PEER-REVIEW | MICRONEEDLING |


Table 1 Average scores for subject self-evalution of wrinkles using a ten-point scale


0 WEEKS 1 WEEK 2 WEEKS 4 WEEKS PERCENTAGE CHANGE FROM BASELINE


Radara Control


4.4 4.5


4.1 4.2


3.8 3.8


3.2 3.3


27.27% 26.7%


Discussion


Past studies have demonstrated the ability of MN’s to effectively deliver molecules past the stratum corneum (SC). Sivamani et al9


, utilised Laser Doppler to demonstrate


an increase in blood flow when delivering hexyl nicotinate, a marker of SC penetration via MN’s with a length of 200m and 40m diameter, into the skin of the forearm. In another study Jung Lee et al10


compared the


Table 2 Average scores for dermatologist evaluation of wrinkles using a ten-point scale


0 WEEKS 1 WEEK 2 WEEKS 4 WEEKS PERCENTAGE CHANGE FROM BASELINE


Average score for test side


4.6 4.3


Average score for control side 4.6 4.4


3.6 3.9 3.1 3.3 32.61% 28.26%


efficacy of a commercially available dermaroller (0.25mm DTS roller; TCellBio, Seoul, Korea) combined with secretory factors of endothelial precursor cells differentiated from human embryonic stem cells (hESC- EPC) versus the dermaroller alone, when treating the whole face in a 25 women split face study. Although the authors reported a significantly greater decrease in objective wrinkle measurements versus micro-needling alone, despite being tolerable, mild pain and temporary erythema were reported in all patients, as well as one case of mild desquamation, which resolved spontaneously within one week. Adverse events were also reported by Bal et al11


, whom


demonstrated that solid arrays of MN’s with a height of 400m significantly increased the incidence of erythema versus 200m. The adverse events reported by both Jung Lee et al and Bal et al highlight some of the limitations of current MN. The results observed in this split face observational study with Radara® reported no cases of unwanted skin reactions or pain, in parallel to the positive outcome of an increase in the difference of objective change in wrinkle depth at 8 weeks between the test and control groups (18.45% versus 8.54% respectively).


Upon interrogation of the data, The results from this


study are compelling in supporting the efficacy of


Radara® in combination with HA serum to help improve the appearance of wrinkles within the CFL area.


some key points are worth addressing. The small difference in change of scores for the 4 week subject self-evaluation of wrinkles for the Radara® (27.27%) and control (26.7%) groups, likely reflects the limited effect of the micro- channelling and HA serum at such an early time point.


The


dermatologist evaluation at the same time point did demonstrate a


slightly larger difference of 32.6% versus 28.2% but may be open to some evaluation bias given the nature of the study. Despite the small difference in the subject evaluation scores at 4 weeks, a larger difference is noted at the 8 week time point. The delay in the increased difference from baseline to 4 and 8 weeks for the subject- assessed scores likely reflects a delay in the impact of the effect of HA in stimulating neo-collagenesis and remodelling from type 3 to 1. Although the impact on wrinkles does decrease from 4 to 8 weeks, the longevity of the effect of Radara® is evident versus HA serum alone. The impact of a modality such as Radara®, cannot be


46 


Figure 6 (A) PRIMOS images at baseline and (B) 4 weeks following Radara® and HA serum application


October 2015 | prime-journal.com


compared to that of the ‘gold standard’ of dynamic rhytide reduction — botulinum toxin. Carruthers et al12 demonstrated in a multicentre double blind, randomised controlled trial that Onabotulinum toxin A achieved a


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