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Study of lip hydration with application of photoprotective lipstick: Influence of skin phototype, size of lips, age, sex and smoking habits

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To study lip hydration levels when applying a lipstick sunscreen for 3 months and to evaluate the influence of size of lips, age, sex, smoking and skin phototype. The study group was formed by 140 volunteer subjects, one group consisting of 70 patients applying a commercial lipstick sunscreen three times a day and the other group of 70 controls in which no product was applied. The age range was 20-86 years. The influence in lip hydration levels of age, sex, phototype, size of the lips and smoking habits was studied using a Corneometer 825 (Courage & Khazaka Electronic GmbH, Cologne, Germany). An increase in lip hydration was found between the basal (53.49 +/- 15.259) and final (59.34 +/- 14.51) Corneometer 825 (Courage & Khazaka Electronic GmbH, Cologne, Germany) measurements over the three months of treatment, with statistically significant differences with respect to the control (p=0.002). However, no statistically significant differences in lip hydration were observed with regard to age, (p=0.48), gender (p=0.876), skin phototype (p=0.653), lip area (p=0.291) and smoking (p=0.178). Application of a lipstick sunscreen 3 times a day for 3 months increases lip hydration.
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Med Oral Patol Oral Cir Bucal. 2010 May 1;15 (3):e445-50. Lipst ick sunscree n application
e445
Journal section: Oral Medicine and Pathology doi:10.4317/medoral.15.e445
Publication Types: Research
Study of lip hydration with application of photoprotective lipstick:
Inuence of skin phototype, size of lips, age, sex and smoking habits
Pía López-Jornet 1, Fabio Camacho-Alonso 1, Ana Rodríguez-Espin 1
1 Department of Oral Medicine, Faculty of Medicine and Odontology, University of Murcia, Spain
Correspondence:
Clínica Odontológica Universitaria
Hospital Morales Meseg uer (Seg unda Planta)
Medicina Bucal
Avda/ Marqués de los Vélez s/n
C.P 30008 Murcia (S pain)
fcamacho@um.es
Received : 12/05/2009
Accepte d: 20/09/2009
Abstract
Objectives: To study lip hydration levels when applying a lipstick sunscreen for 3 months and to evaluate the inu-
ence of size of lips, age, sex, smoking and skin phototype.
Study design: The study group was formed by 140 volunteer subjects, one group consisting of 70 patients apply-
ing a commercial lipstick sunscreen three times a day and the other group of 70 controls in which no product was
applied. The age range was 20-86 years. The inuence in lip hydration levels of age, sex, phototype, size of the
lips and smoking habits was studied using a Corneometer 825® (Courage & Khazaka Electronic GmbH, Cologne,
Germany). Results: An increase in lip hydration was found between the basal (53.49 ± 15.259) and nal (59.34 ±
14.51) Corneometer 825® (Courage & Khazaka Electronic GmbH, Cologne, Germany) measurements over the
three months of treatment, with statistically signicant differences with respect to the control (p=0.002). How-
ever, no statistically signicant differences in lip hydration were observed with regard to age, (p=0.48), gender
(p=0.876), skin phototype (p=0.653), lip area (p=0.291) and smoking (p=0.178). Conclusions: Application of a
lipstick sunscreen 3 times a day for 3 months increases lip hydration.
Key words: Corneometer, lips, lipstick sunscreen, hydration, age.
López-Jor net P, Camacho-Alonso F, Rodríguez-Espin A. Study of lip
hydration with application of photoprotective lipstick: Inuence of skin
phototy pe, size of lips, age, sex and smoking habits. Med Oral Patol Oral
Cir Bucal. 2010 May 1;15 (3):e445-50.
http://w ww.medicinao ral.com/medo ralfree01/v15i3/medor alv15i3p445.pd f
Article Number: 2897 http://www.medicinaoral.com/
© Medicina Oral S. L. C.I.F. B 96689336 - pISSN 1698-4447 - eISSN: 1698-6946
eMail: medicina@medicinaoral.com
Indexed in:
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Med Oral Patol Oral Cir Bucal. 2010 May 1;15 (3):e445-50. Lipst ick sunscree n application
e446
Introduction
The lips, in close connection with the perioral skin, have
important physiological functions. They are one of the
most alluring features on the face, and can express one’s
emotional status during verbal and psychological com-
munication (1,2). The histology of the lips is well de-
scribed, the vermilion area is covered by a thin stratum
corneum, made up of orthokeratotic cells of a shorter
turnover than normal stratum corneum (3,4).
Various methods for determining the hydration state
of the stratum corneum (SC) have been summarized
by Flurr et al. (5). The Corneometer 825® (Courage
& Khazaka Electronic GmbH, Cologne, Germany) is
a capacitive device for measuring the hydration of the
SC and gives important information on the biophysical
properties and function of the skin barrier. With an ad-
equate amount of water in the SC, the skin maintains an
intact barrier function (6-10). The lips and the perioral
region are poorly protected from the sun and this area
is continually exposed to solar radiation, the surface of
the lower lip receives the highest exposure to ultraviolet
light in the whole facial region (4,11,12). Current society
has established the suntan as a fashion symbol of health,
beauty and social status. However, investigations car-
ried out over recent years show that excessive exposure
to solar radiation constitutes a serious danger to the skin
as it causes premature cutaneous ageing and can lead to
the appearance of malignant lesions (13). Even so, the
importance of photoprotecion with lipsticks as part of
a solar protection strategy is sometimes underestimat-
ed. The International Agency for Research on Cancer
(IARC) does not recommend the use of lip protection,
although it does recognize that ultraviolet rays are a fac-
tor of higher risk for the development of premalignant
and malignant lip lesions (13).
The aim of this study was to investigate lip hydration
levels using Corneometer 825® (Courage & Khazaka
Electronic GmbH, Cologne, Germany) when applying
a lipstick sunscreen three times a day for 3 months in
function of lip size, age, sex, smoking, and skin pho-
totype.
Material and Methods
The study was carried out in the Odontology Clinic,
Department of Oral Medicine, at the University of Mur-
cia, after approval from the University Bioethics Com-
mittee. The study was carried out between January and
May 2008. The study group comprised 140 randomly-
selected volunteer subjects. Group A was formed by 70
patients applying lipstick sunscreen 3 times a day, and
group B by 70 controls without lipstick sunscreen. The
age range was 20-86 years. Volunteer patients without
lip pathology, skin lesions, or clinical signs of lip dry-
ness were included. Patients younger than 18 years,
pregnant, with lip pathology or active skin lesions,
psychological inability to follow the recommended ins-
tructions or using another type of lipstick sunscreen
during the study period were excluded. Once informed
and agreeing to participate in the study, the data were
recorded by a single investigator.
Measurement protocol
The patient was required to rest for 10-20 minutes be-
fore the analysis and not to use any cosmetic product on
the lips for at least 2 hours beforehand. For the meas-
urements we used a Corneometer 825® (Courage &
Khazaka Electronic GmbH, Cologne, Germany) which
measures the electrical capacitance of the skin surface
in arbitrar y units. The measurements were made in a
room at a temperature of 20° C and a relative humid-
ity between 40 and 60%, in Murcia, latitude 3 50'
North and 01° 30' West. To evaluate hydration, 3 re-
peated measurements were made with the Corneometer
825® (Courage & Khazaka Electronic GmbH, Cologne,
Germany) on the same area of the lower lip, allowing 5
seconds between each measurement and calculating the
mean. To carry out the measurement, the sensor head is
held at right angles to the lower lip, applying only the
pressure exerted by the spring in the probe head (Fig.
1). The sensor takes the measurement when in contact
with the lip, and uses an audible signal to indicate when
completed. To verify the accuracy of the Corneometer
825® (Courage & Khazaka Electronic GmbH, Cologne,
Germany) and the penetration capacity of the electric
eld, the instrument was recalibrated after prolonged
use. The Corneometer measurements were made on the
day of inclusion in the study and at 3 months.
Fig. 1. Lip hydrat ion measurement using Cor neometer 825® (Cour-
age & Kha zaka Electron ic GmbH, Cologne, Ger many). To carry out
the measurement, the sensor head is held at r ight angles to the lower
lip, applying only the pressure exerted by the spring in the probe
head.
Med Oral Patol Oral Cir Bucal. 2010 May 1;15 (3):e445-50. Lipst ick sunscree n application
e447
We used a commercial lip protector Interapothek SPF
30® (Laboratories Brun, Asturias, Spain), with a rm
consistency and protection factor of 30. The protector is
composed of the following ingredients (Microcrystal-
line wax, Parafn, Cocoa, Zinc Oxide, Castor oil, Oc-
tyldodecanol, Lanolin, Methylparaben, Ethylparaben,
Butylparaben, Propylparaben, Isobutylparaben, Vita-
min C, Tocopheryl Acetate, Lecithin, Edta, Aromas).
The participants were instr ucted to carry the protector
with them and to apply it 3 times a day.
Measurement of protected lip area
In order to evaluate the area of the lip skin usually pro-
tected by lipstick, the test subject applied a coloured
lipstick (Lip red L´Oreal Laboratoire Pharmaceutique,
Paris, France) carefully to the lip skin while standing in
front of a mirror. Afterwards, the subject kissed a sheet
of white photocopy paper, which lay on top of a nely
porous sponge. Before each new application the lip sur-
face was carefully cleaned. The subjects were instruct-
ed to fold their arms behind their back and to touch the
paper with closed and relaxed lips. The 70 participants
made 10 measurements each. The kissing imprint was
outlined, and the area of the lips calculated by scanning
these outlines for each patient and measuring the sur-
face area with the aid of an Imaging program. Analysis
was carried out using MIP 4.5® software (CID, Barce-
lona, Spain) (Fig. 2).
The level of compliance was evaluated by weighing the
protectors before giving them to the subject and then at
the conclusion of the study, thus ascertaining the quan-
tity used.
Statistical analysis
Data were analyzed using the SPSS 12.0 program
(SPSS® Inc, Chicago, IL, USA). A descriptive study
was made of each variable. The associations bet ween
the different qualitative variables were studied using
Pearson’s chi squared test and the Student’s t-test was
used for quantitative variables (for data showing a
non-skewed distribution). The Kolmogorov-Smirnov
normality test and Levene variance homogeneity test
were applied; data with a skewed distribution were an-
alyzed using a non-parametric ranking test. We used
the Kruskal-Wallis test (for more than two samples)
and the Mann-Whitney U-test for two independent
samples. Values of p≤0.05 were accepted as signi-
cant.
Results
Our study was formed by a sample of 140 individu-
als, 70 study and 70 control. The mean age of the
whole sample was 39.64 ± 13.811 with a range of 20
-86 years. The characteristics of the study and control
groups were similar with respect to age, sex, level of
education, skin phototype, mean hours of annual sun
exposure and lip hydration measured with the Corne-
ometer 825® (Courage & Khazaka Electronic GmbH,
Cologne, Germany) in arbit rary units (Table 1). The
lipstick sunscreen was well tolerated by the 70 sub-
jects during the three months of the study, and no
adverse effects, including allergic or irritative reac-
tions, were obser ved. None of the subjects abandoned
the study.
In the group applying the lip protector, the lip area,
perimeter and diameter of both upper and lower lip
were evaluated, nding a total lip area in cm2 of 6.55
± 1.33 (4.04-10.98). When studying the relationship
between the total size of the lips and the increase
in lip hydration over the 3 months of t reatment, we
found that although the smallest increase in hydra-
tion was produced in larger lips, there were no statis-
tically signicant differences (p=0.291) (Table 2).
When studying by age groups, we observed no sig-
nicant differences for age, sex and increase in lip
hydration after 3 months of protector application
(Table 2).
With respect to smoking, in the group applying the
lipstick sunscreen there were 20 smokers (24.3%)
and 50 non-smokers (75.7%) nding no statistically
signicant relationship between smoking and lip hy-
dration (p=0.178) (Table 2).
When evaluating lip hydration measured with the
Corneometer, we observe that the study group in-
creased lip hydration by 6.5 points, however it had
reduced in the control group, with statistical signi-
cant differences (p<0.001).
Fig. 2. The kissing impr int (10 by patient) on top of a nely porous
sponge were scanned for calculate the total lips area using an imag-
ing program me. A nalysis was carr ied out using MI P 4.5® software
(CID, Barcelona, Spain).
Med Oral Patol Oral Cir Bucal. 2010 May 1;15 (3):e445-50. Lipst ick sunscree n application
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Table 1. Homogeneit y of samples (study and control groups) with respect to character istics: age, sex,
sociocult ural level, sk in photot ype, basal Cor neometer 825® (Courage & Khazaka Elect ronic GmbH,
Cologne, Germa ny) measu rement and st ated hours of annual su n exposure. (Student’s t and Pearson χ2
te st s).
Groups
Sample characteristics ------------ -- -- -- ----------------- -- -- -- ---- p-value
Study (n=70) Control (n=70)
Age: (X±SD) 38.10 ± 11.54 41.16 ± 15.69 0.191
Gender 0.583
Male: n (%) 20 (28.57) 23 (32.86)
Female: n (%) 50 (71.43) 47 (67.14)
Education 0.337
Primary: n (%) 7 (10) 8 (11.43)
Secondary: n (%) 14 (20) 21 (30)
University: n (%) 49 (70) 41 (58.57)
Phototype 0.449
T. II: n (%) 11 (15.73) 9 (12.85)
T. III: n (%) 13 (18.57) 8 (11.45)
T. IV: n (%) 16 (22.85) 23 (32.85)
T. V: n (%) 30 (42.85) 30 (42.85)
Initial lip hydration: 53.49 ± 15.25 54.73 ± 17.27 0.652
(X±SD) (au)
Hours of annual sun exposure: 217.97 ± 331.34 157.71 ± 179.17 0.183
(X±SD)
Note: au = arbitrary units. No participant had skin phototype I or VI
Discussion
The vermilion border of the lips (lip for short) consti-
tutes one of the most outstanding parts of the face be-
cause of its features that are distinct from the surround-
ing skin.
Our results show that using lip protection 3 times a day
produces an increase in hydration at 3 months with sta-
tistically signicant differences (p<0.001) with respect
to those that do not, and nding no signicant differ-
ences for age, sex, skin phototype, lip size and annual
amount of exposure to the sun.
An aging population, with more free time and exposure
to ultraviolet (UV) solar radiation, has produced an
increasing demand for protecting the skin against the
detrimental effects of UV exposure (11,12). The pres-
ent study was carried out in the region of Murcia. The
measurements were always made under the same condi-
tions; in the morning at a temperature of 20ºC and rela-
tive humidity of 40-60%.
Cutaneous ageing is a continuous process involving
intrinsic ageing (a universal and inevitable alteration
attributed to the passage of time) and extrinsic ageing
(the superposition over intrinsic ageing of changes at-
tributed to chronic solar exposure and other environ-
mental factors, among which, smoking) (2,4). Smoking
also provokes skin changes. Blood ow alteration lead-
ing to temperature drop can be observed immediately
after smoking. Collagenous and elastic bre degrada-
tion constitute another important modication related
to smoking. Our results found no statistically signicant
differences between smokers and non-smokers for lip
hydration (p=0.178). Leung and Harvey in 2002 (14)
concluded that the magnitude of smoking effects on the
ageing process is so great that if a person smokes 20
cigarettes a day, his or her skin age could increase by up
to 10 years. Kadunce in 1991 (15), after controlling for
age, sex, solar exposure and pigmentation, observed an
independent association between smoking and wrinkles
that shows a signicant tendency with the increase in
tobacco load: smokers of more than 50 packs per year
had a 4.7 times greater chance of developing wrinkles
than non-smokers. Kadunce (15) also observed that so-
lar exposure was associated with the development of
wrinkles. The effects of cigarette smoking and exces-
Med Oral Patol Oral Cir Bucal. 2010 May 1;15 (3):e445-50. Lipst ick sunscree n application
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Tab le 2: Lip hydration measured wit h the Corneometer 825® (Courage & K hazaka Electronic
GmbH, Cologne, Germany) over 3 months of t reatment in the study group, wit h respect to age,
gender, phototype, lip area, hours of su n exposure and protector consumption. (Kruskal-Wallis
H and Mann-Whitney U tests).
Evolution of lip hydration (n =70) in arbitrar y
Variable n (%) units over three months of treatment: p-value
(Mean and range)
Age (years) 0.483
<35: 33 (23.6) 2.36 (-19.37 to 42.47)
35-45: 24 (17.1) 3.61 (-25.46 to 40.07)
>45: 13 (9.3) 8.66 (-22.00 to 49.33)
Sex 0.876
Male: 20 (28.57) 3.52 (-25.46 to 28.70)
Female: 50 (71.43) 3.58 (-22.00 to 49.33)
Phototype 0.653
T. II: 11 (15.73) 4.57 (-11.94 to 42.47)
T. III: 13 (18.57) -1.51 (-13.43 to 28.70)
T. IV: 16 (22.85) 4.56 (-25.46 to 49.33)
T. V: 30 (42.85) 0.43 (-16.30 to 40.07)
Smoking 0.178
Non-smoker 3.81(-11.87 to 40.07)
Smoker 2.41(-2.54 to 49.33)
Total lip area 0.291
<6: 26 (18.6) 3.58 (-19.37 to 49.33)
6-7: 20 (14.3) 4.98 (-15.97 to 42.47)
>7: 24 (17.1) -0.82 (-25.46 to 28.70)
Total hours annual sun exposure 0.771
≤120: 28 (20) 4.76 (-22.00 to 38.53)
121-240: 32 (22.9) 2.90 (-19.37 to 49.33)
>240: 10 (7.1) -1.59 (-25.46 to 42.47)
Total consumption of lip protector (grams) 0.647
<1.35: 24 (17.1) 4.51 (-15.97 to 49.33)
1.35-2.35: 23 (16.4) 3.66 (-19.37 to 35.37)
>2.35: 23 (16.4) 2.47 (-25.46 to 42.47)
sive sun exposure on wrinkling were multiplicative.
In solar protection it is necessary to consider the diffe-
rences in skin type. The skin phototype was classied in
accordance with Fitzpatrick16. This study included sub-
jects with phototypes II, III, IV and V, the majority be-
ing phototype V (42.85%) / In the present study, the skin
phototype was classied in accordance with Malvy J (16),
and included subjects with phototypes II, III, IV and V, the
majority being phototype V (42.85%) nding no statisti-
cally signicant between differences lip hydration and
skin phototype.
We should consider the differences in the nature and
thickness between the skin and the lips. In short, lip
epithelium thickness would increase from the external
part to the most internal mucosal part. Normal skin epi-
dermis would gradually change from ortho-keratinized
epithelium of the vermilion border to para-keratinized
thick intermediate tissue (pre-mucosal area) and then to
non- or para-keratinized mucosa. The incomplete for-
mation of the corneal layer of the surface of the lips may
be responsible for the decreased barrier function. The
presence of water is an essential condition for the main-
tenance of normal SC structure and function (3,4,12).
Dryness or excessive hydration of the SC may cause
dermatitis and other skin diseases. Caisey et al. (17)
investigated and compared the hydration level in diffe-
rent areas of the lip by means of capacitance measures
using the Skin Chip® (ST Microelectronics, Berkley,
Med Oral Patol Oral Cir Bucal. 2010 May 1;15 (3):e445-50. Lipst ick sunscree n application
e450
CA, USA), they found the inner part of the lip mucosa is
less hydrated than the external. These unexpected nd-
ings could be related to the presence of a pre-mucosal
area whose structure is clearly different from the ver-
milion border. Lévêque and Goubanova (1) studied lip
hydration by measuring capacitance and also analyzed
the lip surface patterns obtained from capacitance map
images generated with Skin Chip® (ST Microelectron-
ics, Berkley, CA, USA). They found that both lips are
different in terms of dryness, with the lower lip being
drier than the upper.
The measurement of skin surface hydration has gained
considerable interest in recent years because the water
content of the SC inuences various physical character-
istics of the skin such as barrier function, dr ug penetra-
tion, and mechanical properties. The different noninva-
sive hydration measurement systems, and the informa-
tion they provide, are not same; while the measurement
result with the MoistureMeter® (Deln Technologies,
Kuopio, Finlandia) is dependent both on the hydration
of the SC and the thickness of the dry layer of the SC,
the Corneometer 825® (Courage & Khazaka Electronic
GmbH, Cologne, Germany) provides a hydration value
for a constant depth, (in the rst 10-20 μm of the stra-
tum corneum) (5,7,8,10).
We should emphasize the high motivation of the par-
ticipants since there was no abandonment, in spite of
the 3 months duration of the study. Likewise applica-
tion of the protector produced no adverse effects. Re-
garding the level of compliance, this was evaluated by
weighing the protector before giving it to the subject
and later when the study had concluded, thus checking
the quantity consumed. According to Gaughan MD (18)
a protector with a high area density should preferably be
used, although low density products have greater con-
sumer acceptance, stating that this maybe be one of the
reasons for which patients are poorly protected (18).
It is important to instruct the general public about the
need for protection from the adverse effects of so-
lar radiation, to modify behavior to avoid exposure at
times of highest radiation, using appropriate clothing
for protection, and if necessary to use correctly applied
photoprotection. The European Cosmetic Toiletry and
Perfumery Association (COLIPA) (19), suggest a pro-
tection area density of 2 ± 0.2 mg/cm-2. The importance
of using protection with a high protection factor as well
as frequent reapplications is well-known. However pho-
toprotection with lipsticks as part of a solar protection
strategy is sometimes underestimated.
Our results show that using lipstick sunscreen three
times a day increases hydration after 3 months with sta-
tistically signicant differences (p<0.001).
References
1. Lévêque JL, Goubanova E. Inuence of age on the lips and perio-
ral skin. Dermatology. 2004;208:307-13.
2. Edward s C, Heggie R , Marks R. A study of differences in surface
roughness bet ween sun-exposed a nd unexposed skin with age. Pho-
todermatol Photoimmunol Photomed. 2003;19:169-74.
3. Barrett AW, Morgan M, Nwaeze G, Kramer G, Berkovitz BK. The
differentiation prole of the epithelium of the hu man lip. Arch Oral
Biol. 2005;50:431-8.
4. Kobayashi H, Tagami H. Funct ional properties of the surface of
the vermilion border of the lips are distinct from those of the facial
skin. Br J Dermatol. 2004;150:563-7.
5. Fluhr JW, Lazzerini S, Distante F, Gloor M, Berardesca E. Ef-
fects of prolonged occlusion on stratum corneum barrier function
and water holding capacity. Skin Pha rmacol Appl Skin Physiol.
1999;12:193-8.
6. Salter DC. Examinat ion of stratum cor neum hydration state by
electrical methods. Curr Probl Dermatol. 1998;26:38-47.
7. O’goshi K, Serup J. Inter-instrumental variation of skin capacita nce
measured with the Corneometer. Skin Res Technol. 2005;11:107-9.
8. Alanen E, Nuutinen J, Nicklén K, Lahtinen T, Mönkkönen J.
Measurement of hydrat ion in the strat um corneum with t he Mois-
tureMeter and comparison with the Corneometer. Ski n Res Technol.
2004;10:32-7.
9. Gabard B, Ademola J. Lip sun protection factor of a lipstick sun-
screen. Dermatology. 2001;203:244-7.
10. Maier H, Schauberger G, Brunn hofer K, Hönigsmann H. Assess-
ment of thickness of photoprotective lipsticks and frequency of reap-
plication: results f rom a labor atory test and a eld experiment. Br J
Dermatol. 2003;148:763-9.
11. Maier H, Schauberger G, Mar tincigh BS, Brunnhofer K, Hönigs-
mann H. Ultraviolet protective perfor mance of photoprotective lip -
sticks: cha nge of spectral transmittance because of ultraviolet expo-
sure. Photodermatol Photoim munol Photomed. 2005;21:84-92.
12. Batisse D, Bazin R, Baldeweck T, Querleux B, Lévêque JL. Inu-
ence of age on the wr ink ling capacities of skin. Skin Res Technol.
2002;8:148-54.
13. Vainio H, Miller AB, Bianchini F. An internat ional evalu a-
tion of the cancer-preventive potential of sunscreens. Int J Cancer.
2000;88:838-42.
14. Leung WC, Harvey I. Is sk in agei ng in the elderly caused by su n
exposure or smoki ng? Br J Dermatol. 2002;147:1187-91.
15. Kadunce DP, Burr R, Gress R, Kanner R, Lyon JL, Zone JJ. Ciga-
rette smoking: risk factor for premature facial wrinkling. Ann Intern
Med. 1991;114:840-4.
16. Malvy J, Guinot C, Preziosi P, Vaillant L, Tenenhaus M, Galan P,
et al. Epidemiologic determi nants of skin photoaging: baseli ne data
of the SU.VI.MA X. cohor t. J Am Acad Dermatol. 2000;42:47-55.
17. Caisey L, Gubanova E, Baras D, Lévêque JL. Unexpected dis-
tribution of surface hydration level of the lip. J Eur Acad Der matol
Venereol. 2008;22:1159-62.
18. Gaughan MD, Padilla RS. Use of a topical uorescent dye to
evaluate effectiveness of sunscreen application. Arch Dermatol.
1998;134:515-7.
19. Ak rman J, Kubác L, Bendová H, Jírová D, Kejlo K. Quartz
plates for determining sun protection in vitro and testing photostabil-
ity of commercial su nscreens. Int J Cosmet Sci. 20 09;31:119-29.
... 23 Evidence suggests that applying a lipstick sunscreen helps in increasing lip hydration. 24 Additionally, cosmetics like foundation makeup, help provide an everyday protection with SPF ranging from 4 to 30. 23 Currently, sunscreens with variable SPF are incorporated in moisturizers, providing additional sun protection. ...
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p class="abstract">Sunscreens have been widely known to play an integral part in photoprotection. Both physical and chemical sunscreens have been extensively used for prevention and management of several conditions induced by ultraviolet rays such as sunburn, photoaging, skin cancer, and phototoxic reactions. Currently, sunscreens are available in different formulations like creams, lotions, gels, sticks, and sprays. Forty experts in the field of clinical dermatology participated in the expert group meetings organized via teleconference webinar to discuss definitions, diagnoses, and management. Current evidence on the use of sunscreen agents along with clinical experience of experts was discussed. The application of an adequate amount of sunscreen with an appropriate sun protection factor is imperative, and must be in accordance to skin type and exposure pattern of an individual. As part of a complete sun protection regimen, the judicious use of sunscreens must be combined with avoidance of midday sun exposure and protective clothing. There is an undeniable need to improve public education and awareness regarding use of sunscreens. This review article provides a consensus clinical viewpoint of expert dermatologists on effective use of sunscreens to assist in clinical decision-making for healthcare professionals.</p
... Es finden sich aber auch Gemeinsamkeiten bei kosmetischen Anwendungen. Die Rückfettung der Lippen mit einem Lippenstift der UV-Schutz beinhaltet, funktioniert bei Frauen und bei Männern, unabhängig von Alter, Phototyp, Region der Lippen oder Rauchen (López-Jornet et al. 2010). ...
... However, even in the small number of studies conducted to treat dry lip skin with topical products, efficacy was demonstrated generally based on changes from the baseline dry lip condition. [36][37][38] Due to the unique needs of lip skin, in particular with regard to preventing RHL, a novel lip cream formulation was developed containing UV filters and moisturizers that protect and repair lip skin. This formulation was developed with a novel and proprietary Micro Repair technology that enhances barrier function through including hydrogenated phospholipids, behenyl alcohol, and other plant-derived lipids that together form a similar lamellar structure to that found naturally in the SC that do not disrupt the SC lipids as some other emollients are known to do (Table 1). ...
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Purpose: These studies describe the testing of a novel, daily-use lip cream designed for individuals with lips prone to recurrent herpes labialis (RHL) that protects against environmental triggers. Subjects and methods: In vitro occlusive and in vitro and in vivo photoprotection analyses, a characterization of normal vs dry lips, and a randomized, evaluator-blinded, clinical trial that assessed the lip cream in healthy subjects with dry lips were conducted. In the clinical trial, subjects applied the lip cream or were untreated and evaluated using transepidermal water loss (TEWL), corneometry, visual assessments of lip dryness, expert photographic evaluations, and subject-rated outcomes. Results: The lip cream's in vitro water vapor transmission rate (84.1 g/(m2 h)) indicated moderate occlusivity. The lip cream, but not placebo or control (water), reduced ultraviolet A (UVA)- and UVB-induced DNA damage, and tumor necrosis factor-α (EpiDermFT) and pros-taglandin E2 release (EpiDermFT and EpiGingival™). The lip cream's in vivo sun protection factor (SPF) was 12.2 (lower confidence limit, 11.3) and SPF/UVA protection factor ratio was 0.9. The characterization of dry vs normal lips identified differences in moisturization. In the clinical trial, the lip cream significantly decreased TEWL (difference: -7.19 [95% CI: -11.41, -2.98]; P<0.01), increased corneometry (difference: 4.62 [95% CI: 1.05, 8.19]; P<0.05), and reduced visual dryness (difference: -1.48 [95% CI: 2.24, -0.71]; P<0.001) compared to untreated subjects. Significant benefits were also observed on expert photographic assessments of scaling (difference: -0.89 [95% CI: -1.75, -0.03]; P< 0.05), cupping (difference: -1.50 [95% CI: -2.30, -0.70]; P<0.001), and healthy appearance (difference: -1.44 [95% CI: -2.29, -0.58]; P<0.01); differences in overall healthy appearance were not significant (P=0.51). Subject-rated assessments indicated improvements in cracking, dryness, and flaking in the lip cream group but worsening in untreated subjects. Conclusion: These studies indicate that this novel, daily-use lip cream protects against UV radiation, drying, and chapping, which are established environmental RHL triggers.
... An area of special interest is the aging processes of the perioral region. The lips and its surrounding soft-tissue play a key role in non-verbal communication and psychological communication during speech (Leveque and Goubanova, 2004;Lopez-Jornet et al., 2010). Aging of the perioral region is among the main reasons for patients seeking surgical correction of aging related changes (Sullivan et al., 2010). ...
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