Influence of chronic UV exposure and lifestyle on facial skin photo-aging--results from a pilot study

Awareness of sun exposure risks and photoprotection for preventing pigmentary disorders in Asian populations: Survey results from three Asian countries and expert panel recommendations

BACKGROUND

In this article, we review and discuss the photoprotection behavior of Asians based on the literature, along with a subanalysis of an original online survey, and make recommendations to optimize photoprotection for Asian populations to prevent photoaging and pigmentary disorders.

METHODS

An international panel of eight dermatologists from Asia (China, Korea, Japan, Singapore, Indonesia, and Vietnam) met to discuss sunscreen photoprotection for Asian patients. Additionally, a subanalysis of an online survey by 3000 respondents from three Asian countries (China, Indonesia, and Japan) investigated general public awareness and attitudes to sun exposure.

RESULTS

A pre-meeting survey of the eight experts from Asia showed key concerns of Asian patients consulting dermatologists are pigmentary disorders, especially actinic/senile lentigo, post-inflammatory hyperpigmentation, melasma, vitiligo, and Hori's nevus. The survey subanalysis of participants from China, Indonesia, and Japan with predominantly Fitzpatrick skin types (FST) II to IV revealed that they are particularly concerned about sun exposure causing photoaging and pigmentary disorders. Most of the respondents indicated they have limited knowledge on sunlight radiation and appropriate sunscreen protection factors. Only 22%, 13%, and 3% for China, Indonesia, and Japan, respectively, systematically use multiple protective measures (using sunscreen, avoiding midday sun, staying in the shade, wearing a hat, protective clothing, and sunglasses) when exposed to the sun.

CONCLUSIONS

Further education is needed for Asian populations on the importance of comprehensive daily photoprotection, including broad-spectrum sunscreen, with high UVA and visible light protection, to reduce and prevent photoaging and pigmentary disorders.

Clinical Assessment, Diagnosis, and Management of Infraorbital Wrinkles and Pigmentation

Lower eyelid skin is unique and different from that of other areas. In addition to being an area of high exposure to the sun and elements, there are anatomic considerations and specific histologic characteristics that can cause the skin in this area to be more sensitive. These attributes can readily cause under-eye wrinkling and pigmentation. This review aims to present an updated overview of the current knowledge regarding the clinical characteristics, diagnosis, and management of wrinkles and pigmentation in this area. These disorders are usually caused by different factors, such as genetics, aging, sun exposure, lack of sleep, and stress.

Applications of the new Aeva-HE™ imaging system: Its link with the visual evaluation of facial wrinkles and its potential in screening tensile products

OBJECTIVES

To evaluate, in vivo, a recently developed imaging system (Aeva-HE™), based on fringe projection methodology: (i) its correlation with expert's assessments and real age of 85 French Caucasian women and (ii) its potential, as a screening tool, in rapidly selecting prototypes of tensile cosmetic products.

MATERIALS AND METHODS

First, the bare faces of 85 differently aged French/Caucasian women were photographed under standard conditions and further analyzed by the Aeva-HE™ device. An expert aesthetician graded the severity of wrinkling on a fixed scale, helped by the use of a dedicated Skin Aging Atlas. A panel of 15 judges performed the same task on full-face standard photographs. The Aeva-HE™ software yielded various wrinkle's parameters (density, volume, mean depth, etc.) on different facial locations, according to age-groups. Second, seven women, balanced in age and wrinkling severity, were recruited in a separate study. These women applied at Day 1 a prototype of the tensile product and at Day 2, they applied another prototype of the tensile product. The whole faces (before and after products application) of the seven studied women were captured and analyzed by the Aeva-HE™ system.

RESULTS

The density of wrinkles was significantly highly correlated with the aesthetician scores and, unsurprisingly, with age. Some parameters (volume, depths) of different wrinkles (glabellar, crow's feet, cheeks) were quantified, showing different absolute values and of statistically different progressions with age. The amplitudes of the rapid effects brought by the two prototypes of tensile products were clearly differentiated.

CONCLUSION

The recently developed device Aeva-HE™ is an efficient system for rapidly establishing a faithful and precise status of facial wrinkles, in vivo and seems like a precious tool in the rapid screening of tensile products, possibly performed on a rather limited number of subjects.

Photoaging's portrait: The road map towards its photoprotection

OBJECTIVE

To summarize key research published by the author's group, dealing with skin photoaging and its photoprotection.

MATERIALS AND METHODS

Two methodologies (standard photographs and selfies imaging) resulting from referential skin ageing atlases were applied on 2487 subjects of different ancestries, ages and gender. These aimed at first to best assess and grade the variable severities of some facial signs (texture/wrinkles, pigmentary spots, sagging and vascular disorders) that occur progressively during the photoaging process. Second, such methodologies were used to record the benefits brought by a photoprotective regimen (671 women and men).

RESULTS

In all studied ancestries, each facial sign show an increase severity along decades, at its own pace, some showing a linear like progression, whereas some plateau at early ages. These changes differed according to skin innate colour (phototype) and with individual behaviours vis-à-vis sun exposures, more so among European women than North-East Asian women. An effect of gender (less severe alterations) was observed on Chinese men, as compared to Chinese women. Pigmentary disorders were found hallmarks of photo-aged North-East Asian women. Globally, photoaging impact the apparent age of the different subjects. The counteracting effects of strong topical Photoprotective regimens were evidenced along a 6-month seasonality in Chinese and French women or 1-year period in Brazilian women with phototypes II to VI. Photoprotection led to a more even skin complexion among Indian subjects with pigment irregularities.

CONCLUSION

Two factors clearly hamper a better assessment of the efficiency of photoprotection of the sun-induced cutaneous ageing: short durations (months) of the studies with regard to the global fate of photoaging by decades and the number of studied subjects, limited to hundreds for practical reasons. The methodology based on the automatic analysis of facial signs through selfies images could theoretically bypass both factors, allowing thousands of subjects to be studied along years.

Skin Aging Exposome in Skin of Color Populations: Review of the Literature

BACKGROUND

As life expectancy increases, the comorbidities related to aging require greater attention. Skin aging exposomes were only recently defined and need additional delineation, particularly in Skin of Color (SOC) populations.

OBJECTIVE

The primary objective is to shed the light and summarize the existing literature on skin aging exposome in SOC populations.

MATERIALS AND METHODS

We performed an extensive search in the PubMed and Google Scholar databases. We included peer-reviewed studies in SOC populations around the world regarding one or more of the skin aging exposome factors, and we grouped and organized the studies under each factor of the skin aging exposome.

RESULTS

Some environmental exposome factors are preventable or modifiable, for example, by applying broad-spectrum sunscreens with visible light protection, improving nutrition, and smoking cessation. Other factors such as air pollution will require more complex solutions. Our search revealed a paucity of references on skin aging exposome factors in SOC populations.

CONCLUSION

We identified the need for more dedicated studies in SOC populations to advance knowledge on skin aging exposome factors. This knowledge will provide a better understanding of approaches to minimize extrinsic skin aging in these populations.

Influence of environmental factors on facial pigmented spots: Epidemiological survey of women living in the northern and southern regions of Japan

BACKGROUND

Several epidemiological studies have been conducted to understand the relationship between environmental factors (including chronic sun exposure) and clinical signs of pigmented spots. However, no quantitative analysis has focused on the adverse effects of the detailed features of pigmented spots, including their color intensity, size, and number on the cheek. This study was performed to elucidate the adverse effects of environmental factors on clinical signs of pigmented spots.

METHODS

We conducted an epidemiological survey of 102 Japanese women in 2 regions of high and low sun exposure (southern and northern regions, respectively). Using image analysis of high-resolution digital facial photographs, individual pigmented spots were quantified according to color, size, and total number on the cheek. Each indicator was then compared between the groups.

RESULTS

For the number of pigmented spots on the cheek, the age-related increase curve showed a large slope in the southern group. For the size of pigmented spots, no significant difference was found between the two groups, and large pigmented spots were observed on the cheek even in the northern group. For the color intensity of the spots, the southern group showed a marked age-related change; among older subjects, the pigmented spots were significantly darker in the southern than northern group.

CONCLUSION

Our results may indicate that environmental factors, including chronic exposure to sunlight, mainly increase the number of pigmented spots and darkening of these spots. However, the occurrence of large pigmented spots may be related to intrinsic factors represented by heredity rather than environmental factors.

Real-time wrinkle evaluation method using Visual Illusion-based image feature enhancement System

BACKGROUND

Several advanced methods for evaluating wrinkles are currently available, however, with limitations in their application because wrinkle structures change in response to facial expressions and surrounding environments. A Visual Illusion-based image feature enhancement System (VIS) was used to develop a real-time evaluation method.

OBJECTIVES

This study expands the VIS application into the wrinkle evaluation method by adjusting VIS to evaluate facial wrinkles, evaluating the age-dependent wrinkles, and validating it for real-time wrinkle evaluation.

METHODS

Wrinkles in various Japanese men and women were evaluated using VIS and the current methods. Furthermore, the effectiveness of an eye cream containing niacinamide was evaluated before and after the 4-week treatment.

RESULTS

VIS qualitatively detects even fine wrinkles and numerically records them without any special instrument. Moreover, VIS can be applied to moving images, revealing the effectiveness of the antiwrinkle formulation qualitatively and quantitatively even when the subjects are smiling.

CONCLUSION

This paper presents an epoch-making wrinkle evaluation method that is qualitative and quantitative, with high sensitivity in real-time and relies solely on digital images without any difficulties. Therefore, these results imply that this method enables the wrinkle evaluation under real-life conditions.

Skin, hair and beyond: the impact of menopause

The skin is an endocrine organ and a major target of hormones such as estrogens, androgens and cortisol. Besides vasomotor symptoms (VMS), skin and hair symptoms often receive less attention than other menopausal symptoms despite having a significant negative effect on quality of life. Skin and mucosal menopausal symptoms include dryness and pruritus, thinning and atrophy, wrinkles and sagging, poor wound healing and reduced vascularity, whereas skin premalignant and malignant lesions and skin aging signs are almost exclusively caused by environmental factors, especially solar radiation. Hair menopausal symptoms include reduced hair growth and density on the scalp (diffuse effluvium due to follicular rarefication and/or androgenetic alopecia of female pattern), altered hair quality and structure, and increased unwanted hair growth on facial areas. Hormone replacement therapy (HRT) is not indicated for skin and hair symptoms alone due to the risk-benefit balance, but wider potential benefits of HRT (beyond estrogen's effect on VMS, bone, breast, heart and blood vessels) to include skin, hair and mucosal benefits should be discussed with women so that they will be able to make the best possible informed decisions on how to prevent or manage their menopausal symptoms.

A pilot study evaluating the efficacy and tolerability of a comprehensive, hydrating topical antioxidant developed specifically for men

Introduction

There is growing interest in skincare products designed for men. This pilot study evaluated the efficacy and tolerability of a comprehensive antioxidant product in men.

Methods

This 12‐week study evaluated improvements from baseline in erythema, lines/wrinkles, skin tone, texture, brightness, dryness/flaking and pores (6‐point scale), global improvements (5‐point scale), and sebum levels following daily application in males with mild to moderate photodamaged skin. Subject self‐assessments and adverse events (AEs) were captured.

Results

Twenty‐two subjects completed the study. Early mean percent improvements from baseline were demonstrated in all categories at week 4 with visible improvements in skin tone (29%; p = .0001) and pores (28%; p < .0001). Reductions in skin surface sebum levels (forehead region) from baseline were demonstrated at 8 (p < .0001) and 12 (p < .0003) weeks. Ninety‐six percent of subjects reported overall visible improvement of their skin and that the study product calmed/soothed skin, reducing redness and irritation after shaving. One subject reported mild dryness.

Conclusion

Once daily application of a comprehensive topical antioxidant designed for men led to significant improvements in skin appearance, substantial reductions in skin surface sebum levels, and was well tolerated with a high level of subject satisfaction over 12 weeks.

Comparing the self-perceived effects of a facial anti-aging product to those automatically detected from selfie images of Chinese women of different ages and cities

OBJECTIVE

To assess the agreement, after 1-month application of a popular and efficient anti-aging product, between self-perceived facial signs of aging and those detected and graded by an automatic A.I-based system, using smartphones' selfie images.

MATERIAL AND METHODS

Of 1065 Chinese women, aged 18-60 years, from eight different Chinese cities were recruited. They were asked to apply daily, for 1 month, a referential anti-aging product onto their whole face. Selfie images were taken by all subjects at D₀ and D₂₈ and sent to our facilities for being analyzed through 10 different facial signs. At D₂₈ , all subjects were asked to fill a questionnaire on the status of their faces, through six general statements.

RESULTS

A global agreement between both approaches is reached, particularly among women older than 40 years where the severity of facial signs is already more pronounced or among younger women who present at least facial signs scored above one grading units. This limit becomes, therefore, a prerequisite in the recruitment of Chinese subjects in the case of anti-aging applied studies and possible automatically based on automatic grading system. When respecting such conditions, the positive effects of the product on most facial signs can be demonstrated after 28 days of successive applications.

CONCLUSION

Such methodological approach paves the road in fulfilling the need of consumers of a better transparency in the claims of an anti-aging product.

Prediction of future wrinkles for middle-aged women: A 7-year longitudinal study on the progression of wrinkles in Japanese women

BACKGROUND

It is commonly believed that there is serious heterogeneity in the rate of wrinkle progression among individuals. Although several skin characteristics have been shown to influence wrinkle progression, the ability to predict which individuals with skin characteristics are likely to develop wrinkles is still limited.

OBJECTIVES

The purpose of this study is to develop and validate an effective prediction model for longitudinal changes in wrinkles.

METHODS

We collected annual wrinkle scores and multiple skin physiological characteristics in 48 Japanese women over a period of 7 years. We developed a multivariable prediction model for predicting future wrinkle status based on the various skin physiological characteristics using a linear mixed-effects model.

RESULTS

After variable selection by backwards, the final wrinkle prediction model included age, sebum volume, redness of skin color, lightness of skin color, and an interaction term between sebum volume and redness of skin color. The developed prediction model showed favorable prediction accuracy (R²  = 87.92%, 95% confidence interval 84.27%-90.68%).

CONCLUSIONS

The developed model accurately predicted levels of wrinkles in Japanese women aged 22-60 years. The prediction model is based on age and three practical skin characteristics, which might implicate an essential insight to prevent wrinkle progression in individuals.

Oxidative stress in human facial skin observed by ultraweak photon emission imaging and its correlation with biophysical properties of skin

Oxidative stress is associated with skin ageing and disease in humans. However, it is difficult to evaluate the effects of oxidative stress on the skin in vivo using conventional invasive methods. In this study, we performed two-dimensional imaging of ultra-weak photon emission (UPE) generated by excited species in oxidative reaction to determine regional variations in oxidative stress in human facial skin and analysed the relationship between UPE intensity and biophysical properties in vivo. UPE imaging of the facial skin of volunteers revealed regional variations in oxidative stress. The nose, its surrounding regions, and the area between eyebrows showed higher UPE intensity than other facial regions, indicating high oxidative stress in these regions. In contrast, only the region surrounding the eyes showed age-related alterations in UPE intensity; moreover, wrinkle score in these regions was correlated with UPE intensity. These results suggest that oxidative stress in the skin induces wrinkle formation. UPE intensity was correlated with porphyrin score in the skin; however, no correlation was observed between UPE intensity and skin colour parameters. This study provides insights into the treatment of facial skin areas vulnerable to ageing and helps improve our understanding of topical skin diseases related to oxidative stress.

Investigation of symptoms of hand skin changes with aging in Korean women and development of a new standard grading scale for hand aging

BACKGROUND

Skin aging, particularly facial skin, has been actively studied. However, hand skin research is limited.

METHODS

Aging symptoms of 100 hands of Korean women aged from 20s to 60s were measured by noninvasive and bioengineering methods. Standard grade images were produced.

RESULTS

As people got older, skin wrinkles were getting worse and skin tone was uneven with the occurrence of structural flexion. For each symptom, a suitable standard photograph of the skin of the hand was chosen and a new grading scale was made.

CONCLUSIONS

The new grading scale developed in the present study could be employed in studies to explore aging of hand skin as one of objective indicators.

Analysis of relation between skin elasticity and the entropy of skin image using near-infrared and visible light sources

Skin elasticity has been regarded as one of the main indicators of skin condition. Current measurement devices for skin elasticity are mostly expensive for home-use and should contact the skin surface. As a first step to develop improved methods, we focus on the relation between skin elasticity and the entropy of skin images. Reduced skin elasticity causes wrinkles. It spreads frequency components and increases their randomness in the frequency domain. The randomness is quantified as entropy, which is a measure of the disorder of a system in physics. Therefore, skin elasticity is expected to have a negative relation with entropy. This tendency can be improved by applying penetration depth characteristics according to the wavelength of light. From cheeks and forehead of 12 Korean adults, skin images are acquired with three different light sources (470 nm, 870 nm and broadband light) and skin elasticity is measured. The root mean square error between the measured data and the fitted model is "0.27" (870 nm), "0.49" (broadband light) and "1.42" (470 nm). Furthermore, the results are analyzed by classifying by sex, age and measurement area. This study demonstrates the possibility of developing noncontact home-use devices to measure skin elasticity in the future.

Distinct Habits Of Sun Exposures Lead To Different Impacts On Some Facial Signs Of Chinese Men Of Different Ages

Objective

To clinically evaluate the impacts of sun exposures on some facial signs of differently aged Chinese men with a distinct behavior vis à vis sun exposures.

Methods

Two comparable cohorts of Chinese men (aged 18-75 years old), living in two cities (Shanghai, Hong Kong) were created according to their usual behavior towards sun exposure and through their variable use(s) of a photo-protective product, i.e. non-sun-phobic (N = 127) and sun-phobic (N = 134). Standard photographs (full-face and 45° lateral) allowed to focus on 13 facial signs that were further graded by 15 experts and dermatologists, using a referential Skin Aging Atlas. Absolute differences in the scores of each sign were used (non-sun-phobic minus sun-phobic), by age-classes, to better ascertain the impact of sun exposures and a photo-protecting product, when used.

Results

Most facial signs, particularly wrinkles and skin texture, differentiated the two cohorts. Some others showed some erratic changes with age, albeit more pronounced at older ages. In contrast with previous results obtained in Chinese women, the changes observed in men were not only of a lessened severity but were undetected at early ages (<30 years old). Overall, these different behaviors with regard to sun exposures led to significant differences in the facial signs of Chinese men. The latter can be illustrated by two virtual morphings that combine the impacts of both intrinsic and extrinsic aging processes.

Conclusion

The present work illustrates, for the first time, some specificities of the impacts of sun exposures on the facial skin of Chinese men, more expressed at older ages, inversely to those observed in Chinese women, occurring at younger ages.

Blue Light Induces Down-Regulation of Aquaporin 1, 3, and 9 in Human Keratinocytes

The development in digital screen technology has exponentially increased in the last decades, and many of today’s electronic devices use light-emitting diode (LED) technology producing very strong blue light (BL) waves. Long-term exposure at LED-BL seems to have an implication in the dehydration of the epidermis, in the alterations of shape and number of the keratinocytes, and in the aging of the skin. Aquaporins (AQPs) are water membrane channels that permeate both water and glycerol and play an important role in the hydration of epidermis, as well as in proliferation and differentiation of keratinocytes. Thus, we have hypothesized that AQPs could be involved in the aging of the skin exposed to LED-BL. Therefore, we have examined the expression of AQPs in human keratinocytes exposed to LED-BL at dose of 45 J/cm², used as an in vitro model to produce the general features of photo aging of the skin. The aim was to verify if LED-BL induces changes of the basal levels of AQPs. The keratinocytes exposure to LED-BL produced an increase of reactive oxygen species (ROS), an activation of 8-hydroxy-2’-deoxyguanosine (8-OHdG), an alteration of proliferating cell nuclear antigen (PCNA), and a down-regulation of AQP1, 3 and 9. These findings are preliminary evidences that may be used as starting points for further investigations about the mechanistic involvement of AQP1, 3, and 9 in LED-BL-induced skin aging.

Male versus female skin: What dermatologists and cosmeticians should know

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.

Aging Decreases Hand Volume Expansion with Water Immersion

Hands may show early signs of aging with altered skin texture, skin permeability and vascular properties. In clinics, a hand volumeter is used to measure swelling of hands due to edema, carpal tunnel syndrome or drug interventions. The hand volume measurements are generally taken without taking age into consideration. We hypothesized that age affects hand volumeter measurements and that the younger age group (≤40 years) records a greater change in hand volume as compared to the older group (>40 years). Four volumetric measurements were taken at 5 min intervals during 20 min of water immersion using a clinically-approved hand volumeter. After 20 min of immersion, the hand volume changes of the younger age group were significantly higher than the older age group (p < 0.001). Specifically, the right-hand volume of the younger age group (≤40 years, n = 30) increased by 4.3 ± 2%, and the left hand increased by 3.4 ± 2.1%. Conversely, the right-hand volume of the older age group (>40 years, n = 10) increased by 2.2 ± 2.0%, and the left hand decreased by 0.6 ± 2.4% after 20 min of water immersion. The data are presented as Mean ± SD. Hand volume changes were not correlated with body mass index (BMI) or gender, and furthermore, neither of these two variables affected the relationship between age and hand volume changes with water immersion. We conclude that the younger age group has a higher increase in hand volume with water immersion as compared to the older age group.

The relationship between skin function, barrier properties, and body-dependent factors

BACKGROUND

Skin is a multilayer interface between the body and the environment, responsible for many important functions, such as temperature regulation, water transport, sensation, and protection from external triggers.

OBJECTIVES

This paper provides an overview of principal factors that influence human skin and describes the diversity of skin characteristics, its causes and possible consequences. It also discusses limitations in the barrier function of the skin, describing mechanisms of absorption.

METHODS

There are a number of in vivo investigations focusing on the diversity of human skin characteristics with reference to barrier properties and body-dependent factors.

RESULTS

Skin properties vary among individuals of different age, gender, ethnicity, and skin types. In addition, skin characteristics differ depending on the body site and can be influenced by the body-mass index and lifestyle. Although one of the main functions of the skin is to act as a barrier, absorption of some substances remains possible.

CONCLUSIONS

Various factors can alter human skin properties, which can be reflected in skin function and the quality of everyday life. Skin properties and function are strongly interlinked.

Comparison of skin properties in individuals living in cities at two different altitudes: an investigation of the environmental effect on skin

BACKGROUND

Skin properties vary depending on exogenous factors. Various studies have been used for comparing skin properties between cities for studying environment influence on skin properties. However, for comparison of skin properties between cities, various environmental factors have to be considered.

OBJECTIVES

The purpose of this study therefore was to compare skin properties in individuals of the same ethnicity and sex (Indonesian women) between different altitudes and to interpret the environmental effect on skin.

METHODS

In this study, we reanalyzed the data obtained from previous study. The data were for healthy Sundanese Indonesian females [(n = 136) at Jakarta (n = 49) and Bandung (n = 87)], and the data consisted of published data (skin hydration, sebum level, pH, elasticity, and transepidermal water loss) and unpublished data [skin color (L*, a*, and b*)]. The skin parameters were measured on Indonesian females aged 20-34 using C+K devices (corneometer, sebumeter, pH meter, and cutometer), Delfin vapometer, and Minolta spectrophotometer, respectively.

RESULTS

Sundanese Jakarta (low-altitude) females had higher sebum level and greater redness (a*) value in the forehead than Sundanese Bandung (high-altitude) females. In contrast, Bandung females had higher skin pH, brighter skin color, and greater forehead skin elasticity than Jakarta females.

CONCLUSIONS

The skin properties can be influenced by changing altitude because different altitudes have different environments such as air temperature, humidity, UV radiation, and so on, and it is also necessary to investigate the factors which can influence with perceived skin condition such as skin type and skin concerning.

Solar exposure(s) and facial clinical signs of aging in Chinese women: impacts upon age perception

A new reference clinical atlas of facial signs dedicated to photoaging was applied to 301 Chinese women of various ages through standardized photographs. Such approach aimed at better describing the facial changes induced by both real/chronological age and sun exposure and their respective impact on two subcohorts of different behavior with regard to sun exposure. A total of 28 various facial signs were individually graded according to their severity by a panel of experts, and a perceived apparent age of each subject was assessed. Results showed that the severity of major signs significantly increased rather linearly with age, with a higher rate in sun-exposed subjects as compared with subjects who regularly avoid sun exposure. The severity of facial signs, all impacted by sun exposure, better correlated with perceived apparent age than real/chronological age. The protocol used in the present work, similar to that previously applied to two cohorts of French women, assigned a greater impact of sun exposure in the facial aging signs of Asian women – all clinical signs are influenced by extrinsic factors – as compared with Caucasian women of comparable ages, likely related to much more intense ultraviolet (UV) radiation.

Quantification of age-related facial wrinkles in men and women using a three-dimensional fringe projection method and validated assessment scales

BACKGROUND

Whereas the molecular mechanisms of skin aging are well understood, little information is available concerning the clinical onset and lifetime development of facial wrinkles.

OBJECTIVES

To perform the first systematic evaluation of the lifetime development of facial wrinkles and sex-specific differences using three-dimensional (3D) imaging and clinical rating.

METHODS

200 men and women aged 20 to 70 were selected. Wrinkle severity of periorbital, glabellar, and forehead lines was evaluated using 3D imaging and validated assessment scales.

RESULTS

Wrinkle severity was greater at all assessed locations with older age. In men, wrinkles manifested earlier and were more severe than in women. In women, periorbital lines were the first visible wrinkles, in contrast to the forehead lines in men. In both sexes, glabellar lines did not clinically manifest before the age of 40.

CONCLUSION

The results of the present study confirm a progressive increase of crow's feet and forehead and glabellar lines in men and women. Although the development of facial wrinkles happens earlier and is more severe in men, perimenopause seems to particularly affect development in women. Clinical ratings and 3D measurements are suitable methods to assess facial wrinkle severity in men and women.

Mechanical properties of human skin in vivo: a comparative evaluation in 300 men and women

BACKGROUND

Previous studies have shown that the clinical genesis and onset of facial wrinkles as well as the morphology of the extracellular matrix differ between the sexes. The aim of this present clinical study was to do the first systematic assessment of gender-related differences in skin elasticity, with special focus on age-related changes.

MATERIAL AND METHODS

300 healthy male and female subjects (20-74 years) were selected following strict criteria including age, sun behavior or smoking habits. Skin mechanical properties were assessed at the cheek, neck, volar forearm and dorsum of the hand using a non-invasive suction device.

RESULTS

Data analysis shows a significant negative correlation for all parameters and subject's age. At young age results of the relative parameters are higher for women, whereas absolute parameters are higher for men. Parameters referring to the recovery phase change stronger with aging.

DISCUSSION

The present study verifies the progressive decline of the skin mechanical properties with aging. However, the elastic ability of the skin to recover after stretching is more strongly affected by the aging process than the firmness of the skin. Further, the mechanical properties change differently in men and woman over lifetime.

Gender-dependent differences in degree of facial wrinkles

BACKGROUND/PURPOSE

This study aimed to reveal gender-dependent differences in the degree of facial wrinkles.

METHODS

Subjects comprised 173 Japanese men and women, divided into four groups according to age. Photographs were taken from nine facial regions and used to classify the intensity of wrinkles into five grades. In addition, replicas were taken from five facial sites and used to measure surface roughness. Data were compared between men and women within each age group.

RESULTS

In all age groups, men showed increased forehead wrinkles compared with women. In contrast, no gender-dependent differences were found in upper eyelid wrinkles. Other facial wrinkles were greater in men than in women in all except the oldest group (age, 65-75 years), in which wrinkles in women were greater than or equal to those in men.

CONCLUSION

Our results showed that gender-dependent differences exist in the degree of facial wrinkles. In general, men tend to have more severe wrinkles than women. This tendency disappeared or was reversed in some regions of the face and in individuals more than 60 years old.

Influence of season on some skin properties: winter vs. summer, as experienced by 354 Shanghaiese women of various ages

The facial skin of 354 women, aged 18-80, living in Shanghai, was investigated over two successive 6-month periods, summer and winter. Results from clinical assessments indicate that aging signs, such as wrinkling and sagging, are unaffected over such period. However, physical measurements revealed alterations in some functional criteria of the skin, such as sebum output, skin colour, melanin content of pigmented spots, skin hydration, all being increased during summer. The relationships between all criteria, as well as technical or applied inferences/consequences from this study, are discussed.

Sun-induced changes in stratum corneum function are gender and dose dependent in a Chinese population

Previous studies have demonstrated that UVB radiation changes the epidermal permeability barrier and stratum corneum (SC) hydration. It is well known that sun exposure causes erythema, sunburn and melanoma. However, whether daily sun exposure alters SC integrity and epidermal permeability barrier function is largely unknown, especially in Chinese subjects. In the present study, we assess the SC integrity, SC hydration and epidermal permeability barrier function following various doses of sun exposure. A total of 258 subjects (124 males and 134 females) aged 18-50 years were enrolled. A multifunctional skin physiology monitor (Courage & Khazaka MPA5) was used to measure SC hydration and transepidermal water loss (TEWL) on the forearms. In males, basal TEWL was higher with higher doses of sun exposure than with lower doses and control, whereas in females, basal TEWL was higher with lower doses of sun exposure than with higher doses and control. In the group with higher doses of sun exposure, TEWL in females was significantly lower than that in males. The barrier recovery was faster in females than in males in both control and lower-dose groups. In both males and females, barrier recovery was delayed with higher doses of sun exposure. In males, sun exposure did not alter SC hydration, while in females SC hydration was lower with lower doses of sun exposure as compared with control and higher doses of sun exposure. These results demonstrated that sun-induced changes in SC function and SC hydration vary with gender and the extent of sun exposure.

[Molecular basis of photoaging]

As a result of the increase in life expectancy, the study of the organic process of aging has been stimulated. Skin ageing, which reflects the signs of time, is a time-dependent process of progressive deterioration that can be intensified by sun exposure, which is known as photoaging. The damage of radiation on various cell structures and on the skin results in molecular and morphological changes to these components. Many research studies are performed to try to minimize the effects of photoaging; however, the main strategy to manage it is still prevention, which will only be achieved once we learn about the mechanisms involved in the process.

New wrinkles on wrinkling: an 8-year longitudinal study on the progression of expression lines into persistent wrinkles

BACKGROUND

While cumulative lifetime sun exposure is well recognized as having an important role in the progression of facial wrinkling, the role of facial expression has largely been overlooked, in part due to the lack of comprehensive longitudinal data on the change in both expression lines and persistent wrinkles with age.

OBJECTIVES

To track the detailed pattern of facial wrinkling in the same group of people over several years and to verify that expression lines evolve into persistent wrinkles. In addition, to identify factors predictive of a faster or slower rate of wrinkling.

METHODS

Standardized images were captured at baseline and at 8 years of 122 women (ages 10-72 years, skin types I-VI) with and without a smiling expression. The wrinkle pattern with expression at baseline was compared with the pattern without expression at 8 years. Severity of facial wrinkling was quantified using computer-based image analysis. Skin colour, hydration, sebum and pH were measured at baseline. A structured questionnaire captured demographic and lifestyle data at baseline and at 8 years.

RESULTS

Each subject's unique pattern of persistent facial wrinkling observed without expression at year 8 was predicted by the pattern of lines observed with a smiling expression at baseline. Having a drier, more alkaline stratum corneum, a lighter complexion, being middle-aged (40s) or becoming menopausal were associated with faster persistent wrinkling.

CONCLUSIONS

Repeated skin flexure during facial expression causes persistent wrinkles. The pattern of expression lines predicts the pattern of future persistent wrinkles. Certain intrinsic and extrinsic factors are not causative, but influence the rate, of facial wrinkling.

Lifestyle factors and visible skin aging in a population of Japanese elders

Background

The number of studies that use objective and quantitative methods to evaluate facial skin aging in elderly people is extremely limited, especially in Japan. Therefore, in this cross-sectional study we attempted to characterize the condition of facial skin (hyperpigmentation, pores, texture, and wrinkling) in Japanese adults aged 65 years or older by using objective and quantitative imaging methods. In addition, we aimed to identify lifestyle factors significantly associated with these visible signs of aging.

Methods

The study subjects were 802 community-dwelling Japanese men and women aged at least 65 years and living in the town of Kurabuchi (Takasaki City, Gunma Prefecture, Japan), a mountain community with a population of approximately 4800. The facial skin condition of subjects was assessed quantitatively using a standardized facial imaging system and subsequent computer image analysis. Lifestyle information was collected using a structured questionnaire. The association between skin condition and lifestyle factors was examined using multivariable regression analysis.

Results

Among women, the mean values for facial texture, hyperpigmentation, and pores were generally lower than those among age-matched men. There was no significant difference between sexes in the severity of facial wrinkling. Older age was associated with worse skin condition among women only. After adjusting for age, smoking status and topical sun protection were significantly associated with skin condition among both men and women.

Conclusions

Our study revealed significant differences between sexes in the severity of hyperpigmentation, texture, and pores, but not wrinkling. Smoking status and topical sun protection were significantly associated with signs of visible skin aging in this study population.

Survey on skin aging status and related influential factors in Southeast China

OBJECTIVE

To investigate cutaneous aging patterns of residents in Hangzhou, Zhejiang, China, and their contributing factors.

METHODS

Eight hundred and forty-eight Hangzhou residents received the survey between March 2004 and September 2004.

RESULTS

Facial wrinkling first occurred at 21 years of age and skin elasticity began to lose at 22 years of age. In middle-aged and old people, facial wrinkling and looseness escalated with the increase of ultraviolet (UV)-exposure time, indicating the accelerating effect of a higher accumulative dose of UV radiation on skin aging. Only Fitzpatrick types II, III and IV were found in the skin phototypes of residents in Hangzhou area, and Fitzpatrick type II seemed to be much more subject to severe wrinkling, elasticity destruction and skin tumors than types III and IV. The oily skin was more protected against wrinkling and facial looseness than dry skin. However, as to concomitant cutaneous diseases, no difference was found among different skin types.

CONCLUSION

Age, solar-exposure time, Fitzpatrick type and skin type are the associated forces in promoting skin aging, and emotional factor seems to be another independent risk factor. The age of 49 years and 2 h/d of solar-exposure time seem to be the turning points responsible for dramatic changes of cutaneous appearance in the process of skin aging in Southeast China.

Age-related maculopathy and sunlight exposure evaluated by objective measurement

Aim:

To study the relationship between age-related maculopathy (ARM) and exposure to sunlight using an objective method.

Methods:

In a case–control study of Japanese men aged ⩾50 years (67 controls without ophthalmic disease and 148 with ARM), those with ARM were separated into groups of early (n = 75) and late (n = 73) ARM. Facial wrinkle length and area of hyperpigmentation, which are considered to be associated with exposure to sun, were measured using imaging with computer-based image analysis. Skin tone was also measured on the upper inner arm, which is not exposed to sun. Early and late ARM association with skin measurements was then evaluated.

Results:

Significantly more facial wrinkling (p = 0.047, odds ratio 3.8; 95% CI 1.01 to 13.97) and less facial hyperpigmentation (p = 0.035, odds ratio 0.3; 95% CI 0.08 to 0.92) was present in late ARM cases. The relationship between skin tone and ARM risk was not statistically significant.

Conclusions:

This objective method showed that lifetime exposure to sunlight is an important factor in the progression of late ARM. An individual’s reaction to sunlight exposure may have a role in ARM progression in addition to total lifetime exposure to sunlight.

Protection effect of cosmetics on human skin under simulated rigorous environment

BACKGROUND/PURPOSE

The efficacy of cosmetics on human skin measured under normal mild laboratory environment might be discounted by exterior environment factors such as wind, UV exposure, etc. Few studies have focused on the 'genuine' efficacy of cosmetics on human skin during exposure to external rigorous environment. The aim of this study was to develop a model for the evaluation of the efficacy of cosmetics on human skin under simulated rigorous environment.

METHODS

We measured skin water content and transepidermal water loss (TEWL) before and after products application under simulated windy and sub-erythema UV exposure treatment in a constant temperature and humidity laboratory.

RESULTS

The results showed that the products had higher water content and lower TEWL at 2, 4 and 8 h of products application, and ameliorated the skin moisturization situation after a 3-week continuous use of the products. In addition, the products might protect the skin to maintain the normal water content and TEWL under the simulated windy or sub-erythema UV exposure treatment in our laboratory when compared with untreated area.

CONCLUSION

Our data indicate that this model may provide a more accurate evaluation for the genuine moisturizing effect of cosmetics under external natural climate.

Skin ageing: A comparison between Chinese and European populations

BACKGROUND

Although limited data are available, it is commonly considered that Europeans and Asians have different skin ageing features.

OBJECTIVES

The present studies have been carried out to evaluate the influence of age and sun-exposure on the main clinical signs of Asian skin ageing.

METHODS

One hundred and sixty Chinese and 160 French age-matched women (age range: 20-60 years old) were clinically examined and scored by the same dermatologist. Facial wrinkles (crow's-feet, glabella and perioral wrinkles) and pigmented spots (on face and hands) were assessed in situ and standardized photographs of the face were taken. Lifelong sun-exposure was estimated from answers to a questionnaire. Comparisons were made between 10-year age groups.

RESULTS

Results show that, for each facial skin area, wrinkle onset is delayed by about 10 years in Chinese women as compared to French women. Facial wrinkling rate over the years is linear in French women and not linear in Chinese women who appear to experience a fast ageing process between age 40 and 50. Pigmented spot intensity is a much more important ageing sign in Chinese women (severe for 30% of women over 40) than in French women (severe for less than 8% of women, irrespective of age).

CONCLUSION

These first results underline that main skin ageing features (wrinkles, spots) progress differently in the Chinese and French women we have studied. They require to be confirmed on broad multicentre studies involving larger cohorts.

Multiple senile lentigos of the face, a skin ageing pattern resulting from a life excess of intermittent sun exposure in dark-skinned caucasians: a case-control study

BACKGROUND

Different patterns of skin ageing can be described depending on the predominant lesions, i.e. wrinkles, laxity, atrophy, senile lentigos (SLs), etc. They may correspond to different epidemiological contexts.

OBJECTIVES

To identify and assess the epidemiological factors for a skin ageing pattern characterized by a high density of SLs on the face, or 'lentigo ageing pattern' (LAP).

METHODS

An age- and sex-matched case-control study was conducted in individuals aged between 60 and 80 years, comparing cases (n = 118) with a very high number of SLs on the face for their age, and controls (n = 118) with no or very few SLs for their age. The cases and controls were recruited in two hospitals.

RESULTS

In univariate and multivariate analysis, LAP was associated with skin types III and IV, with frequent sunburns, and with the part of the lifetime cumulative sun exposure which was received during vacations. Conversely, there was no link with the occupational and everyday exposures and the total cumulative exposure. LAP was associated with multiple solar lentigos of the upper back. No relationship was found with postmenopausal hormonal therapy, number of naevi, or freckles.

CONCLUSIONS

Different epidemiological factors may account for the different skin ageing patterns. LAP seems to develop preferentially in dark-skinned caucasians who have repeatedly received intermittent and intense sun irradiations throughout their life, and have often developed solar lentigos on the upper back earlier in life, whereas the 'prominent wrinkling' pattern is known to affect light-skinned people and smokers with a life excess of continuous exposure.

Skin biophysical properties of a population living in Valais, Switzerland

BACKGROUND/PURPOSE

Switzerland has one of the highest rates of skin diseases and particularly skin cancer, in Europe. Skin elastosis, roughness and atopy are also frequent. High UV exposure and prevalence of light skin individuals could be the cause. Valais, in Southern Switzerland, is a mountain region with elevated sun irradiation and low air humidity, an ideal location to study the effect of the environment and life style on skin biophysical characteristics. The purpose of the study was to measure skin biophysical parameters non-invasively on healthy subjects living in Valais, and to correlate the measures with their life style.

METHODS

One hundred and ten women were examined between October 2001 and February 2002. Measures of skin hydration, sebum content, pH and visco-elasticity were taken in a closed environment with constant temperature and controlled air humidity, utilizing commercially available non-invasive devices. Subjects were interviewed using a questionnaire and data on personal traits and life style were collected. Correlations between subject's skin parameters and life style were statistically examined.

RESULTS

On average we observed low values of skin capacitance that identify subjects with dry skin. Measures of skin visco-elasticity ratios were also particularly low, while skin pH and sebum content were in the normal range. Age was correlated with a decrease of skin elasticity and sebum content, but there was no correlation with hydration or pH.

CONCLUSIONS

We confirm, as reported in other studies, the effect of age on skin elasticity and sebum content and we identify, for the first time, a region with a population characterized by particularly low levels of skin hydration and skin visco-elasticity. Although people examined were free of skin diseases, we believe that protection from the sun and treatment of skin with hydrating products need to be emphasized as a prevention strategy, in regions such as Valais, with high sun irradiation and low humidity.