Abstract
Background
Skin wrinkles are one of the most cosmetically concerning signs of aging for women, and improvements in the visual effect of wrinkles become a matter of concern that has an impact on the quality of life. Although various wrinkle treatments are being tried in the area of aesthetics and noninvasive cosmetic surgery, no guideline on how to treat wrinkles exists to date. This study evaluated the clinical effects of four wrinkle treatment methods [fractional erbium yttrium–aluminum–garnet (YAG) laser treatment, intense pulsed light (IPL) therapy, CD-atRA external application, and nutritional therapy with intake of amino acid supplements]. These four methods were selected as promising candidates in a pilot case study to improve wrinkles by following the consensus guideline (Task Force Committee for Evaluation of Anti-Aging Function, J Jpn Cosmet Sci Soc 31:411–431, 2007) for the evaluation of anti-wrinkle effects issued by the Japan Cosmetic Industry Association.
Methods
The wrinkle area fraction and skin viscoelasticity were measured by objective evaluation. Furthermore, a satisfaction survey of the subjects was conducted on the basis of subjective evaluations using the visual analog scale (VAS) method and in accordance with the guideline for the evaluation of antiwrinkle effects.
Results
Fractional erbium YAG laser treatment showed statistically significant improvement in both of the objective evaluations (wrinkle area and skin elasticity). The IPL method showed statistically significant improvement in both of the objective evaluations (wrinkle area and skin elasticity), and it especially demonstrated a more significant difference in skin elasticity. The CD-tretinoin external application method showed statistically significant improvement in both of the objective evaluations (wrinkle area and skin elasticity), and it especially demonstrated a more significant difference in wrinkle area. Nutritional therapy showed statistically significant improvement in wrinkle area, whereas IPL, CD-tretinoin external application, and nutritional therapy demonstrated statistically significant improvement in the degree of wrinkle. As for the subjective assessment of VAS, all four treatments demonstrated equivalent satisfaction.
Conclusion
All four minimally invasive procedures (fractional erbium YAG treatment, IPL therapy, CD-atRA external application, and intake of amino acid supplements) showed significant improvement of wrinkles. Comparative evaluation of wrinkles using the same criteria is important. The findings clearly showed that an evidence-based approach to wrinkle treatments supported by validation of their effectiveness is required.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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References
Maddin S, Lauharanta J, Agache P, Burrows L, Zultak M, Bulger L (2000) Isotretinoin improves the appearance of photodamaged skin: results of a 36-week, multicenter, double-blind, placebo-controlled trial. J Am Acad Dermatol 42:56–63
Tsukahara K, Fujimura T, Yoshida Y, Kitahara T, Hotta M, Moriwaki S, Witt PS, Simion FA, Takema Y (2004) Comparison of age-related changes in wrinkling and sagging of the skin in Caucasian females and in Japanese females. J Cosmet Sci 55:351–371
Bazin R, Doublet E (2007) Skin-aging atlas, vol 1: Caucasian type. Med’com, France
Bazin R, Flament F (2007) Skin-aging atlas, vol 2: Caucasian type. Med’com, France
Babilas P, Schreml S, Szeimies RM, Landthaler M (2010) Intense pulsed light (IPL): a review. Lasers Surg Med 42(2):93–104
Samuel M, Brooke RC, Hollis S, Griffiths CE (2005) Interventions for photodamaged skin. Cochrane Database Syst Rev 1:CD001782
Manríquez JJ, Majerson Gringberg D, Nicklas Diaz C (2008) Wrinkles. Clin Evid 16:1711 (online). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907965/. Accessed 12 Jan 2013
Oresajo C, Yatskayer M, Hansenne I (2008) Clinical tolerance and efficacy of capryloyl salicylic acid peel compared to a glycolic acid peel in subjects with fine lines/wrinkles and hyperpigmented skin. J Cosmet Dermatol 7:259–262
Hantash BM, De Coninck E, Liu H, Gladstone HB (2008) Split-face comparison of the erbium micropeel with intense pulsed light. Dermatol Surg 34:763–772
Taylor MB, Prokopenko I (2006) Split-face comparison of radiofrequency versus long-pulse Nd-YAG treatment of facial laxity. J Cosmet Laser Ther 8:17–22
Task Force Committee for Evaluation of Anti-Aging Function: Guidelines for evaluation of anti-wrinkle products (2007) J Jpn Cosmet Sci Soc 31:411–431
Takahashi K, Morimoto S, Nakamura H, Narusawa T, Seki T, Ooe M, Aoi K, Takada A (2011) Improvement of pharmaceutical potential of all-trans retinoic acid with hydroxypropyl-β-cyclodextrin. J Incl Phenom Macrocycl Chem 70:389–396
Ryu HS, Joo YH, Kim SO, Park KC, Youn SW (2008) Influence of age and regional differences on skin elasticity as measured by the Cutometer. Skin Res Technol 14:354–358
Kist DA, Elm CM, Eleftheriou LI, Studer JA, Wallander ID, Walgrave SE, Zelickson BD (2011) Histologic analysis of a 2,940-nm fractional device. Lasers Surg Med 43:79–91
Borelli C (2007) Laser treatment of wrinkles (update). Hautarzt 58:210–215
Feng Y, Zhao J, Gold MH (2008) Skin rejuvenation in Asian skin: the analysis of clinical effects and basic mechanisms of intense pulsed light. J Drugs Dermatol 7:273–279
Kligman AM, Grove GL, Hirose R, Leyden JJ (1986) Topical tretinoin for photoaged skin. J Am Acad Dermatol 15:836–859
Olsen EA, Katz HI, Levine N, Shupack J, Billys MM, Prawer S, Gold J, Stiller M, Lufrano L, Thorne EG (1992) Tretinoin emollient cream: a new therapy for photodamaged skin. J Am Acad Dermatol 26:215–224
Gupta MA, Schork NJ, Ellis CN (1994) Psychosocial correlates of the treatment of photodamaged skin with topical retinoic acid: a prospective controlled study. J Am Acad Dermatol 30:969–972
Weinstein GD, Nigra TP, Pochi PE, Savin RC, Allan A, Benik K, Jeffes E, Lufrano L, Thorne EG (1991) Topical tretinoin for treatment of photodamaged skin: a multicenter study. Arch Dermatol 127:659–665
Fisher GJ, Voorhees JJ (1996) Molecular mechanisms of retinoid actions in skin. FASEB J 10:1002–1013
Pasonen-Seppänen SM, Maytin EV, Törrönen KJ, Hyttinen JM, Hascall VC, MacCallum DK, Kultti AH, Jokela TA, Tammi MI, Tammi RH (2008) All-trans retinoic acid-induced hyaluronan production and hyperplasia are partly mediated by EGFR signaling in epidermal keratinocytes. J Invest Dermatol 128:797–807
Fisher GJ, Datta S, Wang Z, Li XY, Quan T, Chung JH, Kang S, Voorhees JJ (2000) c-Jun-dependent inhibition of cutaneous procollagen transcription following ultraviolet irradiation is reversed by all-trans retinoic acid. J Clin Invest 106:663–670
Tadaki T, Watanabe M, Kumasaka K, Tanita Y, Kato T, Tagami H, Horii I, Yokoi T, Nakayama Y, Kligman AM (1993) The effect of topical tretinoin on the photodamaged skin of the Japanese. Tohoku J Exp Med 169:131–139
Anadolu RY, Sen T, Tarimci N, Birol A, Erdem C (2004) Improved efficacy and tolerability of retinoic acid in acne vulgaris: a new topical formulation with cyclodextrin complex psi. J Eur Acad Dermatol Venereol 18:416–421
Miura T, Takada A, Ooe M (2012) Tretinoin cyclodextrin complex (RA/CyD) causes less irritation with an equal antiwrinkle effect compared with conventional tretinoin: clinical and histologic studies of photoaged skin. J Aesthetic Plast Surg 36(4):971–981
Wilmore D (2004) Enteral and parenteral arginine supplementation to improve medical outcomes in hospitalized patients. J Nutr 134:2863S–2867S
Proud CG (2007) Amino acids and mTOR signalling in anabolic function. Biochem Soc Trans 35:1187–1190
Wilmore DW (2001) The effect of glutamine supplementation in patients following elective surgery and accidental injury. J Nutr 131:2543S–2549S
Welbourne TC (1995) Increased plasma bicarbonate and growth hormone after an oral glutamine load. Am J Clin Nutr 61:1058–1061
Williams JZ, Abumrad N, Barbul A (2002) Effect of a specialized amino acid mixture on human collagen deposition. Ann Surg 236:369–374
Williams JZ, Abumrad N, Barbul A (2002) Effect of a specialized amino acid mixture on human collagen deposition. Ann Surg 236:369–375
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Ooe, M., Seki, T., Miura, T. et al. Comparative Evaluation of Wrinkle Treatments. Aesth Plast Surg 37, 424–433 (2013). https://doi.org/10.1007/s00266-012-0029-5
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DOI: https://doi.org/10.1007/s00266-012-0029-5