Introduction Combined platelet-rich plasma and hyaluronic acid (PRP-HA) offers a promising nonsurgical technique for tissue regeneration through synergistic efficacy and longevity effects. This study aims to investigate PRP-HA’s efficacy and safety for neck rejuvenation. Methods This 32-week prospective trial enrolled 30 Thai participants with mild-to-moderate neck aging. Treatment consisted of three monthly intradermal PRP-HA injections to the anterior neck surface, with follow-ups at 2 weeks, and 1, 2, 3, and 6 months posttreatment completion. Assessment included skin firmness, elasticity, biometric parameters, pain scores, and adverse effects. Results Of 29 completing participants, neck skin firmness improved 54% from baseline at 3-month posttreatment completion, increasing to 65% at 6 months (p < 0.0001). While gross elasticity initially improved at 1 month posttreatment (p = 0.0217); it subsequently declined. The 6-month follow-up showed substantial reductions in melanin and erythema (p < 0.01). Sustained improvements were observed in hydration through study completion (p < 0.01). Sebum levels decreased significantly after the first two treatments and at 3 months posttreatment (p < 0.05). No significant changes appeared in skin texture, wrinkles, and brightness. Most participants reported 51–75% improvement after the third treatment, maintaining through 6 months. No severe adverse effects were reported. Conclusions PRP-HA demonstrates safe and effective improvements in neck skin firmness, hydration, and pigment and sebum regulation, with benefits lasting 6 months after three treatment sessions. However, variable effects on elasticity and modest results on wrinkles, texture, and brightness warrant further controlled trials to further elucidate and confirm its rejuvenative properties on the neck. Trial Registration This trial is registered under the Thai Clinical Trials Registry (TCTR20230212003).

Background: Melasma is an acquired hyperpigmentation disorder with multifactorial etiologies and limited response to conventional therapies. Recent evidence suggests that Botulinum Toxin A (BoNT-A) may modulate ultraviolet (UV)-induced pigmentation and offer therapeutic benefits. Objective: We sought to evaluate the efficacy and safety of two intradermal dilutions of Letibotulinum toxin A (LetiBoNT-A) in Thai patients with melasma. Methods: In this randomized, double-blind, split-face study, 30 participants aged 32–62 years received a single intradermal injection of LetiBoNT-A, with 20 units administered per cheek. A 1:5 dilution was injected on one side of the face, and a 1:10 dilution was injected on the contralateral side. Outcomes were evaluated over a 6-month period using the Hemi-modified Melasma Area and Severity Index (Hemi-mMASI), VISIA^® brown spot analysis, and quantitative assessments of skin texture. Results: Both dilutions significantly improved Hemi-mMASI scores (1:5, p = 0.043; 1:10, p = 0.002) and brown spots (1:5, p = 0.002; 1:10, p < 0.001). The 1:10 dilution showed earlier and more sustained improvements. Subgroup analysis revealed greater reductions in Hemi-mMASI scores among patients with telangiectatic melasma, particularly with the 1:10 dilution, though they were not statistically significant. Additionally, the 1:10 dilution significantly reduced pore volume, pore area, and sebum levels. One case of transient facial asymmetry was reported with the 1:5 dilution. Conclusions: LetiBoNT-A is a safe and effective adjunct in melasma treatment. The 1:10 dilution offered superior clinical outcomes.

Photoaging is a multifactorial process characterized by progressive degradation of dermal collagen, reduced skin elasticity, textural irregularities, and uneven skin tone. Dihydromyricetin (DHM), a naturally occurring flavonoid, possesses antioxidant and anti-inflammatory properties that may be beneficial for skin rejuvenation. However, clinical data on the topical application of DHM in humans remain limited. To evaluate the efficacy and safety of a topical dihydromyricetin-containing serum for facial and neck rejuvenation in individuals with photoaged skin. This prospective, single-arm clinical study enrolled 30 participants aged 30–45 years with Fitzpatrick skin types III–V and moderate to severe photoaging. Participants applied a DHM-containing serum to the face and neck twice daily for 8 weeks, followed by a 4-week post-treatment observation period. Clinical assessments were performed at baseline and at weeks 4, 8, and 12 using objective bioengineering instruments, including Cutometer ^® for skin elasticity, Colorimeter ^® for skin radiance (individual typology angle, ITA), Antera 3D ^® for skin texture, pore characteristics, and redness; and VISIA ^® UV spots. Safety and tolerability were also monitored throughout the study. Significant improvements in skin elasticity parameters (R0, R3, and R8) over the face and neck were observed at week 8 and were maintained at week 12 (all p < 0.05). Skin radiance, as measured by ITA, showed a significant increase at week 8 with sustained improvement during follow-up. Antera 3D ^® analysis demonstrated significant reductions in infraorbital skin roughness, pore area, and redness. No serious adverse events were reported. Mild, transient dryness or irritation was noted in a small number of participants and resolved without intervention. The topical application of a dihydromyricetin-containing serum was safe and associated with clinically meaningful improvements in skin elasticity, texture, and radiance in photoaged facial and neck skin. These findings support the potential role of DHM as a topical antioxidant for cosmetic skin rejuvenation, particularly in Asian skin types.

To evaluate the efficacy of intralesional human papillomavirus (HPV) vaccination in the management of cutaneous warts. A comprehensive search of PubMed, MEDLINE, Embase, Scopus, and ClinicalTrials.gov was conducted in accordance with a registered PROSPERO protocol (CRD420251170324). Chronic or persistent warts were defined as lesions lasting more than six months or showing inadequate response to conventional therapies. The primary outcome was complete wart clearance, and pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Six studies were included. Intralesional HPV vaccination was associated with a significantly higher rate of complete clearance compared with intralesional normal saline (RR 18.54; 95% CI 6.59-52.18). Subgroup analyses demonstrated comparable efficacy between bivalent and quadrivalent vaccines. Reported adverse events were mild and localized. Intralesional HPV vaccination demonstrated significant therapeutic efficacy in the treatment of cutaneous warts and represents a promising immunotherapeutic option for patients with persistent or treatment-refractory disease.

Macroscopic and microscopic aggregation patterns of reconstituted poly-L-lactic acid (PLLA) products may vary with product formulation, diluent, preparation protocol, and time. This descriptive in vitro pilot study compared two commercial formulations, StiCol Volume (150 mg PLLA reconstituted to 9 mL) and StiCol Soft (50 mg PLLA reconstituted to 6 mL), under 11 diluent conditions and 2 composite preparation protocols: roller mixing for 30 min and manual shaking for 3 min followed by 3 h of hydration. One preparation was evaluated for each formulation–diluent–protocol combination. Gross appearance was documented immediately and at 15, 30, 45, and 60 min and 24 h; microscopy was performed at ×40 and ×100 from 15 min onward. Two evaluators applied an ordinal visual aggregation scale, and the findings were analyzed descriptively. In the observed preparations, the StiCol Soft formulation generally showed lower aggregation grades than StiCol Volume; however, the products differed in nominal PLLA concentration, particle size, and excipient composition, so this pattern cannot be attributed to concentration alone. SWFI-based conditions tended to show fewer microscopic clusters than NSS-based conditions. The roller/30 min protocol also tended to show lower grades than the manual/3 h protocol, although mixing mode and hydration duration were inseparable. Macroscopic upper-layer accumulation was interpreted as vertical phase separation with creaming/flotation-like behavior rather than sedimentation. These exploratory findings generate hypotheses for replicated studies incorporating standardized sampling, redispersibility, particle size, rheological, and injectability testing; they do not establish an administration window or improved clinical safety.

Background: YouTube is a basic source of health information, but the quality of content regarding onychomycosis in Thailand remains under-evaluated. Objective: To assess the quality, reliability, and engagement of YouTube videos on onychomycosis from the perspectives of medical experts and Generation Z student researchers. Materials and Methods: A cross-sectional analysis was conducted on YouTube videos related to onychomycosis in Thai. Videos were categorized by source: healthcare personnel and non-healthcare personnel. Quality and reliability were evaluated using the DISCERN tool, JAMA benchmark criteria, the Global Quality Scale (GQS), and the Video Information and Quality Index (VIQI). Qualitative data were gathered through internal group discussion with Generation Z researchers to identify engagement and noted reliability. Results: Most videos were produced by non-healthcare personnel, with board-certified physicians accounting for only 27% of the content. Healthcare personnel-led videos scored significantly higher in JAMA (transparency), DISCERN (treatment reliability), VIQI (flow and technical clarity), and GQS (quality and flow). Non-healthcare personnel videos frequently promoted harmful or improper treatments. Students identified a “30-second window” critical for engagement and a preference for clear professional affiliation. Interestingly, students’ perceptions of video quality strongly correlated with expert quality assessments. One video utilized artificial intelligence-generated data, highlighting an emerging trend in content creation. Conclusion: Professional medical content on YouTube provides superior quality and reliability but is less prevalent than non-professional content. There is an urgent need for board-certified physicians to increase their video output to reduce misinformation.