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A clinical look at the aging skin.

The aging Caucasian skin becomes yellow, dry, wrinkled and inelastic. Deterioration increases its susceptibility to malignant neoplasms, pruritus, and candidal infection. In addition, psychosomatic problems vascular disease, "little strokes," and chronic malnutrition may precipitate or exacerbate skin disorders in the elderly. Treatment with "strong" medications should be taboo because of the fragility of senile skin. The risk of toxic reactions or of allergic sensitization is great. Because healing is retarded in old tissue, time is an indispensable component of successful treatment.

Adolescent

[The aging skin (author's transl)].

Aging of the skin appears in circumscribed as well as in generalized forms. The localized alterations may be subdivided in such of inflammatory origin and in hyperplastic ones. The latter include benign and also precancerous tumors. The generalized and usually premature manifestations of cutaneous senescence are almost always part of some hereditary disease which frequently also affects the viscera, sense organs, skeleton, and the nervous system.

Aged

A Novel Moisturizer Formulated With Micronized Centella asiatica and Mandelic Acid Improves Mature, Crepey Skin.

BACKGROUND: Dermatoporosis is a condition of fragile, aging skin that manifests as altered pH, wrinkles, laxity, easy bruising, and hyperpigmentation. This study evaluated efficacy, safety, and subject perception after the use of a novel cream, GC (Galderma Laboratories, LP, Fort Worth, TX), on subjects with mature, aging skin. METHODS: A 12-week multicenter, randomized, blinded, in-use study enrolled female and male subjects aged 40 to 60 years of all races, ethnicities, and Fitzpatrick skin types. Subjects were required to have a history of fragile skin and dry, crepey skin on the knees and thighs. GC cream was applied to knee and upper thigh skin twice daily. Assessments included clinical grading, digital photography, bioinstrumentation (skin texture, pH, and heatmap hydration), standard safety assessments, and satisfaction. RESULTS: Use of GC cream for 12 weeks resulted in significant improvements in skin crepiness, photodamage, and firmness, as well as decreased skin pH and early improvements in skin roughness and smoothness from baseline. Corneometer heatmapping documented improved skin hydration over baseline. No adverse events were reported; the GC cream was well tolerated, and subjects reported high satisfaction. CONCLUSION: Twice-daily application of the novel GC skin cream significantly improved the overall skin quality of mature, aging skin, including crepiness, photodamage, firmness, texture, pH, and hydration. GC cream was well tolerated with high subject satisfaction. These data are intended to help guide healthcare providers and patients in choosing an effective moisturizer that was specifically designed for patients with fragile, mature skin.

Humans

Skin-innervating glutamatergic neurons modulate aging.

Peripheral nerves regulate skin homeostasis by secreting neurotransmitters, but their role during skin aging remains incompletely understood. Here, we report that cutaneous denervation accelerates skin aging, as evidenced by collagen reduction. Neurofilament heavy chain (Nefh) is decreased in aged skin and is predominantly expressed in vesicular glutamate transporter 2-positive (Vglut2+) skin-innervating glutamatergic neurons. Notably, dermal fibroblasts, the primary producers of collagen, frequently contact Nefh+ nerve fibers. Moreover, Nefh deletion in Vglut2+ glutamatergic neurons drives skin fibroblast senescence and collagen loss, whereas additional glutamate improves skin aging phenotypes. Mechanistically, cyclin-dependent kinase 5 (Cdk5) interacts with both Nefh and Vglut2 and maintains glutamate release and collagen homeostasis. Additionally, in skin fibroblasts, solute carrier family 1 member 3 (Slc1a3) governs the collagen-promoting and anti-senescence functions of glutamate. Together, these findings reveal Nefh-mediated glutamatergic neuromodulation of skin aging and provide therapeutic targets for aging-related skin disorders.

Animals

Structural changes in aging human skin.

In both exposed and protected areas of progressively older people the underside of the epidermis becomes increasingly flattened out. This flattening is accompanied by a comparable rarefaction of the superficial blood vessels. In this article we review the architecture of the elastic fiber framework in the papillary dermis of skin protected from the sun; aging changes that occur are similar to, but less severe than, those in sun-exposed areas. Most cutaneous sensory end organs are little affected by aging; those in the external genitalia, however, and particularly those underneath the vaginal epithelium become smaller and some disappear.

Adolescent

Intrinsic changes in cell differentiation and identity drive impaired wound healing in aged female murine skin.

Cellular and molecular mechanisms that drive a perturbed wound microenvironment and impaired healing in aged skin have not been fully delineated. To obtain a comprehensive understanding of cell-intrinsic changes acquired during ageing that impact early responses to injury, we performed single-cell RNA sequencing in young and aged intact female murine skin and wounds 3 days post-injury. We observed that substantial changes in the mean proportional distribution and transcriptomic state of skin resident subpopulations in aged, but not young, tissues accompany a global increase in basal inflammation. This is driven by an altered signalling environment leading to impaired keratinocyte differentiation, loss of fibroblast identity and defective macrophage function. Further, we show that ageing-induced changes in skin resident cells persist after injury, resulting in increased expression of senescence-related genes in wound fibroblasts and aberrant monocyte-to-macrophage transitioning coupled to an enhanced inflammatory signature and defective intercellular signalling in comparison to wounds in young mice. In summary, our data highlights a contribution of both cell-intrinsic changes and an altered tissue microenvironment to poor wound healing responses in aged mice.

Animals

Swimming and the skin.

Most skin diseases associated with swimming are relatively minor and either heal spontaneously or respond quickly to treatment. Exceptions are those diseases made worse by sunlight such as lupus erythematosus, skin cancer, or prematurely aged skin. With the use of better sunscreens in the future, that problem will be solved.

Chlorine

Effect of age of non-skin tissues on susceptibility of skin grafts to 7,12-dimethylbenz[alpha]anthracene (DMBA) carcinogenesis in BALB/c mice, and effect of age of skin graft on susceptibility of surrounding recipient skin to DMBA.

The influence of age-dependent alterations in non-skin tissues on chemical carcinogen-induced skin papilloma development was studied by treatment with 7,12-dimethylbenz[alpha]anthracene (DMBA) of 4-month-old skin grafts sewed onto 4- and 20-month-old syngeneic recipients. Skin of 4- and 20-month-old BALB/c female mice differed in susceptibility to DMBA carcinogenesis, but the 4-month-old grafts showed the same papilloma incidence independent of the age of the recipient mice. In a different experiment, the influence of age of skin grafts on papilloma development on DMBA-treated recipient skin was studied. Fourteen- and 26-month-old skin grafts were carried by 14-month-old recipients. Grafts of those two ages are known to differ in susceptibility to DMBA carcinogenesis, but no effect of the grafts on papilloma development on DMBA-treated recipients was detectable. It was concluded that certain age-dependent differences in skin susceptibility to chemical carcinogens are solely a reflection of alterations in the skin at the site of carcinogen treatment.

9,10-Dimethyl-1,2-benzanthracene

Tranexamic acid protects human dermal fibroblasts from D-galactose-induced senescence via the GPR30/MAPK pathway.

BACKGROUND: Tranexamic acid (TXA) is widely used for pigmentary disorders, but its anti-ageing potential remains unclear. This study aimed to evaluate whether topical 3% TXA improves early periorbital wrinkles in women with facial melasma and to investigate whether TXA protects human dermal fibroblasts from D-galactose-induced senescence via the GPR30/MAPK pathway. METHODS: Fifty women with melasma were randomized to 3% TXA serum plus moisturizer or moisturizer alone for 8 weeks, with follow-up to week 12. Periorbital wrinkles were graded using a modified Fitzpatrick Wrinkle Scale (MFWS). Separately, D-gal-induced senescence in HDFs was assessed via viability, SA-β-gal activity, senescence markers, ROS, antioxidant enzymes, SASP/ECM gene expression, and MAPK activation. GPR30 involvement was examined using antagonist G15, shRNA knockdown, and molecular docking. RESULTS: Topical TXA produced significantly greater MFWS reductions versus moisturizer alone at weeks 4, 8, and 12, with benefit persisting post-treatment. In HDFs, TXA preserved viability, reduced SA-β-gal positivity, attenuated p21/p16, restored Lamin B1, decreased ROS, and rescued antioxidant activities. TXA downregulated IL-6, IL-8, MMP1, and MMP3, and suppressed D-gal-induced ERK, JNK, and p38 phosphorylation. These effects were weakened by G15 or GPR30 knockdown; docking supported a stable TXA-GPR30 interaction. CONCLUSIONS: TXA showed clinical anti-wrinkle activity in melasma patients and protected HDFs from D-gal-induced senescence, partly via GPR30-dependent modulation of oxidative stress, SASP/ECM expression, and MAPK signalling. TXA is a promising candidate for skin ageing intervention.

Humans

Effects of aging and chronic sun exposure on melanocytes in human skin.

Both aging and sun exposure have well-documented effects on the human melanocyte system. Paired biopsies of habitually exposed and nonexposed skin from adjacent anatomic sites were obtained from 8 donors aged 28 to 80 yr in order to study the combined effect of chronic actinic irradiation and chronologic aging. Density of dopa-positive melanocytes was roughly twofold higher in the exposed than in the nonexposed skin at all ages, suggesting an irreversible effect of sun exposure. Melanocyte density declined approximately 6 to 8% of the surviving population per decade in both sites. Dopa-positivity of individual melanocytes was consistently greater in the chronically exposed skin than in the nonexposed skin of the same subject and did not vary with age. These data strengthen and expand earlier observations of age-related melanocyte changes, and explain the apparent paradox of a generalized increase in pigmentation and simultaneous decrease in melanocyte density which frequently accompany advancing age. In addition, the present study suggests that the principal effect of chronic sun exposure on the human pigmentary system is not premature "aging" as currently recognized histologically, but rather activation and/or proliferation of the exposed melanocytes.

Adult