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Pu Y, Pu S, Chen Y, Kong Q, Liu X, Zhao Q, Xu K, Liu J, Li M, Xu X, Qiao X, Su B, Chen J, Yang Z. Weakened tanning ability is an important mechanism for evolutionary skin lightening in East Asians. J Genet Genomics 2024; 51:703-713. [PMID: 38461943 DOI: 10.1016/j.jgg.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/03/2024] [Accepted: 03/03/2024] [Indexed: 03/12/2024]
Abstract
The evolution of light-skin pigmentation among Eurasians is considered as an adaptation to the high-latitude environments. East Asians are ideal populations for studying skin color evolution because of the complex environment of East Asia. Here, we report a strong selection signal for the pigmentation gene phenylalanine hydroxylase (PAH) in light-skinned Han Chinese individuals. The intron mutation rs10778203 in PAH is enriched in East Asians and is significantly associated with skin color of the back of the hand in Han Chinese males (P < 0.05). In vitro luciferase and transcription factor binding assays show that the ancestral allele of rs10778203 could bind to SMAD2 and has a significant enhancer activity for PAH. However, the derived T allele (the major allele in East Asians) of rs10778203 decreases the binding activity of transcription factors and enhancer activity. Meanwhile, the derived T allele of rs10778203 shows a weaker ultraviolet radiation response in A375 cells and zebrafish embryos. Furthermore, rs10778203 decreases melanin production in transgenic zebrafish embryos after ultraviolet B (UVB) treatment. Collectively, PAH is a potential pigmentation gene that regulates skin tanning ability. Natural selection has enriched the adaptive allele, resulting in weakened tanning ability in East Asians, suggesting a unique genetic mechanism for evolutionary skin lightening in East Asians.
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Affiliation(s)
- Youwei Pu
- Tianjian Laboratory of Advanced Biomedical Sciences, Academy of Medical Science, Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Siyu Pu
- Department of Pediatric Surgery and Laboratory of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yanyan Chen
- Tianjian Laboratory of Advanced Biomedical Sciences, Academy of Medical Science, Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Qinghong Kong
- Guizhou Provincial College-based Key Lab for Tumor Prevention and Treatment with Distinctive Medicines, Zunyi Medical University, Zunyi, Guizhou 563000, China
| | - Xuyang Liu
- Tianjian Laboratory of Advanced Biomedical Sciences, Academy of Medical Science, Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Qi Zhao
- Yunnan Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, Yunnan 650500, China
| | - Ke Xu
- Tianjian Laboratory of Advanced Biomedical Sciences, Academy of Medical Science, Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Jiuming Liu
- Tianjian Laboratory of Advanced Biomedical Sciences, Academy of Medical Science, Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Mengyuan Li
- Tianjian Laboratory of Advanced Biomedical Sciences, Academy of Medical Science, Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Xiaoyu Xu
- Tianjian Laboratory of Advanced Biomedical Sciences, Academy of Medical Science, Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Xiaoyang Qiao
- Tianjian Laboratory of Advanced Biomedical Sciences, Academy of Medical Science, Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Bing Su
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan 650223, China; Center for Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, Kunming, Yunnan 650223, China
| | - Jing Chen
- Department of Pediatric Surgery and Laboratory of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
| | - Zhaohui Yang
- Tianjian Laboratory of Advanced Biomedical Sciences, Academy of Medical Science, Zhengzhou University, Zhengzhou, Henan 450052, China.
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2
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Goh CF. Diversity of Asian skin: A review on skin biophysical properties. Exp Dermatol 2024; 33:e14959. [PMID: 37864434 DOI: 10.1111/exd.14959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/03/2023] [Accepted: 09/27/2023] [Indexed: 10/22/2023]
Abstract
Asian is home to dozens of different ethnic groups that are characterised by fascinating social and cultural variations. Unfortunately, existing literature on the skin properties of Asians tends to group this diverse population solely based on skin colour, perpetuating the misconception and stereotype that all Asian skin is the same. While Asia is one of the largest continents in the world, the difference in the geographical location and climate have long shaped the population into various ethnic groups with significant differences in the collective and diverse customs, traditions, cultures and living habits. The diverse ethnic groups in this region hint us that their skin biophysical characteristics can be very different from each other. This review features the profiling of the distinctive skin biophysical properties of Asians. We learn more about the different ethnic groups in Asia and acknowledge the unique skin biophysical properties even from the same country.
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Affiliation(s)
- Choon Fu Goh
- Discipline of Pharmaceutical Technology, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
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3
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Wang DQ, Li X, Zhang RY, Yuan C, Yan B, Humbert P, Quan ZX. Effects of Investigational Moisturizers on the Skin Barrier and Microbiome following Exposure to Environmental Aggressors: A Randomized Clinical Trial and Ex Vivo Analysis. J Clin Med 2023; 12:6078. [PMID: 37763018 PMCID: PMC10532330 DOI: 10.3390/jcm12186078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/08/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
The skin microbiota barrier participates in skin barrier function in addition to the physical, chemical, and immunological protective barriers, and is affected by environmental aggressors and skincare regimens. To better understand the exact effects of real-life environmental conditions on the skin and determine the protective methods, this study investigates the effects of three topical cosmetic moisturizers (water gel moisturizers with/without yeast extract (Moisturizers K and C) and a thick-emulsion cream moisturizer (Moisturizer L)) on clinical and skin microbiome endpoints in the presence of environmental aggressors during an 8-week, randomized controlled, triple-blind clinical trial with 110 participants, and molecular- as well as biomarker-level endpoints on ex vivo skin explants after exposure to simulate urban environmental conditions. The results show that all moisturizers are well-tolerated and improve skin barrier function and surface moisture content from the baseline, and the improvement is maintained at the last analysis point (3 days after trial completion). Compared with the untreated control areas (samples taken from the upper chest), treatment with Moisturizer K prevented a reduction in bacterial and fungal richness, and increased the change ratio of the relative abundance of commensal bacteria, such as Staphylococcus epidermidis and Ralstonia, at the treated sites (samples taken from the forehead). Moreover, Moisturizer K-treated ex vivo skin explants had higher levels of caspase 14 (a marker of skin barrier function), collagen I, and elastin (structure components), and lower levels of aryl hydrocarbon receptor (AHR; activated by air pollutants) and interleukin-6 (IL-6) than those in explants treated with other moisturizers and in the untreated areas of the skin. These results suggest that a skin postbiotic moisturizer with yeast extract supports the regulation of the skin's microbiome balance and may provide a holistic barrier (involving skin microbiome, physical, chemical, and immune barriers) to protect the skin against environmental aggressors.
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Affiliation(s)
- Dan-Qi Wang
- Ministry of Education Key Laboratory for Biodiversity Science and Ecological Engineering, Fudan Microbiome Center, Institute of Biodiversity Science, School of Life Sciences, Fudan University, Shanghai 200437, China; (D.-Q.W.); (R.-Y.Z.)
| | - Xi Li
- Translational Science Asia Pacific, Shanghai Technology and Research Center, Johnson & Johnson (China) Ltd., Shanghai 200245, China;
| | - Ru-Yi Zhang
- Ministry of Education Key Laboratory for Biodiversity Science and Ecological Engineering, Fudan Microbiome Center, Institute of Biodiversity Science, School of Life Sciences, Fudan University, Shanghai 200437, China; (D.-Q.W.); (R.-Y.Z.)
| | - Chao Yuan
- Skin and Cosmetic Research Department, Shanghai Skin Disease Hospital, Shanghai 200443, China;
| | - Bo Yan
- Translational Science Asia Pacific, Shanghai Technology and Research Center, Johnson & Johnson (China) Ltd., Shanghai 200245, China;
| | - Philippe Humbert
- Department of Dermatology, Clinical Investigation Center, Besancon University Hospital, 25030 Besancon, France;
| | - Zhe-Xue Quan
- Ministry of Education Key Laboratory for Biodiversity Science and Ecological Engineering, Fudan Microbiome Center, Institute of Biodiversity Science, School of Life Sciences, Fudan University, Shanghai 200437, China; (D.-Q.W.); (R.-Y.Z.)
- IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200437, China
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4
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Ye C, Flament F, Wang Y, Sun H, Yang G, Jiang Y, Delaunay C, Saint-Leger D. Structural and Functional age-related changes in some facial signs of Chinese men. A Pilot study. Int J Cosmet Sci 2022; 44:530-541. [PMID: 35841376 DOI: 10.1111/ics.12802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/05/2022] [Accepted: 07/14/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To associate, on the same Chinese male subjects, changes in facial aging signs with some biomechanical skin properties. METHODS The severities of 20 facial aging signs of 219 differently aged Chinese men (20-65y) were graded in blind by trained experts through standardized photographs, using a referential skin Atlas dedicated to Asian men. On each subject, the mechanical properties were assessed on the cheek area (left or right at random) by the validated suction technique Cutometer®. Finally, the skin color parameters were assessed on images from VISIA-CR device. RESULTS Clinically speaking, the severity of almost all facial aging signs increases from 30y to 65y, in a linear like progression, whereas the 20-30y shows weak increases. Skin color shows slight but progressive decreases in Luminance and ITA, whereas the yellow and red components slightly increased between 40y and 65y. At the exception of skin firmness, the skin mechanical properties show a clear decline during the 30-50y period and plateau beyond. CONCLUSION The present study suggests that the 20-30y period, albeit more clinically "silent" than the other periods of age, seems to be an age-range during which early alterations of some dermal elements' onset. Deeper in vivo investigating techniques (Echography, Multiphotonic microscopy) are needed to confirm such hypothesis.
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Affiliation(s)
- Chengda Ye
- L'Oréal Research and Innovation, Shanghai, China
| | | | - Yang Wang
- L'Oréal Research and Innovation, Shanghai, China
| | - Hua Sun
- China-norm Quality Technical Service, Shanghai, China
| | | | - Yanwen Jiang
- China-norm Quality Technical Service, Shanghai, China
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Du Y, Doraiswamy C, Mao J, Zhang Q, Liang Y, Du Z, Vasantharaghavan R, Joshi MK. Facial skin characteristics and concerns in Indonesia: A cross-sectional observational study. Skin Res Technol 2022; 28:719-728. [PMID: 35785442 PMCID: PMC9907585 DOI: 10.1111/srt.13189] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/03/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Facial skin characteristics and appearance vary according to ethnicity. While much of this knowledge is derived from the Caucasian population, lately there have been efforts to gain such understanding in various regions in Asia. In this paper, we have built an understanding of such features in Indonesia. In Indonesia, a section of females wears a traditional veil (hijab) to cover the scalp and part of face. The influence of the hijab on facial skin attributes was also investigated. METHODS In a cross-sectional observational study design involving 419 female volunteers in Jakarta, Indonesia, facial skin attributes (colour, radiance, hydration, trans-epidermal water loss [TEWL], wrinkles, fine lines, pores, and sebum levels) and conditions (melasma, post-inflammatory hyperpigmentation (PIH), solar lentigines/ senile lentigines, seborrheic keratoses and acne) were assessed by trained operators and dermatologists using standard validated instruments and scales. RESULTS With age, facial skin colour showed darkening in cheek; forehead on the other hand showed slight lightening. The skin evenness and radiance decreased, substantially. Aging attributes measured in terms of lines, wrinkles, and under-eye dark circles showed deterioration with age; the decline was progressively faster than colour change. Facial image data analysis corroborated these findings. Skin hydration remained similar across the age groups even though the skin barrier function measured in terms of TEWL improved with age. Sebum levels in the skin were similar up to the age of 50 but declined in the next group of 50-60 year. Pore severity increased with age. Melasma, seborrheic keratosis and PIH showed a high prevalence (>∼50%) at the young age group (20-30 years), itself. Melasma prevalence attained 100% in the age group of 41-50 year and onwards, and its severity similarly showed a steady rise with age. PIH on the other hand showed a steady decline with age. Solar lentigines prevalence (∼30%) did not change much across age groups, and the severity scores were similar in age groups up to 50 year but increased substantially in 51-60-year age groups. Seborrheic keratosis was similar (∼47%) in age groups up 20-40 year but steadily increased in upper age groups. Its severity was similar in the age groups of 20-30 year and 31-40 year but showed a two-fold increase in subsequent age groups. Acne was 10% in the age group of 20-30 year and declined gradually to 0.7% in the 51-60-year age group. Hijab wearers showed slight protection in skin colour darkening and improvement of evenness and radiance but were similar on aging (fine lines and wrinkles on crow's feet, under eye and peri-oral areas) markers to non-wearers. In general, in majority of age-groups, hijab wearers showed a higher prevalence of melasma, solar/senile lentigines, seborrheic keratosis and PIH.
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Affiliation(s)
- Yaping Du
- Unilever R&D Shanghai, Shanghai, China
| | | | - Jie Mao
- Unilever R&D Shanghai, Shanghai, China
| | | | - Yan Liang
- Unilever R&D Shanghai, Shanghai, China
| | - Zheng Du
- Unilever R&D Shanghai, Shanghai, China
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6
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Li B, Cheng Y, Tan Y, Wang F, Hu W, Wang X, Liu W, Krutmann J, Wang S, Zou Y. Analysis of factors influencing patch test reactions: Results from a large- population-based study in Chinese. J Cosmet Dermatol 2021; 21:2183-2188. [PMID: 34240515 DOI: 10.1111/jocd.14338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patch test, as a helpful tool in clinic diagnosis and safety assessment of cosmetics, is affected by many factors. OBJECTIVES To investigate the influencing factors of patch test reactions in a highly standardized large-scale dataset of Chinese. METHODS Patch test data (n = 151,280) from safety assessments of cosmetic products were obtained following internationally standardized patch testing protocols during 2004-2017 in China. RESULTS The frequency of patch test reactions was 1.45% (2,191/151,280), with majority of the reactions being "score 1" reactions (also known as doubtful reactions, n = 2,075) and a small number being "score 2" reactions (weak reactions, n = 116). Patch test reactions were 67% more frequent in winter (p < 0.001), associated with temperatures (p < 0.001), rather than relative humidity (P:0.29). The frequency of reactions was higher in men than in women (p:0.001), especially in winter. The risk to develop reactions clearly increased with age in women (p < 0.001), but not in men (p:0.14). In women, the frequency of reactions in the old group (≥50 years old) was 30% more than the young group (<30 years old). CONCLUSIONS The frequency of patch test reactions to cosmetic products was 1.45% in our large-scale study. The influencing factors of patch test include season, sex, and age, which should be considered when conducting and interpreting patch testing.
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Affiliation(s)
- Bingjie Li
- Department of Skin and Cosmetics Research, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.,CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, China
| | - Ying Cheng
- Department of Skin and Cosmetics Research, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.,NMPA Key Laboratory for Monitoring and Evaluation of Cosmetics, Shanghai, China
| | - Yimei Tan
- Department of Skin and Cosmetics Research, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.,NMPA Key Laboratory for Monitoring and Evaluation of Cosmetics, Shanghai, China.,Human Phenome Institute, Fudan University, China
| | - Fudi Wang
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, China
| | - Weiyi Hu
- Department of Skin and Cosmetics Research, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.,NMPA Key Laboratory for Monitoring and Evaluation of Cosmetics, Shanghai, China
| | - Xuemin Wang
- Department of Skin and Cosmetics Research, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Wei Liu
- Department of Dermatology, Air Force General Hospital, China
| | - Jean Krutmann
- Human Phenome Institute, Fudan University, China.,IUF Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany.,Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Sijia Wang
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, China.,Center for Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, Kunming, China
| | - Ying Zou
- Department of Skin and Cosmetics Research, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.,NMPA Key Laboratory for Monitoring and Evaluation of Cosmetics, Shanghai, China
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7
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Shimizu S, Yonezawa K, Haruna M, Sasagawa E, Hikita N, Sanada H, Minematsu T. Relationship between the skin barrier function of 2-week-old infants after bathing and facial skin problems during the first 6 weeks of life: A prospective observational cohort study. Jpn J Nurs Sci 2021; 18:e12408. [PMID: 33644989 DOI: 10.1111/jjns.12408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/07/2020] [Accepted: 12/29/2020] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to identify the relationship between the skin barrier function after bathing at 2 weeks of age and subsequent facial skin problems during the first 6 weeks of life. METHODS A prospective observational study was conducted from July 2017 to February 2018 on healthy newborns aged 2 weeks. Skin barrier function was evaluated before bathing and at 30 and 90 min after bathing by measuring transepidermal water loss (TEWL), stratum corneum hydration (SCH), sebum secretion, and skin pH. Infantile facial skin problems were assessed using skin condition diaries maintained by a parent for 4 weeks. RESULTS Analysis of the data from 56 infants showed that 29 infants (51.8%) experienced facial skin problems from 2 to 6 weeks of age. A lesser change in the sebum secretion on the forehead before bathing to 90 min after bathing and a higher SCH of the forehead before bathing were less likely to result in facial skin problems (adjusted odds ratio [AOR] = 0.98, 95% confidence interval [CI]: 0.97-0.99; AOR = 0.96, 95% CI: 0.92-0.99). CONCLUSIONS A greater change in the sebum secretion on the forehead before bathing to 90 min after bathing and a lower SCH of the forehead before bathing were associated with subsequent infantile facial skin problems, indicating that a better ability to recover after bathing is important to prevent facial skin problems. Future studies should identify factors that enhance the recuperative functions of infantile skin.
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Affiliation(s)
- Satsuki Shimizu
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kaori Yonezawa
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- The Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Megumi Haruna
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- The Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Emi Sasagawa
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- The Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naoko Hikita
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiromi Sanada
- The Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takeo Minematsu
- The Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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8
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Peer RP, Burli A, Maibach HI. Unbearable transepidermal water loss (TEWL) experimental variability: why? Arch Dermatol Res 2021; 314:99-119. [PMID: 33638033 DOI: 10.1007/s00403-021-02198-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 01/13/2021] [Accepted: 02/06/2021] [Indexed: 11/24/2022]
Abstract
Despite the wide breadth of research, much disparity exists in transepidermal water loss (TEWL) research data-possibly due to uncontrolled experimental variables. We determined whether such experimental variables significantly impact TEWL studies and cause this disparity. An initial literature search regarding TEWL was performed to determine potential confounding variables. A subsequent search procured relevant and representative studies investigating the impact of these variables on TEWL. Variables, such as age, anatomic site, and temperature, impact TEWL and should be controlled for in TEWL studies. Other variables, such as smoking and menstrual cycle, have inconclusive results or do not provide sufficient data breadth to make a conclusion regarding its effect, if such an effect exists, on TEWL metrics. Therefore, these variables require further research to determine their potential impact on TEWL. Matching for as many experimental variables as possible may reduce the disparity in TEWL data/conclusions.
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Affiliation(s)
- Reva P Peer
- School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
| | - Anuk Burli
- School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Howard I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
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9
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Pan Y, Ma X, Zhao J, Yan S, Liu Q, Zhao H. The Interaction of Age and Anatomical Region Influenced Skin Biophysical Characteristics of Chinese Women. Clin Cosmet Investig Dermatol 2020; 13:911-926. [PMID: 33324083 PMCID: PMC7732761 DOI: 10.2147/ccid.s286402] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/19/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Ageing is an inevitable physiology process of humans, and skin biophysical parameters change owing to genetic and environmental factors in different ethnic populations. AIM To gain comprehensive data on the skin biophysical parameters of different anatomical regions and to explore the change trend of the skin characteristics associated with age for the indicated regions by generalized additive model. METHODS We measured various skin biophysical parameters on forehead, cheek, chin and inner forearm of 178 Chinese women aged between 20 and 64 years living in Beijing. These parameters comprised skin hydration, transepidermal water loss (TEWL), sebum content, erythema index (EI), melanin index (MI), L*a*b* values, individual typology angle (ITA) and pH, which were quantified by non-invasive instruments. RESULTS Comparing the skin parameters among the four test areas, we observed that the hydration, TEWL, EI and a* values were significantly higher for the face than for the forearm, but the L* and ITA values were just the opposite. The cheek was the lightest and brightest region with lowest sebum content, while the chin was much darker and the forehead was yellowish. Considering the change of the skin parameters with age, TEWL, sebum content and melanin and erythema indices had a linear relationship with age, whereas skin hydration, L, a, b, ITA and pH values exhibited a non-monotonic relationship. The turning points of these curves appeared almost at the thirties, showing the lightest and evenest skin color and more hydration, with lower pH values. CONCLUSION This study indicates that the skin biophysical characteristics of Chinese women were significantly affected by age and body regions.
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Affiliation(s)
- Yao Pan
- Department of Cosmetics, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing100048, People’s Republic of China
- Beijing Key Laboratory of Plant Research and Development, Beijing100048, People’s Republic of China
| | - Xue Ma
- Department of Cosmetics, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing100048, People’s Republic of China
- Beijing Key Laboratory of Plant Research and Development, Beijing100048, People’s Republic of China
| | - Jinfeng Zhao
- Department of Cosmetics, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing100048, People’s Republic of China
- Beijing Key Laboratory of Plant Research and Development, Beijing100048, People’s Republic of China
| | - Shiyu Yan
- Department of Cosmetics, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing100048, People’s Republic of China
- Beijing Key Laboratory of Plant Research and Development, Beijing100048, People’s Republic of China
| | - Qi Liu
- Beijing EWISH Testing Technology Co., Ltd, Beijing100142, People’s Republic of China
| | - Hua Zhao
- Department of Cosmetics, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing100048, People’s Republic of China
- Beijing Key Laboratory of Plant Research and Development, Beijing100048, People’s Republic of China
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10
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Dolečková I, Čápová A, Machková L, Moravčíková S, Marešová M, Velebný V. Seasonal variations in the skin parameters of Caucasian women from Central Europe. Skin Res Technol 2020; 27:358-369. [PMID: 33084174 DOI: 10.1111/srt.12951] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/07/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND The human skin is greatly affected by external factors such as UV radiation (UVR), ambient temperature (T), and air humidity. These factors oscillate during the year giving rise to the seasonal variations in the skin properties. The aim of this study was to evaluate the effect of seasons, environmental T, relative and absolute humidity on the skin parameters of Caucasian women, perform a literature review and discuss the possible factors lying behind the found changes. MATERIALS AND METHODS We measured stratum corneum (SC) hydration, transepidermal water loss (TEWL), sebum level, erythema index, and elasticity parameters R2 and R7 on the forehead and the cheek of Caucasian women from the Czech Republic throughout the year. We also performed a non-systematic literature review focused on the seasonal variations in these skin parameters. RESULTS We confirmed a well-documented low SC hydration and sebum production in winter. In spring, we found the lowest TEWL (on the forehead) and the highest SC hydration but also the highest erythema index and the lowest elasticity presumably indicating skin photodamage. For most of the skin parameters, the seasonal variations probably arise due to a complex action of different factors as we extensively discussed. CONCLUSION The data about the seasonal variations in the skin parameters are still highly inconsistent and further studies are needed for better understanding of the normal skin changes throughout the year.
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11
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Li X, Xing L, Lai R, Yuan C, Humbert P. Literature mapping: association of microscopic skin microflora and biomarkers with macroscopic skin health. Clin Exp Dermatol 2020; 46:21-27. [PMID: 32786033 PMCID: PMC7754415 DOI: 10.1111/ced.14353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/09/2020] [Accepted: 05/27/2020] [Indexed: 10/27/2022]
Abstract
Associations between skin microbes or biomarkers and pathological conditions have been reported in the literature. However, there is a lack of clarity on the interaction between the coexistence of common skin microbes with skin physiology and subsequent development of clinical symptoms, and the role of biomarkers in mediating these changes before the development of skin disease. In this review, we aim to identify areas in which extensive research for the studied factors has already been conducted, and which research areas are under-represented. The SciFinder database was searched for articles containing key words including specific skin microbes, biomarkers, skin physiology and diseases from the beginning of the SciFinder data record to 26 April 2016, and we included an additional relevant recent publication from our group. Among the 8000 + articles selected, the frequency of keyword pairs between two roles [microscopic markers (microflora or biomarkers) and reactions (skin physiology or clinical symptoms, or skin disease)] was investigated. Associated research between the individual factors such as skin microflora or biomarkers (chosen based on our earlier publication) and specific biophysical parameters, symptoms or skin disease was identified. The present research heatmap emphasizes the significance of a structured review of research on concerned factor associations to identify early/subclinical clues that can be used to prevent progression to overt skin disease with the help of precise skin care or early intervention, as indicated by skin microflora, biomarkers and an interactive skin biophysics profile. The findings provide a novel approach to explore such associations and may guide future research directed towards predicting disease from early/subclinical symptoms.
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Affiliation(s)
- X Li
- Clinical Science APAC, Johnson & Johnson (China) Ltd, Shanghai Technology and Research Center, Shanghai, China
| | - L Xing
- Clinical Science APAC, Johnson & Johnson (China) Ltd, Shanghai Technology and Research Center, Shanghai, China
| | - R Lai
- External Innovation, Johnson & Johnson (China) Ltd, Minhang District, Shanghai, China
| | - C Yuan
- Skin and Cosmetic Research Department, Shanghai Skin Disease Hospital, Shanghai, China
| | - P Humbert
- Department of Dermatology, Research and Clinic Centre on the Tegument, Clinical Investigation Center, Besançon University Hospital, Besançon, France.,University of Franche-Comté, Inserm U1098, Besançon, France
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Iwamoto S, Tominaga M, Kamata Y, Kawakami T, Osada T, Takamori K. Association Between Inflammatory Bowel Disease and Pruritus. CROHN'S & COLITIS 360 2020; 2:otaa012. [PMID: 36777956 PMCID: PMC9802076 DOI: 10.1093/crocol/otaa012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Indexed: 12/24/2022] Open
Abstract
Background Inflammatory bowel disease (IBD) is often complicated by extraintestinal manifestations. We frequently encounter IBD patients with pruritus; however, clinical evidence for the association of these conditions is lacking. Therefore, the present study investigated the incidence of pruritus in IBD patients. Methods Seventy-one IBD outpatients, including 55 with ulcerative colitis (UC) and 16 with Crohn disease, and 39 healthy volunteers (HVs) were surveyed about their pruritus symptoms using a visual analogue scale (VAS). Disease activities in UC and Crohn disease patients were classified according to partial Mayo and IOIBD (International Organization for the Study of inflammatory Bowel Disease) scores, respectively. Skin barrier condition was examined by measuring transepidermal water loss and stratum corneum hydration. The distribution of intraepidermal nerve fibers in skin samples from 9 UC patients was examined immunohistochemically using an antiprotein gene product (PGP) 9.5 antibody. Results Visual analogue scale scores were higher in IBD patients than in HV (P < 0.001). Active stage IBD patients had more severe pruritus VAS scores than those in the remission stage (P = 0.036). Transepidermal water loss was higher in IBD patients (P < 0.001) and active stage IBD patients (P = 0.004), while stratum corneum hydration was lower in IBD patients (P = 0.019) and active stage IBD patients than in HV (P = 0.019). A relationship was observed between the degree of pruritus and number of PGP9.5-immunoreactive intraepidermal nerve fibers in UC patients. Conclusions Inflammatory bowel disease patients, particularly active stage patients, frequently exhibit symptoms of pruritus and dry skin. This result may have predictive and therapeutic implications for the treatment of IBD symptoms.
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Affiliation(s)
- Shiho Iwamoto
- Juntendo Itch Research Center (JIRC), Institute for Environmental and Gender Specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan,Department of Gastroenterology, Juntendo University School of Medicine, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Mitsutoshi Tominaga
- Juntendo Itch Research Center (JIRC), Institute for Environmental and Gender Specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan,Anti-aging Skin Research Laboratory, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan
| | - Yayoi Kamata
- Juntendo Itch Research Center (JIRC), Institute for Environmental and Gender Specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan,Anti-aging Skin Research Laboratory, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan
| | - Tomohiro Kawakami
- Department of Gastroenterology, Juntendo University School of Medicine, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Taro Osada
- Department of Gastroenterology, Juntendo University School of Medicine, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Kenji Takamori
- Juntendo Itch Research Center (JIRC), Institute for Environmental and Gender Specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan,Anti-aging Skin Research Laboratory, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan,Department of Dermatology, Juntendo University School of Medicine, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan,Address correspondence to: Kenji Takamori, MD, PhD, 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan ()
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Thadanipon K, Kitsongsermthon J. Comparative study into facial sebum level, pore size, and skin hydration between oily-skinned and dry-skinned Thai women. Skin Res Technol 2019; 26:163-168. [PMID: 31562649 DOI: 10.1111/srt.12792] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 09/05/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Subjective facial skin type is most frequently determined by the amount of sebum, which showed trends across subjective skin types in most previous studies while not in some. This study was conducted to evaluate the associations among subjective skin type, amount of sebum, stratum corneum hydration, and pore size in Thai women. METHODS Sixty-two healthy women with either self-described subjective oily or dry skin type were included and casual sebum level (CSL), sebum excretion rate (SER), clinical pore size score, mean pore area, and stratum corneum hydration were measured at several facial sites. Correlation coefficients between amount of sebum and other parameters were estimated. RESULTS Casual sebum level and sebum excretion rate were significantly higher in oily-skinned than dry-skinned group by 1.6-2.1 times. Mean pore area and clinical pore size score were not different between the 2 groups, nor did they correlate with CSL or SER. Corneometry was shown to be significantly higher in dry-skinned than oily-skinned group. Significant, negative correlations between corneometry and CSL were also found. CONCLUSION The subjective facial skin types were consistent with the amount of sebum, but not pore size or corneometry, among Thai women.
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Affiliation(s)
- Kunlawat Thadanipon
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand.,Division of Dermatology, Department of Medicine, and Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Jutarat Kitsongsermthon
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
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14
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Song Y, Pan Y, Wang H, Liu Q, Zhao H. Mapping the face of young population in China: Influence of anatomical sites and gender on biophysical properties of facial skin. Skin Res Technol 2019; 25:325-332. [DOI: 10.1111/srt.12652] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 12/09/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Yanqing Song
- Department of CosmeticsSchool of ScienceBeijing Technology and Business University Beijing China
- Beijing Key Laboratory of Plant Research and Development Beijing China
| | - Yao Pan
- Department of CosmeticsSchool of ScienceBeijing Technology and Business University Beijing China
- Beijing Key Laboratory of Plant Research and Development Beijing China
| | - Huan Wang
- Department of CosmeticsSchool of ScienceBeijing Technology and Business University Beijing China
- Beijing Key Laboratory of Plant Research and Development Beijing China
| | - Qi Liu
- Department of CosmeticsSchool of ScienceBeijing Technology and Business University Beijing China
- Beijing Key Laboratory of Plant Research and Development Beijing China
| | - Hua Zhao
- Department of CosmeticsSchool of ScienceBeijing Technology and Business University Beijing China
- Beijing Key Laboratory of Plant Research and Development Beijing China
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Rahrovan S, Fanian F, Mehryan P, Humbert P, Firooz A. Male versus female skin: What dermatologists and cosmeticians should know. Int J Womens Dermatol 2018; 4:122-130. [PMID: 30175213 PMCID: PMC6116811 DOI: 10.1016/j.ijwd.2018.03.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 02/23/2018] [Accepted: 03/04/2018] [Indexed: 02/08/2023] Open
Abstract
Introduction The skin is important for the perception of health and beauty. Knowledge of the physiological, chemical, and biophysical differences between the skin of male and female patients helps dermatologists develop a proper approach not only for the management of skin diseases but also to properly take care of cosmetic issues. The influence of genetic and environmental factors on skin characteristics is also critical to consider. Methods A literature search of PubMed and Google was conducted to compare the biophysical and biomechanical properties of the skin of male and female patients using the keywords "skin", "hydration", "water loss", "sebum", "circulation", "color", "thickness", "elasticity", "pH", "friction", "wrinkle", "sex", "male", and "female". Results A total of 1070 titles were found. After removing duplications and non-English papers, the number was reduced to 632. Of the 632 titles, 57 were deemed suitable for inclusion in this review. The studies show that the skin parameters of hydration, transepidermal water loss, sebum, microcirculation, pigmentation, and thickness are generally higher in men but skin pH is higher in women. Conclusions These parameters can be considered as age markers in some cases and are susceptible to change according to environment and life style. Biometrological studies of the skin provide useful information in the selection of active principles and other ingredients of formulations to develop a specific approach for cosmetic treatments.
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Affiliation(s)
- S Rahrovan
- Center for Research and Training in Skin Disease and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - F Fanian
- Research and Studies Center on the Integument, Department of Dermatology, Clinical Investigation Center, Besançon University Hospital, University of Franche-Comté, Besançon, France
| | - P Mehryan
- Center for Research and Training in Skin Disease and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - P Humbert
- Research and Studies Center on the Integument, Department of Dermatology, Clinical Investigation Center, Besançon University Hospital, University of Franche-Comté, Besançon, France
| | - A Firooz
- Center for Research and Training in Skin Disease and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
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Topographical diversity of common skin microflora and its association with skin environment type: An observational study in Chinese women. Sci Rep 2017; 7:18046. [PMID: 29273721 PMCID: PMC5741767 DOI: 10.1038/s41598-017-18181-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 12/07/2017] [Indexed: 01/01/2023] Open
Abstract
This study evaluated cutaneous microbial distribution, and microbial co-occurrence at different body sites and skin environments in Chinese women (39.6 ± 11.9 years, N = 100) during the winter season. Microbial distribution (Propionibacterium acnes, Staphylococcus aureus, Staphylococcus epidermidis, Lactobacillus, Pseudomonadaceae, and Malassezia furfur), association with biomarkers (antimicrobial peptides: LL-37, β-defensins [HBD-2, HBD-3]), and claudin-1) and skin biophysical parameters (transepidermal water loss, pH, skin scaliness and roughness, sebum and hydration levels) were also determined. Skin sites (glabella [GL], hand-back [HB], interdigital web-space [IS], antecubital fossa [AF], volar forearm [VF], back [BA]) were classified as normal, oily or dry based on two-step cluster analysis and exposed or unexposed (uncovered or covered by clothes, respectively) based on seasonal apparel. Pseudomonadaceae and Staphylococcus aureus had the highest and lowest detection rate respectively at all sites. Cluster analysis identified skin sites as ‘normal’ (HB, BA, AF, VF), ‘dry’ (IS) and ‘oily’ (GL). Bacterial alpha diversity was higher in exposed (HB, IS, and GL) compared with unexposed sites (BA, AF and VF). Co-occurrence of Staphylococcus aureus with any of the other five microorganisms was lower in dry and oily skin versus normal skin. Skin exposure, biophysical/barrier profile and biomarkers were found to be associated with bacterial distribution and co-occurrence.
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Zhang M, Li B, Wu S, Tan J, Yang Y, Marini A, Vierkötter A, Zhang J, Li H, Schikowski T, Jin L, Krutmann J, Wang S. A Genome-Wide Association Study of Basal Transepidermal Water Loss Finds that Variants at 9q34.3 Are Associated with Skin Barrier Function. J Invest Dermatol 2017; 137:979-982. [DOI: 10.1016/j.jid.2016.11.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 11/17/2016] [Accepted: 11/26/2016] [Indexed: 11/26/2022]
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Dreno B, Araviiskaia E, Berardesca E, Bieber T, Hawk J, Sanchez-Viera M, Wolkenstein P. The science of dermocosmetics and its role in dermatology. J Eur Acad Dermatol Venereol 2014; 28:1409-17. [PMID: 24684296 DOI: 10.1111/jdv.12497] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 03/03/2014] [Indexed: 12/12/2022]
Abstract
Our increased knowledge of normal skin physiology has ushered in a subtle revolution in cosmetic science. Originally designed as preparations to enhance personal appearance by direct application on to the skin, cosmetics have now taken on a new role in dermatology, through the support of the management of many skin disorders. This evolving role of cosmetics in skin care is primarily due to scientific and technological advancements that have changed our understanding of normal skin physiology and how cosmetics modify its appearance both physically and biologically. The vast array of techniques currently available to investigate skin responsivity to multiple stimuli has brought about a new era in cosmetic and dermocosmetic development based on a robust understanding of skin physiology and its varied responses to commonly encountered environmental insults. Most cosmetic research is undertaken on reconstructed skin models crucial in dermatological research, given the strict ban imposed by the European Union on animal testing. In addition, the design and conduct of trials evaluating cosmetics now follow rules comparable to those used in the development and evaluation of pharmaceutical products. Cosmetic research should now aim to ensure all trials adhere to strictly reproducible and scientifically sound methodologies. The objective of this review is to provide an overview of the multidisciplinary scientific approach used in formulating dermocosmetics, and to examine the major advances in dermocosmetic development and assessment, the safety and regulatory guidelines governing their production and the exciting future outlook for these dermocosmetic processes following good practice rules.
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Affiliation(s)
- B Dreno
- Department of Dermato Cancerology, Nantes University, Nantes, France
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Galzote C, Estanislao R, Suero MO, Khaiat A, Mangubat MI, Moideen R, Tagami H, Wang X. Characterization of facial skin of various Asian populations through visual and non-invasive instrumental evaluations: influence of seasons. Skin Res Technol 2014; 20:453-62. [PMID: 24602131 DOI: 10.1111/srt.12140] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2014] [Indexed: 01/07/2023]
Abstract
BACKGROUND/PURPOSE This multicenter study assessed the impact of two types of extreme seasons (i.e. summer and winter) on the facial skin of female subjects living in different regions of Asia. METHODS Facial skin of female subjects of various Asian ethnicities was characterized during summer and winter using dermatological assessments of the cheek and instrumental evaluations of the forehead and cheek. Approximately, 100 female subjects each from five cities in Asia (Harbin and Shanghai in China; New Delhi, India; Seoul, South Korea; and Sendai, Japan) ranging in age from 14 to 75 years were included in this study. RESULTS Dermatologist assessments revealed a general decrease in severity of roughness, wrinkles, pigmentation, and lentigines during winter compared with summer. Instrumental assessments revealed significant differences in various parameters in winter vs. summer such as reductions in melanin index and skin surface hydration, and increases in transepidermal water loss, skin pH, redness, and sebum production. CONCLUSION Facial skin in female subjects living in different Asian cities exhibited a wide range of changes and worsening of various biophysical parameters in response to the low temperature and humidity during the winter season as compared with summer.
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Affiliation(s)
- C Galzote
- Johnson & Johnson China Ltd., Shanghai, China
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