SKIN CARE
SUBJECTIVE PERCEPTION OF DIFFERENT SKIN CONDITIONS (FEMALE) D56
Positive perception (%) Rejuvenates my skin
Reduces my sebum **
Feed my skin p=0.0599
100 90 80 70 60 50 40 30 20 10 0
Reduces my skin spots
Reduces my skin redness
Reduces my wrinkles *
Hydrates my skin p=0.072
Rejuvenates my skin Smoothes my skin Reduces my sebum
SUBJECTIVE PERCEPTION OF DIFFERENT SKIN CONDITIONS (MALE) D56
Positive perception (%) Feed my skin Firms my skin Reduces my
skin spots *
Reduces my
Uniforms my skin tone *
Reduces my skin pores *
Figure 2: Subjective perception by female and male subjects of various skin parameters after 56 days of topical application of 3% Cucurbita pepo var. styriaca extract or placebo.
accordance with the World Medical Association ethical principles defined in the Declaration of Helsinki. All study participants provided their written informed consent at the beginning of the study. The effect that autophagy activation has on skin appearance was investigated in 55 subjects (female and male) with healthy, Caucasian skin aged 50 – 65 years. In this study, personal perception together
with photographic documentation (Visioscan), skin hydration, skin firmness and elasticity, skin desquamation, transepidermal water loss (TEWL), and skin sebum were assessed. Half of the subjects applied placebo while the other half applied the identical formulation containing 3% Reforcyl-Aion; all subjects used the corresponding preparations twice daily for 56 days. The Likert scale was employed for the subjective efficacy questionnaire. It was assumed that high scores equated to the subject being ‘satisfied’ with the results.
Statistics All recorded parameters were subjected to unpaired Student’s t-tests. The statistical values in black are the result of comparison with baseline status while the blue values are the result of comparison with placebo or vehicle control.
Results and discussion Subjective perception Female volunteers were selected so that their ages reflected that of the general average age at which there is onset of the menopause. Since the male andropause is not so well defined, we decided to select male panellists in the same age range as the females. The average age of females was 56.8 and that of males was 56.1 years. Assessed were eleven different skin parameters. The results were evaluated using a standard gender-specific approach (male and female) (Fig 2). Personal perception is extremely important
with regard to cosmetics. Our data show that our female and male subjects had differing perceptions of the results of placebo and verum treatment. Furthermore, it is also apparent that the females tended to have much more
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differentiated opinions and even higher expectations in terms of each skin parameter, while the males were probably less ’trained/ educated’ in this respect. The male volunteers who used the 3% verum formulation were 100% satisfied in all but one parameter - “sebum regulation”. Even so, 90% of male users reported positive impressions. The placebo volunteers were in general much less satisfied, irrespective of gender. Female users had, as said above, a much more differentiated view of effects on their skin. Despite this, in this context verum outperformed placebo in all parameters under investigation. It should be noted that 100% of volunteers reported that the nourishment of their skin was enhanced; at the same time, 90% were satisfied with skin hydration, while pore reduction, skin tone, sebum and wrinkle appearance were perceived as significantly improved. Cucurbita pepo var. styriaca extract or better said its mode of action - autophagy activation – represents a factor that positively influences skin physiology across all individuals in common, whether female or male. Reactivation of the cellular self-cleaning process improves several skin parameters in parallel and leads to an overall improvement in skin appearance in women and men.
Epidermal effects Autophagy in the epidermis plays a dual role in skin barrier homeostasis. Firstly, long-lived and mostly quiescent stem cells require autophagy for intracellular homeostasis and for maintenance of their ability to supply functional progeny cells.2 When all their metabolic activity in the stratum granulosum ceases, cells lose their organelles including the nucleus through autophagy, extrude lipids and proteins onto the cornified envelope scaffold, and this effectively seals the skin.3 Finally, these layers of dead cells are shed off the surface and replaced by new cells. Holocrine secretion of sebum employs the same pathway and requires autophagy to function properly. Desquamation levels increase with age in individuals of both genders due to the weaker adherence of corneocytes. But in general males
have a higher desquamation rate, suggesting that gender-specific hormonal factors probably influence this physiological phenomenon as well. Furthermore, older females tend to have higher desquamation rates in comparison with younger females, something that is not observable in males. This can also be explained by hormonal factors, especially those associated with the menopause.4, 5 In our study, we were able to observe a
gender-specific mode of action. Treatment with 3% verum decreased desquamation in females by up to 16% after 28 days, while desquamation in the males was increased by almost 25% (data not shown). By day 56, there was a decrease in female levels of up to 18% while in the males, the increase fell back slightly to 11% (Fig 3). These results corresponded with the effects on
levels of transepidermal water loss (TEWL) and sebum secretion. In general, alterations to the skin barrier and TEWL have been shown to correlate with skin ageing. An increase in TEWL indicates an impaired barrier function. Furthermore, TEWL is significantly lower in males than in females regardless of their age. In addition, TEWL is higher in post-menopausal females in comparison with those prior to the menopause.1 The results of measurement of TEWL showed
that 3% verum treatment in females decreased TEWL by almost 15% after 28 days (data not shown) and by 10% after 56 days (Fig 3). These data indicate improvements to the skin barrier and are consistent with decreased skin desquamation. In the males, an initial increase of 11% was observed, which had decreased over 20% in total by day 56 (Fig 3). This suggests restructuring/ reorganisation of the skin barrier. Treatment with 3% verum resulted in gender- specific sebum regulation. In the females, sebum production increased by 23% in comparison with baseline, while in males, who in general have a greasier skin, sebum production decreased by almost 32% after 56 days of use (Fig 3). Placebo induced a sebum decrease in both gender groups; in women by up to 30% after 56 days (data not shown). Regulation of sebum helps improve the overall appearance of the skin and contributes
March 2021 PERSONAL CARE
skin redness p=0.059
Reduces my wrinkles
100 80 60 40 20 0
Hydrates my skin Smoothes my skin
51
Placebo ■ REFORCYL® -AION 3% ■
Firms my skin
Mean + SEM; n=33/22;
Uniforms my skin tone
Reduces my skin pores
*=p<0.05 **=p<0.01
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