Erythema Index Research Articles

Comparison of single-spot technique and RGB imaging for erythema index estimation

A commercially available point measurement device, the Mexameter®, and an experimental RGB imaging prototype device were used for erythema index estimation of 50 rosacea patients by analysing the level of skin redness on the forehead, both cheeks and both sides of a nose. Results are compared with Clinician’s Erythema Assessment (CEA) values given by two dermatologists. The Mexameter uses 568 nm and 660 nm LEDs and a photodetector for estimation of erythema index, while the used prototype device acquired RGB images at 460 nm, 530 nm and 665 nm LED illumination. Several erythema index estimation algorithms were compared to determine which one gives the best contrast between increased erythema and normal skin. The erythema index estimations and CEA values correlated much better for the RGB imaging data than for those obtained by the conventional Mexameter technique that is widely used by dermatologists and in clinical trials. In result, we propose an erythema index estimation approach that represents increased erythema with higher accuracy than other available methods.

Daytime Changes of Skin Biophysical Characteristics: A Study of Hydration, Transepidermal Water Loss, pH, Sebum, Elasticity, Erythema, and Color Index on Middle Eastern Skin.

Background:The exposure of skin to ultraviolet radiation and temperature differs significantly during the day. It is reasonable that biophysical parameters of human skin have periodic daily fluctuation. The objective of this study was to study the fluctuations of various biophysical characteristics of Middle Eastern skin in standardized experimental conditions.Materials and Methods:Seven biophysical parameters of skin including stratum corneum hydration, transepidermal water loss, pH, sebum, elasticity, skin color, and erythema index were measured at three time points (8 a.m., 12 p.m. and 4 p.m.) on the forearm of 12 healthy participants (mean age of 28.4 years) without any ongoing skin disease using the CK MPA 580 device in standard temperature and humidity conditions.Results:A significant difference was observed between means of skin color index at 8 a.m. (175.42 ± 13.92) and 4 p.m. (164.44 ± 13.72, P = 0.025), between the pH at 8 a.m. (5.72 ± 0.48) and 4 p.m. (5.33 ± 0.55, P = 0.001) and pH at 12 p.m. (5.60 ± 0.48) and 4 p.m. (5.33 ± 0.55, P = 0.001). Other comparisons between the means of these parameters at different time points resulted in nonsignificant P values.Conclusion:There are daytime changes in skin color index and pH. Skin color index might be higher and cutaneous pH more basic in the early morning compared to later of the day.

Alp Rose stem cells, olive oil squalene and a natural alkyl polyglucoside emulsifier: Are they appropriate ingredients of skin moisturizers - in vivo efficacy on normal and sodium lauryl sulfate - irritated skin?.

Since skin moisturization may be achieved by both actives and chosen carrier, plant stem cells, squalene and natural alkyl polyglucoside emulsifier may be potential components of contemporary cosmetic products. The aim of the study was in vivo evaluation of the skin irritation potential and the efficacy of Alpine Rose stem cells incorporated into li-posomes and olive oil squalene as ingredients of moisturizing creams, with respect to the novel emulsifier used for creams’ stabilization. With the employment of noninvasive skin biophysical measurements, skin hydration (EC), transepi-dermal water loss (TEWL), erythema index (EI) and viscoelas-ticity were measured on 76 healthy volunteers. In the first phase, skin irritation after a 24-hour occlusion and the long-term efficacy of creams (a 21-day study) on healthy skin were evaluated. Phase II of the study focused on the cream efficacy assessment after a 6-day treatment of sodium lauryl sulfate-irritated skin. After a 24-hour occlusion, there were no significant changes in the EI for any tested sample. In the second phase of the study, the EI was not significantly altered for the cream containing squalene, while the application of all active samples resulted in a significant reduction of TEWL. In both phases of the study an EC increase was recorded, espe-cially for the squalene-containing cream. Due to the lack of skin irritation and skin barrier impairment along with the marked hydration effect, it could be said that the in-vestigated actives incorporated into alkyl polyglucoside emulsi-fier-stabilized creams may be safely applied as ingredients for "tailor-made" cosmetic moisturizers intended for normal and dry skin care, whereas olive oil squalene could be used for the treatment of irritated or sensitive skin as well. [Projekat Ministarstva nauke Republike Srbije, br. TR34031]

Prospective Comparison of Dual Wavelength Long-Pulsed 755-nm Alexandrite/1,064-nm Neodymium:Yttrium-Aluminum-Garnet Laser versus 585-nm Pulsed Dye Laser Treatment for Rosacea.

BackgroundRosacea treatments including oral/topical medications and laser therapy are numerous but unsatisfactory.ObjectiveTo compare the effectiveness of the dual wavelength long-pulsed 755-nm alexandrite/1,064-nm neodymium: yttrium-aluminum-garnet laser (LPAN) with that of 585-nm pulsed dye laser (PDL) for rosacea.MethodsThis was a randomized, single-blinded, comparative study. Full face received four consecutive monthly treatments with LPAN or PDL, followed-up for 6 months after the last treatment. Erythema index was measured by spectrophotometer, and digital photographs were evaluated by consultant dermatologists for physician's global assessment. Subjective satisfaction surveys and adverse effects were recorded.ResultsForty-nine subjects with rosacea enrolled and 12 dropped out. There were no significant differences between LPAN and PDL in the mean reduction of the erythema index (p=0.812; 3.6% vs. 2.8%), improvement of physician's global assessment (p=1.000; 88.9% vs. 89.5%), and subject-rated treatment satisfaction (p=0.842; 77.8% vs. 84.2%). PDL showed more adverse effects including vesicles than LPAN (p=0.046; 26.3% vs. 0.0%). No other serious or permanent adverse events were observed in both treatments.ConclusionBoth LPAN and PDL may be effective and safe treatments for rosacea.

The Efficacy and Safety of Fractional CO₂ Laser Combined with Topical Type A Botulinum Toxin for Facial Rejuvenation: A Randomized Controlled Split-Face Study.

Objective. We evaluated synergistic efficacy and safety of combined topical application of Botulinum Toxin Type A (BTX-A) with fractional CO2 laser for facial rejuvenation. Methods. Twenty female subjects were included for this split-face comparative study. One side of each subject's cheek was treated with fractional CO2 plus saline solution, and the other side was treated with fractional CO2 laser plus topical application of BTX-A. Patients received one session of treatment and evaluations were done at baseline, one, four, and twelve weeks after treatment. The outcome assessments included subjective satisfaction scale; blinded clinical assessment; and the biophysical parameters of roughness, elasticity, skin hydration, transepidermal water loss (TEWL), and the erythema and melanin index. Results. BTX-A combined with fractional CO2 laser sides showed higher physician's global assessment score, subject satisfaction score, roughness, skin hydration, and skin elasticity compared to that of fractional CO2 plus saline solution side at 12 weeks after treatment. TEWL and erythema and melanin index showed no significant differences between two sides at baseline, one, four, and twelve weeks after treatment. Conclusion. Topical application of BTX-A could enhance the rejuvenation effect of fractional CO2 laser.

Evaluation of efficacy and safety of a focal fractional laser for the treatment of atrophic acne scars

Objective To evaluate the efficacy and safety of focal fractional laser treatment (FFLT) for atrophic acne scars. Methods A randomized, self-controlled study was performed. A total of 20 patients with atrophic facial acne scars were enrolled into this study. Treatments were randomly administered in a split-face manner. Half of each subject's face received FFLT (FFLT side) , and the other half underwent full-face fractional CO2 laser resurfacing (control side) , for one session. All the patients were followed up for 3 months after the treatment. Evaluation was based on the ECCA grading scale (echelle d'evaluation clinique des cicatrices d'acne) and patient satisfaction score. A VISIA skin detector was used to take photographs and evaluate skin texture. Moreover, physical parameters of the skin, including erythema index, melanin index and transepidermal water loss (TEWL) , were measured. Adverse effects were recorded and evaluated. Statistical analysis was carried out by paired t test, Wilcoxon paired rank test, Fisher's exact test and repeated-measure analysis of variance. Results The ECCA score decreased from 51.24 ± 17.61 at the baseline to 34.46 ± 14.99 at 3 months after the treatment at the FFLT side (t= 7.886, P 0.05). Compared with those before the treatment, skin texture scores decreased in both sides (both P 0.05) from 2 weeks to 3 months after the treatment (all P> 0.05). Conclusion FFLT can improve therapeutic outcomes in atrophic acne scars with reduced adverse reactions. Key words: Cicatrix; Acneiform eruptions; Lasers, gas; Treatment outcome; Drug toxicity

Factors contributing to the treatment duration of diphenylcyclopropenone immunotherapy for periungual warts.

Diphenylcyclopropenone (DPCP) immunotherapy has been shown to be efficacious for the treatment of warts, especially periungual warts for which destructive techniques are limited. However, factors affecting the duration of treatment of periungual warts have not been studied. A total of 61 patients with periungual warts who were completely cured with DPCP immunotherapy were included in this study. Age, sex, disease duration, location (fingernail, toenail, or both), number of warts, diameter of the largest wart, application number for sensitization and two types of sensitization reactions, erythema and blister index (EBI), and pruritus index were evaluated. Multiple linear regression analysis was performed to find correlations of these variables with the treatment duration. Of the nine variables, application number for sensitization (regression coefficient = 3.251 and 2.428, respectively) and EBI (regression coefficient = -9.950 and -9.694, respectively) were independent factors significantly affecting both the total duration of treatment and the duration of treatment after sensitization (p < 0.05, respectively). The sample size was limited. A shorter sensitization period and more severe EBI of the sensitization reaction contribute to a shorter time required for a complete cure in the treatment of periungual warts with DPCP immunotherapy.

A prospective, randomized, double-blind comparison of an ablative fractional 2940-nm erbium-doped yttrium aluminum garnet laser with a nonablative fractional 1550-nm erbium-doped glass laser for the treatment of photoaged Asian skin

Background: As compared with ablative fractional CO2 laser, ablative fractional erbium-doped yttrium aluminum garnet (Er:YAG) laser is considered to be a more suitable treatment option for photoaged skin in Asians due to the lower incidence of postinflammatory hyperpigmentation. Objective: To compare the efficacy and safety of ablative fractional Er:YAG laser (ablative fractional resurfacing [AFR]) and nonablative fractional 1550-nm Er:glass laser (non-AFR [NAFR]) in the treatment of photoaging. Methods: This was a prospective, randomized, double-blinded comparative study. In three sessions, at four-week intervals, 19 patients received Er:YAG AFR, and 15 patients received Er:glass NAFR. Pigmentation, uneven tone/erythema, wrinkles and overall features of photoaging were scored. Patient satisfaction, adverse effects and pain scores were recorded. Melanin and erythema indexes were measured. Results: Reductions in pigmentation and uneven tone/erythema scores were significantly greater after Er:YAG AFR, while wrinkle score reduction was significantly greater after Er:glass NAFR. Physician and patient assessments for the overall features showed greater improvement in the Er:glass NAFR. Treatment-related pain or adverse events were less in the Er:YAG AFR. Conclusion: Both Er:YAG AFR and Er:glass NAFR are effective and safe and could be used in a complementary manner for treating photoaged Asian skin.

In vivo photoprotective effects of cosmetic formulations containing UV filters, vitamins, Ginkgo biloba and red algae extracts

The aim of this study was to assess the photoprotective effects of cosmetic formulations containing UV filters, red algae, Porphyra umbilicalis, extracts and combinations of the extract with vitamins and Ginkgo biloba through the use of in vivo preclinical studies. For this study, 4 groups of 4 hairless mice each were treated with topical formulations applied on the dorsum for 5days as follows: group 1 — control (no treatment); group 2 — application of the formulation F (sunscreen formulation containing only UV filters); group 3 — application of the formulation FA (sunscreen formulation with red algae extract); and group 4 — application of the formulation FVGA (sunscreen formulation with red algae extract, G. biloba and vitamins A, C and E). The effects of these formulations were evaluated by determining the transepidermal water loss (TEWL) and erythema index. Apoptosis was detected by immunohistochemical staining with anti-p53 and anti-caspase-3 antibodies. The results showed that the formulations protected the skin from erythema when exposed to UV radiation. The group that received the formulation FVGA presented a greater TEWL than did the other groups, suggesting that this formulation was involved in cell renewal. Immunohistochemical analysis showed that UV radiation caused an increase in the expression of p53 and active caspase-3, confirming that the damage caused by UV radiation exposure led to apoptosis. The application of all formulations studied resulted in a statistically significant reduction in the expression of p53 and caspase-3, with a more pronounced effect observed following treatment with FA. In conclusion, extracts from the red algae P. umbilicalis could be considered effective ingredients to be used in sunscreen formulations. The combination of vitamins A, E, C and G. biloba along with red algae extracts can improve significantly the performance of the sunscreens, preventing UV-induced DNA damage and inflammation. Thus, they should be considered an interesting combination for an effective photoprotective formulation with anti-aging properties.

A randomized controlled trial of green tea catechins in protection against ultraviolet radiation–induced cutaneous inflammation

Background: Safe systemic protection from the health hazards of ultraviolet radiation (UVR) in sunlight is desirable. Green tea is consumed globally and is reported to have anti-inflammatory properties, which may be mediated through the impact on cyclooxygenase and lipoxygenase pathways. Recent data suggest that green tea catechins (GTCs) reduce acute UVR effects, but human trials examining their photoprotective potential are scarce.Objective: We performed a double-blind, randomized, placebo-controlled trial to examine whether GTCs protect against clinical, histologic, and biochemical indicators of UVR-induced inflammation.Design: Healthy adults (aged 18–65 y, phototypes I–II) were randomly allocated to 1350 mg encapsulated green tea extract (540 mg GTC) with 50 mg vitamin C or placebo twice daily for 3 mo. Impact on skin erythema, dermal leukocytic infiltration, and concentrations of proinflammatory eicosanoids was assessed after solar-simulated UVR challenge, and subject compliance was determined through assay of urinary GTC metabolite epigallocatechin glucuronide.Results: Volunteers were assigned to the active (n = 25) or the placebo (n = 25) group. After supplementation, median (IQR) sunburn threshold (minimal erythema dose) was 28 (20–28) and 20 (20–28) mJ/cm2 in the active and placebo groups, respectively (nonsignificant), with no difference in AUC analysis for measured erythema index after a geometric series of 10 UVR doses. Skin immunohistochemistry showed increased neutrophil and CD3+ T-lymphocyte numbers post-UVR in both groups (P < 0.01) with no statistically significant differences between groups after supplementation. Cyclooxygenase and lipoxygenase metabolites prostaglandin E2 (vasodilator) and 12-hydroxyeicosatetraenoicacid (chemoattractant), respectively, increased after UVR (P < 0.05), with no differences between supplementation groups.Conclusion: Oral GTC (1080 mg/d) with vitamin C over 3 mo did not significantly reduce skin erythema, leukocyte infiltration, or eicosanoid response to UVR inflammatory challenge. This trial was registered at clinicaltrials.gov as NCT01032031.

The Photoprotective Effect of S-Methylmethionine Sulfonium in Skin.

S-Methylmethionine sulfonium (SMMS) was reported to have wound-healing effects; we therefore have investigated the photoprotective effect of SMMS in the present study. SMMS increased the viability of keratinocyte progenitor cells (KPCs) and human dermal fibroblasts (hDFs) following ultraviolet B (UVB) irradiation, and reduced the UVB-induced apoptosis in these cells. SMMS increased the phosphorylation of extracellular signal-regulated kinases (ERK), and the inhibitor of the mitogen-activated protein kinase pathway significantly decreased the SMMS-induced viability of KPCs and hDFs. In addition, SMMS attenuated the UVB-induced reactive oxygen species (ROS) generation in KPCs and hDFs. SMMS induced the collagen synthesis and reduced the matrix metalloproteinase-1 expression in UVB-irradiated hDFs. In animal studies, application of 5% and 10% SMMS before and after UVB-irradiation significantly decreased the UVB-induced erythema index and depletion of Langerhans cells. In summary, SMMS protects KPCs and hDFs from UVB irradiation, and reduces UVB-induced skin erythema and immune suppression. Therefore, SMMS can be used as a cosmetic raw material, and protect skin from UVB.

Preventive Effect of Human Acellular Dermal Matrix on Post-thyroidectomy Scars and Adhesions: A Randomized, Double-Blinded, Controlled Trial.

Acellular dermal matrix (ADM) has been used for antiadhesion formation along with wound healing in various surgical fields. The aim is to assess the efficacy of ADM implantation in the prevention of postoperative scars and adhesions after conventional, open, total thyroidectomy. Forty-four patients with papillary thyroid carcinoma undergoing thyroidectomy were randomly assigned to the study (ADM implantation) or control group (without ADM). Global photographic assessment, Vancouver scar scale (VSS), objective scar assessment, and swallowing impairment index were assessed at baseline, immediately after surgery, and at 1 and 2 months after surgery. Nineteen control and 20 study group participants completed the study. The mean VSS score of the study group was significantly lower than the controls at both 1 month (3.06 ± 1.25 vs 4.41 ± 1.54, respectively) and 2 months (2.76 ± 1.56 vs 4.35 ± 1.58, respectively) after surgery. Scar quality measures (mean melanin and erythema indexes) were significantly lower in the study group compared with controls. Study group participants had significantly lower swallowing impairment scores than controls. The mean postoperative hospitalization of both groups was not significantly different. Acellular dermal matrix-assisted implants appear to improve post-thyroidectomy scar and swallowing impairments without delays in operation time.

Size of the exposed body surface area, skin erythema and body mass index predict skin production of vitamin D

BackgroundCholecalciferol (vitamin D3), produced in the skin by UVB irradiation (290–315nm) of 7-dehydrocholesterol, is metabolized in the liver into 25-hydroxyvitamin D [25(OH)D] which is a major circulating metabolite. AimTo examine changes in serum concentrations of cholecalciferol and its metabolites after UVB exposure of different skin areas. Methods21 healthy Caucasians (skin type II and III, aged 23–47years) were exposed to broadband UVB (290–320nm) and randomized to either exposure to one minimal erythema dose given as a single dose, or a suberythemic dose given for 3 subsequent days. The following areas were exposed: face and back of hands, upper half of the body and the whole body, respectively. Serum cholecalciferol and 25(OH)D were measured immediately before start and 24h after the 1st and last exposure, respectively. ResultsSubjects with whole body exposure had an average S-cholecalciferol increase per dose unit of 0.18ngml−1mJ−1cm2, 0.95 CI: (0.16, 0.20), upper body treatment 0.13ngml−1mJ−1cm2, 0.95 CI: (0.10, 0.15) and face and hands exposure 0.013ngml−1mJ−1cm2, 0.95 CI: (−0.012, 0.037). The increase in cholecalciferol correlated positively to the UVB dose and skin erythema and negatively to body mass index (BMI) when controlling for other factors. Exposure of face and hands induces smaller cholecalciferol production in comparison with exposure of larger skin areas. ConclusionSize of the exposed skin area, UVB dose, skin erythema and BMI were the major determinants for serum levels of skin synthesized cholecalciferol. Exposure of hands and face induces smaller cholecalciferol production in comparison with exposure of larger skin areas.

Integrated approach in the assessment of skin compatibility of cosmetic formulations with green coffee oil.

Green coffee oil (GCO) has been used in cosmetic formulations due to its emollient and anti-ageing properties. However, there are insufficient studies about its safety when applied in cosmetic formulations. Cytotoxicity of GCO and of formulations containing 2.5-15% of GCO was evaluated by the MTT reduction assay, in human keratinocytes. Formulations containing 15% of GCO and the vehicle were applied under in use conditions in the volar forearm of human volunteers during 3days. Transepidermal water loss, stratum corneum water content and erythema index were evaluated each 24h using biophysical techniques. The same formulations were probed for skin tolerance through a patch test. Neither pure GCO nor its formulations showed cytotoxic effects in concentrations up to 100μg mL(-1) . Transepidermal water loss values showed a slight reduction when the formulation containing GCO was applied. Stratum corneum water content and erythema index did not show significant differences, as the results observed in the first day of the study were maintained throughout 3days. None of the volunteers display any reaction after using an occlusive patch. The results obtained in the study indicate that GCO seems to be safe for topical applications and showed good skin compatibility under the experimental conditions of the study.

Inhibitory Effects of Black currant seed oil on 2,4-Dinitrochlorobenzene Induced Atopic Dermatitis in BALB/c Mice Model

This study investigated the clinical parameters of atopic dermatitis and evaluated the inhibitory effects of Black currant seed oil for atopic dermatitis by using a Dinitrochlorobenzene(DNCB) induced BALB/c mice model. Five-week-old BALB/c mice were divided into four groups: normal group (N, non-treated), control group (C, atopic dermatitis-induced), positive control group (PC, Tacrolimus ointment-treated against induced atopic dermatitis, PC), experiment group (E, Black currant seed oil-treated against induced atopic dermatitis). After induction of atopic dermatitis by DNCB, the erythema, edema, eschar, and scratching were severely observed. The symptoms of atopic dermatitis were improved after 2 weeks, and almost disappeared after 4 weeks in PC and E group. The increased frequencies of scratching in C group were decreased in PC and E group. Transepidermal water loss, erythema index and serum IgE level were significantly decreased in E and PC compared to that in C after 4 weeks of the treatment. The results indicated that Black currant seed oil can relieve atopic dermatitis symptoms effectively, and may be possibly used as a functional material for suppression of atopic dermatitis.

Interpretation of the DermaLab Combo® pigmentation and vascularity measurements in burn scar assessment: An exploratory analysis

BackgroundThe DermaLab Combo® measures pigmentation and vascularity of a burn scar more reliably than the modified Vancouver Scar Scale (mVSS). This study aims to examine how the DermaLab Combo® continuous measurements of pigmentation and vascularity of burns scars relate to the mVSS, a standard clinical scar assessment method; and secondly, to obtain evidence to support the concurrent validity of DermaLab Combo® measurements for pigmentation and vascularity. MethodScar assessments were performed on an index burn scar of 100 subjects using two methods: the mVSS (two raters) and the DermaLab Combo® device (one rater). Using the DermaLab Combo®, measurements of pigmentation and vascularity for the index scar and an adjacent normal skin site were obtained. Indices were generated to represent the scar pigmentation (melanin index, MI%) and scar vascularity (erythema index, EI%) relative to the patient's matched normal skin. Exploratory univariate and bivariate analyses were conducted and the concordance of classification by mVSS score using DermaLab® cut-off values was assessed. ResultsFor pigmentation, the results suggest a 80% classification concordance for the DermaLab Combo® MI% values into mVSS pigmentation categories (hypopigmentation, normal pigmentation and hyperpigmentation) using two predictors (MI% and EI%) and visually fitted discriminant axis cut-offs. Due to the high degree of overlap of EI% values between the vascularity categories, meaningful classification of EI% values using the mVSS was not possible. ConclusionQuantifying percentage changes in melanin and erythema relative to matched normal skin improved understanding of the DermaLab Combo® pigmentation and vascularity measurements. The DermaLab Combo® pigmentation MI% values were able to be classified into pigmentation categories of the mVSS, and pigmentation classification concordance was further improved with consideration of the scar's DermaLab Combo® vascularity EI% values. The DermaLab Combo® is an objective tool; however, while the measurement provides continuous numerical data that may be useful for identifying change over time in clinical scar monitoring of pigmentation and vascularity, further work will be useful to understand the DermaLab Combo® measurements to optimise the interpretation of these data.

Biophysical Characteristics of Melasma Skin Comparing with the Perilesional Normal Skin and its Relation to the Melasma Subtype

Background: Melasma is a common disorder of hyperpigmentation affecting millions of people worldwide. All the exact pathways to understand the complete pathogenesis of melasma is unknown. Aims: To determine the biophysical characteristics of melasma skin compared to the normal surrounding skin. Methods: Thirty-six patients with melasma were recruited in this case-control study. The subtype of melasma (epidermal, dermal, or mixed) was determined by Wood lamp examination. The melanin index, erythema index, stratum corneum (SC), hydration, sebum content, transepidermal water loss (TEWL), temperature, friction index, and pH of lesional and perilesional normal skin of patients were measured in standardized temperature and humidity conditions. The epidermal and dermal thickness and dermal echo-density were determined on the same locations. The measurements were compared between lesional and perilesional normal skin using dependent t-test and among three subtypes of melasma using one-way ANOVA. P values of <0.05 were considered statistically significant. Results: Melanin index, erythema index, SC hydration, pH, thickness of dermis and epidermis were significantly higher and the temperature was significantly lower in lesional skin compared with surrounding normal skin. No significant differences were found in TEWL, friction index, sebum content and density of dermis. Melasma subtype, age, skintype, location and duration of melasma had no significant effect on any of these variables. Conclusions: Melasma skin is characterized by certain changes in biophysical factors of epidermis and dermis. The relation of these changes with the hyper-activity of melanocytes and melanin overproduction should be determined in future studies. Keywords: Melasma; Melanin; Skin; Biophysical characteristics

Double Blind Placebo Controlled Trial to Evaluate of the Effectiveness of a Dietary Supplement Rich in Carotenoids as Adjunct to Topical Lightening Cream for the Treatment of Melasma: A Pilot Study

Objectives: To evaluate the efficacy of an oral supplement containing carotenoids as an adjunct to a topical cosmetic lightening cream for the treatment of melasma. Methods: 44 subjects with melasma were recruited into a double-blinded, randomized, placebo controlled trial over 84 days at the Singapore National Skin Centre, to receive either an oral dietary supplement containing carotenoids or a placebo. All were prescribed a commercially available cream. Patients were assessed at onset, day 54 and day 84 by the Modified Melasma area and Severity Index (mMASI), photographic documentation, melanin and erythema indexes using a Mexameter®. Results: 44 patients completed the study. The median mMASI score fell significantly in both groups (both p<0.001). There was a greater decrease seen in those who received the oral supplement group (-2.1 vs -1.8, p <0.379). The erythema score showed significant improvements in both groups, with greater improvement in the group on the oral supplement, compared to placebo (median difference = -30, p =0.018, vs median difference = -20, p =0.020). Conclusion: Oral supplements containing carotenoids are potential adjuncts in melasma treatment. 1.5 Limitations: Small sample size and short study duration limit the observations noted in this study. Further larger-scale studies are required.

Anti-wrinkle Effects of Water Extracts of Teas in Hairless Mouse.

Tea flavonoids and polyphenols are well known for their extraordinary antioxidant activity which is considered important for anti-aging processes in animals. This study evaluated the anti-wrinkle effects of three different kinds of tea (Camellia sinensis) water extracts (CSWEs) including green, white, and black teas using a photoaged hairless mouse model. Data showed that the CSWE-treatment greatly improved skin conditions of mice suffering from UVB-induced photoaging, based on the parameters including the skin erythema index, moisture capacity, and transepidermal water loss. In addition, the wrinkle measurement and image analysis of skin replicas indicated that CSWEs remarkably inhibited wrinkle formation. In histological examination, the CSWE-treated mice exhibited diminished epidermal thickness and increased collagen and elastic fiber content, key signatures for skin restoration. Furthermore, the reduced expression of MMP-3, a collagen-degradative enzyme, was observed in the skin of CSWE-treated animals. Interestingly, comparative data between green, white, and black tea indicated that the anti-wrinkle activity of white tea and black tea is equally greater than that of green tea. Taken together, these data clearly demonstrated that CSWEs could be used as an effective anti-wrinkle agent in photoaged animal skin, implying their extended uses in therapeutics.

Continuous monitoring of arthritis in animal models using optical imaging modalities.

Given the several difficulties associated with histology, including difficulty in continuous monitoring, this study aimed to investigate the feasibility of optical imaging modalities—cross-polarization color (CPC) imaging, erythema index (EI) imaging, and laser speckle contrast (LSC) imaging—for continuous evaluation and monitoring of arthritis in animal models. C57BL/6 mice, used for the evaluation of arthritis, were divided into three groups: arthritic mice group (AMG), positive control mice group (PCMG), and negative control mice group (NCMG). Complete Freund’s adjuvant, mineral oil, and saline were injected into the footpad for AMG, PCMG, and NCMG, respectively. LSC and CPC images were acquired from 0 through 144 h after injection for all groups. EI images were calculated from CPC images. Variations in feet area, EI, and speckle index for each mice group over time were calculated for quantitative evaluation of arthritis. Histological examinations were performed, and the results were found to be consistent with those from optical imaging analysis. Thus, optical imaging modalities may be successfully applied for continuous evaluation and monitoring of arthritis in animal models.