Treatment Of Photoaged Skin Research Articles

Photorejuvenation for Asian skin by intense pulsed light.

Dermabrasion and deep chemical peeling are used in the treatment of photoaged skin. These ablative procedures are effective enough to produce a certain improvement but have often caused postinflammatory hyperpigmentation among Asian patients. To avoid such adverse effects, a new, nonablative procedure has been sought. To determine the effectiveness of photorejuvenation for Asian skin using intense pulsed light (IPL). The specific parameters used, improvement ratios, side-effects, and downtime required are also discussed. Ninety-seven patients were treated for photoaging using IPL. The cutoff filters of 550 nm and 570 nm were utilized for three to six treatments at intervals of 2 to 3 weeks. Treatment results were evaluated and rated by both patients and physicians at the end of the third treatment based on improvement in pigmentation, telangiectasia, and skin texture. A combined rating of "good" or "excellent" was given to more than 90% of the patients for pigmentation, more than 83% for telangiectasia, and more than 65% for skin texture. There were some minor complications in four cases: one had erythema that continued to the next day and three had minor blisters leaving no marks. Photorejuvenation using IPL is a completely safe and effective procedure even for Asian skin. It will be increasingly used for skin rejuvenation in the future.

Imedeen® in the treatment of photoaged skin: an efficacy and safety trial over 12 months1

UV-exposure induces photoaging of the skin. Testing the efficacy and safety of oral Imedeen in photoaged skin. Three month placebo-controlled randomized study of 144 subjects and 9-month-uncontrolled continuation. Efficacy measurements included clinical evaluation, self-evaluation, photograph evaluation, as well as ultrasound, transepidermal water loss and replica measurements. After 3 months, no significant effects were detected. One years treatment gave significant improvement compared with baseline in investigator's evaluation of fine lines and overall photoaging, in photograph evaluation of fine lines, overall photoaging, telangiectasia and hyperpigmentation, in self-evaluation of skin condition, density measurements by ultrasound, trans-epidermal water loss and skin smoothness from analysis of skin replica. No serious side-effects related to treatment were reported. Imedeen appears effective and safe for treatment of photoaged skin.

Analysis of clustered ordinal data with subclusters via a bayesian hierarchical model

We propose a Bayesian hierarchical model to analyze clustered ordinal data. We describe the method in the context of a clinical trial for examining the efficacy of tretinoin emollient cream in the treatment of photo-aged skin. For each patient there were five ordinal responses (each with 4 ordinal categories) from two locations, four from arms and one from face. Thus the data were nested with two levels: patient level and location level. The Bayesian hierarchical model gives estimates for location-specific treatment effect and credible intervals.

Pulsed CO2 Laser Treatment of Superficial BCC and In situ SCC

Pulsed CO2 lasers have been used extensively in the treatment of photoaged skin, but little has been published on their potential efficacy for treating superficial nonmelanoma skin cancer. In this study, 30 superficial neoplasms (17 basal cell carcinomas and 13 squamous cell carcinomas in situ) were treated with two or three passes of a …

A comparison of wire brush and diamond fraisesuperficial dermabrasion for photoaged skin: A clinical, immunohistologic, and biochemical study

Superficial dermabrasion has a proven beneficial effect on photoaged skin, but little is known about the differences between the two major modalities used in dermabrasion, the diamond fraise (DF) and the wire brush (WB). We compared the clinical, immunohistologic, and biochemical changes after superficial dermabrasion with DF and WB. Eight photoaged patients (mean age, 68 years; range, 49 to 80 years) underwent facial dermabrasion to the level of the papillary dermis. Clinical assessments were performed at baseline and at 3 and 12 weeks after dermabrasion. Biopsy specimens were taken from both dermabraded halves at the same time points and assessed by routine histologic and immunohistologic examinations, western blot analysis, and radioimmunoassay. Scoring of intracellular and extracellular transforming growth factor-beta 1 was based on a semiquantitative ordinal scale (0 = no staining to 4 = maximum staining) in half-unit increments. The score for each specimen represents the average of values obtained from four high-power fields. Both methods of dermabrasion resulted in significant resolution of actinic keratoses, lentigines, and wrinkling. No statistical significance was noted between the two methods in regard to clinical efficacy. Significantly fewer milia occurred after DF than after WB. Solar elastosis decreased with both the WB and DF. Immunohistologic examination demonstrated a highly significant increase in papillary dermal fibroblast staining for amino terminal procollagen I (type I pN-collagen) at 3 weeks for both DF and WB compared to baseline. Staining at 12 weeks had decreased from the peak noted at week 3, but was still significantly increased from baseline. Western blotting of type I pN-collagen demonstrated a 5.4-fold (p = 0.01) increase from baseline at 3 weeks and a 4.9-fold (p = 0.002) increase at 12 weeks after dermabrasion with the WB. Similarly, the DF produced a 4.9-fold (p = 0.006) increase at 3 weeks and a 5.1-fold (p = 0.008) increase at 12 weeks after dermabrasion. Western blotting of amino terminal procollagen III (type III pN-collagen) showed a 6.1-fold (p = 0.07) increase from baseline at 3 weeks and a 3.9-fold (p = 0.04) increase at 12 weeks after dermabrasion with the DF. The WB showed a 3.8-fold (p = 0.07) increase from baseline at 3 weeks and a 5.1-fold (p = 0.05) increase at 12 weeks. Transforming growth factor-beta 1 demonstrated a significant increase in extracellular staining with DF (3.3 +/- 0.2) and WB (3.7 +/- 0.2) from baseline (1.2 +/- 0.2, p < 0.001) at 3 weeks. Superficial dermabrasion with DF and WP appears to be similarly efficacious in the treatment of photoaged skin. Significant increases in type I pN-collagen, type III pN-collagen, and TGF-beta 1 occurred in the papillary dermis after both types of dermabrasion. These results suggest that increased fibroblast activity and consequent collagen I and III synthesis underlie the clinical improvement.

The effects of retinoids on extracellular matrix (ECM) gene expression and cell proliferation in vitro: Possible mechanisms of action in the treatment of photoaged skin

The effects of retinoids on extracellular matrix (ECM) gene expression and cell proliferation in vitro: Possible mechanisms of action in the treatment of photoaged skin

Tretinoin emollient cream: A new therapy for photodamaged skin

Tretinoin administered topically in 0.1% concentration has been shown to improve the wrinkling and irregular pigmentation of photoaged skin. The purpose of this study was to assess the safety and efficacy of various concentrations of tretinoin in a new emollient cream base in the treatment of photoaged skin. Three concentrations of tretinoin (0.05%, 0.01%, and 0.001%) in a new emollient cream formulation were compared with vehicle in a 24-week, double-blind, randomized, multicenter study of 296 subjects with photodamaged facial skin. Tretinoin emollient cream 0.05% gave a significantly better global response to therapy than vehicle (p less than 0.001), with 68% of subjects exhibiting improvement at the end of therapy, compared with 43% of subjects in the vehicle group. An excellent or good response was found in 26% of subjects treated with tretinoin emollient cream 0.05% versus 11% of vehicle-treated subjects. Fine wrinkling, mottled hyperpigmentation, and roughness were more improved in subjects who received tretinoin emollient cream 0.05% than in vehicle-treated subjects (p less than 0.05). No significant difference was found between vehicle and tretinoin emollient cream 0.01% or 0.001%. Histologic examination showed increases in epidermal and granular layer thickness, decreased melanin content and compaction of the stratum corneum after therapy with tretinoin emollient cream 0.05% or 0.01%. Mild to moderate skin reactions, such as erythema, peeling, and burning, were the most common side effects and, although most prevalent in the group using the 0.05% concentration, generally did not limit tretinoin use. Tretinoin emollient cream 0.05% appears to be safe and effective in the treatment of photodamaged skin.

Treatment of photoaged skin with topical tretinoin increases epidermal-dermal anchoring fibrils—A preliminary report

Treatment of photoaged skin with topical tretinoin increases epidermal-dermal anchoring fibrils—A preliminary report

Treatment of photoaged skin with topical tretinoin increases epidermal-dermal anchoring fibrils. A preliminary report

Topical 0.1% tretinoin or vehicle control was applied daily to the forearm skin of six caucasian adults for 4 months. Two-millimeter punch biopsy specimens were obtained from treatment sites at the beginning and end of the study period for electron microscopy. Anchoring fibrils within the epidermal-dermal junction of skin treatment sites were quantitated by blinded, standardized, computer-assisted morphometry. After 4 months of continual daily treatment, skin sites that received topical tretinoin showed double the anchoring fibril density compared with vehicle control sites. The possible mechanism by which topical tretinoin increases anchoring fibrils in skin include the drug's property of inhibiting collagenase, a dermal enzyme that degrades anchoring fibril collagen. The authors speculate that increased numbers of collagenous anchoring fibrils within the papillary dermis of human skin is one of the connective-tissue correlates of the clinical improvement observed in photoaged skin after treatment with topical tretinoin.

Tretinoin therapy in photoageing: historical perspective

Tretinoin was shown in the late 1960s to be useful for the treatment of disorders associated with abnormal epithelial differentiation; however, because of irritation, retinoids were only slowly accepted. In the 1970s, evidence accumulated to show that topical tretinoin could modulate many of the abnormalities in the epidermis and dermis associated with photoageing. It has been shown in hairless mice that tretinoin can reverse dermal elastosis with the formation of new collagen and this has led to clinical trials being carried out in man. Randomized, controlled trials have shown that topical tretinoin is effective in the treatment of photoaged skin.