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Introduction and purpose of the work. Aesthetic medicine currently has many methods to keep our skin in the best possible condition, and one of these methods is the use of tissue stimulators. The purpose of the following paper is to analyze, present and apply tissue stimulators in anti-aging prevention. Review methods. The paper is based on a review of literature about tissue stimulators, aesthetic medicine and anti-aging therapy. Most of the publications used were from Pubmed and Google Scholar electronic databases. State of the art description. Aesthetic medicine is a department that over the past few years has been closely associated with the slowing down of skin aging processes. In humans, over the years, proliferative processes slow down, the rate of collagen and elastin degradation increases, and the intercellular matrix is reduced. Substances known as tissue stimulators used in anti-aging therapies mean that the above processes can be delayed. Conclusion. The expectations of patients visiting aesthetic medicine clinics regarding activities that improve their appearance are increasing. They are unable to accept their own aesthetic defects, which is why they often strive for unnatural effects. Tissue simulator treatments can be a valuable way for patients to maintain healthy and rejuvenated skin.

Introduction and purpose The human gut microbiota consists of trillions of microscopic organisms, mostly bacterias. They play a significant role in nutrient metabolism, maintenance of structural integrity of the gut mucosal barrier, immunomodulation and protection against pathogens. Many factors can influence the composition of the intestinal microbiota, for example antibiotics, diet or stress. These factors may lead to dysbiosis which causes activation of neurotransmitters. It can results in the entry of metabolites to the blood stream, systemic immune dysregulation and alteration of skin microbiota. The aim of the study was to review the literature and determine the effects of intestinal microbiota and probiotics in selected skin diseases and what is new - skin aging process. State of knowledge We analyzed numerous studies which indicate that disturbed gut microbiota can be related to some chronic diseases, including skin disorders such as atopic dermatitis, acne vulgaris, psoriasis and rosacea. Additionally, it has been proven that bacterial dysbiosis can intensify the skin aging proces. In order to reproduce normal gut microbiota probiotics are used. Despite the fact that there are only a few studies showing the unequivocal effect of probiotics on skin diseases, their results seem to be encouraging. Conclusions Proper composition of the intestinal microbiome determines the homeostasis of the human body. Disturbance of the gut microbiome play a significant role not only in development and aggravation of many skin diseases, but also have an impact on the skin aging. Despite quite a lot number of studies assessing the impact of microbiota on certain skin disorders, there is still a need to evaluate impact of probiotics. Researches indicate that they can be used as a helpful therapeutic tool. Taking this into account, it is worth considering it in the treatment process.

Skin aging is a complex process involving both internal (chronological aging) and external (biological aging) factors. Slowing down the proliferative and immune processes in the epidermis, reducing the activity of fibroblasts and vascularization of the dermis during chronological aging lead to thinning, dryness, hypersensitivity, vulnerability and superficial wrinkles. Exposure to ultraviolet rays, pollutants, climate, and thermal factors cause keratinocyte disorganization, enhanced melanogenesis, collagen dystrophy, solar elastosis, and disorder of microcirculation. The main signs of external skin aging are deep wrinkles, sagging, pigmentation, telangiectasia, skin neoplasms. Among the local anti-aging agents, retinoids occupy a leading place, as they eliminate the main signs of skin aging. Of the entire group of retinoids, retinoic acids are the most active. However, the possibility of skin irritation limits their use. Therapeutic and cosmetic products with retinol esters (retinol palmitate) have a minimal irritating effect and can be used both for the prevention of skin aging and the elimination of its signs. Oral use of isotretinoin as an anti-aging agent is undesirable due to the many side effects and contraindications.

Aging processes lead to the tremendous changes in every tissues of human and skin is not an exception. Externally observable aging changes of the skin are caused by involutionary processes, which are happening on all levels, from skin to bones. The development of methods of prevention and treatment, which are aimed at fighting age-related changes in the skin and activating regenerative processes, is a live issue and has great scientific and practical significance.One of the important factors of skin aging is involutional changes occurring in the dermis. Currently, injections, based on polylactic acid are actively used as collagen stimulants in aesthetic medicine. Polylactic acid is a hydrophobic, biodegradable polymer derived from lactic acid. However, the mechanism of effect of polylactic acid on the components of the dermis, as well as the morphohistochemical status of the implant itself and the effect on markers of skin inflammation remains insufficiently understood and are actively discussed in the literature.We carried out biochemical studies of rat skin in order to study the effect of polylactic acid on markers of skin inflammation. To assess the condition of the skin of rats, after the administration of the studied drugs, the following was determined:• marker of inflammation - the activity of neutrophilic elastase;• factor of the state of cell membranes - the activity of lysosomal acid phosphatase;• the state of nonspecific antimicrobial protection - the activity of lysozyme.The conducted study allows us to conclude about the relative safety of preparations based on polylactic acid, the subdermal administration of which after 60 days shows minor signs of inflammation and practically does not affect the nonspecific antimicrobial protection of the skin of laboratory rats.

Background. In cosmetology clinics, combinations of techniques are used, so quite often thread lifting is combined with hyaluronic acid injections. In this regard, in order to increase the efficiency and simplify the thread lifting procedure, Aptos developed yarns from a copolymer of L-lactide with ε-caprolactone (poly-L-lactic acid) coated with hyaluronic acid. The purpose of the study: comparison in a long experiment of the effectiveness of the use of filaments based on PLA and PLA HA. Materials and methods. An experimental study was conducted on a pig 4 months., weight 40 kg. 5 threads were implanted on each side of the animal. The operation went without complications. After installation of the threads, skin with subcutaneous fatty tissue was taken for histological examination at the following implantation periods: 14 days, 30 days, 60 days, 90 days, 1 year. Tissue fragments were fixed in neutral 10% formalin; standard histological processing was performed. Sections were stained with: hematoxylin – eosin; according to the Weigert- Van Gieson method; Sirius Red coloring. Micrographs included: an assessment of the inflammatory response, an assessment of the cellular composition, an assessment of collagen and elastic fibers, the identification of the percentage of collagen types, the thickness of the implanted threads. Results. When comparing PLA and PLA HA materials, we can conclude that the latter has a more favorable effect on the skin and subcutaneous fat. The PLA HA material stimulated the formation of elastic fibers largely, especially intensively: in the subcutaneous fatty tissue during the first 2 months; in the skin starting from half of the first month to 3 months. In addition, PLA HA material had a higher percentage of type I and type III collagen at all withdrawal periods. When using this material, collagen fibers were produced at an earlier date and in larger quantities. Conclusions. Based on histological examination, the effectiveness of the use of lifting threads coated with hyaluronic acid has been proved. Moreover, hyaluronic acid did not have any effect on the filament from PLA. The dynamics of the thickness of the thread without HA and with HA was completely repeated.

Many adverse factors including irrational nutrition influence human body. Aim. To study the influence of insufficient consumption of vegetables and fruits on skin state and overall health of 197 males have been examined by questionnaires, clinical examination, ultrasound, biomicroscopic, microbiological, methods. Methods and results. It has been established that low consumption of vegetables and fruits led to deterioration of skin state, blood circulation and microcirculation, violations of microflora of skin, oropharynx, stool. Conclusion. Low consumption of vegetables and fruits can be considered as one of the signs of irrational nutrition and one of the risk factors of accelerated aging of males body in general and skin in particular.

Atopic dermatitis (AD) is one of the most common dermatoses with a complex multifactorial pathogenesis including genetic predisposition, epidermal dysfunction, immune dysregulation, and disruption of the skin microbial landscape. The clinical picture of AD is characterized by age-related dynamics with changes in the morphology and localization of the skin rash; there are infantile, childhood, and adult stages of dermatosis. In recent years, the term «senile AD» has also been discussed for patients aged 60 and older. This form of the disease is supposed to have a number of features of pathogenesis and clinical manifestations due to age-related skin involution and aging of the body as a whole, which requires correction of traditional approaches to diagnosis and therapy of the disease. The presented review systematizes the data on epidemiology, pathogenesis, clinical manifestations and treatment of AD in elderly and senile patients. The analysis of the literature revealed that the epidemiological data on the incidence of AD in elderly and senile patients are solitary and contradictory. The peculiarities of the pathogenesis of this form of dermatosis are synergistic changes in the skin barrier and immune function, which leads to a more severe course of dermatosis. The contribution to the pathogenesis and character of the course of AD of somatic diseases characteristic of the aged over 60 and the therapy patients receive for these comorbidities, as well as the peculiarities of the lifestyle of the elderly and irrational skin care are discussed. There are few data on the specifics of treatment of elderly and senile patients with AD; in severe forms of dermatosis, low-dose dupilumab and methotrexate are suggested as the systemic therapy of choice.

It seems that safety of the impact of the UVA on the skin is associated with insidious identifying of early manifestation of damage and distant consequences of impact on the skin and the whole organism. The imagination of safety of UVA exposure has led to wide spread of radiator of UV rays of range A. This scientific research was devoted to identifying of positive and negative impact of UVA on the skin. The aim of the study was to investigate the morphological and functional state of the guinea pigs' skin under the influence of local fractional UVA radiation. Materials and methods. Studies were conducted on albino guinea pigs that weight 300-350 g. The local fractional regime of exposure was obtained by UV radiator OUFK-03, which generates mainly UVA radiation with the aim of creating the model of exposure in the most similar to real conditions. The shaved area (2x2 cm) of animals' skin (n=6) was exposed for 30 minutes for 5 days. Guinea pigs were located in a distance of 10 centimeters from the source of exposure. Experiments with animals were finished on the 6-th day after exposure. All animals were deduced from the experiment with the help of general anesthesia keeping the principles of bioethics with the aim of investigation of peculiarities of morphological changes of skin. Visible changes in the morphological and functional state of the skin were detected on the 6-th day after irradiation: signs of acute inflammation and a tendency to chronicity of the process, multiple, compared with normal, thickening of the epidermis, degenerative changes in epidermocytes, hyper- and parakeratosis, focal destructive changes in connective tissue fibers in the dermis, which are accompanied by reactive inflammatory processes. Signs of starting reparative processes in proliferative form of functional active fibroblasts and increasing of collagenogenesis at sites of damage of collagen and elastin fibers are market simultaneously. It is considered that the negative effects of UVA in studied regime on the skin, the task of developing of depending actions is to reduce negative UVA impact which will be the aim of our next researches.

The aim of this work was to examine the content of p23 in fibroblasts of human dermis from 20 weeks of pregnancy until 85 years old, and defining of a role of p23 in age-dependent changes in the number and proliferation of fibroblasts in the dermis. p23, proliferating cells nuclear antigen (PCNA), fibroblasts marker vimentin were detected with indirect immunohistochemical technique. Results showed that portion of fibroblasts with positive staining for p23 in the dermis is gradually increased from 20 weeks of pregnancy until 85 years old. Age-related increase in a portion of fibroblasts with positive staining for p23 is significantly correlated with an age-related decrease in total number and percent of PCNA positive fibroblasts in human dermis. Age-related increase in the content of p23 in fibroblasts is involved in an age-dependent decrease in their total number and proliferation in the dermis.

The purpose of the work is to assess changes in the functional state of the microvasculature, study of the features of the morphological parameters of the skin by non-invasive research methods for various morphotypes of aging. The study involved 55 patients with involutional changes in the lower third of the face aged 35 to 65 years, included according with the inclusion and exclusion criteria. 4 morphotypes of aging were identified, depending on which patients were divided into corresponding groups: 1st - 19 patients with deformational type, 2nd - 17 with tired type, 3rd - 8 with fine wrinkled type, 4th - 11 with mixed morphotype of aging. To study the condition of the patients' skin, laser Doppler flowmetry and ultrasound examination of the skin (22 Mhz) were used. The method of laser Doppler flowmetry revealed significant changes when comparing microcirculation indices and the ultrasound method for examining deformational and fine wrinkled type (p<0,05). In the deformational type and mixed type, a predominantly atonic type of microcirculation was observed (9,42±3,71 and 9,56±2,31 perf. u., respectively), and in fine wrinkled spastic type of microcirculation (7,86±1,6 perf. u.), in the oral morphotype the microcirculation index was within the normal range of 7,86±1,6 perf. u. The data of ultrasound examination of the skin made it possible to reveal in the deformational morphotype of aging high values of the thickness of the epidermis (125,94±27,84 μm), the dermis (1 439±118,11 μm) and the density of the dermis (12±2,59 a. u.) compared with the thickness of the epidermis 85±22,01 μm, the thickness of the dermis (1 130±68,55 μm) and the density of the dermis (7,87±2,1 c. u.) in the fine wrinkled morphotype of aging.

Short peptides are applied for supporting skin function during ageing, because they can permeate the intact stratum corneum of the epidermis and affect the cells of the dermis. Short peptides are part of natural metabolism of cells and many of them have geroprotective properties. In the review we are considering the base sorts of peptides that are used for normalized skin fibroblasts function: matrikines, carnosine, collagen peptides, cytokine and growth factor analogs, defensins, immunoprotective peptides and polyfunctional peptides. Polyfunctional peptides (AcSDKP, KED, AEDG, AED) have geroprotective properties, slow apoptosis and stimulate skin cell proliferation, also increase functional activity of skin fibroblasts, normalize intracellular matrix hemostasis. Polyfunctional peptides are the antioxidants and immunoprotectors and can activate microcirculation in dermis. Peptide regulation of skin function during ageing are the fast-developing and prospective area in molecular gerontology.

The aim of this work was to examine the content of arylhydrocarbon receptor nuclear translocator (ARNT) in fibroblasts of human dermis from 20 weeks of pregnancy until 85 years old, and defining of a role of ARNT in age-dependent changes in the number of fibroblasts in the dermis. ARNT, proliferating cells nuclear antigen (PCNA) were detected with indirect immunohistochemical technique. Results showed that a portion of fibroblasts with positive staining for ARNT in the dermis is decreased from 20 weeks of pregnancy to 40 years old. Percent of ARNT positive fibroblasts in dermis is increased sufficiently since 41 year old until 60-85 years old group. A total number and percent of PCNA positive fibroblasts in dermis decreased with progression of age. Most sufficient age-dependent reduction in a total and PCNA positive number of dermal fibroblast was observed from antenatal until 40 years of life. Age-related changes in the content of ARNT in fibroblasts is not associated with an age-related decrease in total number and percent of PCNA positive fibroblasts the dermis.

The purpose of this study was to conduct a comparative analysis of the effectiveness of isolated and combined use of intradermal injections of bioreparant (hyaluronic acid modified with vitamin C, glutathione and cysteine) and platelet-rich autologous plasma on functional indicators of the face skin of women with signs of 3-rd degree of photoaging. In this study, 120 women with 3-rd degree of photoaging were examined (mean age 34.5±1.54) and divided into 3 groups in accordance with the applied therapy method (isolated and combined use of plasma therapy and bio reparation). The study of the functional parameters of the skin, including corneometry (determination of the degree of epidermal hydration), sebometry (assessment of the sebum regulating function of the epidermis), cutometry (determination of the deformation and elastic properties of the skin), TEWL (determination of the transepidermal water loss level), mexametry (assessment of skin pigmentation) and pH-metry (assessment of the skin acid-base balance) was performed in all examined patients. The obtained results testify to various shifts in functional parameters, caused by the use of various therapeutic approaches. A comparative analysis of the data obtained has provided a basis for concluding that efficacy of the autologous plasma and modified hyaluronic acid combined implementation is significantly higher compared to the isolated application of these methods.

Skin pathology is registered in vast majority of patients with diabetes mellitus (DM). Despite the abundance of publications on dermatological problems in DM, there is still a number of gaps to be discussed in terms of pathophysiological mechanisms. The goal of this review was to assess the mechanisms of development of different skin pathologies under DM. One of the key pathogenic mechanisms of skin lesions in diabetes is hyperglycemia and the effects of the advanced glycation end products, inducing oxidative stress, endothelial dysfunction and inflammation; that in its turn can accelerate the mechanisms of skin aging, the development of diabetic dermopathy and scleredema diabeticorum. Imbalance of growth factors, cytokines and hormones under insulin resistance, is associated with increased proliferation of keratinocytes, fibroblasts and sebocytes, mast cell dysfunction and melanogenesis disorders in acanthosis nigricans, acrochordons, acne and inflammatory dermatitis in diabetic patients. In addition, authors discuss the role of dendritic cells and macrophages dysfunction in impairment of peripheral tolerance and diabetic wounds pathogenesis in patients with DM.

Matrix metalloproteinases (MMPs) mediate the degradation of all types of collagens and other extracellular matrix components (elastin, proteoglycans, and laminin), their synthesis and accumulation play a key role in the hydrolysis of basement membrane. MMPs are involved in a wide range of proteolytic processes in the presence of different physiological and pathological changes, including inflammation, wound healing, angiogenesis, and carcinogenesis., Aim: to study the specific features of MMP-1 and MMP-9 expression in different stages of skin photoaging, in the foci of actinic keratosis and basal cell carcinoma by immunohistochemical examination., Material and Methods: 12 samples of the healthy skin (6 samples of the eyelid skin with Glogau grade II photoaging; 6 ones of eyelid skin with Glogau grades III-IV photoaging) and biopsies from 8 foci of actinic keratosis and from 8 ones of basal cell carcinoma were examined. A positive reaction to MMPs was shown as different brown staining intensity in the cytoplasm of keratinocytes/tumor cells., Results: MMP-1 and MMP-9 expression was recorded in 67% of the histological specimens of the Glogau grade III photoaged skin and in 100% of those of Glogau grade IV. In the foci of actinic keratosis, the expression of MMP-1 was observed in 62.5% of cases and that of MMP-9 was seen in 87.5%. In basal cell carcinoma, the expression of MMP-1 and MMP-9 was detected in all investigated samples., Conclusion: The immunomorphological findings are indicative of the important role of the level of MMP-1 and MMP-9 expression that is associated with the degree of progression of skin photoaging processes. Minimal MMP-1 and MMP-9 expression was recorded even in grades III-IV photoaging and in the foci of actinic keratosis. Intense MMP-1 and MMP-9 expression was detected in malignant skin epithelial neoplasms as different clinicomorphological types of basal cell carcinoma.

The review covers the literature proving that ROS formation in aging overbalances the antioxidant defense system potential of the skin structure (horny layer, epidermis and dermis). It has been shown that ROS are involved in the pathogenesis of inflammatory processes and allergic responses in the skin. The role of ROS and antioxidant systems in the cell-mediated responses associated with the MAP kinase activity in the skin is discussed. Special attention is paid to the ultraviolet irradiation exposure, which accounts for its genotoxic, immunosuppressive and carcinogenic effects on the skin.

Remote results of surgical treatment of patients with aging ptosis of face and neck tissues during 15 years are presented. Results were good there where suggested incisions marking was carried out and for those face and neck skin regions which should be corrected. Unsatisfactory results were received in the cases when wounds edges were sewn by uninterrupted blanket sutures without skin deeper layers fixing.

The obtained results of the study are based on observation of life quality of 98 patients which have undergone traditional and combined operation. The article presents quality life indices of healthy subjects and those operated. Traditionally operated patients were established to have lower quality life indices in 6 years after the operation provided in comparison with healthy subjects. It is explained by not-long lasting cosmetic effect of the face-lifting. Combined cosmetic operation was characterized by considerably higher quality life indices reflecting physical activity as well as social and role-emotional life. These data assure that efficiency of combined operation is higher than a traditional one.

Technical aspects of endoscopic aesthetic interventions, conducted in 65 patients with various signs of early ageing of the face and neck tissues and aesthetic defects in 1996-2005 yrs, are stated. In general four types of endoscopic operations were performed: complete (subperiostal) lifting of forehead, the forehead and middle zone of face lifting, the forehead and face lifting, cervicoplasty, the forehead lifting and the twoplane lifting of face. There were presented possible complications of endoscopic operations, which are less frequent and severe than after performance of open interventions.

The method of performance of combined cosmetic operation in 58 women patients in 1996-2005 yrs. was analyzed. As a primary procedure for rejuvenation the combined operation of the face and neck skin lifting permits to achieve impressive results, prevents the "lateral bend" and hollow eyes formation. In patients with unfavourable consequences of the earlier performed standard face lifting the conduction of combined operation permits to eliminate them effectively.

In the recent years the development of methods of skin revitalization (remodeling)--i.e. of its restoration after damage of any nature (including aging)--attracted the attention of not only cosmetologists and dermatologists, but also of endocrinologists, physiotherapists, surgeons and geriatrists. The skin grows old together with the whole organism, and it is impossible to deter this process only in the skin. Nowadays a series of methods is offered in the esthetic medicine, using embryonic cells, regulatory peptides and placenta suspensions to influence the aging processes both in the skin itself and in the whole organism. This adds to life quality improvement and provides for social adaptation of elderly people.

Information on possible human health-changes associated with stratosphere ozone depletion and amplification factor (% increase of the stick rate by 1% decrease of ozone) values for acute (erythema, keratitis, cataract, immunosuppression) and chronic (skin cancer, cataract) effects of natural UV-radiation was analysed. Amplification factor (AF) values for acute UV-effects increase with degree of ozone depletion. For degrees less than 12.5% they are independent of latitude and equal to 1.9 for erythema, 1.3-1.5 for keratitis, 1.7-2.3 for cataract and 0.9-1.1 for immunosuppression. AF values for incidence of non-melanoma skin cancer are independent of age, higher in males than females, and higher for squamous cell carcinoma, than for basal cell carcinoma. Their optimal estimations for whites equal to 2.7 for basal cell and 4.6 for squamous cell carcinoma. AF values for incidence of cutaneous malignant melanoma range between 1 and 2, for melanoma mortality--between 0.3 and 2. AF values for incidence of cataract range between 0.3 and 1.2 with optimal estimations between 0.6 and 0.8. Prognosis of non-melanoma skin cancer and cataract incidences, melanoma mortality and economic loss for different scenarios of stratosphere ozone depletion are presented.

The author describes a method for layout before cosmetic plasty of the face and neck. Three types of layout are described according to age-associated changes of the female face and neck. Positive effect of this method was achieved in 157 women.