .05). The mean rise in hair count (P = .017) and hair thickness (P = .007) was significantly greater in group B compared with control group. Investigator's evaluation of hair regrowth was significantly greater in group A (P = .04) and group B (P = .007) compared with control group.Conclusion: Microneedling with a depth of 0.6 mm in combination with minoxidil is more effective than minoxidil monotherapy in patients with AGA in terms of hair count and hair thickness. This depth of penetration tended to be more beneficial than depth of 1.2 mm.

Introduction: Aging is an inevitable process in life that can pose unsatisfactory changes in appearance. Recently, rejuvenation surgeries have opened an exciting new window toward people who are vulnerable according to their facial appearance. Periocular plastic microsurgeries are among the most common aesthetic surgeries with various outcomes. The current study was aimed to compare outcomes of blepharoplasty with and without peeling regarding lower eyelid rejuvenation.Methods: This is a randomized clinical trial study conducted on 30‐patients referred for inferior lid rejuvenation in 2017‐18. Patients were randomly divided into two 15‐member subgroups of microinvasive blepharoplasty with and without peeling. Peeling for the group underwent blepharopeeling was performed all over the inferior periocular region using Phenol 89%. Then, skin and underlying muscle were incised superficially, and underlying fat tissue was excised. The other group underwent blepharoplasty without peeling. Patients were followed daily for 2 months to assess complications, patients' and physicians' satisfaction.Results: Two assessed groups were not statistically different regarding age and gender distribution (P‐value = .417 and .666, respectively). Considering patients' opinion, symmetry, scar formation, skin laxity, swelling, and total satisfaction score were not different between two groups (P‐value > .05) while physicians presented similar outcomes except for better scar formation status of peeling add‐on therapy (P‐value = .042). Rate of adverse effects was significantly higher among those under blepharoplasty plus peeling treatment (P‐value < .05).Conclusion: Outcomes of blepharoplasty alone versus blepharoplasty plus peeling were not significantly different regarding both patients' and physicians' assessments in general while fewer complications due to blepharoplasty without peeling were presented.

Context: Subcision is a simple surgical method that can be effective in treatment of acne scars.Aims: This study was conducted to evaluate and compare the two methods of Nokor needle and blunt blade (BB) subcision in treatment of acne scars.Settings and design: This clinical trial study was conducted on 28 patients with acne scars.Patients and methods: One side of the face was treated with BB subcision method, and the other side was treated with Nokor needle method. Followed up period was 6 months after treatment. Statistical Analysis Used: Data were analyzed by Statistical Package for the Social Sciences (version 20) software using independent sample t test, Mann‐Whitney test, Friedman test, and Fisher's exact test.Results: In follow‐up period, the improvement of acne scars was comparable in both groups (P > 0.05). Complications were lower in BB method than another method (P < 0.05). The patient satisfaction was higher in BB method (P < 0.05).Conclusions: Both of modalities offered similar improvement, but the complication rate was lower and the patient satisfaction was also higher in the BB method than another method.