10.5826/dpc.1301a15
Objectives: The purpose of this study was to explore the clinical efficacy of medical dextrose tincture liquid (medical dextrose tincture) in the treatment of facial photoaging.&nbsp;
Methods: Thirty-four volunteers were included in the randomized double-blind study. According to the random number table method, the subjects were randomized into control and treatment groups. The subjects in the control and treatment groups were treated with medical hyaluronic acid gel and medical dextrose tincture, respectively. They received three times of mesotherapy therapy with an interval of 28 days. Video image acquisition was performed before treatment and 28 days after treatment. Skin moisture content, glossiness, heme content, collagen density, and elasticity were tested. The subjective evaluation of subjects and doctors before and after treatment were compared.&nbsp;
Results: Compared with before treatment, medical dextran tincture significantly increased the skin moisture retention, skin gloss, and skin collagen density (p&lt;0.001). Additionally, the skin retraction time was significantly reduced, and the skin retraction time was also markedly decreased after treatment with medical dextran tincture (p&lt;0.001). The effects of medical dextran tincture were more significant in comparison with medical hyaluronic acid gel (p&lt;0.05). The subjective evaluation results of doctors showed that after 84 days of treatment, the overall skin photoaging score was significantly reduced (p&lt;0.001). The subjective evaluation results of volunteers showed that the various skin problems of more than 50% of volunteers were improved after treatment.&nbsp;
Conclusion: Medical dextran tincture has obvious effects of moisturizing, increasing luster, improving skin redness, increasing skin collagen content and enhancing skin elasticity.
text/xml
2160-9381
2412
en
Bin Li
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
clinical efficacy
Clinical Efficacy Of Medical Dextrose Tincture Liquid In The Treatment Of Facial Photoaging
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Original Article
2023-01-31
2022-02-22
2023-01-31
2023-02-27
e2023015
Dermatol Pract Concept
Objectives: The purpose of this study was to explore the clinical efficacy of medical dextrose tincture liquid (medical dextrose tincture) in the treatment of facial photoaging.&nbsp;
Methods: Thirty-four volunteers were included in the randomized double-blind study. According to the random number table method, the subjects were randomized into control and treatment groups. The subjects in the control and treatment groups were treated with medical hyaluronic acid gel and medical dextrose tincture, respectively. They received three times of mesotherapy therapy with an interval of 28 days. Video image acquisition was performed before treatment and 28 days after treatment. Skin moisture content, glossiness, heme content, collagen density, and elasticity were tested. The subjective evaluation of subjects and doctors before and after treatment were compared.&nbsp;
Results: Compared with before treatment, medical dextran tincture significantly increased the skin moisture retention, skin gloss, and skin collagen density (p&lt;0.001). Additionally, the skin retraction time was significantly reduced, and the skin retraction time was also markedly decreased after treatment with medical dextran tincture (p&lt;0.001). The effects of medical dextran tincture were more significant in comparison with medical hyaluronic acid gel (p&lt;0.05). The subjective evaluation results of doctors showed that after 84 days of treatment, the overall skin photoaging score was significantly reduced (p&lt;0.001). The subjective evaluation results of volunteers showed that the various skin problems of more than 50% of volunteers were improved after treatment.&nbsp;
Conclusion: Medical dextran tincture has obvious effects of moisturizing, increasing luster, improving skin redness, increasing skin collagen content and enhancing skin elasticity.
Bin Li
2023/01/31
10.5826/dpc.1301a15
e2023015
Department of Cosmetic Dermatology, Beijing EVERCARE Medical Beauty Hospital, Beijing, China
2160-9381
clinical efficacy
en
e2023015
Shin SJ, Her Y, Yu DS, Kim CW, Kim SS. Twenty-four-week multicenter, evaluator-blinded clinical study of the efficacy and safety of a dextran filler in the treatment of nasolabial folds. Dermatol Surg. 2014;40(6):652-657.
Clinical Efficacy Of Medical Dextrose Tincture Liquid In The Treatment Of Facial Photoaging
https://dpcj.org/index.php/dpc/article/download/2412/1980
Clinical Efficacy of Medical Dextrose Tincture Liquid
        in the Treatment of Facial Photoaging
                    Yuexing Song1, Qiuhui Liu2, Yihan Zhang2, Huina Zhang3, Bin Li2


1 Department of Cosmetic Dermatology, Xi’an EVERCARE Medical Beauty Hospital, Xi’an, China
2 Department of Cosmetic Dermatology, Beijing EVERCARE Medical Beauty Hospital, Beijing, China
3 Beijing Evercare Medical Technology Group Co., Ltd, Beijing, China



Key words: medical dextran tincture liquid, facial photoaging, clinical efficacy
Citation: Song Y, Liu Q, Zhang Y, Zhang H, Li B. Clinical Efficacy of Medical Dextrose Tincture Liquid in the Treatment of Facial
Photoaging. Dermatol Pract Concept. 2023;13(1):e2023015. DOI: https://doi.org/10.5826/dpc.1301a15
Accepted: May 5, 2022; Published: January 2023
Copyright: ©2023 Song et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication
Corresponding Author: Bin Li, Beijing EVERCARE Medical Beauty Hospital, Building A, No.3 East Third Ring North Road,
Chaoyang District, Beijing, 100027 China. Tel: 86-010-82037778 Email: binli1228@163.com




  ABSTRACT              Introduction: Exogenous aging mainly refers to photo-aging, which is caused by environmental
                        ­factors including ultraviolet exposure. Dextran is a homopolysaccharide composed of glucose as
                         monosaccharide, and glucose units are connected by glycosidic bonds.
                        Objectives: The purpose of this study was to explore the clinical efficacy of medical dextrose tincture
                        liquid (medical dextrose tincture) in the treatment of facial photoaging.
                        Methods: Thirty-four volunteers were included in the randomized double-blind study. According to
                        the random number table method, the subjects were randomized into control and treatment groups.
                        The subjects in the control and treatment groups were treated with medical hyaluronic acid gel
                        and medical dextrose tincture, respectively. They received mesotherapy therapy three times with an
                        interval of 28 days between treatments. Video image acquisition was performed before treatment
                        and 28 days after treatment. Skin moisture content, glossiness, heme content, collagen density, and
                        elasticity were tested. The subjective evaluations of subjects and doctors before and after treatment
                        were compared.
                        Results: Compared with the pre-treatment baseline, medical dextran tincture significantly increased
                        skin moisture retention, skin gloss, and skin collagen density (p<0.001). Additionally, the skin retrac-
                        tion time was significantly reduced, and the skin retraction time was also markedly decreased after
                        treatment with medical dextran tincture (p<0.001). The effects of medical dextran tincture were more
                        significant in comparison with medical hyaluronic acid gel (p<0.05). The subjective evaluation results




Original Article | Dermatol Pract Concept. 2023;13(1):e2023015                                                                      1
                     of doctors showed that after 84 days of treatment, the overall skin photoaging score was significantly
                     reduced (p<0.001). The subjective evaluation results of volunteers showed that the various skin prob-
                     lems of more than 50% of volunteers were improved after treatment.
                     Conclusion: Medical dextran tincture has obvious effects of moisturizing, increasing luster, improving
                     skin redness, increasing skin collagen content and enhancing skin elasticity.




Introduction                                                      the clinical efficacy of medical dextrose tincture liquid in the
                                                                  treatment of facial photoaging.
Skin is the largest organ of the human body, and its aging is
a complex process caused by a variety of endogenous and
exogenous factors [1]. Endogenous aging is inherent, that         Subjects and Methods
is, natural aging that develops over time. Exogenous aging
mainly refers to photo-aging, which is caused by environ-         Subjects
mental factors including ultraviolet (UV) exposure. The           All volunteers were informed of the purpose of the study in
clinical manifestations of naturally aging skin are decreased     detail and signed the informed consent documents. A total of
skin thickness, dryness and fine wrinkles [2]. However, the       34 volunteers were included in the randomized double-blind
clinical manifestations in the skin caused by photoaging are      study. Inclusion criteria: (1) those whose face had symptoms
deep wrinkles, roughness, relaxation, spotted pigmentation,       of photo-aging, including dryness, dullness, lack of elastic-
telangiectasia and various skin tumors [3].                       ity, etc.; (2) non-smokers; (3) individuals aged more than
    Exogenous aging damage caused by skin exposure to ul-         18 years old. Exclusion criteria: (1) women who were men-
traviolet light (UV) is slow. UV radiation can affect skin pig-   struating, pregnant or breastfeeding; (2) those with a history
ment metabolism [4]. The immediate response is an increase        of food or drug allergies and ethical contraindications; (3)
in the reactive synthesis of melanin and its redistribution,      those who had taken corticosteroids, antibiotics, tretinoin or
and the delayed response is an increase in the number and vi-     other anti-acne medications two weeks before treatment; (4)
tality of melanocytes [4]. UV can upregulate the expression       those who had used hormone drugs and immunosuppressant
level of vascular endothelial growth factor (VEGF), resulting     in the past month; (5) those with obvious damage, redness,
in the proliferation and expansion of capillaries [5]. At the     scars, active skin diseases, inflammation, or infection on the
same time, UV has an autoimmune inhibitory effect, result-        face; (6) those with symptoms of colds, headaches and fever
ing in the changed number and vitality of immune cells, and       on the day of the test; (7) those who were allergic to injection
the expression of related cytokines [6]. The most relevant        materials or certain ingredients in injection preparations; (8)
feature of photoaging caused by UV is the changes in the          those who had injected unknown fillers into the face that
proportion, quality and function of the dermal extracellu-        had not gone away before treatment.
lar matrix [7]. The main components of the dermal extra-             Informed consent has been obtained from all the partici-
cellular matrix are the collagen fiber network, elastic fiber     pants. This study was approved by the Ethics Committee of
network and proteoglycan [8]. The elastic fiber network           Xi’an EVERCARE Medical Beauty hospital (No. 20200501).
provides elasticity to the skin, while proteoglycan plays a
role in moisturizing and biological signal transduction. In       Treatment
exogenously damaged skin, these three components have             Medical hyaluronic acid gel (Huaxi Furuida Biomedical Co.,
undergone specific changes.                                       Ltd., Jinan, China) was marked as product A, and medical
    Dextran is a homopolysaccharide composed of glucose           dextrose tincture liquid (Ningxia Miaolang Biotechnol-
as monosaccharide, and glucose units are connected by gly-        ogy Co., Ltd., Ningxia, China) was marked as product B.
cosidic bonds [9]. According to the type of glycosidic bond,      According to the random number table method, the sub-
dextran can be divided into α-dextran and β-dextran. Dex-         jects were randomized into control and treatment groups
trose is a kind of widely studied and used α-dextran. In ani-     (n = 17). Each volunteer randomly selected product A and
mal models, dextran materials showed good soft tissue filling     product B. The volunteers in the control and treatment
effect and biocompatibility [10,11]. However, there are no        groups were treated with medical hyaluronic acid gel and
relevant reports on clinical research on the therapeutic ef-      medical dextrose tincture, respectively. They received meso-
fects of dextrose on cosmetic dermatology and facial pho-         therapy three times with an interval of 28 days. The steps of
toaging. Therefore, the purpose of this study was to explore      mesotherapy were as follows. Volunteers cleaned their faces


2                                                                     Original Article | Dermatol Pract Concept. 2023;13(1):e2023015
with mild soap. After topical anesthesia for 20-30 min, the          3 points for obvious improvement and 4 points for complete
face was cleaned again. Iodophor solution is used for disin-         improvement.
fection and deiodination. The whole face was injected with
the mesotherapy instrument, the injection depth was 0.8-12           Evaluation Indexes
mm, and the skin punctate hemorrhage was the standard.               On the 0th, 28th, 56th and 84th day of treatment, the visual
After treatment, the facial treatment area was covered with a        images of the face were analyzed. The moisture content of
sterile facial pack for 20-30 min.                                   the stratum corneum, skin gloss and skin heme, skin colla-
                                                                     gen density and skin elasticity were analyzed. Skin subjec-
Image Analysis                                                       tive evaluation of doctors and volunteers was also assessed
On the 0th, 28th, 56th and 84th day of treatment, visual             after treatment.
images of the face were collected by VISIA image acquisition
as previously described [13].                                        Statistical Analysis
                                                                     IBM SPSS statistics 22 was used to make descriptive statis-
Skin Detection and Analysis                                          tics on the measured values and the subjective evaluation
On the 0th, 28th, 56th and 84th day of treatment, skin               scores. The measurement data were expressed as means ±
moisture content test, skin gloss test, skin heme content test,      standard deviation (SD). The count data were expressed as
skin collagen density test and skin elasticity test were car-        a percentage. For the intra-group comparison before and af-
ried out by MPA10 skin tester (CK, Germany) and Derma-               ter treatment, the measured values at different time points
lab skin tester (CORTEX, Denmark). The effects of those              were compared with the initial values. If the data were nor-
two products on skin moisture content, skin gloss, skin              mally distributed, t-test was used for statistical analysis. If
tone, and anti-aging were assessed through the changes in            the data were not normally distributed, t-test was used for
those indexes. The test environment was 20.0℃-22℃, with              statistical analysis.
a humidity of 40.0%RH-60.0%RH. At the junction of the
middle line of the left eye and the nasal wing, the moisture
                                                                     Results
content of the stratum corneum, skin gloss and skin heme
were measured. The skin collagen density and skin elasticity         General Information
were measured at the junction of the middle line of the right        A total of 34 people completed this study. There were 17
eye and the nasal wing.                                              volunteers in group A, including 1 man and 16 women, with
                                                                     an average age of 29.59 ± 1.05 years. There were 17 volun-
Subjective Evaluation                                                teers in group B, including 3 males and 14 females, with an
For subjective evaluation by doctors, two dermatologists             average age of 31.35 ± 1.05 years. There were no significant
scored the degree of facial photoaging before treatment and          differences in general information such as gender and age
after a course of treatment according to the VISIA image. The        between the two groups (p < 0.05).
scoring standard was shown in Table 1. For subjective eval-
uation by volunteers, volunteers rated themselves in terms           Comparison of Skin Moisture Content Between
of skin color, wrinkles, luster, elasticity and moisturizing on      the Two Groups
the 28th day after each treatment. 0 points for deterioration,       After 28, 56 and 84 days of treatment, the skin moisture
1 point for ineffectiveness, 2 points for slight improvement,        contents in group A were significantly increased by 18.0%,



                                           Table 1. Overall score of photoaging.
 Scores                                                           Descriptions
 0          The whole face is smooth, without obvious fine wrinkles and uneven pigment in any part of the cheek, forehead
            and eyes.
 1          There is obvious roughness, uneven pigment (pigmentation or hypopigmentation) or fine wrinkles on one of the
            above three parts of the whole face.
 2          There are obvious roughness, uneven pigment or fine wrinkles on two of the above three parts of the face, or
            rough, uneven pigment and fine wrinkles in one part at the same time.
 3          There are obvious roughness, uneven pigment or fine wrinkles on the above three parts of the face, or rough,
            uneven pigment and fine wrinkles in two parts at the same time.
 4          There is any situation heavier than 3 points on the face.



Original Article | Dermatol Pract Concept. 2023;13(1):e2023015                                                                    3
   A                                                Group A     Group B                   B                                                     Group A     Group B
                                                                                                                       60.0%
                                80.00




                                                                                      Rate of change vs. Day 0 (%)
                                                                            *** ***
Skin moisture content (a.u.)

                                70.00                                                                                  50.0%
                                60.00                   ***     *** ***
                                                  ***                                                                  40.0%
                                50.00
                                40.00                                                                                  30.0%

                                30.00                                                                                  20.0%
                                20.00
                                                                                                                       10.0%
                                10.00
                                 0.00                                                                                  0.0%
                                        Day 0     Day 28       Day 56       Day 84                                                 Day 28             Day 56             Day 84
                                                Experimental check (days)                                                                    Experimental check (days)

   Figure 1. Changes in skin moisture content before and after treatment. (A) skin moisture content; (B) rate of change vs. Day 0. ***p<0.001;
   **
     p<0.01; *p<0.05 vs. Day0.




   A                                                                                     B                                                       Group A       Group B
                                                    Group A     Group B
                               14.00                                                                                   40.0%

                                                                            *** ***
                                                                                        Rate of change vs. Day 0 (%)
                                                                                                                       35.0%
                               12.00                           *** ***
                                                   *    *                                                              30.0%
                               10.00
                                                                                                                       25.0%
Skin gloss




                                8.00
                                                                                                                       20.0%
                                6.00
                                                                                                                       15.0%
                                4.00
                                                                                                                       10.0%
                                2.00                                                                                    5.0%
                                0.00                                                                                    0.0%
                                        Day 0     Day 28       Day 56       Day 84                                                  Day 28           Day 56            Day 84
                                                                                                                                             Experimental check (days)
                                                Experimental check (days)

   Figure 2. Changes in skin gloss before and after treatment. (A) skin gloss; (B) rate of change vs. Day 0. ***p<0.001;                                         **
                                                                                                                                                                  p<0.01; *p<0.05 vs.
   Day0.




   31.4% and 47.0% in comparison with those before treat-                                Comparison of Skin Erythema Index Between
   ment, respectively (p < 0.001). After 28, 56 and 84 days of                           the Two Groups
   treatment, the skin moisture contents in group B were also                            In group A, there was no significant difference in the changes
   notably increased by 23.9%, 33.2% and 53.6% compared                                  in skin erythema index after 28 days, 56 days and 84 days
   with those before treatment (p < 0.001, Figure 1). Taken                              of treatment in comparison with those before treatment
   together, both products A and B had a moisturizing effect,                            (p > 0.05), indicating that product A had no significant change
   which can significantly improve the moisture content of                               in skin heme contents (erythema index). In group B, the av-
   cheek cuticles. Particularly, the effect of product B was more                        erage skin heme content (erythema index) of volunteers be-
   obvious than product A.                                                               fore treatment, 28 days, 56 days and 84 days after treatment
                                                                                         were 351.8 ± 15.2, 332.9 ± 13.4, 313.4 ± 112 and 303.01
   Comparison of Skin Gloss Between                                                      ± 18.0, respectively. Compared with that before treatment,
   the Two Groups                                                                        the changes in skin erythema after treatment with product
   After 28, 56 and 84 days of treatment, skin gloss in group                            B were statistically reduced by 4.8%, 10.0% and 13.1%
   A was markedly increased by 8.4%, 18.3% and 30.3%                                     (p < 0.001, Figure 3). Taken together, product B can signifi-
   in comparison with that before treatment, respectively                                cantly reduce skin erythema index and improve skin redness.
   (p < 0.001). After 28, 56 and 84 days of treatment, skin gloss
   in group B was also significantly increased by 11.0%, 20.4%                           Comparison of Skin Collagen Density Between
   and 33.7% compared with that before treatment, respec-                                the Two Groups
   tively (p < 0.001, Figure 2). In conclusion, both products A                          Although skin collagen density after treatment with prod-
   and B can significantly increase skin gloss.                                          uct A was higher than that before treatment, the effect of



   4                                                                                                                   Original Article | Dermatol Pract Concept. 2023;13(1):e2023015
     A                                                         Group A       Group B                       B                                        Group A       Group B
                               400.00                                              P <0.05                                     1.0%
                               350.00                     *                                                                    -1.0%
                                                                         ***            ***




                                                                                                Rate of chang vs. Day 0 (%)
                               300.00
           Skin heme content



                                                                                                                               -3.0%
                               250.00
                                                                                                                               -5.0%
                               200.00
                                                                                                                               -7.0%
                               150.00
                               100.00                                                                                          -9.0%

                                 50.00                                                                                        -11.0%

                                  0.00                                                                                        -13.0%
                                          Day 0      Day 28        Day 56         Day 84
                                                                                                                              -15.0%
                                                  Experimental check (days)                                                             Day 28          Day 56              Day 84
                                                                                                                                              Experimental check (days)

  Figure 3. Changes in skin heme content before and after treatment. (A) skin heme content; (B) rate of change vs. Day 0. ***p<0.001; **p<0.01;
  *
    p<0.05 vs. Day0.




  A                                                  Group A       Group B                       B                                                 Group A        Group B
                               35.00                                                    ***                                   60.0%
                                                                                  ***
                               30.00
                                                                                              Rate change vs. Day 0 (%)
                                                                   *** ***                                                    50.0%
Skin collagen content




                               25.00                    ***
                                                                                                                              40.0%
                               20.00
                                                                                                                              30.0%
                               15.00

                               10.00                                                                                          20.0%

                                5.00                                                                                          10.0%
                                0.00
                                                                                                                              0.0%
                                         Day 0      Day 28        Day 56           Day 84
                                                                                                                                       Day 28            Day 56             Day 84
                                                  Experimental check (days)
                                                                                                                                                Experimental check (days)

  Figure 4. Changes in skin collagen density before and after treatment. (A) skin collagen density; (B) rate of change vs. Day 0. ***p<0.001 vs.
  Day0.




  product A on skin collagen density showed significant differ-                                 4.4% and 5.4% respectively. After 28, 56 and 84 days of
  ences after 56 and 84 days of treatment, with an increase of                                  treatment, the skin retraction time in group B was decreased
  26.4% and 44.9%, respectively (p < 0.001). After 28, 56 and                                   by 9.5%, 11.2% and 14.8% respectively in comparison with
  84 days of treatment, skin collagen density after treatment                                   that before treatment (p < 0.001, Figure 5). As described
  with product B was increased by 10.6%, 30.9% and 52.5%                                        above, product B can significantly reduce skin retraction
  respectively compared with that before treatment (p < 0.001,                                  time and enhance skin elasticity. The effect of product B on
  Figure 4). In short, both products A and B can significantly                                  skin elasticity was significantly earlier than that of product
  increase skin collagen density, and the effect of product B                                   A, and the effect of improving skin relaxation was better
  on skin collagen density was significantly earlier than that                                  than that of product A.
  of product A.
                                                                                                Comparison of Subjective Assessments of Doctors
  Comparison of Skin Elasticity Between                                                         and Volunteers Between the Two Groups
  the Two Groups                                                                                The lower the score of comprehensive skin improvement, the
  Skin retraction time is one of the indicators to measure skin                                 better the effect of the product on improving skin photoaging.
  elasticity. It refers to the time required for the skin to fully                              Before treatment, the skin scores in group A and group B were
  lift and retract to 33% of the peak height. The shorter the                                   2.14 ± 0.1 and 2.30 ± 0.1, respectively (p > 0.05). After three in-
  retraction time, the better the elasticity of the skin. After 56                              stances of treatment, the doctor’s score was significantly lower
  and 84 days of treatment, compared with before treatment,                                     than that before treatment (p < 0.01). According to the doc-
  the skin retraction time of product A group decreased by                                      tor’s score, after 84 days of treatment, product A and product



  Original Article | Dermatol Pract Concept. 2023;13(1):e2023015                                                                                                                     5
   A                                               Group A    Group B                     B                                                    Group A         Group B
                            300.00                P < 0.01                  P < 0.05                                   0.0%
                                                               *
Skin retraction time (ms)


                            250.00                                           *                                         -2.0%
                                                      ***          ***




                                                                                       Rate of change vs. Day 0 (%)
                                                                                 ***
                            200.00                                                                                     -4.0%

                                                                                                                       -6.0%
                            150.00
                                                                                                                       -8.0%
                            100.00
                                                                                                                      -10.0%
                             50.00
                                                                                                                      -12.0%
                              0.00
                                      Day 0      Day 28       Day 56         Day 84                                   -14.0%
                                               Experimental check (days)                                              -16.0%
                                                                                                                                      Day 28          Day 56             Day 84
                                                                                                                                           Experimental check (days)

   Figure 5. Changes in skin retraction time before and after treatment. (A) skin retraction time; (B) rate of change vs. Day 0. ***p<0.001 vs.
   Day0.



                                              Improvement     No improvement              The skin color became brighter, the pores narrowed and the
                                                                                          gloss increased. Figure 8B showed a case of skin redness and
                            100.00%                                                       uneven complexion improvement (volunteer No. 25, VISIA
                             90.00%                                      24.0%            standard light source mode). After three instances of treat-
Percentage of subjects




                             80.00%           47.0%                                       ment with product B, the volunteer’s skin turned red, and
                             70.00%                                                       the uneven skin color was significantly improved. The skin
                             60.00%
                                                                                          color was uniform, and the skin became bright and white.
                             50.00%
                                                                                          Figure 8C showed a case of skin redness and uneven com-
                             40.00%                                      76.0%            plexion improvement (volunteer No. 25, VISIA standard light
                             30.00%           53.0%                                       source mode). Figure 8C showed a case of skin redness im-
                             20.00%
                                                                                          provement (volunteer No. 38, VISIARed Areas light source
                             10.00%
                                                                                          mode photo). After three instances of treatment with product
                              0.00%
                                                                                          B, the volunteer’s skin redness was significantly improved, the
                                              Group A                Group B
                                                                                          color of erythema became lighter, the red area became smaller,
   Figure 6. The percentage of volunteers who showed improvement                          and skin inflammation was decreased. F
                                                                                                                               ­ igure 8D showed a
   and those who did not show improvement in the subjective evalua-                       case of skin redness and roughness improvement (volunteer
   tion score of doctors.                                                                 No. 8, VISIA standard light source mode). After three in-
                                                                                          stances of treatment with product B, the volunteer’s skin dull-
   B improved the skin condition of 53% and 76% of volunteers,                            ness and roughness were significantly improved, the skin color
   respectively (P > 0.05, ­Figure 6). Volunteers subjectively eval-                      became brighter, the pores narrowed and the gloss increased.
   uated the treatment effect according to the improvement of
   skin color, wrinkles, elasticity, gloss and moisture contents. The
                                                                                          Discussion
   higher the percentage of positive feedback, the more satisfied
   volunteers were. The clinical results were assigned and scored,                        Water light therapy is the accurate injection of nutrients or
   and the higher the score, the better the treatment effect. After                       drugs into specific layers of the skin through hollow mi-
   three treatments, the total score and positive response percent-                       croneedles, which can effectively supplement nutrients, such
   age of product B were higher than those of product A in the                            as hyaluronic acid and vitamins [13]. Moreover, it can stim-
   dimensions of skin color, wrinkles, elasticity, gloss and moisture                     ulate collagen production, make the skin moist and shiny,
   contents (Fig. 7A, 7B).                                                                effectively delay skin aging and improve skin quality [14]. It
                                                                                          can also treat diseases by injecting drugs [15]. The common
   Representative Image of the Treatment Effect                                           drugs and components used in water light therapy can be
   of Product B                                                                           divided into simple use of hyaluronic acid, non-crosslinked
   Fig. 8A is a case of improvement of dull and rough skin                                hyaluronic acid as carrier, matching with different nutrients,
   (volunteer No. 21, VISIA standard light source mode). After                            collagen preparation, mixed growth factor series, cocktail
   three instances of treatment with product B, the dullness and                          formula with multiple components or focusing on one com-
   roughness of the volunteer’s skin were significantly improved.                         ponent, polydeoxynucleoside, etc. [16].


   6                                                                                                                  Original Article | Dermatol Pract Concept. 2023;13(1):e2023015
                       Complete improvement             Obvious improvement              Slight improvement       No improvement
 B
         100.00%                                                                                         5.9%                    5.9%
                                 23.5%                                            17.7%      17.7%                  17.7%
                                                                     29.4%
          80.00% 35.3%                       47.1%       35.3%
                                                                                                                                41.2%
          60.00%                                                                                         64.7%      47.1%
                                                                                  70.6%      64.7%
          40.00% 52.9%           70.6%                   52.9%       64.7%
                                             47.1%                                                                              47.1%
          20.00%                                                                                                    29.4%
                                                                                             11.8%       23.5%
                                                          5.9%                     5.9%
                     11.8%        5.9%        5.9%        5.9%       5.9%          5.9%       5.9%       5.9%        5.9%        5.9%
           0.00%

                        A           B           A           B           A            B          A           B          A           B

                         Skin color                 Wrinkles                Elasticity              Gloss           Moisture retention

Figure 7. Efficacy evaluation after treatment. (A) results obtained from the questionnaire completed by volunteers after 84 days of treatment
with product A and product B. The results are expressed as the total score of each volunteer’s questionnaire. Complete improvement = 4
points, obvious improvement = 3 points, slight improvement = 2 points, no improvement = 1 point, deterioration = 0 points. The higher the
score, the better the skin state; (B) After treatment, the percentage of each item in the volunteers’ questionnaire.



     Dextran is a kind of branched dextran polymer with                 of treatment. It showed that medical dextran can signifi-
molecular weight ranging from 1 kDa to 2000 kDa. The                    cantly improve the roughness of the skin and increase the
side chain degree of dextrose differs according to molecular            moisture content of the skin stratum corneum. In terms of
weight [17]. The smaller the molecular weight, the lower the            moisturizing and improving skin gloss, medical dextran
side chain degree. The closer the molecular weight distribu-            has the same improvement effect as sodium hyaluronate.
tion is, the different application emphases of different molec-         Compared with that before treatment, medical dextran
ular weights are different [18]. Compared with other polymer            treatment significantly reduced skin erythema and redness.
materials, dextran has the advantages of good water solubil-            However, sodium hyaluronate had no significant effect in
ity, biodegradability, small antigenicity and high safety, and it       improving skin erythema. Compared with that before treat-
has been used as a plasma substitute in clinics [19, 20]. There-        ment, medical dextran treatment significantly increased skin
fore, dextran with the above characteristics has important              collagen density, stimulated collagen production, and has
application value in the field of skin rejuvenation treatment.          an anti-aging effect. Particularly, the significant difference
The cross-linked dextran filler (Lipen De, Cheonghwa Medi-              in the effect of medical dextran on skin collagen density
power Corporation, Jangseoung, Korea) was approved by the               appeared earlier than that of sodium hyaluronate, indicat-
Korean food and Drug Administration in 2012. Shin and his               ing that medical dextran can start and promote collagen
team have confirmed that it has a filling effect for more than          regeneration faster. Compared with that before treatment,
six months for the treatment of nasolabial folds [21].                  medical dextrose treatment can significantly reduce the skin
     In this study, we explored the therapeutic effect of med-          retraction time, indicating that it can improve skin sagging
ical dextran as a new type of water-light injection mate-               problems, and the effect was significantly better than with
rial on skin photoaging. Our results showed that compared               sodium hyaluronate.
with that before treatment, medical dextran significantly in-                 The subjective evaluation results of doctors showed that
creased skin moisture retention and skin gloss after 84 days            after 84 days of treatment with medical dextran and sodium


Original Article | Dermatol Pract Concept. 2023;13(1):e2023015                                                                             7
Figure 8. Representative images of improvement of dull, rough, reddish skin and uneven skin color. (A) Representative images of improve-
ment of dull and rough; (B) Representative images of improvement of reddish skin and uneven skin color; (C) Representative images of
improvement of reddish skin; (D) Representative images of improvement of reddish skin and rough.



hyaluronate, the overall score of the volunteers’ photoaging                primary human dermal fibroblasts and ex vivo human skin.
                                                                            Biomed Pharmacother. 2021;145:112461.
was significantly reduced in comparison with that before
                                                                       2.   Chung JH, Eun HC. Angiogenesis in skin aging and photoaging.
treatment, indicating that they can significantly improve skin
                                                                            J Dermatol. 2007;34(9):593-600.
photo-aging problems, including skin roughness, dryness,               3.   Kosmadaki MG, Gilchrest BA. The role of telomeres in skin
lack of elasticity, etc. From the subjective evaluation results             ­aging/photoaging. Micron. 2004;35(3):155-159.
of volunteers, as the time of treatment increased, the percent-        4.    Kim HM, Oh S, Yang JY, et al. Evaluating Whether Radiofre-
age of positive responses from volunteers in various aspects,                quency Irradiation Attenuated UV-B-Induced Skin Pigmentation
                                                                             by Increasing Melanosomal Autophagy and Decreasing Melanin
such as dry skin, skin gloss, uneven skin tone and dullness,
                                                                             Synthesis. Int J Mol Sci. 2021;22(19):10724.
skin elasticity, and skin wrinkles, gradually increased. Espe-
                                                                       5.    Hartono SP, Bedell VM, Alam SK, et al. Vascular Endothelial Growth
cially for gloss and elasticity, the overall improvement with                Factor as an Immediate-Early Activator of Ultraviolet-Induced
medical dextran is better than with sodium hyaluronate.                      Skin Injury. Mayo Clin Proc. 2021;S0025-6196(21):00643-1.
                                                                       6.    Vechtomova YL, Telegina TA, Buglak AA, Kritsky MS. UV Radi-
                                                                             ation in DNA Damage and Repair Involving DNA-Photolyases
Conclusion                                                                   and Cryptochromes. Biomedicines. 2021;9(11):1564.
                                                                       7.    Fernando IPS, Heo SJ, Dias MKHM, et al. (-)-Loliolide Isolated
In conclusion, medical dextran has obvious effects of                        from Sargassum horneri Abate UVB-Induced Oxidative Damage
­increasing moisture content, increasing luster, improving                   in Human Dermal Fibroblasts and Subside ECM Degradation.
skin redness, increasing skin collagen and enhancing skin                    Mar Drugs. 2021;19(8):435.
elasticity. Medical dextrose is superior to hyaluronic acid in         8.    Lin S, He X, He Y. Co-culture of ASCs/EPCs and dermal ex-
                                                                             tracellular matrix hydrogel enhances the repair of full-thickness
improving skin redness and skin relaxation.
                                                                             skin wound by promoting angiogenesis. Stem Cell Res Ther.
                                                                             2021;12(1):129.
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Original Article | Dermatol Pract Concept. 2023;13(1):e2023015                                                                                     9
