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Skin Deep is a blog for dermatologists and skin care professionals with focus on theoretical, cosmetic and aesthetic dermatology. This blog is associated with ‘Dermatologists Sans Borders’ one of the largest curated groups of skin care professionals on facebook. If you are looking for non-technical information, please visit

Dark Circles, Omalizumab, PRP, Metformin and Dermal Fillers

Here is a quick review of few interesting articles before I go into peptides again.

Example of dark circles
Example of dark circles (Photo credit: Wikipedia)
(1) Dark circles is a common and difficult to treat cosmetic concern. Many factors are incriminated including transparency of periorbital skin and microcirculatory disturbance. It may also be just shadows being thrown by your own features. Filling of periorbital hollow with dermal fillers and a variety of other materials claim to improve dark circles. But clinical proof of efficacy is absent in most cases. This article describes a collagenase digested fat cell grafts that minimised visible lumps post procedure. However only 60% of those treated got improvement. Safety of collagenase in this anatomically thin area also needs to be evaluated.

English: Uriticaria
English: Uriticaria (Photo credit: Wikipedia)
(2) The monoclonal anti IgE drug omalizumab has reached phase III trials in Chronic Idiopathic Urticaria. At present it is licensed for the treatment of asthma. The referenced writeup in medpage today depicts it as a serendipitous discovery. Chronic Idiopathic Urticaria should be a natural target for a monoclonal IgE antibody useful in asthma.

(3) As I concluded after my series on PRP, Platelet rich plasma is a mixture of growth factors with diametrically opposite effects.  This study shows that excessively high concentrations of platelets actually have an inhibitory effect on the wound healing processes and are, therefore, counterproductive.
Metformin (Photo credit: Wikipedia)

(4)Metformin reduces hepatic glucose output and has anti-platelet and anti-oxidant effects. It has many non-diabetic cutaneous indications as well. This article reviews its beneficial effect on hirsutism, acne, hidradenitis suppurativa, acanthosis nigricans, psoriasis and skin cancer.

(5) The dermal filler manufacturers control the consistency and longevity of their products by altering the chain length and cross linking. Hyaluronic acid stabilized by carboxyl - hydroxyl inner esterification may have the additional benefit of pro-proliferative activity of cutaneous fibroblasts and keratinocytes.


1. Youn, S. "Correction of Infraorbital Dark Circles Using Collagenase-Digested ..." 2013.

2. "Asthma Drug Curbs Chronic Hives." 2013. 25 Mar. 2013

3. Giusti, Ilaria et al. "The effects of platelet gel–released supernatant on human fibroblasts." Wound Repair and Regeneration (2013).

4. Badr, D, M Kurban, and O Abbas. "Metformin in dermatology: an overview." Journal of the European Academy of Dermatology and Venereology (2013).

5. Wohlrab, Johannes, David Wohlrab, and Reinhard HH Neubert. "Comparison of noncross‐linked and cross‐linked hyaluronic acid with regard to efficacy of the proliferative activity of cutaneous fibroblasts and keratinocytes in vitro." Journal of cosmetic dermatology 12.1 (2013): 36-40.

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About Me

As a Dermatologist and Informatician my research mainly involves application of bioinformatics techniques and tools in dermatological conditions. However my research interests are varied and I have publications in areas ranging from artificial intelligence, sequence analysis, systems biology, ontology development, microarray analysis, immunology, computational biology and clinical dermatology. I am also interested in eHealth, Health Informatics and Health Policy.


Bell Raj Eapen
Hamilton, ON