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ABSTRACT Background Objectives Materials and Methods Results Conclusion Dermal fillers have gained widespread popularity for facial cosmetic enhancement and anti‐aging treatments. Recently, polycaprolactone (PCL) and polynucleotides (PN) fillers have emerged as promising options owing to their safety and long‐lasting effects.This study aimed to compare the efficacy and safety of a novel PCL‐based dermal filler (DLMR01) with purified PN filler (RJR: Rejuran) in correcting crow's feet wrinkles.A randomized, evaluator‐blinded, prospective split‐face study was conducted with 218 healthy Asian participants. The primary outcome was in the improvement rate of the Crow's Feet Grading Scale (CFGS) at rest after 12 weeks. Secondary outcomes included the improvement rate of the CFGS at expression and rest at earlier time points, changes in CFGS, and the Global Aesthetic Improvement Scale (GAIS) assessment.The results showed that DLMR01 was not inferior to RJR in improving crow's feet wrinkles, with a significantly higher CGFS improvement rate at week 12. Both fillers demonstrated good safety profiles, with mild and tolerable adverse events. No serious adverse events were reported during the study period.DLMR01, a pegylated PCL‐based dermal filler, showed effectiveness and safety in improving wrinkles described as crow's feet. The study suggests that DLMR01 could be a promising option for noninvasive anti‐aging treatments. [ABSTRACT FROM AUTHOR]

Background: Eyelid ptosis is characterized by an inferior displacement of the upper eyelid when the eye assumes its primary position. Besides its aesthetic implications, ptosis can also adversely affect visual acuity. Objective: This study aimed to evaluate the simultaneous administration of IncobotulinumtoxinA (IncoBonTA) and hyaluronic acid effect in eyelid ptosis and ocular rejuvenation. Methods: A novel, non‐surgical technique for eyelid ptosis management involving IncoBonTA and hyaluronic acid the co‐administration within a single syringe, and applied using a cannula. Results: The dual action of IncoBonTA and hyaluronic acid in conjunction with the exact injection sites approaches improves overall aesthetic outcomes but also optimizes the restoration of eyelid functionality in palpebral ptosis. Conclusions: The functional balance achieved among the contributory muscles—primarily the orbicularis oculi (OO) and its antagonists, the frontal muscle and levator palpebrae superioris (LPS), yields to both, cosmetic and functional. [ABSTRACT FROM AUTHOR]

PrabotulinumtoxinA has been identified as an effective agent against crow's feet. Our study, which included Korean patients with moderate to severe crow's feet, was undertaken to compare the efficacy and safety of PrabotulinumtoxinA and placebo treatments. Of the 90 study participants, 60 received prabotulinumtoxinA (24 U), whereas 30 received a placebo. The primary outcome assessment included facial wrinkle grading by investigators. At week 4, 69.64% of patients in the prabotulinumtoxinA group exhibited minimal crow's feet severity; in contrast, a 0% improvement was observed in the placebo group (p < 0.0001). At week 12, the improvement rates were 30.36% for prabotulinumtoxinA and 6.90% for the placebo, demonstrating a significant difference (p = 0.0152). Based on the independent review panel's assessment at week 4, the improvement rate was 39.29% in the prabotulinumtoxinA group and 3.45% in the placebo group during maximum smiling. Additionally, patient satisfaction was notably higher in the prabotulinumtoxinA group (32.14%) than in the placebo group (10.34%) at week 4 (p = 0.0289). Both treatments displayed comparable safety profiles, with only mild local reactions reported as ADRs for one patient from the prabotulinumtoxinA group. Thus, prabotulinumtoxinA demonstrates significant potential as a potent and safe remedy for crow's feet. [ABSTRACT FROM AUTHOR]

Background: The safety and efficacy of botulinum neurotoxin type A (BoNTA) treatments are well established, but injection techniques, target muscles, and toxin doses continue to evolve, with each refinement producing improvements in treatment outcomes. The recommendations in this consensus move away from standard templates and illustrate how to tailor treatments to individual patterns and strengths of muscle activity, and patient preferences. Methods: Seventeen experts in the fields of plastic surgery, dermatology, ophthalmology, otorhinolaryngology, and neurology convened in 2022 to develop consensus‐based recommendations for the use of botulinum toxin A for the treatment of horizontal forehead lines, glabellar frown lines, and crow's feet lines that reflect current clinical practice. The focus was on how to tailor injections to individual patients to optimize treatment outcomes. Results: For each upper face indication, consensus members describe how to perform a dynamic assessment to optimize the dose and injection technique for each patient. A tailored treatment protocol is presented for commonly observed patterns of dynamic lines. Units of Inco are defined and the precise location of injection points, illustrated with the use of anatomical images. Conclusion: This consensus provides up‐to‐date recommendations on the tailored treatment of upper facial lines based on the latest research and collective clinical experience of the expert injectors. Optimal outcomes require thorough patient evaluation, both at rest and during animation, using both visual and tactile cues; detailed understanding of facial muscular anatomy and how opposing muscles interact; and use of a BoNTA with high precision to target identified zones of excess muscle activity. [ABSTRACT FROM AUTHOR]

Background: Carboxytherapy is one of the most popular procedures used in dermatology. The treatments are known to be minimally invasive and highly effective for various skin disorders. Therefore, the research carried out in the paper is purposeful and addresses an important area of aesthetic therapies. Aims: Objective, apparatus‐based assessment of the effect of carboxytherapy on skin elasticity around the eyes. Patients/Methods: The study included a group of 39 Caucasian individuals aged 35–55 years. Participants were subjected to a series of five carboxytherapy treatments of eye area at weekly intervals. The Cutometer measuring probe was used to assess skin elasticity. Additionally, photographic documentation was out using the Fotomedicus system. Results: In this study, statistically significant increase in R2 parameter was found as the result of applied treatment. This parameter is considered to be the most important indicator of changes in skin elasticity. In 29 out of 39 subjects, the carboxytherapy treatment significantly improved skin tension and elasticity. Such therapy may also exert a beneficial effect on flexibility since in 28 participants the favorable change in the R7 parameter was visible. Conclusions: The objective analysis of the impact of carboxytherapy treatment on parameters determining skin elasticity revealed that this therapy can be used as an anti‐aging method in the eye area. Obtained results are in agreement with other biochemical, histological, and photographical documentation analyses of the effect of carboxytherapy on skin, performed by independent researchers. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to determine the width of the fibers that extend from the orbicularis oculi muscle (OOc) to the upper lip, and the lateral and inferior lengths of the OOc at the lateral canthus level. Methods: The OOc was investigated in the 40 hemifaces of 20 Korean cadavers. The lateral fibers of the OOc (OOc lat) were traced to determine whether or not these fibers extended to the upper lip. Results: The OOc lat extended to the upper lip at the lateral canthus level in 31 of the 40 specimens (77.5%), whereas some inferolateral fibers of the OOc that extended to the upper lip were observed near the level of the lower margin of the OOc in the other 9 specimens (22.5%). The mean ± SD and maximum widths of the OOc lat that extended to the upper lip at the lateral canthus level were 6.9 ± 3.3 mm and 14.3 mm, respectively. Conclusion: The obtained data will be helpful to distinguish the muscles that underly the wrinkles around the lateral canthus for safer and more-efficient BoNT-A treatments for crow's feet. [ABSTRACT FROM AUTHOR]

Crow's feet is one of the signs of skin aging. Many studies regarding skin aging have been carried out in Caucasians, as for Asians, there are different genotypes and phenotypes. Some anti-aging treatments carry a slightly higher risk of side effects and irritation in Asian skin. Currently, the use of topical active peptides for anti-aging, Acetylhexapeptide-3 (AHP-3) and Palmitoyl pentapeptide-4 (PPP-4), has been widely developed. This study aimed to investigate the anti-aging effects of AHP-3 and PPP-4 on the Asian patient with crow's feet. METHODS: This study was a double-blind randomized trial using 21 Indonesian female subjects aged 26 to 55 years for eight weeks and divided into three groups: AHP-3 cream, PPP-4 cream, and placebo. The cream was applied twice daily to the periorbital area. The three groups were assessed using Corneometer, Tewameter, Cutometer, digital photography and Crow's Feet Grading Scale. RESULTS: Based on clinical photos and data, improvements were found in several subjects using AHP-3 and PPP-4. PPP-4 appeared to demonstrate better results when compared to AHP-3 based on data, clinical photos, and self-assessment questionnaire. CONCLUSION: PPP-4 demonstrated better results when compared to AHP-3 and placebo. This initial study provides an opportunity for further study with a more adequate number of samples and duration. [ABSTRACT FROM AUTHOR]

Background: Crow's feet are bilateral orbital wrinkles formed by the orbital portion of the orbicularis oculi muscle, which is the target muscle for botulinum neurotoxin (BoNT) injection. Objectives: This study's aim was to demonstrate a novel BoNT injection guideline by assessing muscle width, thickness, and dynamic features using ultrasonography. Methods: Twenty healthy Korean volunteers (10 men, 10 women; mean age, 25.6) participated. The width, thickness, and dynamic movement of the orbicularis oculi muscle were measured using ultrasonography. Two volunteers were selected to receive BoNT injections. Injections were administered using a novel method with two curved reference lines passing a point 15 mm lateral to the lateral canthus (conventional injection) and a point 5 mm lateral to the lateral margin of the frontal process of zygomatic bone (additional injection). Result: At the lateral canthus level, the distance between the lateral margin of the frontal process and the most lateral margin of the orbicularis oculi muscle was 12.5 ± 1.3 mm. The thickness of the orbicularis oculi muscle at the midpoint of the frontal process, the lateral marginal of the frontal process, and 5 mm lateral to the lateral marginal of the frontal process was 0.7 ± 0.3 mm, 1.1 ± 0.3 mm, and 1.2 ± 0.3 mm, respectively. The crow's feet of the two volunteers began to disappear from day 3 and completely disappeared on day 7 after the injection. Conclusion: The novel injection technique based on the ultrasonographic anatomy resulted in improvements in the appearance of crow's feet. [ABSTRACT FROM AUTHOR]

Background: Dermal fillers are gaining interest for tissue enlargement and skin improvement. Among them, polynucleotides have demonstrated multiple skin beneficial effects. The effects of polynucleotide fillers were objectively evaluated using an Antera 3D camera, subjectively evaluated by participants and investigators. Methods: Thirty subjects with crow's feet were enrolled in the study. The subjects received polynucleotide filler for crow's feet. Crow's feet grading score (CFGS), global esthetic improvement scale (GAIS), and Antera 3D imaging results were evaluated. Results: Twenty-eight subjects (93.3%) completed the study. An improvement in CFGS compared with that at baseline (p < 0.001) was observed 18 weeks after the first injection of polynucleotides. Additionally, at the final visit, there were improvements in wrinkle, texture, pore, depression, and Hb values compared with those at baseline (p < 0.05). However, no significant difference in melanin level was detected between the initial and final visits. Conclusions: Improvements in wrinkles, pores, texture, depression, and Hb level after polynucleotide filler injection were verified by objective and subjective evaluations. To the best of our knowledge, this is the first report on the objective evaluation of polynucleotide fillers in crow's feet using the Antera 3D camera. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Botulinum neurotoxin injections near the lateral canthal rhytids are commonly used in cosmetic settings; however, there is a lack of thorough anatomical knowledge, and an effective way to treat them with accumulating knowledge is needed. The anatomical characteristics concerning the injection of botulinum neurotoxin into the orbicularis oculi muscle were evaluated in this review. Current knowledge on the identification of botulinum neurotoxin injection points from recent anatomical research was assessed. The lateral canthal lines are involved with the orbicularis oculi muscle and nearby anatomical structures, and the injection points can be more precisely defined. The best possible injection sites were provided, and the injection procedure was described. This review proposes evidence for injection sites associated with the surface anatomy of the orbicularis oculi muscles to enhance the effectiveness of easing lateral canthal rhytids. [ABSTRACT FROM AUTHOR]

Crow's feet lines in the lateral canthal region are a common concern among aging patients, initially appearing as dynamic wrinkles during facial expressions and becoming more pronounced with age. Botulinum neurotoxin temporarily paralyzes muscles by inhibiting acetylcholine release, smoothing wrinkles and enhancing skin's youthful appearance. Effective treatment requires tailored approaches considering individual anatomy and muscle activity. Recent cadaveric studies identified the tear trough muscle, emphasizing its role in infraorbital support and aging. Clinically, patients often present medial eye wrinkles after BoNT treatment for crow's feet, prompting exploration of underlying mechanisms and management strategies. Three cases demonstrated that medial BoNT injections in the orbicularis oculi muscle significantly improve medial eye wrinkles and tear trough appearance. The study underscores the importance of understanding muscle hyperactivity and anatomical variations for precise treatment. Enhanced injection techniques targeting specific areas can achieve better outcomes and minimize complications, particularly in culturally sensitive regions where facial expressions are valued. This research highlights the necessity for comprehensive anatomical knowledge and patient-specific treatment strategies to address medial eye wrinkles effectively., (© 2024 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

Botulinum neurotoxin injections near the lateral canthal rhytids are commonly used in cosmetic settings; however, there is a lack of thorough anatomical knowledge, and an effective way to treat them with accumulating knowledge is needed. The anatomical characteristics concerning the injection of botulinum neurotoxin into the orbicularis oculi muscle were evaluated in this review. Current knowledge on the identification of botulinum neurotoxin injection points from recent anatomical research was assessed. The lateral canthal lines are involved with the orbicularis oculi muscle and nearby anatomical structures, and the injection points can be more precisely defined. The best possible injection sites were provided, and the injection procedure was described. This review proposes evidence for injection sites associated with the surface anatomy of the orbicularis oculi muscles to enhance the effectiveness of easing lateral canthal rhytids.

BACKGROUND: AbobotulinumtoxinA (AboBoNT-A; Dysport®; Ipsen, Boulogne-Billancourt, France/Azzalure®; Galderma, Lausanne, Switzerland) is a botulinum neurotoxin type A approved for aesthetic use in the treatment of glabellar lines in adult patients under 65 years in Europe, the United States, and other countries. OBJECTIVE: We sought to analyze current literature on patient satisfaction with aboBoNT-A for upper facial aesthetic indications. METHODS: A systematic review of literature databases (PubMed/MEDLINE, Embase, the Cochrane Library, and Google Scholar) was performed to identify English-language publications reporting on patients with aesthetic indications (including glabellar lines and wrinkles) receiving aboBoNT-A, that assessed patient and/or physician satisfaction with treatment, with no restrictions on comparator studies. Structured data extraction was used to enable inter-study analysis. A post-hoc analysis was also performed to assess patient satisfaction by sex and age, using results from the noninterventional APPEAL study of patients' satisfaction with aboBoNT-A for treating glabellar lines. RESULTS: Overall, 22 original research papers were identified. Patient satisfaction rates for aboBoNT-A treatment were significantly higher versus placebo from two weeks to between three and five months postinjection. At two to three weeks postinjection, patient satisfaction rates were 52% and 99% across studies. In studies with later time points, patient satisfaction rates were 85 to 87 percent at 5 months and between 25 and 100 percent at 6 months post-injection. Physician satisfaction was also high (97%-100%, across three treatments). No notable differences in patient satisfaction by sex or age were observed in the APPEAL study. CONCLUSION: High rates of patient satisfaction have been achieved with aboBoNT-A treatment for upper facial aesthetic indications. Despite the current recommended interval of ≥12 weeks, satisfaction with the aesthetic results of aboBoNT-A therapy is still evident up to 6 months post-injection in some patients. [ABSTRACT FROM AUTHOR]

Background: Wrinkling is a major health problem following excessive sunlight exposure and aging that gives a bad cosmetic appearance and premature aging. These wrinkles will interfere with job selection and social activities. Materials and Methods: This is a surgical cosmetic interventional trial where four patients shared in this new procedure, their ages ranged from 35-70 years with three males and one female. After local anesthesia, a direct diathermy heated needle was applied on wrinkles (two males, one with crow's feet and one with frown lines). While in other two patients, one male and one female, this procedure was carried out for the whole face wrinkles and other aging changes, followed directly by 35% trichloroacetic acid peel. Patients were given topical and systemic antibiotics to be seen after 2 weeks. Then, the patients were given mild topical corticosteroids and avoiding sunlight exposure. Follow up was done after 1, 2, 4 months and four years. Reduction score of wrinkling was assessed as follow: mild (1-25%), moderate (>25-50%), marked (>50-75%) and excellent (>75-100%). Results: There was marked to excellent reduction of wrinkles with general healthy youthful looking of the face and these cosmetic changes continued even many years after the procedure. No complications were seen apart from temporary pigmentation that was observed during the first month and gone overtime. Conclusion: Heat dermabrasion of moderate to severe wrinkling gave marked to excellent results in reduction of wrinkles and gave more youthful healthy appearance to the face. [ABSTRACT FROM AUTHOR]

The demand for non-surgical facial rejuvenation procedures is rising, and they are more popular than ever, with the aesthetic uses of botulinum toxin dramatically changing the landscape of facial rejuvenation. Botulinum toxin is a neurotoxin that works within cholinergic synapses present at neuromuscular endplates, preventing the transmission of neurotransmitters, such as acetylcholine, from nerves to muscles. This interference with nerve impulses leads to the muscles being temporarily weakened (paralysis). Botulinum toxin A was approved by the US Food and Drug Administration (FDA) for use in the glabella in 2002, followed by crow's feet in 2013 and then the forehead in 2017, with other aesthetic uses being classed as off-license. Botulinum toxin A yields good results in carefully selected patients, and a thorough consultation should always take place. Consultations should include management of expectations and the explanation that botulinum toxin A works on dynamic lines, rather than static lines. Treatment areas can be split into the upper face (glabellar, transverse forehead lines and lateral orbicularis oculi); mid face (bunny lines and perioral vertical lip lines); and lower face (masseter hypertrophy, mentalis, platysmal bands and gummy smile). Each patient should be assessed individually to determine individual anatomy, including the size, strength and location of muscles, with doses being adjusted accordingly. [ABSTRACT FROM AUTHOR]

OnabotulinumtoxinA injection can enhance the appearance of the eyes. This study evaluated the lifting effect of onabotulinumtoxinA treatment of the eye area. A retrospective, single-center audit of patients treated for glabellar and crow's feet rhytids was undertaken. Standardized photographs taken before and 2–4 weeks after treatment were assessed. Computer-based measurements were made of the height of the visible superior tarsal plate (STP) and brow (measured from upper eyelid lash edge to eyebrow base) at rest and maximum frown. One hundred patients were included (96 females; mean age: 46.2 ± 8.8 years). Mean onabotulinumtoxinA doses were 14.95 ± 0.61 units (glabella) and 17.83 ± 2.74 units (crow's feet). There were significant post-treatment increases in mean STP height at rest (left side, 0.76 ± 0.99 mm, p =.02; right side, 0.79 ± 0.94 mm, p =.01) and maximum frown (left, 2.25 ± 1.52 mm, p <.0001; right, 1.87 ± 1.34 mm, p <.0001), and mean brow height at rest (left side, 1.54 ± 1.49 mm, p =.0006; right side, 1.47 ± 1.84 mm, p =.0009) and maximum frown (left, 4.37 ± 2.29 mm, p <.0001; right, 4.16 ± 1.88 mm, p <.0001). OnabotulinumtoxinA injection is effective for elevating brow position and increasing STP show. [ABSTRACT FROM AUTHOR]

Background: No data on the clinical results and safety profiles of the polycaprolactone (PCL) ‐based dermal filler for crow's feet correction have been published. Aims: This study was designed to compare the efficacy and safety of a novel PCL‐based dermal filler, DLMR01, with that of RJR, a purified polynucleotide dermal filler. Patients/Methods: A total of 30 subjects with symmetric crow's feet of 2‐4 points on the Crow's Feet Grading Scale (CFGS) were enrolled in this randomized, patient/evaluator‐blinded, split‐face study. Each subject was randomized to receive injections of DLMR01 or RJR in their right or left crow's feet. At 4 and 12 weeks, all participants were evaluated via CFGS, Global Aesthetic Improvement Scale (GAIS), and PRIMOS software system. Results: No significant difference in CFGS, GAIS, and Ra value was detected between DLMR01 side and RJR at 12 weeks (improvement rate in CFGS from baseline at week 12—DLMR01: 48.28% [14/29], RJR: 41.38% [12/29]). Conclusion: The novel PCL‐based dermal filler DLMR01 shows suitable efficacy and safety, widening the selection possibilities for clinicians and patients in the treatment crow's feet. [ABSTRACT FROM AUTHOR]

Objective To explore the application and efficacy of infrabrow incision lift combined with internal fixation technique in periocular rejuvenation. Methods The clinical data of 236 patients underwent infrabrow incision lift combined with internal fixation for periocular rejuvenation were analyzed retrospectively. All patients were divided into two groups, traditional infrabrow incision was performed in 120 patients in the control group and infrabrow incison lift combined with internal fixation was performed in 116 patients in the experimental group. Images were collected by EVA3D camera and the changes of distance between eyebrow peak and palpebral margin were measured. The changes of palpebral fissure width were measured through METLAB software. The changes of crow's feet and wrinkles of upper eyelid were measured by VISIA. Results All 236 patients were followed up from 3 to 12 months. All incisions were stage I healing and no complications such as bleeding, infection or scar hyperplasia occurred. All patients were satisfied with the surgical outcome. The height of eyebrows of experimental group was raised (1.09±1.43) mm, while the control group decreased (4.13±1.19) mm. The difference was statistically significant (P<0.05). Conclusion The application of infrabrow incision lift combined with internal fixation technique has a significant efficacy in periocular rejuvenation. This technique has a wide range of indications, less trauma and scars. The normal physiological structures and functions of eyebrows were not damaged. The eyelid was tightness and the efficacy of blepharoplasty was natural. It is considerable to promotion in clinic. [ABSTRACT FROM AUTHOR]

Background: Placental extract has been mostly used in skin care for cosmetic purposes. However, the use of various placental extracts has been limited due to the lack of established and effective application methods., Objective: In this study, we investigated the antiwrinkle effect of a cream formulation-LNC wrinkle eye cream (LNC-EC)-containing horse placental extract as the main ingredient., Methods: A total of 24 healthy women, aged 37-54 years, with wrinkle grades 1-3, were treated with LNC-EC for 2 weeks. The cream was applied on one-half of the participants' faces, and the results were compared with the untreated half of the face., Results: Visual inspection, using the wrinkle grade standard, showed that the area treated with LNC-EC had a significantly lower wrinkle grade than the untreated area when comparing before and after the application of LNC-EC. In addition, replica analysis showed a significant reduction in both the maximum wrinkle width and the number of wrinkles in the LNC-EC-treated area in comparison to the untreated area before and after the application. These results suggest that LNC-EC has an antiwrinkle effect on the corners of the eyes based on parameters like the maximum wrinkle width and the number of wrinkles., Conclusions: LNC-EC, with horse placental extract as its main ingredient, was shown to be effective in improving wrinkles at the eye corners, presumably due to a reduction in the maximum wrinkle width and the number of wrinkles. Interpretation of the results is limited because this study was conducted only in the intervention group. A randomized controlled trial with a placebo control group is necessary to verify the antiwrinkle effects of horse placental extract., (©Tsuyuko Watanabe, Kentarou Tahara, Eiichi Hirano. Originally published in JMIR Dermatology (http://derma.jmir.org), 15.11.2023.)

Background: Photo‐numeric scales could lack precision and objectivity on evaluating the improvements on wrinkles after a treatment with botulinum toxin type A. The authors suggest a new digital evaluation method to analyze its effectiveness. Objectives: This study aims to investigate retrospectively the effect of intramuscular injection of botulinum toxin type A on skin texture in the lateral peri‐orbital region with a new objective method. Methods: Skin texture roughness (STR) in the lateral peri‐orbital region is evaluated with a multi‐directional light beam by light emitting diodes of different wavelengths (Antera 3D®), before and after injections of 12 units of botulinum toxin type A. The wrinkles and lines deeper than 0.5 mm are filtered to measure accurately skin texture. Results: We observed an improvement of STR in all cases treated with botulinum toxin type A. A significant decrease of STR was recorded as follows: 17.08% (P < .0001) at 4 weeks and 12.14% at 4 months (P = .001). Conclusion: Botulinum toxin type A treatment of crow's feet was able to improve STR. The Antera® device and software are a valuable, objective, easy and reproducible method to assess the effects of the toxin. [ABSTRACT FROM AUTHOR]

Summary: Background: Glycolic acid (GA) chemical peels are a popular treatment for photoaged skin rejuvenation, but retinaldehyde (RAL)‐based cosmetic creams have also demonstrated efficacy in improving photoaging, and are potentially better tolerated than chemical peels. Aims: To compare the efficacy and safety of an antiaging cream containing 0.1% RAL associated with Glycylglycine Oleamide (GGO, Relastide®) and Pre‐tocopheryl®, to GA peels sessions in the treatment of photoaging. Patients and methods: Fifty‐five women with photoaging were randomized in 2 treatment groups: (1) Daily application of the antiaging cream for 8 weeks or (2) Three sequential GA peels (20%, 50%, and 70%), 2‐3 weeks apart. Skin surface texture, length of wrinkles, complexion radiance, and evenness of pigmentation and texture were assessed by profilometry using skin replicas, computer image analysis, and self‐assessment. Results: Efficacy of both treatments was similar in reducing crow's feet wrinkles depth (STm −7.61%, P = .0007 vs −4.34%, P = .0348; P = .3049 intergroup) and volume, crow's feet and periorbital wrinkle length, and number of fine lines and wrinkles at end of treatments. The efficacy of the cream in refining skin texture was superior to the peels (contrast: −5.61%, P = .0025 vs +3.54, P = .08; P intergroup = .0252). The 8‐week treatment with the antiaging cream was well tolerated; adverse events were fewer and of milder intensity than with the peels, (12‐fold lower incidence of physical signs). Conclusion: A dermocosmetic cream containing 0.1% RAL, GGO (Relastide®) and Pre‐tocopheryl® is as effective as 3 sequential GA peels, better tolerated, and is an alternative in the management of photoaged skin. [ABSTRACT FROM AUTHOR]

Background/purpose: This research investigated the ability of shadow analysis (via the Courage + Khazaka Visioline and Image Pro Premiere 9.0 software) to accurately assess the differences in skin topography associated with photo aging. Methods: Analyses were performed on impressions collected from a microfinish comparator scale (GAR Electroforming) as well a series of impressions collected from the crow's feet region of 9 women who represent each point on the Zerweck Crow's Feet classification scale. Analyses were performed using a Courage + Khazaka Visioline VL 650 as well as Image Pro Premiere 9.0 software. Results: Shadow analysis showed an ability to accurately measure the groove depth when measuring impressions collected from grooves of known depth. Several shadow analysis parameters showed a correlation with the expert grader ratings of crow's feet when averaging measurements taken from the North and South directions. The Max Depth parameter in particular showed a strong correlation with the expert grader's ratings which improved when a more sophisticated analysis was performed using Image Pro Premiere. Conclusion: When used properly, shadow analysis is effective at accurately measuring skin surface impressions for differences in skin topography. Shadow analysis is shown to accurately assess the differences across a range of crow's feet severity correlating to a 0-8 grader scale. The Visioline VL 650 is a good tool for this measurement, with room for improvement in analysis which can be achieved through third party image analysis software. [ABSTRACT FROM AUTHOR]