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Be damned or be beautiful—The history of alopecia and wigs
P226
P228
TOPICAL NIACINAMIDE-CONTAINING PRODUCT REDUCES FOREARM HYPERPIGMENTATION Kukizo Miyamoto, Don Bissett, Larry Robinson, Cindy Berge, Procter & Gamble, Cincinnati, OH, United States
USE OF ARTIFICIAL SKIN IN ASSESSMENT OF EFFECT AND SAFETY OF COSMETICS Jong Hee Lee, MD, PhD, Kwang Hyun Cho, MD, PhD, Ho Jun Youn, MD, Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea; Ji Eun Kim, DDS, Laboratory of Cutaneous Aging Research, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea The evaluation of the efficacy and safety for newly developed cosmeceuticals is best performed with clinical trials, but these have limitations in that too much cost and time are involved; moreover, invasive techniques usually cannot be done. In vitro test models are more objective, less time- and cost-consuming, and well-correlated with in vivo clinical trials. We studied the usefulness of an in vitro test using threedimensional artificial skin models in the evaluation of the efficacy of cosmetics in treating wrinkles. We chose the two indices of new collagen synthesis and matrix metalloproteinase (MMP-1) expressions for evaluation of the efficacy of wrinkleimproving agents. Artificial skins are made with three-dimensionally cultured keratinoyctes on the collagen matrix populated with fibroblasts. Retinoic acid, retinol, retinyl palmitate, and adenosine were applied on the artificial skins, and the amount of type I procollagen and MMP-1 expressions was measured. These two indices were also observed in the artificial skin treated with wrinkle-improving cosmetics.We also observed the influence of UVB radiation on collagen synthesis and MMP-1 expressions. The protective effect of topically applied retinoids and cosmetics against UVB exposure was examined. In retinoid-treated artificial skin, the expressions of type I procollagen were increased according to treated concentrations and those of MMP-1 were decreased. Adenosine seems to have little or no effect on the collagen synthesis and slightly increases MMP-1 expression. UVB exposure decreased collagen synthesis and increased MMP-1 expression in artificial skin. Retinoids were shown to reverse these changes. Retinoic acid showed the most protective effect against UVB exposure, retinol the next, and retinyl palmitate the least protective. Cosmetics-applied artificial skin showed no disturbance of cellular architecture or loss of cell viability. Cosmetics applications lead to increased collagen synthesis and decreased MMP-1 expressions in the artificial skin and showed protection from UVB exposure. These artificial skin models provide a promising means for study and evaluation of the effects of topically applied products.
The primary focus of clinical evaluation of treatments of hyperpigmentation has been on the face. However, hyperpigmentary problems occur on other chronically sun-exposed sites of the body such as the forearm. Previous clinical testing of topical niacinamide-containing products has revealed reduction in appearance of hyperpigmented spots on the face. The current work was done to assess the effect of this treatment on spots on the forearm. A forearm repositioning system was constructed and equipped with UVA lighting and UV camera for capturing forearm images. Such UV photography is a very sensitive means for visualizing skin pigmentation. In double-blind, left-right randomized, placebo-controlled forearm clinical testing (N = 45), 3 pigmentation parameters were assessed by quantitative computer image analysis: total pigmented spot area, number of pigmented spots, and pigmented spot area fraction. Images were captured at baseline and at 2-week intervals up to 8 weeks. In all 3 parameters, topical niacinamide-containing oil-inwater formulations (up to 5% niacinamide dosing) were significantly effective in reducing the appearance of spot pigmentation versus oil-in-water formulation placebo controls. The spot reduction effects were significant after 2 to 4 weeks of treatment. This illustrates that this technology is effective on hyperpigmentation on body sites other than the face, and the imaging and analysis methods may be useful for evaluating other pigmentation control technology. Nothing to disclose.
100% sponsored by Korea Drug and Food Association
P227 TREATMENT TO IMPROVE SKIN TEXTURE (WRINKLING) IN HANDS Gregg Siegel, MS, Bakul Bhatt, PhD, Phyllis Siegel, MBA, Biomedical Development Corporation, San Antonio, TX, United States; H. Ralph Rawls, PhD, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States Background: A breathable, overnight peel treatment that can remain intact for approximately 48 hours was evaluated for its ability to reduce fine lines and wrinkles. Methods: Sixty-seven female volunteers, 33 to 79 years of age, were instructed to use an acetone, polymer, and vitamin E solution overnight on the back of their left hand. Epoxy replicates were made from low-viscosity siloxane impressions taken before and after 3 months of treatment. A profilometer (Taylor Hobson Inc.) was used to record vertical movements during horizontal travel of the stylus. The average of the largest peak to valley heights (Ry) was taken as a measure of wrinkle depth, while the average distance between peaks (Sm) was used as a measure of wrinkle spacing. The treatment results were analyzed by the paired Student t-test method. Results: Both Ry and Sm increased significantly during the treatment, with 67% showing an increase (improvement) in wrinkle spacing (i.e., fewer wrinkles), and 33% either no change or a small decrease. The average peak height increased 15 m, from 155 6 26 m to 170 6 33 m (10%). Discussion: The greater the spacing between wrinkles and the lower the peak heights, the smoother the skin. It is generally accepted that the limit of fine detail detected by the human eye (assuming a person with perfect eyesight under ideal viewing conditions) is 1/16 mm or 62.5 m. Two lines spaced less than this distance apart will appear as one line. Average spacing between wrinkles increased from 728 to 828 m (P = .015). This is an increase of 100 m and is thus a readily detected change. Although Ry increased by 15 m (P = .004), this 10% change is unlikely to be perceptible. The larger the spacing, the fewer the wrinkles; thus these results are indicative of an overall reduction in wrinkles of 19%. Of the 67% of subjects showing an improvement, the average reduction in wrinkle spacing was 39%. Improvements ranged up to 200%. Conclusions: The increase in spacing between vertical skin texture features, after 3 months of treatment, indicates that 67% of the subjects who completed the treatment experienced an average reduction in wrinkles of 39%, with some improving as much as 200%. Thus the overnight peel is an effective treatment for reducing fine lines and wrinkles. All authors are shareholders in Epikeia Inc. 100% sponsored by Epikeia Inc., San Antonio
MARCH 2005
Art, History, and Humanities of Dermatology P300 BE DAMNED OR BE BEAUTIFUL—THE HISTORY OF ALOPECIA AND WIGS Samantha Bunting, MBBS, Kieron Leslie, MBBS, Nick J. Levell, MBBS, Norfolk and Norwich University NHS Trust, London, England Throughout history, healthy luxurious hair has been associated with youth, sexuality, and sex appeal. The symbolism of hair is perhaps best represented by Samson who lost his power and strength when he was given a haircut by the Philistines, aided by the treacherous Delilah. Historically, lack of hair has not only been considered unattractive but in many cultures has come to suggest doubtful character; the Chinese have an ancient proverb which states ‘‘Of 10 bald men nine are deceitful and the tenth is stupid.’’ Shakespeare used hair loss to portray aging kings, fools, or villains, and James Bond rarely faces a foe that isn’t bald. The optimal solution, to counteract this negativity, has been to wear a wig. The earliest records of wig-wearing was from the Incas; mummies were buried in full regalia, with wigs crafted from twigs and animal hair. The ancient Egyptians were similarly preoccupied with aesthetics. Cleopatra suggested Julius Caesar apply a concoction made from domestic mice, bear grease, and deer marrow to treat his androgenetic alopecia. Unfortunately, this was ineffective so Caesar adopted laurel wreaths to mask his diminishing coiffeur. Wigs were the ultimate status symbol. It appears that even the Romans preferred blonds; hair and wigs made of real hair from Germany were de rigueur among the chic upper classes. They also served to mask disease; wigs came into their own in European society when infections such as syphilis became rampant. Indeed, the wig market broadened as a consequence; the unsightly sores needed treating if a girl was to earn money, and the treatment for syphilis before penicillin was mercury, which resulted in alopecia of a more personal nature! The merkin thus became the prosthesis of choice to hide a litany of horrors. However, of course wigs themselves were not without problems. The best (and most expensive) wigs were crafted from real human hair. In the late 1600s (as chronicled by Samuel Pepys in his illustrious diaries) one needed to be vigilant or you were liable to get a wig that was already lice-infested. There was also concern over where the hair came from; at the time of the bubonic plague, anxiety levels were particularly high in this regard. In conclusion, the answer to hair loss has never been easy. Solutions have been vexing physicians since the time of Hippocrates, and although some progress has been made in recent years, the wig remains the most effective tool to restore the illusion of youth and vitality to its wearer. Nothing to disclose.
J AM ACAD DERMATOL
P33
P228
TOPICAL NIACINAMIDE-CONTAINING PRODUCT REDUCES FOREARM HYPERPIGMENTATION Kukizo Miyamoto, Don Bissett, Larry Robinson, Cindy Berge, Procter & Gamble, Cincinnati, OH, United States
USE OF ARTIFICIAL SKIN IN ASSESSMENT OF EFFECT AND SAFETY OF COSMETICS Jong Hee Lee, MD, PhD, Kwang Hyun Cho, MD, PhD, Ho Jun Youn, MD, Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea; Ji Eun Kim, DDS, Laboratory of Cutaneous Aging Research, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea The evaluation of the efficacy and safety for newly developed cosmeceuticals is best performed with clinical trials, but these have limitations in that too much cost and time are involved; moreover, invasive techniques usually cannot be done. In vitro test models are more objective, less time- and cost-consuming, and well-correlated with in vivo clinical trials. We studied the usefulness of an in vitro test using threedimensional artificial skin models in the evaluation of the efficacy of cosmetics in treating wrinkles. We chose the two indices of new collagen synthesis and matrix metalloproteinase (MMP-1) expressions for evaluation of the efficacy of wrinkleimproving agents. Artificial skins are made with three-dimensionally cultured keratinoyctes on the collagen matrix populated with fibroblasts. Retinoic acid, retinol, retinyl palmitate, and adenosine were applied on the artificial skins, and the amount of type I procollagen and MMP-1 expressions was measured. These two indices were also observed in the artificial skin treated with wrinkle-improving cosmetics.We also observed the influence of UVB radiation on collagen synthesis and MMP-1 expressions. The protective effect of topically applied retinoids and cosmetics against UVB exposure was examined. In retinoid-treated artificial skin, the expressions of type I procollagen were increased according to treated concentrations and those of MMP-1 were decreased. Adenosine seems to have little or no effect on the collagen synthesis and slightly increases MMP-1 expression. UVB exposure decreased collagen synthesis and increased MMP-1 expression in artificial skin. Retinoids were shown to reverse these changes. Retinoic acid showed the most protective effect against UVB exposure, retinol the next, and retinyl palmitate the least protective. Cosmetics-applied artificial skin showed no disturbance of cellular architecture or loss of cell viability. Cosmetics applications lead to increased collagen synthesis and decreased MMP-1 expressions in the artificial skin and showed protection from UVB exposure. These artificial skin models provide a promising means for study and evaluation of the effects of topically applied products.
The primary focus of clinical evaluation of treatments of hyperpigmentation has been on the face. However, hyperpigmentary problems occur on other chronically sun-exposed sites of the body such as the forearm. Previous clinical testing of topical niacinamide-containing products has revealed reduction in appearance of hyperpigmented spots on the face. The current work was done to assess the effect of this treatment on spots on the forearm. A forearm repositioning system was constructed and equipped with UVA lighting and UV camera for capturing forearm images. Such UV photography is a very sensitive means for visualizing skin pigmentation. In double-blind, left-right randomized, placebo-controlled forearm clinical testing (N = 45), 3 pigmentation parameters were assessed by quantitative computer image analysis: total pigmented spot area, number of pigmented spots, and pigmented spot area fraction. Images were captured at baseline and at 2-week intervals up to 8 weeks. In all 3 parameters, topical niacinamide-containing oil-inwater formulations (up to 5% niacinamide dosing) were significantly effective in reducing the appearance of spot pigmentation versus oil-in-water formulation placebo controls. The spot reduction effects were significant after 2 to 4 weeks of treatment. This illustrates that this technology is effective on hyperpigmentation on body sites other than the face, and the imaging and analysis methods may be useful for evaluating other pigmentation control technology. Nothing to disclose.
100% sponsored by Korea Drug and Food Association
P227 TREATMENT TO IMPROVE SKIN TEXTURE (WRINKLING) IN HANDS Gregg Siegel, MS, Bakul Bhatt, PhD, Phyllis Siegel, MBA, Biomedical Development Corporation, San Antonio, TX, United States; H. Ralph Rawls, PhD, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States Background: A breathable, overnight peel treatment that can remain intact for approximately 48 hours was evaluated for its ability to reduce fine lines and wrinkles. Methods: Sixty-seven female volunteers, 33 to 79 years of age, were instructed to use an acetone, polymer, and vitamin E solution overnight on the back of their left hand. Epoxy replicates were made from low-viscosity siloxane impressions taken before and after 3 months of treatment. A profilometer (Taylor Hobson Inc.) was used to record vertical movements during horizontal travel of the stylus. The average of the largest peak to valley heights (Ry) was taken as a measure of wrinkle depth, while the average distance between peaks (Sm) was used as a measure of wrinkle spacing. The treatment results were analyzed by the paired Student t-test method. Results: Both Ry and Sm increased significantly during the treatment, with 67% showing an increase (improvement) in wrinkle spacing (i.e., fewer wrinkles), and 33% either no change or a small decrease. The average peak height increased 15 m, from 155 6 26 m to 170 6 33 m (10%). Discussion: The greater the spacing between wrinkles and the lower the peak heights, the smoother the skin. It is generally accepted that the limit of fine detail detected by the human eye (assuming a person with perfect eyesight under ideal viewing conditions) is 1/16 mm or 62.5 m. Two lines spaced less than this distance apart will appear as one line. Average spacing between wrinkles increased from 728 to 828 m (P = .015). This is an increase of 100 m and is thus a readily detected change. Although Ry increased by 15 m (P = .004), this 10% change is unlikely to be perceptible. The larger the spacing, the fewer the wrinkles; thus these results are indicative of an overall reduction in wrinkles of 19%. Of the 67% of subjects showing an improvement, the average reduction in wrinkle spacing was 39%. Improvements ranged up to 200%. Conclusions: The increase in spacing between vertical skin texture features, after 3 months of treatment, indicates that 67% of the subjects who completed the treatment experienced an average reduction in wrinkles of 39%, with some improving as much as 200%. Thus the overnight peel is an effective treatment for reducing fine lines and wrinkles. All authors are shareholders in Epikeia Inc. 100% sponsored by Epikeia Inc., San Antonio
MARCH 2005
Art, History, and Humanities of Dermatology P300 BE DAMNED OR BE BEAUTIFUL—THE HISTORY OF ALOPECIA AND WIGS Samantha Bunting, MBBS, Kieron Leslie, MBBS, Nick J. Levell, MBBS, Norfolk and Norwich University NHS Trust, London, England Throughout history, healthy luxurious hair has been associated with youth, sexuality, and sex appeal. The symbolism of hair is perhaps best represented by Samson who lost his power and strength when he was given a haircut by the Philistines, aided by the treacherous Delilah. Historically, lack of hair has not only been considered unattractive but in many cultures has come to suggest doubtful character; the Chinese have an ancient proverb which states ‘‘Of 10 bald men nine are deceitful and the tenth is stupid.’’ Shakespeare used hair loss to portray aging kings, fools, or villains, and James Bond rarely faces a foe that isn’t bald. The optimal solution, to counteract this negativity, has been to wear a wig. The earliest records of wig-wearing was from the Incas; mummies were buried in full regalia, with wigs crafted from twigs and animal hair. The ancient Egyptians were similarly preoccupied with aesthetics. Cleopatra suggested Julius Caesar apply a concoction made from domestic mice, bear grease, and deer marrow to treat his androgenetic alopecia. Unfortunately, this was ineffective so Caesar adopted laurel wreaths to mask his diminishing coiffeur. Wigs were the ultimate status symbol. It appears that even the Romans preferred blonds; hair and wigs made of real hair from Germany were de rigueur among the chic upper classes. They also served to mask disease; wigs came into their own in European society when infections such as syphilis became rampant. Indeed, the wig market broadened as a consequence; the unsightly sores needed treating if a girl was to earn money, and the treatment for syphilis before penicillin was mercury, which resulted in alopecia of a more personal nature! The merkin thus became the prosthesis of choice to hide a litany of horrors. However, of course wigs themselves were not without problems. The best (and most expensive) wigs were crafted from real human hair. In the late 1600s (as chronicled by Samuel Pepys in his illustrious diaries) one needed to be vigilant or you were liable to get a wig that was already lice-infested. There was also concern over where the hair came from; at the time of the bubonic plague, anxiety levels were particularly high in this regard. In conclusion, the answer to hair loss has never been easy. Solutions have been vexing physicians since the time of Hippocrates, and although some progress has been made in recent years, the wig remains the most effective tool to restore the illusion of youth and vitality to its wearer. Nothing to disclose.
J AM ACAD DERMATOL
P33