Anti-aging Effect of Mixed Extract from Medicinal Herbs

Purpose: This study was conducted to confirm the applicability of a mixed herbal extract (MHE) as an anti-aging cosmetic ingredient by investigating its skin anti-aging activities in vitro and in vivo.Methods: In this study, we prepared MHE using an ultrasonic extraction containing Forsythiae fructus, Tribuli fructus, Solomon’s seal, Siberian ginseng, Ponciri fructus and Ginseng. We investigated the anti-aging effect of the MHE for skin in dermal fibroblasts. The anti-aging activity was determined by the type I collagen synthesis levels. Matrix metalloproteinase-1 (MMP1) and tissue inhibitor of metalloproteinases 1 (TIMP1) mRNA levels were measured by qRT-PCR. MMP1 protein levels were evaluated by blotting analysis. Clinical tests of skin moisture, elasticity, texture, and wrinkles were performed using cosmetics containing 1% MHE.Results: The MHE induced the upregulation of pro-collagen type I synthesis and TIMP1 mRNA expression. The MHE led to the downregulation of MMP1 mRNA levels and protein levels. Furthermore, after skin application of cosmetics containing 1% MHE, skin hydration, elasticity, texture, and crow’s feet were improved 4 weeks after the treatment.Conclusion: MHE has an anti-aging effect by promoting collagen synthesis and suppressing MMP1 gene expression in vitro, and it has a skin improvement effect in vivo. Therefore, the MHE was shown to have value as a functional cosmetic ingredient.

Facial Aesthetic Priorities and Concerns: A Physician and Patient Perception Global Survey

Background Minimally invasive and noninvasive facial aesthetic treatments are increasingly popular, and a greater understanding of patient perspectives on facial aesthetic priorities is needed. Objectives To provide data to aesthetic physicians that may be useful during patient consultations in increasing post-treatment satisfaction by surveying facial aesthetic concerns, desires, and treatment goals of aesthetically conscious men and women, and physicians, in 18 countries. Methods A global, internet-based survey on desired appearance and experiences with, or interest in, facial aesthetic treatments. Eligible survey respondents were aesthetically conscious adults (21-75 years). Eligible aesthetic physicians were required to see ≥30 patients/month for aesthetic reasons, have 2-30-years’ experience in clinical practice, and spend ≥70% of time in direct patient care. Results A total of 14,584 aesthetically conscious adults (mean age, 41 years; 70% women) and 1,315 aesthetic physicians (mean age, 45 years; 68% men) completed the survey. Most surveyed respondents (68%) reported that aesthetic procedures should be sought in their 30s-40s, while surveyed physicians recommended patients seek treatment earlier. Respondents expressed greatest concern over crow’s feet lines, forehead lines, facial skin issues, hair-related concerns, and under-eye bags or dark circles; in contrast, physicians tended to underestimate patient concerns about under-eye bags or dark circles, mid-face volume deficits, and skin quality. While both physicians and respondents cited cost as a major barrier to seeking aesthetic treatments, respondents also emphasized safety, fear of injections or procedure-related pain, and concern about unnatural-looking outcomes. Conclusions This large, global survey provides valuable insight into facial aesthetic concerns and perspectives of aesthetically conscious patients that may be implemented in patient education and consultations to improve patient satisfaction following aesthetic treatments.

Infrabrow excision to correct upper eyelid dermatochalasis in middle-aged and elderly patients

AIM: To evaluate the effects, advantages, disadvantages, and indications of infrabrow skin excision to correct upper eyelid dermatochalasis in middle-aged and elderly Chinese women. METHODS: Sixty eyelids in 30 patients were subjected to this surgical procedure from January to June 2018. All patients had upper eyelid dermatochalasis, and the functions of their levator palpebrae were all normal. The primary indications of the procedure were upper lid dermatochalasis with lateral hooding. All 30 patients underwent infrabrow skin excision at Shanxi Eye Hospital. The degree of skin relaxation before and after surgery was evaluated in all patients, and surgical outcomes and postoperative complications were also assessed. RESULTS: All patients were female, ranging from 40 to 64 (mean: 53.20±7.10) years old. Skin relaxation of the upper eyelid was improved in all 30 patients. One month after the operation, 52 lids (86.7%) showed good results and 8 lids (13.33%) showed fair results. The objective Strasser system was applied to evaluate surgical results at 1 and 6 months. All patients had scores between 0 and 1 point, indicating good results. Preoperative unsatisfactory position and shape of the eyebrows were improved, and crow's feet and frontal lines were reduced. All patients were satisfied with the results. No complications related to wound dehiscence, lagophthalmos, or hypertrophic scars were observed. CONCLUSION: Infrabrow skin excision is a simple, useful operation to reconstruct the upper eyelids in selected patients of Chinese ancestry. This procedure not only retains the advantages of classic blepharoplasty, but also alleviates many eyebrow problems at the same time, and maintains the original shape of the eyelid, minimizes scarring, and produces a smoother, more youthful appearance.

Novel Rotational Combination Regimen of Skin Topicals Improves Facial Photoaging: Efficacy Demonstrated in Double-Blinded Clinical Trials and Laboratory Validation

Topical antiaging products are often a first-line intervention to counter visible signs of facial photoaging, aiming for sustained cosmetic improvement. However, prolonged application of a single active topical compound was observed clinically to lead to a plateau effect in improving facial photoaging. In view of this, we set out to reduce this effect systematically using a multi-tiered approach with laboratory evidence and clinical trials. The objective of the study was to evaluate the effects of active topical ingredients applied either alone, in combination, or in a rotational manner on modulation of facial photoaging. The study methodology included in vitro, organotypic, and ex vivo skin explants; in vivo biopsy study; as well as clinical trials. We demonstrate for the first time that a pair of known antiaging ingredients applied rotationally, on human dermal fibroblasts, maximized pro-collagen I production. Indeed, rotational treatment with retinol and phytol/glycolic acid (PGA) resulted in better efficacy than application of each active ingredient alone as shown by explants and in vivo biopsy study, with penetration of active ingredients confirmed by Raman spectroscopy. Furthermore, two split-face, randomized, double-blinded clinical trials were conducted, one for 12 months to compare treated vs. untreated and the other for 6 months followed by a 2-month regression to compare treated vs. commercially marketed products. In both studies, rotational regimen showed superior results to its matching comparison as assessed by clinical grading and image analysis of crow's feet wrinkles. In conclusion, rotational regimen using retinol and PGA is effective in treating facial photoaging signs with long-lasting benefits.

Static Crow’s Feet Treated with Voltaic Arc Dermabrasion (Atmospheric Plasma): Post-Operative Pain Assessment by Thermal Infrared Imaging

Background: In the literature, several strategies have been described for the treatment of unaesthetic marks on the face resulting from the aging processes. The atmospheric plasma procedure is a non-invasive, inexpensive technique proposed for the rejuvenation of facial tissues. The aim of this study was to evaluate the performance of voltaic arc dermabrasion (VAD) for the treatment of static crow’s feet of the periorbital area. Methods: The crow’s feet of 135 patients (127 female and 8 male) were treated using the VAD technique. The perioperative skin temperature measurement was assessed using an Infrared Temperature sensor. The pain was measured using the Visual Analogic Score (VAS) at 1 week, 1 month and 1 year. The patient’s and surgeon’s satisfaction were assessed using the Global Aesthetic Improvement Scale (GAIS) at 1 month and 1 year from the procedure. The severity of the crow’s feet was rated using the Crow’s Feet Grading Scale (CFGS). Results: A complete epidermal healing of all the subjects treated was evident at 7 days. The atmospheric plasma technique showed an efficient treatment for the removal of the crow’s feet, with a good aesthetic outcome, high surgeon and patient satisfaction, without clinical complications. Conclusions: The atmospheric plasma technique can be a useful modality in the cosmetic as well as therapeutic treatment of crow’s feet.

A Clinical Study on Anti-wrinkle Efficacy of a Cosmetics Containing Oligoarginine Conjugation of Palmitoyl-GHK peptide for Skin Penetrating

In this study, Arg 4 (R4) was conjugated with Pal-GHK to get palmitoyl heptapeptide, Pal-GHK‐R4 and wrinkle improvement clinical trials of cosmetics containing Pal-GHK‐R4 were conducted. As a result of total 21 subjects used the test products 4 weeks use on the face area; 1) measurement results of crow’s feet after 2 and 4 weeks of test products use, analysis value of crow’s feet statistically significantly decreased after 2 and 4 weeks of test products use compared to before use of products (p<0.05); 2) measurement results of skin moisturization after 2 and 4 weeks test products use, measured value of skin moisture content statistically significantly increased after 2 and 4 weeks use compared to before use of products (p<0.05); 3) measurement results of TEWL after 2 and 4 weeks use, measured value of TEWL statistically significantly decreased after 2 and 4 weeks use compared to before use of product(p<0.05); 4) there was no skin adverse event reported after using the products during the study period. Therefore, the test products containing both wrinkle improving and skin penetrating peptides, Pal-GHK‐R4 are considered to have beneficial effects on improvement of skin wrinkle, moisturization, transepidermal water loss(TEWL) after 2 and 4 weeks use of test product.

Multimodal Facial Aesthetic Treatment on the Appearance of Aging, Social Confidence, and Psychological Wellbeing: HARMONY Study

Background A global approach to facial rejuvenation involves multiple treatment modalities. Objectives This study evaluated the impact of multimodal facial aesthetic treatment on self-reported psychological and social outcomes. Methods HARMONY, a prospective, multicenter, 4-month study, enrolled patients aged 35 to 65 years to receive on-label treatment with a combination of hyaluronic fillers (VYC-20L, HYC-24L, and/or HYC-24L+), onabotulinumtoxinA, and bimatoprost. Fillers were injected on day 1, with touch-ups performed on day 14. OnabotulinumtoxinA was injected at month 3 into glabellar lines and/or crow’s feet lines. Patients applied bimatoprost to eyelashes once daily for 17 weeks. Mean change from baseline on FACE-Q Psychological Well-being and Social Confidence Scales, FACE-Q Aging Appearance Appraisal Scale, and FACE-Q Age Appraisal Visual Analog Scale were assessed. Results Of 100 patients treated, 93 were evaluated at 4 months posttreatment. Significant improvement vs baseline was observed on the FACE-Q Scales for Psychological Well-being (mean change, −19.9; p &lt; 0.00001), Social Confidence (mean change, −18.2; p &lt; 0.00001), and Aging Appearance (mean change, −28.5; p &lt; 0.0001). On average, patients’ self-assessed age was 0.1 year older than actual age at baseline and 4.5 years younger at month 4 (p &lt; 0.001 vs baseline). Forty-two patients experienced adverse events, all mild to moderate. Conclusions Multimodal, full facial aesthetic treatment improves patients’ self-reported psychological well-being, social confidence, aging appearance, and perceptions of chronologic age.

Comparison of Prabotulinumtoxin A to Onabotulinumtoxin A in the Treatment of Lateral Canthal Rhytids: A Side-by-Side, Randomized, Double-Blind Comparison

Botulinum toxin type A (Onabotulinumtoxin A, Incobotulinumtoxin A, Abobotulinumtoxin A) has been successfully used in the treatment of lateral canthal rhytid (crow’s feet) reduction. Prabotulinumtoxin A is a newer medication that has been shown to have efficacy for the treatment of upper limb spasticity and improvement in moderate to severe glabellar lines. This study evaluated the onset of action, maximal effect, duration of action, and side effect profile for Prabotulinumtoxin A compared with Onabotulinumtoxin A in the treatment of crow’s feet. A total of 18 subjects aged 25 to 60 without a previous history of neuromuscular disorders, eyelid surgery, or botulinum toxin type A injections were included. Patients received 3 injections of botulinum toxin in the crow’s feet area on each side. Each side received 4U/.1cc of Prabotulinumtoxin A or Onabotulinumtoxin A at each site for a total of 12U/.3cc. The surgeon was masked to the serotype injected. The subjects had their lateral canthal areas photographed in relaxed and smiling positions preoperatively, daily from postinjection days 1 to 4, and weekly thereafter for a total of 12 weeks. Two masked oculoplastic surgeons were given the preoperative photos and postinjection photos and graded them on a scale of 0 to 3 (0 = no wrinkles, 1 = minimal wrinkles, 2 = moderate wrinkles, 3 = significant wrinkles). All subjects tolerated the injections well with no significant side effects or complications. The average onset of action was 3.47 days (1-14) for Onabotulinumtoxin A and 3.81 (1-14) for Prabotulinumtoxin A. The average time to peak effect was 11.11 days (1-56) for Onabotulinumtoxin A and 9.58 days (2-42) for Prabotulinumtoxin A. The average duration of action with improvement compared with baseline crow’s feet was 11.22 weeks (7-12) for Onabotulinumtoxin A and 11.11 weeks (6-12) for Prabotulinumtoxin A. Treatment of crow’s feet lines with Prabotulinumtoxin A achieves a comparable efficacy and safety profile compared with Onabotulinumtoxin A at a 1:1 dose. Therefore, Prabotulinumtoxin A can be used as another option in the treatment of crow’s feet.

Onabotulinumtoxin Type-A Dosage for Upper Face Expression Lines in Males: A Systematic Review of Current Recommendations

Background Botulinum toxin injection is the most commonly performed minimally invasive aesthetic procedure in men. Despite various recommendations by experts on the use of onabotulinumtoxin type A in the literature, distinct guidelines for its use in males and females do not exist. Objectives The aim of this study was to delineate safe and effective doses for the use of onabotulinumtoxin type A in males for correction of upper facial expression lines. Methods PubMed (MEDLINE), Embase, the Cochrane database, and Google Scholar were searched from 2002 to 2019 inclusive. Three researchers independently assessed trials for inclusion, extracted data, checked for accuracy, and assessed the evidence with AGREE II. Results Average dosing recommended for the treatment of upper face expression lines was specific to glabellar frown lines, crow’s feet, and horizontal forehead lines. Changing trends and gender variation was noted in each of the studies. Six of the 11 recommendations suggest the need to alter dosing in male patients, although do not give separate recommendations. Conclusions There is an urgent need for up-to-date recommendations for the use of onabotulinumtoxin type A in upper face expression lines of male patients.