Introduction: Port-wine stain (PWS) is a congenital malformation that does not resolve spontaneously and can cause a physiological or psychological burden to the patients. At present, most of the studies done on PWS are focused on the treatment rather than the quality of life and psychological effects of the disease. Material and Methods: A comprehensive literature search was done in MEDLINE using PubMed database, Embase^®, and Cochrane. All observational studies were included in this review. Results: A total of 17 relevant articles with 2,135 PWS patients were included in this review. There were 36 measurement tools used to assess the quality of life and the psychological effects among PWS patients. The results showed that patients with facial PWS had a significant negative effect on their quality of life and had also suffered from psychological disabilities. The PWS lesion tends to worsen with age and may cause further adaptation problems towards the social environment, especially in children. Conclusion: Early treatment, psychological assistance, and patient support are the key management in improving the quality of life of patients with PWS. Quality of life must be regularly assessed together with the improvement of treatment.

Introduction This split-face, double-blind, randomized controlled study investigated the efficacy and safety of using a microneedling radiofrequency (RF) device with polynucleotides (PN) versus RF alone for the treatment of melasma. Methods Thirty adult participants with melasma (Fitzpatrick skin types III–V) received three treatments with an invasive, bipolar, pulsed-type microneedling RF device on both sides of the face. The treatment sessions occurred once every 2 weeks. The hemifaces of each participant were designated for treatment and control with PN and normal saline solution (NSS), applied after treatment with RF. Measurements were made of melanin index (MI), erythema index (EI), skin roughness (by the Antera 3D system), modified melasma area severity index (mMASI) for each hemiface, and patients’ self-assessed improvement. These occurred at baseline and again following the final treatment (2 weeks and 1, 2, 3, and 6 months after). Mean values were obtained for MI, EI, skin roughness, and mMASI. A generalized estimating equation (GEE) was used to compare the obtained values for the outcome measures across all assessment points. Results All patients were women (mean age, 43.2 ± 7.0 years). Mixed melasma predominated (61.5%; n = 16), and the mean duration of melasma was 8.9 ± 6.5 years. Twenty-six participants were followed up to the 6-month assessment point. Significant improvements were observed from baseline in MI, skin roughness, and mMASI scores for both the PN and control sides at 6 months, with no statistically significant differences between sides. Patients’ self-assessed improvement scores also showed a positive trend. Melasma recurrence was observed in three patients at 2, 3, and 4 months after the last treatment session (10% recurrence rate). Conclusions The combination of an invasive, bipolar, pulsed-type microneedling RF with PN is not superior compared with microneedling RF alone in the treatment of melasma. Microneedling RF may be considered as safe and efficacious for the improvement of skin roughness, and as an adjunctive treatment option for melasma. Clinical Trial Registration This study was registered on ClinicalTrials.gov and assigned NCT number TCTR20210804002.

Introduction Asian patients often seek to address lower facial aging through clinical interventions that increase anterior projection and jawline contouring. The Definisse™ (also known as Happy Lift™) thread lift treatment uses barbed absorbable threads to suspend tissues and induce biostimulation. We evaluated the efficacy and safety of absorbable barbed threads for lower facial reshaping in Thai patients. Methods This prospective, evaluator-blinded study enrolled 27 Thai patients diagnosed with mild to moderate facial laxity. Patients underwent thread implantation along the mandibular angle with one of two double needle thread lengths (12 and 23 cm) to create a “J stitch”. Primary outcome was the clinical improvement in facial laxity as graded by two blinded dermatologists at baseline, immediately after treatment, and at 1 week and 1, 2, 3, 6, and 12 months follow-up. Objective measurements included volume in the jawline, nasolabial folds, and submental area. Patients’ self-assessment scores and adverse reactions were recorded. Results Of the 27 patients recruited to the study, 25 (92.6%) attended all follow-up visits. Clinical improvement of facial laxity was observed immediately after thread implantation. There was significant volume improvement in the jawline, nasolabial folds and submental area at almost all follow-up visits (p < 0.007), with most patients (51.9%) reporting excellent lifting effect as early as the 1 week follow-up visit. All adverse reactions were mild and resolved spontaneously without any medical intervention. Conclusion Implantation of absorbable barbed threads is a safe and effective treatment for facial rejuvenation in Thai patients. Long threads (23 cm) showed a slight superiority to short threads (12 cm) in terms of face-lifting efficacy, which suggests the benefit of additional barbs in tissue suspension and biostimulation. The disadvantage of absorbable threads is that their visible lifting effects are not as long-lasting as those of non-absorbable ones, since they are reabsorbed from 6 months onwards. Trial registration ClinicalTrials.gov identifier: TCTR20210415001. This clinical trial was retrospectively registered 12 April 2021.

Introduction A few studies have evaluated the efficacy and safety of noninsulated radiofrequency microneedling (RFMN) to treat periorbital wrinkles in Asian patients. Recently, wound healing accelerators, polynucleotides (PNs), have received attention in wound management. However, their efficacy and safety have not been fully elucidated following RFNM. This study aimed to evaluate the efficacy and safety of noninsulated RFMN for periorbital wrinkles and the synergistic effect of PNs after RFMN. Methods Thirty subjects with Fitzpatrick skin types III to V and facial wrinkles (Fitzpatrick grades I and II) were enrolled. All volunteers were treated over the entire face with noninsulated RFMN for three sessions at 2-week intervals. The left and right sides of each patient’s face were randomly assigned to receive PNs (treatment group) or normal saline solution (control group). The indentation and maximum depth of wrinkles were objectively measured using Antera 3D. Subjective self-evaluations were obtained at baseline, 2 weeks after the third treatment, and at 1, 2, 3, and 6 months after the final treatment. In addition, pain scores, immediate reactions, and other adverse effects were evaluated. Results Twenty-nine subjects completed the treatment protocol. Most presented with grade II wrinkling (69%). At 2-month follow-up, Antera 3D image analysis revealed faster improvement for the treatment group. At 6-month follow-up, the majority of subjects reported an improvement of 25–75% in their periorbital wrinkles. The average pain score was 2.2 out of 10. No serious adverse events (infection, pigmentary alteration, persistent erythema, or scarring) were observed. Conclusions Noninsulated RFMN is safe and effective for treating periorbital wrinkles and can be used as a modality for transdermal drug delivery. Topical polynucleotides as an adjunctive treatment provide additional benefits for periorbital wrinkle treatment. Trial Registration Number TCTR20201105007.