1. Combination with Vitamin C

(1) Principle

Cold Atmospheric Plasma (CAP) can promote the metabolism and microcirculation of skin cells, thereby enhancing the skin's absorption capacity. Vitamin C is an antioxidant that functions in skin brightening, antioxidation, and promotion of collagen synthesis. When the two are combined, CAP helps the skin absorb vitamin C more effectively, thereby enhancing the skin-brightening and anti-aging effects of vitamin C[1][2][3][4].

(2) Therapeutic Effects

It can effectively reduce melanin deposition, improve uneven skin tone, brighten the complexion, and at the same time increase skin elasticity and radiance, reduce the formation of wrinkles, so as to achieve the cosmetic effects of skin brightening and anti-aging.

2. Combination with Hyaluronic Acid

(1) Principle

Hyaluronic Acid has a strong moisturizing function. It can form a breathable film on the skin surface to prevent transepidermal water loss, and can also promote the absorption of nutrients by the skin. CAP can form microchannels on the skin surface, which increases the absorption and penetration of Hyaluronic Acid by the skin, allowing Hyaluronic Acid to better exert its moisturizing and filling effects[5][6][7][8].

(2) Therapeutic Effects

It can significantly increase the moisture content of the skin, making the skin more hydrated and plump, alleviate problems such as dry skin and fine lines, and improve skin firmness and smoothness.

3. Combination with Growth Factors

(1) Principle

Growth Factors can stimulate the proliferation, differentiation, and migration of cells, and promote the repair and regeneration of skin tissue. CAP can activate the activity of skin cells, create a more favorable environment for the functioning of Growth Factors, and enhance the repair and regeneration effects of Growth Factors on skin cells[6][7][9].

(2) Therapeutic Effects

It has a good improvement effect on problems such as skin damage, acne scars, and enlarged pores. It can promote the renewal and repair of skin cells, accelerate the synthesis of collagen and elastic fibers, and make the skin healthier, firmer, and more elastic.

4. Combination with Plant Extracts

(1) Principle

Many plant extracts, such as green tea extract and licorice extract, have anti-inflammatory, antioxidant, and soothing effects. When CAP is combined with plant extracts, on the one hand, it can promote the absorption of plant extracts, and on the other hand, it can enhance their biological activity, enabling them to better exert beneficial effects on the skin[7][10].

(2) Therapeutic Effects

It can reduce skin inflammatory reactions, relieve skin sensitivity symptoms, reduce the damage of free radicals to the skin, and at the same time improve the oil secretion of the skin, regulate the water-oil balance of the skin, and keep the skin in a fresh and comfortable state.

5. Other Combinations

In addition to the above four categories, there are many other substances that can be combined with CAP for skin cosmetology. The following are some common ones[5][7][11][12]:

(1) Vitamin E

· Antioxidant Synergy: Vitamin E is a fat-soluble vitamin with strong antioxidant properties. It can scavenge free radicals in the skin, reduce oxidative damage, and delay skin aging. When combined with CAP, the active substances produced by CAP can further enhance the antioxidant effect of Vitamin E. The two work together to more effectively resist skin damage caused by external factors such as ultraviolet rays, prevent the formation of spots, and maintain skin elasticity and radiance.

· Skin Protection and Repair: Vitamin E can protect the skin cell membrane from the attack of free radicals and maintain the integrity of skin cells. CAP may cause slight stimulation to skin cells to a certain extent, while Vitamin E can reduce such stimulation and at the same time promote cell repair and regeneration, making the skin healthier.

(2) Collagen

· Enhancing Firming Effect: Collagen is the main structural protein of the skin, which can maintain skin firmness and elasticity. CAP can stimulate the synthesis of the skin's own collagen. Meanwhile, when used in combination with exogenous collagen, it can help collagen penetrate into the dermal layer of the skin more effectively, supplement the lost collagen, increase the thickness and toughness of the skin, make the skin firmer, and reduce the formation of wrinkles.

· Promoting Tissue Regeneration: Collagen can also provide a good growth environment for skin cells and promote the regeneration and repair of skin tissue. By regulating the metabolism and function of skin cells, CAP cooperates with collagen to promote the self-renewal of the skin and improve the texture and appearance of the skin.

(3) Plant Essential Oils

· Soothing and Anti-Inflammatory: Many plant essential oils, such as lavender essential oil and tea tree essential oil, have soothing and anti-inflammatory effects. They can reduce skin inflammatory reactions and relieve skin discomfort such as redness and itching. When combined with CAP, the bactericidal effect of CAP can be combined with the anti-inflammatory effect of plant essential oils, which can better treat inflammatory skin diseases such as acne, and at the same time soothe the skin and reduce skin sensitivity.

· Skin Beauty and Nourishment: Some plant essential oils also have cosmetic effects such as antioxidation and skin brightening. For example, rose essential oil is rich in antioxidant components, which can help scavenge free radicals and brighten the skin tone. CAP can promote the absorption of active ingredients in plant essential oils, enhance their cosmetic effects, and make the skin smoother, more delicate, and radiant.

(4) Combined Application of Normal Saline and Plasma-Activated Water[13]

· Teeth Whitening

· Oral Medicine

References

[1] Shakouri, Reza, et al. In vivo study of the effects of a portable cold plasma device and vitamin C for skin rejuvenation. Scientific reports 11.1 (2021): 21915.

[2] Hinek, A. et al. Sodium l-ascorbate enhances elastic fibers deposition by fibroblasts from normal and pathologic human skin. J. Dermatol. Sci. 75, 173-182 (2014).

[3] Pihlajaniemi, T., Myllyla, R. & Kivirikko, K. I. Prolyl 4-hydroxylase and its role in collagen synthesis. J. Hepatol. 13, 2-7 (1991).

[4] Matsumura, Y. & Ananthaswamy, H. N. Toxic effects of ultraviolet radiation on the skin. Toxicol. Appl. Pharmacol. 195, 298 - 308 (2004).

[5] Chang, R. X., & Yang, C. J. (2012). Medical applications of low-temperature plasma in dermatology. Chinese Journal of Dermatology and Venereology, 26(12), 1133-1135.

[6] Choi J H, Nam S H, Song Y S, et al. Treatment with low-temperature atmospheric pressure plasma enhances cutaneous delivery of epidermal growth factor by regulating E-cadherin-mediated cell junctions[J]. Archives of dermatological research, 2014, 306: 635-643.

[7] Applications and principles of low-temperature plasma in skin care.

[8] The role and effects of hyaluronic acid in cosmetology. Beauty & Body Care Network. 

[9] Yuan, C. Y., Li, J. H., Wang, H. Y., Gao, L. Q., Zheng, Y. Y., & Ai, L. (2017). Clinical study on the efficacy of micro-plasma beam combined with recombinant bovine basic fibroblast growth factor gel in the treatment of depressed acne scars. Chinese Journal of Aesthetic Medicine, 26(12), 113-116.

[10] Yang, Y. Y., Yang, Z. G., Hu, S. G., Li, Y., Xue, Q., & Sun, H. F. (2019). The efficacy of silymarin in dermatology and its application in cosmetics. China Surfactant Detergent & Cosmetics, 49(4), 259-263.

[11] Zhang, S., Li, X. W., Ge, L. Y., Chen, H. X., Lu, X. P., & Liu, D. W. (2023). Application of atmospheric pressure cold plasma in skin diseases. Chinese Journal of Dermatovenereology, 37(12), 384-389.

[12] Li, X. W., Zhang, S., Wei, F., & Chen, H. X. (2023). Direct and indirect applications of atmospheric pressure cold plasma in dermatology. Chinese Journal of Dermatovenereology, 37(12), 390-399.

[13] Chen, D. C., Yang, X., Nie, L., Ren, G., Li, X. Y., & Li, C. H. (2019). Efficacy and safety evaluation of bleaching teeth with atmospheric pressure low - temperature plasma combined with normal saline. Acta Academiae Medicinae Militaris Tertiae (Journal of Third Military Medical University), 41 (13).