A prospective study of anti-aging topical therapies using a quantitative method of assessment

BACKGROUND: In the treatment of photoaged skin, glycolic acid works by removing superficial portions of the epidermis and stimulating dermis regeneration. Vitamins A, C, and E should stimulate collagen production and antioxidants should prevent free radical damage and skin aging. However, the effectiveness of different therapies has often relied on subjective methods of assessment. Histologic analysis has seldom been used because of the drawback of permanent scarring. In the literature, the use of a quantitative method for the assessment of facial rejuvenation has been described: the silicone replica technique. The authors' aim was to promote and recommend the use of this technique and, in particular, to test the effect of glycolic acid and multivitamin- and antioxidant-based products on skin texture. METHODS: The authors performed a prospective, randomized, double-blind, controlled study on 30 women treated topically in the outer canthal region (crow's-feet area). Patients were divided into three groups (groups A, B, and C); each group consisted of five patients between the ages of 31 and 40 years and five patients between the ages of 41 and 50 years. Group A was treated by glycolic acid application, initially at home for 2 weeks, followed by a higher concentration administered in the office weekly for six applications. Group B was treated by topical application at home of a multivitamin product daily for 3 months. Group C was treated with a cream base (placebo) for 3 months and represented the control group. Skin areas under treatment were photographed and reproduced by the silicone replica technique at baseline and at the end of treatment. This technique reproduces exactly the skin's texture. Digital images were obtained from skin replicas and analyzed by specific software for different parameters: roughness, microsulcus number, and width. Pretreatment and posttreatment values were compared using the Wilcoxon signed-rank test. RESULTS: In group A, microsulcus number and width were statistically decreased, but roughness was not. In groups B and C, parameters were not statistically modified. CONCLUSIONS: The silicone replica technique allowed a quantitative analysis of results obtained with different topical therapies. In particular, it confirmed the efficacy of glycolic acid in skin rejuvenation.