The Utilization of a Topical Nitric Oxide Serum in Aesthetic Medicine

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  1. Nitric oxide is free radical gas. It is produced endogenously and is synthesized from arginine by nitric oxide synthase.
  2. Nitric oxide mediates vasodilation, inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adherence to endothelial cells. As a result, Nitric Oxide is a potent vasodilator and increases blood flow via capillary recruitment.
  3. A Nitric Oxide serum can be safely formulated without the generation of nitric dioxide and is necessary for optimal cellular health.
  4. Nitric Oxide serum can be topically applied for many cosmetic purposes, and also has anti-inflammatory and anti-bacterial properties.
  5. Topical Nitric Oxide serum by itself yields improvement in fine lines and wrinkles and enhances the tone/texture of the skin.
  6. When used prior to any other topical, the vasodilatory property primes the skin to enhance the absorption of other products.


  • Fifty patients were enrolled in a multi-limb study. Ages ranged from 15 to 76. There were 36 females and 14 males. Patients were enrolled under four categories: Aging Skin, Active Acne, Scar Therapy, and Wound Care.
  • The Aging Skin population utilized Pneuma bid after cleansing. Photographs were taken weekly for 30 days. Linear analog scales examined skin tone, wrinkles, clarity, and pigment variation. No other products were used concomitantly.
  • The Active Acne patients were divided into mild, moderate, and severe states based on nodule and pustule counts.
  • Pneuma was applied AM and PM after cleansing. Photographs were taken weekly for 30 days.
  • Pustule and nodule counts were recorded weekly.
  • Pneuma was applied bid in the treatment of atrophic scars, striae, acne scars, hypertrophic scars, and excised keloid scar beds. Photos were taken weekly for 30 days.
  • Several wound types were examined. Surgical incisions, healing surgical flaps, diabetic ulcers and smoking-induced vascular compromised skin. Pneuma was applied daily. Photographs were taken daily for the surgical patients, and weekly for 30 days for the remainder of the population.


  • The Aging Skin population reported improvement in fine lines, wrinkles, skin tone and pigmentation. Linear Analog improvement scores recorded by patients ranged from 1.5 to 3.2 points. The average was 2.1. Linear analog improvement scores recorded by the treating physician ranged from 0.75 to 2.5, with an average of 1.6.

  • The Acne population showed a range in pustule and nodule reduction ranging from 20% to 84%. The average reduction was 68%.

  • The Scar Therapy population showed positive trends. The atrophic scar patients and those with striae improved the most. Softening of hypertrophic scar tissue was noted.

  • Keloid wound beds healed faster than non-treated patients. Improved vascularity is speculated.

  • The wound healing population, without exception, showed excellent results. Rhytidectomy, Blepharoplasty, and Rhinoplasty patients displayed less bruising, edema, and more rapid healing. Non-healing ulcers healed within 30 days. Revascularization was routinely evident in compromised flaps.


Pneuma Nitric Oxide delivers bioactive nitric oxide via a dual chamber delivery device. It is a revolutionary product which is an important addition to the armamentarium of any aesthetic provider.