A difficult patient at a cosmetologist appointment: early lip changes in women smokers: causes, and methods of correction

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A smoker’s lips are more likely to change because of exposure to reactive oxygen species that contain oxygen in large quantities in tobacco smoke. Oxidative stress is a crucial factor in the development of smoking-related diseases, such as oral cancer, lung cancer, and chronic obstructive pulmonary diseases. The damaging effect occurs because of the imbalance between the generation of reactive oxygen species and their detoxification. Markers of oxidative stress include parameters of lipid peroxidation, the activity of glutathione and antioxidant enzymes, and oxidative DNA damage. The destruction of hyaluronic acid (HA), the only drug used to correct lip changes, in smokers is accelerated by its participation in reactions with active oxygen forms, and not just by pathemization because of enzymatic cleavage by hyaluronidase. Mannitol has strong antioxidant properties, which makes it an ideal auxiliary substance in the composition of fillers based on HA. The role of reactive oxygen species in the aging process and their effects on both endogenous HA and HA-based drugs developed for esthetic use are discussed. A review of drugs, based on mannitol with hyaluronic fillers, is provided. The inclusion of mannitol in hyaluronic fillers is an effective and safe way to improve both short-term and long-term esthetic effects of the HA injection.

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M. A. Shirshakova

Medical practice center

Author for correspondence.
Email: doc.elene@mail.ru
Russian Federation, Moscow, 127473

Elena A. Morozova

I.M. Sechenov First Moscow State Medical University (Sechenovskiy University)

Email: doc.elene@mail.ru
ORCID iD: 0000-0001-5826-5018

MD, PhD, postgraduate of Department

Russian Federation, Moscow, 119991


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Supplementary files

Supplementary Files
1. Fig. 1. The mechanism of premature aging caused by smoking (cited from [6]).

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2. Fig. 2. Patient N. Pronounced purse-string wrinkles, lip asymmetry, a decrease in the volume of the red border, indistinctness of the upper lip contour.

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3. Fig. 3. Patient M., 37 years old. Reduction of the volume of the red border, deterioration of the quality of the skin of the perioral area, changes in the brightness and color of the lips, purse-string wrinkles.

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4. Fig. 4. Patient O., 56 years old. Pronounced purse-string wrinkles, a decrease in the volume of the red border, an increase in the distance of the skin part of the upper lip, "puppet wrinkles". a - before the procedure; b - the day after the procedure for contouring and volumetric lip plastics.

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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