Hormones are very important in the aging process because some of their levels decrease. Therefore it can be hypothesized that hormone replacement therapy might slow aging. In light of the increasing interest in rejuvenating treatments that can yield good results, hormone replacement therapy has dawned in scientific circles. This review examines the roles of growth hormones melatonin and dehydroepiandrosterone, as well as those of bioidentical hormones in rejuvenation. The authors have also sought to evaluate the results of studies on hormone replacement therapy, considering the risks and benefits of using those hormones, which are seen as the "fountain of youth."

Keywords: HORMONES; REJUVENATION; GROWTH HORMONE; MELATONIN; DEHYDROEPIANDROSTERONE.

Keywords: BOTULINUM TOXINS; DISEASE; DERMATOLOGY; SKIN.

Introduction: Androgenetic alopecia is the most common type of hair loss in men and women. Nowadays, medication based treatments are the most frequently used nevertheless they yield poor results. More recently, the use of lasers has been proposed to treat this condition. At the same time, the infiltration of medications in the scalp has also been growing as a therapeutic option, although there are few scientific studies on this treatment modality.
Objective: To evaluate the results of using 1,550nm Erbium-Glass laser associated with the injection of active principles (minoxidil, finasteride, growth factors and a vitamin complex) for the treatment of male and female androgenetic alopecia.
Methods: A retrospective study was carried out with patients with androgenetic alopecia diagnosis, who underwent monthly sessions of the proposed combination therapy. The results were evaluated by means of comparative photographs taken before and after the treatment period and the assessment of the patients' opinion.
Results: Sixty-two patients were treated with 3 to 14 sessions; 48.39% of patients had mild improvement, and 46.77% had significant improvement. The vast majority (96.77%) was satisfied with the treatment. The patients who were very satisfied with the outcomes underwent a greater number of sessions (more than six, on average).
Conclusions: The association of 1,550nm Erbium-Glass laser therapy with the injection of active principles in the scalp is an effective and safe option for the treatment of androgenetic alopecia.

Keywords: ALOPECIA; LASERS; THERAPEUTICS

Introduction: Acne scars result from inflammation of acne vulgaris and are a frequent cause of complaints in dermatology practices. Atrophic scars are the most common, and may be classified into superficial, medium, and deep. There are several treatment options for deep atrophic scars, however they have limited efficacy in general, undesirable side effects and are expensive.
Objective: To evaluate the treatment of deep atrophic scars with high frequency electrosurgery.
Methods: Ten patients with deep atrophic acne scars received 3 high frequency electrosurgery treatment sessions with intervals of 1 month. The following were used to evaluate the outcome 1 month after the last session: histological aspects of selected scars as compared to the baseline; ratings attributed to the results by the patients (worsened, unchanged or improved); and standardized photographs at baseline and 1 month after the last session performed by a physician not related to the study, who also rated the results (worsened, unchanged or improved).
Results: Histological analysis evidenced a reduction in local fibrosis. All patients noticed improvement in the lesions. The evaluator dermatologist physician verified the presence of clinical improvement in all patients.
Conclusion: High frequency electrosurgery is a straightforward, inexpensive and effective method for the treatment of atrophic deep acne scars.

Keywords: CICATRIX; ACNE VULGARIS; ELECTROSURGERY

Vitiligo is an acquired pigmentation disorder characterized by the development of well-defined achromic macules in the skin. It is deemed stable when no new lesion emerges or when pre-existing lesions do not undergo changes for at least one year. In these cases, surgical treatment is an important therapeutic option. Punch micrografting is the most commonly performed melanocyte transplantation technique, resulting in excellent repigmentation. The authors describe a variation of this technique using even smaller and finer grafts (consisting of epidermis and thin dermis), in order to achieve aesthetical outcomes that are better than those obtained with the traditional technique, especially when treating areas with significant aesthetic impairment.

Keywords: Melanocytes; Transplantation; Vitiligo

INTRODUCTION: Acne scars treatment is challenging since, in the most of the cases, there are different types of scars in the same patient.
OBJECTIVE: Associate three distinct acne scar treatment techniques in the same session in order to optimize results.
METHODS: Retrospective observational study evaluating 25 patients with acne scars treated with the following sequence of associated techniques: high frequency electrosurgery, CO₂ laser and Nd:YAP laser.
RESULTS: High patient satisfaction index and evident improvement in photographs in most of cases.
CONCLUSIONS: The combination of techniques in one session was safe and effective in the treatment of acne scars, a condition of great psychological impact to affected individuals.

Keywords: Acne vulgaris; Cicatrix; Laser therapy

Rosacea is a common chronic skin disease that has several clinical manifestations, with erythema and inflammation being predominant characteristics. Its presence is associated with psychosocial impact on patients' lives. Although there are several options for topical and systemic treatments, it is known that only the inflammation is treated and that the erythema persists in most cases. More recently, there have been some publications describing the treatment of rosacea with botulinum toxin associated with good results. In this manner, the authors sought to evaluate the action of botulinum toxin in the treatment of rosacea that is persistent and refractory to various clinical treatments.

Keywords: Rosacea; Botulinum Toxins; Therapeutics

The evolution of medicine has allowed an increasingly in-depth knowledge of diseases and medications, involving cellular structures and associated molecules. In dermatology, we begin to unveil cell modulation associated to the use of substances such as botulinum toxin, hyaluronic acid, among others. This new era allows us to comprehend information that goes beyond a macroscopic view and explore cell interaction, leading to a broader knowledge to optimize dermatologic treatment.

Keywords: Biology; Cells; Dermatology

INTRODUCTION: Facial aging occurs due to loss of facial volume and altered skin texture. Hyaluronic acid fillers are the main non-surgical tools used to recover the volume loss, since, besides filling, they act as skin remodeling.
OBJECTIVE: To describe a new facial rejuvenation technique with hyaluronic acid: delta V lifting. Through this technique, we seek not only to fill in areas with volume deficits but mainly to stimulate tissue regeneration through the interaction between hyaluronic acid and superficial subcutaneous tissue, the main application plan.
METHODS: A retrospective observational study assessing 200 patients treated with 2 ml of hyaluronic acid at a concentration of 23 mg/ml in a single therapy session with the delta V lifting technique.
RESULTS: 87% of patients rated the result as “great improvement” and 13% as “good improvement” according to the Global Aesthetic Improvement Scale. Also, they all reported progressive improvement of the result until the moment of return within one month after the procedure.
CONCLUSIONS: The delta V lifting technique was effective in bringing satisfactory aesthetic results with a minimal amount of hyaluronic acid. The interaction between hyaluronic acid and adipose tissue is believed to be involved in optimizing results.

Keywords: Hyaluronic acid; Rejuvenation; Techniques

Q-switched lasers are widely used in dermatology to treat one of the most common complaints of dermatological routine: the pigmented lesions. The several pigments, targets of laser treatment on the skin, have different characteristics as color, size, tissue location, and origin. Q-switched lasers can interact with the pigments in various ways. Since the emergence of Q-switched technology, different and new ways of use have emerged. Understanding the mechanisms of action involved and their main clinical applicabilities is essential to optimize the therapeutic outcomes.

Keywords: Lasers; Tattooing; Melanosis; Skin pigmentation

Osteoma cutis is a rare tumor characterized by the presence of bone tissue in the dermis and/or hypodermis. We describe the case of a patient diagnosed with osteoma cutis on the scalp for approximately ten years with progressive growth and local alopecia area. The patient underwent surgical excision of the lesion using the rotation flap "S" italic technique to reconstruct the area aiming at the best possible aesthetic result.

Keywords: Nasal Surgical Procedures; Neoplasms, Basal Cell; Nose Neoplasms

Hyaluronic acid is one of the most used substances in dermatology. It presents structural roles in the extracellular matrix, binding to cells and biological components through specific and nonspecific interactions. The native ligand for hyaluronic acid is the transmembrane CD44 receptor, which interacts not only with hyaluronic acid but also with different growth factors, cytokines, and extracellular matrix proteins. We seek to review the interaction of the CD44 receptor with the various forms of hyaluronic acid in the skin to better understand its action and fully explore its use in dermatology.

Keywords: Rejuvenation; Hyaluronic acid; Skin

Exosomes are small extracellular vesicles, released by different types of cells, that play roles in intercellular communication. In the skin, exosome-mediated information transfer and intercellular communication are necessary for the maintenance of cellular function and tissue homeostasis. Recently, several studies have demonstrated the involvement of exosomes in skin diseases and rejuvenation, including potential therapeutic uses. In this context, we address recent research on exosomes in dermatology by reviewing the role of exosomes in skin diseases and rejuvenation.

Keywords: Exosomes; Skin; Rejuvenation.

Autologous fat grafting is a common option for the correction of facial asymmetry. Recently, therapies using injectable substances that promote lipolysis have emerged to reduce undesired fat volume, offering an alternative to surgical removal of adipose tissue. We report an experimental case in which fat-dissolving injections were used to correct facial asymmetry following fat grafting, demonstrating satisfactory results with a minimally invasive procedure.

Keywords: Facial Asymmetry; Adipose Tissue, Subcutaneous; Mesotherapy.