补肾益气中药抗皮肤光老化作用研究进展

<正>皮肤光老化属于光感性皮肤病范畴,本病的发生除与光线、光感物有关外,个体敏感性在发病过程中占重要地位。其临床主要表现为皮肤纹理改变(干燥粗糙、皱纹加深)和皮肤色素异常(点状色素沉着或色素减退斑点),严重者可诱发癌变。发病机制为表皮细胞萎缩,黑素细胞数量减少或分布局限,胶原纤维、弹力纤维组织结构缺失,无定形弹力蛋白样物质沉积,毛细血管扩张等病理组织学改变等特点[1]。现代研究认为皮肤光老化的发生机理,主要集中     

非创伤性检测技术在光老化皮肤治疗中的应用进展

皮肤的老化分为内源性老化和光老化,内源性老化即自然老化,目前大多数研究认为光老化加速了皮肤自然老化的进程。皮肤光老化常发生于习惯暴露的部位,其中面部是最易受累的部位,另外还有手背、前臂、上胸部等光暴露部位。光老化的临床特点为:皮肤质地的改变,如皮肤干燥、松弛、细小皱纹、皮肤粗糙、毛孔扩大等;色素性改变,如色素增加     

非创伤性检测技术在光老化皮肤治疗中的应用进展

皮肤的老化分为内源性老化和光老化,内源性老化即自然老化,目前大多数研究认为光老化加速了皮肤自然老化的进程。皮肤光老化常发生于习惯暴露的部位,其中面部是最易受累的部位,另外还有手背、前臂、上胸部等光暴露部位。光老化的临床特点为:皮肤质地的改变,如皮肤干燥、松弛、细小皱纹、皮肤粗糙、毛孔扩大等;色素性改变,如色素增加或脱失;血管性改变,如皮肤血管扩张等[1-3]。对光老化皮肤的     

化学剥脱术治疗皮肤光老化

1　皮肤光老化　皮肤光老化是由于皮肤长期、反复暴露于日光下所引起的一系列临床及组织学改变 ,又称皮肤过早老化。它不同于固有性老化 ,后者是与机体衰老同步进展的生理现象 ,出现组织学、功能和临床上的减退和改变。光老化不是单纯的美容问题 ,它与皮肤癌的发生可能有着病因学的联系[1] 。1.1　作用光谱及其机制　光老化主要是经常和长期受日光(主要为紫外线ＵＶＲ)照射的结果。ＵＶＲ主要分为短波ＵＶＣ、中波ＵＶＢ与长波ＵＶＡ。ＵＶＣ不能透过臭氧层 ,无生物学效应 ;ＵＶＢ照射可产生红斑、ＤＮＡ损伤和皮肤癌[2 ] ;ＵＶＡ产生这种效…     

皮肤光老化的光一电疗法

1983年,Anderson和Parrish提出了选择性光热作用理论对皮肤激光外科和光老化的治疗有很大的积极影响。基于皮肤光老化在生物学、组织学及临床表现上的改变,选择性光热解效应能对抗多种皮肤老化的症状的效果已被证实,这一概念对选择一个合理的光老化治疗手段是非常重要的。激光、强脉冲光（IPL）、发光二极管（LED）等对于特定的皮肤靶向治疗都是基于选择性光热解这一作用机制。     

皮肤光老化的临床评价

皮肤长期暴露于紫外线下会发生形态学、组织学和生理学的改变，称之为光老化。目前对于光老化的临床评价方法较多，主要分为：临床描述和图像分析两类。光老化标准化评价方法可提高不同国家和地区在皮肤光损伤研究和评价方面的可比性。其中量化的评价方法优于描述性评价方法，二者相结合是未来皮肤光老化临床评价方法的发展方向。     

紫外线诱导皮肤光老化的形成机制

光老化是人体暴露部位皮肤衰老的主要原因,其机理的阐明对防护皮肤衰老及治疗光损性疾病具有十分重要的意义。本文总结了近些年该领域的研究成果,发现日光中的UV主要通过损伤DNA、进行性蛋白质交联、降低免疫应答、产生高度反应自由基损伤细胞和组织等机制造成皮肤光老化。UVB和UVA在诱导皮肤光老化形成中,既有各自的特点,又相互协同,而UVA单独对真皮深层的穿透能力及对真皮组织的损伤机制尚待进一步研究。     

光动力嫩肤技术的研究进展

皮肤衰老是内源性因素与外源性因素共同作用的结果,根据原因不同可分为自然老化(natural aging)和光老化(photoaging).自然老化主要是由机体内源性因素引起,临床表现为皮肤松弛、皱纹、干燥、脱屑、脆性增加、修复功能差等.光老化是由于长期和反复的紫外线照射导致,临床表现为脂溢性角化、色素沉着过多、皮肤颜色改变、日光性雀斑样痣、良性血管损害、毛细血管扩张、玫瑰痤疮性红斑,以及表皮和真皮结构的改变,如皱纹、皮肤弹性降低、胶原组织和结缔组织变化、毛孔扩大等.     

化学剥脱术治疗皮肤光老化

1 皮肤光老化 皮肤光老化是由于皮肤长期、反复暴露于日光下所引起的一系列临床及组织学改变，又称皮肤过早老化     

强脉冲光治疗面部光老化的疗效评估

目的:评价强脉冲光(intense pulsed light,IPL)治疗面部光老化的疗效。方法:应用皮肤测试仪检测IPL治疗前后皮肤水分含量、弹性及色素值。结果:面部光老化经IPL治疗后,皮肤水分含量略增加(P0.05),皮肤弹性增加(P0.01),黑色素值下降(P0.01),血红素值下降(P0.01)。结论:应用皮肤测试仪检测IPL治疗前后皮肤水分含量、弹性及色素的改变,使评价IPL的治疗效果更为科学、准确、客观。     

皮肤光老化、活性氧簇与抗氧化剂

皮肤长期反复暴露于日光紫外线（UV）下可导致皮肤光老化.近年来研究表明活性氧簇（ROS）在UV致皮肤光老化过程中起重要作用.UV可在皮肤中诱生高浓度ROS,这些具有一个或多个未配对电子的原子或分子如不能被皮肤抗氧化系统及时清除则会和皮肤中的核酸、脂质、蛋白质等生物大分子发生化学反应,并影响相关细胞信号转导途径和基因表达,导致皮肤光老化发生,使用抗氧化剂清除ROS可能成为一种重要的光老化防治策略.     

Double-Blinded, Placebo-Controlled Trial of Green Tea Extracts in the Clinical and Histologic Appearance of Photoaging Skin

Background. Green tea extracts have gained popularity as ingredients in topical skin care preparations to treat aging skin. Green tea polyphenolic compounds have significant antioxidant and anti-inflammatory activities, and studies suggest that these extracts help mediate ultraviolet radiation damage.
Objective. To evaluate the effects of a combination regimen of topical and oral green tea supplementation on the clinical and histologic characteristics of photoaging.
Methods. Forty women with moderate photoaging were randomized to either a combination regimen of 10% green tea cream and 300 mg twice-daily green tea oral supplementation or a placebo regimen for 8 weeks.
Results. No significant differences in clinical grading were found between the green tea–treated and placebo groups, other than higher subjective scores of irritation in the green tea–treated group. Histologic grading of skin biopsies did show significant improvement in the elastic tissue content of treated specimens (p<.05).
Conclusion. Participants treated with a combination regimen of topical and oral green tea showed histologic improvement in elastic tissue content. Green tea polyphenols have been postulated to protect human skin from the cutaneous signs of photoaging, but clinically significant changes could not be detected. Longer supplementation may be required for clinically observable improvements.
THIS STUDY WAS SUPPORTED BY NU SKIN INTERNATIONAL, INC. DR. KIMBALL HAS SERVED AS A CONSULTANT TO NU SKIN AND HAS RECEIVED HONORARIA FOR SPEAKING.     

Photoaging and Nonablative Photorejuvenation in Ethnic Skin

Background:. Advances in nonablative skin rejuvenation technologies have sparked a renewed interest in the cosmetic treatment of aging skin. More options exist now than ever before for reversing cutaneous changes caused by long-term exposure to sunlight. Although Caucasian skin is more prone to ultraviolet light injury, ethnic skin (typically classified as types IV to VI) also exhibits characteristic photoaging changes. Widespread belief that inevitable or irreversible textural changes or dyspigmentation occurs following laser- or light-based treatments has been challenged in recent years by new classes of devices capable of protecting the epidermis from injury during treatment. Demographic changes in the US population favor an increasing trend of older, ethnically diverse patients requesting treatment to recapture a youthful appearance.
Objective. The purpose of this article is to review the recent literature regarding clinical recognition and treatment of photoaging changes in ethnic skin. This article provides a basis for classification of current and future nonablative technologies with regard to the safety and efficacy of treatment in ethnic skin.
Conclusions. Nonablative technologies have emerged to meet the public demand for no-downtime treatment of aging skin. As these technologies continue to evolve and improve, physicians are challenged to define realistic goals, expectations, and limitations for treatment. Whenever possible, ongoing and future studies should attempt to address treatment in ethnic skin types. Photoaging changes in ethnic skin can be recognized and successfully treated with nonablative technology with minimal risk and downtime.     

皮肤光老化的研究进展

人的皮肤长期受到紫外线的照射容易引起光老化,而光老化与脂溢性角化、色素斑、日光性角化病及皮肤恶性肿瘤等多种疾病的发生有关,因此,预防和改善皮肤光老化已经逐渐成为皮肤科医生研究的热点。近年来,国内外学者对光老化的研究有了新的进展,通过查阅文献,笔者主要从光老化的发生机制、光老化的防治以及α1抗胰蛋白酶在光老化中的研究进展三个方面进行综述。     

Aesthetic analysis of Asian skin

Attention to restoring healthy and more youthful facial skin complements facial plastic surgery, optimizing cosmetic results. Asian skin has structural and physiologic differences from white skin. These distinctions account for variations in response to ultraviolet light exposure and alternate clinical manifestations of photoaging. The response to cosmetic treatment modalities also differs in patients of darker skin pigmentation, and this needs to be recognized by the cosmetic and laser surgeon. This article reviews the biology of Asian skin and discusses a clinical approach to aesthetic analysis of Asian skin.     

真皮多能干细胞移植对大鼠光老化皮肤组织的修复作用

目的:进一步探讨真皮多能干细胞(dermal multipotential stem cells,DMSCs)移植对大鼠皮肤光老化(skin photoage)后组织修复作用的影响。方法:SD大鼠58只随机分为正常对照组(8只)、细胞移植组(25只)和PBS对照组(25只),细胞移植组和模型对照组采用UVA和UVB紫外灯同时进行照射制备皮肤光老化模型。体外分离培养DMSCs,吸取1ml细胞悬液(约1×106个)或等量PBS液分别于皮肤光老化区真皮层内多点注射移植,正常对照组不做任何处理。移植后4周、8周分别采用VG染色和Weigert染色观察皮肤全层胶原纤维、弹力纤维的表达变化;同时应用免疫组织化学染色观察各组大鼠皮肤真皮层vimentin的表达变化。结果:皮肤光老化损伤后,与对照组相比,DSMCs治疗组大鼠受损皮肤组织出现较多的新生胶原纤维和弹力纤维;DMSCs移植治疗组大鼠在真皮层内vimentin染色阳性的成纤维细胞的数量明显多于PBS对照组,移植后4周主要分布于真皮浅层,8周后广泛均匀弥散在皮肤各层。结论:DMSCs移植对大鼠光老化皮肤具有明显的促进组织修复的作用。     

5-Aminolevulinic Acid-based Photodynamic Intense Pulsed Light Therapy Shows Better Effects in the Treatment of Skin Photoaging in Asian Skin: A Prospective, Single-blinded, Controlled Trial

Objective: To investigate the effects of photodynamic intense pulsed light therapy on skin photoaging in Asian skin. Methods: This was a prospective, single-blinded, controlled, clinical trial with 40 patients enrolled. The enrolled patients applied 5% 5-aminolevulinic acid on the left side of the face while a placebo was applied on the right side of the face. After a one-hour incubation, the patients received intense pulsed light therapy. After four treatment cycles, the pH values, transepidermal water loss of the dermis of the forehead and canthus skin, as well as the moisture capacity of stratum corneum and the global score of photoaging were assessed. Results: The pH value of forehead and canthus skin, moisture capacity of stratum corneum, and the dermis of forehead and canthus skin of the photodynamic intense pulsed light therapy treated sides were significantly higher than those of the control sides in all of the patients. The photoaging score decreased after the therapy on both sides, with the photodynamic intense pulsed light therapy treated sides decreasing more than the control sides (P<0.01). Conclusion: 5-aminolevulinic acid photodynamic intense pulsed light therapy showed better effects in the treatment of skin photoaging compared to intense pulsed light therapy alone.Photoaging is caused primarily by sun exposure, especially ultraviolet light, UVA and UVB. It usually appears in patients before 30 years of age and may be characterized by pigmentation, deep wrinkles, large pores, telengiectasia, and skin relaxation.¹ Several methods have been reported to have positive effects in treating photoaging, such as intense pulsed light (IPL), surgery, drugs, and cosmetic therapy. In today''s experience, the IPL therapy is recognized as one of the most common methods to treat photoaging, as it is safe and effective.² To enhance the efficacy of the IPL, the photodynamic intense pulsed light therapy (IPL-PDT) is now widely performed, with the application of a photosensitizer, such as 5-aminolevulinic acid (ALA). However, data concerning the use of IPL-PDT in Chinese individuals are limited.In this study, the authors investigated the effects of IPL-PDT in the treatment of skin photoaging compared to IPL alone in Chinese patients.     

A prospective study of the safety and efficacy of a combined bipolar radiofrequency,intense pulsed light,and infrared diode laser treatment for global facial photoaging

The clinical features of photoaging include: skin texture changes, laxity, rhytides, pigmentary changes, and vascular changes such as erythema and telangiectasias. In order to meet patients’ increasing demands for improving all aspects of photoaging at one office visit, employing a multi-modality treatment for all aspects of photoaging has become increasingly desirable for the physician and patient alike. We examine a novel device that employs bipolar radiofrequency (RF), intense pulsed light (IPL), and infrared diode laser. These laser and light source treatments are performed sequentially. This study aims to evaluate the clinical efficacy and safety of this device (i.e., ELOS Triniti?). Twenty-six subjects received four ELOS Triniti? treatments at 1-month intervals. They were followed up 1, 3, and 6 months after completing the treatments. Two blinded dermatologists used a comprehensive grading scale to evaluate the degree of the photoaging in terms of rhytides, laxity, dyschromia, erythema, telangiectasias, and texture. Subjects used a 0–10 grading scale for self-assessment of photoaging. Additionally, we measured the Erythema Index (EI), Melanin Index (MI), transepidermal water loss scores (TEWL), stratum corneum moisture scores (SC), and dermis moisture scores (D) before treatment and 1, 3, and 6 months after treatment. There was a statistically significant improvement in all five aspects of the comprehensive grading scale. Overall, it had excellent efficacy for improving erythema, telangiectasias, and skin texture. It also had a relatively long effect on improving skin laxity; however, it had only a limited ability to improve rhytides and dyschromia. It can mildly to moderately improve the global photoaging. This global effect can be noted 1 month after treatment and becomes most clinically apparent 3 months after treatment. This is maintained at least 6 months after treatment. MI index and SC and D values increased while EI index and TEWL values decreased after the treatment. The subjects’ self-assessment improved by 2.7 ± 1.2 points. The overall satisfaction rate was 88%. The degree of pain measured 2.5 ± 1.9 points on average. There was no downtime and no severe side effects reported. The sequential implementation of bipolar radiofrequency based optical combination devices (IPL, IR, diode laser) is effective and safe for global facial photoaging.     

Measurement of protection afforded by ultraviolet-absorbing window film using an in vitro model of photodamage

BACKGROUND AND OBJECTIVES: The effects of chronic sun damage including telangiectasias, solar lentigos, rhytides, enlarged pores, sagging skin, and pre-cancerous and cancerous growths are among the most common presenting complaints in a dermatologist's office. These changes are often worse on the driver's side of the face, emphasizing the role of UVA exposure received while driving in producing these changes. This study was undertaken to measure the ability of car window glass alone and in combination with ultraviolet (UV)-absorbing film to reduce UV-damage as measured using an established in vitro model of photoprotection. STUDY DESIGN MATERIALS AND METHODS: Using the 3T3 neutral red uptake photoprotection assay with solar simulating radiation (SSR) administered by a xenon arc solar simulator, we measured the photoprotection ability of auto glass, window film that filters UV radiation, and the combination of window film and auto glass. RESULTS: As measured by the 3T3 neutral red uptake photoprotection assay, auto glass reduced cell death from SSR by 29%, while window film reduced it 90%, and the combination of auto glass and film reduced cell death by 93%, when compared to unfiltered SSR. CONCLUSIONS: Window film that filters UV radiation results in dramatic reductions in cytotoxicity when measured by the neutral red uptake photoprotection assay. Widespread use of window film provides an ever-present barrier to ultraviolet A (UVA) exposure and could potentially reduce the detrimental effects of UVA, including photoaging, skin cancer, and ocular damage, such as cataracts. In addition, such film is essential for patients suffering from conditions sensitive to UV radiation, such as lupus erythematosis.