Clinical Efficacy of a Novel Two-Part Skincare System on Pollution-Induced Skin Damage
September 2018 | Volume 17 | Issue 9 | Original Article | 975 | Copyright © 2018
Elizabeth T. Makino BS MBA,a Annie Jain MD,b Priscilla Tan BA,a Audrey Nguyen BS,a Alain Moga MSc,c Cécile Charmel,d Kuniko Kadoya PhD,a Tsing Cheng PhD,a and Rahul C. Mehta PhDa
aSkinMedica, Inc., an Allergan Company, Irvine, CA bCIDP Biotech India Pvt. Ltd, New Delhi, India cSynelvia S.A.S., Labège, France dDermScan Group, Villeurbanne, France
Introduction: Air pollution continues to be a global health concern and recent studies have shown that air pollutants can cause skin damage and skin aging through several pathways that induce oxidative stress, inflammation, apoptosis, and skin barrier dysfunction. Preventive measures need to be considered to retain optimal skin health, and topical skincare products may be able to alleviate the negative effects of air pollution on skin. A randomized, double-blind, placebo-controlled clinical usage study was conducted to assess the efficacy and tolerability of a novel two-part skincare system (LVS) that was developed to provide protection against environmental skin aggressors including air pollution. After 8 weeks of use in subjects exposed to extremely high levels of pollution, LVS provided significant improvements compared to placebo in all clinical efficacy parameters including crow’s feet wrinkles, overall skin damage, skin tone evenness, tactile roughness, and visible redness. Subject self-assessment questionnaires showed that the treatment product was highly rated in self-perceived efficacy. Decreased SQOOH and MDA content in skin swab samples suggest that LVS helped to reduce oxidative stress in patients’ skin. Histological analyses of biopsy samples using biomarkers related to skin structure, damage and function (collagen IV, MMP1, CPD, and CD1a) further support the clinical benefits of LVS. Altogether, the presented study is among the first to show that topical skincare products can help to reduce pollution-induced skin damage and improve skin quality, especially when specifically formulated with active ingredients that combat the harmful effects of air pollutants. J Drugs Dermatol. 2018;17(9):975-981.
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Increased awareness of the hazardous consequences of air pollution has led to global efforts to reduce air pollution and improve air quality. Air pollution is a serious issue for overall public health as it has been linked to ~7 million deaths annually, primarily through cardiovascular and pulmonary diseases. As such, it is the world’s largest environmental health risk putting it in the same league with other health risks including smoking, high cholesterol and obesity.1 Air pollution also has aggravating effects on skin conditions and diseases such as atopic dermati- tis.2-4 Various organic and inorganic matter make up air pollution including fine particulate matter (defined by a diameter ≤2.5 μm or ≤10μm as PM2.5 or PM10, respectively) that can penetrate the skin, gases (such as nitrogen dioxide, carbon monoxide, and ground-level ozone), and toxic chemicals (for example, polycy- clic aromatic hydrocarbons (PAH) and dioxins). While the current understanding is that various environmental factors contribute to extrinsic skin damage and aging, the primary research focus has historically been on solar radiation, especially UV exposure.5 However, the past decade has seen increased research efforts to determine the mechanisms through which pollution could cause skin damage as well as its effects on skin aging. In 2010, an epidemiological cohort study following 400 women revealed a significant correlation between air pollution exposure and signs of skin aging, specifically pigment spots and wrinkles.6 A multicenter clinical study in Mexico, including subjects from a high pollution area and from a low pollution area, described a higher frequency of certain skin conditions in the population exposed to more pollution. Interestingly, skin swab and corneo- adhesive disc samples taken in this study also revealed several changes in biochemical parameters including decreased squalene and ATP levels as well as an increase in carbonylated proteins suggesting increased oxidative stress due to pollution.7 Several mechanisms through which air pollutants cause skin damage and aging have been proposed including generation of free radicals and reactive oxygen species (ROS) resulting in oxidative damage to lipids, proteins and DNA. For exam- ple, ozone is highly reactive with skin surface lipids causing lipid peroxidation, which results in cascading inflammatory and oxidative effects in the deeper skin layers, and depletion of surface antioxidants such as squalene.8,9 Squalene is the major scavenger of ozone in the skin and oxidized squalene (squalene monohydroperoxide; SQOOH) is a biomarker for environmental pollution.10,11 Particulate matter (PM) was found