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Summary Background While cumulative lifetime sun exposure is well recognized as having an important role in the progression of facial wrinkling, the role of facial expression has largely been overlooked, in part due to the lack of comprehensive longitudinal data on the change in both expression lines and persistent wrinkles with age. Objectives To track the detailed pattern of facial wrinkling in the same group of people over several years and to verify that expression lines evolve into persistent wrinkles. In addition, to identify factors predictive of a faster or slower rate of wrinkling. Methods Standardized images were captured at baseline and at 8 years of 122 women (ages 10–72 years, skin types I–VI) with and without a smiling expression. The wrinkle pattern with expression at baseline was compared with the pattern without expression at 8 years. Severity of facial wrinkling was quantified using computer-based image analysis. Skin colour, hydration, sebum and pH were measured at baseline. A structured questionnaire captured demographic and lifestyle data at baseline and at 8 years. Results Each subject’s unique pattern of persistent facial wrinkling observed without expression at year 8 was predicted by the pattern of lines observed with a smiling expression at baseline. Having a drier, more alkaline stratum corneum, a lighter complexion, being middle-aged (40s) or becoming menopausal were associated with faster persistent wrinkling. Conclusions Repeated skin flexure during facial expression causes persistent wrinkles. The pattern of expression lines predicts the pattern of future persistent wrinkles. Certain intrinsic and extrinsic factors are not causative, but influence the rate, of facial wrinkling.

BACKGROUND: The number of studies that use objective and quantitative methods to evaluate facial skin aging in elderly people is extremely limited, especially in Japan. Therefore, in this cross-sectional study we attempted to characterize the condition of facial skin (hyperpigmentation, pores, texture, and wrinkling) in Japanese adults aged 65 years or older by using objective and quantitative imaging methods. In addition, we aimed to identify lifestyle factors significantly associated with these visible signs of aging. METHODS: The study subjects were 802 community-dwelling Japanese men and women aged at least 65 years and living in the town of Kurabuchi (Takasaki City, Gunma Prefecture, Japan), a mountain community with a population of approximately 4800. The facial skin condition of subjects was assessed quantitatively using a standardized facial imaging system and subsequent computer image analysis. Lifestyle information was collected using a structured questionnaire. The association between skin condition and lifestyle factors was examined using multivariable regression analysis. RESULTS: Among women, the mean values for facial texture, hyperpigmentation, and pores were generally lower than those among age-matched men. There was no significant difference between sexes in the severity of facial wrinkling. Older age was associated with worse skin condition among women only. After adjusting for age, smoking status and topical sun protection were significantly associated with skin condition among both men and women. CONCLUSIONS: Our study revealed significant differences between sexes in the severity of hyperpigmentation, texture, and pores, but not wrinkling. Smoking status and topical sun protection were significantly associated with signs of visible skin aging in this study population.

Aim: To study the relationship between age-related maculopathy (ARM) and exposure to sunlight using an objective method. Methods: In a case–control study of Japanese men aged ⩾50 years (67 controls without ophthalmic disease and 148 with ARM), those with ARM were separated into groups of early (n = 75) and late (n = 73) ARM. Facial wrinkle length and area of hyperpigmentation, which are considered to be associated with exposure to sun, were measured using imaging with computer-based image analysis. Skin tone was also measured on the upper inner arm, which is not exposed to sun. Early and late ARM association with skin measurements was then evaluated. Results: Significantly more facial wrinkling (p = 0.047, odds ratio 3.8; 95% CI 1.01 to 13.97) and less facial hyperpigmentation (p = 0.035, odds ratio 0.3; 95% CI 0.08 to 0.92) was present in late ARM cases. The relationship between skin tone and ARM risk was not statistically significant. Conclusions: This objective method showed that lifetime exposure to sunlight is an important factor in the progression of late ARM. An individual’s reaction to sunlight exposure may have a role in ARM progression in addition to total lifetime exposure to sunlight.

Background/aims: There are few available methods that can be used to quantify hyperpigmented spots on a wide area of the face. The objective of this study was to develop such a method through the use of specialized image analysis technologies. Methods: This imaging system was composed of a source of illumination whose light intensity was controlled with a dimmer, a 3-CCD video camera connected to a computer, and a positioning device used to correctly align the subject's face. This system was calibrated by adjusting the light intensity, the camera position, and white balance of the camera in order to acquire reproducible images. Using a specific algorithm for the image analysis, this system enabled us to measure both the total area of hyperpigmented spots (mm2) and the averaged skin colour tone (quasi L*a*b*) excluding the area of those hyperpigmented spots in a wide area of the face. The accuracy and reproducibility of the system was validated using a mannequin head with six standard colour chips obtained from the GretagMacbeth ColorChecker®, and brown-coloured patches that simulated hyperpigmented spots whose colour and area were both known. The correlation between CIE L*a*b* and quasi L*a*b* values was examined by conducting simultaneous measurements of the facial skin colour of 187 subjects with a tristimulus colourimeter (Minolta Chromameter) and our imaging system. Results: The measurement errors in quasi L*a*b* values of colour chips and the area of brown patches were less than 2 and 5%, respectively, unless these chips or patches were located in the peripheral zone of the mannequin head. The variation in quasi L*a*b* values and the area of hyperpigmented spots (mm2) in five repeated measurements performed once every hour was less than 2%. There was an excellent correlation between the CIE L*a*b* and quasi L*a*b* values, and the Pearson's correlation coefficient between CIE L* and quasi L* value, for instance, was 0.908. Conclusions: As long as the region to be evaluated is limited to the cheek and periorbital areas, this system enables automatic detection of hyperpigmented spots in a wide area of the face, as well as the correct measurement of those areas and determination of skin colours.

SummaryBackground Cutaneous hyperpigmentation occurs in multiple conditions. In addition, many Asian women desire a lighter skin colour. Thus, there is a need for the development of skin lightening agents. Niacinamide is a possible candidate. Objectives To investigate the effects of niacinamide on melanogenesis in vitro and on facial hyperpigmentation and skin colour in vivo in Japanese women. Methods Melanin production was measured in a purified mushroom tyrosinase assay, cultured melanocytes, a keratinocyte/melanocyte coculture model, and a pigmented reconstructed epidermis (PREP) model. The clinical trials included 18 subjects with hyperpigmentation who used 5% niacinamide moisturizer and vehicle moisturizer in a paired design, and 120 subjects with facial tanning who were assigned to two of three treatments: vehicle, sunscreen and 2% niacinamide + sunscreen. Changes in facial hyperpigmentation and skin colour were objectively quantified by computer analysis and visual grading of high-resolution digital images of the face. Results Niacinamide had no effect on the catalytic activity of mushroom tyrosinase or on melanogenesis in cultured melanocytes. However, niacinamide gave 35–68% inhibition of melanosome transfer in the coculture model and reduced cutaneous pigmentation in the PREP model. In the clinical studies, niacinamide significantly decreased hyperpigmentation and increased skin lightness compared with vehicle alone after 4 weeks of use. Conclusions The data suggest niacinamide is an effective skin lightening compound that works by inhibiting melanosome transfer from melanocytes to keratinocytes.

Background/aims: The aim of this study was to quantify and confirm the efficacy of cosmetic formulations for hyperpigmented spots over a wide area of the face using a high quality digital imaging system that we developed. Methods: A total of 120 Japanese female volunteers aged 25–60 years with solar lentigines were treated for 6 months with a skin lightening moisturizer (SLM, thereafter) containing 3% magnesium ascorbyl phosphate on one side of the face and vehicle on the other side. During the course of the study, facial images were collected by the image analysis to measure facial skin colour and the total area of hyperpigmented spots. The evaluation was also conducted by visual grading. Measurements were made before and 1, 3, and 6 months after starting the application, and again 6 months after discontinuing the treatment. Three similar clinical studies using the same protocol were repeated for up to one-month to confirm the reproducibility of the results and to examine seasonal variation. Results: SLM significantly reduced the total area of hyperpigmented spots (P