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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
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
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)
Received : 12/05/2009
Accepte d: 20/09/2009
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 ralfree01/v15i3/medor alv15i3p445.pd f
Article Number: 2897
© Medicina Oral S. L. C.I.F. B 96689336 - pISSN 1698-4447 - eISSN: 1698-6946
Indexed in:
-Index Medicus / MEDLINE / PubMed
-EMBASE, Excerpta Medica
-Indice Médico Español
Med Oral Patol Oral Cir Bucal. 2010 May 1;15 (3):e445-50. Lipst ick sunscree n application
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-
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
Med Oral Patol Oral Cir Bucal. 2010 May 1;15 (3):e445-50. Lipst ick sunscree n application
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-
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
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).
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
Note: au = arbitrary units. No participant had skin phototype I or VI
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
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
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).
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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
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4. Kobayashi H, Tagami H. Funct ional properties of the surface of
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Dermatol. 2003;148:763-9.
11. Maier H, Schauberger G, Mar tincigh BS, Brunnhofer K, Hönigs-
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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.
13. Vainio H, Miller AB, Bianchini F. An internat ional evalu a-
tion of the cancer-preventive potential of sunscreens. Int J Cancer.
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.
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18. Gaughan MD, Padilla RS. Use of a topical uorescent dye to
evaluate effectiveness of sunscreen application. Arch Dermatol.
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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). ...
To adequately perform perioral rejuvenation procedures, it is necessary to understand the morphologic changes caused by facial aging. Anthropometric analyses of standardized frontal view and profile photographs could help to investigate such changes. Photographs of 346 male individuals were evaluated using 12 anthropometric indices. Data from two groups of health subjects, the first exhibiting a mean age of nearly 20 and the second of nearly 60 years, were compared. To evaluate the influence of combined nicotine and alcohol abuse, the data of the second group were compared to a third group exhibiting a similar mean age who were known alcohol and nicotine abusers. Comparison of the first to the second group showed significant decrease of the vertical height of upper and lower vermilion and relative enlargement of the cutaneous part of upper and lower lips. This effect was stronger in the upper vermilion and medial upper lips. The sagging of the upper lips led to the appearance of an increased mouth width. In the third group the effect of sagging of the upper lips, and especially its medial portion was significantly higher compared to the second group. The photo-assisted anthropometric measurements investigated gave reproducible results related to perioral aging.
The vermilion lip is a body site particularly susceptible to water loss. Therefore, the role of hydration in tactile perception at the lip was investigated. A series of measures of tactile performance and response were obtained from 22 female subjects, namely: (1) the subjective assessment of lip feel, (2) tactile sensitivity, (3) spatial acuity, (4) thermal sensitivity, and (5) the subjective assessment of thermal stimulation. These measures were obtained from lips in their natural (untreated) state, and lips that had been treated using a hydrating preparation. The preparation altered the subjective feel of the lips consistent with the treatment increasing lip hydration and compliance. Hydrated lips showed greater sensitivity to light touch, and there was a trend toward the lip's thermal sensitivity being altered consistent with the lip treatment having a physical cooling effect. Spatial acuity was unaltered by the state of lip hydration. The sensitivity changes on hydration were proposed to have mechanical basis.
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Comparisons of clinical assessment with measurement of physical parameters are rare. To standardize the horizontal wrinkling of the skin in order to define a reference chart of the different wrinkling grades and to propose an interpretation of the clinical pattern in terms of skin layers thickness and mechanical parameters. A device allowing reproducible wrinkling of the skin was made. The skin folds created in this way were clinically assessed on women of different ages. Measurements of the mechanical properties of the skin were carried out by using a Torquemeter. Skin layers' thicknesses were measured by using in vivo Confocal Microscopy (CM) and Ultrasound Imaging (B mode). Skin wrinkling grades increase versus age. Skin elasticity, extensibility and echogenicity decrease also versus age and the wrinkling grade. Wrinkling appears to be related to skin rigidification (for both stratum corneum and dermis) coupled to a certain weakening of the upper dermis (loss of echogenicity). This study points out the key role of the age-related alterations of the upper dermis in skin wrinkling capacities.
Although skin disorders associated with long-term sun exposure account for high morbidity, only few data on sun-related preclinical skin changes are available in the general population. In the present study we determined reference values for markers of photoaging in French adults, and we evaluated the relationship between photoaging, phototype, and both behavioral and environmental factors. The SU.VI.MAX trial is a multicenter, national intervention trial on 12,735 adults living in France. A transverse analysis was performed on the inclusion data of the sample of volunteers between 45 and 60 years of age who underwent skin evaluation in 1995: 3057 women and 3606 men. Skin was evaluated by means of the Larnier skin photoaging photographic scale and a sun reactive skin type classification derived from those proposed by Fitzpatrick in 1976 and Césarini in 1977. The prevalence of skin photoaging, assessed as a dichotomous variable (from moderate/severe to very severe), was comparable in men and women in same age groups: in women, age group 45-49 years = 22%, 50-54 years = 36%, and 55-60 years = 42%; in men, age group 45-49 years = 17%, 50-54 years = 38%, and 55-60 years = 45%. After adjusting for body mass index, exposure to tobacco, and sunlight exposure, the only variables found to be related to skin photoaging in women were age (55-60 years age group: adjusted odds ratio [AOR] = 6.0, 95% confidence interval [CI] = 4.4-8.2), phototype IIIa, IIIb, and IV (AOR = 0.2, 95% CI = 0.1-0.4; AOR = 0.3, 95% CI = 0.2-0.6; and AOR = 0.4, 95% CI = 0.3-0.8; respectively), menopausal status (AOR = 1.4, 95% CI = 1.1-1.9), and geographic location (Southern France: AOR = 0. 7, 95% CI = 0.6-0.9), with a more pronounced effect in lighter phototypes I-II and a protective impact related to southern locations. No relationship was found between the use of oral contraceptives and skin photoaging. The age effect was also found in men (55-60 years age group: AOR = 10.4, 95% CI = 8.3-13.1) and geographic location (Southern France: AOR = 0.8, 95% CI = 0.6-0.9), with a most pronounced effect in darker phototypes (phototypes > IV: AOR = 2.8, 95% CI = 1.4-5.6). Our results suggest that the prevalence of skin photoaging in the adult French population is determined by age, sex, geographic location, and phototype. The continuation of this longitudinal study will allow for the investigation of the relationship between skin photoaging and the risk of the development of skin diseases.
Testing plate made of optical quartz has been developed for the purpose of determination of sun protection factor (SPF)(in vitro) by the method of diffusion transmission spectroscopy; the plates were coarsened by sanding and grinding to surface roughness values (Ra) of 18 mum. The plate was coated with a film of sunscreen by an application of 2 mg cm(-2) as that used for determination of SPF(in vivo) by the COLIPA method. The transmission values measured were converted into the SPF(in vitro) and the protection factor in ultraviolet A light, UVAPF(in vitro). The testing plate was tested with commercial sunscreens. The found values of SPF(in vitro) fit well with the values determined by means of the COLIPA method in vivo. The plates coated with sunscreen film were irradiated with light simulating the sun radiation. The values of protection factors obtained before and after irradiation were compared, and the differences were used for estimation of photostability of the UV filters included.
The functional properties of human lips depend on their hydration level. Limited data are, however, available. To investigate water distribution through the lower lip surface. Images from the surface of the lip were recorded using a new capacitance imaging technique. Capacitance and conductance measurements were also carried out in various points of lower lip and on adjacent skin. Data clearly show that the closest part of the mucosa of the lip is less hydrated than the external part. These unexpected findings could be related to the presence of a premucosa area whose structure is clearly different from that of vermilion zone.
To determine if cigarette smoking is a risk factor for the development of premature facial wrinkling. Cross-sectional study. Smoking cessation clinic and community. Convenience sample of 132 adult smokers and non-smokers in 1988. A questionnaire was administered to quantify cigarette smoking and to obtain information about possibly confounding factors such as skin pigmentation, sun exposure, age, and sex. Wrinkling was assessed using photographs of the temple region, and a severity score based on predetermined criteria was assigned. A logistic regression model, which controlled for confounding variables, was developed to assess the risk for premature wrinkling in response to pack-years of smoking. The prevalence of premature wrinkling was independently associated with sun exposure and pack-years of smoking. After controlling for age, sex, and sun exposure, premature wrinkling increased with increased pack-years of smoking. Heavy cigarette smokers (greater than 50 pack-years) were 4.7 times more likely to be wrinkled than nonsmokers (95% CI, 1.0 to 22.6; P value for trend = 0.05). Sun exposure of more than 50,000 lifetime hours also increased the risk of being excessively wrinkled 3.1-fold (CI, 1.2 to 7.1). When excessive sun exposure and cigarette smoking occurred together, the risk for developing excessive wrinkling was multiplicative (prevalence ratio of 12.0; CI, 1.5 to 530). Cigarette smoking is an independent risk factor for the development of premature wrinkling.
We aimed to evaluate whether prolonged occlusion can induce stratum corneum barrier damage, alterations in stratum corneum hydration or water-holding capacity (WHC) lasting longer than the occlusion time. 12 subjects were occluded on the forearm for 24, 48, 72 and 96 h. Two hours after occlusion removal, transepidermal water loss (TEWL) and skin hydration were measured and a sorption-desorption test performed. TEWL showed an increase reaching a plateau on day 2. Hydration and WHC did not show significant changes. Hygroscopicity showed the highest level on day 1, decreasing during the following days. A highly significant correlation between capacitance values and the WHC could be detected (p < 0.0001, r = 0.8206). No correlation could be detected between hygroscopicity and TEWL. Prolonged occlusion induces barrier damage without skin dryness. Occlusion also induces an increased hygroscopicity. A correlation between these two findings could not be proven.
The IARC convened a working group of experts in Lyon, France, on 10-18 April, 2000, to evaluate the cancer-preventive activity of sunscreens and to compile the fifth volume of the IARC Handbooks of Cancer Prevention. The working group concluded that the topical use of sunscreens reduces the risk of sunburn in humans and that sunscreens probably prevent squamous-cell carcinoma of the skin when used mainly during unintentional sun exposure. No conclusion can be drawn about the cancer-preventive activity of topical use of sunscreens against basal-cell carcinoma and cutaneous melanoma. Use of sunscreens can extend the duration of intentional sun exposure, such as sunbathing. Such an extension may increase the risk for cutaneous melanoma. The working group warned against relying solely on sunscreens for protection from UV radiation.
There is a well-documented need for effective human UVA and UVB photoprotection. Since there are important anatomical variations, the sun protection factor (SPF) of a lipstick sunscreen was measured on the anatomical site intended for use. The SPF tests were performed according to Federal US and European COLIPA guidelines. Prior to performing a test on the lip, the minimal erythemal dose (MED) of the unprotected back skin was determined. Subsequently, the sunscreen SPF was measured on the anatomical target site (lip). The evaluator was blinded with respect to scoring the SPF of each sunscreen treatment. Individual test sites were assigned to one of the following treatment conditions: (1) no treatment (MED of unprotected skin); (2) test formulation; (3) reference standard. The MED on unprotected back skin was found to be 25% lower than on unprotected lip skin. The SPF of the lipstick sunscreen was measured 2 units lower than the SPF determined in the classical way on the back skin. It was hypothesized that the higher MED of the lower lip compared with back skin was due to the adaptation of this tissue to the continuous exposure to UV radiation.