facial skin, as well as age-related changes in body skin, are described in Tables 1 and 2.
Pathways to Improving Body Skin Quality
In considering the key goals for a topically administered product designed to improve the quality of body skin, we concluded that the most desirable goals from the patient viewpoint were to improve skin health and quality generally across multiple parameters, improve the appearance/reduce the extent of cellulite, and complement in-office body-contouring procedures and facilitate rapid recovery and improvement in skin quality.
Based on our collective experiences and knowledge of dermal anatomy and physiology, as well as the extant literature, we translated these broad goals into modulation of critical biological target areas and pathways (Figure 2)29.
Support for and remodeling of the extracellular matrix (ECM): Promoting expression of ECM protein elements (chiefly collagens, fibronectin, and elastic fiber proteins) to improve the skin’s biomechanical properties (firmness, elasticity) and facilitate skin tightening via ECM reconstruction/recovery.30-33
Support cellular clearance and recycling: This involves support for autophagy and promotion of proteasome activity. Autophagy leads to the clearance of damaged and worn-out cellular components and organelles via lysosomes. Proteasomes are largely responsible for clearance/removal of damaged/ misfolded proteins.34
Improve lymphatic drainage: This facilitates the removal of released fatty acids and cellular/macromolecular debris and promotes the discharge of excess tissue fluids to reduce edema.35,36
Promote lipolysis: Induction of and increasing the rate of lipolysis to release free fatty acids (FFAs) and glycerol into the circulation to regulate lipid accumulation, adipocyte volume, and fat mass.37,38
Inhibit lipogenesis: Suppressing lipogenesis (ie, lipid synthesis and storage in adipocytes) maintains healthy cell activity and prevents adipocyte volume increase; this also involves inhibiting adipocyte reuptake of FFA and other lipid components.37,38
Topical Products for Body Skin Quality Improvement
'We review here published clinical evaluations of 3 body skin treatments promoted for skin restoration and skin quality improvement (Table 3) in which skin quality parameters were evaluated.
Published Clinical Results
In a case series, 5 female subjects (age range, 23-69 years) applied Body Tightening Concentrate (BTC; SkinCeuticals, Garland, TX) twice daily for 18 weeks, following laser lipolysis using the SculpSure system (Cynosure, Westford, MA) for
