Repetitive Daylight Photodynamic Therapy versus Cryosurgery for Prevention of Actinic Keratoses in Photodamaged Facial Skin: A Prospective, Randomized Controlled Multicentre Two-armed Study

Actinic keratoses are a chronic condition in ultraviolet-damaged skin, with a risk of progressing to invasive skin cancer. The aim of this study was to investigate the preventive potential of field-directed repetitive daylight photodynamic therapy for actinic keratoses. A randomized trial was performed, including 58 patients with ≥5 actinic keratoses on photodamaged facial skin, who received either 5 full-face sessions of day-light photodynamic therapy within a period of 2 years or lesion-directed cryosurgery. Primary outcome was the mean cumulative number of new actinic keratoses developed between visits 2 and 6 (visit 6 being a follow-up). This outcome was lower after daylight photodynamic therapy (7.7) compared with cryosurgery (10.2), but the difference did not reach significance (–2.5, 95% confidence interval –6.2 to 1.2; p=0.18). Several signs of photoageing (fine lines, pigmentation, roughness, erythema, sebaceous gland hyperplasia) were significantly reduced after daylight photodynamic therapy, but not after cryosurgery. Significantly less pain and fewer side-effects were reported during day-light photodynamic therapy than during cryosurgery. This study found that repetitive daylight photodynamic therapy had photo-rejuvenating effects. However, the prevention of actinic keratoses by this therapy could not be proven in a statistically reliable manner.

Study of the Exposome Ageing-related Factors in the Spanish Population

To characterize the exposome of the Spanish population and its association with skin ageing a cross-sectional epidemiological study was conducted in men and women (18–60 years old). A total of 1,474 participants were included. Mean age (± standard deviation) was 40.84± 10.26 years. Most participants had Fitzpatrick skin phototype II (44.1%) and skin ageing in accordance with their current age (69.0%). In the logistic model, age, smoking habit, use of sunscreen and use of cosmetics were all significant independent predictors of skin ageing. Thus, tobacco consumption increased the score of the model towards presenting skin ageing above that expected for age, while the opposite occurred with the use of sunscreen and a complete skin care routine. The exposome therefore has an impact on skin ageing, with age, smoking habit, use of sunscreen and the use of cosmetics identified as predictors of skin ageing. Skin care routines and sunscreen use may help to prevent this process.