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Background: Medical aesthetic procedures for facial antiaging with laser and energy-based devices (EBDs) are rapidly increasing, but standards integrating skincare before, during, and after these treatments are lacking. The algorithm for integrated skin care for facial antiaging treatment with EBDs aims to stimulate healing, reduce downtime, and improve comfort and treatment outcomes., Methods: A panel of 8 global physicians employed a modified Delphi method and reached a consensus on the algorithm integrating skincare based on the best available evidence, the panel's clinical experience, and opinions., Results: The algorithm has a pretreatment (starts 2 - 4 weeks before the procedure) and treatment (day of treatment) section, followed by care after the procedure (0 - 7 days) and follow-up care (1 - 4 weeks after the procedure or ongoing). Applying a broad-spectrum sunscreen with an SPF 50 or higher, combined with protective measures such as wearing a wide-brimmed hat and sunglasses, is recommended to protect the face from sun exposure. Dyschromia is a significant concern for those with skin of color (SOC). Clinicians may recommend skincare using a gentle cleanser and moisturizer containing vitamins C and E, retinoid, or other ingredients such as niacinamide, kojic acid, licorice root extract, azelaic acid, and tranexamic acid, depending on the patient's facial skin condition., Conclusion: Medical aesthetic procedures for facial antiaging with EBDs integrating skincare or topical treatments may improve outcomes and patient satisfaction. Topical antioxidants and free radical quenchers can combat photodamage and may offer a safe alternative to topical hydroquinone.  J Drugs Dermatol. 2024;23(5):353-359.     doi:10.36849/JDD.8092.

The present study investigated the effect of topical application of Epidermidibacterium Keratini (EPI-7) ferment filtrate, which is a postbiotic product of a novel actinobacteria, on skin aging, by performing a prospective randomized split-face clinical study on Asian woman participants. The investigators measured skin biophysical parameters, including skin barrier function, elasticity, and dermal density, and revealed that the application of the EPI-7 ferment filtrate-including test product resulted in significantly higher improvements in barrier function, skin elasticity, and dermal density compared to the placebo group. This study also investigated the influence of EPI-7 ferment filtrate on skin microbiome diversity to access its potential beneficial effects and safety. EPI-7 ferment filtrate increased the abundance of commensal microbes belonging to Cutibacterium , Staphylococcus , Corynebacterium , Streptococcus , Lawsonella , Clostridium , Rothia , Lactobacillus , and Prevotella . The abundance of Cutibacterium was significantly increased along with significant changes in Clostridium and Prevotella abundance. Therefore, EPI-7 postbiotics, which contain the metabolite called orotic acid, ameliorate the skin microbiota linked with the aging phenotype of the skin. This study provides preliminary evidence that postbiotic therapy may affect the signs of skin aging and microbial diversity. To confirm the positive effect of EPI-7 postbiotics and microbial interaction, additional clinical investigations and functional analyses are required.

Orally administered collagen peptides could contribute to antiaging by replacing the degraded extracellular matrix proteins caused by photoaging. This study aimed to evaluate the efficacy and safety of low-molecular-weight collagen peptides for treating photoaged and dry skin. In this randomized, placebo-controlled, parallel-group, double-blinded trial, we randomly assigned study participants ( n  = 100) to either the test product group or placebo group at a 1:1 ratio for 12 weeks. The wrinkle scale score, eye wrinkle volume, roughness parameters, such as the average maximum height of the wrinkle (Rz), arithmetic average within the total measuring length of the wrinkle (Ra), maximum profile valley depth of the wrinkle (Rv), and skin hydration, transepidermal water loss (TEWL), overall elasticity (R2), and ratio of elastic recovery to total deformation (R7) were evaluated at baseline, 6 weeks, and 12 weeks. Safety assessments with serial blood tests were also conducted. Efficacy assessments of data from 84 participants were conducted as the per-protocol analysis. After 12 weeks, the 10-grade crow's feet photo scale score, eye wrinkle volume, skin roughness parameters (Rz, Ra, and Rv), skin elasticity (R2 and R7), skin hydration, and TEWL were significantly improved in the test product group compared to the placebo group. There were no adverse events or abnormalities according to laboratory analysis associated with using the test material during the study period. This study showed that the oral supplementation of low-molecular-weight collagen peptides could improve the wrinkles, elasticity, hydration, and barrier integrity of photoaged facial skin. This clinical study was registered with the Korean Clinical Research Information Service and International Clinical Trials Registry Platform (No: KCT0006500).

Ambient particulate matter (PM) is a major contributor to environmental air pollution-associated skin damage. However, most published studies are observational or epidemiologic and have not mechanistically investigated the effects of air pollutants on cellular senescence and aging, particularly in combination with ultraviolet (UV) radiation. Herein, we analyzed whether UVA aggravates the PM-induced inflammatory cascade, which contributes to the aging of skin-derived cells. We hypothesized that cellular senescence is involved in PM&UVA-induced aging and tested whether an l-ascorbic acid compound (LAC), containing vitamin E and ferulic acid, can inhibit PM&UVA-induced aging. PM&UVA-exposed HDFs showed further elevated reactive oxygen species (ROS) levels detected by flow cytometry. We then demonstrated that PM induces MAPK signaling activation and the expression of AhR and NF-κB, responses that are both exacerbated by UVA. The levels of inflammatory cytokines, IL-1β and IL-6, were significantly higher in the PM&UVA-exposed group which resulted in increased transcription of MMPs, causing downregulation of type I collagen. Meanwhile, treatment with LAC reduced the levels of ROS and inflammatory cytokines. Additionally, PM&UVA-induced SA-β-gal production (staining assay) was reduced by LAC. These findings suggest a role of atmospheric pollution and UVA radiation in cellular senescence induction. Our findings also suggest a possible role of AhR inhibition by topical antioxidants to prevent atmospheric pollution-induced skin aging., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: As the average life expectancy increases, skin aging and wrinkles due to photoaging have gained attention. Collagen is closely involved in the process of skin aging. Among the potential methods of drug delivery to the skin, oral disintegrating films show promise for their ability to bypass the loss of active components that is typical of drug absorption via oral administration. This study was conducted to investigate the effect of an oral disintegrating collagen film on skin aging., Methods: We performed a prospective, single-arm study in a cohort of 22 women to assess the anti-aging effect of a novel oral disintegrating film containing collagen applied daily over a 12-week period. We measured the clinical indicators of skin integrity and performed immunofluorescence and high-performance liquid chromatography analyses of an ex vivo oral mucosa model to compare the absorption rates of collagen films and conventional oral tablets via the mucosa., Results: We found that the oral disintegrating collagen film reduced skin wrinkle depth and number and significantly increased skin elasticity and density., Conclusions: The novel mode of delivery of collagen via oral disintegrating films has a clinically potential anti-aging efficacy and is safe and convenient for daily use., (© 2021 the International Society of Dermatology.)

Background: Skin aging can be described as a combination of intrinsic and extrinsic aging. Various parameters for evaluating skin characteristics have been proposed. However, an accurate biomarker for skin aging and the relationship between biomarkers and biomechanical parameters of the skin is yet to be explored., Materials and Methods: This study included 20 subjects by age. Skin aging was measured using non-invasive devices. Skin tissues were acquired through punch biopsy for immunohistochemistry and qRT-PCR of skin aging biomarkers, and analyzed correlation both, validated their use., Results: Biomechanical properties of skin aging decreased with age. Among the biomarkers previously reported, we found that the expression of Moesin, TXNDC5, RhoGDI, and RSU1 decreased, while that of Vimentin and FABP5 increased with age. Pearson correlation showed that the expression levels of TXNDC5, RhoGDI, RSU1, and Vimentin were significantly correlated with the results of non-invasive measurements. In addition, the expression of TXNDC5, RhoGDI, and RSU1 increased, while that of Vimentin decreased, in skin explants upon treatment with one of the anti-aging compounds, retinoic acid., Conclusion: From this study, we identified practical molecular biomarkers of skin aging, TXNDC5, RhoGDI, RSU1, and Vimentin, which correlated with the skin biomechanical properties of skin aging., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Retinaldehyde is one of the major members of the retinoid family, which has potential skin rejuvenating effects on photoaged skin and has a good safety profile., Aims: The study aimed to evaluate the efficacy and safety of multilamellar vesicle containing retinaldehyde (MLV-RAL) 0.05% and 0.1% used to treat photoaged skin., Patients and Methods: A randomized, prospective, investigator-blinded, split-face comparison study was conducted. We enrolled 23 Korean volunteers who applied MLV-RAL 0.05%/0.1% cream on one randomized side of their face and retinol 0.05%/0.1% cream on the opposite side. Wrinkle depth on both crow's feet was assessed by the Antera 3D system. Skin hydration, elasticity, facial curved length, and dermal density were also evaluated., Results: After an 8-week application, all objective parameters, including wrinkle depth, were significantly improved in both MLV-RAL 0.05%/0.1% and retinol 0.05%/0.1% treated sides. Compared with the retinol-treated side, MLV-RAL-treated side showed a significant improvement of objective assessments except for dermal density. Additionally, there was no adverse event associated with the use of either MLV-RAL 0.05%/0.1% or retinol 0.05%/0.1% cream., Conclusion: The application of MLV-RAL 0.05%/0.1% cream improved wrinkle, facial contour, and biophysical parameters associated with skin aging., (© 2021 Wiley Periodicals LLC.)

Aging-associated dermatological pigmentary diseases are associated with accumulation of senescence cells and the disruption of basement membrane due to chronic ultraviolet radiation (UVR) exposure. Our study is on the synergistic effect of the novel 300 μm needle-depth fractional microneedling radiofrequency (FMR) treatment and conventional Q-switched ND:YAG laser on aging-associated hyperpigmentation of the skin. The prospective controlled clinical trial of 25 Asian women revealed significantly higher improvements not only on wrinkles, but also on hyperpigmentation. Additional ex vivo study revealed significant reduction of pro-melanogenic markers as well as senescent keratinocytes, while increased expression of collagen type IV on the epidermal basement membrane, after additional FMR treatment on UV-irradiated human tissues. These results demonstrate that 300 μm needle-depth FMR might effectively remove senescent keratinocytes that secrete pro-melanogenic markers, and repair disrupted basement membrane, therefore preventing constant hyperpigmentation of the aged skin.

Background: Recent advancements in laser-assisted drug delivery have emphasized the importance of post-laser use of active ingredients., Aims: We evaluated the effect of topical post-laser treatment with adipocyte-derived stem cell-containing medium (ADSC-CM) in combination with niacinamide through a double-blind, randomized, vehicle-controlled study., Patients/methods: Twenty-five patients with aging skin underwent ablative fractional laser (AFL) treatment on both sides of the face for skin rejuvenation. Moisturizers with or without ADSC-CM plus 2% niacinamide was applied to the designated sides of faces for 3 weeks. The wrinkle and the melanin indices were assessed using a specialized digital photography analyzer. Additional in vitro assays were performed., Results: The wrinkle index, melanin index, patient satisfaction score, and the investigator's global esthetic improvement scale (GAIS) after use of ADSC-CM plus niacinamide were significantly higher than after use of the vehicle cream. The in vitro UVB irradiation assays with human keratinocytes showed decreased levels of pro-inflammatory cytokines upon incubation with ADSC-CM plus niacinamide, and the cell scratch assay displayed decreased MMP-1 and MMP-2 expression as well as increased Type 1 collagen expression., Conclusions: We demonstrated that post-laser topical application of ADSC-CM in combination with niacinamide has anti-aging effect on skin., (© 2020 Wiley Periodicals LLC.)