Use of platelet-rich plasma for COVID-19-related olfactory loss: a randomized controlled trial
Many people globally reported losing their sense of smell after contracting COVID-19.
This study evaluated the results of using platelet-rich plasma (PRP), an autologous blood product with supraphysiologic concentrations of growth factors to treat loss of smell in patients recruited in the US as a consequence of COVID-19.
The authors conducted a randomised controlled trial (RCT) and recruited several patients with COVID-19 who had reported loss of smell between six and 12 months of contracting COVID-19. Patients in the trial were randomly given either three intranasal injections of PRP or sterile saline into their olfactory clefts. A total of 35 patients were recruited but only 26 of these completed the study.
The results showed that the patients who had received PRP treatment had a greater improvement in olfaction compared with the placebo group at three months. Also noted was a greater improvement in smell discrimination following the PRP treatment compared with placebo; however, there was no difference in smell identification or threshold. There was also no difference in subjective scores between the PRP and placebo groups. No adverse effects were reported during the trial.
In conclusion, the authors report that olfactory function following COVID-19 may improve after a duration of six months but can also improve with the help of PRP injections. These trial results will help to build on PRP being a potential and safe treatment option for patients with COVID-19-related loss of smell. The authors also state that future larger scale studies will be required in order to help further assess its efficacy.
Lived experiences of patients with hidradenitis suppurativa-related pain
Hidradenitis suppurativa (HS) is a common chronic skin condition that causes painful lumps under the skin. It can be found in the armpits, around the groin, buttocks and breasts. For most people with HS, pain is the most common and troublesome symptom.
The authors carried out this study at one academic medical centre in Atlanta, Georgia, US. A total of 21 adults with HS-related pain were interviewed by the authors so they could learn more about how the pain impacted on their lives.
English-speaking patients who were ≥18 years of age and who had previously been diagnosed with HS by a dermatologist and reported HS-related pain in the past seven days were included.
The study participants used a wide variety of terms to describe their HS-related pain and frequently associated pain with itch. HS-related pain caused:
- ►Physical difficulties, such as decreased mobility and problems with sleeping
- ►Decreased psychological wellbeing, including irritability, perceived loss of control and depression
- ►Relationship stress, including difficulty talking about their pain.
The authors found that one of the most challenging aspects of HS-related pain was being unable to predict when flareups of painful HS lesions were going to happen.
The authors noted that although pain was a significant issue for the participants interviewed, many of these had treated their own pain without seeking help from a health professional. This was due to difficulties in scheduling appointments during HS flare-ups or from fear of judgement by healthcare providers.
In conclusion, the authors note that HS-related pain had a severe impact on many aspects of the patients’ lives, including physical function, psychological wellbeing and relationships.
They further state that, in addition to treating this skin disease, it is extremely important to treat the symptom of pain. They advise that all health professionals should ask every patient about their HS-related pain as better communication with patients would help to identify any unmet pain needs and to improve the patient’s quality of life.
Effects of probiotics supplementation on skin photoageing and skin barrier function: a systematic review and meta-analysis
Ultraviolet (UV) irradiation is one of the major causes of skin ageing. Currently, there are very limited studies available to show evidence for the use of oral probiotics for the treatment of skin antiphotoageing.
The aim of this systematic review and meta-analysis was to assess the effects of probiotics on skin photoageing.
To conduct this study, the authors carried out a detailed search of both PubMed and Embase databases to include studies that were published up until 31 August 2021. The authors included RCTs, murine randomised controlled experiments and in vitro studies. Skin barrier function was compared between UV-irradiated probiotics and controls.
The results showed that oral probiotic supplements caused a significant reduction of photoageing; this was shown to be the case in all types of measured matrix metalloproteinases (MMPs) in both murine and in vitro studies. The results also showed that oral probiotic supplementation had significantly reversed UV-induced increase in epidermal thickness.
In conclusion, the authors found that oral probiotics were effective against skin photoageing in terms of MMP pathways and in reversing the skin barrier function from murine randomised data. It was also highlighted that further RCTs involving humans are required to confirm these results.
Influence of COVID-19 mRNA vaccination on the efficacy and safety of Botulinum toxin type A injections
Globally, there have been concerns raised regarding the efficacy and safety of Botulinum toxin type A (BTA) injections following COVID-19 vaccination.
The aim of this study was to assess the influence of BNT162b2 mRNA COVID-19 vaccine on the safety and efficacy of BTA injections performed for aesthetic indications.
A retrospective cohort study was carried out on 45 patients (mean age of 48 years) who underwent periodic BTA treatments and who also had two doses of the BNT162b2 vaccine.
For each patient, the authors looked at the time periods between having the BTA injections, before and after getting vaccinated. Efficacy and longevity of BTA was evaluated by the latency between BTA injections. Patients were also monitored for the development of any subsequent adverse reactions.
The results showed that the mean number of BTA injections pre- and post-COVID-19 vaccination was 5.1 and 3.1, respectively. The average interval between BTA injections after COVID-19 vaccination was significantly shorter than before. No severe BTA-associated adverse events were registered after the administration of BNT162b2 vaccine.
The authors concluded that their findings would indicate that BTA may be less effective after COVID-19 vaccination but that further research would be required
Expert recommendations on supportive skin care for non-surgical and surgical procedures
Clinicians require a thorough knowledge of non-surgical and surgical procedures, including any associated contraindications, potential risks and side-effects. It is essential that any clinician should be able to reduce the incidence of these and to ensure that patients receive the most benefit from the procedures they undergo.
Patients with darker skin tones and a high Fitzpatrick phototype are at a greater risk of dyschromias. Both melasma and post-inflammatory hyperpigmentation may be treated using medical aesthetic procedures; however, the authors state that these conditions may also be as a result of some of these procedures.
To carry out this study, a group of experts in the fields of cosmetic surgery and dermatology reviewed all of the published literature. They discussed recommendations for optimising outcomes with practical advice on supportive skin care before, during and after non-surgical or surgical procedures.
It was recommended that patients use a broad-spectrum sunscreen with a high sun protection factor against UVB and high protection against UVA. This was deemed essential for all treatment modalities for the prevention and potential improvement of any pigmentation disorders.
Supportive skin care products were also deemed crucial so that the patient could prepare, cleanse and protect their skin. Post-procedure anti-inflammatory skin care products to aid healing were recommended to speed up regeneration and wound healing, while minimising scarring and downtime.
In addition, skin care products with antioxidant, anti-ageing, and lightening properties were also found to potentially enhance and benefit the skin.