Pakistan Journal of Medical and Surgical Aesthetics
The Pakistan Journal of Medical and Surgical Aesthetics (PJMSA) is a prestigious, peer-reviewed, quarterly research journal dedicated to advancing knowledge and fostering innovation in the fields of medicine, surgery, and aesthetic sciences. PJMSA serves as a dynamic platform for academics, researchers, clinicians, and practitioners to share groundbreaking research, clinical studies, and insightful reviews that shape the future of medical and surgical aesthetics.
ASSOCIATION OF AESTHETIC PHYSICIANS OF PAKISTAN
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Artificial Intelligence in Aesthetic Dermatology: Current Applications and Future Perspectives
Copyright (c) 2026 Pakistan Journal of Medical and Surgical Aesthetics https://creativecommons.org/licenses/by/4.0
Comparative study between the efficacy of micro-needling combined with 5-Fluorouracil versus micro-needling with trichloroacetic acid in treatment of stable vitiligo
Background: Vitiligo is a common de-pigmenting disorder. Despite advancements in therapy, managing the condition remains challenging. Combining treatment approaches may improve outcomes. Objective: To compare the efficacy and safety of microneedling with 5-fluorouracil (5-FU) versus trichloroacetic acid (TCA) 35% in stable vitiligo. Methods: This single-blinded study was designed as interventional and comparative. Nineteen patients (43 patches) with stable vitiligo were enrolled and randomized into two groups. One group (10 patients, 22 patches) received microneedling with 5-FU, and the other (9 patients, 21 patches) received microneedling with 35% TCA. Eight biweekly sessions were performed. Follow-up was done 2 months after the final session. Results: No significant difference was observed in mean re-pigmentation between the two groups. Both showed a significant reduction in lesion surface area. Excellent response was seen in 9.1% (5-FU) and 9.5% (TCA), while no or poor pigmentation occurred in 72.8% and 80.9%, respectively. Lesion site (5-FU group) and skin phenotype (TCA group) showed significant associations with pigmentation. An inverse correlation existed between re-pigmentation and lesion size in both groups. Conclusion: Microneedling with either 5-FU or TCA appears safe, practical, and affordable for treating stable vitiligo. The mean repigmentation response was comparable in both groups.
The Efficacy of Skin Booster Containing Hyaluronic Acid, Glutathione and Salmon-Derived Polydeoxyribonucleotide in Skin Hydration and Brightness: A Case Study
Skin booster is a biological material that is injected intradermally to improve skin quality. The content of hyaluronic acid (HA), glutathione, and polydeoxyribonucleotide (PDRN) in the skin booster is used to increase skin hydration, brightness, and reduce wrinkles. A 61-year-old woman with photoaging was subjected to a split-face treatment approach. The left cheek received topical therapy, while the right cheek underwent a combination of topical therapy and intradermal injection of a skin booster containing HA, glutathione, and salmon PDRN. This treatment was administered in two sessions with a four-week interval. The results of the corneometry examination showed an increase in hydration (right increase 1.34; left fixed). Additionally, there were improvements in skin brightness observed in both the MASI score (reduced from 7.2 to 6.6) and spectrophotometer measurements (right increase by 3.37; left 2.53). HA works by hydrating the skin through the activation of fibroblasts and stimulation of neocollagenesis. Glutathione can prevent melanin formation by blocking the tyrosinase enzyme and enhancing lighter pigments. PDRN has been shown to reduce melanin production, tyrosinase activity, and certain protein expressions while enhancing specific signaling pathways in melanocytes.
Background: In recent years, there has been a tremendous increase in the number and types of cosmetic or aesthetics procedures, mostly indicated and some are non-indicated and not advised procedures. Objective: To report all side effects and complications of all cosmetic procedures. Methods: This is a case series descriptive study that was carried out during the period from 2014-2025, where all cases with cosmetic procedures that developed effects and complications were recorded, and full clinical assessments were performed. Results: Fifty-five patients with different cosmetic complications were enrolled in the study. The following side effects and complications were noticed and as follows: filler problems in 26 (47.2%) patients, 15 (27.3%) patients presented with biofilms, 6 (10.9%) allergic reaction, 3 (5.5%) overcorrection and 2 (3.6%) cases with gangrene. Fourteen female (25.5%) patients with tattooing sarcoidosis were included. Pigmentation and scarring following facial Laser hair reduction were seen in 7 (12.7%) patients. Botulinum A toxin side effects were reported in 3 (5.5%) cases, including left asymmetry of lips and eyelids, allergic reactions, and pigmentation. Three (5.5%) male patients had scalp gangrene that followed a hair transplant. Conclusion: Many complications and side effects were observed in different patients, predominantly among females. Grave complications included gangrene, biofilm formation, and tattoo-induced sarcoidosis. Many of these complications could be avoided and prevented using the appropriate injecting materials and most importantly, by selecting the right procedures.
Complications of aesthetic liposuction and evidence-based risk-reduction strategies: A systematic review
Liposuction is considered one of the most frequently performed aesthetic procedures around the globe. The reason behind it is that it is safe but contains some complications like infection, seroma, hematoma, contour deformities, and venous thromboembolism continue to occur, particularly in high-volume procedures or combined surgeries. However, for improving patient outcomes, there is a need for detailed assessment of complication patterns with evidence-based risk reduction strategies. The objective of the study is to systematically review all complications linked with aesthetic liposuction and summarize evidence-based and validated strategies that minimize perioperative risks. A systematic search of MEDILINE, Cochrane CENTRAL, Embase, Web of Science, and Scopus was conducted from inception to the search date. The required eligible studies included undergoing aesthetic liposuction, preventive strategies or reporting complications. Moreover, two reviewers independently screened, assessed risk, and extracted data of bias using the Newcastle-Ottawa Scale and ROBINS-L Data were synthesized proportionally and narratively. Key findings are that complication rates were changed substantially by volume, patient factors, techniques used, and whether liposuction was combined with other procedures. From them, infection, seroma, hematoma and contour irregularities were highly common. Also, thromboembolic events are extremely rare but considered clinically significant. Strong evidence is required to support optimized tumescent techniques, early mobilization, careful patient selection, and risk stratified VTE prophylaxis. Our conclusion is that most of the liposuction complications are preventable by meticulous surgical techniques, structured risk-reduction protocols, and perioperative optimization. However, a standardized safety framework can easily minimize variability in outcomes and enhance patient safety.
Background: Auricular keloids are not uncommon skin problem that is observed among young females following ear piercing. They can occur in earlobes as well as in the skin and cartilage higher on the ear. Different types of therapy are available, but are often followed by relapse. Objective: To assess the efficacy and safety of the intralesional injection of combination of steroid and methotrexate, followed by shaving. Methods: All patients gave a history of ear piercing that was followed by the appearance of keloid. Full data from the participants regarding the demographic and clinical characteristics were described. After intralesional injection of keloid with combination of triamcinolone (20 mg in 0.5ml) and (10 mg in one ml) methotrexate, shaving of the lesion with a scalpel and a simple diathermy needle was performed. Then patients were followed after 3-4 weeks, and the combination injection was also done again. Follow-up was carried on regular basis for one year. Results: Nine females were treated by this new therapeutic regime; their ages ranged from 18 to 33 years, with a mean of 27 years. Seven patients had a single keloid on one side, while two patients had a single lesion on both ears. All patients had complete clearance of keloids without complications, like infection or new keloid formation. No relapses were recorded within a one-year follow-up period. Conclusion: This novel modality shows excellent cosmetic appearance with no recurrence during a one-year follow-up.
Precision supraperiosteal microdroplet cannula technique (Shash technique) for tear trough filling
Background: Tear trough deformity produces a fatigued appearance due to shadowing along the nasojugal groove. Hyaluronic acid fillers are widely used for correction; however, complications such as Tyndall effect, edema, contour irregularities, and filler migration remain important concerns. Objective: To evaluate the safety and effectiveness of a precision supraperiosteal microdroplet cannula technique for tear trough correction. Methods: A case series of 20 patients aged 20–50 years presenting with tear trough deformity was conducted over a period of one year. Hyaluronic acid filler was injected using a 25G, 50‑mm blunt cannula via a single entry point over the zygomatic bone. Microdroplets of approximately 0.05 mL were deposited in the supraperiosteal plane along the nasojugal groove. Outcomes were assessed by immediate clinical improvement, standardized photographic documentation, and patient satisfaction measured using a 10‑point Likert scale. Final evaluation was performed at two weeks. Complications including Tyndall effect, prolonged swelling, and nodularity were recorded. Results: All patients demonstrated visible improvement immediately after treatment. Maximum aesthetic correction was observed at the two‑week follow‑up. The mean satisfaction score was 8.25 ± 0.97 (range 6–10) with a 95% confidence interval of 7.83–8.67. No cases of Tyndall effect or prolonged edema occurred. Two patients developed small nodules which resolved after hyaluronidase injection. Conclusion: The supraperiosteal precision microdroplet cannula technique appears to be a safe and effective method for tear trough rejuvenation with high patient satisfaction and minimal complications.
Exosomes: Myth or reality? Efficacy and safety of exosomes versus platelet rich plasma in patients of androgenetic alopecia
Background: Androgenetic alopecia (AGA) is terminal hair loss from scalp after puberty. Currently, FDA approved treatments topical minoxidil and oral finasteride are not favourable by patients due to their adverse effects. Platelet rich plasma (PRP) is a commonly used effective therapy. Exosomes is another emerging treatment modality, showing promising results in patients of AGA. Objective: To compare the efficacy and safety of PRP and Exosomes in patients of androgenic alopecia areata. Methods: This interventional study was conducted on AGA patients for one year. Patients were divided in two groups. Group A patients received injections exosomes whereas group B received PRP intradermally in scalp respectively, two sessions in exosomes group and 4 sessions in PRP group. In both groups patients were followed six months after the last procedure. The efficacy was assessed using trichoscopy, photographs, physician global assessment score and patient global assessment score. Results: Among total 30 patients, mean age of patients was 37 years and 80% were males. At the end of 6 months, mean hair density, physician and patient global assessments showed significant improvement from baselines (p value < 0.05), more in Exosomes group as compared to PRP group. No significant adverse effect was observed in any patient. Conclusion: It is concluded from this study that the Exosomes have better efficacy and comparable safety than PRP in AGA.
Radiofrequency microneedling challenged by warnings and defended by competent practice
Subcision Combined with Platelet-Rich Plasma Versus Subcision Combined with Autologous Biofiller for Atrophic Acne Scars
Abstract Background: Atrophic acne scars significantly impair psychosocial well-being and quality of life (1). Subcision is a well-established technique for releasing fibrotic dermal tethering (4). Platelet-rich plasma (PRP) enhances collagen synthesis through growth factor-mediated pathways (5). Autologous plasma biofiller provides additional structural volumization while maintaining autologous safety (14). This randomized prospective clinical study done at QMC Multan compares subcision combined with PRP versus subcision combined with autologous biofiller. Methods: Fifty-six patients (56) were randomized into two equal groups (n=28 each). Outcomes were assessed using Goodman & Baron qualitative grading system (1) and patient satisfaction scores. Results: Mean improvement was 57.8±12.4% in PRP group and 71.9±10.6% in biofiller group (p=0.0008). Conclusion: Subcision combined with autologous biofiller provides superior and sustained clinical improvement.
Clinical evaluation of the efficacy and safety of double needle thread lift for facial rejuvenation
Background: The double needle thread lift is a minimally invasive cosmetic procedure designed to enhance facial contours and promote skin tightening. Despite its increasing popularity, comprehensive clinical data evaluating its efficacy and safety are limited. Objective: To assess the clinical outcomes and safety profile of the double needle thread lift in patients seeking non-surgical facial rejuvenation. Methods: This study involved 50 participants aged 30-50 years with mild to moderate skin laxity. Each participant underwent a double needle thread lift procedure. Outcomes were evaluated at baseline, and at 1, 3, and 6 months post-procedure. Primary endpoints included patient satisfaction, physician-assessed improvement using the Global Aesthetic Improvement Scale (GAIS), and objective skin tightening measured via digital imaging. Secondary endpoints included adverse events and pain assessment using a Visual Analog Scale (VAS). Results: At 6 months post-procedure, 85% of participants reported high satisfaction with the aesthetic outcomes. GAIS scores indicated significant improvement in facial contours and skin tightness in 78% of cases. Digital imaging showed a mean reduction in skin laxity of 25%. Adverse events were mild and transient, including swelling (60%), bruising (50%), and mild discomfort (30%). No severe complications were reported. Conclusion: The double needle thread lift is an effective and safe option for patients seeking non-surgical facial rejuvenation, with high satisfaction rates and a favorable safety profile. Further long-term studies are warranted to confirm these findings and optimize procedural techniques.
Hyaluronic acid skin boosters in aesthetic medicine: A comparative review of RRS Hyalift 75 syringe, Jalupro SuperHydro, Profhilo, and Monalisa skin in the Egyptian market
Hyaluronic acid (HA) skin boosters have become integral to modern aesthetic medicine as demand grows for minimally invasive, regenerative, and natural looking rejuvenation therapies. This review examines four widely utilized HA based products available in the Egyptian market; RRS Hyalift 75 syringe, Jalupro SuperHydro, Profhilo, and Monalisa Skin, focusing on their biochemical properties, mechanisms of action, clinical evidence, injection protocols, safety, and therapeutic indications. By comparing their composition, rheological characteristics, biostimulatory potential, and longevity, the article provides a clinically relevant guide to optimizing brand specific selection in aesthetic practice. Despite variations in formulation, all reviewed products demonstrate strong safety profiles and efficacy in improving hydration, elasticity, and dermal quality. Continued comparative research, especially head to head trials, is needed to standardize treatment pathways and expand their therapeutic applications.
The secret beauty of the beard: Between the insight of God and the insight of a dermatologist
Double rhomboid skin flap in near basal cell carcinoma
The rhombic flap is a local geometric transposition flap and offers significant versatility in reconstructive surgery. This flap is most often used to fill skin cancer defects in the head and neck area. Basal cell carcinoma (BCC) is the most common cancer in humans. For many subtypes of BCC, the gold standard treatment is surgical excision. For low aggressive BCC, alternative treatments such as cryosurgery, curettage and cryosurgery, photodynamic therapy (PDT) and topical Imiquimod can be used. A case of BCC with adjacent lesions was reported and was treated by surgical excision using a modified double rhomboid flap technique.
Multimodal aesthetic dermatological treatment of a nasal laceration managed without sutures: A case report
Facial lacerations are typically managed with primary suturing to achieve optimal cosmetic outcomes. However, when patient refuse surgical closure it may necessitate alternative approaches. We report a case of nasal laceration managed conservatively using topical adhesive, followed by multimodal dermatological interventions to optimize long-term cosmetic results. A young male presented with a fresh lacerated wound on the nose following a roadside accident. The patient electively refused surgical closure. The wound was initially approximated using topical skin adhesive after achieving hemostasis. Early outcome was suboptimal, with poor cosmetic satisfaction at one week. Subsequently, the patient underwent a staged dermatological rehabilitation plan including fractional CO₂ laser resurfacing, Q-switched laser sessions for post-traumatic pigmentation and microneedling. Over a 4-month follow-up period, the patient demonstrated marked improvement in scar texture, pigmentation, and overall cosmesis, exceeding initial expectations. This case underscores the potential of multimodal dermatological therapies in enhancing cosmetic outcomes of traumatic facial wounds, especially when surgical closure is not an option. It highlights the evolving role of dermatologists in post-trauma scar modulation and aesthetic rehabilitation.
Copyright (c) 2025 Pakistan Journal of Medical and Surgical Aesthetics https://creativecommons.org/licenses/by/4.0
Regenerative aesthetics: The role of stem cells and growth factors in skin rejuvenation
Regenerative aesthetics is an emerging paradigm that prioritizes tissue repair and biological rejuvenation over temporary correction of age-related change.1 Stem-cell-based approaches, especially adipose-derived mesenchymal stem cells (ADSCs), can stimulate fibroblast activity, enhance collagen synthesis and support angiogenesis, contributing to improved dermal quality and scar remodeling.2,3 In parallel, growth-factor strategies, e.g. fibroblast or MSC-derived growth-factor formulations and platelet-rich plasma (PRP) have shown clinically meaningful improvements in photoaging and acne scars, particularly when paired with procedures like microneedling or lasers.4,5 Early human data also suggest that topical platelet-derived exosomes can reduce cellular senescence markers and up-regulate extracellular-matrix pathways in aged skin.6 However, translation is limited by variability in preparation protocols, lack of standardization and evolving regulatory guidance for human cell/tissue-based products and exosome-containing products.7,8 This review summarizes current evidence for stem cells, PRP/ growth factors and exosomes in aesthetic practice and highlights future directions for standardized, evidence-based use.9
Non-scarring diffuse hair loss in females (18-45 years) of age
Objective: To evaluate the etiology and severity of diffuse non-scarring hair loss in Iraqi females of the reproductive age. Methods: The study is a prospective observational study conducted at the Dermatology Center, Medical City Teaching Hospital, Baghdad, Iraq from March 2021 to September 2022 on a convenient sample of 100 female patients 18-45 years of age who presented with non-scarring diffuse hair loss, decrease in hair density or both for at least 1 year. Full history, general and local scalp examination, hair pulling test, 24 hour hair count, hair density count, Dermatology Life Quality Index and relevant blood investigations were done for all patients. Results: The highest proportion of study patients were in the age < 25 years (46%). Regarding hair pull test, it ranged from 3-20 hairs with a mean of 5.7 hairs and 24 hours hair count shed ranged from 21-700 hairs with a mean of 157.22 hairs/24 hours, hair density in the vertex was 80.47±19.05 hair/cm2, left temporal area 82.23±18.85 hair/cm2 and right temporal area 83.19±18.8 hair/cm2. By investigations Hemoglobin was < 12 G/dl in 45% and serum ferritin was <40µG/l in 54% of patients. Conclusion: The most common diagnosis for hair loss in females of 18-45 years of age was telogen effluvium followed by androgenetic alopecia. Young females (less than 25 years) constituted the majority. Detailed history, general examination, local scalp examinations and investigations are important in diagnosing, evaluating and finding the etiology of diffuse non-scarring alopecia in young females.
Knowledge, perception and attitude towards aesthetic medicine among medical residents in Pakistan: A cross-sectional study
Aesthetic medicine is a rapidly expanding specialty that blends clinical science with artistry, and patient centered care. While the Global demand for minimally invasive procedures is rising, its integration into medical education and structured training remains limited in many developing countries, including Pakistan. Objective: To explore the knowledge, perception, and attitude of medical residents in Pakistan regarding aesthetic medicine, including its training requirements, and role in clinical practice. Methods: A descriptive cross-sectional survey was conducted among 89 medical residents from public and private hospitals in Pakistan using a structured questionnaire assessing demographics, prior exposure, knowledge, perception, and attitude toward aesthetic medicine. Data was analyzed using descriptive statistics. Results: The mean age of participants was 30 years; 43% were male and 57% female. Only 11% had attended a private course or workshop in aesthetic medicine. While 94% correctly identified botulinum toxin, fillers, and lasers as central to the field, 16% expressed uncertainty about its evidence base. A majority (62%) supported recognition of aesthetic medicine as a separate specialty with more than 83% agreed that aesthetic procedures improve psychological well-being.3,6 Patient inquiries about cosmetic procedures were reported by 69% of residents, and 60% acknowledged cultural influences on patient preferences. Despite positive perceptions, 74% had never performed an aesthetic procedure. Conclusion: Medical residents in Pakistan show strong interest and favorable perception towards aesthetic medicine, but exposure and structured training remain limited. Formal integration of aesthetic medicine as a distinct specialty could help bridge knowledge gaps and prepare physicians to meet growing patient demand.
Q-TIER: A structured, anatomy-guided framework for advanced facial profiling with fillers
Hyaluronic acid (HA) fillers dominate non-surgical facial rejuvenation, yet outcomes hinge on precise plane selection, product rheology, and injection strategy. The TIER framework (Face profiling framework based on inverted triangle of beauty) systematically sequences treatment from the upper to lower face: top foundation (forehead and temples), infraorbital core (under-eyes and cheeks), essential midface (nasolabial and piriform), and refining apex (chin and jawline). Here, we synthesize literature from 2019-2024 to defend TIER’s anatomical logic, safety, and efficacy, illustrating how its inverted-triangle lens aligns with facial thirds and optimizes aesthetic harmony.
Dermabrasion of acne scarring using continuous fractional carbon dioxide laser versus heat dermabrasion using diathermy needle in patients with dark complexion
Objective: The objective of the study is to compare the efficacy and safety of fractional CO2 laser compared with heat dermabrasion using diathermy needle in the treatment of different types of acne scars. Methods: One hundred and forty patients with different types of acne scars were divided into two groups: Group A (CO2 laser): Forty patients, 30 (75%) females and 10 (25%) males were treated with one session of CO2 dermabrasion using continuous fractional CO2 laser. Group B (heat dermabrasion): One hundred patients, 60 (60%) females and 40 (40%) males were treated with one session of heat dermabrasion using diathermy needle. Scoring was done during follow-up period to assess the reduction in the scars. Results: Group A (CO2) laser: Severity of scars: mild in 10 (25%) cases, moderate in 20 (50%), and severe in 10 (25%). Reduction rate: 4 weeks post CO2 laser session; the reduction was moderate (5%), marked (90%) and excellent (5%). Group B (heat dermabrasion): Severity of scars: mild in 23 (23%) patients, moderate in 49 (49%), and severe in 28 (28%). Reduction rate: 4 weeks post heat dermabrasion session, the reduction rates were moderate (5%), marked (52%) and excellent (43%). Conclusion: Overall, while both heat dermabrasion and CO2 laser are effective in reducing scar severity, single session of heat dermabrasion may offer superior outcomes in terms of achieving higher levels of scar reduction with minimal side effects.
Clinical Evaluation of Mesenchymal Stem Cell-Derived Exosome Therapy Combined with PRP for Skin Rejuvenation: A Prospective Study
Background: Exosomes derived from mesenchymal stem cells (MSCs) are gaining prominence in regenerative dermatology due to their ability to mediate intercellular communication and stimulate tissue repair. When combined with platelet-rich plasma (PRP), they may enhance dermal remodeling and skin rejuvenation. Objective: To evaluate the efficacy of MSC-derived exosomes combined with PRP in improving skin texture, pigmentation, and acne scars in adult female patients. Methods: Fourteen female patients (aged 21–46 years) received four sessions of intradermal injection of 2.5 billion exosomes every six weeks using a Hydrapen device. PRP was administered at the 3-week midpoint between exosome treatments. Exosomes were enriched with growth factors, cytokines, nucleic acids, and structural proteins. Post-care included avoidance of washing for 3 hours, no cosmetics for 48 hours, delayed sunscreen use, and icing after 2 hours. Results: Marked improvements were observed in skin texture, tone, pore size, pigmentation, and radiance. Three of four patients with acne scarring experienced near-complete resolution. No adverse events were reported. Conclusion: MSC-derived exosome therapy, when combined with PRP and microneedling, demonstrates significant potential in non-invasive skin rejuvenation with high patient satisfaction and safety. However, larger controlled studies are necessary to confirm findings.
A systematic review of the efficacy of chemical peeling in active acne and acne scars
Chemical peeling is a widely used dermatological procedure for managing acne and acne scars. This article evaluates existing studies on the efficacy and safety of chemical peels in treating active acne and post-acne scarring. A systematic search was conducted on PubMed and other databases for clinical trials from 2000 to 2025 using the keywords “chemical peels, acne, acne scars.” A total of 18 studies were identified, out of which 10 prospective clinical trials were included. Studies involving animal models or other facial dermatoses and those without prospective clinical trials were excluded. The results of the reviewed studies suggest that chemical peels are a safe and effective treatment option for acne and post-acne scars. Different types of peels, including glycolic acid, salicylic-mandelic acid, Jessner’s solution, lactic acid, and trichloroacetic acid, have demonstrated varying degrees of success in reducing active acne, post-inflammatory hyperpigmentation, and superficial scarring. Combination therapies and higher-concentration peels show promise for deeper scars, though they require careful application to minimize adverse effects such as erythema and post-inflammatory hyperpigmentation.
Techniques of using botulinum toxin for forehead wrinkles: A narrative review
The use of botulinum toxin extracted from bacteria Clostridium Botulinum for obliteration of forehead wrinkles has proven to be exceptionally efficient. Injection techniques are based on muscle groups targeted with minimal adverse effects when executed by a professional. Outcome is determined by a grading scale and differs based on the type of wrinkles. It is judged on day 1-4 post injection and peak effects are noticed around 1-4 weeks. It was seen that wrinkle reduction was dependent on dilution criteria and dose of the toxin. Bruising and hematoma formation are common local complications. Adverse effects are seen with concomitant use of other medications like Aminoglycosides, muscle relaxants and Anticholinergic drugs.
Copyright (c) 2025 Nabeela Shahzadi, Saumara Atif, Ammara Arshad (Author) https://creativecommons.org/licenses/by/4.0
Audit of 75 patients of hirsutism treated with Intense Pulse Light (IPL) in Dermatology Department, Mayo Hospital Lahore
Objective: Hirsutism is a common issue in dermatology affecting 5- 10% of females during their reproductive years and is characterised by excessive terminal hair in male pattern. It causes significant psychological and emotional stress in females. The objective of the study is to evaluate the percentage of patients achieving satisfactory outcomes and to determine incidence of side effects. Methods: This clinical audit was done at dermatology unit II Mayo Hospital, Lahore over a period of 3 months, on 75 patients of hirsutism, all treated with intense pulse light (IPL). Data of 75 patients was retrospectively analyzed. Variables extracted including age, association with Poly Cystic Ovarian syndrome (PCOs), number of sessions done and power range. Results: The study population had a mean age of 28.48±8.09 years with a wide range spanning from 16 to 64 years. After evaluation it was noticed that 58.67% (n=44) of patients experienced a satisfactory response to intense pulse light and the majority of patients reported no side effects (n=64). Conclusion: This audit revealed that IPL appears to be a safe and effective treatment option for hirsutism with a significant proportion achieving satisfactory outcomes.
Copyright (c) 2025 Madiha Sanai, Zunaira Arshad, Asma Shakir, Wajeeha Nusrat, Mahwish Zahoor, Muhammad Tariq (Author) https://creativecommons.org/licenses/by/4.0
Ultrasound devices powered by artificial intelligence: The future of aesthetic dermatology
A heavy price for a hollow fix: Complications of under-eye fillers
This case report discusses a 35-year-old female patient who presented with complications following the administration of dermal fillers in the under-eye region. The patient received the fillers from an aesthetic clinic, leading to swelling, unevenness, and Tyndall effect. It was decided to dissolve the filler using hyaluronidase, and the patient's subsequent response to the treatment is documented.
Copyright (c) 2025 Aisha Ghias, Wajeeha Nusrat, Zunaira Arshad (Author) https://creativecommons.org/licenses/by/4.0
Efficay of 308-mm Excimer Laser in patients with alopecia areata
Objective: Alopecia areata (AA) is characterized by patchy non-scarring hair loss involving the scalp and other hair-bearing surfaces. This study aims to determine the effectiveness of 308-nm Excimer laser in patients with alopecia areata. Methods: A total of 168 patients with alopecia areata (within 12 months) were included in the study in a consecutive manner and subjected to 308-nm Excimer laser. Baseline and follow up Severity of Alopecia Tool (SALT) scoring was done to determine the effectiveness of the therapy. Results: The mean baseline SALT score was 26.4±13.3 which increased to 75.6±12.7 (p <0.001). The mean difference between baseline and follow up SALT score was 49.2±12.7. According to categories of difference between baseline and follow up SALT scoring, 41.7% were in fair category (11-50) and 58.3% were in excellent category (SALT 51-74). Effectiveness (minimum 50 improvements in SALT from baseline) was recorded in 58.3% of patients. Erythema was the only side-effect noted in our study. Conclusion: 308-nm Excimer laser is effective in the treatment of alopecia areata and is significantly associated with improvement in baseline SALT score.
Copyright (c) 2025 Irfan Ullah Afridi, Mehran Khan, Sehrish, Mah Rukh, Sarbjeet Singh (Author) https://creativecommons.org/licenses/by/4.0
Facial ultrasound in aesthetic dermatology: A revolutionary approach
Aesthetic dermatology has seen tremendous advancements over the last few decades, with innovations aimed at improving patient outcome and safety. One such groundbreaking technology is facial ultrasound, which has transformed the way aesthetic procedures are performed. In 1979 ultrasound was introduced in dermatology clinical parctice and much later in aesthetic dermatology.1 Traditionally used in medical imaging, ultrasound is now an indispensable tool in aesthetic dermatology, offering real-time visualization of the skin layers, fat compartments, and vascular structures. This article explores the role, benefits, applications, and future prospects of facial ultrasound in aesthetic dermatology
Copyright (c) 2025 Shehla Shaukat, Zahida Rani (Author) https://creativecommons.org/licenses/by/4.0
Plant exosomes products in the Egyptian market: Innovation, regulatory gaps, and scientific controversy
Plant derived extracellular vesicles (PDEVs), often marketed as plant based exosomes, have gained attention in regenerative medicine and aesthetic dermatology due to their biocompatibility and bioactive cargo. This narrative review critically examines commercially available PDEV based products in the Egyptian market, focusing on their reported composition, proposed mechanisms of action, regulatory status, and current clinical evidence. Products including V-Tech Serum® (Promoitalia, Italy), Rx Elysee Exosome PDRN Ampoule® (Dermafirm, South Korea), Glow Exosome® (Louisderma, France), and ExoLure VISAGE® (Hyalure, Italy) are discussed. Available data suggest potential roles in skin rejuvenation, wound healing, and hair restoration; however, product specific clinical evidence remains limited. Significant gaps persist regarding standardized manufacturing methods, transparency of bioactive components, and regulatory oversight. Future well designed clinical trials and standardized characterization protocols are essential to validate safety, efficacy, and reproducibility of PDEV based therapies in aesthetic and therapeutic dermatology.
Polynucleotide injectables in aesthetic medicine: A review of mechanisms, clinical uses, and comparative products with insights from the Egyptian market
Polynucleotides (PNs), derived primarily from purified trout or salmon DNA, have recently emerged as injectable biostimulatory agents in regenerative and aesthetic medicine. By enhancing hydration, stimulating fibroblast proliferation, modulating inflammation, and promoting collagen synthesis, PNs support tissue repair and skin rejuvenation. Several formulations including; Rejuran®, Nucleospire®, PhilArt®, and Plenhyage XL® have been introduced, each differing in composition, clinical applications, and market presence. This review provides a comparative overview of these products, emphasizing their mechanisms of action, clinical indications, regulatory status, and safety profiles. Beyond their use in dermatology and aesthetics, PN-based injectables show promise in dentistry, ophthalmology, and orthopedics, highlighting their expanding role in regenerative therapies. While accumulating evidence supports their efficacy, gaps remain in standardization, comparative clinical trials, and long-term safety evaluation.