Effects of CE Ferulic^® Combined with Microneedling in the Treatment of Pigmentary Disorders: A Monocentric, Split Face, Comparative Study

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Dear authors

I wanted to express my appreciation for your manuscript titled "Effects of CE Ferulic © Combined with Microneedling in the Treatment of Pigmentary Disorders: A Monocentric, Split Face, Comparative Study." It is indeed a relevant contribution that could significantly impact the field of pigmentary disorders, particularly regarding the use of combined procedures compared to microneedling alone. Your discussion, supported by relevant prior studies, is commendable.

Iam reaching out to invite you to consider some suggestions for improving the quality of your manuscript:

Abstract

 

Lines 118-123: Clarify whether the patient applies CE Ferulic on both sides of the face or only on the left side during home treatment.

Lines 142-152, 153-167: The descriptions of the SkinPen treatment and CE Ferulic effects seem more suitable for the introduction or discussion sections. Consider focusing the method section solely on the applied protocol.

 

Results

 

Line 198: Table 1 repeats information already described in the text. I recommend either omitting the data from the text or eliminating the table, depending on what you believe is more appropriate.

 

Discussion

Line 331: I suggest relocating the mention of the manufacturer, Crown Aesthetics, to the Materials and Methods

Your attention to these suggestions would undoubtedly enhance the clarity and impact of your manuscript. I look forward to seeing the revisions and the continued progress of your work.

Thank you for considering these recommendations.

Best regards

Author Response

Thank you very much for taking the time to review this manuscript. Please find the detailed responses in the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Dear Authors,

Your manuscript is interesting and demonstrated the efficacy of CE Ferulic © and microneedling. However, I have some concerns and suggestions to improve the quality of the manuscript.

1. The last paragrapgh of the Introduction section includes information that should be written in the Methods section, and also some information about your results. I recommend to rewrite this paragraph including only the aim of the study. 

2. Include the inclusion criteria in the Methods section, the reason you decided to apply CE ferulic on the left side of the face instead of randomizing the side of the face. In the Methods section is not necessary to repeat the mechanism of action and benefits of the interventions, this information should be included in the Introduction section.

3. Please explain which variables you included in the regression model.

4. I recommend to communicate the results per dermatological diagnosis, because you have 3 groups of patients: photodamage, melasma and rosacea. The efficacy of the interventions should be shown to the readers by group of diagnosis.

I hope theses recommendations help you to improve the quality of the manuscript.

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

The study is interesting. The results obtained are promising and may be of interest to clinicians. A disadvantage of the work is the small study group (15 persons), yet the work is valuable. The methodology is well described. The results are clearly presented. In my opinion, after minor corrections (comments below), the work will be suitable for publication in a journal.

Minor comments:

1. Subheadings („Background”; „Methods”;…)  in the abstract should be removed.

2. Introduction: The Authors should include brief information about drug-induced hyperpigmentations, eg. Hyperpigmentations induced by homonal contraceptives or phototoxic drugs.

Author Response

Dear Reviewer,

please see our response in the attachment.

Author Response File: Author Response.pdf

Reviewer 4 Report

Comments and Suggestions for Authors

The paper by Proietti et al. examining vitamin C plus ferulic acid with microneedling via a split-face study on pigment disorders is of interest.  However, several issues must be addressed, as outlined below.

1.How does your study provide the readership with novel, different or innovative information on vitamin C plus ferulic acid treatment with microneedling?

a.  How are your results similar to, different from, or novel compared to references 12 through 14?

b. What are the reasons the average age of 50 years old is not discussed?  How many subjects were menopausal?  How does this influence the results?

c. What were the inclusion criteria?

d. The right vs. left side of the face pigmentation is not uniform, as covered in lines 351-354, but how did this influence the present study outcomes?

e. It is obvious from figures 2, 3 and 4 that microneedling alone improved the skin parameters, but this is not discussed?  And more importantly it is difficult to follow the statistical analysis/results reported associated with the study parameters.

f. What was the age of the subjects shown in each photo?

g. Except for Figure 2, where there is improvement of the nasal-labial fold for pigmentation, the other vitamin D plus ferulic acid changes were modest, at best, please cover these points.

2. Figure 1 and Table 2 are difficult to follow, please provide more information, labels, etc. so the readership can understand what is being presented.

3. The discussion section should discuss the present results in reference to previously published data, not be a repeat of the results section.

3. The conclusion section is too long and should be presented in brief.

4. The limitations of the present study are not addressed in the discussion, nor is there a clear description of the value of the treatments over what has been previously published.

Based upon the points outlined above the value/significance of this study is unknown.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 4 Report

Comments and Suggestions for Authors

Lines 201 thru 204 are not in English

The authors provided this reviewer with a description/explanation of age, menopause and HRT use in their cover letter but I did not see this information incorporated into the text of the study.  Please include this information and how it may have influenced the outcomes/results of this study.

Author Response

Please see the attachment

Author Response File: Author Response.pdf