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Efficacy and Safety of a New Cosmeceutical Regimen Based on the Combination of Snail Secretion Filtrate and Snail Egg Extract to Improve Signs of Skin Aging

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Abstract and Figures

BACKGROUND: Two extracts derived from the gastropod Cryptomphalus aspersa have been shown to have dermal regeneration properties: SCA® (secretion filtrate) with fibroblast growth factor-like activity and IFC®-CAF (cellular activating factor), a snail egg extract with skin stem cell activation activity. OBJECTIVE: The objectives of this study were to evaluate the synergic antiaging activity and tolerability of SCA and IFC-CAF in a combined regimen compared to vehicle as a placebo control. METHODS: A three-month, single-center, double-blinded, randomized, vehicle-controlled trial assessed the effects of a daily skincare routine divided into two treatment phases, as follows: intensive (1 month) and maintenance (2 months). Fifty women, aged 45-65 years, with signs of photoaging were randomized to receive either the active ingredients (n=30) or vehicle (n=20). Clinical evaluations included objective measurements of barrier function and skin hydration, elasticity, and color/brightness. Subjective assessments were conducted according to the Rao-Goldman and Glogau scales for wrinkles, the Patient Global Assessment (PGA) scale and Investigator Global Assessment (IGA) scale. RESULTS: Subjects in the active treatment group experienced reductions in transepidermal water loss and significant improvements in skin roughness, firmness, and elasticity. Both groups showed significant improvements in fine lines and wrinkles. PGA and IGA assessments indicated greater improvement in the active treatment group. CONCLUSION: The active snail extract treatment appears to be effective in improving signs of skin aging in women 45 to 65 years old. Larger randomized, controlled studies are needed to confirm our results.
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JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY March 2020 • Volume 13 • Number 3
ORIGINAL RESEARCH
S
Skin aging includes intrinsic aging, a
process attributable to the passage of the
time, and extrinsic aging, which involves
changes induced by exogenous factors, such
as pollution and solar radiation. Both types of
aging demonstrate abnormal elastin synthesis
and collagen degradation. Degeneration of
the extracellular matrix (ECM) is accelerated
due, in part, to the increase in number and
transcription rate of matrix metalloproteinases
(MMPs).1 These proteolytic enzymes are
synthesized by broblasts and, to date, more
than 20 dierent types have been identied.
Aging skin shows an increased expression
of MMPs, mainly MMP-1 and MMP-3.2
Modications are sometimes detected in the
tissue inhibitors of MMPs that bind to these
enzymes to prevent them from degrading the
matrix.1
In the skin, specic growth factors (GF)
regulate vital cellular activities, including
mitogenesis, motogenesis, angiogenesis,
chemotaxis, and the formation of the ECM. GFs
are involved in wound healing, through their
abillity to reverse the eects of collagenases,
increase collagen levels, and decrease
tissue inammation.3 Clinical studies have
demonstrated that topical application of
human or animal-derived GFs or the injection
of autologous GFs can increase dermal collagen
synthesis, thus reducing signs of skin aging,
such as ne lines and wrinkles.3
Two extracts derived from the gastropod
Cryptomphalus aspersa have demonstrated
dermal regeneration properties: SCA®
(secretion ltrate) with broblast growth
factor-like activity, and IFC®-CAF (cellular
activating factor), a snail egg extract that
activates skin stem cells.4–6 These extracts
are commercially available under the trade
name Endocare, manufactured by Cantabria
Labs (Industrial Farmacéutica Cantabria SA,
Madrid, Spain). The primary objective of this
study was to evaluate the synergistic antiaging
activity of SCA (secretion ltrate) and IFC-CAF
(cellular activating factor) in a combined
cosmeceutical regimen, compared to vehicle as
placebo control. The secondary objective was
to evaluate the tolerability of this combined
regimen.
ABSTRACT
BACKGROUND: Two extracts derived from the
gastropod Cryptomphalus aspersa have been
shown to have dermal regeneration properties:
SCA® (secretion ltrate) with broblast growth
factor-like activity and IFC®-CAF (cellular
activating factor), a snail egg extract with skin
stem cell activation activity. OBJECTIVE: The
objectives of this study were to evaluate the
synergic antiaging activity and tolerability of SCA
and IFC-CAF in a combined regimen compared
to vehicle as a placebo control. METHODS: A
three-month, single-center, double-blinded,
randomized, vehicle-controlled trial assessed the
eects of a daily skincare routine divided into two
treatment phases, as follows: intensive (1 month)
and maintenance (2 months). Fifty women,
aged 45–65 years, with signs of photoaging
were randomized to receive either the active
ingredients (n=30) or vehicle (n=20). Clinical
evaluations included objective measurements
of barrier function and skin hydration, elasticity,
and color/brightness. Subjective assessments
were conducted according to the Rao-Goldman
and Glogau scales for wrinkles, the Patient Global
Assessment (PGA) scale and Investigator Global
Assessment (IGA) scale. RESULTS: Subjects in the
active treatment group experienced reductions
in transepidermal water loss and signicant
improvements in skin roughness, rmness,
and elasticity. Both groups showed signicant
improvements in ne lines and wrinkles. PGA and
IGA assessments indicated greater improvement
in the active treatment group. CONCLUSION:
The active snail extract treatment appears to be
eective in improving signs of skin aging in women
45 to 65 years old. Larger randomized, controlled
studies are needed to conrm our results.
KEY WORDS: Cryptomphalus aspersa, snail
secretion, snail egg extract, skin aging, photoaging
Efficacy and Safety of a New
Cosmeceutical Regimen Based on the
Combination of Snail Secretion Filtrate
and Snail Egg Extract to Improve Signs
of Skin Aging
by VANESSA ZIYING LIM, MBBS; ANGELINE ANNING YONG, MBBS;
WEE PING MELISSA TAN, MBBS; XIAHONG ZHAO, BSC (HONS), PhD;
MARIA VITALE, MD; and CHEE LEOK GOH, MBBS
Drs. Lim, Yong, Tan, Zhao, and Goh are with the National Skin Centre in Singapore. Dr. Vitale is with the Medical Department,
Cantabria Labs in Madrid, Spain.
J Clin Aesthet Dermatol. 2020;13(3):31–36
FUNDING: This work was supported by grants from Cantabria Labs.
DISCLOSURES: Dr. Goh is an advisory board member for Cantabria Labs. Dr. Vitale is an employee of Cantabria Labs. The
other authors have no conicts of interest relevant to the content of this article.
CORRESPONDENCE: Ziying Vanessa Lim, MBBS; Email: drvanessalim@gmail.com
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JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY March 2020 • Volume 13 • Number 3
ORIGINAL RESEARCH
METHODS
This was a three-month, single-center,
double-blinded, randomized, placebo-
controlled trial designed to assess the eects of
a daily skin care routine comprising an intensive
phase (1 month in duration) and a maintenance
phase (2 months in duration) conducted
at the National Skin Centre in Singapore.
Fifty women, aged 45 to 65 years old, with
Fitzpatrick Skin Phototypes II to V and signs of
photoaging (Rao-Goldman wrinkle score7 of
2–4) were recruited. Subjects were enrolled
after being informed regarding research
participation and potential risks, benets of
participation, and condentiality concerns;
informed consent forms (translated into four
languages) were received from all participants.
Subjects included in this study agreed to
discontinue their own existing facial and eye
moisturizers, but were allowed to continue
other skincare products, such as cleansers
and cosmetics. Exclusion criteria included
presence of any uncontrolled systemic disease,
a signicant history or current evidence of
a medical, psychological, or other condition
that, by the investigator’s discretion, would
preclude enrollment into the study, known
hypersensitivity to any of the components
of the study products, use of any systemic
steroids six months prior to the study period,
previous treatment with botulinum toxin,
ller, or biostimulatory molecule injections
to the facial area, facial dermabrasion, laser
treatments, microdermabrasion, or chemical
peels six months prior to the study, recent
excessive facial exposure to sunlight or
articial ultraviolet light (e.g., tanning beds),
and recent history or active presence of any
facial skin condition that might interfere
with the diagnosis or evaluation of study
parameters (e.g., moderate-to-severe acne
vulgaris, atopic dermatitis, psoriasis, rosacea,
seborrheic dermatitis, and excessive facial hair
or coloration).
This study was approved by the institutional
ethics committee. Subjects were randomized to
receive either the active ingredients (n=30) or
vehicle only (n=20).
Study products. Endocare Tensage
Serum (Cantabria Labs, Madrid, Spain) is a
cosmeceutical product based on the secretion
of the mollusc Cryptomphalus aspersa (SCA) and
other active ingredients, including Tensderm,
vitamins C and E, nicotinamide, dismutin,
and mimosa extract. Endocare Cellage/
CellPro products are based on a combination
of IFC-CAF, Retinsphere® technology, and
Wharton Gel Complex® (WGC), with additional
ingredients added to enhance antioxidant,
anti-inammatory and antiglycation activity.5
A new Endocare Cellage/CellPro Concentrate
formulation for the treatment of skin aging
contains a higher concentration of the active
ingredients IFC-CAF and WGC. Endocare
Cellage/CellPro products have demonstrated
clinical improvement in signs of skin aging.8
Because the main trigger for photoaging is sun
exposure, the treatment regimen also included
a photoprotector sun protection factor (SPF)
50 (Heliocare Gel SPF50; NeoAsia, Singapore),
which was used daily by all study subjects.
Study regimen. In the intensive phase
(i.e., rst month), participants were instructed
to apply Endocare Tensage Serum or vehicle
in the morning in sucient quantity to cover
the entire face. After complete absorption of
the serum, participants applied the sunscreen
provided. At night, participants applied
approximately 2 to 3 pumps of the intensive
Endocare Cellage/CellPro Concentrate or
vehicle.
During the maintenance phase (second and
third months), participants were instructed to
apply the Endocare Tensage Serum or placebo
vehicle in the mornings in sucient quantity
to cover the entire face. After complete
absorption, they were instructed to apply
the sunscreen provided. At night, they were
instructed to apply 2 to 3 pumps of Endocare
Cellage/CellPro Cream or placebo vehicle to
their face.
All patients were educated on the need for
sun protection and instructed to stop all other
topical facial products other than their own
cleansers and cosmetics.
Assessment methods. Clinical evaluation
included subjective assessments by patients
and physician investigators for wrinkles,
Investigator (IGA) and Patient Global
Assessments (PGA), and a self-assessment
patient questionnaire. Objective skin
measurements included transepidermal water
loss (TEWL), skin hydration, skin elasticity, and
skin brightness.The Rao-Goldman Five-Point
Scale7 is scored by physicians and assesses
wrinkles at the perioral and periocular areas.
The Glogau Four-Point scale9 is also scored
by physicians and assesses the presence of
wrinkles at rest or in motion.
Physician perception of subject improvement
was evaluated according to the IGA scale and
the Investigator Skin Condition evaluation,
which included the parameters of skin
roughness, lack of skin brightness, lack
of elasticity, pore prominence, mottled
pigmentation, and lines and wrinkles at
baseline (T0) and during the two follow-up
visits (T30 and T90). Physicians also assessed
tolerability based on symptoms of stinging,
burning, itching, erythema, desquamation, and
edema at both follow-up visits (T30 and T90).
Subject-reported assessment of their
own overall skin condition was evaluated
at each study visit according to a PGA scale
and a Self-Assessment of Facial Skin Quality
Questionnaire.
TEWL was measured on the cheek area
by the Tewameter® 300 (Courage+Khazaka,
electronic GmbH, Köln, Germany). A decreased
TEWL index value signies an improvement
of skin barrier functions.10 Skin hydration
was also measured on the cheek area by the
Corneometer® CM 825 (Courage+Khazaka,
electronic GmbH, Köln, Germany). The
Corneometer® measures the change in the
dielectric constant as the stratum corneum
hydration level aects the capacitance of a
precision capacitor. A higher hydration index
value reects greater hydration.11
The Cutometer® (Courage+Khazaka,
electronic GmbH, Köln, Germany) quantitatively
evaluates the mechanical and viscoelastic
parameters of skin rmness (R0) and elasticity
(R2). The rmness of skin is determined at
baseline, and elasticity refers to the resistance
to mechanical force versus the ability of skin to
return to its original state after suction pressure
is applied.12
The quantitative evaluation of whitening/
brightening was measured by the Mexameter®
MX18 (Courage+Khazaka, electronic GmbH,
Köln, Germany) on the cheek. With this device,
a high-power halogen lamp illuminates the
skin through optical bers. The light is analyzed
and a melanin index of the skin pigmentation
is calculated. The melanin index readings are
expected to reduce proportionately with skin
whitening.13
Photographic documentation with the
VISIA® camera system (software version 6.4.2;
Caneld Scientic, Parsippany, New Jersey)
was performed at baseline (T0) and during the
33
JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY March 2020 • Volume 13 • Number 3
ORIGINAL RESEARCH
follow-up examinations (T30 and T90). Images
were taken with standardized camera settings
and standardized positioning of the subject.
Statistical analysis. A sample size of 50
patients (n=20, placebo group; n=30, active
treatment group) was estimated assuming a
power of 80 percent and a level of signicance
of ve percent (p<0.05), based on variability
of the parameters found in previous clinical
studies. To test the possible signicant
dierences in the study outcomes evaluated
at baseline (T0), one month (T30), and three
months of treatment (T90), generalized linear
mixed-eect models with a within-subjects
factor to account for repeated measurements
taken from each individual, a treatment factor
(active vs. vehicle), time factor (T90 vs. T30
vs. T0), and an interaction term between
the treatment factor and time factor were
performed. For ordinal study outcomes, a
ordinal logistic link function was applied,
whereas a linear link function was applied for
study outcomes reported using an interval/ratio
scale. Descriptive statistics were summarized
using means and standard deviations (SDs)
for interval/ratio variables and medians
and ranges for ordinal variables. The age of
participants between treatment groups was
compared using a two-sample Student’s t-test.
Skin tolerability parameters, PGA score, and IGA
score between treatment groups at each study
visit were compared using the Mann-Whitney U
test. Signicance was tested at a level of 0.05.
All statistical analyses were conducted using
R version 3.5.3 (R Foundation for Statistical
Computing, Vienna, Austria).14
RESULTS
The mean ages were 54.3 years (range:
45–54.3, SD: 6.0) and 55.8 years (range:
45–65, SD: 5.1) in the vehicle and active
groups, respectively. There was no statistical
dierence in age between the vehicle (mean:
54.3; SD: 6.0 years) and active group (mean:
55.8; SD: 5.1 years) (p=0.361).
Objective measurements at the follow-up
visits are summarized in Figure 1. Subjects
in the active treatment group experienced
signicantly greater improvement in the
reduction of TEWL compared to the vehicle
group at T90 (p=0.026). Subjects in the
active treatment group also demonstrated
signicantly greater improvement in skin
rmness, measured by the Cutometer®, at both
the 30-day (p=0.012) and 90-day (p=0.005)
follow-up visits and in skin elasticity at T90
(p=0.024), compared to the vehicle group. The
active treatment group demonstrated increased
hydration index values according to the
Corneometer® at both T30 and T90, although
the improvement was not signicantly dierent
between the active treatment and vehicle
groups. Both the active treatment and vehicle
groups showed a borderline nonsignicant
reduction in melanin index values measured
with the Mexameter® after 30 days of
treatment (p=0.051).
Based on the Rao-Goldman Five-Point
Scale, the active and control groups both
showed signicant improvement in periocular
(relative risk [RR]: 0.052; p=0.021) and perioral
(RR: 0.106; p=0.033) wrinkles at the end of
treatment without signicant dierences
between the groups; results on the Glogau
scale were similar.
Per the Investigator Skin Condition
evaluation, our physicians assessed the
parameters of skin roughness, lack of skin
FIGURE 1. Objective assessment outcomes by treatment group
FIGURE 2. Subjects in the active treatment group demonstrated signicant improvement in skin roughness relative to
vehicle
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JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY March 2020 • Volume 13 • Number 3
ORIGINAL RESEARCH
brightness, lack of elasticity, pore prominence,
mottled pigmentation, and lines and wrinkles
at baseline and during the two follow-up
visits. Subjects in the active treatment
group demonstrated signicantly greater
improvement in skin roughness compared to
those in the vehicle group at the end of the
study (p=0.002) (Figure 2). Subjects in both
treatment groups experienced signicant
improvement in skin brightness (p<0.001),
elasticity (p=0.019), mottled pigmentation
(p=0.027), and lines and wrinkles (p=0.004)
at the end of the study, but there was no
signicant dierence between the active and
vehicle-treated groups (Figures 3 and 4).
The global assessment performed by the
researcher (IGA) greater improvement in the
active group compared to the vehicle group
at one month after treatment and at the last
follow-up visit. The statistical signicance
was reached after one month of treatment
(79.3% vs. 36.8%; p=0.005) (Figure 5). The
improvement assessed using the PGA was
greater in the active group at both visits
compared to the vehicle group. The results of
both PGA and IGA were in concordance.
There was a total of three withdrawals from
the study, including one subject from the
active treatment group who withdrew after
one month (T30) due to the development of
facial herpes zoster unrelated to the study
products. The other two other subjects, one
from the active treatment group and one
from the vehicle group, withdrew due to the
development of contact dermatitis, but we
were unable to ascertain if the development
was directly related to the study products or
to other reasons, due to lack of availability of
ingredients required to conduct conrmatory
patch testing.
The active treatment group reported
signicantly less stinging (p=0.002), burning
(p=0.002), and erythema (p=0.034) compared
to the vehicle group by the end of the study,
but there was no signicant dierence in
reports of itching, desquamation, and edema
between the active treatment and vehicle
FIGURE 3. VISIA® images taken at baseline, Day 30, and Day 90 showing improvement in skin brightness, improved barrier functions, and elasticity
FIGURE 4. VISIA® images taken at baseline and Day 90 showing improvement in skin brightness, improved barrier
functions, and elasticity
35
JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY March 2020 • Volume 13 • Number 3
ORIGINAL RESEARCH
groups; hence, the overall tolerability was
equal or better in the active group than in the
vehicle group.
DISCUSSION
In-vitro studies have demonstrated several
key changes in photoaged skin, including
accumulation of degenerated elastic bers,
decreased bronectin activity, and reduced
collagen synthesis, which results in dermal
thinning and a loss of structural support.15–17
SCA has GF-like activity that increases the
proliferation, migration, and activity of
broblasts and keratinocytes, improving
the cell structure and assembly of ECM.4–6,18
Several studies have previously demonstrated
that SCA is eective in the treatment of
photoaged skin.4–6,19 SCA has been shown to
prevent elastosis in aged skin and accelerate
the processes of skin regeneration and wound
healing, as evidenced by its use in injured skin
(e.g., radiodermatitis). SCA has demonstrated
faster skin regeneration after dermatological
procedures like laser or peeling.20–22
IFC-CAF is a derivative of Cryptomphalus
aspersa eggs that has regenerative properties.
It activates skin stem cells, stimulating
dierentiation and migration, and the
synthesis of ECM components.4–6 In addition,
IFC-CAF promotes improvements in skin
structure by aiding in the organization of the
cytoskeleton, which promotes epithelial tissue
regeneration,4–6 and increasing collagen and
bronectin synthesis in the dermis. Moreover,
MMP-release is downregulated.4–6 Of note,
in-vitro studies have demonstrated that IFC-
CAF induces the dierentiation of stem cells
to cutaneous cell lineages, the migration of
a human keratinocyte cell line (HaCaT cells),
primary dermal broblasts, and senescent
dermal broblasts, organizes the cytoskeletal
proteins, and enhances the production of
ECM bronectin and collagen I to prevent
cutaneous aging.6 These eects suggest that
IFC-CAF might have a clinical impact on skin
rejuvenation and regeneration of wounded
tissues and serves as a therapeutic agent for
the treatment of skin aging. This evidence
suggests that SCA and IFC-CAF might work
synergistically to rm and densify skin while
reducing lines and wrinkles.
Retinsphere, a combination of a retinoid
ester, hydroxipinacolone retinoate, and retinol
glycospheres, aids in the normalization of
epidermal proliferation and facilitates the
penetration of other active ingredients.23
Retinsphere technology has demonstrated
ecacy in improving photoaging and
melasma.23
WGC is an active ingredient derived from
the ECM of porcine umbilical cord. It is rich
in glycosaminoglycans and growth factors
(insulin-like GF-1, transforming GF-β,
broblast GF-1, broblast GF-2) and has been
shown to increase human primary broblast
proliferation while preserving their viability
and morphology.4–6 WGC has also been shown
to promote broblast migration, exhibiting a
high chemotactic capacity. The analysis of ECM
components suggests that WGC can increase
the levels of collagen I and bronectin bers
and the synthesis of collagen III and VII and
hyaluronic synthases 1 and 3.4–6
Endocare Cellage/CellPro formulations
combine IFC-CAF, Retinsphere, and WGC and
have shown signicant improvement in both
investigator and patient assessments in overall
photoaging.4–6 These ndings were related to
the increase in epidermal thickness observed
histologically and the greater levels of dermal
ECM bers, Collagen Types I and III, elastin
density, and bronectin expression.4–6 The
increase in the expression of these various
components of the ECM is thought to be
responsible for the objective and subjective
improvements in aging. This combination
therapy is also well-tolerated.4–6
Our study suggests that the synergic activity
of SCA and IFC-CAF in Endocare Tensage and
Cellage/CellPro products can produce overall
improvement in TEWL, skin roughness,
rmness, and elasticity in aging skin compared
to vehicle controls. There was also subjective
improvement in the overall appearance of skin
aging, based on the IGA and PGA assessment
scores. In particular, the results of this study
suggest that the Endocare Cellage/CellPro
regimen is well-tolerated in the Asian skin type.
In several ecacy parameters, this regimen
demonstrated superiority over the vehicle,
which contains ingredients with hydration and
moisturization ecacy but without the active
ingredients.
CONCLUSION
Subjects who received the active gastropod
extract treatment showed signicant
improvement in a number of skin aging
parameters, including TEWL, skin elasticity,
wrinkles, skin roughness, and overall IGA and
PGA assessments versus subjects who received
the vehicle. In addition, the active ingredients
were generally well tolerated by subjects in
the active treatment group. The combination
of the two extracts applied using the intensive
and maintenance treatment regimens appear
to be an eective antiaging treatment regimen.
Larger, randomized, controlled trials are needed
to conrm our ndings.
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FIGURE 5. Patient Global Assessment and Investigator Global Assessment scores by treatment group
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... Otherwise, the Glogau scale is a classic method to evaluate skin photoaging in efficacy studies of antiaging treatments such as laser [51,52], surgery [52], radiofrequency [53], skin aging treatments (e.g., platelet-rich plasma treatments or retinoic acid treatments) [54,55], or cosmetics [56]. ...
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... Skin aging is a physiological process involving a combination of innate (intrinsic) changes and environmental (extrinsic) damage. 1 It manifests clinically as fine and coarse wrinkling, skin thickening, loss of elasticity (skin laxity), surface roughness, dyspigmentation, and texture changes leading to coarseness of the skin. 2 Histologically, aged skin is characterized by a decrease in the proliferation and physiology of fibroblasts and keratinocytes. 3 There is decreased epidermal renewal and reduced synthesis of dermal extracellular matrix components, such as collagen and elastin. ...
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... Garden snail mucus reportedly increased healing rates through antioxidant and free radical regulation (Nguyen et al., 2020). Mucus from garden improved erythema in rat models, and, the same rats showed reduction of photoaging as well (Lim et al., 2020). As well as being able to treat superficial injuries, mucins have shown the ability to be used on internal wounds. ...
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Background: A validated scale is needed for objective and reproducible comparisons of facial fine lines before and after treatment in practice and clinical studies. Objective: To describe the development and validation of the 5-point photonumeric Allergan Fine Lines Scale. Methods: The Allergan Fine Lines Scale was developed to include an assessment guide, verbal descriptors, morphed images, and real subject images for each scale grade. The clinical significance of a 1-point score difference was evaluated in a review of multiple image pairs representing varying differences in severity. Interrater and intrarater reliability was evaluated in a live subject validation study (N = 289) completed during 2 sessions occurring 3 weeks apart. Results: A score difference of ≥1 point was shown to reflect a clinically significant difference (mean [95% CI] absolute score difference, 1.06 [0.92-1.21] for clinically different image pairs and 0.50 [0.38-0.61] for not clinically different pairs). Intrarater agreement between the 2 live subject validation sessions was almost perfect (weighted kappa = 0.85). Interrater agreement was substantial during the second rating session (0.76, primary end point). Conclusion: The Allergan Fine Lines Scale is a validated and reliable scale for physician rating of severity of superficial fine lines.
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Background Noninvasive quantification of stratum corneum water content is widely used in skin research and topical product development. Methods The original EEMCO guidelines on measurements of skin hydration by electrical methods and transepidermal water loss (TEWL) by evaporimeter published in 1997 and 2001 have been revisited and updated with the incorporation of recently available technologies. Results Electrical methods and open‐chamber evaporimeters for measurement of TEWL are still the preferred techniques to measure the water balance in the stratum corneum. The background technology and biophysics of these instruments remain relevant and valid. However, new methods that can image surface hydration and measure depth profiles of dermal water content now available. Open‐chamber measurement of TEWL has been supplemented with semiopen and closed chamber probes, which are more robust to environmental influence and therefore convenient to use and more applicable to field studies. However, closed chamber methods interfere with the evaporation of water, and the methods cannot be used for continuous monitoring. Validation of methods with respect to intra‐ and inter‐instrument variation remains challenging. No validation standard or test phantom is available. Results and Conclusions The established methods for measurement of epidermal water content and TEWL have been supplemented with important new technologies including methods that allow imaging of epidermal water distribution and water depth profiles. A much more complete and sophisticated characterization of the various aspects of the dermal water barrier has been accomplished by means of today's noninvasive techniques; however, instrument standardization and validation remain a challenge.
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p>New cosmeceutical ingredients that improve skin appearance are of interest to the dermatologist. Cryptomphalus aspersa is a snail raised on farms in Spain for its mucinous secretions and eggs. These natural products have been demonstrated in vitro to trigger mesenchymal stem cell differentiation, promote dermal fibroblast and keratinocyte migration, prevent keratinocyte aging, prevent oxidative damage, stimulate the extracellular matrix, and regulate MMPs. This 12-week study enrolled 40 male and female subjects age 40-70 years of Fitzpatrick skin types I-IV with moderate to severe facial aging and Rao-Goldman scores of 4-5 who applied an eye and face anti-aging cream twice daily containing a mollusk egg extract. Dermatologist investigator, subject, and elasticity assessments were performed at baseline, week 8, and week 12. At week 12, the investigator rated a 53% reduction in skin roughness (P less than 0.001), 26% improvement in skin brightness (P less than 0.001), and 12% reduction in skin dyspigmentation (P=0.033). The noninvasive elastometer measurements demonstrated an increase in skin elasticity at week 8 of 11% with a continuing elasticity increase at week 12 of 39% (P less than 0.001). The formulation studied included moisturizing, emollient, film-forming, and retinoid ingredients in addition to the mollusk egg extract to produce the clinical improvement. J Drugs Dermatol. 2017;16(7):678-681. .
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The actual skin colorimeters analyse reflect values from a limited number of broad spectral bands and consequently present limited reproducibility and specificity when measuring skin colour. Here, Antera 3D(®) , a new device which uses reflectance mapping of seven different light wavelengths spanning the entire visible spectrum, has been compared with Mexameter(®) MX-18, an established narrow-band reflectance spectrophotometer and with Colorimeter(®) CL-400, an established tristimulus colorimetric instrument. Thirty volunteers were exposed to a controlled ultra-violet B light. Measurements with Antera 3D(®) , Mexameter(®) MX-18 and Colorimeter(®) CL-400 were done before treatment and after 2, 7 and 14 days. Antera 3D(®) showed to have a better sensitivity and specificity than Mexameter(®) MX-18 regarding the melanin parameter. A similar sensitivity between Antera 3D(®) and Mexameter(®) MX-18 was found for erythema determination and also for the Commission Internationale de l'Eclairage L*, a* and b* parameters between Antera 3D(®) and Colorimeter(®) CL-400. Good correlations were observed for all the parameters analysed. Repeatability of Mexameter(®) MX-18 and Colorimeter(®) CL-400 values were lower than that of Antera 3D(®) for all the parameters analysed. Antera 3D(®) , such as Mexameter(®) MX-18 and Colorimeter(®) CL-400, are robust, sensitive and precise equipment for the skin colour analysis. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Article
Synopsis Background The search of substances that minimize cutaneous ageing has increased in the last few years. Previous studies have described the regenerative properties of the secretion of the mollusc Cryptomphalus aspersa (C.aspersa) when applied topically. Objective We evaluate the in vitro effects of a new product derived from the eggs of C.aspersa, IFC-CAF, on cell proliferation, migration, distribution of cytoskeletal proteins, production of extracellular components as well as its ability to prevent cutaneous ageing because of intrinsic or extrinsic factors (exposure to UVB) by determination of ageing markers. Methods We have used the human keratinocyte cell line (HaCaT cells), primary dermal fibroblasts (HDF) and senescent dermal fibroblasts (SHDF). The effects of the compound on cell proliferation and on the cell cycle were determined by the MTT colorimetric assay, estimation of total protein and/or trypan blue test and by flow cytometry, respectively. We also studied cell migration using the wound-healing migration assay, whereas ELISA assays, Western Blot and immunofluorescence microscopy were carried out to test the expression of proteins related to cytoskeleton, extracellular matrix and with ageing. ResultsWe have found that IFC-CAF does not promote proliferation but induces migration of HaCaT, HDF and SHDF in a time- and dose-dependent manner; a better organization of cytoskeletal proteins (F-actin and vimentin) and promotes the production of extracellular components (fibronectin, collagen 1 and MMPs) and the adhesion to cell-substrate vinculin protein. IFC-CAF also prevents cutaneous ageing. The treatment decreases the expression of the ageing-related markers b-Gal, p53 and p16INK4 in SDDF cells, and improves cell survival after UVB irradiation and nuclear repair in HaCaT cells. ConclusionIFC-CAF has regenerative properties and protects against ageing factors being, therefore, a potential therapeutic agent for treating or preventing skin ageing.
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Growth factors and cytokines (referred to collectively hereafter as GFs) control cell growth, proliferation, and differentiation via a network of inter and intracellular signaling pathways. There are striking parallels between the pathways involved in skin wound healing and those implicated in photoaging of the skin. In recent years, topical and injectable GFs have emerged as an intriguing therapeutic modality that can be harnessed for aesthetic and medical purposes. This article provides a review of available evidence for the role in skin regeneration of topical GFs, and of injectable GFs contained in autologous platelet-rich plasma (PRP). It presents data from recent studies of GFs, offers a discussion of their potential to serve as antiaging actives, and includes safety considerations. As studies of injectable GFs typically assume preexisting familiarity with PRP protocols and the theory behind them, explanatory notes are provided. An assessment is provided of the evidence gaps that exist currently between experimental observations regarding GFs and their proven clinical benefits. Data of evidence levels II and III support the use for skin rejuvenation of topical GFs derived from sources including secretions or lysate of human dermal fibroblasts, and secretions of the snail Cryptomphalus aspersa. GFs with associated stem cell proteins, secreted by human dermal fibroblasts under hypoxic stress, can accelerate skin healing after laser resurfacing. In vitro and animal studies, small case series of PRP-treated patients and one prospective clinical study of its variant, platelet-rich fibrin matrix (PRFM), suggest the value of injectable GFs for skin rejuvenation. However, data of higher power are required to expand this proof of concept into an evidence-based paradigm. The clinical applications of topical and injectable GFs are promising, and remain to be fully defined. With continued study, data of higher evidence level can be accrued and formulations can be developed that offer optimal clinical efficacy, safety, tolerability, and stability. Better understanding of the mechanism of action of GFs can potentially advance our general understanding of dermal signaling pathways, and hence of hyaluronic acid and other alloplastic fillers; and allow the development of protocols for synergistic combination of GFs with other skin rejuvenation modalities.