Antioxidant Efficacy of a Standardized Red Orange (Citrus sinensis (L.) Osbeck) Extract in Elderly Subjects: A Randomized, Double Blind, Controlled Study.

The world population is rapidly aging. This should cause us to reflect on the need to develop a new nutritional approach to mitigate the accumulation of reactive oxygen species (ROS)-induced damage. A randomized, double blind, controlled study was carried out on 60 elderly male and female subjects. Product efficacy was measured before and after 2 and 8 weeks of product intake. The reduced (GSH) and oxidized (GSSG) glutathione concentrations in the erythrocytes and the reactive oxygen metabolites (d-ROMs) hematic concentration were measured to assess the antioxidant efficacy. The tumor necrosis factor-alpha (TNF-α) levels in the serum were measured to assess the anti-inflammatory effectiveness. The wellbeing was assessed by Short Form Health Survey (SF-36) questionnaire (male) and by Menopause Rating Scale (MRS) (female). Blood, urine analysis and electrocardiography (ECG) were carried out to assess the product's safety. The results showed that GSH/GSSG ratio increased by 22.4% and 89.0% after 2 and 8 weeks of product intake. Serum TNF-α levels decreased by 2.5% after 8 weeks of product intake. The SF-36 QoL and the MRS questionnaire outputs indicate, preliminarily, a positive effect of the extract intake in ameliorating the wellbeing of both male and female subjects. The product was well-tolerated. Our findings suggest that the test product has antioxidant and anti-inflammatory efficacy and has a positive effect on the wellbeing of elderly female and male subjects.

Photoprotective and Antiaging Effects of a Standardized Red Orange (Citrus sinensis (L.) Osbeck) Extract in Asian and Caucasian Subjects: A Randomized, Double-Blind, Controlled Study.

The increase in solar ultraviolet radiation (UVR) that reaches the Earth's surface should make us reflect on the need to develop new approaches in protecting the skin from UVR exposure. The present study aims to evaluate the photoprotective and antiaging efficacy of a red orange extract (100 mg/day) in both Asian and Caucasian subjects. A randomized, double-blind, controlled study was carried out in 110 Asian and Caucasian subjects. Product efficacy was measured as follows: (1) the photoprotective effect was measured by the minimal erythema dose (MED) assessment; (2) the efficacy in decreasing the UVA+B-induced skin redness was measured by colorimetry; (3) the antioxidant efficacy was measured by the ferric-reducing antioxidant power (FRAP) and the malondialdehyde (MDA) assay; and (4) skin moisturization, skin elasticity, skin radiance, the intensity of melanin staining, transepidermal water loss (TEWL), and wrinkles were measured to assess the antiaging efficacy. The intake of the product for 56 days was effective in improving the skin reaction to UV exposure; in increasing the skin antioxidant capacity as well as in decreasing UVA-induced lipid peroxidation; in increasing the skin moisturization, skin elasticity, and skin radiance; and in decreasing TEWL, the intensity of melanin staining inside dark spots, and wrinkle depth. Our results suggest that the test product is effective in counteracting both the harmful effects of UVR exposure and aging signs.

Effectiveness of Multistrain Probiotic Formulation on Common Infectious Disease Symptoms and Gut Microbiota Modulation in Flu-Vaccinated Healthy Elderly Subjects.

The decline of the immune system with aging leads elderly people to be more susceptible to infections, posing high risk for their health. Vaccination is thus important to cope with this risk, even though not always effective. As a strategy to improve protection, adjuvants are used in concomitance with vaccines, however, occasionally producing important side effects. The use of probiotics has been proposed as an alternative to adjuvants due to their efficacy in reducing the risk of common infections through the interactions with the immune system and the gut microbiota. A placebo-controlled, randomized, double-blind, clinical trial was carried out on fifty elderly subjects, vaccinated for influenza, to determine the efficacy of a probiotic mixture in reducing common infection symptoms. The incidence of symptoms was evaluated after 28 days of probiotic intake (namely, T28) and after further 28 days of follow-up (namely, T56). The number of subjects, as well as the number of days with symptoms, was remarkably reduced at T28, and even more at T56 in the probiotic group. Furthermore, the influence of probiotics on immunological parameters was investigated, showing a significant positive improvement of total antioxidant capacity and ß-defensin2 levels. Finally, faecal samples collected from participants were used to assess variations in the gut microbiota composition during the study, showing that probiotic intake enhanced the presence of genera related to a healthy status. Therefore, the collected results suggested that the treatment with the selected probiotic mixture could help in reducing common infectious disease symptom incidence through the stimulation of the immune system, improving vaccine efficacy, and modulating the composition of the resident gut microbiota by enhancing beneficial genera.

Efficacy Evaluation of a Cosmetic Product for the Periocular Area in Caucasian Women Aged Over 40 Years Old.

Purpose: The present study was aimed at evaluating the efficacy of a cosmetic product in improving the appearance of periocular skin. Patients and Methods: An open-label study on 40 female subjects showing clinical signs of skin aging in the periocular area (including bags under the eye and dark circles) was conducted. At day 0 and day 28 the bags under eye volume, dark circles color, skin texture, skin moisturization, skin elasticity, and skin radiance were measured. The instrumental measurements were integrated by clinical analysis carried out by a board-certified dermatologist and by a self-assessment questionnaire carried out by each subject participating in the study. Results: After 28 days of product use the volume of the bags under the eye was decreased by 6.8% (p = 0.005), the dark circle color red and blue component improved by 7.1% (p = 0.001) and 4.0% (p = 0.001), respectively, wrinkle depth and skin roughness decreased by 15.8% (p = 0.001) and 6.3% (p = 0.011), respectively, skin moisturization increased by 11.7% (p = 0.000), the skin distensibility decreased by 8.9% (p = 0.000), the overall skin elasticity increased by 10.4% (p = 0.000), and the skin radiance increased by 16.3% (p = 0.000). The instrumental measured effects were also confirmed by the clinical analysis of the dermatologist and the self-assessment questionnaire output. Conclusion: Conclusions: our results suggest that the test product is effective for periocular skin aesthetics (reduction of imperfections undermining the periocular area) and wellness.

Oral intake of a new full-spectrum hyaluronan improves skin profilometry and ageing: a randomized, double-blind, placebo-controlled clinical trial.

BACKGROUND: Skin aging is a physiological condition which leads to structural and functional changes in skin. Common signs of aging are the gradual decrease of hyaluronic acid (HA) in the skin and the appearance of wrinkles. Therefore, effective HA supplementation could counteract HA deficiency and improve skin parameters, providing a safe profile for use which is easily incorporated into daily routine. OBJECTIVES: To evaluate a food supplement containing a wide range of hyaluronans of different molecular weights (full-spectrum hyaluronan [FS-HA]) in order to ameliorate skin conditions in adult females. MATERIALS & METHODS: Sixty subjects showing mild-to-moderate skin aging signs were enrolled in a double-blind, randomized, placebo-controlled clinical trial to receive 200 mg/day of FS-HA (ExceptionHYAL® Star), or placebo, for 28 days. Dermatological parameters were evaluated at T0d and T28d. Product efficacy and tolerance were further evaluated using a self-assessment questionnaire. In addition, HA serum levels were weekly evaluated in a proportion of enrolled subjects. RESULTS: After only 28 days, subjects in the active arm showed a statistically significant improvement in all evaluated dermatological parameters related to skin aging. Skin became more hydrated (+10.6%) and protected from dehydration, with a decrease in both wrinkle depth (-18.8%) and volume (-17.6%) and increase in elasticity and firmness (+5.1%). Instrumental results were further confirmed by self-assessment questionnaire outcomes. CONCLUSION: Administration of a food supplement based on innovative hyaluronans from bio-fermentation, characterized by a wide range of molecular weights, resulted in a quick and significant amelioration of typical signs of skin aging.

Efficacy of a probiotic supplement in patients with atopic dermatitis: a randomized, double-blind, placebo-controlled clinical trial.

BACKGROUND: Atopic dermatitis (AD) is a multifactorial long-standing inflammatory skin disease with a high incidence worldwide in both adults and children. According to the recognized correlation between skin and intestine-the so-called "gut-skin axis"-gut unbalances can affect skin by inducing systemic inflammation and triggering dermatological diseases such as AD. OBJECTIVES: To evaluate the efficacy of a food supplement containing selected strains of probiotics in ameliorating AD symptoms and skin conditions in adult volunteers. MATERIALS & METHODS: Eighty adult subjects showing mild-to-severe AD, skin dryness, desquamation, erythema and itching were enrolled in a randomized controlled trial to receive, for 56 days, a placebo or a mixture of lactobacilli (L. plantarum PBS067, L. reuteri PBS072 and L. rhamnosus LRH020). The latter was chosen according to the patients' production of post-biotic metabolites and B-group vitamins, anti-inflammatory and anti-oxidant capacity and anti-microbial activity. Clinical and instrumental dermatological evaluation was performed at T0d, T28d and T56d, and then at T84d (after a one-month wash-out). Inflammatory cytokine levels from skin tape stripping, sampled close to AD lesions at T0d and T56d, were also measured. RESULTS: Subjects receiving the probiotic mixture showed an improvement in skin smoothness, skin moisturization, self-perception, and a decrease in SCORAD index as well as in the levels of inflammatory markers associated with AD at T28d, with a positive trend up to T56d which was maintained at T84d. CONCLUSION: Administration of selected probiotic strains resulted in a fast and sustained improvement in AD-related symptoms and skin conditions.

Pleuran-ß-Glucan from Oyster Culinary-Medicinal Mushroom, Pleurotus ostreatus (Agaricomycetes), Soothes and Improves Skin Parameters.

Ultraviolet (UV) radiation, particularly UVB radiation, is one of the major risk factors for environmentally influenced skin disorders. ß-D-glucans represent a class of natural compounds, and their use in the cosmetic and pharmaceutical industries is increasing. The goal of this study was to evaluate the soothing effect of a ß-glucan pleuran-based cream against skin alterations caused by a solar simulator (UVA/UVB exposure) and to assess the efficacy of the cream after 30 days of use on the face and body in 20 human subjects with all skin types (sensitive, atopic, and normal) and phototypes II and III. The study consisted of the following two tests: one short term and one long term. In the short-term test, the minimal erythemal dose was determined by applying a pattern of radiation consisting of six doses of UVA+UVB radiation and was visually assessed 24 h after UV exposure. In the long-term test, pleuran-based cream was applied twice a day on both the nonirradiated face and body of all subjects for a 30-day period. Subsequently, noninvasive techniques such as skin moisture, skin brightness/radiance, skin elasticity, and total antioxidant capability were utilized. The pleuran-based cream had a positive effect on erythema induced by UV exposure, with visibly reduced erythema compared to the control area. Moreover, long-term use of the cream over a 30-day period improved all monitored skin parameters on the face and body. In summary, these results indicate that ß-glucans can be used as an active ingredient with UV light-protective and soothing properties after UV exposure for the cosmetic and pharmaceutical industries.

Effective Use of Nonablative Fractional Laser on Multiple Whip Scars.

BACKGROUND: Laser technology provides different solutions for scar treatment from the traditional ablative lasers to the more recent fractional devices. PATIENTS AND METHODS: We present the case of a young woman treated for scars induced by severe whipping since the age of 10. She received four monthly nonablative fractional 1550 nm erbium glass laser treatments. Fluence used was 20 mJ/cm2 with 1500 microthermal zones/cm2. RESULTS: Significant improvement was documented in the color and texture of the lesion at the end of treatment and at follow-up. Treatment had no major side effects and was well tolerated. CONCLUSIONS: We believe that nonablative fractional lasers, used mainly for cosmetic purposes, may be useful in managing post-traumatic scars as well.

Acne RA-1,2, a novel UV-selective face cream for patients with acne: Efficacy and tolerability results of a randomized, placebo-controlled clinical study.

BACKGROUND: General skincare measures such as the use of moisturisers and products containing adequate photoprotection are important components of acne patients' management to complement the pharmacological regimen. Acne RA-1,2 is a novel dermato-cosmetic product which contains selective photofilters and active ingredients against the multifactorial pathophysiology of acne. OBJECTIVES: To evaluate the tolerability of Acne RA-1,2 and its effect on the clinical signs of acne. METHODS: This double-blind, placebo-controlled study randomized 40 adult patients with 10-25 comedones per half face to once-daily application of Acne RA-1,2 or placebo for 8 weeks. Evaluations after 4 and 8 weeks included the number of comedones, transepidermal water loss (TEWL), sebum production, and tolerability. RESULTS: In the Acne RA-1,2 group, there was a significant 35% decrease in the mean number of comedones from 26 at baseline to 17 at Week 8 (P<.001), a 7% significant reduction in TEWL (9.32 to 8.66 g/h/m2 ; P<.001), and a 24% significant reduction in sebum production (154.8 to 117.6 µg/cm2 ; P<.001). The reductions in TEWL and sebum production were significantly greater than those in the placebo group at Weeks 4 and 8 (P<0.05). There were no adverse events. CONCLUSIONS: Acne RA-1,2 was well tolerated and effective at reducing comedones and sebum production and improving epidermal barrier function. These results suggest that Acne RA-1,2 is useful against acne-prone facial skin, particularly as it targets sebum production, which topical pharmacological acne therapies do not address.

Skin photoprotective and antiageing effects of a combination of rosemary (Rosmarinus officinalis) and grapefruit (Citrus paradisi) polyphenols.

BACKGROUND: Plant polyphenols have been found to be effective in preventing ultraviolet radiation (UVR)-induced skin alterations. A dietary approach based of these compounds could be a safe and effective method to provide a continuous adjunctive photoprotection measure. In a previous study, a combination of rosemary (Rosmarinus officinalis) and grapefruit (Citrus paradisi) extracts has exhibited potential photoprotective effects both in skin cell model and in a human pilot trial. OBJECTIVE: We investigated the efficacy of a combination of rosemary (R. officinalis) and grapefruit (C. paradisi) in decreasing the individual susceptibility to UVR exposure (redness and lipoperoxides) and in improving skin wrinkledness and elasticity. DESIGN: A randomised, parallel group study was carried out on 90 subjects. Furthermore, a pilot, randomised, crossover study was carried out on five subjects. Female subjects having skin phototype from I to III and showing mild to moderate chrono- or photoageing clinical signs were enrolled in both studies. Skin redness (a* value of CIELab colour space) after UVB exposure to 1 minimal erythemal dose (MED) was assessed in the pilot study, while MED, lipoperoxides (malondialdehyde) skin content, wrinkle depth (image analysis), and skin elasticity (suction and elongation method) were measured in the main study. RESULTS: Treated subjects showed a decrease of the UVB- and UVA-induced skin alterations (decreased skin redness and lipoperoxides) and an improvement of skin wrinkledness and elasticity. No differences were found between the 100 and 250 mg extracts doses, indicating a plateau effect starting from 100 mg extracts dose. Some of the positive effects were noted as short as 2 weeks of product consumption. CONCLUSIONS: The long-term oral intake of Nutroxsun™ can be considered to be a complementary nutrition strategy to avoid the negative effects of sun exposure. The putative mechanism for these effects is most likely to take place through the inhibition of UVR-induced reactive oxygen species and the concomitant inflammatory markers (lipoperoxides and cytokines) together with their direct action on intracellular signalling pathways.

A home-based eyebrows lifting effect using a novel device that emits electrostatic pulses containing RF energy, resulting in high frequency, low level transdermal microcurrent pulsations: Double blind, randomized clinical study of efficacy and safety.

BACKGROUND: As the appearance of the face is a primary concern of many people, ways in which to tighten the skin are increasingly in demand. In recent years, radiofrequency (RF) has become a promising nonablative, non-invasive, technique for facial rejuvenation. OBJECTIVE: To assess the safety and the efficacy of a unipolar RF-based device for home use in increasing skin tightness (lifting effect) in the eyebrows area. METHODS: Subjects (N = 50) aged between 30 and 70 years old showing skin wrinkledness all over the face and skin laxity in the eyebrows area were enrolled. The primary endpoint was the assessment of the eyebrow to hairline distance by means of a morphometric digital image analysis technique. RESULTS: The eyebrows to hairline distance was statistically significant (both vs. basal condition and placebo) decreased by 1.338 ± 0.170 cm in the treated eyebrow. CONCLUSION: The obtained results confirm the safety and the efficacy of the tested device in decreasing skin laxity in the eyebrows area. The treatment is not time-consuming (about 6 minutes) and can be done at home. The device seems to be then a useful tool to delay skin laxity or to prolong the time to the first surgical facial lift.

Resveratrol-procyanidin blend: nutraceutical and antiaging efficacy evaluated in a placebocontrolled, double-blind study.

BACKGROUND: Skin is constantly exposed to pro-oxidant environmental stress from several sources, including air pollutants, ultraviolet solar light, and chemical oxidants. Reactive oxygen species have been implicated in age-related skin disorders. Dietary bioactive antioxidant compounds, such as polyphenols, have beneficial effects on skin health. The advantage of a nutritional administration route is that blood delivers nutraceutical bioactive compounds continuously to all skin compartments, ie, the epidermis, dermis, and subcutaneous fat. The purpose of this study was to evaluate the topical and systemic effects of a dietary supplement containing resveratrol and procyanidin on age-related alterations to the skin, the skin antioxidant pool, and systemic oxidative stress levels. METHODS: An instrumental study was performed in 50 subjects (25 treated with supplements and 25 with placebo) to identify clinical features induced by chronoaging or photoaging. Product efficacy was evaluated after 60 days of treatment in terms of in vivo and in situ skin hydration, elasticity, and skin roughness levels, systemic oxidative stress levels by plasmatic derivatives of reactive oxygen metabolites and oxyadsorbent tests, and extent of the skin antioxidant pool. RESULTS: After 60 days of treatment, values for systemic oxidative stress, plasmatic antioxidant capacity, and skin antioxidant power had increased significantly. Additionally, skin moisturization and elasticity had improved, while skin roughness and depth of wrinkles had diminished. Intensity of age spots had significantly decreased, as evidenced by improvement in the individual typological angle. CONCLUSION: Nutraceutical and pharmacological intervention with a supplement characterized by a specific blend of resveratrol and procyanidin may be a promising strategy to support treatments for the reduction of skin wrinkling, as well as reducing systemic and skin oxidative stress.

Mycosis fungoides in childhood: description and study of two siblings.

Primary cutaneous T-cell lymphomas are exceedingly rare in children and adolescents. However, mycosis fungoides (MF) is the most frequent primary cutaneous lymphoma diagnosed in childhood. Two cases of MF in siblings (a 14-year-old boy and his 10-year-old sister) are reported. On the basis of clinical features (histopathological and immunophenotypical findings) a diagnosis of MF patch lesions was made in both siblings. Since recent data in the literature have underlined a high frequency of the HLA-DQB1*03 allele in patients with familial MF (including child patients), the HLA profile of the patients was analysed, indicating the presence of a haplotype (HLA-DQB1*03,*03 in the girl, HLA-DQB1*02,*03 in the boy) corresponding with that described in recent literature. Two rare and exceptional cases of MF in siblings are reported, highlighting the presence of a peculiar haplotype.