Aesthetic aspects of skin aging, prevention, and local treatment

[Skin aging: Pathophysiology and innovative therapies]

One of the major challenges of the 21^st century is the fight against aging, defined as a set of physiological mechanisms altering the physical and intellectual capacities of human beings. Aging of the skin is only one visible part of this process. It is associated with major healing defects linked in part to the alteration of the biomechanical properties of skin cells, mainly dermal fibroblasts. The immune system, another key component in maintaining skin homeostasis and the efficient healing of wounds, also suffers the effects of time: the consequent skin immunosenescence would limit the anti-infectious and vaccine response, while promoting a pro-tumor environment. The main skin damages due to aging, whether intrinsic or extrinsic, will be detailed before listing the effective anti-aging strategies to combat age-related dermal and epidermal stigmas.

Facial Expression Wrinkles and Their Relaxation by a Synthetic Peptide

Expression wrinkles form over time due to repeated facial movements such as smiling and frowning. They have an imprint on facial skin in areas such as the corner of the eyes, where they take the form of crow’s feet, the forehead and the glabella, where they appear as frown lines, and around the mouth, as marionette lines. In the study presented here, we recruited two sets of volunteers. An older group of 57 volunteers aged 50 to 65 years, and a group of eight younger volunteers aged 21–35 who were the biological daughters of eight of the older volunteers. Using VISIA CR, we took images of the volunteers in relaxed, angry and smiling mode to assess similarities in expression wrinkle patterns. In addition, the older volunteers were split into a placebo group and an active group who applied a formulation of 4% of a cosmetic product containing the peptide diaminobutyroyl benzylamide diacetate (DABBA) for four weeks. Wrinkles were assessed by image analysis, expert grading and Primoslite measurements. Our study found striking similarities in the facial wrinkle patterns of mothers with relaxed faces and daughters with angry or smiling faces. We found a decrease in visible wrinkles in the group of older volunteers applying DABBA. We created a facial map for graded wrinkles showing these changes. Volunteers using the active formulation showed significantly less wrinkle area and length on the forehead when frowning compared to the placebo group (p < 0.05).

Early and maintained application of the secretion of Cryptomphalus aspersa (SCA) 40% improves cutaneous healing after ablative fractional laser in skin aging

BACKGROUND

Ablative fractional laser generates a regulated skin damage, which secondarily improves skin aging.

AIMS

The main objective of the present study was to figure out if the adverse effects induced by laser and the skin recovery could improve with the application of a cosmetic product based on the secretion of Cryptomphalus aspersa (SCA).

PATIENTS/METHODS

A prospective double-blind controlled study with vehicle in 10 patients with skin aging. The patients received one session of fractional ablative CO₂  laser, and the formulation with SCA 40% was applied immediately and maintained throughout the 21-day duration of the study. The active treatment (SCA) was applied to one hemifacial area and vehicle to the other, and the patient acting was her own control. Clinical evaluations, dermoscopy, photography, and other parameters like cutaneous hydration, elasticity, and wrinkles were evaluated. In addition, the severity of the adverse effects was evaluated.

RESULTS

Significant greater decrease in the density of microcolumns produced by laser was detected on the active-treated side, indicating greater and faster postprocedure recovery compared to the vehicle-treated side. In addition, side effects were reduced and some antiaging effects were more apparent on the side treated with SCA 40%.

CONCLUSION

SCA 40% applied immediately after ablative laser, and during the next days, it can accelerate laser-induced damage regeneration. In addition, SCA improves the cosmetic outcome after laser application.

Combined therapy with Endoret-Gel and plasma rich in growth factors vs Endoret-Gel alone in the management of facial rejuvenation: A comparative study

BACKGROUND

Skin suffers progressive decrement. An endogenous regenerative technology has been developed that has the versatility to provide an autologous injectable gel (Endoret-Gel) or a liquid plasma rich in growth factors (PRGF) based on the patient´s own platelet-rich plasma.

AIMS

To compare the efficacy of the combined therapy with Endoret-Gel and PRGF versus Endoret-Gel alone in the management of facial rejuvenation.

METHODS

Twenty clinically diagnosed patients with aged skin received either Endoret-Gel monotherapy or Endoret-Gel + PRGF combined therapy. Patients underwent three sessions at one-month intervals and were clinically assessed for six months. Corneometry, sebumetry, and high-resolution topographic analysis were carried out. Patient self-assessment questionnaires and clinical improvement scores were also performed.

RESULTS

The combined therapy showed to promote a higher hydration index. These results were also significant for spot improvement at three months, while conversely, monotherapy with Endoret-Gel demonstrated higher UV spot improvement. A significant decrease of sebum production and wrinkle development was observed for both treatment groups. Red areas also improved in a similar way at the end of the follow-up period. After Endoret-Gel or Endoret-Gel + PRGF therapy, 30% and 70% of patients referred to be very satisfied, respectively. Accordingly, 40% and 80% showed a "very improved" esthetic performance. None of the patients reported a negative change and no adverse events were recorded.

CONCLUSION

Both Endoret-Gel monotherapy and the combined treatment with PRGF were shown to promote facial rejuvenation and to palliate the age-related cutaneous atrophy. The combined therapy may exert a synergistic effect that addresses both skin quality improvement and soft tissue restoration in a shorter period.

Efficacy of home-use light-emitting diode device at 637 and 854-nm for facial rejuvenation: A split-face pilot study

BACKGROUND

The use of light-emitting diode (LED) in combination wavelength for facial rejuvenation has been previously reported. Nowadays, there has been a growing market for home-use cosmetic devices because of its low cost and convenience.

AIMS

To evaluate the efficacy and safety of home-use LED device on facial rejuvenation.

METHODS

This was a prospective split-face clinical trial with a total of 24 subjects, who presented with photo aging skin. All subjects were treated with the home-use LED device on the left side of their face, twice a week for 8 weeks. Primary outcomes measured in the study were the changes in the biophysical properties of the skin assessed with the following parameters: skin elasticity, skin hydration, texture, and wrinkles. Evaluations were done at baseline, 2-, 4-, 6-, and 8-week follow-up. Subjects' self-improvement scores and adverse reactions were also recorded.

RESULTS

All 24 subjects completed the study and attended all follow-up. Skin elasticity was significantly higher in the LED group compared to the control during the 6- and 8-week follow-up (P < .05). In the LED group, an image of the treated skin captured using Visioscan^® showed improvement of the skin texture at 8-week follow-up. Majority of the subjects in the LED group scored good improvement on all follow-ups (37.5%, 41.7%, 58.3%, and 62.5%) when compared to the baseline. No adverse reactions or pain were recorded in the study.

CONCLUSION

The home-use LED device, with a combination wavelength of 637 and 854 nm, is safe and can be used as an adjunctive treatment for self-administered facial rejuvenation.

Natural anti-aging skincare: role and potential

The deterioration of the skin morphology and physiology is the first and earliest obvious harbinger of the aging process which is progressively manifested with increasing age. Such deterioration affects the vital functions of the skin such as homeodynamic regulation of body temperature, fluid balance, loss of electrolytes and proteins, production of vitamin D, waste removal, immune surveillance, sensory perception, and protection of other organs against deleterious environmental factors. There are, however, harmful chemicals and toxins found in everyday cosmetics that consumers are now aware of. Thus, the natural beauty industry is on the rise with innovative technology and high-performance ingredients as more consumers demand healthier options. Therefore, the aims of this review are to give some critical insights to the effects of both intrinsic and extrinsic factors on excessive or premature skin aging and to elaborate on the relevance of natural beauty and natural anti-aging skincare approaches that will help consumers, scientists and entrepreneurs make the switch. Our recent investigations have shown the potential and relevance of identifying more resources from our rich natural heritage from various plant sources such as leaves, fruits, pomace, seeds, flowers, twigs and so on which can be explored for natural anti-aging skincare product formulations. These trending narratives have started to gain traction among researchers and consumers owing to the sustainability concern and impact of synthetic ingredients on human health and the environment. The natural anti-aging ingredients, which basically follow hormetic pathways, are potentially useful as moisturizing agents; barrier repair agents; antioxidants, vitamins, hydroxy acids, skin lightening agents, anti-inflammatory ingredients, and sunblock ingredients.

Dermatoporosis - The Chronic Cutaneous Fragility Syndrome

Dermatoporosis is an important clinical condition leading to chronic skin fragility. It can be separated into primary and secondary subtypes, with the latter induced by medical drugs and environmental factors. Dermatoporosis can be classified into 4 major stages with increasing morbidity and mortality with the advanced stages. Its aetiology has been related to the epidermal hyalusome. Dermatoporosis is a cause of mortality in the intensive care unit and should be known not only by a dermatologist but another medical speciality as well. Prevention is of major importance. Therapeutic options are limited but available.