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Physical appearance is a factor that contributes to an individual's self-esteem. Maintaining a healthy appearance is a growing quest by the population, and aging is the main cause of discomfort for men and women. There are several aesthetic treatments capable of mitigating or delaying the effects of aging in all its layers of alteration (dermis, hypodermis, musculature and bone), and the combination of therapies has been increasingly proposed in search of a positive synergy. The dermal application of polydioxanone threads (PDO) and the low-power red LED (photobiomodulation - PBM) are individual options of resources for which there already are reports in the literature about their mechanisms of action in the proliferation of fibroblasts and collagen production. However, the joint application of these techniques requires further studies.
A total of 40 patients, aged between 30 and 60 years old, phototypes I-IV in Fitzpatrick scale, Glogau 3-4, presenting static wrinkle at the glabellar region will be recruited and distributed among 2 groups: PDO thread + PBM or PDO thread + sham PBM. The treatments will consist of 30 days, with one application of PDO thread and PBM twice a week (total of 9 sessions).
This is a controled, randomized, double blind, two arms clinical trial. The main objective of this study is to evaluate the effect of PBM with red light associated to PDO threads in individuals with static wrinkles in the glabellar region in terms of oedema, dermal thickening and PDO thread hydrolysis.
The sample will be divided into 2 groups: Group 1 will receive PDO thread and PBM with Red LED (Newskin, MMO), 150 milliwatt (mW), 2 Joule (J) per point, 4 J/cm² , 10 points per session, Group 2 will receive PDO thread and PBM sham. A total of 40 patients with glabellar wrinkle, aged 30 to 60 will be included. The treatments will consist of 9 sessions, twice a week for 30 days. The oedema and dermal thickness will be evaluated by linear ultrasound (10-14 MegaHertz (MHz), Mobisson). Photographic records will also be made.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PDO thread with active red LED photobiomodulation (PBM) | Experimental | Participants will receive the PDO thread and the intervention with PBM using red light (Newskin, MMO) 150 mW, 2J per point, 4J/cm2, 10 points, twice a week. |
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| PDO thread with sham photobiomodulation (PBM) | Sham Comparator | Participants will receive the PDO thread and the simulated intervention with PBM using Newskin, MMO. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Photobiomodulation | Device | Patient will receive the application of the low-power 660 nm Newskin MMO red LED in the immediate postoperative period. The application will be made punctually over the entire length of the wire, which measures 5 cm, totaling 10 application points with 1 cm of distance between them. The LED application will be repeated twice a week, with a minimum interval of 48 hours, totaling 9 laser applications over 30 days. |
| Measure | Description | Time Frame |
|---|---|---|
| Edema assessed by Ultrasound | Ultrasound transversal measurement from epidermis to the beginning of muscle tissue. | Before treatment (day 0) |
| Edema assessed by Ultrasound | Ultrasound transversal measurement from epidermis to the beginning of muscle tissue. | 24 hours after PDO thread application (day 1) |
| Measure | Description | Time Frame |
|---|---|---|
| dermis thickness | Ultrasound transversal measurement from epidermis to the beginning of muscle tissue. | Before treatment (day 0) |
| dermis thickness | Ultrasound transversal measurement from epidermis to the beginning of muscle tissue. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Christiane Pavani, PhD | University of Nove de Julho | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Clinic Cursos | São Paulo | São Paulo | Brazil |
Individual participant data that underlie the results reported in this article, after deidentification (text, tables, figures, and appendices will be shared). The sharing will begin 3 months following article publication. Researchers who provide a methodologically sound proposal will have the access. Proposals should be directed to chrispavani@gmail.com. To gain access, data requestors will need to sign a data access agreement.
The sharing will begin 3 months following article publication.
Researchers who provide a methodologically sound proposal.
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| ID | Term |
|---|---|
| D004487 | Edema |
| ID | Term |
|---|---|
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D028022 | Low-Level Light Therapy |
| ID | Term |
|---|---|
| D053685 | Laser Therapy |
| D013812 | Therapeutics |
| D010789 | Phototherapy |
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All participants will receive PDO thread at glabella. Immediately after application, the participants will receive the intervention related to their treatment group, according to the allocation given by randomization. After randomization, the study population will be divided into two groups (n=20 per group), which are: (1) Group A - PDO thread + PBM with red LED, (2) PDO thread + PBM sham. The treatment will be performed twice a week for 30 days, in total 9 sessions.
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Neither the participants involved in the study, nor the outcomes assessor will be aware of the groups formed, as well as the treatments received.
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| PDO thread | Procedure | The participant's face will be cleaned with a 0.2% chlorhexidine solution. 0.1 ml of injectable anesthetic (2% lidocaine hydrochloride without vasoconstrictor, XYlestesin) will be administered in the skin layer at the point of incision in the glabellar region with a 30-gauge needle. A subincision will be made with a 21-gauge cannula in the glabellar ridge and then an injectable thread will be applied in the deep dermal layer below the glabellar ridge in the same direction as it. |
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| day 90 |
| PDO thread hydrolysis | Ultrasound identification of presence or absence of the thread | day 180 |
| Photos | Image registration of the region treated | Before treatment (day 0) |
| Photos | Image registration of the region treated | 24 hours after PDO thread application (day 1) |
| Photos | Image registration of the region treated | day 90 |
| Photos | Image registration of the region treated | day 180 |