Modeling of global skin aging indices among Caucasian and Asian women.

BACKGROUND: The skin aging process is defined as the gradual degradation of several skin properties such as firmness, color, or the appearance of wrinkles. These properties can be assessed by trained experts, who perform an overall evaluation of the entire face. OBJECTIVE: The objective of this paper is the construction of two Global Skin Aging Indices specifically designed to model the overall skin aging process of Caucasian and Asian women. METHODS: Two hundred forty Asian women and 129 Caucasian women aged between 20 and 60 years old are recruited. Parameters related to wrinkles, sagging, elasticity, and skin tone are measured (clinically or instrumentally). The global skin aging index is defined as the normalized projection on the first principal component of a principal component analysis of the skin measurements. Then, linear regressions are performed between the indices and age of both panels. RESULTS: The first principal component carries around 50% of the initial variance for both indices. Both Global Skin Aging Indices statistically correlate with age (R2 ≥ 0.7, p-value < 0.05). An equation linking the indices with age is computed. CONCLUSION: The proposed indices are good indicators of the overall aging process for Caucasian and Asian women. They offer new approaches to assess antiaging product efficacy.

A Harungana madagascariensis extract with retinol-like properties: Gene upregulations and protein expressions in human fibroblasts and skin explants.

OBJECTIVE: Because they limit, even reverse, age-induced skin alterations, retinoids became a staple in cosmetology. However, their use can result in undesired secondary effects and there is a demand for natural sources of compounds with retinoid-like effects. A preliminary screening identified a Harungana madagascariensis plant extract (HME) as possibly inducing genes stimulated by retinol. We analysed its effect on gene and protein expression, comparing it to retinoids. METHODS: Gene expression was analysed by real-time qPCR on RNA from isolated fibroblasts subjected to retinol or the plant extract for 6, 48 or 96 h. Skin markers were quantified in fibroblasts cultured with retinol or extract containing medium, and UV-aged skin explants subjected to topical applications of creams containing retinol, retinaldehyde or HME. RESULTS: Real-time qPCR shows that the extract induced all RARs and RXRs, even RXRγ that was not induced by retinol. Eighty-eight per cent of the 25 early retinoid reaction genes induced by a concentration of retinol are induced by the extract. In fibroblasts, only the extract increased collagen III labelling, while collagen I and fibronectin labelling are increased by retinol and the extract, with higher levels for the extract. When topically applied to UV-aged skin explants, only the cream containing the HME led to increased labelling of CRABP1 in the epidermis. CRABP2 and Ki67 are induced by all three creams and no effect was detected on RXRs. In the dermisthe extract containing cream increased CRABP2, total collagen, procollagen I and collagen I while creams with retinol or retinaldehyde only affected some of these proteins. CONCLUSIONS: The HME induces an overall retinol-like gene induction profile in isolated fibroblasts and retinoid-like stimulation of protein synthesis in both isolated fibroblasts and photoaged skin explants.

OBJECTIFS: Limitant, voire inversant les altérations cutanées induites par l'âge, les rétinoïdes sont devenus incontournables en cosmétologie. Cependant, leur application topique peut entraîner des effets secondaires indésirables et il existe une demande pour des composés naturels ayant des effets similaires à ceux des rétinoïdes. Un screening préliminaire nous avait permis d'identifier un extrait de la plante Harungana madagascariensis (HME) comme pouvant induire des gènes stimulés par le rétinol. Nous avons donc analysé son effet sur l'expression de gènes et de protéines induits par les rétinoïdes et comparé les résultats à ceux obtenus en présence de rétinoïdes. MÉTHODES: L'expression de gènes a été analysée par qPCR en temps réel réalisée sur l'ARN de fibroblastes isolés soumis au rétinol ou à l'extrait végétal pendant 6, 48 ou 96 heures. Différentes protéines cutanées ont été quantifiés dans des fibroblastes cultivés en présence de rétinol ou d'un milieu contenant l'extrait. Des quantifications ont également été faites sur des explants de peau vieillie par les UV et soumis à des applications topiques de crèmes contenant du rétinol, du rétinaldéhyde ou le HME. RESULTATS: La qPCR en temps réel montre que l'extrait induit tous les gènes RARs et RXRs, même RXRγ qui n'était pas induit par le rétinol. Quatre-vingt-huit pour cent des 25 gènes impliqués dans la réaction précoce aux rétinoïdes induits par une concentration de rétinol ont été induits par l'extrait. Dans les fibroblastes, seul l'extrait a augmenté le marquage du collagène III, tandis que le marquage du collagène I et de la fibronectine a été augmenté par le rétinol et l'extrait, avec des niveaux plus élevés pour l'extrait. En application topique sur des explants de peau vieillie par les UV, seule la crème contenant le HME a entraîné une augmentation du marquage de CRABP1 dans l'épiderme. CRABP2 et Ki67 ont été induits par les trois crèmes et aucun effet n'a été détecté sur les RXRs. Dans le derme, la crème contenant l'extrait a augmenté CRABP2, le collagène total, le procollagène I et le collagène I, tandis que les crèmes contenant du rétinol ou du rétinaldéhyde n'ont affecté que certaines de ces protéines. CONCLUSIONS: Chez les fibroblastes isolés, le HME induit un profil d'induction génique globalement similaire à celui du rétinol. Chez les fibroblastes isolés et des explants de peau photo-vieillie, il entraine une stimulation de la synthèse protéique similaire à celle des rétinoïdes.

In elderly Caucasian women, younger facial perceived age correlates with better forearm skin microcirculation reactivity.

BACKGROUND: Visual and molecular changes occurring upon aging are rather well characterized. Still, aging signs show great significant inter-individual variations, and little is known concerning the link between perceived age and cutaneous microcirculation. MATERIALS AND METHODS: To investigate this point, we recruited Caucasian women in their mid-50's to mid-70's and subsampled women looking older or younger than their age. We studied their facial skin color, as well as their microvascular reactivity to local heating assessed in the forearm skin. We also used skin biopsies from some of these women for gene expression or immunohistochemical analysis. RESULTS: Clinical and instrumental analysis of skin color revealed that subjects who look 5 years younger differ only by a higher glowing complexion. Our most striking result is that subjects looking 5 years younger than their age present a higher microcirculation reactivity in forearm skin. Transcriptome comparison of skin samples from women looking older or younger than their age revealed 123 annotated transcripts differentially expressed, among which MYL9 relates to microcirculation. MYL9 is downregulated in the group of women looking younger than their real age. Microscopy shows that the labeling of MYL9 and CD31 are altered and heterogeneous with age, as is the morphology of microvessels. CONCLUSION: Therefore, assessing generalized vascular reactivity in non-photo-exposed skin to focus on the intrinsic aging allows subtle discrimination of perceived age within elderly healthy subjects.

Raman confocal microscopy and biophysics multiparametric characterization of the skin barrier evolution with age.

Skin aging is a multifactorial phenomenon that involves alterations at the molecular, cellular and tissue levels. Our aim was to carry out a multiparametric biophysical and Raman characterization of skin barrier between individuals of different age groups (<24 and >70 years old). Our results showed a significant decrease of lipids to proteins ratio overall the thickness of the stratum corneum and higher lateral packing in the outer part of the SC for elderly. This can explain the decrease in trans epidermal water loss measured values rather than only SC thickening. Both age groups showed similar water content at SC surface while elderly presented higher water content in deep SC and viable epidermis. Mechanical measurements showed a decrease in the elasticity and an increase in the fatigability with age and were correlated with partially bound water. Highest correlation and anti-correlation values were observed for the deepest part of the SC and the viable epidermis.

Self-perceived and objective measurements of facial puffiness in Chinese women.

BACKGROUND: Facial puffiness, caused by mild or normal fluid retention, commonly experienced by women, may not pose a health risk, but it can be a cause of cosmetic concern. The objectives of this study were to determine whether self-perceived facial puffiness can be measured objectively. MATERIALS AND METHODS: A total of 151 Chinese women between 20 and 68 years of age were recruited. Facial water content, skin thickness, and elasticity were measured at two time points within a day (visit one occurred when the participants perceived they had facial puffiness; visit two occurred when the participants perceived their facial puffiness had subsided). Participants were also given a rating scale to self-evaluate their puffiness and firmness at different regions of the face. RESULTS: The participants could perceive a difference in facial puffiness between the two visits. Water content and skin thickness were significantly higher in all regions of the face for all participants during the first visit. Skin elasticity was also significantly different between visits one and two. There was a significant increase in water content and skin thickness in the lower eyelid region in women who were older than 40 years. CONCLUSION: This is the first study to show that self-perceived facial puffiness can be measured objectively and that skin elasticity can change significantly when facial puffiness subsides.

Real-time skin chromophore estimation from hyperspectral images using a neural network.

BACKGROUND: Hyperspectral imaging for in vivo human skin study has shown great potential by providing non-invasive measurement from which information usually invisible to the human eye can be revealed. In particular, maps of skin parameters including oxygen rate, blood volume fraction, and melanin concentration can be estimated from a hyperspectral image by using an optical model and an optimization algorithm. These applications, relying on hyperspectral images acquired with a high-resolution camera especially dedicated to skin measurement, have yielded promising results. However, the data analysis process is relatively expensive in terms of computation cost, with calculation of full-face skin property maps requiring up to 5 hours for 3-megapixels hyperspectral images. Such a computation time prevents punctual previewing and quality assessment of the maps immediately after acquisition. METHODS: To address this issue, we have implemented a neural network that models the optimization-based analysis algorithm. This neural network has been trained on a set of hyperspectral images, acquired from 204 patients and their corresponding skin parameter maps, which were calculated by optimization. RESULTS: The neural network is able to generate skin parameter maps that are visually very faithful to the reference maps much more quickly than the optimization-based algorithm, with computation times as short as 2 seconds for a 3-megapixel image representing a full face and 0.5 seconds for a 1-megapixel image representing a smaller area of skin. The average deviation calculated on selected areas shows the network's promising generalization ability, even on wide-field full-face images. CONCLUSION: Currently, the network is adequate for preview purposes, providing relatively accurate results in a few seconds.

The effect of air pollution on the skin colour and tone of Chinese women: A multicentre cohort study.

BACKGROUND: Overall facial skin colour is an important sign of perceived health and attractiveness, is predetermined by genetic factors, and is influenced by cultural and living habits, ultraviolet (UV) exposure, climate/seasons and ageing. The objective of this study was to determine the impact of pollution on the skin colour of Chinese women. MATERIALS AND METHODS: A total of 203 Chinese women between 20 and 59 years of age participated in the study and were selected from two cities with different levels of air pollution. Skin colour (L*, a* and b* values), melanin and haemoglobin levels were measured at three sites: the cheek, eye and inner upper arm. Measurements of the inner upper arm were taken as this area of skin was exposed to air pollutants but had minimal exposure to UV light. RESULTS: There were significant differences in skin chromophores between Chinese women living in two different cities with different levels of pollution. The b* value (yellowness) was higher in the eye and cheek region, and the a* value (redness) was lower in the cheek and arm region for women in the moderately polluted city. The melanin index was significantly higher, and the haemoglobin level was lower for the eye region for women living in the city with a higher level of air pollution. CONCLUSION: This study has shown that air pollution may negatively affect the skin colour of Chinese women.

Visible characteristics and structural modifications relating to enlarged facial pores.

BACKGROUND: Many factors relate to enlargement and visibility of facial pores. However, how enlargement relates to modification of the skin structure is still poorly analysed. Therefore, our aim was to characterise the visible features and the micro-environment of facial pores. MATERIALS AND METHODS: We recruited 160 women, half of them with normal-size facial pores, the other half presenting enlarged pores. We analysed their right cheek using standardised photography, in vivo reflectance microscopy and optical coherence tomography. RESULTS: If the area of pores is indeed the most differentiating visible characteristic, enlarged facial pores are also denser and more contrasted. At the structural level, enlarged facial pores present a more regular organisation of keratinocytes, an irregular dermo-epidermal junction and a higher attenuation of collagen between the surface and deeper layers. Still, the most relevant alterations of enlarged facial pores are the presence of bright tubular structures surrounding hair follicles and enlarged hair shafts. CONCLUSION: These observations suggest that alterations of the stroma could result in altered skin tensions, leading to the dilation of the infundibulum and enlarged hair shaft. The modified tension would also explain the more regular organisation of the keratinocytes and the irregular dermo-epidermal junction.

Skin surface lipid composition in women: increased 2,3-oxidosqualene correlates with older age.

The importance of the hydrolipidic film of skin has been well documented, however, few data are available in cases of very old age. Our aim was to characterize the difference in skin surface lipid (SSL) composition between individuals of different age groups. Data were collected from the forehead of 22 young volunteers (18-24 years old) and 18 senior volunteers (70-75 years old). The amount of sebum was obtained by sebumetry. To acquire relevant information about the molecular composition of high complex mixtures, SSLs were analysed in a single run to ensure that the lipid structures remain intact, using high-temperature gas chromatography coupled with mass spectrometry. The major features associated with aged skin were documented. In aged skin, a lower sebum content was observed, together with modification of the relative SSL composition involving a significant reduction in the intensity of many components of the hydrolipidic film. In contrast, the intensity of 2,3-oxidosqualene was shown to increase with an inverse relationship between triglycerides and their hydrolytic products. These adaptations could be related to modifications of enzymatic activity.

Three-dimensional conditional random field for the dermal-epidermal junction segmentation.

The segmentation of the dermal-epidermal junction (DEJ) in in vivo confocal images represents a challenging task due to uncertainty in visual labeling and complex dependencies between skin layers. We propose a method to segment the DEJ surface, which combines random forest classification with spatial regularization based on a three-dimensional conditional random field (CRF) to improve the classification robustness. The CRF regularization introduces spatial constraints consistent with skin anatomy and its biological behavior. We propose to specify the interaction potentials between pixels according to their depth and their relative position to each other to model skin biological properties. The proposed approach adds regularity to the classification by prohibiting inconsistent transitions between skin layers. As a result, it improves the sensitivity and specificity of the classification results.

Aging and Facial Changes-Documenting Clinical Signs, Part 2: Methods of Documentation of Facial Changes.

Skin metrology has emerged as a multidisciplinary approach for objectively documenting skin anatophysiologic aspects and transformations. Methods have been proposed to describe age-related changes of facial skin. Some of them capture information describing visible clinical signs of aging such as wrinkles, sagging, and pigmentation. These methods include but are not limited to digital imaging, 3-dimensional imaging, and colorimetry. Other methods focus more on structural or physiologic changes of underlying tissues, among these are reflectance confocal imaging, magnetic resonance imaging, and ultrasound imaging. Finally, a group of methods including corneometry and reviscometry are used to describe changes in skin properties. This contribution describes available methods for documenting age-related changes affecting the shape, texture, and color of the face.

Aging and facial changes--documenting clinical signs, part 1: clinical changes of the aging face.

The process of aging induces the transformation of the face with changes that are usually classified as either chronological or photo-induced and that affect the shape, the texture, and the color of the face. Facial shape is mainly transformed by the evolution of bones and soft tissues (muscles, fat, and skin) in addition to noticeable effects of gravity. Skin texture is mainly determined by wrinkles, which arise from atrophy of the skin layers, elastosis, and facial expressions. Skin color is related to the distribution of skin chromophores and the structure of the dermis, which affects light scattering. All facial changes are dependant on sex, ethnicity, and lifestyle. They affect self-perception and social interactions and can sometimes be slowed down or reversed using appropriate clinical procedures (eg, dermatological, surgical, cosmetic interventions).

The skin aging index: a new approach for documenting anti-aging products or procedures.

OBJECTIVE: The overall appearance of an aged skin is characterized by a combination of several attributes such as wrinkles, brown spots and sagging. Our objective was to develop and validate a statistical framework to assess the overall anti-ageing benefits of products/procedures. METHOD: Different skin attributes were evaluated by a clinical grader and combined using a Principal Component Analysis (PCA). The Skin Ageing Index was defined as the normalized projection of the clinical grading values on the first PCA axis. Several Skin Indexes were built by grouping specific parameters related to a skin condition such as overall ageing, wrinkles and sagging. The method was validated following two steps. Firstly, a clinical study was performed on 173 Caucasian women and the correlation between the Skin Indexes and the volunteers' real and perceived age was estimated. Secondly, a double-blinded placebo-controlled randomized study was performed on 87 Caucasian women to assess the efficacy of an anti-wrinkle cream containing retinol, hyaluronic acid and dihydroxymethylchromone. Facial wrinkles were clinically evaluated and a Wrinkle Index was built. RESULTS: All indexes were highly correlated with the real and the perceived age (0.57 ≤ Pearson R ≤ 0.92, P-value ≤ 0.05). Finally, the Wrinkle Index provides documented evidence that the tested product significantly reduced the appearance of wrinkles versus the placebo and the baseline assessment (-23.53% after 4 weeks, -27.83% after 8 weeks). CONCLUSION: Skin ageing Indexes capture information relevant to the visual transformation of facial skin with age, while providing documented product benefits. These tools may enable a simpler and more consistent comparison of anti-ageing products/procedures.

Aging and facial changes--documenting clinical signs, part 1: clinical changes of the aging face.

The process of aging induces the transformation of the face with changes that are usually classified as either chronological or photo induced and that affect the shape, the texture, and the color of the face. Facial shape is mainly transformed by the evolution of bones and soft tissues (muscles, fat, and skin) in addition to noticeable effects of gravity. Skin texture is mainly determined by wrinkles, which arise from atrophy of the skin layers, elastosis, and facial expressions. Skin color is related to the distribution of skin chromophores and the structure of the dermis, which affects light scattering. All facial changes are dependant on sex, ethnicity, and lifestyle. They affect self-perception and social interactions and can sometimes be slowed down or reversed using appropriate clinical procedures (e.g., dermatological, surgical, and cosmetic interventions).

Clinical evidence for the activity of tetrahydroxypropyl ethylenediamine (THPE), a new anti-aging active cosmetic.

UNLABELLED: BACKGROUND/ OBJECTIVES: The cellular surface modification of superficial epidermal keratinocytes can induce immediate skin tensioning effects and may improve signs of skin aging. Tetrahydroxypropyl ethylenediamine (THPE) is an active that has been described to induce keratinocytes' morphological changes in vitro. We conducted an in vivo study to assess anti-aging clinical benefits of a THPE-containing product. METHODS: An eight-week double-blind, randomized intra-individual placebo controlled clinical study was performed to evaluate the clinical benefits of a 2.5% THPE-containing cream. This study included 41 Caucasian women who received the THPE cream product on one side of the face and a placebo cream on the other side daily. Evaluations were performed at baseline, 45 minutes after first application, week 4 and week 8 and included clinical examination and digital photography. RESULTS: The study demonstrated the immediate lifting effect of a 2.5% THPE-containing cream. Forty-five minutes after a single application on the face, as the skin surface smoothed out, light reflection was modified: healthy glow and radiance of the skin were significantly improved (respectively 22.9% and 40% of improvement) and skin yellowishness was reduced (7.1%). Notably, the THPE-treated side was significantly lifted, both immediately after product application (8.1%) and after 8 weeks of application (14%), compared to the placebo-treated side. CONCLUSION: This clinical study demonstrated that the effect of a 2.5% THPE-containing cream on the keratinocytes cells leads to an immediate and long-term clinical improvement of the skin appearance (radiance and skin firmness, skin lifting) and can therefore be considered as a new anti-aging cosmetic active.

Detection of melanoma from dermoscopic images of naevi acquired under uncontrolled conditions.

BACKGROUND AND OBJECTIVE: Several systems for the diagnosis of melanoma from images of naevi obtained under controlled conditions have demonstrated comparable efficiency with dermatologists. However, their robustness to analyze daily routine images was sometimes questionable. The purpose of this work is to investigate to what extent the automatic melanoma diagnosis may be achieved from the analysis of uncontrolled images of pigmented skin lesions. MATERIALS AND METHODS: Images were acquired during regular practice by two dermatologists using Reflex 24 x 36 cameras combined with Heine Delta 10 dermascopes. The images were then digitalized using a scanner. In addition, five senior dermatologists were asked to give the diagnosis and therapeutic decision (exeresis) for 227 images of naevi, together with an opinion about the existence of malignancy-predictive features. Meanwhile, a learning by sample classifier for the diagnosis of melanoma was constructed, which combines image-processing with machine-learning techniques. After an automatic segmentation, geometric and colorimetric parameters were extracted from images and selected according to their efficiency in predicting malignancy features. A diagnosis was subsequently provided based on selected parameters. An extensive comparison of dermatologists' and computer results was subsequently performed. RESULTS AND CONCLUSION: The KL-PLS-based classifier shows comparable performances with respect to dermatologists (sensitivity: 95% and specificity: 60%). The algorithm provides an original insight into the clinical knowledge of pigmented skin lesions.