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Skin Health Clinical Studies

Skin Health Clinical Studies

 

1) Skin needling which may take such forms as CIT (collagen induction therapy) and PCI (Percutaneous Collagen therapy) has wide advantages over the other methods of skin treatments procedures. To start with is the fact that the epidermis is never negatively affected whatsoever as seen in other treatments (peeling and laser resurfacing). This is done through eliminating the possible side effects on the skin. Secondly is that the skin retains its natural and could not be distinguished from a normal one even after the procedure has been done on a patient; if anything, the treated skin showed more papillae content than a normal one. Third the skin becomes thicker with more collagen and elastin metrics which takes place in a period of 1-6 year after the operation. Fourth, there is a scientifically proven proof that this treatment option stimulates the revascularization, regimentation of the stretch marks and the refilling of the cutaneous wrinkles. Fifth, the treatment is safe and recommendable for practically all the dermatological states of a patient. Sixth, the process is generally less expensive the skin resurfacing laser and does not to permanent damaging of the skin. In addition, the process uses easy- to -master equipment which eliminates any possibility of skin-sun-sensitivity and can be used to forestall telangiectasia. Finally, is the fact that the short time taken for the procedure to fully reach threshold as it were is sure to fully heal the ‘acne bug’.

The needling of the skin stimulates the healing mechanisms of the body, a process that happens in three phases; phase 1: the phase is also called the inflammatory phase where the platelets are stimulated releasing the chemotactic material involved in stimulation of other platelets (neutrophils and fibroblasts), phase 2: this is the phase the monocytes comes in in the place of the neutrophils and leads to the releasing of platelets fibroblasts and transforming growth factors. After a day or two the keratinocytes stimulate the deposition of collagen by the fibroblasts. Finally phase 3 is where the remodeling of the tissues actually takes place; this mainly drags on for months and is primarily accomplished by the fibroblasts. Here the type 3 of the collagen fiber is deposited on the upper dermis which is soon after ousted by the type 1 which takes place for a year or more. In conclusion, the matrix metalloproteinase types 1-3 are central in this phase (Acton, 2012).

3) Describe the histological and visual changes noted after the two needling sessions

There are various changes observed here; first off is the fact that the skin remains as natural as before the session. Secondly, the severity of acne is reduced in the patient and there was an overall improvement on the aesthetic value of the patient. Finally, there was no any observable signs of the procedure and hyperpigmentation.

4) What would be the course of action to be taken in the event of a needle stick injury and how can you prevent any potential cross-contamination associated with skin needling?

The affected area should be cleaned thoroughly with ant disinfectants and soap. Secondly, the case should be reported immediately to the manager or the administration of the institution for that matter. Third, the medical practitioner in question should fill in the incident report form making sure to indicate the date and time of the incident, the nature of the injury and the name of the affected patient. Finally, the medical practitioner should ensure that the patient is treated right after the injury.

If any blood gets on the skin of a person other than the patient irrespective of whether or the person has cuts on the skin, the area should be screened for any infections and the necessary follow-up procedures carried out to prevent a cross-contamination. In addition, the affected person should be screened for hep B, C and H.I.V for precautionary purposes.

 

There are various effects associated with the resurfacing laser procedure. To start with is the discovery that the keratinocytes apparently increase the production of the type one keratin which is more of a mucosal activity than it is a fiber production activity. Secondly, there is an increase in the glycosaminoglycan in the spaces between the cells. In addition, there is a shoot up as it were in the epidermal thickness during the first year which greatly nosedives in the next two years of usage where roughly 50 % of the thickness is lost and there is a significant reduction in the stratum granulosum; the upper half of the epidermis appear to be turning pale with the lower half revealing a disorientation of the keratinocytes. Fourth, there is increased count of fibroblasts which by now seems to be producing pink collagen fibrils in the upper epidermis and the papillary dermis. Fifth, there is an improved skin blood circulation which is indicted by the extensive dilation of the blood vessels and the angiogenesis sets in.

2) List the disadvantages of the deeper chemical peeling and discuss why non-physicians should use should only perform very superficial and superficial peels.

There are various disadvantages associated with the deep chemical peeling: Firstly, the process may eventuate in the chronic scarring of the skin which proves to be counterproductive to the sole purpose of the procedure. Secondly, the treatment may result in the infection of the skin especially when the chemicals are used by an amateur. Third, it may lead to the activation of herpes simplex infection which now damages the complexity of the skin. Fourth, there is a significant difference in the treated skin which may cause emotional and physical discomfort as it were. The no-physicians should only perform superficial peeling since it less expensive and has minimal effects on the emotions of the patient. Secondly, such conditions as furrows, folds and scars only respond to superficial peeling. Third, the superficial peeling is not dependent on concentrations, otherwise performing the deep option may have adverse effects on the patients based on the fact that it is done using specific concentrations depending on the patient; as such, due to the fact the non-physicians may not be privy to such concentrations, any attempt in that direction will only serve to jeopardize the skin health of the patient.

3) This article identifies 4 indications for the use of superficial peeling. Briefly describe the effects of superficial peeling on each of these indications.

The first indication is acne (this is not in the order of occurrence though); light peeling is an effective option against acne because it provides a solution for scarring acne and improves on the complexity. Second is the fine wrinkling indication, the light peeling stimulates pigmentary changes which reduces the wrinkles. Third is the simple weathering of the skin, as observed earlier the treatment brings about the deposition of collagen which curbs this indication. Finally, is the poikilodermatous changes which include minimized pores, the superficial peeling enhances the dilation of vessels and angiogenesis which increases the pore count.

The period variation during the treatment procedures largely depend on: the concentration of the chemical; with a strong concentration, the period between treatments will be longer, the type of the chemical also affects the period between treatments whereby the retinoic acid has the shortest periods between the treatments (daily) and finally is the occurrence of a complication mainly due to skin sensitivity where the intervals will be longer than usual.

There are various substances used in the degreasing of the skin, this may include alcohol and acetone among others. There two reasons for the degreasing process: to measure the content of the oil that needs to be removed from the epidermis and to maintain a clean epidermis for easier absorption of the chemicals to be used.

 

6) Why do you think people with fair skin have high sensitivity in some segments of their face?

Some of the factors that cause skin dryness may include, skin dryness, use of topical treatments on a daily basis, extreme exposure to the sun and the hormonal imbalances related to the menstrual cycle. The depth of the skin may be increased by skin stretching, skin rubbing, apply more moist gauze, excessive coating and introducing closer treatment intervals.

The two methods (TCA and the Jessner’s method) differ in a number of ways: first off is the fact that Jessner’s method is only applicable on the face of the patients and not any other part as it were, with TCA the deepening of the skin is achieved by increasing the concentration of the skin and increasing the exposer time while with the Jessner’s method, it is done through rubbing the skin, stretching it and via applying more overcoats, For TCA washing is essential but for the Jessner’s method washing is totally unnecessary though the same sensations are experienced but with the former washing has no such effects as easing the burning sensation common with the procedure. I think that the Jessener’s formula is more effective because its concentration has no effect on the patient, time duration into the treatment are not necessary and the fact that there are fewer chances of mistakes and complication with this formula.

9) Why are Jessner’s peels limited to small areas?

The application of the Jessner’s is only limited to some body parts for two reasons: to rule out the possible toxicity from the poisonous resorcinol and to circumvent the inherent resorcin membrane may clog the pores and restrict the free movement of the body.

 

10) Why would use Jessner’s solution on a patient rather the TCA?

I would use the Jessner’s solution because: the TCA has possible toxicity due to the resorcinol in it, the Jessner’s solution does not require washing, the deepening process is not dependent on concentration which would otherwise not auger especially with type I and II of the skin, the solution also poses no threats to the skin health of a patient and the solution does not require time duration during the applications.

11) Discuss the importance of skin preparation at least two weeks prior to the treatment and list three ingredients suitable for skin preparation.

There are various things that show the importance of skin preparations. First off, is the fact that preparing the skin, degreasing for that matter removes the subcutaneous oil from the skin. Secondly, the preparation introduces a clean skin which makes it easy to absorb the chemicals and expedites the results of the peeling treatment. In addition, preparation also helps the physician know the type skin they are handling for better treatment and attainment of healthy results. Finally, the preparation of the skin helps the therapists know the sensitive parts of the skin at hand and decide on what concentrations to use depending on their finding about the skin type. The three Key ingredients used in the peeling procedure are water alcohol and acetone (Rawlings, 2007).

  • In summary, what is the statistical incidence of complications reported in the survey

five suffered from the complications of light-based hair removal, three suffered from NPO administered microdermabrasion and tattoo removal, one patient suffered from a three-inch round skin abrasion on her right cheek and one patient suffered from a fever of 102.5 F on tattoo removal making the total complications ten incidences.

  • Why do you think there was a high incidence of complications in rosacea patients and discuss why non-physicians should not attempt to diagnose skin diseases?

The high prevalence of the complications is due to the delayed treatments and the misdiagnosis especially by the non-physicians. On-physicians should diagnose skin diseases because: they end giving misdiagnosis, they carry out their operations outside the hospital or authorized where they may not have the necessary equipment to use, they are so bogus in their operations that even the traditionally simple medical procedures ate being the cause of hypopigmentation, scars and permanent burns.

  • From the patient complications outlined in the table 1, how do you think the NPO contributed to these complications?

The NPOs contributed to the said complications due to: carrying out the treatment formulae based on a misdiagnosis, some may not be having the wherewithal to use the medical machinery( the laser machines )and thereby end up exposing undue radiations to the patients which grossly affects them, some with respect to the nurses had barely had the training to offer such treatment and therefore offered the treatment based on meagre knowledge on the same and finally some conducted the procedures to earn money at the expense of the patients safety this evidenced by the complications caused by the product sellers.

  • How do you think this NPOs could have responded to their complications?

The NPOs would have responded to the complications by referring the affected patients to the professional practioners and desist from conducting such treatment in the future, the salon owners would have employed the professional therapist to forestall such avoidable complications and carrying out the treatment, if they must, in the supervision of a therapist.

  • How is the cosmetic medicine portrayed by media in this article?

The article portrays the cosmetic medicine as unscrupulous where that any tom dick and harry could practice it intent on earning and paying minimal concern for the safety of the patients. In addition, the article also portrays this field as the one full of impunity where rogue practioners perform the treatment, causing complications on the patients and going scot free. Moreover, the field is painted as unreliable and as irresponsible where we see patients go to enlist help only to go down with serious complications. Additionally, we also that the field has also been projected as the one having no legal requirements which opens the floodgates to the NPOs.

  • How can the NPOs establish more credibility within the cosmetic medical profession?

They should perform the procedure in the presence of medical technicians. They should also employ the trained therapists. Furthermore, they should undergo the relevant training in order to provide safe treatments. Performing such procedures in registered health institutions will also increase the credibility of their practice.

  • Please discuss your experiences of the NPO. For example, have you had any patients requesting treatment of adverse reactions due to inappropriate treatment with other providers.
    I have had many such cases of the NPOs in my in-tray. One example is about a lady whose intention was to increase the smoothness of her facial complexion only to end up having a disfigured face. The cream used- Lecithin was mismatched with wrong skin type and as such ended up backfiring. Based on my research the patient’s skin type was type IV which does not respond to the used cream but only responds positively to the dermalogica cream. I thereby followed up with the right treatments and saved the hapless patient (Berlin, 2012).

1) Fill in the table below.

 

Grade Characteristics Treatment
I Appearance of blackheads Using product with salicylic acid and steaming
II Presence of papules and pustules Applying the topical treatments
III Acne scarring Application of topical treatments and oral antibiotics
IV Cysts and nodules Injection of Corticosteroids directly into the cysts and nodules

 

2) What do you think the e confounding variable is within this study and how do you think it may affect the study’s result?

The confounding variable is the patient who never got cured of their acne III condition, this would affect the result since anyone reading such results may question the efficacy of the treatment modality used.

3) What was the protocol used for the MDA treatment?

The protocol used was that the candidates for the treatment were aged between 6-19 years and were under the dermatological care at the time of the treatment. In addition, it was ensured that they all received oral treatment; those who were pregnant by then and those who had been on isotretinoin were excluded from the treatment. In intervals of 7-1o days the treatment was performed to each candidate. Lastly the post treatment photographs were taken two weeks after the treatment.

4) What results were obtained after the MDA session?

The results were, twenty-seven patients completed the treatment and one patient was withdrawn from the study after having completed four rounds of the treatment to start the isotretinoin treatment. The results on the success of the treatment were as follows: 38% of the patients obtained excellent outcomes, 34% achieved good outcomes, 17% had average results and 12 % had negative results (Murad, 2011).

5) How would you advise a patient on the efficacy of MDA treatment based on this study?

The MDA treatment us effective is seen that 92 % of the patients reported positive changes on their skin and 96 % of them would even recommend the treatment to others.

 

References

David J Goldberg, Alexander Berlin (2012). Acne and Rosacea: Epidemiology, Diagnosis and Treatment. CRC Press, Pg. 77.

Guy F. Webster, Anthony V. Rawlings (2007). Acne and Its Therapy. CRC Press.

Murad Alam (2011). Evidence-Based Procedural Dermatology. Springer Science & Business Media.

  1. Ashton Acton (2012). Issues in Dermatology and Cosmetic Medicine: 2011 Edition. Scholarly Editions.