Objectives: The objectives of this presentation is to show how EBD’s can be used successfully to treat hypertrophic scars and keloids.

Introduction: Several EBD’s have been used over the past several years to treat hypertrophic scars and keloids. From PDL to fractional non-ablative and ablative lasers, these devices have shown to be successful in reducing the scars themselves and also allowing increased mobility in many.

Materials / method: Evidence-based medicine will be reviewed including the authors own experience in how to incorporate these devices into one’s clinical practices.

Results: EBDs can be successfully used to treat hypertrophic scars and keloids.

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请注明名称（个人，公司，学会等等）: Lumenis, Candela

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Objectives: Keloid disorder (KD) is one the most difficult-to-treat human illnesses. Although keloids can occur at any age, they tend to develop more rapidly during and after puberty. Epidemiology and age of onset of keloid has not been properly studied.

With highly variable and diverse clinical presentation, patients with KD are in need of different treatment options that would address each unique clinical scenario. Although localized treatments may be proper for patients with early and limited stage KD, patients with more advanced stages of KD are in need of systemic treatments.

Introduction: The armamentarium for treatment of KD is limited to suboptimal methods, with minimal data to guide treatment pathways and no systemic treatment options.

Treatment strategy starts with establishing treatment goals which often vary from patient to patient. With our limited understanding of its pathophysiology, and the lack of academic and industry interest, most treatment options that are used to treat keloid patients have been borrowed from other areas of medicine.

Materials / method: The most important aspect of treating keloid patients is “do no harm”.

Intralesional Steroid (ILS) Injection is the most commonly used treatment modality for KD, however repeated injections can lead to worsening of keloids in about 17% of patients.

Lasers are among the most commonly used tools in day-to-day practice of dermatology. Although there are several reports about the utility and efficacy of laser treatment in keloid lesions, there is data suggesting that laser treatments can lead to worsening of keloids in about 20% of patients.

Results: Surgical removal of keloids is known to lead to very high rate of recurrence and worsening of keloids in a large number of patients.

Efficacy of cryotherapy in treatment of keloids has been reported by various authors. Cryotherapy is highly effective in the treatment of ear keloids as well as bulky and tumoral keloidal lesions.

Conclusion: At the current time, the author advises against surgery, radiation therapy and laser treatments for early-stage keloids. These recommendations are data-driven and are aimed to reduce the risk for iatrogenic worsening of the keloids.

Author’s presentation will cover various clinical aspects of KD as well as treatment strategy and non-surgical interventions such as cryotherapy and intralesional chemotherapy.

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Objectives: Senescence of the skin as a result of extrinsic and intrinsic confounders is known to serves as the index organ for internal organ, Among others oxidative stress induces cellular senescence next to mitochondrial dysfunction which result increasing ECM levels-degrading proteins such as MMPs, and decreased collagen synthesis. MMPs also destroy the basement membrane, which is involved in skin elasticity as one of the major visible changes. To date there is a growing body of evidence that oxidate stress as well as mitochondrial dysfunction can be attributed by antioxidants, hyaluronate and exosoms

Introduction: Mainly extrinsic ageing is derived from oxidate stress resulting from an dysbalance of synthesis of reactive oxygen species (ROS) and defense modalities to neutralize it by means of glutathione (GSH), superoxide dismutase (SAD), and catalase. Due to this ECM degrading factors such as collagenase and matrix metalloproteinases are upregulated. On the other hand ROS downregulates TGFß pathways leading to de-creased synthesis of collagen type I. Various effective compounds such as GSH, hyaluronate, vitamin C, and niacinamide have been proven for efficacy.

Materials / method: Analysis of compounds composition, galenics and ways of administration were ana-lyzed to provide a most up-to date recommendation of it use. Analysis of compounds composition, galenics and ways of administration were analyzed to provide a most up-to date recommendation of it use. Ways of administration, dosage and therapeutic regimen were analyzed..

Results: Analysis of compounds composition, galenics and ways of administration were ana-lyzed to provide a most up-to date recommendation of it use. Ways of administration, dosage and therapeutic regimen were investigated. Additional mode of actions to be included in future concepts fight inflammation (Beta-glucan), maintain hydration (Galactoarbinan) and serve as humectants (Betaine).
,

Conclusion: In order to fight oxidative stress on a cellular and molecular level specific compound like effective compounds such as GSH, hyaluronate, vitamin C, and niacinamide (vit-amin B3) are in use. Exosoms next to it provide a new field of otions but also risk profiles. In order to maximize the effect appropriate galenics of their composition in conjunction with new compounds as well as new concepts of compound delivery are developed to fight senescence of the skin.

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