Background: Various botulinumtoxinA formulations are approved for glabellar lines treatment worldwide, including abobotulinumtoxinA (Dysport^®). Objectives: Assess abobotulinumtoxinA superiority versus placebo and non-inferiority versus active comparator (onabotulinumtoxinA; Botox^®), for the treatment of Chinese patients with moderate/severe glabellar lines. Methods: Phase 3, randomized study (NCT02450526) comprising a double-blind (cycle 1) phase and an open-label (cycles 2−5) phase. Patients received abobotulinumtoxinA 50 units or matching placebo (5:1), active comparator (onabotulinumtoxinA 20 units) or matching placebo (5:1). In cycles 2–5, eligible patients were retreated with abobotulinumtoxinA only. Responders had glabellar lines of none/mild severity. Primary endpoint: responder rates at cycle 1, day 29 at maximum frown with abobotulinumtoxinA versus placebo (for superiority; by investigator’s live assessment [ILA] and subject’s self-assessment [SSA]), and versus active comparator (for non-inferiority; by ILA). Treatment-emergent adverse events were recorded. Results: Overall, 520 patients were randomized. Superiority and non-inferiority, respectively, were demonstrated for abobotulinumtoxinA versus placebo (ILA, SSA; both p < 0.0001) and abobotulinumtoxinA versus active comparator. AbobotulinumtoxinA efficacy was maintained over open-label cycles; median time to onset of efficacy was 2.0 days. After 6 months, 17% of patients treated with abobotulinumtoxinA remained responders. AbobotulinumtoxinA was well-tolerated. Safety results were in line with the known profile of abobotulinumtoxinA; adverse events rate decreased with repeated treatment. Conclusions: After a single injection, abobotulinumtoxinA demonstrated superiority versus placebo and non-inferiority versus onabotulinumtoxinA for the treatment of moderate-to-severe glabellar lines in Chinese patients. Multiple injections of abobotulinumtoxinA demonstrated efficacy and safety in the treatment of glabellar lines in Chinese patients. Level of Evidence I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Background: Injection of cross-linked hyaluronic acid (CLHA) has been traditionally utilized to treat wrinkles and provide volume. Recent studies have also shown that intradermal placement of CLHA provides lasting secondary effects and may be a useful method for improving skin appearance and physiology. Objectives: The aim of this study was to investigate the biostimulatory effects and potential underlying mechanisms induced by repeated intradermal microinjections of small-particle cross-linked hyaluronic acid (SPCLHA) for skin rejuvenation. Methods: Eight patients with photoaged forearm skin underwent three intradermal microinjections of SPCLHA and isotonic sodium chloride (control). At 0, 4, 8, 12, and 24 weeks, biophysical parameters were measured, and skin biopsies were obtained at 12 and 24 weeks for assessment employing histological and immunohistochemical analyses, transmission electron microscope, and real-time fluorescence quantitative polymerase chain reaction. Results: SPCLHA treatments significantly improved skin appearance and physiologic functions starting at 8 weeks. Histologic examination revealed thickening of the epidermis, more red-stained collagen fibers in the dermis, and increased formation of blood vessels in SPCLHA-treated skin. Immunohistochemical evaluation showed increased collagen deposition, proliferation of keratinocytes and fibroblasts, and cutaneous vascularity in SPCLHA-treated skin compared with controls. Fibroblasts appeared morphologically stretched with well-developed rough endoplasmic reticulum. Gene expression concerning various extracellular matrix (ECM) proteins and growth factors was upregulated at 12 weeks and several genes remained upregulated at 24 weeks. Conclusions: Intradermal microinjections of SPCLHA can stimulate production of collagen and other ECM components, restore the structural integrity of dermal microenvironment, and may be considered an effective method for skin rejuvenation. Level of Evidence: 2:

BACKGROUND: The chin is an important component of facial harmony, and deficient chins are associated with unattractiveness. Previous studies have reported microgenia as the most common subtype of chin deformities. OBJECTIVE: To investigate the prevalence and severity of microgenia in a Chinese population through facial anthropometric analysis. METHODS: A total of 800 Han Chinese adults from various age groups of both sexes were recruited for facial anthropometric measurements and photographic analysis. Chin deficiencies in both sagittal and vertical dimensions were evaluated using G-S-P angle, chin retrusion distance, and Sn–Vl/Sn–Me ratio criteria. RESULTS: In the sagittal dimension, microgenia was present in 60.7% of men and 68.6% of women according to the G-S-P angle criterion, and the angle significantly decreased with age in women (p < .05). According to the chin retrusion criterion, microgenia was present in 38.7% of men and 32.3% of women, and the retrusion distance significantly increased with age in both sexes (p < .05). Vertical microgenia was present in 69.6% of men and 81.9% of women according to the Sn–Vl/Sn–Me criterion, and the ratio gradually increased with age in both sexes (p < .05). CONCLUSION: Microgenia is common among Chinese, particularly in women, and the prevalence and severity increase with age.

Mask-wearing behavior, common in the post-COVID-19 era, raises concerns for sensitive skin. This split-face study investigated mask-related changes in skin barrier function and microbiome composition among 30 female volunteers with sensitive skin and assessed the mitigating effects of a moisturizer containing biological lipids and probiotics. Skin physiological indicators (transepidermal water loss, erythema index, stratum corneum hydration, pH, temperature) of masked and unmasked areas were collected at baseline, after three hours of mask-wearing, post-tape stripping, and after 24 h, respectively. Microbiome samples collected from the masked areas before and after wearing a medical mask were analyzed with bioinformatics methods. Mask-wearing significantly weakened barrier function in both masked and adjacent unmasked areas, while reducing bacterial diversity. It was also associated with an increase in Cutibacterium (P = 0.110) and decreases in Streptococcus (P = 0.032) and Prevotella (P = 0.026) abundance. Moisturizer application prior to mask-wearing significantly reduced transepidermal water loss and erythema (both P < 0.001) and further improved erythema after 24 h (P = 0.048). These findings demonstrate that mask-wearing can disrupt the skin barrier and microbiome in individuals with sensitive skin and applying a moisturizer beforehand can mitigate mask-related discomforts by aiding barrier repair and reducing sensitivity.