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One of the major challenges of the 21 st century is the fight against aging, defined as a set of physiological mechanisms altering the physical and intellectual capacities of human beings. Aging of the skin is only one visible part of this process. It is associated with major healing defects linked in part to the alteration of the biomechanical properties of skin cells, mainly dermal fibroblasts. The immune system, another key component in maintaining skin homeostasis and the efficient healing of wounds, also suffers the effects of time: the consequent skin immunosenescence would limit the anti-infectious and vaccine response, while promoting a pro-tumor environment. The main skin damages due to aging, whether intrinsic or extrinsic, will be detailed before listing the effective anti-aging strategies to combat age-related dermal and epidermal stigmas., (© 2020 médecine/sciences – Inserm.)

Photoaging is associated with increasing pigmentary heterogeneity and darkening of skin color. However, little is known about age-related changes in skin pigmentation on sun-protected areas. The aim of this explorative study was to measure skin color and dyspigmentation using image processing and to evaluate the reliability of these parameters. Twenty-four volunteers of three age-groups were included in this explorative study. Measurements were conducted at sun-exposed and sun-protected areas. Overall skin-color estimates were similar among age groups. The hyper- and hypopigmentation indices differed significantly by age groups and their correlations with age ranged between 0.61 and 0.74. Dorsal forearm skin differed from the other investigational areas (p<0.001). We observed an increase in dyspigmentation at all skin areas, including sun-protected skin areas, already in young adulthood. Associations between age and dyspigmentation estimates were higher compared to color parameters. All color and dyspigmentation estimates showed high reliability. Dyspigmentation parameters seem to be better biomarkers for UV damage than the overall color measurements.

Dermal and epidermal structures in human skin change during intrinsic and extrinsic aging. Epidermal thickness is one of the most often reported parameters for the assessment of skin aging in cross-sectional images captured by optical coherence tomography (OCT). We aimed to identify further parameters for the noninvasive measurement of skin aging of sun-exposed and sun-protected areas utilizing OCT. Based on a literature review, seven parameters were inductively developed. Three independent raters assessed these parameters using four-point scales on images of female subjects of two age groups. All items could be detected and quantified in our sample. Interrater agreement ranged between 25.0% and 83.3%. The item scores “stratum corneum reflectivity,” “upper dermal reflectivity,” and “dermoepidermal contrast” showed significant differences between age groups on the volar and dorsal forearm indicating that they were best able to measure changes during skin aging. “Surface unevenness” was associated with the skin roughness parameters, Rz and Rmax, on the inner upper arm and volar forearm supporting the criterion validity of this parameter on sun-protected skin areas. Based on the interrater agreement and the ability to differentiate between age groups, these four parameters are being considered as the best candidates for measuring skin aging in OCT images.

Facial skin ageing is caused by intrinsic and extrinsic mechanisms. Intrinsic ageing is highly related to chronological age. Age related skin changes can be measured using clinical and biophysical methods. The aim of this study was to evaluate whether and how clinical characteristics and biophysical parameters are associated with each other with and without adjustment for chronological age. Twenty-four female subjects of three age groups were enrolled. Clinical assessments (global facial skin ageing, wrinkling, and sagging), and biophysical measurements (roughness, colour, skin elasticity, and barrier function) were conducted at both upper cheeks. Pearson's correlations and linear regression models adjusted for age were calculated. Most of the measured parameters were correlated with chronological age (e.g., association with wrinkle score, r = 0.901) and with each other (e.g., residual skin deformation and wrinkle score, r = 0.606). After statistical adjustment for age, only few associations remained (e.g., mean roughness (R z ) and luminance (L (*)),  β = -0.507, R (2) = 0.377). Chronological age as surrogate marker for intrinsic ageing has the most important influence on most facial skin ageing signs. Changes in skin elasticity, wrinkling, sagging, and yellowness seem to be caused by additional extrinsic ageing.

Pressure ulcers (PUs) are injuries to the skin and underlying tissues, caused by sustained deformations and occur frequently in aged patients. Skin microtopography and stiffness affect the interaction of skin with contact surfaces contributing to PU development. We simulated immobility in 20 healthy females (mean age 69.9 years). Skin microtopography and stiffness were measured at the PU predilection sites before and after loading. Skin roughness decreased at the heels by 18.1% after 90 minutes (p = 0.022), but remained unchanged at the sacrum and the upper back. Structural elasticity and elastic deformations increased at all skin areas; changes over time were significant at the sacrum (p = 0.005) and the heel, (p = 0.002). The residual skin deformation increased at all skin areas after loading significantly at the sacrum (32.0%, p = 0.013) and upper back (20.6%, p = 0.007). The structural "biological" elasticity of the skin decreased significantly at the upper back after loading, but remained unchanged at the heels. All skin changes recovered after unloading. Results indicate that prolonged loading causes structural skin changes in humans in vivo in PU predilection sites. The pathogenesis of PUs is different at the heels, the sacral and upper back skin., (© 2015 by the Wound Healing Society.)