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Sleeping on an Anti-Wrinkle Pillow Reduces Facial Wrinkles: Results from an Anatomical Study

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  • University Hospital Lewisham, London, United Kingdom

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Background: A special pillow was designed to redistribute mechanical stress during sleeping in order to slow down the formation of facial skin wrinkles. Objective: To investigate whether sleeping on a specially designed pillow reduces facial skin wrinkles. Participants and Methods: A 28-day pilot study was carried out in which fifteen healthy female volunteers aged 23-55 years (mean age 35. 6 ± 8.5) slept on an antiwrinkle pillow. Evaluation of facial wrinkles was conducted before commencing the study (T0), following at 14 days (T14), and at 28 days (T28) when the study ended. Wrinkle density was assessed by computerized analysis of 2D images of participants' faces. Results: A statistically significant decrease in wrinkle density was detected while smiling around both eyes, around the right eye in a relaxed facial expression, on average in all observed facial areas, around the left periorbital area in participants who predominantly slept on their left side of the body, but not on the frontal area. Limitations: A 3D camera could be used to better visualize and analyze wrinkle density. Conclusions: Sleeping on the specially designed pillow reduces facial wrinkles.
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Forensic Medicine and Anatomy Research, 2015, 3, 48-56
Published Online April 2015 in SciRes. http://www.scirp.org/journal/fmar
http://dx.doi.org/10.4236/fmar.2015.32010
How to cite this paper: Poljsak, B., Godic, A., Fink, R., Oder, M., Lampe, T. and Dahmane, R. (2015) Sleeping on an Anti-
Wrinkle Pillow Reduces Facial Wrinkles: Results from an Anatomical Study. Forensic Medicine and Anatomy Research, 3,
48-56. http://dx.doi.org/10.4236/fmar.2015.32010
Sleeping on an Anti-Wrinkle Pillow
Reduces Facial Wrinkles: Results
from an Anatomical Study
Borut Poljsak1, Aleksandar Godic2, Rok Fink1, Martina Oder1, Tomaz Lampe1,
Raja Dahmane3,4*
1Laboratory for Oxidative Stress Research, Faculty of Health Sciences, University of Ljubljana, Ljubljana,
Slovenia
2Department of Dermatology, Cambridge University Hospitals, Addenbrookes Hospital, Cambridge, UK
3Biomedicine in Health Care Division, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
4Faculty of Medicine, Institute of Anatomy, Ljubljana, Slovenia
Email: *raja.dahmane@guest.arnes.si
Received 3 March 2015; accepted 30 March 2015; published 2 April 2015
Copyright © 2015 by authors and Scientific Research Publishing Inc.
This work is licensed under the Creative Commons Attribution International License (CC BY).
http://creativecommons.org/licenses/by/4.0/
Abstract
Background: A special pillow was designed to redistribute mechanical stress during sleeping in
order to slow down the formation of facial skin wrinkles. Objective: To investigate whether sleep-
ing on a specially designed pillow reduces facial skin wrinkles. Participants and Methods: A 28-day
pilot study was carried out in which fifteen healthy female volunteers aged 23 - 55 years (mean
age 35. 6 ± 8.5) slept on an antiwrinkle pillow. Evaluation of facial wrinkles was conducted before
commencing the study (T0), following at 14 days (T14), and at 28 days (T28) when the study ended.
Wrinkle density was assessed by computerized analysis of 2D images of participantsfaces. Re-
sults: A statistically significant decrease in wrinkle density was detected while smiling around
both eyes, around the right eye in a relaxed facial expression, on average in all observed facial
areas, around the left periorbital area in participants who predominantly slept on their left side of
the body, but not on the frontal area. Limitations: A 3D camera could be used to better visualize
and analyze wrinkle density. Conclusions: Sleeping on the specially designed pillow reduces facial
wrinkles.
Keywords
Sleeping, Wrinkles, Facial Anatomy, Anti-Wrinkle Pillow
*
Corresponding author.
B. Poljsak et al.
49
1. Introduction
The facial skin responds to repetitive contractions of underlying muscles while smiling, frowning, and other
physical movements. Usually, by the mid-twenties, most people begin to notice faint lines on the forehead, be-
tween the eyebrows, in the nasolabial folds and the periorbital areas [1] [2]. Early wrinkles are seen at first dur-
ing facial expression, whereas persistent wrinkles, such as crow’s feet, glabellar frown lines and forehead trans-
verse lines, appear later [3]. Facial expressions are produced by 43 muscles, which can produce over 100,000
variations [1]. The palpebral and orbital components of the orbicularis oculi muscle surround the pretarsal and
preseptal aspects and function essentially as the sphincter muscle of the eyelid, which is responsible for blinking
and gentle eye closure. Its direct antagonist is the Levator palpebrae muscle. Some of the fibres of the superior
medial orbital component function as depressors of the medial eyebrow, whereas the superior lateralorbital or-
bicularis acts partly as a depressor of the lateral eyebrow. Forceful mechanical pressure on the orbital compo-
nent induces concentric folds emanating from the lateral canthus, resulting in lateral canthal lines, or “crow’s
feet”. The zygomaticus major muscle forms the angle of the mouth superiorly, laterally and posteriorly, in a sim-
ilar manner as seen in laughing, smiling and chewing. The zygomaticus minor muscle functions as one of the lip
elevators, and both contribute to the formation of the melolabial fold. Mechanical pressure on both zygomaticus
muscles produces synergistic effects in the periorbital region, which is accentuated by pressure on the orbital
orbicularis muscle, and all together contributes to the formation of radially oriented folds at the lateral cantus.
The orbicularisoris is responsible for forceful lip closure and serves as a sphincter of the mouth. Pressure on this
muscle induces folds that radiate perpendicularly to the vermilion border. This muscle is partly an antagonist of
the lip elevators. The lip depressors include the orbicularis oris, mentalis, depressor angulioris, depressorlabii
and platysma muscles. The levator labii superioris alaeque nasi muscle is a lip elevator and its contraction can,
in some people, cause obliquely oriented wrinkles along the nasal dorsum and sidewall, after just 30 seconds of
mechanical pressure [4].
Longitudinal studies confirm that persistent wrinkles evolve directly from temporary ones [5]. An image-
based method was developed which showed that a subjects’ unique pattern of persistent facial wrinkles observed
during a neutral expression at the age of 8 years was predicted by the pattern of temporary wrinkles observed
while smiling [6]. Factors which contribute to facial wrinkle formation include genetic predisposition, environ-
mental influences, habits, hyperdynamic facial expression, loss of underlying skeletal and soft tissue support,
decreased skin elasticity, and gravitational force [7]. Underlying mechanical stress is an obligatory factor. If it is
not present, as seen on the dorsal forearms, wrinkles do not form regardless of photo damage severity. The loss
of the skins mechanical property is significantly faster on sun-exposed than on sun-protected areas [8]. Persis-
tent facial wrinkle formation thus depends on both the cumulative amount of mechanical stress and reduced skin
elasticity caused by aging and photo damage due to previous sun exposure. Ultraviolet (UV)-induced skin dam-
age is thus not a cause but an accelerator of wrinkle formation [1].
Sleep lines are caused by repetitive and constant pressure of the face on a pillow during sleeping and body
position importantly contributes to their formation [9]. People sleep approximately eight hours per day and when
sleeping on one side of the body (or on the stomach), temporary sleeping lines become permanent after some
time. Sleeping can cause irreversible damage to the dermis and adipose tissues in an individual and result in fa-
cial deformities. It exhibits long-term tension on the skin, which pushes or pulls the skin in a direction that is
perpendicular to the direction of the muscles of the face. Gravitational force becomes very aggressive and causes
the muscles to elongate. Permanent sleeping wrinkles often fade in morning in young, although they may be
visible for several hours until the facial skin adopts its initial relaxed state. As we age, this interval prolongs,
leading to permanently damaged soft tissue and permanent wrinkles.
The aim of our study was to investigate to what extent sleeping contributed to formation of facial wrinkles
and whether sleeping on the specially designed pillow reduced them. We adopted methods from the study of
Baek et al. to demonstrate that sleeping on the specially designed pillow reduced facial skin wrinkles [10].
2. Materials and Methods
2.1. Participants
A 28-day pilot study was carried out in which fifteen healthy female volunteers aged 23 - 55 years (mean age
35.6 ± 8.5) slept on our specially designed pillow. Inclusion criteria were that the volunteers were healthy Cau-
B. Poljsak et al.
50
casian women without pre-existing skin disease (including damaged skin, previous sunburn, tattoos, and scars),
chronic diseases, pregnancy, or taking medication which could influence the skin response. Participants’ wrin-
kles were measured before they started sleeping on the anti-wrinkle pillow (baseline) (T0) and then two (T14) and
four (T28) weeks afterwards when the experiment ended. None of the subjects had had invasive or non-invasive
facial procedures in the past (surgical, laser, fillers, Botox, peelings). They were asked not to change any habits,
which could influence the quality of the skin (e.g. sun exposure, extreme sport activities, alcohol and cigarette
consumption, ingestion of antioxidants and food supplements, usage of cosmetics, etc.). No adverse reactions
were observed or reported during the study. Measurements were performed under controlled and identical envi-
ronmental conditions for all participants. The ambient temperature was maintained at 21˚C ± 3˚C and the rela-
tive humidity in the range of 50% ± 8%. None of participants wore makeup and were allowed to relax on a
comfortable diagnostic bed for some minutes before the pictures were taken. All pictures were taken between 12
p.m. and 3 p.m. The study was conducted during the period from June to July 2013, according to the Declaration
of Helsinki Principles and was approved by the National Medical Ethics Committee of the Republic of Slovenia.
2.2. Properties of the Anti-Wrinkle Pillow
We evaluated the specially-designed pillow to reduce and improve facial wrinkles/deformities while sleeping.
Standard pillows exert pressure on an individual’s face when a user is lying in a prone position with the face
pressed against a pillow, mostly on its central part. The pressure is thus generally unevenly dispersed and results
in formation of the facial deformities and wrinkles, especially on the cheeks, around the eyes and the mouth
where the pressure is highest (Figure 1(a)). The anti-wrinkle pillow was designed to redistribute pressure from
the central face (the cheeks, eyes and mouth) to the chin and the forehead (Figure 1(b) and Figure 2). It has a
central hole with a centric wire to regulate its size to suspend the user’s face whilst sleeping and two different
sides, which enable the user to choose according to the length of his/her neck for a proper neck support (Figure
2) [4].
(a)
(b)
Figure 1. (a) and (b) Presentation of the force distribution on the face with standard and anti-wrinkle pil-
lows. Redistribution of the pressure from delicate parts of the face to the chin and the forehead can be
seen if sleeping on an anti-wrinkle pillow. The measurement of the pressure was done by mFLEX® in-
strument that evaluates the interaction between a human body and the surface that supports it. (a) Stan-
dard pillow; (b) Anti-wrinkle pillow.
B. Poljsak et al.
51
Figure 2. The specially designed anti-wrinkle pillow. Legend: 1: central hole; 2: centric wire; 3: va-
riable filling; 4 and 5: different sizes (fillings), which enable more/less neck support.
2.3. Facial Wrinkles Assessment
Evaluation of facial wrinkles was conducted at baseline (T0), at two (T14) and at four (T28) weeks afterwards.
Participants’ faces were photographed by 2D Image Analysis Skin CT computerized camera (Meizy Beauty
Equipment Manufacturer, China) and photographs were analysed with the built analysing software. This ana-
lysing system of 2D images allows fast, contact-free, and direct measurement of the skin surface topography in
vivo and at high resolution. Severity of wrinkles was quantified as the wrinkle density (percentage of wrinkles
per observed area), which was calculated by dividing the total wrinkle pixel area (marked with green dots and
lines in Figure 3) by total pixels of the area of interest (outlined area in Figure 3) based on the default parame-
ter settings from the manufacturer. All images were analysed by the red, green, and blue model (RGB), which is
based on three independent primary colours, and the value of each component strongly depends on the light in-
tensity of the image. The RGB system was used to minimize errors caused by irregular light intensity of images.
The computer-based image analysis was used to identify and quantify facial wrinkles, since it is less artefact
prone and more accurate method than the commonly used silicon replica technique [11] [12].
The surface of observed wrinkle areas (outlined with green dots/lines in Figure 3) on each subject’s image was
defined by standardized facial landmarks: both lateral canthuses, alar fibro-fatty tissue of the nose and corners of
the mouth. This standardized surface was then used to assess subjects’ images taken under same conditions in
neutral and smiling facial expressions at T0, T14, and T28 (Figure 3). The analysis was based on the relative
change of facial wrinkles, since the relative change of wrinkles would reflect the efficiency of the anti-wrinkle
pillow, which would thus allow the interpretation of the results more accurately than absolute values, with which
each individual should have their own reference value. Reference values were defined separately for each indi-
vidual before sleeping on pillow.
2.4. Statistical Analysis
Paired t-test analysis was conducted using R software program [13]. We analysed differences in wrinkle densi-
ties before commencing the study (T0), two (T14), and four (T28) weeks afterwards. We analysed five facial areas
separately (as described above) and all together.
3. Results
A statistically significant decrease in wrinkle density occurred 14 days of anti-wrinkle pillow use; around the
right eye in neutral and smiling facial expressions, around the left eye whilst smiling and on average in all ob-
served areas (p < 0.05) (Table 1). Even greater differences were observed after 28 days (Table 2) but they were
not statistically significant when compared T14 and T28 (Table 3). All selected facial parameters showed statisti-
cally significant decrease in wrinkle densities after 28 days except the frontal area (p = 5.38). Results also
showed that wrinkles decreased mostly around the right eye, the left eye while smiling and on average in all ob-
served areas of the face (total area) regardless of the duration of the study (T14 and T28). The average reduction
of wrinkles in total investigated area of the face (expressed as the density of wrinkles per observed skin surface)
was approximately 7% after 14 days, and 12% after 28 days. We also further tested whether there was a statis-
tical difference between the sleeping position (left vs. right side of the body) and facial wrinkle improvement in
B. Poljsak et al.
52
Figure 3. The face was divided into five observed wrinkle areas: around the right (a) and left eyes (b), frontal area (c); and
both nasolabial folds (d). Pictures (a), (b), (c) and (d) were taken in a neutral relaxed expression of participants’ faces (to as-
sess persistent wrinkles), and a* and b* while smiling to assess temporary wrinkles. Five pictures of an each participant were
analysed: one taken in a frontal view ((c) and (d)) and four in an oblique 45˚ view ((a), (a*), (b), (b*)). The program detects
the total pixels of the wrinkle area (marked with green dots), and the wrinkle density was calculated as the percentage of total
pixels of the outlined area (marked with green lines).
Table 1. Wrinkles density at the baseline and following 14 days of sleeping on a pillow at different anatomical regions of the
face.
T0 T14 Mean of the differences 95% confidence interval t-value p-value
Average Average Low Upper
Front 46.26 45.85 0.71 4.60 6.03 0.29 0.7763
Eye right 50.66 45.64 6.85 3.64 10.06 4.61 0.0005*
Eye right smile 56.01 51.64 5.78 2.25 9.31 3.53 0.0036*
Eye left 52.26 51.28 2.71 0.86 6.29 1.63 0.1251
Eye left smile 65.20 57.35 10.07 4.51 15.63 3.91 0.0017*
Total area 56.6 49.6 7.08 2.29 11.86 3.17 0.00679*
Legend: T0baseline; T14after 14 days of using a pillow; *p < 0.05.
B. Poljsak et al.
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Table 2. Wrinkle density at the baseline and following 28 days of sleeping on a pillow at different anatomical regions of the
face.
T0 T28 Mean of the differences 95% confidence interval t-value p-value
Average Average Low Upper
Front 46.26 47.35 0.71 3.15 1.72 0.63 0.5387
Eye right 50.66 44.71 5.78 1.99 9.57 3.29 0.0057*
Eye right smile 56.01 51.07 5.14 0.88 9.40 2.60 0.0216*
Eye left 52.26 45.92 6.92 1.76 12.09 2.89 0.0124*
Eye left smile 65.20 54.57 11.71 4.22 19.20 3.37 0.0049*
Total area 56.6 44.4 12.20 1.76 15.46 2.69 0.01737*
Legend: T0baseline; T28after 28 days of using a pillow; *p < 0.05.
Table 3. Wrinkle density after 14 and 28 days of sleeping on a pillow at different anatomical regions of the face.
T14 T28 Mean of the differences 95% confidence interval t-value p-value
Average Average Low Upper
Front 45.85 47.35 3 6.94 0.94 1.65 0.1236
Eye right 45.64 44.71 / 4.42 4.42 0 1.0000
Eye right smile 45.64 44.71 0.61 5.85 4.62 0.25 0.8022
Eye left 51.28 45.85 4.23 1.49 9.95 1.60 0.1335
Eye left smile 57.35 54.57 2.78 5.31 7.92 0.43 0.6746
Total area 49.6 44.4 5.2 7.95 11.01 0.34 0.7339
Legend: T14after 14 days of using a pillow; T28after 28 days of using a pillow; *p < 0.05.
neutral and smiling facial expressions after sleeping on the anti-wrinkle pillow for 28 days. To test this hypothe-
sis, participants were divided into two groups, those who reportedly sleep predominantly either on the left or on
the right side of the body. Sleeping habits of participants were as follows: twelve participants reported that they
sleep predominantly on the left or both sides of the body, six predominantly on the right or both sides, eleven on
both sides, three on their stomach, and one on her back (Table 4 and Table 5). Results did not reveal statistical-
ly significant reduction in wrinkle density in a neutral facial expression, however, wrinkle density decreased
around the left periocular area in participants who claimed to sleep predominantly on their left (or both) side of
the body while smiling, and the difference was statistically significant (Table 5) (p = 0.0490). Finally, we inves-
tigated if sleeping position influences overall density of facial wrinkles. To test this hypothesis, participants
were divided into two groups, those who sleep predominantly on either side of their bodies and those who sleep
on their backs and/or stomachs. Total wrinkle area was compared in both groups at time T0 and T28 and average
improvement/reduction of facial wrinkles was evaluated (Table 6). Those participants who sleep on either side
of their bodies (left or right) (N = 11) showed statistically significant reduction in total wrinkle improvement (p
= 0.0109) compared to those who sleep on their back (N = 1) and stomach (N = 3).
4. Discussion
Stegman postulated for the first time in his paper “Sleep Creases” published in 1987 the likely aetiology of
sleeping creases, which he observed to form diagonally on the cheeks and the lower face and vertically on the
forehead [14]. It was noticed later that sleeping wrinkles can also manifest as the nasolabial folds and as “crow’s
feet” around the eyes. Stegman also noticed that sleeping wrinkles are different than wrinkles caused by sun
damage, due to smoking, frowning or laughing, since they are caused by specific sleeping behaviour and be-
come deepened over time if sleeping patterns do not change. His theory was later confirmed by Fulton and Ga-
minchi [15] and Sarifakioğlu et al. [9].
B. Poljsak et al.
54
Table 4. Comparison of sleeping position (left vs. right side of the body) and wrinkle improvement/reduction at the both pe-
riocular areas in a neutral facial expression after sleeping on an anti-wrinkle pillow for 28 days.
ΔT (T0 T28)
Left eye ΔT (T0 T28)
Right eye Mean of the
differences
95% confidence interval t-value p-value
Average Average Low Upper
Sleeping on the right or
both sides (N = 6) 5.83 6.66 0.83 8.61 6.94 0.27 0.7941
Sleeping on the left or
both sides (N = 12) 8.25 7.25 1 4.06 6.06 0.434 0.6721
Legend: ΔTaverage change of wrinkles’ densities; *p < 0.05.
Table 5. Comparison of sleeping position (left vs. right side of the body) and wrinkle improvement/reduction at both peri-
ocular areas while smiling after sleeping on an anti-wrinkle pillow for 28 days.
ΔT (T0 T28)
Left eye smile ΔT (T0 T28)
Right eye smile Mean of the
differences
95% confidence interval t-value p-value
Average Average Low Upper
Sleeping on the right or
both side (N = 6) 9.33 3.33 6 12.8 24.8 0.016 0.4513
Sleeping on the left or
both side (N = 12) 14.58 6.08 8.5 67.3 18.8 5.663 0.0490*
Legend: ΔTaverage change of the wrinkle density; *p < 0.05.
Table 6. Comparison of sleeping position (left/right side of the body vs. back/stomach) and total wrinkle improvement/
reduction.
ΔT (T0 T28)
Sleeping on either side ΔT (T0 T28)
Sleeping on back or stomach Mean of the
differences
95% confidence interval t-value
p-value
Average Average Low Upper
Total wrinkle
improvement 9.63 5.8 8.5 67.3 18.8 5.66 0.0109*
Legend: ΔTchange in average percentage of wrinkles; *p < 0.05.
According to Hillebrand et al., age at onset and rate of persistent facial wrinkles depend on both, the cumula-
tive amount of mechanical stress (frequency of temporary wrinkles) and reduced skin elasticity due to cumula-
tive harmful environmental influences, such as sun exposure [1]. The skin progressively loses its elasticity due
to decreased synthesis of procollagen I and III, reduced elastin gene expression in the dermis, and decreased
proliferative capacity of the skin cells and intercellular matrix synthesis [16] [17]. Considering that most people
sleep about one third of their life, prolonged and repeated distortion of their facial skin will eventually lead to
premature wrinkle formation. Nasolabial folds and wrinkles around periocular areas are particularly noticeable
on mornings after waking up. The depth of wrinkles usually reduces during day because the gravity causes the
cheeks to pull down the skin around the eyes thereby reducing wrinkles. However, continuous and repetitive
pressure on the face during sleeping leads to formation of permanent wrinkles. Fulton and Gaminchi observed
that sleep lines were related to facial attachments of the superficial musculoaponeurotic system and recom-
mended to release them with a carbon dioxide laser in order to achieve a good clinical outcome [15]. We present
an alternative solution to reduce sleep-related facial deformities and wrinkles while sleeping. Sleeping on a spe-
cially designed pillow resulted in significant decrease in wrinkle density. The average reduction in total investi-
gated area of the face (expressed as the density of wrinkles per observed skin surface) was approximately 7%
after 14 days, and 12% after 28 days (Table 1 and Table 2). Similar results were obtained by Beak et al., who
demonstrated that sleeping on pillowcases which contained copper-impregnated fibres, reduce depth of skin
wrinkles by approximately 9% [10]. On the other hand, improvement in wrinkle density at frontal area of the
face (the nasolabial folds and the forehead) could not be observed, although we expected deterioration of obli-
que wrinkles located unilaterally on the left and right side of the forehead, since the pillow was not designed to
release the pressure of the forehead. Two possible explanations would be that participants were too young and
B. Poljsak et al.
55
had too elastic skin and that evaluation was made hours after waking up when temporary wrinkles disappeared.
Since evaluation of frontal pictures included the forehead and nasolabial folds together, the possible improve-
ment in nasolabial folds and/or deterioration in forehead wrinkles could not be observed because we did not
analyse those two regions of the face separately. The further improvement in wrinkle density after sleeping on a
pillow from a 2nd week to a 4th week (comparison of T14 and T28) could also not be observed (Table 3), most
probably because wrinkles become less noticeable already after few days of cessation of the pressure on delicate
parts of the face and did not improve further. We also found in our study that those participants who were
sleeping on either side of their bodies (left or right) showed statistically significant reduction in total wrinkle
density compared to those who were sleeping on their back and stomach. This could mean that people who sleep
predominantly on their left or right side of the body could benefit more from using the anti-wrinkle pillow com-
pared to those who sleep predominantly on their back or stomach. Furthermore, wrinkle density improved
around the left periorbital area in participants who reportedly sleep predominantly on their left side of the body
while smiling but not in relaxed facial expression. In those participants we demonstrated improvement of tem-
porary wrinkles despite of their relatively young age when one does not expect dramatic decrease in skin elastic-
ity and severe sun damage. This further supports the benefit of an anti-wrinkle pillow. We did not observe any
correlation between reduction in wrinkle density and age of participants most likely because age differences of
our participants were too small to observe dramatic reduction in skin elasticity.
5. Conclusion
Sleeping on the specially designed pillow results in a significant reduction of facial skin wrinkle density. Redi-
stribution of the mechanical stress on the delicate areas of the face during sleep can significantly slow down the
rate and extent of facial wrinkles formation, especially in users who tend to sleep predominantly on sides of their
bodies. The anti-wrinkle pillow may represent an effective method to prevent sleeping wrinkles.
Acknowledgements
Authors would like to thank Florian Probst for his valuable comments. Pillows were donated by Maremico,
d.o.o. The first author declares the following: Prof. Dr. Borut Poljsak is a consultant for the company Maremico,
d.o.o. All other authors do not report any conflicts of interest. No grants or other financial assistance was pro-
vided for the study.
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... Two smaller studies revealed that the severity of sleep lines could be reduced with an appropriate pillow or pillowcase. The study of Poljsak et al., [4] revealed that the average reduction of wrinkles in total investigated area of the face (expressed as the density of wrinkle per surface skin) was approximately 12% after 28 days of sleep on a specially-designed pillow. This study, however, has three important limitations: a small sample size, short duration (only one month), and lacks a control group. ...
Article
The duration of sleep and the position of the face while resting on a pillow have a negative impact on the facial skin appearance and may lead to the formation of sleep wrinkles. Sleep lines occur when there is repetitive, long-term tension on the facial skin, which pushes or pulls the skin in a direction that is perpendicular to the direction of the muscles of the face. These lines tend to be more vertically oriented than expression lines and can be found on the forehead, around the eyebrows , the eyes, the cheeks, the chin, and the nasolabial folds. Our studies revealed that the average reduction of wrinkles in total investigated area of the face (expressed as the density of wrinkle per surface skin) was approximately 12% after 28 days of sleep on a specially-designed pillow. The specially designed anti-wrinkle pillows eliminate the pressure on the cheeks, the eyes and the mouth during sleep. Many such pillows have been designed to reduce the aging process and to encourage users to sleep in specific positions. Evidence supporting the claim that a special pillow prevents wrinkles was presented. Nevertheless, prolonged human studies are required to further elucidate the role of sleeping on appearance of facial wrinkles.
... Two smaller studies revealed that the severity of sleep lines could be reduced with an appropriate pillow or pillowcase. The study of Poljsak et al., [4] revealed that the average reduction of wrinkles in total investigated area of the face (expressed as the density of wrinkle per surface skin) was approximately 12% after 28 days of sleep on a specially-designed pillow. This study, however, has three important limitations: a small sample size, short duration (only one month), and lacks a control group. ...
Article
The duration of sleep and the position of the face while resting on a pillow have a negative impact on the facial skin appearance and may lead to the formation of sleep wrinkles. Sleep lines occur when there is repetitive, long-term tension on the facial skin, which pushes or pulls the skin in a direction that is perpendicular to the direction of the muscles of the face. These lines tend to be more vertically oriented than expression lines and can be found on the forehead, around the eyebrows , the eyes, the cheeks, the chin, and the nasolabial folds. Our studies revealed that the average reduction of wrinkles in total investigated area of the face (expressed as the density of wrinkle per surface skin) was approximately 12% after 28 days of sleep on a specially-designed pillow. The specially designed anti-wrinkle pillows eliminate the pressure on the cheeks, the eyes and the mouth during sleep. Many such pillows have been designed to reduce the aging process and to encourage users to sleep in specific positions. Evidence supporting the claim that a special pillow prevents wrinkles was presented. Nevertheless, prolonged human studies are required to further elucidate the role of sleeping on appearance of facial wrinkles.
... Two smaller studies revealed that the severity of sleep lines could be reduced with an appropriate pillow or pillowcase. The study of Poljsak et al., [4] revealed that the average reduction of wrinkles in total investigated area of the face (expressed as the density of wrinkle per surface skin) was approximately 12% after 28 days of sleep on a specially-designed pillow. This study, however, has three important limitations: a small sample size, short duration (only one month), and lacks a control group. ...
Article
Full-text available
The duration of sleep and the position of the face while resting on a pillow have a negative impact on the facial skin appearance and may lead to the formation of sleep wrinkles. Sleep lines occur when there is repetitive, long-term tension on the facial skin, which pushes or pulls the skin in a direction that is perpendicular to the direction of the muscles of the face. These lines tend to be more vertically oriented than expression lines and can be found on the forehead, around the eyebrows, the eyes, the cheeks, the chin, and the nasolabial folds. Our studies revealed that the average reduction of wrinkles in total investigated area of the face (expressed as the density of wrinkle per surface skin) was approximately 12% after 28 days of sleep on a specially-designed pillow. The specially designed anti-wrinkle pillows eliminate the pressure on the cheeks, the eyes and the mouth during sleep. Many such pillows have been designed to reduce the aging process and to encourage users to sleep in specific positions. Evidence supporting the claim that a special pillow prevents wrinkles was presented. Nevertheless, prolonged human studies are required to further elucidate the role of sleeping on appearance of facial wrinkles.
Patent
Full-text available
Methods and systems are disclosed to realistically simulate facial wrinkle aging of a person using a neutral state (natural look) image and one or more expression images (e.g., smile, frown, pout, wink) that induce wrinkles. The neutral and expression images are processed to simulate wrinkle aging by registering the wrinkles that are visible in the expression image onto the neutral image, thereby generating a wrinkle-aged simulated image. Advantageously, a person's own wrinkle histological data is utilized, hence providing an accurate and realistic wrinkle aging simulation. Similarly, the neutral image is processed to eliminate all visible wrinkles thereby generating a wrinkle de-aged simulation image. Additionally, blending of a neutral image with an aged or de-aged simulation image is disclosed, where the degree of blending is based on statistical modeling of skin condition with age and/or expected outcome of a particular type of treatment. The methods and systems disclosed have wide applicability, including, for example, areas such as dermatology, cosmetics and computer animation, among others.
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Skin aging appears to be the result of two overlapping processes, intrinsic and extrinsic. It is well accepted that oxidative stress contributes significantly to extrinsic skin aging, although findings point towards reactive oxygen species (ROS) as one of the major causes of and single most important contributor; not only does ROS production increase with age, but human skin cells' ability to repair DNA damage steadily decreases over the years. We extrapolated mechanisms of intrinsic oxidative stress in tissues other than skin to the skin cells in order to provide effective anti-aging strategies and reviewed the literature on intrinsic skin aging and the role of oxidative stress.
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Full-text available
The study addressed the influence of sleep as an important but overlooked contributory factor to the formation and progression of facial wrinkles and an alternative pillow was designed to reduce them. Fifteen healthy young participants of both sexes (aged 26-42 years) volunteered for this study. We used a transparent PVC pillow filled with air to demonstrate mechanical forces and deformations of the face as a consequence of sleeping on a pillow. We used a Podometer (PDMTR) (integrated fluorescent luminaire lamp) as a diagnostic device to visualize and to document the imprint of facial deformities on a glass, as seen during sleeping. We observed various facial deformities and wrinkles during sleep ('crow's feet' fine lines, lines around the mouth, flattening of the forehead, blunting of the nasofrontal angle, melolabial and nasolabial folds) and design an alternative pillow to reduce them by redistributing the pressure from the wrinkling parts of the face.
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Damage to human skin due to ultraviolet light from the sun (photoaging) and damage occurring as a consequence of the passage of time (chronologic or natural aging) are considered to be distinct entities. Photoaging is caused in part by damage to skin connective tissue by increased elaboration of collagen-degrading matrix metalloproteinases, and by reduced collagen synthesis. As matrix metalloproteinase levels are known to rise in fibroblasts as a function of age, and as oxidant stress is believed to underlie changes associated with both photoaging and natural aging, we determined whether natural skin aging, like photoaging, gives rise to increased matrix metalloproteinases and reduced collagen synthesis. In addition, we determined whether topical vitamin A (retinol) could stimulate new collagen deposition in sun-protected aged skin, as it does in photoaged skin. Sun-protected skin samples were obtained from 72 individuals in four age groups: 18-29 y, 30-59 y, 60-79 y, and 80+ y. Histologic and cellular markers of connective tissue abnormalities were significantly elevated in the 60-79 y and 80+ y groups, compared with the two younger age groups. Increased matrix metalloproteinase levels and decreased collagen synthesis/expression were associated with this connective tissue damage. In a separate group of 53 individuals (80+ y of age), topical application of 1% vitamin A for 7 d increased fibroblast growth and collagen synthesis, and concomitantly reduced the levels of matrix-degrading matrix metalloproteinases. Our findings indicate that naturally aged, sun-protected skin and photoaged skin share important molecular features including connective tissue damage, elevated matrix metalloproteinase levels, and reduced collagen production. In addition, vitamin A treatment reduces matrix metalloproteinase expression and stimulates collagen synthesis in naturally aged, sun-protected skin, as it does in photoaged skin.
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Copper up-regulates the secretion of extracellular skin proteins and stabilizes the extracellular matrix once formed. As copper can be absorbed through intact skin, we reasoned that sleeping on pillowcases containing copper-impregnated fibers would reduce skin wrinkles. Demonstrate that sleeping on pillowcases containing copper-impregnated fibers reduce facial skin wrinkles. An 8-week, double blind, parallel, randomized study was carried out, in which healthy volunteers, aged 30-60, used either copper oxide-containing pillowcases (1% weight/weight) (test group, n = 30) or control pillowcases without copper (control group, n = 31). Skin conditions of the subjects were evaluated by visual grading by two expert graders and by 3D Image Analysis GFM PRIMOS(®) at baseline (before treatment) and following 4 and 8 weeks of sleeping on the pillowcases. The use of the copper oxide-containing pillowcase resulted in significant decrease of crow's feet after 4 (P = 0.01) and 8 (P = 0.002) weeks, but none was observed in the control group, as determined by the expert graders. On the basis of the 3D measurements, three roughness (R) parameters were improved after 4 and 8 weeks (P < 0.02) and the Rmax parameter at 8 weeks (P = 0.016) in the test group, but there were no changes in the R-parameters during the course of the study in the control group. The average reduction per month in the R-parameters was approximately 9%. No adverse reactions were observed or reported during the 8 weeks study. Sleeping on copper oxide-containing pillowcases results in reduction of wrinkles depth and overall improvement of skin appearance.
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background. A new method for treating facial rhytides and acne scars with nonablative laser and light source techniques has recently been introduced. Given the inherent limitations of photographic and clinical evaluation to assess subtle changes in rhytides and surface topography, a new noninvasive objective assessment is required to accurately assess the outcomes of these procedures.objective. The purpose of this study was to measure and objectively quantify facial skin using a novel, noninvasive, In-vivo method for assessing three-dimensional topography. This device was used to quantify the efficacy of five treatment sessions with the 1064 nm QS Nd:YAG laser for rhytides and acne scarring, for up to six months following laser treatment.methods. Two subjects undergoing facial rejuvenation procedures were analyzed before and after therapy using a 30-mm, three-dimensional microtopography imaging system (PRIMOS, GFM, Teltow, Germany). The imaging system projects light on to a specific surface of the skin using a Digital Micromirror Device (DMD™ Texas Instruments, Irving, TX) and records the image with a CCD camera. Skin Surface microtopography is reconstructed using temporal phase shift algorithms to generate three-dimensional images. Measurements were taken at baseline, at various times during the treatment protocol, and then at three and six-month follow-up visits. Silicone skin replicas (FLEXICO, Herts, England) were also made before and after the laser treatment protocol for comparison to In-vivo acquisition.results. Skin roughness decreased by 11% from baseline after three treatment sessions in the wrinkles subject, while a 26% improvement of skin roughness was recorded by 3D In-vivo assessment six months following the fifth treatment session. The subject with acne scarring demonstrated a 33% decrease in roughness analysis after three treatment sessions by 3D In-vivo assessment. A 61% improvement in surface topography was recorded 3-months following the fifth treatment session, which was maintained at the 6-month follow-up.conclusion. Three-dimensional In-vivo optical skin imaging provided a rapid and quantitative assessment of surface topography and facial fine lines following multiple treatment sessions with a 1064-nm QS Nd:YAG laser, correlating with clinical and subjective responses. This imaging technique provided objective verification and technical understanding of nonablative laser technology. Wrinkle depth and skin roughness decreased at the three and six-month follow-up evaluations by 3D In-vivo assessment, indicating ongoing dermal collagen remodeling after the laser treatment protocol. Future applications may include comparison of nonablative laser technology, optimization of treatment regimens, and objective evaluation of other aesthetic procedures performed by dermatologists.
Article
While cumulative lifetime sun exposure is well recognized as having an important role in the progression of facial wrinkling, the role of facial expression has largely been overlooked, in part due to the lack of comprehensive longitudinal data on the change in both expression lines and persistent wrinkles with age. To track the detailed pattern of facial wrinkling in the same group of people over several years and to verify that expression lines evolve into persistent wrinkles. In addition, to identify factors predictive of a faster or slower rate of wrinkling. Standardized images were captured at baseline and at 8 years of 122 women (ages 10-72 years, skin types I-VI) with and without a smiling expression. The wrinkle pattern with expression at baseline was compared with the pattern without expression at 8 years. Severity of facial wrinkling was quantified using computer-based image analysis. Skin colour, hydration, sebum and pH were measured at baseline. A structured questionnaire captured demographic and lifestyle data at baseline and at 8 years. Each subject's unique pattern of persistent facial wrinkling observed without expression at year 8 was predicted by the pattern of lines observed with a smiling expression at baseline. Having a drier, more alkaline stratum corneum, a lighter complexion, being middle-aged (40s) or becoming menopausal were associated with faster persistent wrinkling. Repeated skin flexure during facial expression causes persistent wrinkles. The pattern of expression lines predicts the pattern of future persistent wrinkles. Certain intrinsic and extrinsic factors are not causative, but influence the rate, of facial wrinkling.