The influences of skin visco-elasticity, hydration level and aging on the formation of wrinkles: a comprehensive and objective approach

The gold protocol: A combined treatment approach for neck rejuvenation with calcium hydroxyapatite, botulinum toxin, and hyaluronic acid in the same session

BACKGROUND

The signs of aging seem to be more visible on the neck compared to other locations, especially if a patient has already gone through facial rejuvenation procedures. Treatment of the aging neck imposes a challenge to the clinician, since one single approach is usually not enough to achieve the desired result, requiring multiple injections and sessions, which apart from being painful for the patients, is time-consuming for the clinician.

AIM

To describe the use of calcium hydroxyapatite, incobotulinum toxin type A and Cohesive poly-densified matrix hyaluronic acid diluted in the same syringe and injected in the same session for neck rejuvenation.

PATIENTS AND METHODS

Fifteen women, older than 18 years, with cervical skin flaccidity grade 1-4 in a previously validated 5-point rating scale (Dermatologic Surg, 2016; 42, S94), who sought neck rejuvenation were injected in this pilot study with a single session with a combined hybrid mixture of calcium hydroxyapatite, incobotulinum toxin type A, and Cohesive poly-densified matrix hyaluronic acid and followed up for 90-180 days.

RESULTS

At the 4-month post injection evaluation, 93.3% of the patients presented at least 1-grade improvement in the 5-point scale as evaluated by the investigator. No serious adverse events were reported, being most mild and transient in nature.

CONCLUSION

CaHA, incoBonTA, and CPM-HA have complementary mechanisms of action and may be injected from the same syringe in the same session, boosting the final outcome, with high patient satisfaction, and ease of process for both patients and clinicians.

Women's skin care behaviors: How to influence sunscreen use

BACKGROUND

It is well known that women have been plagued by various skin problems. However, research on the characteristics of women's skin at different ages is still inadequate. In addition, there is a lack of research on the extent of women's skincare habits and skin care awareness.

METHODS

A cross-sectional survey on skin was carried out in Shanghai, China, which was conducted by means of a questionnaire. 3678 women, aged 18-59 years, participated in the study. The information collected focused on the importance they place on their skin, the skin problems they have, and their use and perception of skin care products.

RESULTS

Before the age of 25, the most common skin problems that women face are dryness and oiliness, while after the age of 30, skin-ageing issues begin to appear and worsen with age. In addition, the higher the level of education, the higher the frequency of and compliance with sunscreen use, and the economy also affects women's use of sunscreen. Importantly, the importance women place on their skin and the level of sunscreen awareness affects women's use of sunscreen.

CONCLUSIONS

This study was conducted to understand the skin characteristics of women of different age groups as well as to determine the factors that influence the use of sunscreens, which will not only promote women's skin care practices and product development, but also provide important clues for future activities on sunscreen use and health promotion.

Film-Forming, Moisturizing, and Sensory Properties of a Cosmetic Formulation Containing Tara Gum and Brazilian Berry Extracts

The development of cosmetic formulations with moisturizing and film-forming properties has been very important to help keep skin physiology and protection. In this context, this study aimed to develop a cosmetic formulation containing Tara gum and Brazilian berry extract and evaluate its physical-mechanical, film-forming, and sensory properties. A gel formulation was developed based on Tara gum added to Plinia cauliflora extract and was characterized by its spreadability profile and sensory properties. A clinical study was carried out with ten participants to evaluate the skin microrelief, stratum corneum water content, transepidermal water loss (TEWL), and skin morphological characteristics by reflectance confocal microscopy (RCM) before and after 2 h of application of the formulations. The formulation with Brazilian berry significantly decreased the work of shear parameter, which can be correlated with improved spreadability in the sensory analysis. The clinical study showed that both formulations improved skin hydration and reduced the TEWL. The RCM imaging analysis showed the visible film on the skin surface, a decrease in the size of furrows, an increase in the reflectance of the interkeratinocytes, and reflectance of the stratum corneum for both formulations. These results were more pronounced for the formulation containing Brazilian berry. The Tara gum in the gel formulation promoted the formation and visualization of a polymeric net on the stratum corneum surface, demonstrated by the images obtained from RCM. However, the formulation added with the Brazilian berry extract improved the skin microrelief, honeycomb pattern of the epidermis, and skin hydration in deeper layers of the epidermis.

A Retrospective Analysis of Safety in Participants Treated with a Hybrid Hyaluronic Acid and Calcium Hydroxyapatite Filler

Background

Limited long-term safety data are published on HA/CaHA/L, a hybrid dermal filler combining hyaluronic acid (HA), calcium hydroxyapatite (CaHA), and lidocaine (L).

Methods

This retrospective multicenter study assessed treatment-emergent adverse events (TEAEs) in adults treated with HA/CaHA/L. The full analysis set (FAS) included eligible consented adults (N = 403); the long-term safety analysis (LTSA) set included FAS participants with greater than or equal to 12-months HA/CaHA/L exposure (n = 243).

Results

Participants were majority female (94.0%), with Fitzpatrick skin phototypes II/III (80.1%) and a mean age of 50.1 years. Most participants (86.4%) received one HA/CaHA/L treatment. The median time between participants' first HA/CaHA/L treatment and chart review was 15.4 months. Participants received a mean of 2.2 mL (0.5-8.9 mL) filler per treatment. Treated areas were predominantly malar (71.2%) and mandible (69.7%) regions. Most participants (95.0%) had one or more aesthetic treatments other than HA/CaHA/L [eg, other dermal fillers (84.1%), botulinum toxin (63.3%)]. Nineteen (4.7%) FAS participants had 20 documented TEAEs; most (3.5%, n = 14 participants) were mild in severity. Twelve TEAEs in 11 participants (2.7%) were related to HA/CaHA/L: induration (three, 0.7%), edema (3, 0.7%), and implant site nodules (five, 1.2%), which were noninflammatory and likely related to product placement. Among the LTSA, 15 (6.2%) participants had 16 documented TEAEs (six edema, five implant site nodules, one inflammation, three skin induration, one hypersensitivity); most were mild in severity. Nine TEAEs in eight participants (3.3%) were HA/CaHA/L-related. No treatment-emergent serious AEs were reported.

Conclusion

The data from this noninterventional retrospective study support the favorable longer term (>12 month) safety profile of HA/CaHA/L.

Biophysical effects of a natural peloid on normal skin

A protocol study was designed to examine cutaneous behavior after continuous application of a peloid in the dry mineral residue of Lanjarón-Capuchina natural mineral water. This study aims to analyze the biomechanical behavior of normal skin using various non-invasive bioengineering techniques after the application of this peloid. We determine the effects of its application for 3 months on 38 healthy volunteers (41.4 ± 5.9 years, range 32-58) without a previous history of skin diseases by courtmetry, sebumetry, pH-metry, reviscometry, and tewametry. It was shown that the production of cutaneous sebum is significantly reduced by 6%, trans epidermal skin loss (TEWL) by 21%, skin fatigue by 30%, elasticity increased by 19%, firmness by 5%, and a skin redensification by 6% was obtained under these experimental conditions. Disparate and non-significant results were obtained concerning pH and viscoelasticity. Continuous skin care with the Lanjarón-Capuchina natural peloid modifies skin behavior, normalizing sebaceous secretion, favoring the biomechanical properties of the skin and the skin barrier function without modifying skin homeostasis.

Clinical evidence of the efficacy and safety of a new multi-peptide anti-aging topical eye serum

BACKGROUND

Skin aging is a complex multifactorial progressive process. With age, intrinsic and extrinsic factors cause the loss of skin elasticity, with the formation of wrinkles, resulting in skin sagging through various pathways. A combination of multiple bioactive peptides could be used as a treatment for skin wrinkles and sagging.

OBJECTIVES

This study aimed to evaluate the cosmetic efficacy of a multi-peptide eye serum as a daily skin-care product for improving the periocular skin of women within the ages of 20-45 years.

METHODS

The stratum corneum skin hydration and skin elasticity were assessed using a Corneometer CM825 and Skin Elastometer MPA580, respectively. The PRIMOS CR technique based on digital strip projection technology was used for skin image and wrinkle analysis around the "crow's feet" area. Self-assessment questionnaires were filled on Day 14 and 28 of product use.

RESULTS

This study included 32 subjects with an average age of 28.5 years. On Day 28, there was a significant decrease in the number, depth, and volume of wrinkles. Skin hydration, elasticity, and firmness increased continuously during the study period, consistent with typical anti-aging claims. A majority of the participants (75.00%) expressed overall satisfaction with their skin appearance after using the product. Most participants noted a visible skin improvement, with an increase in skin elasticity and smoothness, and confirmed the extensibility, applicability, and temperance of the product. No adverse reactions related to product use were observed.

CONCLUSIONS

The multi-peptide eye serum uses a multi-targeted mechanism against skin aging to improve the skin appearance, making it an ideal choice for daily skincare.

Improved Patient Satisfaction With Skin After Treatment of Cheek Skin Roughness and Fine Lines With VYC-12L: Participant-Reported Outcomes From a Prospective, Randomized Study

BACKGROUND

VYC-12L is a hyaluronic acid filler to improve skin quality. A prospective study showed safety and effectiveness of VYC-12L for improving cheek skin smoothness and fine lines.

OBJECTIVES

To report participant-reported outcomes, subgroup analyses, and physician experience from the prospective study.

METHODS

Adults with moderate to severe Allergan Cheek Skin Smoothness (ACSS) scale scores were randomized 2:1 to VYC-12L or control (no treatment with optional treatment). Participant assessments included FACE-Q Satisfaction With Skin, FACE-Q Appraisal of Lines, natural look and feel, the Global Aesthetic Improvement Scale (GAIS), and safety. Subgroup analyses examined ACSS responder rate (≥1-grade improvement from baseline to 1 month).

RESULTS

FACE-Q Satisfaction With Skin overall mean scores improved from baseline to 1 month posttreatment by 32.0 and 1.4 in the VYC-12L and control groups, respectively. FACE-Q Appraisal of Lines overall mean scores improved from baseline to 1 month posttreatment by 23.3 and 0.4 in VYC-12L and control, respectively. Treated participants had high median scores (≥9.0) of natural look and feel of their cheek skin. GAIS responder rate was high at Month 1 (85.5%; 95% CI, 79.3%-91.7%) and through Month 6 (83.1%; 95% CI, 76.5%-89.7%). Mean participant-rated pain scores were low (<3). The most common injection site reactions were redness, swelling, and lumps/bumps; most resolved within 3 days. Subgroup analyses showed significant differences in ACSS responder rate between VYC-12L and control groups 1 month posttreatment. Physician injectors reported that VYC-12L was easily injected at the superficial skin and integrated quickly.

CONCLUSIONS

VYC-12L treatment produced significant improvements in satisfaction with skin and cheek skin smoothness, as measured by participant-reported outcome measures.

LEVEL OF EVIDENCE: 2

Encapsulation of alpha arbutin, a depigmenting agent, in nanosized ethosomes: Invitro and invivo human studies

Alpha arbutin is a skin-whitening agent in cosmetics. Structurally, it is 4-hydroxyphenyl-α-glucopyranoside. Ethosomes encourage the formation of lamellar-shaped vesicles with improved solubility and entrapment of whitening agents. The objective of this study was to fabricate an optimized nanostructured ethosomal gel loaded with alpha arbutin for the treatment of skin pigmentation. Different ethosomal suspensions of alpha arbutin were prepared by the cold method. Invitro evaluation included zeta potential, droplet size analysis, polydispersity index, entrapment efficiency (EE), scanning electron microscopy (SEM) and Fourier transform infrared (FTIR) spectroscopy. Stability studies of the optimized ethosomal and control gels were performed for three months under different temperature conditions. The optimized ethosomal gel loaded with alpha arbutin was further analyzed on human volunteers for skin benefits by measuring melanin level, moisture content and elasticity. It was concluded that the optimized formulation had a size, zeta potential, polydispersity index and entrapment efficiency of 196.87 nm, -45.140 mV, 0.217 and 93.458343%, respectively. Scanning electron microscopy (SEM) depicted spherical ethosomal vesicles. Stability data was obtained in terms of pH and conductivity. Rheological analysis revealed non-Newtonian flow. The cumulative drug permeated for ethosomal gel was 78.4%. Moreover, encapsulation of alpha arbutin causes significant improvement in skin melanin, moisture content and elasticity. The overall findings suggested that the arbutin-loaded ethosomal formulation was stable and could be a better approach than conventional formulation for cosmeceutical purposes such as for depigmentation and moisturizing effects.

Non-invasive Microneedle Application Increases Ceramide and Natural Moisturizing Factors in a Reconstructed Human Skin Model

Recently, microneedling as a cosmetic product has attracted attention as one way to improve skin barrier function and moisturizing function to reduce wrinkle formation. However, some cases of erythema and edema have been reported as side effects. In order to develop safer microneedle cosmetics, we investigated whether microneedles can improve skin barrier function and moisturizing function even when applied in a non-invasive manner that does not penetrate the stratum corneum. We established the condition of non-penetrating microneedle application on reconstructed human full-thickness skin models and examined the effect on the skin models when microneedles were applied under this condition. Microneedle application increased the gene expression of serine palmitoyltransferase long chain base subunit (SPTLC) 3, filaggrin, and transglutaminase 1. The amount of ceramide produced by SPTLC was also increased by microneedle application. Gene expression of filaggrin-degrading enzymes and the amount of free amino acids, a product of filaggrin degradation, were also increased by microneedling. These results suggest that non-invasive microneedle application can improve skin barrier function and moisturizing function by increasing the amount of ceramide and natural moisturizing factors.

Treatment of periorbital hyperpigmentation using sublative fractional radiofrequency (SFR)

BACKGROUND

Periorbital hyperpigmentation (POH) is a common cosmetic concern. Numerous techniques of treatment have been assessed with variable results.

AIM

The purpose of this research is to assess the efficacy of non-ablative radiofrequency, Sublative fractional Radiofrequency (SFR) on POH treatment.

METHODS

In this research study, nine patients with POH and the age range of 25-57 years, were enrolled. The patients were treated by non-ablative radiofrequency SRF. The outcomes were assessed by biometric assessment. The skin lightness and melanin content of the periorbital skin were assessed by colorimeter and Mexameter. Skin elasticity was assessed by Cutometer. The skin ultrasound imaging system was used to evaluate the diameter and density of the epidermis and dermis. Visioface was used to evaluate the skin color and wrinkles. Also, patient's satisfaction and physician's assessment were assessed.

RESULTS

The results showed that the lightness and elasticity of the periorbital skin were significantly increased after treatment. Also, the melanin content of the skin was decreased. The denser skin layers were seen in both dermis and epidermis. The Visioface results displayed the reduction in the percent change of the skin color and wrinkle (p < 0.05). Similarly, the physician and patients' assessment confirmed the outcomes. No serious adverse effect was reported.

CONCLUSION

In conclusion, the SFR technique is an effective and satisfactory therapeutic choice for treatment of POH.

Characterization of the anisotropy of the natural human cheek skin tension in vivo

Natural skin tension plays an important role during surgical procedures and during the healing process especially for the face. The study of skin tension can be a means of assessing the aging effect, or the application of a medical or cosmetic product. In this work we propose a characterization of the natural human cheek skin tension in vivo and its variability with age using three characterization methods. These methods consist of facial photography to assess the ptosis of the lower face and the nasolabial fold, suction test to estimate mechanical parameters using the cutometer, and topographic analysis of the skin at rest and during folding test to study the skin relief. The study was carried out on 41 volunteers representing two age groups: 18 young volunteers [20-30] years-old and 23 elderly volunteers [50-65] years-old. The results show that the ptosis of the lower face and the nasolabial fold increase with age. The sagging of the skin observed on the facial photos is related to the loss of elasticity and the increase in the skin viscoelasticity with age. The analysis of the cheek skin relief shows that it has a very fine and flexible lines network. This analysis of the skin relief at rest and during the folding test allowed to determine the main directions of skin tension for the different age groups: [20°-40°] for the young group and [20°-60°] for the elderly group. The natural skin tension decreases with age, wrinkles appear and the skin becomes more anisotropic.

A Randomized, Multicenter, Evaluator-blind Study to Evaluate the Safety and Effectiveness of VYC-12L Treatment for Skin Quality Improvements

BACKGROUND

Skin quality may be assessed by degrees of skin smoothness, fine lines, and hydration. VYC-12L is a recently developed hyaluronic acid filler to improve skin quality.

OBJECTIVE

This was a randomized, evaluator-blind study assessing safety and effectiveness of intradermal VYC-12L treatment for improving cheek skin smoothness, fine lines, and hydration.

METHODS

Participants (≥22 years) with moderate-to-severe investigator-assessed Allergan Cheek Smoothness Scale (ACSS) scores were randomized in 2:1 ratio to receive VYC-12L or control (no treatment with optional treatment). Effectiveness was assessed 1 month after last injection (initial or touch-up) by a responder rate (≥1-grade improvement from baseline on both cheeks) using investigator-rated ACSS and Allergan Fine Lines Scale (AFLS), and tissue dielectric constant probe-measured skin hydration. Safety was evaluated throughout.

RESULTS

Participants (VYC-12L, n = 131; control, n = 71) were 86.1% female with a median age of 58.0 years. At month 1, ACSS and AFLS responder rates were statistically significantly higher in the VYC-12L group (57.9%, 58.3%, respectively) than in the untreated controls (4.5%, 5.4%, respectively; p < .001). VYC-12L ACSS and AFLS responder rates remained consistent throughout the 6-month follow-up. Six participants reported treatment-related adverse events; none led to study discontinuation.

CONCLUSION

VYC-12L is an effective, well-tolerated treatment for lasting improvement of cheek skin smoothness, fine lines, and hydration.

The Effectiveness of Injectable Hyaluronic Acid in the Improvement of the Facial Skin Quality: A Systematic Review

Background

Several studies have evaluated the role of various injectable formulations of hyaluronic acid (HA) in the improvement of the quality of facial skin. It is important to systematically summarize the available evidence in this regard.

Methods

Relevant databases were searched for clinical studies that evaluated the therapeutic role of any injectable formulation of HA in improving the quality of facial skin in adult humans until 31 December 2022. The available studies were critically analyzed and the data were extracted.

Results

A total of 2996 articles were screened and 13 studies were finally included. Eight studies evaluated the effect of various formulations of HA alone, while five evaluated the effect of various formulations of HA along with other active ingredients (cocktails) on the quality of facial skin. All types of HA formulations cause a significant improvement in facial skin quality, in terms of hydration, firmness, skin-tiring effect/fatigue, brightness, texture, radiance, and elasticity. The effect of HA monotherapy was more pronounced than that of the cocktail ingredients. HA treatment was quite safe and the patient satisfaction level was high.

Conclusion

The clinical evidence on the use of injectable HA alone in the improvement of the quality of facial skin, in terms of hydration, firmness, skin-tiring effect/fatigue, brightness, texture, radiance, and elasticity, is quite promising. Large randomized controlled trials are required in this regard.

Whitening effect of kojic acid dipalmitate loaded nanosized ethosomal gel for the treatment of hyperpigmentation: In vitro and in vivo characterization

BACKGROUND

In recent years, the demands of depigmenting agents in cosmetics have been increased to treat skin conditions such as hyperpigmentation and melasma. Tyrosinase is a major enzyme involve in hyperpigmentation. Kojic acid dipalimate (KAD) is an ester derivative of kojic acid and exhibit excellent tyrosinase inhibiting activity on human skin.

OBJECTIVE

To develop and characterize a novel topical delivery system for KAD by using ethosomes and their in vitro, in vivo characterization for the treatment of hyperpigmentation.

METHODS

Different KAD loaded ethosomal suspensions were prepared using soy phosphatidylcholine, ethanol, propylene glycol, and water with cold method. These formulations were evaluated for size, zeta potential, Polydispersity index, entrapment efficiency, FTIR spectroscopy, and scanning electron microscopy (SEM). Afterward, the stability of optimized gel was checked and the in vivo studies were carried out in order to evaluate the skin benefits.

RESULTS

The optimized formulation has zeta potential, size, and entrapment efficiency of -23.4 mV, 148 nm, and 90.0008%, respectively. SEM results showed vesicles were spherical in shape. Ethosomal gel had a good stability at lower temperature (8, 25°C). In addition, ethosomal gel gives significant decrease in skin melanin, erythema, and sebum level while it causes improvement in skin hydration level and elasticity during non-invasive in vivo studies.

CONCLUSION

The overall findings indicated that the prepared KAD loaded ethosomal formulation was stable and provides deep penetration of KAD into the skin. It offers a promising therapeutic approach for use in skin hyperpigmentation as it has skin whitening and moisturizing effects.

In Vitro and Ex Vivo Mechanistic Understanding and Clinical Evidence of a Novel Anti-Wrinkle Technology in Single-Arm, Monocentric, Open-Label Observational Studies

Skin aging is a biological process leading to visible skin alterations. The mechanism of action, clinical efficacy and tolerance of a novel anti-wrinkle technology were evaluated in two skin care products formulated for different skin types. Two single-arm monocentric, open-label observational clinical studies, which were 56 days long, evaluated a cream-gel (n = 30) and a cream (n = 33) on the face and neck. Morphometric analyses of five types of wrinkles were performed at 0, 7, 28 and 56 days. Structural changes in extracellular matrix (ECM) including collagen, elastin and hyaluronic acid (HA) were visualized and quantified by histochemical imaging after daily treatment of skin explants for 6 days. Protein and gene expression related to barrier and hydration were analyzed using ELISA and qRT-PCR, respectively, in a reconstituted human skin model treated daily for 48 h. A decrease in wrinkle dimensions was found in the majority of parameters after 28 days of treatment. Collagen, elastin, HA, procollagen type I, hyaluronan synthases, HAS2 and HAS3 were all stimulated. Based on significant and consistent changes in our investigations, we conclude that the underlying mechanism of action of the novel anti-wrinkle technology could be the remodeling of dermal ECM, and both the test formulations were efficacious and well tolerated.

Enhanced Antioxidant, Hyaluronidase, and Collagenase Inhibitory Activities of Glutinous Rice Husk Extract by Aqueous Enzymatic Extraction

In this research, we aimed to compare the biological activities related to cosmeceutical applications of glutinous rice husk extracted by aqueous enzymatic extraction (AEE) and conventional solvent extraction. Cellulase enzymes were used to assist the extraction process. The vanillic and ferulic acid contents of each extract were investigated by high-performance liquid chromatography, and their antioxidant and anti-aging activities were investigated by spectrophotometric methods. The irritation effects of each extract were investigated by the hen’s egg test on chorioallantoic membrane. The rice husk extract from AEE using 0.5% w/w of cellulase (CE0.5) contained the significantly highest content of vanillic and ferulic acid (p < 0.05), which were responsible for its biological activities. CE0.5 was the most potent antioxidant via radical scavenging activities, and possessed the most potent anti-skin wrinkle effect via collagenase inhibition. Aside from the superior biological activities, the rice husk extracts from AEE were safer than those from solvent extraction, even when 95% v/v ethanol was used. Therefore, AEE is suggested as a green extraction method that can be used instead of the traditional solvent extraction technique given its higher yield and high quality of bioactive compounds. Additionally, CE0.5 is proposed as a potential source of natural antioxidants and anti-aging properties for further development of anti-wrinkle products.

A Prospective, Open-Label Study to Evaluate the Impact of VYC-12L Injection on Skin Quality Attributes in Healthy Volunteers

Purpose

Age-related changes in skin structure and function can negatively impact skin quality. VYC-12L is a crosslinked hyaluronic acid filler for treating fine lines and improving hydration and elasticity. The goal of this study was to understand skin quality, histologic, and genomic changes underlying long-term clinical benefits of VYC-12L treatment.

Patients and Methods

In this prospective, nonrandomized, open-label study, 11 healthy men (n = 2) and women (n = 9) received intradermal VYC-12L treatment on the volar forearm. Clinical probes assessed skin quality at baseline and months 1 and 3 post-treatment. Punch biopsies were collected 1 and 3 months post-treatment to evaluate histologic and genomic changes. Safety was evaluated throughout.

Results

Participants had a mean age of 41 years and Fitzpatrick skin phototypes II (54.5%) and III (45.5%). At months 1 and 3, VYC-12L-treated skin had higher hydration in the stratum corneum than untreated skin. Cutometer measurements indicated treated skin that was firmer and more resistant to deformation. Histology showed increased epidermal AQP3 and Ki67 expression 1 and 3 months post-treatment and a qualitative increase in papillary dermal collagen I at month 3. Genomic analyses demonstrated treatment-related upregulation of genes involved in adipocyte differentiation, lipid metabolism, keratinocyte renewal, and dermal extracellular matrix (ECM) maintenance. Injection site reactions were mild-to-moderate in severity and resolved by month 1. Five participants reported 19 adverse events; most (68.4%) were related to the biopsy and none to VYC-12L.

Conclusion

VYC-12L produced changes in hydration, firmness, and ECM density and composition consistent with improved skin properties, demonstrating that VYC-12L can act as a substrate for tissue repair.

Minimally invasive skin sampling and transcriptome analysis using microneedles for skin type biomarker research

BACKGROUND

Minimally invasive skin sampling is used in various fields. In this study, we examined whether it was possible to obtain skin specimens using biocompatible microneedles composed of sodium hyaluronate and performed transcriptome analysis.

MATERIALS AND METHODS

Thirty-three subjects with different skin conditions, such as skin aging, skin hydration, skin pigmentation, oily skin and sensitive skin, were recruited. Skin types were evaluated based on age, non-invasive measurement devices, 10% lactic acid stinging test and visual assessment; the skin specimens were sampled from the face using microneedles. Total RNA was extracted, and microarray was performed. Correlations between various biomarkers and skin condition parameters were analysed.

RESULTS

Several skin-type biomarkers are correlated with age, non-invasive device measurements, LAST score and visual assessment of acne lesions. Representatively, COL1A1 (Collagen type 1 alpha 1 chain), FN1 (Fibronectin 1) and PINK1 (PTEN-induced putative kinase protein 1) for skin aging, FLG (Filaggrin), KLF4 (Kruppel-like factor 4) and LOR (Loricrin) for skin hydration, GPNMB (Glycoprotein non-metastatic melanoma protein B), MLANA (Melan-A) and TYR (Tyrosinase) for skin pigmentation, IGF1 (insulin-like growth factor-1), MPZL3 (Myelin protein zero like 3) and AQP3 (Aquaporin 3) for oily skin and PGF (placental growth factor), CYR61 (cysteine-rich angiogenic inducer 61), RBP4 (retinol-binding protein 4), TAC1 (Tachykinin precursor 1), CAMP (Cathelicidin antimicrobial peptide), MMP9 (Matrix metallopeptidase 9), MMP3, MMP12 and CCR1 (C-C motif chemokine receptor 1) for sensitive skin.

CONCLUSION

Microneedle skin sampling is a new and minimally invasive option for transcriptome analysis of human skin and can be applied for diagnosis and treatment efficacy evaluation, as well as skin type classification.

Clinical significance of the water retention and barrier function-improving capabilities of ceramide-containing formulations: A qualitative review

A decrease in the ceramide content of the stratum corneum is known to cause dry and barrier-disrupted skin. In this literature review, the clinical usefulness of preparations containing natural or synthetic ceramides for water retention and barrier functions was evaluated. The PubMed, Cochrane Library, and Igaku Chuo Zasshi databases were searched using keywords such as "ceramide", "skincare products", "barrier + hydration + moisture + skin", and "randomized trial". All database searches were conducted in February 2019. Forty-one reports were selected based on the following criterion: comparative control studies that evaluated the effects of ceramide-containing formulations based on statistical evidence. Among the 41 reports, 12 were selected using the patient, intervention, comparison, and outcome approach. These 12 reports showed that external ceramide-containing preparations can improve dry skin and barrier function in patients with atopic dermatitis. However, a double-blinded comparative study with a large sample size is warranted for appropriate clinical use.

Phyllanthus emblica L. (amla) branch: A safe and effective ingredient against skin aging

BACKGROUND AND AIM

Skin aging influences the changes in skin, including skin dryness, wrinkle, and irregular pigmentation. Amla (Phyllanthus emblica L.) branch has shown several benefits, but not the anti-skin aging. The study aimed to evaluate the anti-skin aging efficacy of amla branch.

EXPERIMENTAL PROCEDURE

Amla branches were standardized the phenolic acids. The extract was investigated anti-skin aging activities, including antioxidant, anti-tyrosinase, anti-melanogenesis, and matrix metalloproteinase-2 inhibitory assays. Topical gel containing extract was prepared and evaluated the skin irritation by a single closed patch test. Randomized, double-blind, placebo-control study was performed in 20 volunteers for 84 consecutive days. The tested skin was evaluated by Chromameter® CR 400, Dermalab® USB, Mexameter® MX 18, Corneometer® CM 825, and Visioscan® VC 98.

RESULTS

Amla branch extract, a dark brown powder, consisted a variety of phenolic acids, mainly sinapic and ferulic acids. The extract exhibited the potent antioxidant and tyrosinase inhibitory activities in vitro assays and the melanin suppression through inhibition of tyrosinase and tyrosinase-related protein-2 activities, the strong antioxidant, and the potent matrix metalloproteinase-2 in cellular assays at 0.1 mg/mL. Topical gel containing 0.1% extract was a stable and safe formulation. Clinical study was proved the superior anti-skin aging efficacy, including the lightening skin color, the enhanced skin elasticity and hydration, and the skin wrinkle reduction.

CONCLUSION

The study results suggested that amla branch is a rich source of bioactive compounds and can be a potential ingredient for utilization in anti-skin aging products.

Antiwrinkle efficacy of 1-ethyl-β-N-acetylglucosaminide, an inducer of epidermal hyaluronan production

BACKGROUND

Hyaluronan (HA) has a unique hydration capacity that contributes to firmness and bounciness of the skin. Epidermal HA declines with skin aging, which may lead to clinical signs of aging including skin wrinkles and loss of hydration and elasticity. Recently, we developed a new cosmetic agent 1-ethyl-β-N-acetylglucosaminide (β-NAG2), which enhances HA production in cultured human keratinocytes. The aim of this study was to explore antiaging potential of β-NAG2 in reconstructed human epidermal models and human clinical trial.

MATERIALS AND METHODS

The amount of HA in β-NAG2-treated epidermal models by topical application was analyzed by enzyme-linked immunosorbent assay (ELISA)-like assay. A randomized, double-blind and placebo-controlled study was conducted in Japanese females (n = 33) by topically treating each side of the face with a lotion formulated with β-NAG2 or placebo for 8 weeks.

RESULTS

Topically applied β-NAG2 dose dependently increased HA production in epidermal models. Treatment with β-NAG2-formulated lotion significantly improved skin hydration and elasticity and reduced skin wrinkling in crow's foot areas when compared to the placebo formulation.

CONCLUSION

Topically applied β-NAG2 promoted epidermal HA production in vitro and showed antiwrinkle activity in vivo accompanying the improvement in skin hydration and elasticity. Our study provides a novel strategy for antiwrinkle care through β-NAG2-induced epidermal HA production.

Cyanobacteria and microalgae bioactive compounds in skin-ageing: potential to restore extracellular matrix filling and overcome hyperpigmentation

As the largest organ in human body, skin acts as a physicochemical barrier, offering protection against harmful environmental stressors, such as chemicals, pathogens, temperature and radiation. Nonetheless, skins prominence goes further, with a significant psychosocial role in an increasingly ageing population. Prompted by consumers’ concern regarding skincare, cosmetic industry has been developing new formulas capable of lessening the most visible signs of ageing, including reduction in skin density and elasticity, wrinkling and hyperpigmentation. Allied to skincare is the rising importance set on natural products, sustainably obtained from less environmental impacting methods. Cyanobacteria and microalgae are adding importance in this field, given their ability to biosynthesize secondary metabolites with anti-ageing potential. In this review, we present an overview on the potential of cyanobacteria and microalgae compounds to overcome skin-ageing, essentially by exploring their effects on the metalloproteinases collagenase, elastase, gelatinase and hyaluronidase, and in other enzymes involved in the pigmentation process.

Defining Skin Quality: Clinical Relevance, Terminology, and Assessment

BACKGROUND

Flawless skin is one of the most universally desired features, and demand for improvements in skin quality is growing rapidly. Skin quality has been shown to substantially impact emotional health, quality of life, self-perception, and interactions with others. Although skin quality improvements are a common end point in studies of cosmeceuticals, they are rarely assessed in clinical studies of other aesthetic treatments and products. Descriptive terminology for skin quality parameters also varies considerably within the aesthetic field, relying on a range of redundant and occasionally contradictory descriptors. In short, skin quality has not been clearly defined.

OBJECTIVE

The goal of this review is to highlight the importance of skin quality to patients and physicians, explore known and unknown factors comprising skin quality, and provide clarity regarding terminology, descriptors, and evaluation tools for assessing skin quality.

MATERIALS AND METHODS

A review of the literature on skin quality was performed without limitation on publication date. Relevant articles are presented.

RESULTS AND CONCLUSION

We propose a framework of attributes contributing to skin quality rooted in 3 fundamental categories-visible, mechanical, and topographical-with the aim to provide information to help guide clinicians and inform future clinical studies.

Skin Quality - A Holistic 360° View: Consensus Results

Introduction

Skin quality is an important component of human attractiveness. To date, there are no standardized criteria for good skin quality. To establish a consensus for good skin quality parameters and measurement and treatment options, a virtual skin quality advisory board consisting of a global panel of highly experienced aesthetic dermatologists/aesthetic physicians was convened.

Methods

A total of 10 dermatologists/aesthetic physicians served on the advisory board. A modified version of the Delphi method was used to arrive at consensus. Members accessed an online platform to review statements on skin quality criteria from their peers, including treatment and measurement options, and voted to indicate whether they agreed or disagreed. Statements that did not have agreement were modified and the members voted again. Consensus was defined as: strong consensus = greater than 95% agreement; consensus = 75% to 95% agreement; majority consent = 50% to 75% agreement; no consensus = less than 50% agreement.

Results

There was strong consensus that good skin quality is defined as healthy, youthful in appearance (appearing younger than a person's chronological age), undamaged skin and that skin quality can be described across all ethnicities by four emergent perceptual categories (EPCs): skin tone evenness, skin surface evenness, skin firmness, and skin glow. The EPCs can be affected by multiple tissue layers (ie, skin surface quality can stem from and be impacted by deep structures or tissues). This means that topical approaches may not be sufficient. Instead, improving skin quality EPCs can require a multilayer treatment strategy.

Conclusion

This global advisory board established strong consensus that skin quality can be described by four EPCs, which can help clinicians determine the appropriate treatment option(s) and the tissue or skin layer(s) to address. Skin quality is important to human health and wellbeing and patients' perception for the need for aesthetic treatment.

Identification of skin aging biomarkers correlated with the biomechanical properties

BACKGROUND

Skin aging can be described as a combination of intrinsic and extrinsic aging. Various parameters for evaluating skin characteristics have been proposed. However, an accurate biomarker for skin aging and the relationship between biomarkers and biomechanical parameters of the skin is yet to be explored.

MATERIALS AND METHODS

This study included 20 subjects by age. Skin aging was measured using non-invasive devices. Skin tissues were acquired through punch biopsy for immunohistochemistry and qRT-PCR of skin aging biomarkers, and analyzed correlation both, validated their use.

RESULTS

Biomechanical properties of skin aging decreased with age. Among the biomarkers previously reported, we found that the expression of Moesin, TXNDC5, RhoGDI, and RSU1 decreased, while that of Vimentin and FABP5 increased with age. Pearson correlation showed that the expression levels of TXNDC5, RhoGDI, RSU1, and Vimentin were significantly correlated with the results of non-invasive measurements. In addition, the expression of TXNDC5, RhoGDI, and RSU1 increased, while that of Vimentin decreased, in skin explants upon treatment with one of the anti-aging compounds, retinoic acid.

CONCLUSION

From this study, we identified practical molecular biomarkers of skin aging, TXNDC5, RhoGDI, RSU1, and Vimentin, which correlated with the skin biomechanical properties of skin aging.

Enhancement of skin barrier and hydration-related molecules by protopanaxatriol in human keratinocytes

Background

Protopanaxatriol (PPT) is a secondary intestinal metabolite of ginsenoside in ginseng. Although the effects of PPT have been reported in various diseases including cancer, diabetes and inflammatory diseases, the skin protective effects of PPT are poorly understood.

Methods

HaCaT cells were treated with PPT in a dose-dependent manner. mRNA and protein levels which related to skin barrier and hydration were detected compared with retinol. Luciferase assay was performed to explore the relative signaling pathway. Western blot was conducted to confirm these pathways and excavated further signals.

Results

PPT enhanced the expression of filaggrin (FLG), transglutaminase (TGM)-1, claudin, occludin and hyaluronic acid synthase (HAS) −1, −2 and −3. The mRNA expression levels of FLG, TGM-1, HAS-1 and HAS-2 were suppressed under NF-κB inhibition. PPT significantly augmented NF-κB-luc activity and upregulated Src/AKT/NF-κB signaling. In addition, PPT also increased phosphorylation of the mitogen-activated protein kinases (MAPKs) ERK, JNK and p38 and upstream MAPK activators (MEK and MKK). Furthermore, transcriptional activity of AP-1 and CREB, which are downstream signaling targets of MAPK, was enhanced by PPT.

Conclusion

PPT improves skin barrier function and hydration through Src/AKT/NF-κB and MAPK signaling. Therefore, PPT may be a valuable component for cosmetics or treating skin disorders.

Ultrathin Glass-Based Flexible, Transparent, and Ultrasensitive Surface Acoustic Wave Humidity Sensor with ZnO Nanowires and Graphene Quantum Dots

Flexible electronic devices are normally based on organic polymer substrate. In this work, an ultrathin glass-based flexible, transparent, and ultrasensitive ZnO/glass surface acoustic wave (SAW) humidity sensor is developed using a composite sensing layer of ZnO nanowires (NWs) and graphene quantum dots (GQDs). It shows much larger effective electromechanical coupling coefficients and signal amplitudes, compared to those of flexible polymer-based SAW devices reported in the literature. Attributed to large specific surface areas of ZnO NWs, large numbers of hydrophilic functional groups of GQDs, as well as the formation of p-n heterojunctions between GQDs and ZnO NWs, the developed ZnO/glass flexible SAW sensor shows an ultrahigh humidity sensitivity of 40.16 kHz/% RH, along with its excellent stability and repeatability. This flexible and transparent SAW sensor has demonstrated insignificant deterioration of humidity sensing performance, when it is bent on a curved surface with a bending angle of 30°, revealing its potential applications for sensing on curved and complex surfaces. The humidity sensing and human breathing detection have further been demonstrated for wearable electronic applications using ultrathin glass-based devices with completely inorganic materials.

Improvements in Skin Quality Biological Markers in Skin Explants Using Hyaluronic Acid Filler VYC-12L

Hyaluronic acid (HA), both crosslinked and uncrosslinked, is used clinically to treat fine lines and provides additional improvements in skin quality attributes. The purpose of this study was to assess potential early differences in the expression of biological markers of skin quality in living human skin explants injected with uncrosslinked and crosslinked HA gels.

Methods

Living human skin explants injected with VYC-12L or noncrosslinked HA with mannitol (HYD) and noninjected controls were assessed via microscopy, histology, and immunohistochemistry on days 3 and/or 8 for biological markers of elasticity (collagen density, elastin, fibrillin-1) and hydration [aquaporin-3, acidic glycosaminoglycans (GAGs), HA]. Hydration was also assessed via a corneometer probe on days 0, 1, 2, and 8.

Results

On day 3 versus controls, VYC-12L moderately increased collagen density in the upper reticular dermis and clearly increased fibrillin-1 expression, with slight increases persisting on day 8. Increases with HYD were smaller and did not persist on day 8. Both VYC-12L and HYD increased aquaporin-3 expression and GAG content on days 3 and 8, but VYC-12L produced greater GAG increases in the reticular dermis. Day 8 instrument-assessed hydration increased by 49% and 22% for VYC-12L and HYD, respectively. Elastin expression in oxytalan and elaunin fibers was unchanged. Upper-dermal HA reductions suggested HA injection-induced hyaluronidase expression.

Conclusion

VYC-12L produced greater, more lasting improvements in biological markers of skin quality than HYD.

Collagen formula with Djulis for improvement of skin hydration, brightness, texture, crow's feet, and collagen content: A double-blind, randomized, placebo-controlled trial

BACKGROUND

The efficacy of Djulis for skin care is currently based on cellular or animal models, and the clinical aspect is not in place.

AIM

This clinical study is to investigate the synergistic effect of fish collagen and Djulis (Chenopodium formosanum Koidz.) for improvement of skin parameters. We used the combination of hydrolyzed collagen and Djulis to develop a new functional formula for skin improvement.

PATIENTS/METHODS

Fifty volunteers were randomly allocated (in a 1:1 ratio) to the placebo or collagen drink group. Volunteers were required to consume a 50 mL of a collagen drink or placebo drink daily for 8 weeks. For measurements, the indexes of skin conditions were measured at the baseline and 4 and 8 weeks.

RESULTS

The improvements of skin hydration, brightness, crow's feet, texture, wrinkles, pores, spots, and collagen content after 8 weeks in collagen group were 17.8%, 5.4%, 14.9%, 9.9%, 29.3%, 10.4%, 9.9%, and 22.3%, respectively. Noticeably, over 68% of subjects got improved for their skin parameters after 8-week intake of collagen drink. The improvement levels indicated competitive skin improvement effects in comparison with previous studies.

CONCLUSION

This clinical study demonstrates the synergistic effect of fish collagen and Djulis (the main components) for the substantial improvements in hydration, brightness, crow's feet, texture, wrinkles, pores, surface spots, and collagen content in skin. The collagen drink comprehensively improved skin parameters for most subjects after 4-week intake and manifested competitive efficiency in comparison with other similar studies. We convince that the collagen drink may delay skin aging process and improve skin aging parameters.

Microemulsion composed of combination of skin beneficial oils as vehicle: Development of resveratrol-loaded microemulsion based formulations for skin care applications

Microemulsion can be a potential delivery vehicle to deliver skin care actives to deep skin layer for chronic skin care benefits. On top of skin care active, microemulsion vehicle composed of multiple skin beneficial oils can deliver additional skin care efficacies. In this study, microemulsions were developed using combinations of two skin beneficial oils, tea tree oil and medium chain triglyceride instead of single oil. For that, pseudo ternary phase diagrams were constructed on these oil combinations at different ratios of surfactant/co-surfactants. Ratio of oils and surfactant/co-surfactant combinations exhibited significant impact on the microemulsion region. A few compositions were selected from the single phase microemulsion regions of these phase diagrams for the preparation of resveratrol-loaded microemulsion and microemulsion gel formulations. The particle size of the resveratrol-loaded microemulsions were <50 nm. Cryogenic scanning electron microscope image clearly showed nano-droplets dispersed in continuous phase. Both physical and chemical stability of the formulations varied depending on their compositions, such as surfactant/co-surfactant combination and % total oil. The presence of chelating agent and anti-oxidant was also crucial to stabilize the formulations. The selected formulations demonstrated good physicochemical stability at 5 °C, 25 °C, and 40 °C/75 % RH (relative humidity) stability conditions. The results further showed that the % total oil and surfactant phase composition had huge influence on resveratrol release and skin permeation patterns from the microemulsion gels. In vitro skin permeation result indicated that the microemulsion gels can help resveratrol penetration into deep skin layer. Therefore, the developed resveratrol-loaded microemulsion gels can be utilized as skin care product with multiple skin care benefits.

The influence of autogenic training on the physical properties of skin and cardiac autonomic activity in postmenopausal women: an exploratory study

BACKGROUND

Autogenic training (AT) is a major relaxation training technique whose clinical efficacy has been verified in dermatology. Many reports demonstrate ameliorated skin conditions in AT-treated subjects with reduced psychological stress. However, no studies have examined the effects of AT on the skin of postmenopausal women.

OBJECTIVES

We examine the influences of AT on the physical properties of skin and cardiac autonomic activity in postmenopausal women.

METHODS

Postmenopausal women were classed into an AT group and a control one. The women in the AT group were mentored by a professional to practice AT twice a day for 7 weeks. The women in the control group were instructed to close their eyes for 3 minutes instead of AT. Hydration of the stratum corneum (SC), transepidermal water loss (TEWL), skin elasticity and heart-rate variability (HRV) were measured before and after the study period to examine how they changed.

RESULTS

SC hydration and skin elasticity of the cheek, increased in both groups, and the increase was significantly higher in the AT group (n = 14) than in the control group (n = 12) (P < 0.05, Cohen's d = 1.03; P < 0.05, Cohen's d = 0.99; respectively). TEWL did not change in either group. LF/HF was lower in the AT group than in the control group (P < 0.05, Cohen's d = 0.91).

CONCLUSION

AT increased SC hydration and skin elasticity with changes in the balance of autonomic nervous system activity in postmenopausal women, implying that AT may have improvement effects on aged skin by menopause.

Role of HYBID (Hyaluronan Binding Protein Involved in Hyaluronan Depolymerization), Alias KIAA1199/CEMIP, in Hyaluronan Degradation in Normal and Photoaged Skin

Photoaged skin is characterized clinically by apparent manifestations such as wrinkles and sagging, and histologically by an accumulation of abnormal elastin and a severe loss of collagen fibers in the dermis. Quantitative and qualitative alterations in elastin and collagens are considered to be responsible for the formation of wrinkles and sagging. However, since the integrity of elastin and collagen fibers in the dermis is maintained by their interactions with hyaluronan (HA) and a proteoglycan network structure, HA degradation may be the initial process, prior to the breakdown of the fibrillary components, leading to wrinkles and sagging in photoaged skin. We have recently discovered a new HA-degrading mechanism mediated by HYBID (hyaluronan binding protein involved in hyaluronan depolymerization), alias KIAA1199/CEMIP, in human skin fibroblasts, and examined the implication of HYBID for skin photoaging. In this review, we give an overview of the characteristics of HYBID and its prospective roles in HA turnover in normal skin and excessive HA degradation in photoaged skin. In addition, we describe our data on the inhibition of HYBID activity and expression by plant extracts in skin fibroblasts; and propose novel strategies to prevent or improve photoaging symptoms, such as skin wrinkling, by inhibition of HYBID-mediated HA degradation.

VYC-12 Injectable Gel Is Safe And Effective For Improvement Of Facial Skin Topography: A Prospective Study

Objective

Evaluate safety and effectiveness of VYC-12 (Juvéderm Volite; an injectable crosslinked hyaluronic acid gel designed to improve skin quality attributes such as surface smoothness and hydration) for facial intradermal injection.

Materials and methods

In a prospective, single-arm study, subjects with moderate/severe cheek skin roughness per Allergan Skin Roughness Scale (ASRS) received VYC-12 in the cheeks and forehead, and/or neck, with touch-up treatment to correct asymmetry 30 days later and optional repeat treatment 9 months after last treatment. The primary effectiveness measure was ASRS responder rate (percentage of cheeks with ≥1-point improvement from baseline) at month 1. Skin hydration was instrument-assessed.

Results

Of 131 subjects treated, 31 (23.7%) received touch-up treatment. ASRS responder rate was 96.2% at month 1, 76.3% at month 4, 34.9% at month 6, and 87.1% after repeat treatment. Responder rate in cheeks with severe baseline roughness was 93.8%, 83.1%, and 52.3% at months 1, 4, and 6, respectively. Skin hydration improved significantly (P<0.01) from baseline at all timepoints through month 9. Injection site responses were as expected. All treatment-related adverse events were mild/moderate.

Conclusion

VYC-12 safely and effectively improved skin smoothness up to 6 months and hydration lasting 9 months.

Skin Improvement Effects of Gardeniae fructus Extract in HaCaT Keratinocytes, B16F10 Melanocytes, and CCD-986sk Fibroblast Cells

The development of functional cosmetics with skin improvement effects from natural sources is necessary. In this study, the antioxidant, antiwrinkling, moisturizing, and whitening effects of Gardeniae fructus extract (GF) were investigated in keratinocytes, melanocytes, and fibroblast cells. Antioxidant activity was determined by a DPPH free radical scavenging assay. MMP-1, MMP-9, HAS1, and filaggrin mRNA levels were measured by RT-PCR in keratinocytes and fibroblast cells. MITF and tyrosinase protein levels were evaluated by blotting analysis in melanocytes. DPPH free radical activity was investigated to determine whether GF showed dose-dependent inhibitory activity. GF induced the upregulation of HAS1 and filaggrin mRNA expression in keratinocytes and fibroblast cells. GF led to the downregulation of MMP mRNA levels in keratinocytes and fibroblast cells. Western blotting was performed to confirm the whitening-related protein (MITF and tyrosinase) levels induced by GF in melanocytes, and the inhibitory activity was superior to that of the α-MSH used for the comparison test. GF showed marked antioxidant, antiwrinkling, skin moisturizing, and whitening activity in keratinocytes, melanocytes, and fibroblast cells. Through the results of these experiments, the applicability of GF as a natural and functional cosmetic material was verified.

Understanding rates of genital-anal injury: Role of skin color and skin biomechanics

PURPOSE

A series of studies suggest that non-Hispanic White women have significantly more injuries than non-Hispanic Black women after sexual assault and consensual sexual intercourse. One explanation for this difference is that the degree of skin protection may vary as skin mechanics and skin pigmentation vary. The aim of the study was to determine the association among genital-anal injury, skin color, skin viscoelasticity and skin hydration in women following consensual sexual intercourse when controlling for age, smoking history, body mass index (BMI), sun exposure, and health status.

PROCEDURES

We employed a prospective cohort study design to enroll women 21 years of age or older at two study sites. They underwent two data collection sessions, baseline and follow-up after consensual sexual intercourse. Baseline genital-anal injury identification occurred with a standard forensic examination (direct visualization, nuclear staining with toluidine blue contrast, and colposcopy examination) and measurements of other variables (skin color, skin viscoelasticity, skin hydration, age, smoking history, body mass index [BMI], sun exposure, and health status). Participants were then asked to have consensual sexual intercourse with a male partner of their choice and to return for a second forensic examination for injury detection. Genital-anal injury was regressed on skin color, skin viscoelasticity, skin hydration, age, smoking history, BMI, sun exposure, and health status.

FINDINGS

We enrolled 341 participants, 88 non-Hispanic White (25.8%), 54 non-Hispanic Black (15.8%), 190 Hispanic/Latina (55.7), and 9 Other Identities (2.6%). At baseline the genital-anal injury prevalence was 57.77% and at follow-up after consensual sexual intercourse, injury prevalence was 72.73%. External genital injury prevalence was associated with increased L* (lightness) values (Adjusted Odds Ratio [AOR] = 1.98, 95% Confidence Interval [CI] = 1.03, 4.04) and decreased skin elasticity (AOR = 0.96, 95% CI = 0.93, 0.99) at baseline. Increased skin hydration was associated with a significantly higher frequency of external, internal, anal, and total genital-anal injuries (Adjusted Rate Ratio [ARR] > 1.27) at follow-up. Also at the follow-up examination, Hispanic/Latina participants had significantly lower external genital and total genital-anal injury prevalence and frequency as compared to non-Hispanic White participants (AOR < 0.40).

CONCLUSIONS

Our findings provide qualified support for the importance of skin color during the forensic examination. Women with lighter skin tones may have skin that is more easily injured than women with darker tones. In contrast, external genital injuries may be more easily identified in women with light as compared to dark skin, a situation that is important in both the health care and criminal justice systems. Additionally, women with decreased viscoelasticity and increased hydration may be more easily injured. These findings support the need to develop forensic procedures that are effective in people across the range of skin colors and to interpret forensic findings considering the innate properties of the skin.

A prospective study comparing topic platelet-rich plasma vs. placebo on reducing superficial perioral wrinkles and restore dermal matrix

Introduction: The goal of our prospective study was to assess the efficacy of the topical Platelet-rich plasma on reducing superficial perioral wrinkles and restoring the dermal matrix. Materials and methods: 50 women with moderate to severe perioral wrinkles were treated on the perioral area by a single session of fractional CO2 laser skin resurfacing plus intradermal injection of prp. 25 patients (group 1) applied topically prp twice a day for 12 weeks as post laser treatment. 25 (group 2) applied gentamicin and betamethasone twice a day for the first 7 days and then hyaluronic acid gel for the following 12 weeks. Results: In group 1, moisture (p < 0.001), amount of collagen fiber (p < 0.001) skin elasticity (p < 0.001), PSAl (p < 0.001) and SSAl (p < 0.001) improved significantly. In group 2 all the parameters investigated improved but did not reach significant difference. Discussion: Our medical device with a plasma-like formulation is able to maintain prp active for a period of 7 days so patients are able to apply topically growth factors at home. Conclusions: Our prospective study proves that the use of topical prp reduces superficial perioral wrinkles and restore dermal matrix when used at home for 12 weeks.

Facial application of high-concentration carbon dioxide prevents epidermal impairment associated with environmental changes

Purpose

The transdermal application of carbon dioxide (CO₂) gas dissolved in a solution and bathing in carbonated springs have been known to improve circulatory disorders. We aimed to elucidate and profile the effects of CO₂ application on local skin function.

Patients and methods

A liquid formulation that included high-concentration CO₂ or a control formulation was applied to the face of healthy men for 8 weeks. Quantitative analysis was performed during the dry winter months.

Results

At the site where the control formulation was applied, transepidermal water loss (TEWL) increased while the moisturizing function (conductance) of facial skin decreased during the study period. However, at the CO₂-treated site, increases in TEWL and decreases in conductance were significantly suppressed. In addition, the deterioration in scaliness and wrinkles parameters were suppressed by ≥40% at the CO₂-treated site. There were no significant differences in skin surface pH or color properties between the control and test sites.

Conclusion

This study suggests that the continuous application of a high-concentration CO₂ formulation can affect skin physiology and has the potential to suppress reductions in the barrier and moisturizing functions of the stratum corneum accompanied by desquamation, which occurs during the winter.

Inhibitory effects of Sanguisorba officinalis root extract on HYBID (KIAA1199)-mediated hyaluronan degradation and skin wrinkling

OBJECTIVES

Hyaluronan (HA), an important constituent of extracellular matrix in the skin, has many biological activities such as hydration that contributes to firmness and bounciness of the skin. We have reported that reduction in HA in the papillary dermis and over-expression of HYBID (HYaluronan Binding protein Involved in hyaluronan Depolymerization, alias KIAA1199 or CEMIP), a key molecule for HA degradation in skin fibroblasts, are implicated in facial skin wrinkling in Japanese and Caucasian women. However, little or no information is available for substances which inhibit the HYBID-mediated HA degradation.

METHODS

Inhibition of Sanguisorba officinalis root extract and ziyuglycoside I, one of the components of Sanguisorba officinalis root extract, to the HYBID-mediated HA degradation was assessed by size-exclusion chromatography of HA depolymerized by stable transfectants of HYBID in HEK293 cells (HYBID/HEK293 cells) or normal human skin fibroblasts (Detroit 551 cells and NHDF-Ad cells). The HYBID mRNA and protein expression was examined by quantitative real-time PCR and immunoblotting in the skin fibroblasts treated with Sanguisorba officinalis root extract, and size distribution of newly produced HA was evaluated by preparing metabolically radiolabelled HA. A double-blind, randomized and placebo-controlled study was carried out in the 21 healthy Japanese women, who were topically treated with the formulation containing Sanguisorba officinalis root extract or the placebo on each side of the face including crow's foot area.

RESULTS

Sanguisorba officinalis root extract, but not ziyuglycoside I, abolished HYBID-mediated HA degradation by HYBID/HEK293 cells. Sanguisorba officinalis root extract also inhibited HYBID-mediated HA degradation in skin fibroblasts by down-regulating HYBID mRNA and protein expression. Although control untreated skin fibroblasts produced polydispersed HA, the cells treated with Sanguisorba officinalis root extract produced only high-molecular-weight HA. Treatment with Sanguisorba officinalis root extract-formulated lotion significantly improved skin elasticity, and reduced skin wrinkling scores at the outer eye corner compared with the placebo formulation.

CONCLUSION

Sanguisorba officinalis root extract showed an anti-HYBID-mediated HA degradation activity and anti-wrinkle activity on human facial skin, which is accompanied by the improvement in elasticity. Our study provides the possibility of a new strategy to inhibit HYBID-mediated HA degradation for anti-wrinkle care.

Inhibition of HYBID (KIAA1199)-mediated hyaluronan degradation and anti-wrinkle effect of Geranium thunbergii extract

BACKGROUND

Hyaluronan (HA) is an essential constituent of extracellular matrix in the skin. HA reduction in the dermis and overexpression of HYBID (KIAA1199), a key molecule for HA degradation in skin fibroblasts, are implicated in facial skin wrinkling.

AIMS

We aimed to obtain anti-wrinkle agent(s) by screening for inhibition of HYBID-mediated HA degradation.

METHODS

Various plant extracts were screened for inhibition of HA degradation in HYBID-stable transfectants in HEK293 (HYBID/HEK293). Inhibition of HA-degrading activity and HYBID mRNA and protein expression by Geranium thunbergii extract was studied in skin fibroblasts and HYBID/HEK293 cells. Size distribution of newly produced HA was evaluated by preparing metabolically radiolabeled HA in skin fibroblasts. A double-blind, randomized, and placebo-controlled study was performed in healthy Japanese women (n = 21) by topically treating each side of the face with a lotion formulated with G. thunbergii extract or placebo for 8 weeks.

RESULTS

Among the plant extracts tested, only G. thunbergii extract abolished HA depolymerization in skin fibroblasts and HYBID/HEK293 cells by down-regulating HYBID mRNA and protein expression and by inhibiting HYBID-mediated HA-degrading activity. Although untreated skin fibroblasts produced polydispersed HA, G. thunbergii extract-treated cells produced high-molecular-weight HA. Treatment with G. thunbergii extract-formulated lotion significantly improved skin elasticity and reduced skin wrinkling scores at the outer eye corner compared with the placebo formulation.

CONCLUSIONS

Geranium thunbergii extract inhibited HYBID-mediated HA degradation in vitro and showed anti-wrinkle activity in vivo accompanying the improvement in skin elasticity. Our study provides a possible strategy for anti-wrinkle care through inhibition of HYBID-mediated HA degradation.

Combinatorial application of dissolving microneedle patch and cream for improvement of skin wrinkles, dermal density, elasticity, and hydration

BACKGROUND

Dissolving microneedles (DMNs), microscale needles with a biodegradable polymer matrix, have been widely investigated for transdermal drug delivery. However, the restricted drug loading space of DMNs limited the delivery of the desired quantity of active compounds. In this study, we developed novel combinatorial therapies involving sequential application of adenosine-loaded DMN (Ad-DMN) patches and a topical adenosine-loaded cream (Ad-cream). The application of DMNs created skin channels, which delivered encapsulated drugs from both the DMNs and cream. The use of combinatorial therapies can maximize drug delivery.

METHODS

To compare the efficacy of combinatorial therapies and Ad-cream application, a double-blind clinical test was conducted over 10 weeks on 21 females with wrinkles around their eyes, and the skin parameters such as wrinkles, dermal density, elasticity, and hydration were analyzed. The skin irritation test was assessed by expert interviewers to elucidate undesirable side effects.

RESULTS

The combinatorial therapies showed statistically significant efficacy for the improvement of average depth of wrinkles, dermal density, elasticity, and hydration after an 8-week application (P < 0.001). Adverse effects on the skin were not observed in any subject during the test period.

CONCLUSION

The efficacy and safety results showed that the combinatorial therapies were a safe and outstanding innovation for the optimization of transdermal therapy.

Adenosine-loaded dissolving microneedle patches to improve skin wrinkles, dermal density, elasticity and hydration

OBJECTIVE

Although dissolving microneedle patches have been widely studied in the cosmetics field, no comparisons have been drawn with the topical applications available for routine use. In this study, two wrinkle-improving products, adenosine-loaded dissolving microneedle patches and an adenosine cream, were evaluated for efficacy, with respect to skin wrinkling, dermal density, elasticity, and hydration, and safety in a clinical test on the crow's feet area.

METHODS

Clinical efficacy and safety tests were performed for 10 weeks on 22 female subjects with wrinkles around their eyes. The adenosine-loaded dissolving microneedle patch was applied once every 3 days, in the evening, for 8 weeks to the designated crow's feet area. The adenosine cream was applied two times per day, in the morning and evening, for 8 weeks to the other crow's feet area. Skin wrinkling, dermal density, elasticity, and hydration were measured by using PRIMOS^® premium, Dermascan^® C, Cutometer^® MPA580, and Corneometer^® CM 825, respectively. In addition, subjective skin irritation was evaluated by self-observation, and objective skin irritation was assessed through expert interviews.

RESULTS

The adenosine-loaded dissolving microneedle patches had a similar or better efficacy than the adenosine cream. Both groups showed statistically significant efficacy for almost all parameters (P < 0.05). The dissolving microneedle patches had a long-lasting effect on the average wrinkle depth (P < 0.05), only showed efficacy in dermal density (P < 0.05), had an early improving effect on elasticity (P < 0.05), and demonstrated better hydration efficacy (P < 0.001). No adverse effects were observed in either group during the test period.

CONCLUSIONS

In the clinical efficacy test of four skin-improvement parameters, adenosine-loaded dissolving microneedle patches showed the same or better effect than the adenosine cream, although the weekly adenosine dose was 140 times lower. The dissolving microneedle patches caused no adverse reactions. These adenosine-loaded dissolving microneedle patches are expected to be safe, effective, and novel cosmetics for skin improvement.

Two-phase delivery using a horse oil and adenosine-loaded dissolving microneedle patch for skin barrier restoration, moisturization, and wrinkle improvement

BACKGROUND

Dissolving microneedles (DMNs) have been used for skin restoration and wrinkle improvement. Although lipophilic compounds, for example, natural oils or ceramides, enrich the skin barrier, their delivery via DMNs is challenging because of DMN fabrication difficulties.

OBJECTIVES

In the present study, we combined a topical formulation and a DMN patch to perform two-phase delivery comprising a lipophilic formulation and hydrophilic compound-loaded DMNs to improve skin barrier status and the efficacy of drug delivery.

METHODS

Horse oil-spread and adenosine-loaded DMN arrays were developed in a single patch (HOS-Ad-DMN patch). In vitro analysis was conducted to confirm the successful delivery of the compositions. Clinical assessments were conducted on the lateral canthus of 20 women to compare the efficacy of HOS-Ad-DMN patches with that of adenosine-loaded DMN patches (Ad-DMN patches).

RESULTS

Adenosine was delivered via the DMNs after skin penetration and horse oil was delivered successfully into the skin through the microchannels created by the Ad-DMNs. Compared with Ad-DMN patches, HOS-Ad-DMN patches significantly improved skin elasticity, hydration, dermal density, and wrinkles. No adverse events were observed.

CONCLUSION

HOS-Ad-DMN patches are a safe and efficient system for skin restoration and wrinkle improvement.