Skin mechanical properties measured with skin elasticity measurement device in patients with lymphedema: Scoping review.

BACKGROUND: Skin conditions in patients with lymphedema have been identified according to changes in skin mechanical properties. The skin elasticity meter is a non-invasive tool for measuring the mechanical properties of the skin; however, its potential use in patients with lymphedema has received little attention. This review aimed to provide an overview of studies measuring the skin mechanical properties of patients with lymphedema using a skin elasticity meter. MATERIALS AND METHODS: Search terms and synonyms related to lymphedema and skin mechanical property measurement using a skin elasticity meter were identified, and electronic databases containing articles in English were searched. RESULTS: A total of 621 articles were retrieved, and four articles were analyzed after screening. Despite this research subject receiving increasing attention, no consensus has been reached regarding the best methods. CONCLUSION: Measurement methods are expected to be standardized in the future to elucidate the skin mechanical properties of patients with lymphedema.

Vellus hair condition is related to dermal elasticity and facial sagging severity.

BACKGROUND: Sagging of facial skin is a critical factor associated with an aged appearance. However, the mechanism of sagging has not been fully elucidated. The facial skin contains vellus hair (fine hair), but the contribution of vellus hair to skin condition and facial aging has yet to be studied. AIM: We aimed to clarify the influence of vellus hair on the physical properties and sagging severity of facial skin by establishing an evaluation system for vellus hair condition. METHOD: Photographs were taken to assess the vellus hair condition in the cheek area in 30 middle-aged female volunteers. Skin elasticity was measured with a cutometer and sagging severity was evaluated by using previously established photograph-based grading criteria. RESULTS: Facial skin vellus hairs were divided into three types: fine, thick, and normal thickness. Based on this observation, we established a 6-grade photograph-based grading system based on the dominant type of vellus hair in the target area and used it to evaluate vellus hair condition at the cheek. We found that vellus hair condition is significantly positively related to skin elasticity parameters Ua/Uf (representing overall elasticity including creep and creep recovery), Ur/Ue (representing net elasticity without viscoelastic creep), and Ur/Uf (ratio of elastic recovery to total deformation). Further, vellus hair condition was significantly negatively correlated to sagging severity. CONCLUSION: Our results suggest that vellus hair condition positively contributes to the skin's physical properties, and consequently deterioration of the vellus hair condition promotes an aged facial appearance.

Bayesian Inference With Gaussian Process Surrogates to Characterize Anisotropic Mechanical Properties of Skin From Suction Tests.

One of the intrinsic features of skin and other biological tissues is the high variation in the mechanical properties across individuals and different demographics. Mechanical characterization of skin is still a challenge because the need for subject-specific in vivo parameters prevents us from utilizing traditional methods, e.g., uniaxial tensile test. Suction devices have been suggested as the best candidate to acquire mechanical properties of skin noninvasively, but capturing anisotropic properties using a circular probe opening-which is the conventional suction device-is not possible. On the other hand, noncircular probe openings can drive different deformations with respect to fiber orientation and therefore could be used to characterize the anisotropic mechanics of skin noninvasively. We propose the use of elliptical probe openings and a methodology to solve the inverse problem of finding mechanical properties from suction measurements. The proposed probe is tested virtually by solving the forward problem of skin deformation by a finite element (FE) model. The forward problem is a function of the material parameters. In order to solve the inverse problem of determining skin properties from suction data, we use a Bayesian framework. The FE model is an expensive forward function, and is thus substituted with a Gaussian process metamodel to enable the Bayesian inference problem.

Efficacy of fractional laser, radiofrequency and IPL rejuvenation of periorbital region.

The purpose of this study was to assess skin elasticity, the reduction in the number and the depth of wrinkles and changes in the other skin defects (bags under the eyes, dark circles under the eyes, skin hyperpigmentation in the ageing eye area following the use of non-ablative fractional laser, bipolar radiofrequency and intense pulsed light). Moreover, the study was also comparison which device brought better results than the others. This study included 71 patients (66 women, 5 men), aged 33-63 years (the average age was 45.81 years) with skin phototypes II and III. Twenty-four patients received five treatment sessions with a 1410-nm non-ablative fractional laser in 2-week intervals, 23 patients received five treatment sessions with a bipolar radiofrequency in 1-week intervals and 24 patients received five treatment sessions with an intense pulsed light in 2-week intervals. The treatment was applied on the skin in the eye area. The Cutometer (Courage + Khazaka electronic) reference test was used as an objective method for the assessment of skin elasticity. A questionnaire was used to compare baseline state with changes that occurred after the series of treatment sessions. The results of cutometric measurements of R2, R6 and R7 parameters and the results of questionnaires indicated that non-ablative fractional laser therapy, bipolar radiofrequency and intense pulsed light improved skin elasticity. Of the three treatments, the most significant percentage improvement in the R6 parameter was demonstrated by non-ablative fractional laser therapy which gave better final results than the other methods (p < 0.0001). No other statistically significant relationships were found between RF and IPL. In the (subjective) opinion of study participants (questionnaire), all used methods resulted in the reduction of the amount and the depth of wrinkles. However, they did not observe significant impact of individual treatment method on the signs of skin ageing, including discolorations within eye area, bags (fatty hernia), dark circles (vascular/pigmentary) and oedema (predisposition to water retention). Non-ablative fractional laser therapy, bipolar radiofrequency and intense pulsed light improved skin elasticity and the reduction of wrinkles. The most significant improvement of elasticity was demonstrated by laser therapy. It seems necessary to expand the group with the effect of individual treatments against bags and dark circles under the eyes.

A novel method to measure skin mechanical properties with three-dimensional digital image correlation.

BACKGROUND: Measuring skin mechanical properties has been of great interest in the skincare industry. It is a high accuracy and non-invasive optical technique which quantitatively tracks skin movement and deformation under mechanical perturbations. METHODS: A study was conducted with female subjects (25-65 years old). A refined speckle pattern applied onto the skin surface was used for DIC measurements. A unidirectional force pulled the skin at a constant velocity, while the deformation process was quantified by the DIC. Prior to the DIC measurement, Cutometer® readings were taken on the same area. The DIC protocol's reproducibility across multiple pattern applications, the measurement's repeatability, and the sensitivity in differentiating skin mechanical properties were investigated. RESULTS: Subjects were clustered with statistical significance according to their skin mechanical properties described by six DIC metrics (µ [major strain], σ [major strain], µ [minor strain], σ [minor strain], µ [displacement], and σ [displacement]). Most measurement random errors are below 6%. This is several folds smaller in magnitude than the difference in the mean response between the clusters. Several Cutometer® parameters also showed good agreement with µ (displacement). CONCLUSIONS: DIC was able to differentiate skins of different mechanical qualities. We also proposed the physical significance of the DIC metrics. Some of the DIC metrics potentially offer new insights into skin mechanical properties that complement those revealed by conventional instruments. Accurate measurements, large measurement areas along with ease of direct visualization are substantial advantages of DIC.

Non-invasive analysis of skin mechanical properties in patients with lamellar ichthyosis.

BACKGROUND: Reliable methods for the quantitative evaluation of skin of patients with ichthyosis are critically needed. Our purpose was to evaluate the biomechanical parameters of skin in a cohort of patients with clinically diagnosed lamellar ichthyosis. MATERIALS AND METHODS: Twenty-two patients diagnosed with lamellar ichthyosis were studied. Ichthyosis plaques located in upper distal limbs were assayed, and a nearby anatomical region without plaques from the same patient was employed as control. Skin biomechanical properties were studied through a non-invasive device (Cutometer® MPA 580). RESULTS: Ichthyosis plaques had higher values for the Uf-Ua parameter and lower values for the Ua/Uf, Ur/Ue, and Ur/Uf parameters. Adults and children showed similar statistical differences. There were no significant differences in data from men, whereas in women differences for all of the parameters were found. There was a significant decrease in the hydration and an increase in melanin index in the ichthyosis plaques. CONCLUSION: Our results suggest that analysis of parameters Uf-Ua, Ua/Uf, Ur/Ue, Ur/Uf, hydration, and melanin index could be employed for quantitative monitoring of skin. Therefore, the non-invasive method applied may be suitable for evaluation of skin of patients with ichthyosis in response to medical treatments.

Randomized Controlled Study Comparing Disposable Negative-Pressure Wound Therapy with Standard Care in Bilateral Breast Reduction Mammoplasty Evaluating Surgical Site Complications and Scar Quality.

BACKGROUND: Negative pressure wound therapy (NPWT) for postsurgical incision treatment has demonstrated benefits. A prospective randomized study was developed including 32 patients who underwent bilateral breast reduction mammoplasty. Patients served as their own control and received NPWT to one breast and fixation strips to the other breast. METHODS: The primary outcome was the number of wound healing complications within 21 days when comparing NPWT treatment with fixation strips. The secondary outcome was aesthetic appearance and quality of scarring using questionnaires [visual analogue scale (VAS) and Patient and Observer Scar Assessment Scale (POSAS)] scored at day 42-, 90-, 180- and 365-day follow-up using additional scar measurement modalities, such as viscoelasticity. RESULTS: For the 32 included patients, the number of wound complications was significantly lower (p < 0.004) for the NPWT treated sites compared to fixation strips. POSAS and VAS scores at 42 and 90 days revealed a significantly better quality of scarring in the NPWT treatment breasts than in fixation strips. At 180-day follow-up, there was a significant improvement in total VAS scores, as well as a comparable improvement in POSAS scores. No consistent significant improvement in scar quality was demonstrated with the assays that were used. CONCLUSIONS: Our study showed less complications and a significant improvement in quality of scarring in favor of the NPWT-treated sites. The results indicate NPWT to be an attractive option for these patients. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Mexametric and cutometric assessment of the signs of aging of the skin area around the eyes after the use of non-ablative fractional laser, non-ablative radiofrequency and intense pulsed light.

The assessment of the signs of aging within eyes area in cutometric (skin elasticity) and mexametric (discoloration and severity of erythema) examination after the treatment with: non-ablative fractional laser, non-ablative radiofrequency (RF) and intense light source (IPL). This study included 71 patients, aged 33-63 years (the average age was 45.81) with Fitzpatrick skin type II and III. 24 patients received 5 successive treatment sessions with a 1,410-nm non-ablative fractional laser in two-week intervals, 23 patients received 5 successive treatment sessions with a non-ablative RF in one-week intervals and 24 patients received 5 successive treatment sessions with an IPL in two-week intervals. The treatment was performed for the skin in the eye area. The Cutometer and Mexameter (Courage + Khazaka electronic) reference test was used as an objective method for the assessment of skin properties: elasticity, skin pigmentation and erythema. Measurements of skin elasticity were made in three or four sites within eye area. The results of cutometric measurements for R7 showed the improvement in skin elasticity in case of all treatment methods. The largest statistically significant improvement (p < .0001) was observed in case of laser and RF, during treatment sessions, at sites at upper and lower eyelid. The smallest change in skin elasticity for the laser, RF and IPL - p = .017, p = .003 and p = .001, respectively-was observed in a site within the outer corner of the eye. In all sites of measurements and for all methods, the greatest improvement in skin elasticity was demonstrated between the first and second measurement (after 3rd procedures). The majority of the results of mexametric measurements-MEX (melanin level) and ERYT (the severity of erythema) are statistically insignificant. Fractional, non-ablative laser, non-ablation RF and intense light source can be considered as methods significantly affecting elasticity and to a lesser extent erythema and skin pigmentation around the eyes. Fractional non-ablative laser is a method which, in comparison to other methods, has the greatest impact on skin viscoelasticity. These procedures are well tolerated and are associated with a low risk of side effects.

Evaluation of skin firmness by the DynaSKIN, a novel non-contact compression device, and its use in revealing the efficacy of a skincare regimen featuring a novel anti-ageing ingredient, acetyl aspartic acid.

BACKGROUND: One of the key strategies for anti-ageing in the cosmetics industry today is to target the structural changes responsible for ptosis of the skin, given its impact on age perception. Several objective and non-invasive methods are available to characterise the biomechanical properties of the skin, which are operator-dependent, involving skin contact and providing single-dimensional numerical descriptions of skin behaviour. The research introduces the DynaSKIN, a device using non-contact mechanical pressure in combination with fringe projection to quantify and visualise the skin response in 3-dimensions. We examine the age correlation of the measurements, how they compare with the Cutometer® , and measure skin dynamics following application of a skincare regimen containing established anti-ageing ingredients. METHODS: DynaSKIN and Cutometer® measurements were made on the cheek of 80 Caucasian women (18-64 years). DynaSKIN volume, mean depth and maximum depth parameters were correlated with age and 15 Cutometer® parameters. Subsequently, the firming efficacy of a skincare regimen featuring acetyl aspartic acid (AAA) and a peptide complex was examined in a cohort of 41 volunteers. RESULTS: DynaSKIN volume, mean depth and maximum depth parameters correlate with age and the Cutometer® parameters that are associated with the skin relaxation phase (R1, R2, R4, R5, R7 and F3). Furthermore, the DynaSKIN captured significant improvements in skin firmness delivered by the skincare regimen. CONCLUSION: The DynaSKIN is a novel device capable of capturing skin biomechanics at a high level of specificity and successfully detected the firming properties of a skincare regimen. Its independent measuring principle, consumer relevance and skin firmness 3D visualisation capabilities bring objectivity and novelty to product efficacy substantiation evaluation.

Intense pulsed light (IPL) treatment for the skin in the eye area - clinical and cutometric analysis.

OBJECTIVE: The aim of the research was to establish the influence of IPL treatment on skin ageing in the eye area. MATERIAL AND METHODS: This study included 24 women, aged 38-63 years (mean age was 48.04) with Fitzpatrick skin type II and III who underwent five successive treatment sessions with an IPL in two-week intervals. The Cutometer (Courage + Khazaka electronic) reference test was an objective method for the assessment of the biomechanical properties of the skin. The measurements were made in three places around the eye. The photo documentation was used to compare state of skin before and after three months of treatments. Additionally, patients filled in a questionnaire, which contained questions concerning self-assessment of the procedure effects. RESULTS: Cutometric analysis showed significant improvement of skin elasticity (statistical significance level is mostly < 0.0001). The comparison of clinical changes in the therapy, based on photo documentation, showed a 25% improvement. CONCLUSIONS: This treatment was used in order to improve skin elasticity and decrease the amount and depth of wrinkles. It is a non-invasive treatment, with low risk of complications.

Correlation study between image features and mechanical properties of Han Chinese facial skin.

OBJECTIVE: Mechanical properties are considered to be vital factors that influence skin physiology during ageing. Wrinkles and skin roughness are the two main features in aged skin. The purpose of this study is to characterize the relationship between facial skin mechanical properties and image features using quantitative methods. METHODS: Two hundred and forty healthy male and female volunteers living in Shanghai, China (aged 20-70 years), were examined in this study. Facial images were photographed by VISIA-CR. Wrinkle volume of middle forehead and skin roughness of upper cheek were analysed by Skin Surface Analyzer (SSA) software. Mechanical parameters at the middle forehead and upper cheek were measured using Cutometer® MPA 580 and Reviscometer® RVM 600. RESULTS: Skin wrinkles and roughness increased during ageing, where men have a higher level and earlier manifestation than women. Skin mechanical parameters R2, R5, R7 and RRT were found decreased with age. Moreover, mechanical parameters including R2, R7, RRT and anisotropy showed significant correlations with wrinkle volume and/or skin roughness. CONCLUSION: The facial image features including wrinkle volume and skin roughness are significantly correlated with skin elasticity and anisotropy, which could well describe the skin features of Han Chinese.

Efficacy of gelatin gel sheets in sustaining the release of basic fibroblast growth factor for murine skin defects.

BACKGROUND: Gelatin has been used as a material sustaining the release of basic fibroblast growth factor (bFGF), which promotes fibroblast proliferation and capillary formation and accelerates wound healing. In the application of these materials, bFGF is impregnated immediately before application, and it is difficult to conform the shape to the wound. In this study, we prepared a pliable and plastic gelatin gel sheet (GGS) that sustains bFGF and conforms to the shape of the wound as a result of cross-linking just before application. In addition, we examined the sustained release profile of bFGF from GGS and its effect on wound healing in murine skin defects. MATERIALS AND METHODS: A 13-wt% gelatin solution was mixed with bFGF before cross-linking with 1% glutaraldehyde solution. GGSs impregnated with 7 µg/cm(2) of bFGF were incubated in phosphate-buffered saline and collagenase solution, and GGS degradation and bFGF release were evaluated. In the murine experiments, GGSs treated without bFGF and GGSs impregnated with 1, 3.5, 7, or 14 µg/cm(2) of bFGF were applied to full-thickness skin defects created on the backs of C57BL/6JJcl mice, and the wound closure, epithelial length, extent of granulation tissue and capillary formation were compared. RESULTS: bFGF was released according to the degradation of GGS in phosphate-buffered saline, and the remaining bFGF was released in collagenase solution. In the animal studies, epithelialization was accelerated in the GGSs treated with 1 and 3.5 µg/cm(2) of bFGF, and granulation tissue formation and angiogenesis were promoted based on the amount of bFGF impregnated into the GGS. CONCLUSIONS: GGS impregnated with bFGF is capable of sustaining the release of bFGF, with consequent accelerated epithelialization, granulation tissue formation, and angiogenesis in vivo. GGS is a novel and promising wound dressing that sustains bFGF and can be adapted to the shape of various wounds in the treatment of both acute and chronic wounds.

Dermal anchoring structures: convex matrix structures at the bottom of the dermal layer that contribute to the maintenance of facial skin morphology.

BACKGROUND/PURPOSE: Facial skin must be linked to underlying structures to maintain facial morphology and prevent sagging, but the mechanism of facial skin retention is largely unknown. We aimed to elucidate this mechanism. METHODS: Twenty-two cheek skin specimens (age range: 10s-60s, both genders) were observed histologically. And 30 cheek of healthy Japanese volunteers (age range: 30s-50s, female) was photographed and the severity of sagging was graded. Dermal layer morphology was observed non-invasively with ultrasound. Skin-retaining force was measured with a Cutometer MPA 580(®) , and sagging severity was evaluated by grading criteria. RESULTS: Histological observation revealed characteristic convex structures at the bottom of the dermal layer. Non-invasive study showed that the depth of the convex structures, measured by ultrasonography, was significantly negatively related to the ratio of viscoelastic to elastic distention (Uv/Ue) and positively related to the ratio of elastic recovery to total deformation (Ur/Uf) at the cheek of female volunteers, measured by cutometer. It was also negatively related to sagging severity. Further, Ur/Uf was negatively and Uv/Ue was positively related to sagging severity. CONCLUSION: Characteristic convex structures at the bottom of the dermal layer serve as anchoring structures to maintain skin morphology.

Skin characteristics: normative data for elasticity, erythema, melanin, and thickness at 16 different anatomical locations.

BACKGROUND: The clinical use of non-invasive instrumentation to evaluate skin characteristics for diagnostic purposes and to evaluate treatment outcomes has become more prevalent. The purpose of this study was to generate normative data for skin elasticity, erythema (vascularity), melanin (pigmentation), and thickness across a broad age range at a wide variety of anatomical locations using the Cutometer(®) (6 mm probe), Mexameter(®) , and high-frequency ultrasound in a healthy adult sample. METHODS: We measured skin characteristics of 241 healthy participants who were stratified according to age and gender. Sixteen different anatomical locations were measured using the Cutometer(®) for maximum skin deformation, gross elasticity, and biological elasticity, the Mexameter(®) for erythema and melanin, and high-frequency ultrasound for skin thickness. Standardized measurement procedures were applied for all participants. RESULTS: The means and standard deviations for each measured skin characteristic for females and males across five different age groups (20-29, 30-39, 40-49, 50-59, 60-69, and 70-85 years old) are presented. As previously described, there were variations in skin characteristics across age groups, anatomical locations, and between females and males highlighting the need to use site specific, age and gender matched data when comparing skin characteristics. CONCLUSION: The reported data provides normative data stratified by anatomical location, age, and gender that can be used by clinicians and researchers to objectively determine whether patients' skin characteristics vary significantly from healthy subjects.

Alteration of Skin Mechanical Properties in Patients Undergoing Botulinum Toxin Type A Injections of Forehead Rhytides.

BACKGROUND: Although application of botulinum toxin type A (BTX-A) for the treatment of forehead rhytides has become very popular, the effects of its intramuscular injections on the skin mechanical properties remain unclear. OBJECTIVES: We prospectively investigated the alterations in the mechanical properties of the skin of patients who received intramuscular injections of botulinum toxin A (BTX-A) for forehead rhytides and compared two injection doses. METHODS: Of the 42 enrolled patients, one randomly assigned half received intramuscular injections of two units (group I), and the other half received four units (group II) of BTX-A in each injection point. The baseline and post-treatment skin mechanical parameters, including gross elasticity (R2), net elasticity (R5), viscoelastic ratio (R6) and biological elasticity (R7), were measured using the Cutometer(®) and compared. RESULTS: Treatment with BTX-A resulted in significant overall alterations in the mechanical properties of skin at the injection sites of both treatment groups during the 16-week period, and no significant differences were observed between groups. Significant decreases in biological elasticity, net elasticity and viscoelasticity properties were observed at 2 weeks follow-up and began to recover at that time. All of the skin mechanical properties recovered to baseline levels by 16 weeks of follow-up in both dosage groups, which indicates that the higher dosage (4 units) did not delay relapse compared to the two-unit dosage. CONCLUSIONS: We concluded that intramuscular injections of BTX-A significantly regulated the gross elasticity, net elasticity, functional elasticity and viscoelastic elasticity at the injection point over a radius of 1.5 cm at 2, 4 and 8 weeks follow-up. The alteration in the skin measurements had completely diminished by the 16-week follow-up. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

[Anti-wrinkle creams with hyaluronic acid: how effective are they?]. / Hyaluronsäurehaltige Antifaltencremes: Wie gut wirken sie? : Eine Analyse von Antifaltencremes unterschiedlicher Preisklassen auf Basis objektiver Messmethoden.

BACKGROUND: Anti-wrinkle creams containing hyaluronic-acid are often advertised as an efficacious option for the treatment of wrinkles and have even been presented as an option equal to some medical procedures in this regard. Evidence from conclusive and systematic research supporting those claims, however, is widely lacking. OBJECTIVES: During this trial we examined whether the daily use of anti-wrinkle creams containing hyaluronic-acid has an influence on the depth of wrinkles as well as skin tightness and elasticity. METHODS: We split up 20 patients into four groups, each of which were assigned an anti-wrinkle cream containing hyaluronic acid for daily use. Four different creams within different price ranges were chosen (Balea, Nivea, Lancôme, Chanel). Before and after the 3 month trial, wrinkle depth was assessed using the PRIMOS(pico) (GFMesstechnik, Teltow, Germany) and skin-tightness and elasticity were evaluated using the Cutometer MP580 (Courage+Khazaka, Cologne, Germany). Additionally, after the trial, questionnaire data on patient satisfaction with their individual product was collected. RESULTS: The depth of perioral and orbital wrinkles decreased significantly in all groups, with depth reduction ranging between 10% and 20%. Skin-tightness increased significantly in all groups, rising by 13 to 30%. Minimal significant changes in skin-elasticity could only be shown in individual groups. CONCLUSIONS: The regular use of hyaluronic-acid containing anti-wrinkle creams for over 3 months showed clear and positive effects on wrinkle-depth and skin-tightness. Due to the design of the study, however, no clear indication on the efficacy of hyaluronic acid could be shown.

In vivo topical application of acetyl aspartic acid increases fibrillin-1 and collagen IV deposition leading to a significant improvement of skin firmness.

OBJECTIVE: Acetyl aspartic acid (A-A-A) was discovered through gene array analysis with corresponding Cmap analysis. We found that A-A-A increased keratinocyte regeneration, inhibited dermal matrix metalloprotease (MMP) expression and relieved fibroblast stiffness through reduction of the fibroblast stiffness marker F-actin. Dermal absorption studies showed successful delivery to both the epidermal and dermal regions, and in-use trial demonstrated that 1% A-A-A was well tolerated. In this study, the aim was to investigate whether A-A-A could stimulate the synthesis of extracellular matrix supporting proteins in vivo and thereby improving the viscoelastic properties of human skin by conducting a dual histological and biophysical clinical study. METHOD: Two separate double-blind vehicle-controlled in vivo studies were conducted using a 1% A-A-A containing oil-in-water (o/w) emulsion. In the histological study, 16 female volunteers (>55 years of age) exhibiting photodamaged skin on their forearm were included, investigating the effect of a 12-day treatment of A-A-A on collagen IV (COLIV) and fibrillin-1. In a subsequent pilot study, 0.1% retinol was used for comparison to A-A-A (1%). The biomechanical properties of the skin were assessed in a panel of 16 women (>45 years of age) using the standard Cutometer MPA580 after topical application of the test products for 28 days. The use of multiple suction enabled the assessment of F4, an area parameter specifically representing skin firmness. RESULTS: Twelve-day topical application of 1% A-A-A significantly increased COLIV and fibrillin with 13% and 6%, respectively, compared to vehicle. 1% A-A-A and 0.1% retinol were found to significantly reduce F4 after 28 days of treatment by 15.8% and 14.7%, respectively, in the pilot Cutometer study. No significant difference was found between retinol and A-A-A. However, only A-A-A exhibited a significant effect vs. vehicle on skin firmness which indicated the incremental benefit of A-A-A as a skin-firming active ingredient. CONCLUSION: In this study, we showed the in vivo efficacy of 1% A-A-A both on a protein level (fibrillin and collagen IV) and on a clinical end point, specifically skin firmness, providing proof that, acetyl aspartic acid has a strong potential as an anti-ageing 'cosmeceutical' ingredient answering the needs of our key consumer base.

Comparison of skin elasticity test results from the Ballistometer(®) and Cutometer(®).

BACKGROUND: Long-term exposure to sunlight changes skin features like amount of facial wrinkling and skin elasticity, which is useful in estimating skin health and age-related changes. Skin elasticity is evaluated by quantitative methods such as the noninvasive suction device Cutometer(®) , which is widely used to evaluate regional body-elasticity differences and correlate these findings with the results of other instrumental data. Few field studies have been done with the Ballistometer(®) device, another noninvasive method for measuring skin elasticity. METHOD: In this study, we measured the skin elasticity of each subject's forehead, cheek, and volar forearm using two devices with different means of obtaining quantitative measurements - Ballistometer(®) (Diastron Ltd.) and Cutometer(®) (CK electronics). RESULTS: The results from testing with the Ballistometer(®) and Cutometer(®) devices showed that the degree of skin elasticity of the volar forearm is greater than those found on the cheek and forehead. The parameters measured by the Ballistometer(®) showed high correlation patterns. On the cheek skin, the correlation coefficient between Ballisto-parameters and R parameters (R0, R3, R8) was higher than other skin sites. CONCLUSION: Taken together, R parameters measured by the Cutometer(®) device have been widely distributed in the evaluation of skin elasticity in research and cosmetics. Although the methodologies are different, the Ballistometer(®) device is also a useful tool to evaluate skin elasticity.

Mechanical properties of human skin in vivo: a comparative evaluation in 300 men and women.

BACKGROUND: Previous studies have shown that the clinical genesis and onset of facial wrinkles as well as the morphology of the extracellular matrix differ between the sexes. The aim of this present clinical study was to do the first systematic assessment of gender-related differences in skin elasticity, with special focus on age-related changes. MATERIAL AND METHODS: 300 healthy male and female subjects (20-74 years) were selected following strict criteria including age, sun behavior or smoking habits. Skin mechanical properties were assessed at the cheek, neck, volar forearm and dorsum of the hand using a non-invasive suction device. RESULTS: Data analysis shows a significant negative correlation for all parameters and subject's age. At young age results of the relative parameters are higher for women, whereas absolute parameters are higher for men. Parameters referring to the recovery phase change stronger with aging. DISCUSSION: The present study verifies the progressive decline of the skin mechanical properties with aging. However, the elastic ability of the skin to recover after stretching is more strongly affected by the aging process than the firmness of the skin. Further, the mechanical properties change differently in men and woman over lifetime.

Ultra-Hypofractionated Whole Breast Radiotherapy with Automated Hybrid-VMAT Technique: A Pilot Study on Safety, Skin Toxicity and Aesthetic Outcomes.

Purpose: The most prevalent treatment-related side effect related to adjuvant radiotherapy (RT) for breast cancer is acute skin toxicity in the irradiated area. The purpose of this single-institution pilot study is to provide preliminary clinical results on the feasibility and safety of a breast ultra-hypofractionated radiation treatment delivered using an automated hybrid-VMAT technique. Skin damage was assessed both with clinical examination and objectively using a Cutometer equipment. Patients and Methods: Patients received 26 Gy to the whole breast and 30 Gy to the tumoral bed in 5 fractions using an automated hybrid-VMAT approach with the option for the breath hold technique if necessary. Acute and late toxicities were clinically evaluated at baseline, 1- and 6-months after treatment using the CTC-AE v.5.0 scale. An instrumental evaluation of the skin elasticity was performed using a Cutometer® Dual MP580. Two parameters per patient, R0 (the total skin firmness) and Q1 (the elastic recovery), were registered at the different timelines. Results: From June 2022 to January 2024, 30 patients, stage T1-T2, N0 were enrolled in the study. Four out of 30 (13.3%) patients reported G2 acute skin toxicities. At 6 months, G2 late toxicity was registered in 3 patients (10%). A total of 2160 measures of R0 and Q1 were recorded. At 1 month after treatment, no correlation was found between measured values of R0 and Q1 and clinical evaluation. At 6 months after treatment, clinical late toxicity ≥1 was strongly associated with decreased R0 and Q1 values ≥24% (p = 0.003) and ≥18% (p = 0.022), respectively. Conclusion: Ultra-hypofractionated whole-breast radiotherapy, when supported by advanced treatment techniques, is both feasible and safe. No severe adverse effects were observed at any of the different timeframes. Acute and late skin toxicities were shown to be lower in contrast to data presented in the literature.