Journal of Clinical and Aesthetic Dermatology

DEC 2017

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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29 JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY December 2017 • Volume 10 • Number 12 O R I G I N A L R E S E A R C H tradename product might have more than one active ingredient within its formulation and will have more than one International Nomenclature of Cosmetic Ingredients (INCI) name. Procedure. Qualified subjects reported to the test facility and were examined by a trained technician. Faces were devoid of topical treatments. Subjects equilibrated to the ambient environment for 30 minutes before baseline measurements of surface evaluation of living skin (SELS), transepidermal water loss (TEWL), and electroconductivity (EC). SELS uses an optical system in a special camera that measures four parameters related with skin surface topography: roughness, scaling, smoothing, and wrinkling. This method provides analysis of living skin directly; indirect methods (e.g., profilometric) require replicas and pictorial representations of skin topography. However, when using SELS, the four skin parameters are mutually interdependent. 5 Subjects were instructed to apply the day cream test product to the face and neck every morning. After the use of a facial cleanser, subjects patted their skin dry and applied enough of the test product to form a thin layer on the skin. The test product was then massaged into the skin. The night cream test product was applied to the face every evening, and the eye cream was applied above and below the eyes every morning and evening. The day lip cream was applied in and around the lips twice in the morning and twice in the afternoon, and the night lip cream was applied in and around the lips once at night. The efficacy of each test product was objectively evaluated by measuring the evaluation parameters (i.e., SELS, TEWL, EC) at the test sites prior to the initial application of the test product and 15 minutes after the initial application. Evaluation parameters were then measured after seven, 14, 28, and 56 days of test product use. SELS was measured by a Visioscan (Courage- Khazaka electronic GmbH, Cologne, Germany) which uses a specially designed camera and halogen lamps to obtain images that permit the user to characterize the topography of the skin surface. 5 Of interest, in the present study, skin roughness (SEr; measured in relative units) was used as an indicator of the depth of fine and coarse wrinkles. TEWL represents the level of water that constantly transpires through the skin. In this study, TEWL was used as an indicator of skin barrier protection. 6 TEWL was measured with a computerized evaporimeter (cyberDERM, Inc., Media, Pennsylvania) in a quiet area, apart from the general traffic and activity of the test center. Readings were obtained by placing the probe lightly in contact with the skin. EC was measured with a Nova Dermal Phase Meter (DPM 9003; Nova Technology Corp., Gloucester, Massachusetts). The DPM measures skin impedance, an indicator of the retained water content of the skin. 7 Analysis of results. The data used in the statistical analysis reflect changes from baseline. Differences were tested for significance by a Student's t-test using p<0.05 as the cutoff level. Topographical analyses of target areas before and after treatment were provided by AMA Laboratories, Inc. (New York, New York) using data from spatial and pixel coordinates to provide high-resolution images. The experience trial. In an open-label study, patients from 19 physician practices were screened, and approximately 244 subjects were enrolled in the study. The objective of the study (a survey) was to evaluate subject satisfaction and perception of results after one month of daily use of the same five skin care products that contain Novasome, RHA, TruCollagen, and the supporting base formulation. Qualified subjects were aged 40 to 60 years of age and were generally healthy with Fitzpatrick Skin Types I to IV. Subjects regularly used moisturizer and had mild-to-moderate facial lines. Subjects agreed to not use facial skin products other than those provided for the study, to avoid excessive sun exposure, minimize use of sunscreen, not use plumping lipsticks, and not undergo facial procedures during the study. Subjects were willing to comply with all instructions during the study. Subjects were excluded if they had skin disease, a photosensitivity condition, acne, adverse reactions to skin care products, recent injections of neurotoxin or dermal filler, or recent invasive facial procedures. Pregnancy, lactation, recent changes in oral contraceptives or hormone replacement therapy, or recent participation in a similar study were also grounds for exclusion. All subjects provided signed informed consent to participate in the study. Subjects were divided into five groups in which they applied test products in the evening, morning, or both (Table 3). Group 1 comprised patients who had early signs of facial aging manifested by lines around the eyes. These subjects used the facial cleanser and eye product twice a day (morning and evening) and the bamboo microdermabrasion exfoliant 2 to 3 times per week. Group 2 comprised patients who TABLE 3. Product application schedule GROUP # skIN 3 PRODUCTS (APPLIED DAILY) MORNING EVENING 1 Gentle Purifying Cleanser Rapid Eye Restore Gentle Purifying Cleanser Bamboo Microderm Exfoliant* Rapid Eye Restore 2 N/A Gentle Purifying Cleanser Bamboo Microderm Exfoliant* Rapid Eye Restore Deeply Transforming Night Renewal 3 Gentle Purifying Cleaner Bamboo Microderm Exfoliant* Rapid Eye Restore Fulfilling Day Rejuvenation N/A 4 Revitalizing Lip Triplex Day** Restorative Lip Triplex Night 5 Gentle Purifying Cleanser Rapid Eye Restore Fulfilling Day Rejuvenation Gentle Purifying Cleanser Bamboo Microderm Exfoliant* Rapid Eye Restore Deeply Transforming Night Renewal N/A: not applicable *applied on alternate days **may be applied numerous times during the day

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