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EEMCO Guidance for the assessment of skin topography
Abstract
Numerous factors can modify the visibility or the actual dimensions of the skin microrelief and wrinkles. To quantify these changes, several methods, including clinical and non-invasive ones, have been proposed. This article reviews the advantages et drawbacks of all of them and lists some experimental recommendations to make the results of studies using these methods, more reliable.
... (2) main lines, crossing the skin to form a parallelogram, rectangle, or square, depth of 20~100 µm; (3) secondary lines, side lines branching out from the main lines, a depth of about 5~40 µm; (4) tertiary lines, that is, small lines forming keratinocyte boundaries, with a depth of about 0.5 µm; and (5) fourth-grade lines, corresponding to the small uneven lines of keratinocytes, with a depth of about 0.05 µm [21]. In this paper, the main lines and secondary lines were constructed, and a brush with an average value of 50 µm was selected, and the brush provided depth information so that the depth of each point was different. ...
... The thickness of the printed section was selected to be 25 microns. The EEMCO standard classifies skin texture according to depth and shape as follo (1) visible wrinkles, grooves, folds, or furrows, with a depth of 100 µm to a few millim ters; (2) main lines, crossing the skin to form a parallelogram, rectangle, or square, de of 20~100 µm; (3) secondary lines, side lines branching out from the main lines, a depth about 5~40 µm; (4) tertiary lines, that is, small lines forming keratinocyte boundaries, w a depth of about 0.5 µm; and (5) fourth-grade lines, corresponding to the small une lines of keratinocytes, with a depth of about 0.05 µm [21]. In this paper, the main lines a secondary lines were constructed, and a brush with an average value of 50 µm was lected, and the brush provided depth information so that the depth of each point w different. ...
Skin aging is a complex physiological process, in which cells and the extracellular matrix (ECM) interreact, which leads to a change in the mechanical properties of skin, which in turn affects the cell secretion and ECM deposition. The natural skin microrelief that exists from birth has rarely been taken into account when evaluating skin aging, apart from the common knowledge that microreliefs might serve as the starting point or initialize micro-wrinkles. In fact, microrelief itself also changes with aging. Does the microrelief have other, better uses? In this paper, owing to the fast-developing 3D printing technology, skin wrinkles with microrelief of different age groups were successfully manufactured using the Digital light processing (DLP) technology. The mechanical properties of skin samples with and without microrelief were tested. It was found that microrelief has a big impact on the elastic modulus of skin samples. In order to explore the role of microrelief in skin aging, the wrinkle formation was numerically analyzed. The microrelief models of different age groups were created using the modified Voronoi algorithm for the first time, which offers fast and flexible mesh formation. We found that skin microrelief plays an important role in regulating the modulus of the epidermis, which is the dominant factor in wrinkle formation. The wrinkle length and depth were also analyzed numerically for the first time, owing to the additional dimension offered by microrelief. The results showed that wrinkles are mainly caused by the modulus change of the epidermis in the aging process, and compared with the dermis, the hypodermis is irrelevant to wrinkling. Hereby, we developed a hypothesis that microrelief makes the skin adaptive to the mechanical property changes from aging by adjusting its shape and size. The native-like skin samples with microrelief might shed a light on the mechanism of wrinkling and also help with understanding the complex physiological processes associated with human skin.
... The skin is the outer covering of our body and is the largest organ of the integumentary system. Skin characteristics can vary due to numerous factors [1,2] such as malignancy, aging, cosmetics and personal care products. Hence, the evaluation of the human skin surface topography is of particular importance to both dermatological and cosmeceutical practice and research. ...
... Roughness measurement is then performed on the skin replicas using mechanical profilometry approach or optical techniques such as microphotography. However, replica-based methods are inconvenient in clinical settings and susceptible to distortions (including the presence of air bubbles) during skin relief reproduction, and require long scanning times [1]. Hence, direct in vivo methods are preferable. ...
... Besides, skin is the outermost tissue of the human body whose surface is characterised by polyhydric mesh structures representing the three dimensional organization of the dermis and the subcutaneous tissue [13,14]. The topography of the skin is directly related to the cell growth patterns under the skin surface [11]. ...
... As discussed previously (in Section 1.1), skin is the outermost tissue of the human body whose surface is characterised by polyhydric mesh structures representing the three dimensional organisation of the dermis and the subcutaneous tissue [13,14]. ...
Examining surface shape appearance by touching and observing a lesion from different
points of view is a part of the clinical process for skin lesion diagnosis. Motivated
by this, we hypothesise that surface shape embodies important information that serves
to represent lesion identity and status. A new sensor, Dense Stereo Imaging System
(DSIS) allows us to capture 1:1 aligned 3D surface data and 2D colour images simultaneously.
This thesis investigates whether the extra surface shape appearance information,
represented by features derived from the captured 3D data benefits skin lesion
analysis, particularly on the tasks of segmentation and classification. In order to validate
the contribution of 3D data to lesion identification, we compare the segmentations
resulting from various combinations of images cues (e.g., colour, depth and texture)
embedded in a region-based level set segmentation method. The experiments indicate
that depth is complementary to colour. Adding the 3D information reduces the error
rate from 7:8% to 6:6%. For the purpose of evaluating the segmentation results, we
propose a novel ground truth estimation approach that incorporates a prior pattern analysis
of a set of manual segmentations. The experiments on both synthetic and real data
show that this method performs favourably compared to the state of the art approach
STAPLE [1] on ground truth estimation. Finally, we explore the usefulness of 3D information
to non-melanoma lesion diagnosis by tests on both human and computer
based classifications of five lesion types. The results provide evidence for the benefit
of the additional 3D information, i.e., adding the 3D-based features gives a significantly
improved classification rate of 80:7% compared to only using colour features
(75:3%). The three main contributions of the thesis are improved methods for lesion
segmentation, non-melanoma lesion classification and lesion boundary ground-truth
estimation.
... C HARACTERISTICS OF the skin surface topography are widely applied parameters in dermatological practice and research. For instance, roughness parameters are used as endpoints in clinical studies to characterize xerotic skin (1) and skin irritation (2), to investigate intrinsic and extrinsic skin aging (3- 6) or to evaluate the efficacy of preventive (or anti-aging) treatments (7,8). The skin relief consists primarily of furrows, wrinkles, and lines. ...
... Besides clinical assessments of skin roughness several instrumental technologies have been developed. First methods were mainly based on analysis of skin replicas, which allowed objective clinical, mechanical (23) or optical investigations (24) as well as quantification of skin micro-topographic characteristics (7,25). Today, these techniques are partly substituted by other direct, non-contact optical methods, using raking light or UV illumination, such as phaseshift rapid in vivo measurement of skin (PRIMOS) (26) or the VisioScan â VC 98 device (8,27). ...
Background
The topography of the skin surface consists of lines, wrinkles, and scales. Primary and secondary lines form a network like structure that may be identified as polygons. Skin surface roughness measurements are widely applied in dermatological research and practice but the relation between roughness parameters and their anatomical equivalents are unclear. This study aimed to investigate whether the number of closed polygons (NCP) per measurement field can be used as a reliable parameter to measure skin surface topography. For this purpose, we analysed the relation between skin surface roughness parameters and NCP in different age groups.Methods
Images of the volar forearm skin of 38 subjects (14 children, 12 younger, and 12 older adults) were obtained with the VisioScan VC98. The NCP was counted by three independent researchers and selected roughness parameters were measured. Interrater reliability of counting the number of closed polygons and correlations between NCP, roughness parameters, and age were calculated.ResultsThe mean NCP/mm² in children was 3.1 (SD 1.1), in younger adults 1.0 (SD 0.7), and in older adults 1.0 (SD 0.9). The interrater reliability was 0.9. A negative correlation of NCP/mm² with age was observed, whereas measured roughness parameters were positively associated with age. NCP/mm² was weakly related to skin roughness.Conclusion
The NCP/mm² is a reproducible parameter for characterizing the skin surface topography. It is proposed as an additional parameter in dermatological research and practice because it represents distinct aspects of the cutaneous profile not covered by established roughness parameters.
... The study included 10 subjects-women, aged 30-70 years, all skin types. The evaluation has been performed at the site of application before (D0) and after 28 days (D28) of regular use of the cosmetic formulation [61][62][63][64][65]. ...
The importance of incorporating hyaluronic acid (HA) as a cosmetic ingredient in skin care formulations emerged lately because the amount of HA naturally found in the epidermis decreases with age, and when applied to the skin through cosmetic products, it confers hydration and reduces the appearance of wrinkles. Currently, the diversity of cosmetic products for mature skin and the use of various and innovative active ingredients supporting their anti-ageing effect represent ample proof that the cosmetic industry is currently relying on these actives. The main objective of this study was the development of an anti-ageing formulation, incorporating HA and different other active ingredients. The developed formulation contains a novel complex of natural waxes, with an essential role in the restoration of the skin’s hydro–lipid barrier, in combination with innovative active ingredients—like low-molecular hyaluronic acid (LMW-HA), sodium hyaluronate (NaHA), ectoin, gold, and an anti-ageing botanical complex—contributing to optimal skin hydration specifically designed to reduce the visible signs of ageing. An important objective was represented by the skin compatibility and topography assessment after 28 days (D28) of regular application of the developed cream. Stability testing, physicochemical characteristics, and microbiological control, including efficacy testing of the used preservative (challenge test) were performed for the cosmetic formulation. In silico approaches were applied to demonstrate the safety of cosmetic-related substances and the risk assessment of the cosmetic formulation. Safety and instrumental evaluation were performed to demonstrate the skin tolerance—the compatibility and the efficacy, respectively—of the developed anti-ageing cream. As result, quality control of the developed cosmetic formulation evidenced an appropriate cosmetic preparation with desirable aspect and adequate physicochemical characteristics. The concentrations of restricted ingredients like preservatives and UV filters were in accordance with those recommended by the Regulation (EC) No. 1223/2009 and so were considered to be safe. Additionally, according to the margin of safety (MoS) calculation, cosmetic ingredients incorporated in the developed formulation could be considered safe. The developed formulation was very well tolerated, and wrinkle depth and length in the periorbital area were significantly reduced after 28-day cosmetic treatment. Subjects’ assessment questionnaires revealed self-perceived benefits referring to the cosmetic qualities and efficacy of the anti-ageing cream. This study confirmed the skin tolerance and efficacy of the new complex anti-ageing cream incorporating HA, microencapsulated sodium hyaluronate, ectoin, and a botanical extract. The formulated cosmetic product could serve as a daily care for mature skin to alleviate the effects of skin ageing.
... 14 Calculations were made by "ImageJ" software. 15,16 This type of calculation needs working on a 32 bit image size and also a pluginstall named "Analyze" is also necessary. Under analyze option, the process named "Surfcharj 1q" should be selected. ...
Objectives
Antioxidant containing cosmeceuticals are commonly prescribed products in treating wrinkles and revitalizing the skin. The aim of this study is the comparative evaluation of physicochemical stability and clinical anti‐wrinkle efficacy of transdermal emulgel preparations of sodium ascorbyl phosphate (SAP) and ascorbic acid (AA) on human volunteers.
Methods
Emulgel preparations containing 5% of (SAP) and or (AA) were prepared. HPLC analysis were performed for stability evaluations. Clinical anti‐wrinkle efficacy of the formulations were examined on human healthy volunteers in crow’s feet area. Elasticity and digital images were recorded before and after treatment.
Results
Formulations with added antioxidants and kept in the refrigerator exhibited better stability characteristics. Two sided blind study and placebo‐controlled study showed that both actives were effective in wrinkles depth reduction and also elasticity enhancement but statistically significant difference in the efficacy of the products was not observed.
Conclusion
Formulations containing (AA) and or (SAP) both improved elasticity and wrinkles of the skin almost by the same extent and it is necessary to add antioxidant stabilizing agents to both preparations to reach a desired stability.
... During ageing, these polygonal patterns lose their isotropic distribution and form preferred structural orientations which gives rise to anisotropic distributions [114][115][116]. The characteristics of skin microrelief can be classified according to the orientation and depth of featured lines into primary, secondary, tertiary and quaternary lines [114,115,[117][118][119][120] (primary and secondary lines are indicated in Fig. 4). These multiple hierarchical levels effectively induce a Fig. 4. Computer-generated image representing the typical microrelief of human skin surface (ridges and furrows), reconstructed from laser scanning profilometry of a silicone replica of a human volar forearm skin patch (from a 40 year-old healthy Caucasian male subject). ...
... properties are direction-dependent) by forming preferred structural orientations (Piérard et al., 1974). The characteristics of skin microrelief can be classified according to the orientation and depth of featured lines into primary, secondary, tertiary and quaternary lines (Hashimoto, 1974;Lévêque, 1999;Piérard-Franchimont and Piérard, 1987;Piérard et al., 1974). ...
The quest for efficient anti-wrinkle treatments has mainly focused on biochemical approaches aiming to mitigate or slow down the effects of both intrinsic and extrinsic ageing. However, the biophysical principles that govern the formation and evolution of wrinkles remain to be elucidated. Georges Limbert shares the findings of a study his computational biophysics group conducted with US researchers.
The prospects and consequences of ageing are of concern to all, especially with regard to wrinkles. Wrinkles are not only a hallmark of ageing, with its various cosmetic and social implications, but also play a fundamental role in how people interact with many products and devices, from moisturisers and make-up, to adhesive plasters, incontinence products, razors and clothing fabrics. Unveiling the underlying biophysical principles that condition the morphologies and patterns of wrinkles are essential in evaluating, and ultimately, predicting, how ageing or aged skin interacts with its environment.
... Human skin is not flat but rather is a microrelief structure, whose grooves have a maximum depth of 100 µm. 7) To physically conform to the skin, materials should be as thin as possible because flexural rigidity is proportional to the cube of thickness. 8) Thus, to precisely detect skin strain at the microscopic (submillimeter to millimeter) scale, an ultrathin sensor should adhere to the skin without using glue, and also conform to the skin while interfering with the natural deformation of the skin as little as possible. ...
To minimize the interference that skin-contact strain sensors cause natural skin deformation, physical conformability to the epidermal structure is critical. Here, we developed an ultrathin strain sensor made from poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS) inkjet-printed on a polystyrene–polybutadiene–polystyrene (SBS) nanosheet. The sensor, whose total thickness and gauge factor were ~1 µm and 0.73 ± 0.10, respectively, deeply conformed to the epidermal structure and successfully detected the small skin strain (~2%) while interfering minimally with the natural deformation of the skin. Such an epidermal strain sensor will open a new avenue for precisely detecting the motion of human skin and artificial soft-robotic skin.
... One might want to distinguish between skin microrelief-characterised by characteristic intersecting lines and regularly splayed follicular and eccrine duct openings-and skin wrinkles (or skin folds) [91] generally associated with ageing and dynamic wrinkles associated with skin movement. The characteristics of skin microrelief can be further classified according to the orientation and depth of featured lines [61,89,90] into primary, secondary, tertiary and quaternary lines. [90]. ...
This chapter provides a review of what are considered state-of-the-art of constitutive models used to describe and predict the biomechanics of skin. The focus is on the mathematical constitutive formulations which, ultimately, have also to be implemented into computational codes so that practical problems featuring complex geometries and boundary conditions can be solved via appropriate numerical techniques (e.g. the Finite Element Method (FEM)). Structurally-and phenomenologically-based constitutive modeling approaches, together with a combination of those two are presented. Models featuring elastic and inelastic responses (e.g. viscoelasticity, viscoplasticity) are reviewed. Mechanobiological models, going beyond the traditional realm of continuum mechanics by incorporating coupling between mechanics and biology are also discussed in the context of growth. For sake of completeness, a brief on non-linear continuum mechanics is also provided in this review. Finally, as an illustration, a practical application of the computational modeling of skin (wrinkles) is presented.
... All measurements were performed on forearms, after subjects were allowed to acclimatize for at least 30 min under standard atmospheric conditions previously reported. Skin hydratation levels were measured using a Corneometer CM 825 (Courage Khazaka, Electronic GmbH, Cologne, Germany) according to European Group for Efficacy Measurements on Cosmetics and Other Topical Products (EEMCO) guidelines 17 . Three measurements at least were taken per area. ...
Context:
Coffee silverskin (CS), a food by-product of the coffee roasting industry, has been studied as an active ingredient for skin care products due to its high potential of antioxidant activity and low cytotoxicity. Another food waste used as ingredient with promising characteristics is obtained from Medicago sativa (MS), which antioxidants and isoflavones content is high.
Objective:
The aim of this study is to evaluate and characterize a new body formulation containing two food by-products extracts.
Materials and methods:
Different parameters (such as pH, rheological behavior, color, antioxidant content and microbiological analysis) of a body cream formulation containing by-products (CSMS) and a formulation without extracts (F) were evaluated under a stability study during 180 days at different temperatures. Moreover, the in vitro cell toxicity and the in vivo skin safety and protective effects were also assessed.
Results:
Formulation showed stable physical properties and antioxidant activity during 180 days of storage. In vitro toxicity was screened in two skin cell lines (fibroblasts and keratinocytes) and any toxicity was reported. The in vivo test carried out showed that, with respect to irritant effects, CSMS formulation can be regarded as safe for topical application and the skin hydratation improved after 30 days of its use. Also, considering the consumer acceptance, more than 90% of volunteers classified it as very pleasant.
Conclusions:
CSMS formulation is stable and safe for topical use as no adverse and/or side effects were observed during the application period of testing, improving skin protective properties.
... The instrumental measurements were carried out in a temperature and humidity-controlled room (24 ± 2 °C; 50% ± 10% relative humidity). Measurements of skin hydration [3] (Corneometer, Courage and Khazaka, Köln, Germany) and of elasticity [4,5] (Cutometer, Courage and Khazaka) were performed on the cheeks while skin roughness measurements [6,7], taken by means of silicone replicas (SILFLO, J&S Davis, Stevenage, UK) and image analysis (Quantilines, Monaderm, Monaco), were instead performed on the crow's feet wrinkles of the eye contour. In the analysis we included the basal data taken before the cosmetic treatment, and the variations (i.e., improvement or worsening in the considered parameters) obtained at the end of the period of application. ...
In this study we investigated the correlation between the basal skin hydration data, elasticity and surface roughness and the age of volunteers. Then, we analyzed the variations obtained at the end of the treatments with anti-age cosmetic products for the face. The aim was to investigate the susceptibility to improvement of volunteers from different age groups. Data were collected in our testing laboratory based in Milan over a 6-year long activity. We only considered measurements performed on the face of a female population aged between 18 and 70 years of age. Values were subdivided in age groups for each considered parameter and were statistically compared. As expected, skin roughness increased and R2 elasticity parameter decreased with ageing, while hydration values resulted to be higher in older women. Apparently, this unaccountable result is probably due to the fact that elderly women living in urban areas tend to take appropriate care of their skin, thus improving skin hydration effectively. Interestingly, as for skin hydration, the analysis showed that women aged 61–70 were the most susceptible to improvement induced by several types of cosmetic treatments. However, when considering the skin roughness values, women over 50 years old seemed to react better to cosmetic treatment. As for skin elasticity, the highest improvement values were found with women between 31 and 50 years of age.
... It has been clarified that wrinkles, a symptom of aging, are formed due to age-related changes in skin elasticity and the degeneration of dermal collagen and elastin, and ultraviolet light and cigarette smoking are involved factors [9] [10]. In photoaging induced by chronic exposure to ultraviolet light, induction of matrix metalloproteinases (MMPs) is enhanced, and accompanying degradation of extracellular matrix, such as collagen Types I and III and elastin, promotes wrinkle formation [11]. ...
... Certain individual facets of this complex can be investigated by non-invasive instrumental techniques, which are objective. The microcirculation can be examined by videocapillaroscopy (2,3) or laser Doppler (4), quantitative assessments of skin color can be made using colorimetry (5) and skin surface texture can be measured by profilometry (6) or fringes projection (7). The brightness level of the skin can be estimated objectively from physical parameters. ...
... Skin microrelief parameters were evaluated using a Visio Scan ® VC98 (Courage and Khazaka), which is a special high resolution UV-A light video camera developed especially to study the skin surface directly, and the Surface Evaluation of the Living Skin (SELS) method. The images show the structure of the skin and the level of dryness and the grey level distribution of the image is used to evaluate the following skin roughness parameters: skin roughness (Rt), skin smoothness (SEsm-proportional to width and form of the wrinkles) and number and width of the wrinkles (SEw) [40]. ...
This study presents the association of active antioxidants substances in a multifunctional cosmetic formulation with established efficacy against signs of aging. A multifunctional cosmetic formulation containing an association of UV filters and antioxidant substances (liposoluble vitamins A, C and E, Ginkgo biloba and Phorphyra umbilicalis extracts) was evaluated. This formulation was submitted to a clinical efficacy study using biophysics techniques and skin images analysis (digital photography imaging systems, 20 MHz ultrasound, and reflectance confocal microscopy). The volunteers applied the formulation containing the UV filters and antioxidant substances during the day and the formulation with antioxidant substances and without the UV filters at night, for 90 days. The formulation increased the hydration and protected the skin barrier function after a single application. At the long term assessment the formulation provided an improvement in skin barrier function and skin hydration to the deeper layers of the epidermis, leading to an improvement in skin appearance by reducing wrinkles and skin roughness. The multifunctional cosmetic formulation studied can be suggested to preventing signs of aging and improving skin conditions. In addition, this study presents the benefits of associating different active antioxidants substances in a single cosmetic formulation to prevent skin aging.
... • Photographic documentation and profilometry [19][20][21][22][23][24][25] of the wrinkles around the eyes ("crow's feet"). The photographic documention was performed with Primos ® compact portable system (GFMesstechnik, Berlin, Germany), a phase-shift rapid in vivo measurement which provides high-resolution profilometry of skin surfaces by using phase-shifted light stripes projected. ...
The aim of this study was to evaluate clinically and by non invasive instrumental evaluations the efficacy and tolerability of a cosmetic treatment containing an innovative active ingredient, ethyl ximenynate, in the prevention of dark circles under the eyes and blemishes of skin aging on the eye profile. Evaluations were performed at baseline and after 2 and 4 weeks of treatment on 22 volunteers; the study was planned as a double blind half-face trial. Data showed a trend towards a lifting of the eyelid skin; all investigator scores (eye puffiness, skin smoothness, roughness and dryness) decreased. In addition, profilometric results confirmed the anti-wrinkles efficacy of the active product and its lifting action, while those related to spectrophotometry underlined the decongestant effect on dark circles that appeared, at the end of the study, to be less marked. The improvement of skin microcirculation and capillary resistance and vascular tone in the eye area underlines a general mitigation of all relevant skin imperfections and blemishes of skin aging on the eye profile. The active ingredient was shown to be effective for the cosmetic treatment of the periocular area.
... The current overwhelming trend steering dermatology aims toward making the descriptions more scientific and clearly identifiable. The skin microrelief and its seasonal withered aspect are conveniently assessed using a series of dedicated noninvasive and scientifically validated methods [4][5][6]. One of these relies on the collection of negative replicas from the skin surface. ...
Laypeople commonly perceive some skin xerosis and withering (roughness) changes during winter on some parts of the body, particularly on the dorsal hands. The aim of the study was to assess the withered skin surface changes occurring during the four seasons. A total of 47 menopausal women completed the study. A group of 31 volunteers were on hormone replacement therapy (HRT) and 16 were out of HRT. Skin xerosis and scaliness were rated clinically. In addition, skin whitening was assessed by computerized shadow casting optical profilometry and by skin capacitance mapping. The volunteers were not using topical creams and over-the-counter products on their hands. Marked changes, recorded over the successive seasons, corresponded to patchy heterogeneous stratum corneum hydration and heterogeneous skin surface roughness changing over seasons; they likely resulted from changes in the environmental temperature and atmosphere moisture. The severity of the changes revealed by clinical inspection was not supported by similar directions of fluctuations in the instrumental assessments. This seemingly contradiction was in fact due to different levels of scale observation. The clinical centimetric scale and the instrumental inframillimetric scale possibly provide distinct aspects of a given biological impact.
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.
Syringe-injectable biomaterials and medical devices are important as minimally invasive implants for diagnosis, therapy and regenerative medicine. Free-standing polymeric nanosheets having a thickness less than 1 μm and a flexural rigidity less than 10-2 nN m are a promising platform of syringe-injectable, implantable devices that provide conformable and long-term stable adhesion to the target biological tissues for in situ delivery of therapeutic materials. Here, we developed free-standing ultrathin films (< 1-μm-thick) based on polyurethane shape memory polymer and magnetic nanoparticles, termed MNP-SMP nanosheets. With the temperature-mediated shape memory effect of SMP, we overcome the limitation in the manipulation of the conventional polymer nanosheets. In particular, we demonstrated the following four capabilities using the 710-nm-thick MNP-SMP nanosheet with the glass transition temperature (Tg) of 25˚C: (1) syringe-injectability through the medical needles, (2) self-expandability after ejection, (3) conformability and removability on the biological surfaces, and (4) guidablity in an external magnetic field. The MNP-SMP nanosheets were readily interfaced with an additional layer of poly-lactic-co-glycolic acid (PLGA) to extend the functionality as a carrier of molecular and cellular drugs. The MNP-SMP nanosheets will contribute to the development of advanced syringe-injectable medical devices as a platform to deliver drugs, sensors, cells and engineered tissues to the specific site or lesion in the body for minimally invasive diagnosis and therapy.
Atrophy and infection of the tongue mucosa contribute to dysgeusia resulting from changes in lingual papillae. However, influences of the changes of lingual papillae on oral mechanoreceptive sensation is unclear. Previous studies have suggested that filiform papillae function as a unit of the mechanoreceptive system and play an important role in somatosensation. We hypothesized that lingual papillae including filiform papillae participate in intraoral texture sensation. The aim of present study was to investigate the relationship between morphometric characteristics of lingual papillae and the texture sensation in tongue-hard palate. Sensory evaluation was performed in 10 healthy participants to evaluate the sensitivity of the tongue-hard palate to granularity. The sample food was an aqueous suspension containing crystalline cellulose, with an average particle diameter of 50 μm, and a concentration of 0 to 6.4 wt%. The participants were divided into high- or low-sensitivity groups (n=6 vs. 4) by evaluating the sensitivity to the granularity of the suspension. To assess the quantitative and morphometric parameters of lingual papillae, the surface roughness defined by JIS was measured by using X-ray micro-CT for image analysis of the surface configurations, which were recorded by silicone rubber impressions taken from the anterior region of the tongue. A concentration of the sample for determining the granular sensitivity threshold ranged from 0.4 to 3.2 wt%. Comparison of the high- and low-sensitivity groups revealed that the root mean square deviation (Rq) and arithmetical mean deviation (Ra) were significantly larger in the high-sensitivity group. In contrast, the lowest valley (Rv) was significantly larger in the low-sensitivity group. These results suggest that the morphometric characteristics of lingual papillae, evaluated in terms of surface roughness, may play a role in intraoral texture sensation.
Background: Skin topographic measurements are of paramount importance in the
field of dermo-cosmetic
evaluation. The aim of this study was to investigate how the
Antera 3D, a multi-purpose
handheld camera, correlates with other topographic techniques
and changes in skin topography following the use of a cosmetic product.
Methods: Skin topographic measurements were collected on 26 female volunteers
aged 45-70
years with the Antera 3D, the DermaTOP and image analysis on parallel-polarized
pictures. Different filters for analysis from the Antera 3D were investigated
for repeatability, correlations with other imaging techniques and ability to detect improvements
of skin topography following application of a serum.
Results: Most of Antera 3D parameters were found to be strongly correlated with the
DermaTOP parameters. No association was found between the Antera 3D parameters
and measurements on parallel-polarized
photographs. The measurements repeatability
was comparable among the different filters for analysis, with the exception of wrinkle
max depth and roughness Rt. Following a single application of a tightening serum,
both Antera 3D wrinkles and texture parameters were able to record significant improvements,
with the best improvements observed with the large filter.
Conclusion: The Antera 3D demonstrated its relevance for cosmetic product evaluation.
We also provide recommendations for the analysis based on our findings.
The objective of this paper is to provide a review on some aspects of the mathematical and computational modelling of skin biophysics, with special focus on constitutive theories based on nonlinear continuum mechanics from elasticity, through anelasticity, including growth, to thermoelasticity. Microstructural and phenomenological approaches combining imaging techniques are also discussed. Finally, recent research applications on skin wrinkles will be presented to highlight the potential of physics-based modelling of skin in tackling global challenges such as ageing of the population and the associated skin degradation, diseases and traumas.
Background:
The skin imaging analysis instruments are widely used to record and measure the surface and subsurface skin conditions. The main aim of this study is to reveal the differences and correlations in measuring wrinkle, skin texture, coloration/evenness, vascular features, and pore between two commercially available instruments.
Methods:
Twenty-eight subjects were enrolled in the study. A 2*2 cm cardboard was used to make sure the two instruments analyze the same area. Pictures were taken and analyzed by the VISIA(®) from Canfield and the ANTERA 3D(®) CS from Miravex, in sequence.
Results:
The spot, ultraviolet spot, brown spot, red area, texture values measured with VISIA(®) were positively correlated with age, while the pore and wrinkle values showed no significance. The wrinkle, texture, melanin, hemoglobin, pore index, pore volume values measured with ANTERA 3D(®) had a significantly positive correlation with age. The spot, brown spot values from VISIA(®) were positively correlated with the melanin value from ANTERA 3D(®) . Texture value measured with the two instruments revealed positive linear correlation. Strong correlation was found between the red area value from VISIA(®) and the hemoglobin value from ANTERA 3D(®) . Ultraviolet spot from VISIA(®) showed no linear correlation with the melanin value from ANTERA 3D(®) . Neither of the wrinkle and pore measured with the two instruments showed linear correlation.
Conclusions:
ANTERA 3D(®) relies on multidirectional illumination obtained by LEDs of different wavelengths from different directions which make it advanced at the qualitative evaluation of various dermatologic conditions. Compared with VISIA(®) , ANTERA 3D(®) is more sensitive in the assessment of wrinkle and it may also be available to evaluate the aging-related enlarged pore.
Growth factors play a key role in the regulation of numerous cell processes including wound healing. More recently, they have been recognized also for use in skin rejuvenation. Aged skin reveals a similarly altered growth factor response as a chronic wound. Growth factors may reduce signs of skin aging due to their capacity to promote dermal fibroblast proliferation and to stimulate extracellular matrix formation. Growth factor products for skin rejuvenation can contain either recombinant growth factors, growth factors as part of conditioned cell culture media, or growth factors as part of cell lysates. Numerous randomized controlled clinical trials demonstrated the good tolerability and efficacy of those products. Today, there is evidence that the signs of aging skin may be best improved with a balanced mixture of growth factors.
Background/purpose:
This research investigated the ability of shadow analysis (via the Courage + Khazaka Visioline and Image Pro Premiere 9.0 software) to accurately assess the differences in skin topography associated with photo aging.
Methods:
Analyses were performed on impressions collected from a microfinish comparator scale (GAR Electroforming) as well a series of impressions collected from the crow's feet region of 9 women who represent each point on the Zerweck Crow's Feet classification scale. Analyses were performed using a Courage + Khazaka Visioline VL 650 as well as Image Pro Premiere 9.0 software.
Results:
Shadow analysis showed an ability to accurately measure the groove depth when measuring impressions collected from grooves of known depth. Several shadow analysis parameters showed a correlation with the expert grader ratings of crow's feet when averaging measurements taken from the North and South directions. The Max Depth parameter in particular showed a strong correlation with the expert grader's ratings which improved when a more sophisticated analysis was performed using Image Pro Premiere.
Conclusion:
When used properly, shadow analysis is effective at accurately measuring skin surface impressions for differences in skin topography. Shadow analysis is shown to accurately assess the differences across a range of crow's feet severity correlating to a 0-8 grader scale. The Visioline VL 650 is a good tool for this measurement, with room for improvement in analysis which can be achieved through third party image analysis software.
Clinical assessments of environmental dermatoses may be biased owing to their subjectivity and their wide interobserver variations.
Skin bioinstrumentation aims at bringing accuracy, objectivity, reproducibility, sensitivity, and precision to clinical assessments.
Occupational and environmental threats frequently alter the biological functions of the stratum corneum, and induce inflammation.
Irritant and allergic contact dermatoses are conveniently explored using bioengineering methods.
Transepidermal water loss and skin capacitance imaging represent two major dermometrological methods in occupational dermatology.
Currently there is no bioengineering method elucidating the differential diagnosis between irritant and allergic contact dermatitis because the specificity of each method is limited.
Due to their high sensitivity, the biometrological methods allow the severity rating of environmental dermatoses.
Background/aims:
To determine the roughness of the surface of human skin at highly sun-exposed anatomical sites in a wide age range in order to derive consequences for sunscreen application.
Methods:
The forehead, cheek, nose, shoulder, and dorsal hand of 4 age groups (0-9, 20-39, 40-59, and >60 years) were investigated by replica formation, and areal topography was determined by confocal chromatic imaging. The arithmetic mean height as a roughness parameter and the void volume of the surface profile were calculated.
Results:
Age and site had a significant effect on roughness. Both the dorsal hand and nose exhibited the greatest roughness over the age of 40, and the forehead of the youngest age group exhibited the smallest roughness. Differentiation between sites progressed with age, whereas roughness increased significantly with age for the dorsal hand and nose but not for the other sites. The void volume was smaller than the volume corresponding to the typically recommended amount of sunscreen application except for the cases of largest roughness.
Conclusions:
Different site-age combinations show significant variation of skin surface roughness. The application of sunscreen may in some instances need to be adjusted to take into account the increased roughness of highly sun-exposed anatomical sites.
Growth factors play a key role in the regulation of numerous cell processes including wound healing. More recently, they have been recognized also for use in skin rejuvenation. Aged skin reveals a similarly altered growth factor response as a chronic wound. Growth factors may reduce signs of skin aging due to their capacity to promote dermal fibroblast proliferation and to stimulate extracellular matrix formation. Growth factor products for skin rejuvenation can contain either recombinant growth factors, growth factors as part of conditioned cell culture media, or growth factors as part of cell lysates. Numerous randomized controlled clinical trials demonstrated the good tolerability and efficacy of those products. Today, there is evidence that the signs of aging skin may be best improved with a balanced mixture of growth factors.
Growth factors play a key role in the regulation of numerous cell processes including wound healing. More recently, they have been recognized also for use in skin rejuvenation. Aged skin reveals a similarly altered growth factor response as a chronic wound. Growth factors may reduce signs of skin aging due to their capacity to promote dermal fibroblast proliferation and to stimulate extracellular matrix formation. Growth factor products for skin rejuvenation can contain either recombinant growth factors, growth factors as part of conditioned cell culture media, or growth factors as part of cell lysates. Numerous randomized controlled clinical trials demonstrated the good tolerability and efficacy of those products. Today, there is evidence that the signs of aging skin may be best improved with a balanced mixture of growth factors.
Background Nowadays, good health, beauty and fitness are perceived as qualities that are required for social acceptance and professional success. The cosmetic surgery industry is dynamic and growth levels reach record high. The technological advancements, especially in non-surgical procedures such as anti-aging techniques are developing with an astonishing speed. The demonstration of functionality with scientific measures becomes necessary and it is a right of the buyer as well as of the patient. To maintain high scientific standards in such evaluations, adequate protocols and statistical tests must be applied. In our review we describe some of the targeted skin conditions in anti-aging procedures, namely skin moisturization, elasticity, surface wrinkledness, skin thickness, evaluated with specific instruments. We are also able to follow the treatment of acne phenomenon as well as skin whitening, cellulite, stretch marks and hair loss by using special devices. Digital photography is a well established method for treatment evaluation; however the standardization of digital images is gaining importance. Conclusions Nevertheless, human perceptions enable the analysis of the sensory responses to specific stimulus in qualitative and quantitative ways. Such analysis can be as accurate and statistically significant as the instrumental anlaytical evaluations. We want to stress the increasing popularity of anti-aging techniques and the need for their evaluation. The family practice doctors as well as researchers in the field of anti-aging should benefit from this article.
Nail surface changes are observed during aging and in some chronic inflammatory dermatoses. Descriptive terms are commonly used, but quantitative analytic measurements are welcome to increase sensitivity, precision, and reproducibility of observations. Bioinstrumentation, particularly optical profilometry, allows both static and repetitive assessments in time in order to derive aspects of onychochronobiology.
In many instances, subjective clinical assessments are open to bias and interobserver variation. Thus, objective assessments and measurements in dermatology and cosmetology are continuously in search of improvements and additional breakthroughs. Dermometrology and bioengineering have been and remain closely associated in improving both the descriptive and quantitative noninvasive assessments. A few decades ago, ingenious researchers pioneered methods with continuous improvements; they may now look crude, time-consuming, and sometimes lacking fine-tuned reproducibility. These early bioengineering times and the initial phase of dermometrology are over. With more recent progress, the noninvasive technology has made great advances in the design of measuring devices. Such an evolution was paralleled by a greater knowledge in many aspects of skin biology. The issue is now evident with the development and refinement of meaningful approaches used in cutaneous biology, physiology, and dermocosmetology. Dermometrology has become a full-fledged science rooted in several nonbiological disciplines. In addition, healthy close working relationships were established among a series of professional societies, research institutes, and private commercial companies. A convergence of interest is clearly perceptible among dermatologists, bioengineers, cosmetologists, clinical scientists, physiologists, and biologists.
This study intended to check the skin and eye acceptability and to assess the cosmetic qualities and efficacy of the cosmetic product with Argan oil [8, 9]-ANTI WRINKLE EYE CONTOUR CREAM after repeated applications on face including eye contour under normal conditions of use for 28 consecutive days on a panel of 20 women and to check the skin acceptability and to assess the cosmetic qualities and efficacy of the second cosmetic product with Argan oil-NUTRITIVE AND MOISTENING DAY CREAM, after repeated applications on face, under the normal conditions of use, for 28 consecutive days on a panel of 20 women too. The anti-wrinkle effect was assessed objectively after taking of replicas, before and after 28 consecutive days of treatment and image analysis with computer (VisiolineÒ VL 650 software from Courage Khazaka in colaboration with Monaderm). The product application during 28 consecutive days contributed to the decrease of the wrinkles surface with a mean value of 12.21 mm 2 (23.67%) and to the decrease of the wrinkles number with a mean value of 9.72 (11.02%). The nutritive and moistening effect of the Nutritive and moistening day cream, was assessed objectively after taking of replicas, before and after 28 consecutive days of treatment; trans epidermal water loss was assessed objectively by instrumental measurements of Tewameter TM 300Ò (Courage & Khazaka), on the face, before the first application (D1/T0), at one hour after the first application (D1/T1) and after 28 consecutive days of product use on D29.After 28 consecutive days of use was recorded an decrease of the TEWL values (a mean value of 16.23%) which means that the equilibration of the barrier function at lower flow values is directly correlated with the regeneration of the epidermis obtained by the nutritive contribution of the product[7]. The subjective cosmetic qualities and efficacy were assessed, at the end of the study, using a target questionnaire, for both cosmetic products.
Skin aging is the phenomena finally expressed on the skin surface and related to the changes in the microstructure of the skin texture. Which is resulted in wrinkle formation and uneven tone of skin and so on. In this study, the synergy effect of Cedrol and a collagen-derived peptide in type III collagen synthesis was evaluated by in vitro test. The physiological skin state of 22 female volunteers was measured after using the cosmetics for 4 weeks. Results showed that Cedrol and a collagen-derived peptide had the excellent synergy effect in type III collagen synthesis. The cosmetics improved skin microrelief, star configurations, skin gloss, skin tone, hydration and elasticity except skin lightening. In conclusion, this study proved that Cedrol and collagen-derived peptide had the synergy effect of type III collagen synthesis in the cell level and cosmetics with those was improved skin aging in human volunteer test.
Growth factors are polypeptides or proteins, which play a key role in the regulation of a number of physiological processes operating at extremely low concentrations [1]. Together with cytokines, they are important regulators of cell division, differentiation, chemotaxis and adhesion, cellular trafficking, cell activation, apoptosis, cell survival, and transformation. They typically mediate interactions between cells within a specific tissue microenvironment, thereby, binding its corresponding receptor located on the outer surface of the target cell, which ultimately results in a biological response in a complex cascade of events.
The physiological stratum corneum (SC) pH regulates epidermal permeability
barrier (EPB) function and skin microbiota. While the physiological SC-pH is
just below 5, in aged skin it is elevated up to 6. As a result, EPB integrity and
recovery is significantly reduced. Furthermore, changes in quantity and
quality of the resident microflora occur in aged skin. We addressed the
question whether acidic skin care shows positive clinical, biophysical and
microbiological effects on aged skin.
Single application of an O/W-emulsion (pH 4.0) leads to normalization of the
increased pH on aged skin over 7 hours. To investigate long-term effects of
pH 4.0 skin care products on EPB function and skin microbiota, a
randomized, controlled and double-blind study was performed. Two groups of
elderly (≥ 80 years), residents of a nursing home, used a range of test
products (cream, lotion, syndet) with different pH values (group A: pH 4.0;
group B: pH 6.0). After 7 weeks of application skin dryness was reduced, but
without significant differences between the groups. Compared to baseline
EPB integrity showed a significant improvement in group A (p=0.007), while
there were no changes in group B (p=0.672). A significant decline (p=0.025)
in barrier cohesion was observed in group B, whereas in group A barrier
cohesion remained stable (p=0.814). Barrier recovery 24 hours after
perturbation increased significantly in group A (p=0.004) compared to
baseline. Barrier recovery in group B was not significant, compared to
baseline (p=0.327). Skin flora evaluation revealed a significant increase in
CFU per cm2 skin in group A (p=0.016) and B (p=0.017). Moreover, after
treatment in group A more subjects (100%) with a mixed resident flora were
determined compared to group B (88%).
Se pretende ofrecer un avance del estudio sobre el uso de diferentes técnicas de
tratamiento termal en el seno del Programa de Termalismo Social del IMSERSO,
trabajo que no estará finalizado hasta el mes de junio del año 2011, en que se dispondrá
del 100% de los datos relativos a técnicas aplicadas en la totalidad de los balnearios y
turnos del Programa a lo largo de 2010.
Los datos analizados en este estudio habrán sido recogidos y tratados por la nueva
aplicación informática que el IMSERSO y los balnearios participantes en su Programa
han puesto en marcha durante la presente campaña del IMSERSO.
El presente avance recoge los datos disponibles en el mes de junio de 2010,
relacionados con el uso de peloides naturales y parapeloides en los turnos iniciales de este periodo.
This study was conducted to develop methods for measuring skin fine-structure via optical image and apparatus for photographing to analyze efficacy of anti-aging.
We developed an apparatus named 3D Skin CycloScan(™) to evaluate the efficacy of cosmetics by imagification of skin fine-structure such as wrinkles, pores, and skin texture. The semi-sphere shaped device has 12 different sequential flashing light sources captures optical image simultaneously in one second to exclude the influence of the subject's movement. The normal map that is extracted through shape from shading method is composed of face contour and skin fine-structure parts. When the low-frequency component which is the result of the Gaussian Filter application is eliminated, we can get only skin fine-structure. In this normal map, it is possible to extract two-dimensional vector map called direction map and we can regulate the intensity of the image of wrinkles, pores, and skin texture after filtering the direction map. We performed a clinical study to apply this new apparatus and methods to evaluate an anti-aging efficacy of cosmetics visually and validate with other conventional methods.
After using anti-aging cream including 2% adenosine for 8 weeks, the total amount of fine wrinkle around eye area detected via 3D Skin CycloScan(™) was reduced by 12.1%. Also, wrinkles on crow's feet measured by PRIMOS COMPACT(®) (GFMesstechnik GmbH, Germany) reduced 11.7%.
According to an aspect of the present study, by changing the direction of the lights toward to subject's skin, we can obtain the information about the fine structures present on the skin such as wrinkles, pores, or skin texture and represent it as an image.
© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
This study intended to check the skin and eye acceptability and to assess the cosmetic qualities and efficacy of the cosmetic product with Argan oil [8, 9]-ANTI WRINKLE EYE CONTOUR CREAM after repeated applications on face including eye contour under normal conditions of use for 28 consecutive days on a panel of 20 women and to check the skin acceptability and to assess the cosmetic qualities and efficacy of the second cosmetic product with Argan oil-NUTRITIVE AND MOISTENING DAY CREAM, after repeated applications on face, under the normal conditions of use, for 28 consecutive days on a panel of 20 women too. The anti-wrinkle effect was assessed objectively after taking of replicas, before and after 28 consecutive days of treatment and image analysis with computer (VisiolineÒ VL 650 software from Courage Khazaka in colaboration with Monaderm). The product application during 28 consecutive days contributed to the decrease of the wrinkles surface with a mean value of 12.21 mm 2 (23.67%) and to the decrease of the wrinkles number with a mean value of 9.72 (11.02%). The nutritive and moistening effect of the Nutritive and moistening day cream, was assessed objectively after taking of replicas, before and after 28 consecutive days of treatment; trans epidermal water loss was assessed objectively by instrumental measurements of Tewameter TM 300Ò (Courage & Khazaka), on the face, before the first application (D1/T0), at one hour after the first application (D1/T1) and after 28 consecutive days of product use on D29.After 28 consecutive days of use was recorded an decrease of the TEWL values (a mean value of 16.23%) which means that the equilibration of the barrier function at lower flow values is directly correlated with the regeneration of the epidermis obtained by the nutritive contribution of the product[7]. The subjective cosmetic qualities and efficacy were assessed, at the end of the study, using a target questionnaire, for both cosmetic products.
The immediate lifting effect of a new anti-wrinkle cosmetic serum (Instant Lifting) was eva-luated with the application on the skin of the face (periorbital areas, lip contour) and on the back of the hands in 21 women and 3 men, 50-65 years old (average age: 58,3 years). Before and 5 minutes after product application, cutaneous replicas and digital photos of the treated areas have been ex-ecuted. The instrumental measurements showed that the product application induced after 5 minutes a sig-nificant decrease (p<0.0001) of the cutaneous roughness parameters, either for the Ra (mean roughness value) either for the Rz (maximum roughness value), at level of periorbital, lip con-tour and back of the hands wrinkles. The imme-diate lifting effect is also evidenced by a visible de-crease of cutaneous roughness, clearly visible in the digital images. A pilot test with another cosmetic serum, refer-ence for the category, showed the superiority of the product Instant Lifting ® . The related data are not reported because such comparative tests have been carried out on a limited number of subjects and in-tended as general orientation only. All subjects testing Instant Lifting ® declared a high level of satisfaction for the immediate and vis-ible results. As a matter of compliance, samples of the product for personal use have been asked, after the end of the test, by all volunteers.
Skin aging is associated with a flattening of the dermal-epidermal junction (DEJ) and a less effective anchoring system predisposing to bullae formation, trauma, and shear-type injuries. An artificial and controlled technique for standardized dermal-epidermal separation is the suction blister method, whereby the strength of dermal-epidermal adhesion is characterized by blistering time. The aim of this systematic review was to identify and to quantify influencing factors on blistering time in healthy humans. A search in the databases MEDLINE and Embase (1946 to June 2014) and in reference lists was conducted. In total, results of 147 suction blister experiments in 3427 individuals reported in 60 publications were analysed. The median blister diameter was 6 (IQR 5 to 6) mm and the median suction pressure was -200 (IQR -200 to -300) mmHg resulting in a median blistering time of 75 (IQR 49 to 120) minutes. In the multivariate model skin temperature and age were the strongest predictors for suction blistering time (p < 0.001, R(2) adjusted = 0.707). This strong association between temperature and suction blistering indicates that the DEJ loses its strength with increasing skin temperature. This finding supports the practice of skin and tissue cooling to prevent injuries. The increased vulnerability of the skin seems to exist irrespectively of applied mechanical loads. We conclude that blistering time is an important and clinically relevant (outcome) parameter measuring the structural and mechanical integrity of deeper cutaneous layers. This article is protected by copyright. All rights reserved.
In order to achieve an early detection of skin cancers, various state-of-the-art imaging modalities have been investigated from optical, impedance, biomechanical and physiological perspectives to find out the potential biomarkers. However multilayered skin microstructure and a wide spectrum of dynamical chromophores embedded underneath skin make it very challenging to quantify this mostly accessible, but very complex and heterogeneous largest organ of the human body. Rather than concentrating on characterizing those internal features in a microscopic level, both lesion reflectance (colour) and 3D geometry have been suggested to recover through a relative easy and cost effective way towards an improved diagnosis of melanoma. The reflectance recovered can be used as a good replacement for conventional photograph for the measurement of the ABCD criteria, while the geometry of lesion surface provides extra dimension for characterizing the topography disruption of lesion region. As both the reflectance and geometry of skin surface generally reflect the growth of chromophore cells under the skin, any external abnormalities indicating the change of skin conditions must accompany with some irregular evolvement and change with these cells. For example, a blurred and asymmetrical border possibly reveals an abnormal growth of melanocytes in the horizontal phase; whiles 3D surface indentations and protrusions accompanying variegated pigmentation may indicate an aggressive penetration of melanin into the dermal layer. We compared new features derived from reflectance and geometrical information with those traditional ones and demonstrated their significance as additional clues for melanoma diagnosis.
Background
The non-contact optical methods phaseshift rapid in vivo measurement of skin (PRIMOS) and surface evaluation of living skin (SELS) are widely applied for measuring skin surface topography. The aims of the present study were to evaluate reliability and validity of these methods and to compare skin roughness intraindividually.MethodsSELS and PRIMOS measurements were performed on four skin areas of the left and right volar forearms in 12 healthy elderly subjects. Reliability and correlations were analyzed for Visioscan® and PRIMOS roughness parameters. Student's t-tests for estimating differences between contralateral volar forearm sites were applied.ResultsICC coefficients of the Visioscan® roughness estimates ranged between 0.50 and 0.95 and of the PRIMOS measurements between 0.01 and 1.00. The Visioscan® parameters SEr, SEsm, Rmax, and Rz, and the PRIMOS parameters Ra, Rz, Smax, Wt, and Sz showed most significant correlations with each other and to additional roughness parameters. Mean roughness differences between contralateral forearm skin areas ranged between 0.0 (SEsc) and 6.7 (Rmax).Conclusions
The Visioscan® parameters SEr, Rmax, and Rz showed most reliable and valid values and were largely comparable on contralateral forearm skin sites in elderly subjects. Rmax, Rz, and Ra should be preferred for measuring skin surface topography with PRIMOS.
Human skin, the outer and largest organ covering our body, can be described in terms of both its 3D spatial topography and its 2D spectral reflectance. Such a characterization normally requires the application of separate procedures using different kinds of equipment, where spectral reflectance can only be obtained from a small patch of the skin surface. This paper investigates the integration of multiple imaging modalities to simultaneously capture both spectral and spatial information from the skin surface over a wide area. By extending the imaging spectrum from the visible to the near-infrared (NIR), we improve general recovery, obtain a more detailed skin profile, and are able to identify the distribution of various principal chromophores within the deeper dermal layers. Experiments show that new dimensions of skin characterization can be generated through the recovered geometrical and spectral information, so that an enhanced visibility of important skin physiological phenomena can be achieved
Whereas the molecular mechanisms of skin aging are well understood, little information is available concerning the clinical onset and lifetime development of facial wrinkles.
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.
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.
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.
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.
Background:
Biophysical skin measurement techniques are widely used to quantify the skin barrier function. In clinical research usually several parameters are subsequently measured in the same skin areas. In this study, possible interfering effects of subsequent measurement procedures on transepidermal water loss (TEWL), stratum corneum hydration (SCH) and skin surface pH were investigated.
Methods:
An exploratory study was conducted. Twelve young (mean age 32.9 ± 7.2 years) and 12 elderly (mean age 68.3 ± 2.5 years) subjects without any skin diseases were enrolled. The parameters TEWL, skin surface pH, SCH, sebum content, and surface evaluation of living skin were obtained successively in pairs from 4 contralateral volar forearm skin areas.
Results:
SCH and skin surface pH seemed to be unaffected by previous measurement procedures. TEWL was systematically increased after pH and systematically decreased after stratum corneum measurements.
Conclusions:
Measurements per se might interact with the skin, thus changing its characteristics. If several skin barrier function parameters need to be assessed subsequently in the same skin areas, we recommend that TEWL should be measured first followed by all others.
We have previously found that topical all-trans retinoic acid (RA), partially reverses the skin changes induced in kidney transplant recipients by long-term systemic corticosteroid therapy. In the present study, we used a clinical assesment and non-invasive methods to study the effect of topical RA (0.05%; Galderma Labs) on the face and upper limbs of 17 female kidney transplant recipients over a two-month period. Sixteen patients completed the study. Compared to the aspect prior to treatment, a clinical improvement in the number and depth of facial wrinkles was noted. Similarly, the papery appearance and texture of the skin of the dorsal forearms improved relative to the excipient-treated contralateral side. A computerized study of the skin microrelief and crow's foot wrinkles on Silflo® replicas showed a decrease in line density and the coefficient of developed skin surface (CDSS), both for the crow's foot area (vs outset) and the treated forearms (vs the excipient-treat contralateral side). On the treated forearms, examination with other non-invasive methods showed an increase in overall skin thickness, a large increase in skin electrical conductance, a decrease in skin rigidity and an increase in skin luminance. All these changes were significant after only sixty days' treatment; the rapidity of the effects of RA on such patients is noticeable.
A low cost image analysis system is described. The system consists of a 64K Apple II+ microcomputer fitted with a MICRO WORKS DS-65 Digisector board and a monochrome closed circuit video camera fitted with a 50 mm focal length lens. Silicone negative replicas of the skin surface were dusted with pulverised black iron oxide powder to eliminate artifacts from the translucent quality of the replica surface, greatly enhancing the image quality. Due to the anisotropy of the skin surface texture, the observed distribution of grey levels is affected by the direction of incident light used to view the samples. Thus, the data from a given replica were represented by a series of ratios of statistical characteristics of the grey level distributions from two picture measurements, one with incident lighting normal to the major furrows and one parallel. The utility of the approach is illustrated by a comparison of untreated skin with solvent and emollient treated skin. Shadow area, variance, skewness and kurtosis ratios were all sensitive to treatment effects.
The surface of a body is by definition its outer part which limits it in any direction. More importantly, it is the visible covering of the body. This simple fact has considerable sociological importance, which immediately justifies the interest that researchers have taken in studying the skin for the past 10 years or so. First of all, the surface of the skin is largely what we perceive of others, and this type of received information will be, at first, the basis of judgements concerning a whole series of related criteria (pleasant or unpleasant, young or old, healthy or sick, aggressive or not, etc). In addition to the olfactory aspects of an encounter between two individuals, contact can be established by touch, which is a highly developed sense. Very little is yet known about its physiology, but it involves physical contact of two surfaces which, as we shall see later, have a very complex organization. The very important part played by appearance, and hence by the skin surface, in social relations has now been acknowledged and scientifically described [1]. It gives additional significance and responsibility to dermatology and cosmetology.
• We studied facial frown lines on cadaver skin. These wrinkles persisting after death were kept unmodified during the collecting procedure; some included the underlying bone. Their microanatomical basis lies in the hypodermis where trabeculae of the retinacula cutis are broader and much shorter underneath the wrinkle than in the surrounding skin. These trabeculae contain striated muscle cells. The hypertrophy of the extracellular matrix of the hypodermal septae is probably related to repetitive mechanical stimuli generated by the muscle cells.
(Arch Dermatol. 1989;125:1090-1092)
Image processing algorithms and photographic techniques have been developed to allow objective, reproducible quantification of facial skin wrinkles, age spots, pores, and other visible skin features. The methods have been used to determine the effects of environmen-tal solar exposure on facial skin aging.
The skin surface is characterized by small ridges, prominences and furrows that change with aging and degree of sun expose. Quantifying such geometric characteristics as the ridges and furrows on the skin surface can provide cosmetic researchers with a means of assessing changes in wrinkles and understanding the wrinkling process.Many attempts have been tried to analyze the features of wrinkles in order to evaluate the efficacy of anti-wrinkles preparations. However, measurement systems proposed up to now have been unable to provide 3-D information about wrinkle shapes. The authors have developed a new non-contact 3-D measurement system to profile wrinkles based on a fringe scanning method using a sinusoidal grating pattern instead of interference fringes generated by laser. The grating projection system makes it possible to capture the three-dimensional nature of the objective. Another feature of the new device is that fringe scanning is introduced to the grating projection system. The system provides a greater density of measurement points and eliminates the influence of skin surface anomalies such as spots, freckles, moles, etc. Using this system, the depth of wrinkles can be obtained within 1.0 second with a depth accuracy of less than ±14μm over an area of 12.5mm×15mm.3-D measurements of wrinkles were taken on the external corners of the eyes of 599 Japanese women ranging in age from 20 to 67. A mathematical model is proposed which aims to assist in understanding the effects of aging and the efficacy of cosmetic products.
The human skin’s three dimensional surface is subjected to continuous structural changes. These result from the influences of the seasons, climate, diurnal rhythms, pathological conditions, age, psychic reactions, and cosmetics [1–6].
An optical profilometer, based on a triangulation principle, has been designed to measure the topography of surfaces. It uses a laser diode source (λ = 0.788 μm) and position sensing detectors. Response is obtained with a minimum of error due to a double detection system. Sensitivity is about ±3 μm for a vertical range of 1 mm. Vertical range can attain 5 mm, and more than 10 mm with a wide range numerical arrangement. Non-contact with the surface means a scanning speed of about 4 mm s−1, and a 512 × 512 matrix (with a 12 bit definition) can be created in 9 min.
The architecture and the plasticity of the dermo-epidermal interface of normal and pathological human skin have been studied by scanning electron microscopy. Biopsies were incubated in a sodium bromide solution to dissociate the epidermis from the dermis. The cleavage plane was located at the level of the lamina densa of the basal membrane as evidenced by optical and transmission electron microscopy. The surface on either side has digital projections, presenting on the epithelial side the relief of the basal cells and on the dermal side the complementary architecture. The highly folded basement membrane can be considerably stretched and its architecture can be modified by two processes. A passive type results from movement transmitted to the basement membrane in response to mechanical stress. An active type, depending upon metabolic remodelling, is illustrated by the dermal downgrowth of basal cell carcinoma.Copyright © 1974 S. Karger AG, Basel
Background/aims: Usually, skin topography is quantified by means of 2D profilometry using negative- or positive-replicas. To allow a direct in vivo measurement, a new profilometer is built, based on an optical triangulation principle.
Conclusion: High speed of measurement can be reached using a non contact profilometer. The ability of a position sensing detector to read the center of gravity of the spot reflected by the skin surface, allows one to reduce the effects of the enlargement due to the skin absorption of the laser beam.
Synopsis This study was designed to develop a noninvasive model system for analyzing the condition of human skin in vivo and to provide a method of objective measurement which would correlate with the subjective evaluation of the skin surface. Positive replicas of the upper arm were prepared for scanning electron microscopy and surfanalysis. Skin condition was evaluated by scoring SEM photomicrographs for plump- ness, an indication of hydradon, and for stratum comeurn damage represented by surface scales and cracks. Skin surface profiles parallel with and perpendicular to the major furrows were produced using a surfan- alyzer. The profiles were computer analyzed for standard roughness parameters utilized by the metals industry, including arithmetic average roughness (Ra) and mean depth of roughness (Rz). Eleven to thirteen individual samples were examined. The subjective value for plumpness correlated (p < 0.02) with both Ra and Rz, and the correlation was not dependent on the trace direction of the surface profile. The subjective evaluation of stratum corneum damage, however, did not correlate with any of the roughness parameters or with plumpness. This may be due in part to the sensitivity of the measurement, with cracking and flaking being restricted to small changes in the upper few microns of stratum corneum and plumpness being a reflection of larger changes throughout the stratum corneum and perhaps involving the epidermis. A special program was written which could identify cracks in a roughness profile with a high degree of certainty, and the number of cracks identified was significantly correlated (p < 0.01) with a subjective assessment of the corresponding photomicrographs.
SUMMARYA method is described which enables measurement to be made of the roughness of the surface of skin surface biopsies. The instrument used in this investigation has previously been employed to measure the degree of unevenness of metal and ceramic surfaces and is called a ‘surfometer’. Using this technique the tracings that resulted from examination of normal skin, psoriasis and certain ichthyotic states could easily be distinguished. It was also demonstrated that there was a consistent pattern of change with increasing hydration of the stratum corncum in the absence of easily identifiable morphological alterations.
Background/aims: Visual and tactile assessment of dry skin and ichthyosis is difficult and may vary. There is a need for standardized assessment according to universal scoring schemes.
Material and methods: A guidance to subjects (consumers) and experts evaluation with control of individual and other factors is presented. Scoring schemes include analogue scales, the overall dry skin score (ODS) and the specified symptom sum score (SRRC) system with grading of scaling, roughness, redness and cracks. The dry skin/ichthyosis area and severity index (DASI) is defined for dermatological evaluation of the entire skin surface. Conclusion: The EEMCO guidance is a practical research tool both for characterization of xerotic skin conditions and for efficacy substantiation of products. The guidance is developed to harmonize research in this field and improve interlaboratory comparison.
Background/aims: Quantitative measurement of skin roughness has proved to be a valuable tool in the efficacy-control of external applications, but it suffers from not yielding easily comparable results. The most important sources of inter-observer variability are high-pass filters used to separate roughness and waviness, and low-pass filters which result from the finite resolution of the instrument or from the finite sampling interval of digital measurement. In the present study, the effects of high-pass filters and sampling intervals on the roughness measured were investigated.
Methods: Dynamically focusing optical profilometry was used to measure the surfaces of negative replicas of healthy human skin. High-pass cut-off wavelengths and sampling intervals were varied systematically.
Results/conclusions: Virtually unbiased estimates for the roughness parameters K, Sk, Rq, and Ra can be obtained using sampling intervals of 40 or even 80 μm. Regarding these roughness parameters, it is far better to do more scans than to shorten the sampling interval. The roughness parameters Rz, Rp, Rt, Rpm, Rmax, Pt, on the other hand are very sensitive to the influence of the sampling interval; to achieve satisfying estimates, the sampling interval should be no longer than 2 to 5 urn; as an important parameter’of the measurement, it is worthy of remark and should always be indicated. The way the mean square roughness Rq depends on the cut-off wavelength is not well described by the Sayles-Thomas-relation Rq∼λc0.5. If the power-spectrum |h*(v)|2 approximates sufficiently to a power law, |h*(v)|2∼vδ, a better estimate is given by Rq∼λcγ with γ=-(δ+1)/2. In many cases, γ=1 or Rq∼λc will suffice.
Objective The degree of reproducibility and precision of the mechanical direct profilometry and the intra- and interindividual fluctuations of 7 surface parameters were investigated.
Material and methods Negative replicas were sampled from defined areas of the skin of 31 volunteers an evaluated with the profile-tracking device TKC 300 Hommeltester in order to derive data about the inter- and intraindividual fluctuations. To determine the precision of this method 6 roughness parameters and J of waviness of each replica were repetitively evaluated. The practicability was tested introducing minimal changes in the experimental set-up. Further, the effect of urea-containing creme on the skins topography was investigated in a double-blind clinical setting on a collective of 11 patients.
Results The precision of this method is shown by nearly unchanged topographic parameters. Moreover, our data show smaller intra- than interindividual fluctuations of roughness (Ra) and waviness (Wt), being an important demand for clinical investigations.
Conclusion In this paper we demonstrate that the parameters of both roughness as well as the recently introduced waviness can be conveniently evaluated with a high degree of precision with the direct profilometry.
Synopsis
A method of skin profilometry is presented. The data generated using this method are used to (a) uncover sources of variation in skin profilometry, (b) provide information regarding the choice of roughness parameters best suited for characterizing the skin's topography, and (c) determine if skin profilometry is a valuable tool for quantitatively assessing changes in the skin's surface pattern.
The data show the roughness parameter values to be dependent on the orientation of the tracings with regard to the major grooves and ridges present in the surface patterns. Large variabilities of roughness parameter values obtained for multiple scans within small areas of replicas are indicative of the nonhomogeneity of the skin's surface. The number of peaks, mean peak size, mean depth of roughness, depth of smoothness, and residual profile length appear to be the most utile roughness parameters for quantifying changes in the skin's topography. The ability of skin profilometry to detect subtle changes in the skin's surface pattern due to hydration indicates the method is a sensitive means of quantifying the skin's topography.
Quantification de la topographie de la pedu par la profilométrie de la pedu
Synopsis
An image analysis method to measure the human skin microrelief has been previously proposed.
This new method has been recently automated, using a ‘robot’electronically driven by a Quantimet 900. This ‘robot’consists of a change‐over specimen driven by four motors, and allows forty Silflo® replicas to be analysed in 6 hours, each analysis giving the main directions of the furrows, their density and their mean depth.
For example, the volar forearm microrelief was studied from the detected shadows created by a 26° angle lighting, in the range of 5 to 100 μ m deep furrows. A 38° angle lighting allows such measurements from 50 to 1000 μ m and is used for studying ‘crow's feet’wrinkles of the face.
Results clearly show that deep wrinkles appear as early as 30 years old on the human face. The consequences of actinic and mechanical stresses over the life span are discussed.
Un système automatique pour l'étude du relief cutané chez l'homme
Synopsis
Image analysis provides a practical method for studying the cutaneous relief and better understanding of the formation of wrinkles during ageing and their regression induced by an anti‐wrinkle product. Quantimet 900° allows a fully automated analysis of 40 replicas of skin surface per cycle of 6 h. The basic principle consists of measuring shadows, generated by incident lighting at the surface of Silflo replicas. Incident light of 38° was selected for analysing crow's feet wrinkles and 26° for the microrelief when crow's feet were absent (slight furrows less than 50 μ‐m). The following parameters were recorded: the number of wrinkles, their mean depth, and the coefficient of developed skin surface (CDSS).
An O/W emulsion containing 30% biological ingredients was applied daily on the face of 140 female subjects, aged from 20 to 57 years, during 4 weeks. Replicas were made before the first application ( t 0 ) and 24 h after the last one ( t 0 ). Data obtained with the image analysis method showed a decrease in number and depth of crow's feet from t 0 , to t 4 of 16% and a sharp decrease of the CDSS (30%). No modification of the microrelief was observed. These results were confirmed by measuring forehead casts with the Anaglyphographc® apparatus (a profilometric method) on the same subjects: a decrease of 40% in number and 23% in depth were recorded for the forehead wrinkles, with no modification of the microrelief.
Both image analysis and profilometry measured the effects provoked by this treatment. The CDSS, which might measure the reservoir of extensibility of the surface of the skin, should be the best parameter to demonstrate the efficiency of anti‐wrinkle products.
Evaluation des effets anti‐rides chez I'homme
Synopsis
Topically applied water, occlusion and topically applied glycerol were used to investigate and characterize some of the changes which occur in the hydrated stratum corneum. The effects of these treatments were monitored using non‐invasive techniques under controlled conditions.
The Servomed Evaporimeter was used to determine natural water flux from the skin surface before and after treatment. The performance of the Evaporimeter in this type of study had previously been improved by attaching a paper baffle to the detector. This eliminated the variance in output caused by atmospheric movement. Experiments were carried out at temperatures below the threshold of thermal sweating and emotional sweating was minimized.
Skin surface topography was characterized by means of a new type of profilometer. The instrument's design allowed a diamond stylus to traverse the living skin surface without significantly altering its structure. Changes in skin surface roughness were further elucidated using scanning electron microscopy and macrophotography.
In vivo penetration of glycerol was assessed by chemical analysis of stratum corneum layers of treated skin. Samples were obtained by sequential stripping of the stratum corneum using adhesive tape.
Topically applied water produced only a transient benefit because of rapid evaporation. More prolonged hydration was achieved by suppressing transepidermal water loss with polyethylene film. This occlusive hyperhydration was characterized by a significant reduction in profile roughness and by a smoother macroscopic appearance.
Glycerol achieved the same effects by reducing the magnitude of the natural water flux from the skin surface and by reducing the rate of evaporation of water from applied aqueous glycerol solution or cosmetic product. Both effects were seen as the result of lowered water activity in the proximity of glycerol.
Smoothing effects of glycerol on the skin surface, and improved appearance, persisted for at least 24 h. This persistence was explained by evidence for diffusion of glycerol into the stratum corneum where it formed a reservoir.
Hydration of the skin is known to affect its barrier function and thereby exert a profound effect on penetration of both lipophilic and hydrophilic molecules. Clinically, this effect may be achieved using liberal applications of occlusive petroleum jelly and ointments. The results presented in this paper suggest that the use of humectants could achieve useful hydration using cosmetically acceptable materials.
Synopsis
The surface configuration of the skin, as characterized by surface furrows and plateaux, is known to change with ageing and skin condition. There have been many attempts to analyse the surface configuration in order to evaluate the effect of skin care products. However, the systems proposed up to now are insufficient to obtain three‐dimensional data.
A system based on image analysis and Fourier transformation has been developed. By using this system, we can make a quick and quantitative analysis of the three‐dimensional surface configuration of the skin. This system was applied to measure changes in the surface configuration with ageing, and to clarify the effects of cosmetic cream.
As a result, it was found that the furrows become less clear, become parallel in one direction and the texture becomes coarse and irregular, as ageing continues. These changes are believed to correspond to deterioration of the metabolic and moisturizing functions of the skin.
It was also found that the furrows become clear and the texture becomes finer after the application of cream than before. This is believed to be the result of the improvement of the skin condition due to the moisturizing effect of the cream.
The skin relief influences the exterior aspect of the skin which is very sensitive to aging. It could also be related to the mechanical properties and structure of both dermis and stratum corneum. Consequently, quantitative measurement of the skin surface roughness would seem most useful, as it would permit a quantification of skin aging, an in vivo analysis of mechanical forces acting on the skin structure, and the detection of abnormalities otherwise not visible. The method described comprises three steps: (1) making a silicone rubber negative replica, (2) making an Araldite positive cast, (3) roughness measurement of the cast with a device commonly used in engineering, which provides quantitative parameters: Ra, Rp, Rt, Rmax and others. The reliability of each of these steps was checked, and also the absolute need to locate precisely the site of sampling and to know the angle of the scanning direction with the main axis of the limb or the body. The method seems useful for studying aging, either normal or affected by UV rays and other physiopathological events influencing the skin surface.
A method is described which enables measurement to be made of the roughness of the surfact of skin surface biopsies. The instrument used in this investigation has previously been employed to measure the degree of unevenness of metal and ceramic surfaces and is called a 'surfometer'. Using this technique the tracings that resulted from examination of normal skin, psoriasis and certain ichthyotic states could easily be distinguished. It was also demonstrated that there was a consistent pattern of change with increasing hydration of the stratum corneum in the absence of easily identifiable morphological alterations.
The distinction between intrinsic and extrinsic ageing can be made on both histological and clinical grounds. Clinical criteria associated with the diagnosis of extrinsic ageing are coarse wrinkles, actinic lentigines, elastotic conditions, purpura, telangiectasia and cutaneous neoplasms. These parameters are always superimposed on changes associated with intrinsic ageing: namely, fine wrinkles and benign growths. There is heightened interest in extrinsic ageing as a result of studies demonstrating the efficacy of topical tretinoin in improving this condition. As a consequence, systems for grading extrinsic ageing have been developed, including a photographic standard scale which removes some of the subjectivity inherent to current methodology.
Tretinoin administered topically in 0.1% concentration has been shown to improve the wrinkling and irregular pigmentation of photoaged skin.
The purpose of this study was to assess the safety and efficacy of various concentrations of tretinoin in a new emollient cream base in the treatment of photoaged skin.
Three concentrations of tretinoin (0.05%, 0.01%, and 0.001%) in a new emollient cream formulation were compared with vehicle in a 24-week, double-blind, randomized, multicenter study of 296 subjects with photodamaged facial skin.
Tretinoin emollient cream 0.05% gave a significantly better global response to therapy than vehicle (p less than 0.001), with 68% of subjects exhibiting improvement at the end of therapy, compared with 43% of subjects in the vehicle group. An excellent or good response was found in 26% of subjects treated with tretinoin emollient cream 0.05% versus 11% of vehicle-treated subjects. Fine wrinkling, mottled hyperpigmentation, and roughness were more improved in subjects who received tretinoin emollient cream 0.05% than in vehicle-treated subjects (p less than 0.05). No significant difference was found between vehicle and tretinoin emollient cream 0.01% or 0.001%. Histologic examination showed increases in epidermal and granular layer thickness, decreased melanin content and compaction of the stratum corneum after therapy with tretinoin emollient cream 0.05% or 0.01%. Mild to moderate skin reactions, such as erythema, peeling, and burning, were the most common side effects and, although most prevalent in the group using the 0.05% concentration, generally did not limit tretinoin use.
Tretinoin emollient cream 0.05% appears to be safe and effective in the treatment of photodamaged skin.
The skin microrelief can be assessed in vivo using a noninvasive method based on the image analysis of negative replicas, shadowed by oblique illumination. This technique was used to study changes in the surface furrows of the human volar forearm, related to the degree of extension, in volunteers of three age groups. Results confirmed that the skin in elderly subjects can be characterized by the lack of one of the two perpendicular furrow orientations observed in the young. During extension of the arm, the response of the microrelief in young subjects was clearly different from that in the elderly. Young skin buffered strain through a progressive shift in line density and furrow depth from one orientation to the other, whereas in the elderly, a progressive rotation of the single furrow orientation occurred. These differences would appear to be related to changes in the architecture and physical properties of the dermis. Microrelief, in the elderly subjects, showed a mean line density of 24/cm, regardless of the degree of extension. This constancy may reflect the ultimate stage in the chronological aging of the skin and may be characteristic of a loosened and relaxed dermis.
• The clinical and histologic effects of a new emollient cream formulation of topical tretinoin at concentrations of 0.05% and 0.01% were examined in 251 subjects with mild to moderate photodamaged facial skin in a randomized, doubleblind, vehicle-controlled, multicenter study. Seventy-nine percent of the subjects who received 0.05% tretinoin for 24 weeks showed overall improvement in photodamaged skin compared with improvement in 48% of the vehicle-treated control subjects. Significant reductions were found in fine wrinkling, mottled hyperpigmentation, roughness, and laxity after 0.05% tretinoin therapy when compared with controls. In addition, histologic changes of increased epidermal thickness, decreased melanin content, and stratum corneum compaction provide independent evidence supporting clinical improvement. Side effects of erythema, peeling, and stinging were usually mild and well tolerated.
(Arch Dermatol. 1991;127:659-665)
An open clinical study was undertaken to evaluate the anti-photoageing efficacy of topical tretinoin. A length of cream of approximately 1 cm was applied to the face daily in the evening for 6 months: during month 1 of therapy 0.01% tretinoin cream was administered; 0.025% was given during month 2; and 0.05% was given in months 3-6. The clinical symptoms of photoageing (coarse wrinkling, fine wrinkling, skin thinning, mottled hyperpigmentation, laxity and xerosis) were evaluated before and after therapy. A total of 19.1% of patients withdrew from the study; only 5.6% were for treatment-related reasons. At the end of the treatment period all the clinical parameters, except xerosis, were improved. The amount of improvement varied, but only 4.2% of patients failed to show any improvement. Tolerability was excellent in 51.4% of patients, good in 44.4% and fair in 4.2%, and compliance was excellent in 47.0% of patients, good in 48.5% and fair in 4.5%. Tolerability and compliance were improved by applying the same amount of cream each day but increasing the concentration of tretinoin over the 6-month period. Silicone skin replicas of the same area of skin taken before and after treatment, analysed by scanning electron microscopy, profilometry and computer image analysis, showed a decrease in the width of wrinkles, and an improvement in skin texture and follicle density.
We performed a 22-month trial of topical tretinoin (retinoic acid) in the treatment of photoaging. Thirty patients participated in a 4-month, randomized, blinded, vehicle-controlled study that has been reported previously; 21 patients continued tretinoin therapy on an open-label basis, participating in the study for a total of 10 months, and 16 patients continued for 22 months. During the open-label study, the statistically significant improvement that had occurred in fine and coarse wrinkling and skin texture during our original study was sustained, despite reductions in dose or frequency of application of tretinoin. The number of discrete lentigines decreased by 71% compared with the number before therapy. Histologic findings included a statistically significant thickening of the epidermis. Side effects were limited to a cutaneous retinoid reaction that diminished as therapy proceeded.
We studied facial frown lines on cadaver skin. These wrinkles persisting after death were kept unmodified during the collecting procedure; some included the underlying bone. Their microanatomical basis lies in the hypodermis where trabeculae of the retinacula cutis are broader and much shorter underneath the wrinkle than in the surrounding skin. These trabeculae contain striated muscle cells. The hypertrophy of the extracellular matrix of the hypodermal septae is probably related to repetitive mechanical stimuli generated by the muscle cells.
Facial fine lines and wrinkles can be faithfully captured by silicone rubber impression materials. Computerized digital image processing of such specimens provides objective measurement of the skin's topography, which has a significant degree of correlation with clinical grading. Optical profilometry provides a dimension of objectivity that can complement clinical assessment in the study of agents that may be useful in the therapy of photodamaged skin.
We review the use of topical tretinoin (all-trans-retinoic acid) in the treatment of aging skin. We have found topical tretinoin capable of improving aged-appearing skin in both a double-blind, vehicle-controlled trial and our clinic patients. The most impressive improvement occurs after application of tretinoin 0.1% cream for 8 to 12 months. Side effects have been limited to a mild, transient, and clinically insignificant burning sensation in the eyes and mild irritation of tretinoin-exposed skin.
The use of a combination of transmission electron microscopy, scanning electron microscopy, replica methods and freeze fracture or freeze etching techniques tremendously widened the scope of dermatological research. In this report some of the interesting observations made recently are reviewed and discussed.
The architecture and plasticity of the dermo epidermal interface of normal and pathological human skin were studied by scanning electron microscopy. Biopsies were incubated in a sodium bromide solution to dissociate the epidermis from the dermis. The cleavage plane was located at the level of the lamina densa of the basal membrane as determined by optical and transmission electron microscopy. The surface on either side had digital projections, presenting on the epithelial side the relief of the basal cells and on the dermal side the complementary architecture. The highly folded basement membrane could be considerably stretched and its architecture could be modified by 2 processes. It is concluded that passive type results from movement transmitted to the basement membrane in response to mechanical stress and active type, depending upon metabolic remodelling, is illustrated by the dermal downgrowth of basal cell carcinoma. (10 references.)
This article deals with the office treatment of several common cosmetic problems. The topic of benign lesions is discussed, which includes the management of lentigines, milia, spider nevi, telangiectasis, xanthelasma, and keloids. The use of several modalities for the treatment of acne scarring is advocated; these include dermabrasion, punch-transplant replacement techniques, and collagen implants. Chemical face peels for actinic damage and premature wrinkling are described, and the use of hair transplants, scalp-reduction techniques, and scale flaps to surgically correct male-pattern alopecia are discussed.
Two methods for the assessment of severity of actinic skin damage were evaluated in a population-based survey of 1216 subjects. After controlling for the effects of age, skin texture changes graded by cutaneous microtopography were found to be associated strongly with the presence of solar keratoses and a past history of non-melanotic skin cancer. Changes in skin condition graded by paraocular photography had a weaker relationship with the presence of keratoses and showed no association with non-melanotic skin cancer. These results, together with a higher level of agreement between observers in grading cutaneous microtopographs, support the use of cutaneous microtopography as an index of actinic skin damage in epidemiological research.
There are no established techniques for the measurement of scaliness and skin smoothness. In this paper a new photographic technique for assessment of the skin surface is described. Photographic negatives of the skin surface taken under standardized conditions arc scanned on a densitometer and the scan tracing length used as a measure of roughness. The technique has been used to assess (a) the roughening effect of adhesive tape stripping, (b) the smoothing effect of emollient preparations, and (c) the alterations in roughness of scaling dermatoses during treatment. It has been found to be reproducible and to correlate well with assessment of skin surface contour.
The skin of the volar forearm is a site selected for many biometrological studies. We studied the influence of forearm position when evaluating the surface topography and mechanical properties of the skin in normal young adults. Optical profilometry of skin replicas and the suction biomechanical method (Cutometer ®, 2 and 8 mm probes) were used in combination with evaluation of the thickness and sliding mobility of the dermis and dermohypodermal tissues.
The dermal and dermohypodermal thicknesses did not correlate with the various profilometric and biomechanical measurements. The surface topography and the axial sliding mobility of the skin were markedly influenced by forearm position, while the only mechanical property of the skin to be affected was skin stretchability assessed with the 2 mm probe.
It is concluded that limb position mostly influences biometrological measurements made in the plane of the skin surface, while it has little effect on most of the Cutometer measurements.
In order to quantify the skin aging, the skin surface contours for
72 male subjects from in his 20's to in his 60's were measured
three-dimensionally and analyzed by 2D Fourier transform method. The
measuring part of the body was the back of the hand. Results of the 3D
measurements showed that the pattern composed of longitudinal, oblique,
and transverse ridges on the skin surface changed with age. Results of
the 2D Fourier analysis of skin surface contours showed that the skin
surface contours of young male subjects included much of high spatial
frequency components while the skin surface contours of aged male
subjects included low spatial frequency components mainly. The aging
parameter for 72 male subjects, which expressed the skin aging
quantitatively, was calculated by summing up the Fourier coefficients
within a specified area on the X-Y spatial frequency plane. The aging
parameter decreased with age. However the aging parameter showed wide
scattering. The wide scattering of the aging parameter can be removed by
applying the high pass digital filter to the skin surface contours