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

Clinical efficacy of intradermal type I collagen injections in treating skin photoaging in patients from high-altitude areas

BACKGROUND

Photoaging, a result of chronic sun exposure, leads to skin damage and pigmentation changes. Traditional treatments may have limitations in high-altitude areas like Yunnan Province. Intradermal Col Ι injections stimulate collagen production, potentially improving skin quality. This study aims to assess the efficacy and safety of this treatment for photoaging.

AIM

To evaluate the efficacy and safety of intradermal type Ι collagen (Col Ι) injection for treating photoaging.

METHODS

This prospective, self-controlled study investigated the impact of intradermal injections of Col Ι on skin photodamage in 20 patients from the Yunnan Province. Total six treatment sessions were conducted every 4 wk ± 3 d. Before and after each treatment, facial skin characteristics were quantified using a VISIA skin detector. Skin thickness data were assessed using the ultrasound probes of the Dermalab skin detector. The Face-Q scale was used for subjective evaluation of the treatment effect by the patients.

RESULTS

The skin thickness of the right cheek consistently increased after each treatment session compared with baseline. The skin thickness of the left cheek significantly increased after the third through sixth treatment sessions compared with baseline. The skin thickness of the right zygomatic region increased after the second to sixth treatment sessions, whereas that of the left zygomatic region showed a significant increase after the fourth through sixth treatment sessions. The skin thickness of both temporal regions significantly increased after the fifth and sixth treatment sessions compared with baseline (P < 0.05). These findings were also supported by skin ultrasound images. The feature count for the red areas and wrinkle feature count decreased following the treatment (P < 0.05). VISIA assessments also revealed a decrease in the red areas after treatment. The Face-Q-Satisfaction with Facial Appearance Overall and Face-Q-Satisfaction with Skin scores significantly increased after each treatment session. The overall appearance of the patients improved after treatment.

CONCLUSION

Intradermal Col Ι injection improves photoaging, with higher patient satisfaction and fewer adverse reactions, and could be an effective treatment method for populations residing in high-altitude areas.

Facial Skin Aging Characteristics of the Old-Perceived Age in a 20-40 Years Old Chinese Female Population

Purpose

In the quest for a youthful appearance, women use a variety of anti- aging cosmetics. Defining skin problems is especially important for the selection of anti-aging solutions. However, the skin problems faced by Chinese women at different ages are different. This study aimed at Chinese women aged 20-40 years old and analyzed facial skin aging characteristics of those with old-perceived age.

Patients and Methods

The total of 400 standard facial photographs from Chinese female volunteers aged 20-40 was assessed by another 126 Chinese women. The facial areas and skin aging characteristics that influenced age estimation were collected at the same time. Skin aging characteristics, including wrinkles, skin tone, pigmentation and pores, were analyzed based on facial photographs. Groupings were made based on deviation of perceived age from chronological age, and skin aging characteristics among groups were compared.

Results

The perceived age of Chinese women aged 20-40 has a moderate correlation with chronological age. Women aged 20-30 generally had an old-perceived age. Deep skin tone was a prominent problem in this age group, with those who had the older-perceived age observed the darker and redder skin tone. Women aged 31-40 were perceived partly old but appeared with wrinkle aggravation, as well as deepening of redness, enlarged pores, and increased pigmentation at the mid-face. The perceived older women also had more visible frown lines and darker skin tone at the upper face.

Conclusion

The perceived age of Chinese women aged 20-40 tends to deviate from their chronological age. Women aged 20-30 with old-perceived age are associated with deep skin tone, even found darker and redder in older-perceived women group, while women aged 31-40 are associated with wrinkles and deterioration at mid-face area and upper-face problems drive more attention in older-perceived women group.

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.

9-Hydroxyoctadecadienoic acid plays a crucial role in human skin photoaging

Human skin is regularly exposed to ultraviolet (UV) rays from sunlight, leading to photoaging, which differs from intrinsic aging. Although the acute effects of UV exposure have been extensively studied, limited research has addressed the long-term consequences of chronic UV exposure. This study aimed to investigate the underlying causes of chronic photoaging. A questionnaire-based assessment of sunlight exposure was conducted among volunteers in their 20s and 50s, and the stratum corneum of their skin was analyzed for bioactive lipid content. Volunteers were categorized into low and high UV exposure groups based on the questionnaire scores. The analysis results revealed a significant increase in 9-hydroxyoctadecadienoic acid (9-HODE) levels in the skin of individuals in their 50s with high UV exposure. However, UV exposure did not affect 9-HODE levels in the skin of individuals in their 20s. In vitro experiments further indicated that 9-HODE contributes to chronic inflammation, pigmentary changes, and extracellular matrix alterations during photoaging. Specifically, 9-HODE stimulated cytokine production [interleukin-6 (IL6), IL8, and granulocyte-macrophage colony-stimulating factor (GM-CSF)] and reduced dickkopf-1 (DKK1) production in keratinocytes. In fibroblasts, 9-HODE stimulated matrix metalloproteinase-1 (MMP1) and MMP3 production while reducing collagen I (COL1) production. The expression of G2A, the receptor for 9-HODE, was also confirmed in fibroblasts, suggesting that 9-HODE exerts its effects via G2A, as observed in keratinocytes. Overall, these findings indicate that 9-HODE is a mediator of chronic photoaging and highlight its potential significance in photoaging prevention.

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.

Antioxidant and phytometabolite profiles of ethanolic extract from the cascara pulp of Coffea arabica collected from Gayo Highland: A study for potential anti-photoaging agent

Background: As the most abundant coffee by-product, cascara pulp has been considered a good source of antioxidants which could be used to prevent photoaging. The aim of this study was to determine the phytometabolite profiles, antioxidant and photoaging properties of the ethanolic extract of Coffea arabica cascara pulp. Methods: Ethanolic maceration was performed on the fine powder of C. arabica cascara pulp collected from Gayo Highland, Aceh Province, Indonesia. The filtrate obtained was evaluated for its 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging activity, total phenolic content (TPC), and total flavonoid content (TFC). The phytometabolite profiling was conducted qualitatively using reagents and quantitatively using gas chromatography-mass spectroscopy (GC-MS). The potential of the cascara pulp phytometabolites in inhibiting activator protein-1 (AP-1) was evaluated through molecular docking. Results: The extract had TPC and TFC of 2.04 mg gallic acid equivalent/g extract and 91.81 mg quercetin equivalent/g extract, respectively. The half-maximal inhibitory concentration (IC 50) for the DPPH inhibition reached as low as 9.59 mg/L. Qualitative phytocompound screening revealed the presence of alkaloids, saponins, tannins, flavonoids, steroids, quinones, polyphenols, and triterpenoids. GC-MS revealed the extract containing 5-hydroxy-methylfurfural (22.31%); 2,5-dimethyl-4-hydroxy-3(2H)-furanone (0.74%); and caffeine (21.07%), which could form interaction with AP-1 with binding energies of -172.8, -150.8, and -63.188 kJ/mol, respectively. Conclusion: Ethanolic extract from C. arabica cascara pulp potentially have anti-photoaging properties which is worthy for further investigations in the future.

Cosmetic Formulations with Melaleuca alternifolia Essential Oil for the Improvement of Photoaged Skin: A Double-Blind, Randomized, Placebo-Controlled Clinical Study

This aim of this study was to evaluate the penetration depth, antioxidant capacity and the clinical efficacy of Melaleuca alternifolia pure essential oil and in a nanoemulsion to prevent skin photoaging. For this, 2% of pure essential oil or 2% of this essential oil in a nanoemulsion were vehiculated in a formulation. The skin penetration was evaluated using confocal Raman microspectroscopy. The radical protection factor was evaluated using electron paramagnetic resonance spectroscopy. For a clinical study, 40 male participants, aged 18-28 years, were enrolled, being divided into three groups: vehicle formulation, M. alternifolia pure essential oil and M. alternifolia Nanoemulsion. All the participants also received a sunscreen SPF 50 to use during the day. Before and after 90 days of study, skin hydrolipidics and morphological characteristics were performed by skin imaging and biophysical techniques. The nanoemulsion presented a lower antioxidant capacity and a higher penetration through the stratum corneum, reaching the viable epidermis, improving the stratum granulosum morphology. The groups presented an increase in the papillary depth, improving in the dermis echogenicity and the collagen fibers. Melaleuca alternifolia essential provides the potential to improve photoaged skin, being the application of nanoemulsion able to reach deeper skin layers.

Structural and Functional age-related changes in some facial signs of Chinese men. A Pilot study

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.

Defining skin aging and its risk factors: a systematic review and meta-analysis

Skin aging has been defined to encompass both intrinsic and extrinsic aging, with extrinsic aging effected by environmental influences and overlaying the effects of chronological aging. The risk factors of skin aging have been studied previously, using methods of quantifying skin aging. However, these studies have yet to be reviewed. To better understand skin aging risk factors and collate the available data, we aimed to conduct a systematic review and meta-analysis. We conducted our systematic review in compliance with Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guidelines. Embase, PubMed and Web of Science databases were searched in October 2020 using specific search strategies. Where odds ratios were reported, meta-analyses were conducted using the random effects model. Otherwise, significant factors were reported in this review. We identified seven notable risk factors for various skin aging phenotypes: age, gender, ethnicity, air pollution, nutrition, smoking, sun exposure. This review's results will guide future works, such as those aiming to examine the interaction between genetic and environmental influences.

Daily photoprotection to prevent photoaging

BACKGROUND

Extrinsic skin aging or photoaging was previously thought to be almost exclusively due to solar ultraviolet (UV) radiation. However, recent literature has described other contributing factors and clarification is thus required as to what extent and what type of daily photoprotection is needed to mitigate extrinsic skin aging.

METHODS

We reviewed the existing scientific evidence on daily photoprotection, and specific requirements at the product level, to prevent extrinsic skin aging. We critically reviewed the existing evidence on potential ecological and toxicological risks which might be associated with daily photoprotection.

RESULTS

Evidence shows that broad protection against the entire solar range of UVB, UVA, UVA1, visible light, and short infrared (IRA) is required to prevent extrinsic aging. Other exposome factors, such as air pollution and smoking, also contribute to skin aging. Daily broad-spectrum sunscreen photoprotection should thus contain antioxidant ingredients for additional benefits against UV, IRA, and pollution-induced oxidative stress as well as anti-aging active ingredients to provide clinical benefits against skin aging signs, such as wrinkles and dark spots. Broad-spectrum sunscreen containing pigments, such as iron oxide, may be required for melasma prevention. There is no conclusive clinical evidence that daily sunscreen use is unsafe or that it compromises vitamin D synthesis.

CONCLUSION

Daily use of broad-spectrum sunscreen containing antioxidant and anti-aging active ingredients can effectively reduce extrinsic aging.

Changes in facial signs due to age and their respective weights on the perception of age, on a tired-look or a healthy glow among differently aged Chinese men

OBJECTIVE

To determine the respective weights of certain facial signs on the assessment of perceived age, tired-look and healthy glow on Chinese men of different ages.

MATERIAL AND METHODS

Photographs were taken of the faces of 420 Chinese men of different ages, under standardized conditions. These photographs allowed to focus and define 15 facial signs, which were then graded by 15 experts and dermatologists, using standardized scales provided by a reference Skin Aging Atlas. The facial signs were dispatched into 5 clusters, namely wrinkles/texture, ptosis/sagging, pigmentation disorders, vascular disorders and cheek skin pores. A naïve panel, composed of 80 Chinese women, of similar age range were asked, when viewing full-face photographs, to: (i) attribute on a 0-10 scale their perception of both the tired-look and healthy glow aspects and (ii) estimate the age of the subject.

RESULTS

With the exception of vascular disorders, the severity of all 4 clusters increased with age, although at different rates. The ptosis/sagging or pigmentation disorders showed a rather regular progression. Although perceived ages and real ages were found to be closely correlated, the vast majority of subjects were judged older by 2-10 years. The changes in facial signs (and their related clusters) were significantly correlated with perceived age, with the exceptions of skin spot density and cheek skin pores. Although the aspects of tired-look and healthy glow were logically found to be anti-correlated, tired-look was more statistically associated with perceived age for the five clusters. Signs of eye contour appear to be closely correlated with the perception of a tired-look.

CONCLUSION

Within facial clinical clusters, wrinkles/texture and ptosis/sagging are major factors in the assessment of perceived age in Chinese men. Tired-look appears to be strongly associated with perceived age.