Extrinsic Skin Aging Research Articles

The effect of aging on mast cell density in human skin: a comparative analysis of photoexposed and photoprotected regions.

Mast cells are mononuclear cells originating from bone marrow. They produce various biologically active substances, which allow them to actively participate in immune and inflammatory processes associated with intrinsic and extrinsic skin aging. This research focused on distribution and density of mast cells in healthy skin in different stages of skin aging. This project included samples of photoexposed and photoprotected skin, obtained from 90 cadavers aged 0-82 years. The samples were classified into five age groups: newborns, young age, middle age, senior age and the oldest age. In order to visualize the mast cells, we have employed several histochemical staining protocols. The number of mast cells of the photoexposed skin significantly correlated to the individual's age. The number of mast cells of the photoprotected skin was in general statistically significantly lower in younger compared to older groups; however, the correlation of the mast cell density in photoprotected skin and the age did not reach statistical significance. In middle age, senior age and the oldest age groups, a significantly higher number of mast cells was recorded in the skin of the photoexposed compared to photoprotected region. The increase in mast cell density correlated with age only in photoexposed skin. Age-related higher accumulation of dermal mast cells in photoexposed skin can be an important factor in the photoaging process, as well as the contributing factor in the occurrence of skin cancer.

Elimination of damaged mitochondria during UVB-induced senescence is orchestrated by NIX-dependent mitophagy.

Skin aging is the result of two types of aging, "intrinsic aging" an inevitable consequence of physiologic and genetically determined changes and "extrinsic aging," which is dependent on external factors such as exposure to sunlight, smoking, and dietary habits. UVB causes skin injury through the generation of free radicals and other oxidative byproducts, also contributing to DNA damage. Appearance and accumulation of senescent cells in the skin are considered one of the hallmarks of aging in this tissue. Mitochondria play an important role for the development of cellular senescence, in particular stress-induced senescence of human cells. However, many aspects of mitochondrial physiology relevant to cellular senescence and extrinsic skin aging remain to be unraveled. Here, we demonstrate that mitochondria damaged by UVB irradiation of human dermal fibroblasts (HDF) are eliminated by NIX-dependent mitophagy and that this process is important for cell survival under these conditions. Additionally, UVB-irradiation of human dermal fibroblasts (HDF) induces the shedding of extracellular vesicles (EVs), and this process is significantly enhanced in UVB-irradiated NIX-depleted cells. Our findings establish NIX as the main mitophagy receptor in the process of UVB-induced senescence and suggest the release of EVs as an alternative mechanism of mitochondrial quality control in HDF.

Oleaeuropaea leaf exosome-like nanovesicles encapsulated in a hyaluronic acid / tannic acid hydrogel dressing with dual “defense-repair” effects for treating skin photoaging

Photoaging, primarily caused by ultraviolet (UV) light, is the major factor in extrinsic skin aging. Existing anti-photoaging strategies mainly focus on early sun protection or repairing damaged skin, lacking a comprehensive treatment strategy. Therefore, this study developed a dressing that actively shields against UV radiation and repairs photoaged skin, offering double protection. This study utilized exosome-like nanovesicles derived from Olea europaea leaves (OLELNVs), enhancing them into a potent core biomaterial with high-dose effects and skin-friendly, non-cytotoxic inhibition of cell aging. These nanovesicles were incorporated into a cross-linked hyaluronic acid (HA) and tannic acid (TA) hydrogel with strong UV-absorbing properties, creating the OLELNVs@HA/TA hydrogel system. In vitro and in vivo experiments demonstrated that OLELNVs@HA/TA hydrogel can effectively reduce UV-induced skin damage and promote skin repair and regeneration. Additionally, RNA-seq and clustering analysis of miR168a-5p predicted targets revealed significant down-regulation of the NF-κB signaling pathway, mediating inflammatory aging responses. Overall, the OLELNVs@HA/TA hydrogel represents a novel dual-strategy approach for clinical application in combating photoaging.

Skin Color Analysis of Various Body Parts (Forearm, Upper Arm, Elbow, Knee, and Shin) and Changes with Age in 53 Korean Women, Considering Intrinsic and Extrinsic Factors.

Background/Objectives: Skin color is innately determined by race and other genetic factors, and it also undergoes acquired changes due to various intrinsic and extrinsic factors. Previous studies on skin color have mainly focused on the face, and research has recently expanded to other body parts. However, there is limited information about the age-dependent changes in the skin color of these body parts. The purpose of this study is to analyze the differences in skin color between various body parts and the changes in skin color of each body part with age. Methods: This study examined the skin color of 53 Korean women subjects evenly distributed in age from the 20s to 60s on several body parts: forearm, upper arm, elbow (extended or folded), knee (extended or folded), thigh, and shin. The lightness (L*), redness (a*), and yellowness (b*) were measured using a spectrophotometer, and the individual typology angle (ITA°) was calculated from the L* and b* values. The melanin index and erythema index were measured using the mexameter. Results: The results showed that the elbow skin had the lowest L* and ITA° values and the highest a* and b* values among the examined body parts, followed by the knee. The melanin index and erythema index were also high in the skin of these body parts. In the analysis of age-dependent changes in the skin color of various body parts, the forearm skin exhibited the most notable decrease in the L* and ITA° values and increases in the a* and b* values, followed by upper-arm skin. The melanin and erythema indices in the forearm also increased as the subjects aged, whereas those in the elbow and knee rather decreased with age. Conclusions: This study suggests that differences in intrinsic and extrinsic skin aging in various body parts may be expressed as different changes in skin color and raises the need for cosmetic and dermatological research to identify the physiological significance of these changes.

Evaluation of an advanced antioxidant and double-conjugated retinoid/AHA cream in participants with FST IV-V.

Topical antioxidants and retinoids are foundational components of an effective skincare regimen. Pyrroloquinoline quinone (PQQ) is a potent free radical scavenger that supports efficient mitochondrial energy creation. An advanced antioxidant combines topical allyl PQQ with existing WEL antioxidant technology (TAP) to comprehensively address extrinsic and intrinsic skin aging. In conjunction with TAP, a double-conjugated retinoid/alpha hydroxy acid (AHA-Ret) designed to minimize irritation and optimize delivery was used over 12 weeks to improve the appearance of photodamaged skin. Twice-daily application of TAP and nightly application of AHA-Ret was evaluated in female participants aged 40-65 years with FST IV-V and mild (3) to moderate (6) facial photodamage using a 10-point grading scale. Visible improvements from baseline in lines/wrinkles, skin texture, skin tone, skin dullness and erythema were assessed using a six-point grading scale (0 = None to 5 = Severe). Adverse Events (AEs) were captured throughout the study period. Participants (N = 21; mean age, 56 years) equally represented mild and moderate photodamage, and FST IV and V (41%, Hispanic; 36%, African American; and 32%, Caucasian). Significant mean improvements from baseline occurred in skin dullness, skin texture, and skin tone (all, p < 0.0001), and significant mean reductions from baseline were demonstrated in erythema and melanin at Week 12. Mild, transient AEs were reported. No participant discontinued study participation due to an AE. A skincare regimen comprised of an advanced antioxidant and AHA-Ret cream, in conjunction with daily use of a broad-spectrum sunscreen (SPF 56), led to significant improvements at 12 weeks in the appearance of photodamaged skin in females with FST IV and V.

Dietary Isoeugenol Supplementation Attenuates Chronic UVB-Induced Skin Photoaging and Modulates Gut Microbiota in Mice.

Photoaging, the primary cause of skin aging damage, results from chronic ultraviolet (UV) exposure, leading to dryness and wrinkle formation. Nutritional intervention has emerged as a practical approach for preventing and addressing the effect of skin photoaging. The primary aromatic compound isolated from clove oil, isoeugenol (IE), has antibacterial, anti-inflammatory, and antioxidant qualities that work to effectively restrict skin cancer cell proliferation. This investigation delved into the advantages of IE in alleviating skin photoaging using UVB-irradiated skin fibroblasts and female SKH-1 hairless mouse models. IE alleviated UVB-induced photodamage in Hs68 dermal fibroblasts by inhibiting matrix metalloproteinase secretion and promoting extracellular matrix synthesis. In photoaged mice, dietary IE reduced wrinkles, relieved skin dryness, inhibited epidermal thickening, and prevented collagen loss. Additionally, the intestinal dysbiosis caused by prolonged UVB exposure was reduced with an IE intervention. The results of Spearman's analysis showed a strong correlation between skin photoaging and gut microbiota. Given the almost unavoidable UVB exposure in contemporary living, this research demonstrated the efficacy of dietary IE in reversing skin photoaging, presenting a promising approach to tackle concerns related to extrinsic skin aging.

Predicting the evolution of clinical skin aging in a multi-ethnic population: Developing causal Bayesian networks using dermatological expertise.

Software to predict the impact of aging on physical appearance is increasingly popular. But it does not consider the complex interplay of factors that contribute to skin aging. To predict the +15-year progression of clinical signs of skin aging by developing Causal Bayesian Belief Networks (CBBNs) using expert knowledge from dermatologists. Structures and conditional probability distributions were elicited worldwide from dermatologists with experience of at least 15 years in aesthetics. CBBN models were built for all phototypes and for ages ranging from 18 to 65 years, focusing on wrinkles, pigmentary heterogeneity and facial ptosis. Models were also evaluated by a group of independent dermatologists ensuring the quality of prediction of the cumulative effects of extrinsic and intrinsic skin aging factors, especially the distribution of scores for clinical signs 15 years after the initial assessment. For easiness, only models on African skins are presented in this paper. The forehead wrinkle evolution model has been detailed. Specific atlas and extrinsic factors of facial aging were used for this skin type. But the prediction method has been validated for all phototypes, and for all clinical signs of facial aging. This method proposes a skin aging model that predicts the aging process for each clinical sign, considering endogenous and exogenous factors. It simulates aging curves according to lifestyle. It can be used as a preventive tool and could be coupled with a generative AI algorithm to visualize aging and, potentially, other skin conditions, using appropriate images.

Hesperetin activates CISD2 to attenuate senescence in human keratinocytes from an older person and rejuvenates naturally aged skin in mice

BackgroundCDGSH iron-sulfur domain-containing protein 2 (CISD2), a pro-longevity gene, mediates healthspan in mammals. CISD2 is down-regulated during aging. Furthermore, a persistently high level of CISD2 promotes longevity and ameliorates an age-related skin phenotype in transgenic mice. Here we translate the genetic evidence into a pharmaceutical application using a potent CISD2 activator, hesperetin, which enhances CISD2 expression in HEK001 human keratinocytes from an older person. We also treated naturally aged mice in order to study the activator’s anti-aging efficacy.MethodsWe studied the biological effects of hesperetin on aging skin using, firstly, a cell-based platform, namely a HEK001 human keratinocyte cell line established from an older person. Secondly, we used a mouse model, namely old mice at 21-month old. In the latter case, we investigate the anti-aging efficacy of hesperetin on ultraviolet B (UVB)-induced photoaging and naturally aged skin. Furthermore, to identify the underlying mechanisms and potential biological pathways involved in this process we carried out transcriptomic analysis. Finally, CISD2 knockdown HEK001 keratinocytes and Cisd2 knockout mice were used to study the Cisd2-dependent effects of hesperetin on skin aging.ResultsFour findings are pinpointed. Firstly, in human skin, CISD2 is mainly expressed in proliferating keratinocytes from the epidermal basal layer and, furthermore, CISD2 is down-regulated in the sun-exposed epidermis. Secondly, in HEK001 human keratinocytes from an older person, hesperetin enhances mitochondrial function and protects against reactive oxygen species-induced oxidative stress via increased CISD2 expression; this enhancement is CISD2-dependent. Additionally, hesperetin alleviates UVB-induced damage and suppresses matrix metalloproteinase-1 expression, the latter being a major indicator of UVB-induced damage in keratinocytes. Thirdly, transcriptomic analysis revealed that hesperetin modulates a panel of differentially expressed genes that are associated with mitochondrial function, redox homeostasis, keratinocyte function, and inflammation in order to attenuate senescence. Intriguingly, hesperetin activates two known longevity-associated regulators, namely FOXO3a and FOXM1, in order to suppress the senescence-associated secretory phenotype. Finally, in mouse skin, hesperetin enhances CISD2 expression to ameliorate UVB-induced photoaging and this occurs via a mechanism involving CISD2. Most strikingly, late-life treatment with hesperetin started at 21-month old and lasting for 5 months, is able to retard skin aging and rejuvenate naturally aged skin in mice.ConclusionsOur results reveal that a pharmacological elevation of CISD2 expression at a late-life stage using hesperetin treatment is a feasible approach to effectively mitigating both intrinsic and extrinsic skin aging and that hesperetin could act as a functional food or as a skincare product for fighting skin aging.

Vitamin C compounds mixture prevents skin barrier alterations and inflammatory responses upon real life multi pollutant exposure.

Cutaneous tissues is among the main target of outdoor stressors such as ozone (O3 ), particulate matter (PM), and ultraviolet radiation (UV) all involved in inducing extrinsic skin aging. Only a few reports have studied the multipollutant interaction and its effect on skin damage. In the present work, we intended to evaluate the ability of pollutants such as O3 and PM to further aggravate cutaneous UV damage. In addition, the preventive properties of a cosmeceutical formulation mixture (AOX mix) containing 15% vitamin C (L-ascorbic acid), 1% vitamin E (α-tocopherol) and 0.5% ferulic acid was also investigated. Skin explants obtained from three different subjects were exposed to 200 mJ UV light, 0.25 ppm O3 for 2 h, and 30 min of diesel engine exhaust (DEE), alone or in combination for 4 days (time point D1 and D4). The results showed a clear additive effect of O3 and DEE in combination with UV in terms of keratin 10, Desmocollin and Claudin loss. In addition, the multipollutant exposure significantly induced the inflammatory response measured as NLRP1/ASC co-localization suggesting the activation of the inflammasome machinery. Finally, the loss of Aquaporin3 was also affected by the combined outdoor stressors. Furthermore, daily topical pre-treatment with the AOX Mix significantly prevented the cutaneous changes induced by the multipollutants. In conclusion, this study is among the first to investigate the combined effects of three of the most harmful outdoor stressors on human skin and confirms that daily topical of an antioxidant application may prevent pollution-induced skin damage.

Dermoscopic analysis of skin changes associated with sun exposure among medical students in a tertiary care center in Central Kerala

Background: Skin is an important barrier of the human body, which offers protection from pathogens, UV radiation, and chemical and mechanical injury. Solar UV radiation is the major cause of extrinsic skin aging and it leads to many acute and chronic cutaneous reactions. Dermoscope is an instrument that helps to visualize the morphological features unseen to the naked eye, using the principle of transillumination and magnification of skin. Aim and Objective: The aim of the study was to study the skin changes associated with sun exposure on the lateral and medial aspects of the forearm using dermoscope. Materials and Methods: A cross-sectional descriptive study of 82 1st-year MBBS students belonging to 18–25 years of age was conducted at Government Medical College, Thrissur, after getting ethics committee approval. Sample size calculated was 76. With the help of a questionnaire, personal details and details related to the sun exposure habits of the subjects were obtained. Dermoscopic photographs of the lateral and medial side of the forearm were taken after informed consent. Results: Chi-square test showed significant changes in pigmentation pattern and hair pattern on the lateral side of the forearm among subjects who had sun exposure for more than half an hour which was not found on the medial side. Conclusion: Photoaged skin appears coarse with uneven pigmentation. Dermoscopy allows the assessment of subtle morphological features of skin aging. Monitoring skin changes due to sun exposure among our population helps in the early identification of abnormal patterns with sun exposure which needs immediate medical attention.

The Impact of Photoaging on Skin: A Systematic Review Analysis

Aging of the skin is a complex biological process. The process of skin aging can be divided into two categories namely intrinsic and extrinsic aging. Intrinsic skin aging or natural aging is caused by changes in skin elasticity that occur with age. This type of aging cannot be prevented. While extrinsic skin aging is caused by environmental factors such as exposure to solar radiation (photoaging). In this study, the type of research approach used is a type of qualitative research through a literature review. The type of data used is the type of secondary data. Secondary data is a type of data obtained from certain parties or media indirectly, meaning that certain parties become intermediaries where they obtain and record these data beforehand. The aging process of the skin is influenced by intrinsic and extrinsic factors. The extrinsic factor that most influences the aging process of the skin is chronic sun exposure which is called photoaging. Sunlight contains 96% UVA and has the most significant biological effect compared to UVB and UVC. Several factors that affect photodamaging are skin type, pigmentation, and acclimatization. Skin changes that occur in photoaging include the presence of vesicles in the epidermis, reduced Langerhans cells, and enlarged and pale epidermal cells; in the dermis, there is an elastic mass; pigment changes in the form of dotted (irregular pigmentation) and hyperpigmentation.

The effect of long exposure to uvb rays on histological features of wistar rats (Rattus norvegicus) in photoaging model

Introduction: Indonesia is a tropical country with exposure to UV rays from the sun throughout the year, so the Indonesian population is very vulnerable to skin aging, especially extrinsic skin aging due to prolonged exposure to UV rays. This study aimed to determine the effect of long exposure to UVB rays on the thickness of the epidermis, the thickness of the dermis, and the number of blood vessels and sunburn cells in (Rattus norvegicus) Wistar strain. Methods: This research was a post-test-only control group design using 27 rats which were divided into 3 groups, namely: control group K was untreated rats, and treatment groups P1 and P2 were rats exposed to UVB radiation for 3 weeks and 6 respectively exposure weeks. Test the effect on the study using the One-Way ANOVA test and Tukey’s Post Hoc Test. Results: The results indicated an increase in epidermal thickness of groups P1 (44.87 μm) and P2 (56.90 μm) (significant p&lt;0.05). A decrease in dermis thickness occurred in groups P1 (726.91 μm) and P2 (559.40 μm) (significant p&lt;0.05). In the photoaging area, there was an increased amount of sunburn cells in group P1 (6.40) and P2 (11.40) (significant p&lt;0.05). There was a difference in the number of blood vessels between groups K and P2 and groups P1 and P2 (p&lt;0.05). Conclusion: There was an effect of long exposure to UVB rays on histology in rats (Rattus norvegicus) of the photoaging model including the thickness of the epidermis layer and dermis layer, the number of blood vessels, and sunburn cells.

Promoting New Approach Methodologies (NAMs) for research on skin color changes in response to environmental stress factors: tobacco and air pollution.

Aging is one of the most dynamic biological processes in the human body and is known to carry significant impacts on individuals' self-esteem. Skin pigmentation is a highly heritable trait made possible by complex, strictly controlled cellular and molecular mechanisms. Genetic, environmental and endocrine factors contribute to the modulation of melanin's amount, type and distribution in the skin layers. One of the hallmarks of extrinsic skin aging induced by environmental stress factors is the alteration of the constitutive pigmentation pattern clinically defined as senile lentigines and/or melasma or other pigmentary dyschromias. The complexity of pollutants and tobacco smoke as environmental stress factors warrants a thorough understanding of the mechanisms by which they impact skin pigmentation through repeated and long-term exposure. Pre-clinical and clinical studies demonstrated that pollutants are known to induce reactive oxygen species (ROS) or inflammatory events that lead directly or indirectly to skin hyperpigmentation. Another mechanistic direction is provided by Aryl hydrocarbon Receptors (AhR) which were shown to mediate processes leading to skin hyperpigmentation in response to pollutants by regulation of melanogenic enzymes and transcription factors involved in melanin biosynthesis pathway. In this context, we will discuss a diverse range of New Approach Methodologies (NAMs) capable to provide mechanistic insights of the cellular and molecular pathways involved in the action of environmental stress factors on skin pigmentation and to support the design of raw ingredients and formulations intended to counter their impact and of any subsequently needed clinical studies.

The collagen enhancement by Spirulina extract in intrinsic and extrinsic skin aging in albino rat

BackgroundThe aging of the skin is considered a cumulative process that is classed as intrinsic or extrinsic. Environmental factors like sun exposure and air pollution are considered the main cause of extrinsic aging. Mainly, intrinsic aging reflects the genetic background and depends on time. Spirulina platensis unicellular blue–green algae have a variety of biological and nutritional activities because of their high level of nutrients. The current study aims to investigate the mechanism by which spirulina extract (SE) may act anti-aging in female albino rats. Spirulina extract (20 mg/mL) was injected subcutaneously before UVA irradiation (2.16 J/cm2), daily for 7 days. The epidermal thickness and the collagen fibers layer were stained utilizing hematoxylin and eosin and Masson.ResultsSE induced significant improvements in the activities of antioxidants including superoxide dismutase and reduced glutathione, down-regulating in expressions of inflammatory cytokines: interleukin-1β and tumor necrosis factor-α and reverses excessive ROS levels. As well as , the recovery of collagen density and reduction in the production of matrix metalloproteinases were presented.ConclusionsThe results found that spirulina extract may delay the signs of skin aging by enhancing collagen as well as antioxidant activities and inhibiting collagen degradation and inflammation.

In vitro, ex vivo, and clinical evaluation of anti-aging gel containing EPA and CBD.

Skin aging manifestation, such as coarse wrinkles, loss of elasticity, pigmentation, and rough-textured appearance, is a multifactorial process that can be exacerbated by air pollution, smoking, poor nutrition, and sun exposure. Exposure to UV radiation is considered the primary cause of extrinsic skin aging and accounts for about 80% of facial aging. Extrinsic skin aging signs can be reduced with demo-cosmetic formulations. Both cannabidiol (CBD) and eicosapentaenoic acid (EPA) have been previously suggested as potent active dermatological ingredients. The objective of the current research was to evaluate the compatibility of both agents in the prevention and treatment of skin aging. First, the impact of both agents was assessed using standard photoaging models of UV-induced damage, both in vitro (HaCaT cells) and ex vivo (human skin organ culture). Then, a clinical validation study (n = 33) was performed using an optimized topical cream formulation tested at different time points (up to Day 56). EPA was found to potentiate the protective effects of CBD by reducing the secretion of prostaglandin E2 (PGE2 ) and interleukin-8 (IL-8), two primary inflammatory agents associated with photoaging. In addition, a qualitative histological examination signaled that applying the cream may result in an increase in extracellular matrix (ECM) remodeling following UV radiation. This was also evidenced clinically by a reduction of crow's feet wrinkle area and volume, as well as a reduction of fine line wrinkle volume as measured by the AEVA system. The well-established age-dependent subepidermal low-echogenic band (SLEB) was also reduced by 8.8%. Additional clinical results showed significantly reduced red spots area and count, and an increase in skin hydration and elasticity by 31.2% and 25.6% following 56 days of cream application, respectively. These impressive clinical results correlated with high satisfaction ratings by the study participants. Collectively, the results show a profound anti-aging impact of the developed formulation and strengthen the beneficial derm-cosmetic properties of CBD-based products.

Subepidermal Low-Echogenic Band-Its Utility in Clinical Practice: A Systematic Review.

High-frequency ultrasonography (HF-USG) is a relatively new imaging method that allows the evaluation in a non-invasive manner of the skin layers and skin appendages. It is a diagnostic tool with increasing usefulness in numerous dermatological pathologies. High reproducibility, non-invasiveness and short diagnostic time make this method an increasingly used tool in dermatological practice. The subepidermal low-echogenic band is a relatively newly described parameter that seems to be a marker not only of intrinsic and extrinsic skin aging, but also of inflammatory processes taking place at the skin level. This systematic review aims to evaluate the role that SLEB has in the diagnosis and monitoring of the treatment of some inflammatory and non-inflammatory dermatological conditions, as well as its utility as a disease marker.

Skin aging associated with chromium among rural housewives in northern China

Previous studies have found associations between chromium exposure and skin damage. However, few studies have focused on both chromium and skin aging. This study aimed to assess the degree of skin aging symptoms and estimate the relationship between hair chromium and skin aging among rural housewives. We recruited 405 subjects in Shanxi Province of northern China and analyzed 397 eligible hair samples with inductively coupled plasma–mass spectrometry (ICP–MS). The subjects’ skin aging symptoms were assessed with SCINEXA™ (SCore of INtrinsic and EXtrinsic skin Aging). After adjusting for age and other important covariates, the regression results showed more severe skin aging symptoms in women with a higher level of hair chromium and presented an increasing linear trend. Vegetables, fruits, and beans might be a source of chromium exposure. We concluded that skin aging might be positively associated with hair chromium. It is necessary to take measures to reduce chromium exposure to prevent skin aging.

Quantitative morphometric analysis of intrinsic and extrinsic skin ageing in individuals with Fitzpatrick skin types II-III.

Skin ageing is an intricate physiological process affected by intrinsic and extrinsic factors. There is a demand to understand how the skin changes with age and photoexposure in individuals with Fitzpatrick skin types I-III due to accelerated photoageing and the risk of cutaneous malignancies. To assess the structural impact of intrinsic and extrinsic ageing, we analysed 14 skin parameters from the photoprotected buttock and photoexposed dorsal forearm of young and ageing females with Fitzpatrick skin types II-III (n=20) using histomorphic techniques. Whilst the minimum viable epidermis (Emin ) remained constant (Q > 0.05), the maximum viable epidermis (Emax ) was decreased by both age and photoexposure (Q ≤ 0.05), which suggests that differences in epidermal thickness are attributed to changes in the dermal-epidermal junction (DEJ). Changes in Emax were not affected by epidermal cell proliferation. For the first time, we investigated the basal keratinocyte morphology with age and photoexposure. Basal keratinocytes had an increased cell size, cellular height and a more columnar phenotype in photoexposed sites of young and ageing individuals (Q ≤ 0.05), however no significant differences were observed with age. Some of the most striking changes were observed in the DEJ, and a decrease in the interdigitation index was observed with both age and photoexposure (Q ≤ 0.001), accompanied by a decreased height of rête ridges and dermal papilla. Interestingly, young photoexposed skin was comparable to ageing skin across many parameters, and we hypothesise that this is due to accelerated photoageing. This study highlights the importance of skin care education and photoprotection from an early age.

The Effectiveness of Oral Fish Collagen Supplementation on Skin Aging: A Systematic Review and Meta-analysis of Skin Hydration, Skin Elasticity, and Skin Wrinkles

Introduction: Skin aging is a complex biological process with cumulative structural and physiological changes, progressive changes in each layer of the skin, and changes in the appearance of the skin. Human skin undergoes 2 types of skin aging, that are intrinsic and extrinsic skin aging. Skin aging is characterized by a decrease in skin hydration and elasticity, as well as an increase in skin wrinkles. Anti-aging strategies are still being developed. A new anti-aging therapy modality that has been widely used is nutraceutical supplementation, such as fish collagen. Fish collagen is a new alternative source of collagen with a high degree of homology to human collagen structure and high bioavailability. The aim of this study was to assess the efficacy of oral fish collagen supplementation on skin aging. Methods: This study was an analytic observational study, with systematic review and meta-analysis. Data searching was conducted online at Pubmed-MEDLINE, EBSCO (CINAHL), Scopus, SpringerLink, ProQuest, Cochrane Library, ClinicalTrials.gov, Cambridge Core, and Google Scholar, as well as hand searching from libraries in Indonesia. Twelve studies were included in the qualitative analysis (systematic review) (n=753 subjects) and 6 of them were included in the quantitative analysis (meta-analysis) (n=426 subjects). Results: The results of the meta-analysis showed that the increase in skin hydration in the group given oral fish collagen supplementation was greater significantly than in the placebo group, with standardized mean difference (SMD) (95% CI)=0.56 (0.32 to 0.81), Z=4.47 (p<0.00001), I2=24%. The increase in skin elasticity in the group given oral fish collagen supplementation was greater significantly than in the placebo group, with SMD (95% CI)=0.33 (0.17 to 0.49), Z=4.05 (p<0 ,0001), I2=21%. The reduction in skin wrinkles in the group given oral fish collagen supplementation was greater significantly than in the placebo group, with SMD (95% CI)=-0.47 (-0.74 to -0.19), Z=3.34 ( p=0.0008), I2=49%. Adverse events were not found in the included studies. Conclusion: Oral fish collagen supplementation is effective against skin aging, mainly in increasing skin hydration and skin elasticity, and reducing skin wrinkles.

The CSIESA: A Novel Score for the Assessment of Intrinsic and Extrinsic Skin Aging Based on Reflectance Confocal Microscopy Imaging.

Skin aging is an intricate physiological process governed by intrinsic and extrinsic factors. Increasing life expectancy has turned skin aging into a growing concern for the general population. Clinical examination of the skin does not fully describe the skin aging process. This study aims to evaluate the healthy skin of five different age groups in order to develop an easy-to-use confocal score for quantifying signs of skin aging and test the correlation between this new score and the already described clinical score, SCINEXA (score of intrinsic and extrinsic skin aging). Thirty-five subjects split into five age groups: &lt;35; 36-45; 46-55; 56-65, and &gt;65 years old were enrolled. Clinical signs were quantified using the SCINEXA score, and known confocal variables of skin aging were evaluated. Three different semi-quantitative scores were calculated: epidermal disarrangement score (EDS), epidermal hyperplasia score (EHS), and dermal score (DS). The EDS showed a stable trend up to the age of 65 and a dramatic increase in older subjects. EHS was characterized by an ascending trend from younger subjects to middle-aged ones. The DS was progressive with age, with a different proportion of distinct collagen types. The confocal CSIESA (confocal score for the assessment of intrinsic and extrinsic skin aging) score correlated well with the SCINEXA score. Reflectance confocal microscopy is a powerful, non-invasive technique for microscopically quantifying aging signs.