Novel Facial Treatment Regimen Improves Aging Skin Appearance

March 2021 | Volume 20 | Issue 3 | Original Article | 274 | Copyright © March 2021


Published online February 9, 2021

Patricia Farris MDa, Zoe Diana Draelos MDb, Luiz Felipe de Oliveira Stehling BPharmc

aSanova Dermatology, Metairie, La;Tulane School of Medicine, New Orleans, LA
bDermatology Consulting Services, PLLC, High Point, NC
cLuxbiotech Farmaceutica Ltda, Hortolandia, SP/BRA

Abstract
Background: Skin care regimens with multiple active ingredients offer a multimodal approach to anti-aging treatments.
Objective: The objective of this research was to investigate the efficacy of a multimodal skincare regimen on facial skin appearance after 12 weeks of twice daily use as compared to baseline.
Method: 35 healthy female subjects 35–65 years of age of Fitzpatrick skin types I–III with mild to moderate facial photoaging characterized by hyperpigmentation were enrolled. Subjects were seen at baseline, week 6, and week 12, and underwent subject and investigator assessments along with noninvasive evaluations (elasticity, corneometry, dermaspectrophotometer) and photography.
Results: Most notable at week 12 was a 60% improvement in smoothness, 82% improvement in dryness, 30% improvement in fine lines, and 24% improvement in crow’s feet. There was an 8% reduction in macule hyperpigmentation (P<0.001) at week 12, supporting excellent pigment lightening qualities for the regimen. There was a statistically significant increase in skin firmness (decrease in elasticity) as early as week 6 of 6% with further improvement observed at week 12 of 16% (P=0.002).
Summary: A multimodal skincare regimen with antioxidants, retinol, hydrolyzed pearl, caviar extract, peptides, and growth factors including EGF and TGF-β results in an improvement in the appearance of photoaged skin after 12 weeks of twice daily use.

J Drugs Dermatol. 20(3):274-278. doi:10.36849/JDD.2021.5791

INTRODUCTION

The clinical appearance of aging skin is the result of natural aging superimposed with the effects of the environment or extrinsic aging. While solar radiation remains the most important factor in extrinsic aging, pollution including particulate matter, and ozone also play a role.1 Intrinsically aged skin is characterized by thinning, increasing fragility, paleness, loss of elasticity, and fine wrinkling. In contrast, extrinsically aged skin has course deep wrinkles, mottled pigmentation, brown spots, sallowness, roughness, and dryness. Accordingly, extrinsic aging is often cited as the primary contributor to prematurely aged skin.

While the pathogenesis of intrinsic and extrinsic skin aging has some differences, oxidative stress is common to both. Skin is protected by an array of antioxidants that neutralize reactive oxygen species (ROS) and help prevent oxidative stress.2 Ultraviolet light is the most potent initiator of ROS in skin, however recent data suggests visible and infrared radiation also play a role.3 With aging, antioxidants are diminished, leaving skin more vulnerable to damaging ROS and oxidative stress.4 Accumulation of ROS in the skin can oxidize important biologic molecules such as DNA, proteins, and membrane lipids damaging skin directly. Additionally, in response to oxidative stress, transcription factors in keratinocytes and fibroblasts such as activator protein 1 (AP-1) are upregulated.

AP-1 is responsible for the synthesis of the metalloproteinases enzymes (MMPs) that breakdown collagen.5 AP-1 also inhibits transforming growth factor beta (TGF-β) and reduces collagen production. These effects result in a net loss of dermal collagen, weakening the supporting structure of the skin, and wrinkling. Oxidative stress also upregulates nuclear factor kappa beta (NF-kB) triggering keratinocytes to release a variety of inflammatory mediators such as tumor necrosis factor alpha (TNFα) and interleukin 1 (IL-1).6 This signaling pathway brings activated macrophages, monocytes, and lymphocytes into the skin as well as neutrophils containing collagenases involved in collagen degradation. ROS also contribute to melanogenesis by increasing α-melanocyte stimulating hormone.7

In view of the mechanisms in play that contribute to skin aging, an effective treatment regimen must provide a multimodal approach by combining a variety of active agents to achieve a final positive appearance effect. In this study, we evaluated a treatment regimen with novel ingredients to both protect and repair aging skin. The morning regimen included a serum with a unique combination of antioxidants and peptides to defend against the effects of solar light, pollution, and glycation.8,9,10 This serum also contained encapsulated maslinic acid for skin brightening.11 An elixir containing hydrolyzed pearl, caviar extract, and epidermal growth factor (EGF) was also applied