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Objectives: The skin aging exposome encompasses internal and external factors that contribute to clinical signs of facial aging. Aging skin can be characterized by distinctive features such as wrinkles, lentigines, elastosis, and roughness. Optical coherence tomography (OCT) is capable of noninvasively measuring skin characteristics. This study aimed to assess bilateral features using OCT to explore temporal skin changes among decades and potential changes in facial skin aging based on laterality. Methods: A total of 97 subjects between 20 and 89 years old with Fitzpatrick skin types I to IV were enrolled. VivoSight, a Multi-Beam OCT system intended to gather topographical and histological images of skin, was used to scan the area inferolateral to the lateral canthus, bilaterally. Investigators compared characteristics of skin roughness, attenuation coefficient and blood flow across age groups and based on laterality to determine any differences. Results: Only data from successful OCT scans were used. Seventy subjects, 10 from each specified decade, had successful bilateral scans and were thus included in the analysis. Chronological aging was characterized by significantly decreased dermal attenuation coefficient with increased age. Skin roughness measurements showed trends of increased roughness with age; however, no statistically significant changes were seen between groups. Qualitative differences amongst scans taken on right and left sides of the face showed no significance regarding roughness, density or blood flow at depths ranging from 0.05 to 0.5 mm. Conclusions: OCT is an effective method for evaluating changes in aging skin. Our results illustrate a decline in skin density with chronological age. Additionally, it was illustrated that structural change in the epidermis and dermis does occur, however on a microscopic scale, there are no significant differences based on laterality. OCT holds promise as a noninvasive technique for characterization of aging skin. Its utility and application in the clinical management and treatment of aged skin requires further research; however, the technology has potential to personalize therapies based on objective findings.

Background Historically, common evaluations for photoaging have been subjective analysis; however, recently, investigators have turned to non-invasive devices for more objective evaluation of facial aging. Objectives This study aimed to establish a clinical correlation between the Glogau Photoaging Scale and VISIA-CR Complexion Analysis System. In doing so, decreasing intra- and inter-observer variability when assessing photodamage. Methods One-hundred seventeen subjects between ages 18 and 89 were included. 2D facial photographs were analyzed by three independent reviewers and were assigned Glogau scores. Images were also captured and analyzed using VISIA software. Data was grouped by median Glogau score and compared between groups. Results All groups were statistically different (p < 0.05) for Spots, Wrinkles and Remasked Wrinkles, except for Glogau 1 and 2 for Spots and Remasked Wrinkles. Wrinkles scores were plotted against age, and an exponential regression model was noted to be a better fit (R 2 = 0.5) compared to a linear model (R 2 = 0.47). The same was true for Spots with an exponential (R 2 = 0.36) compared to linear model (R 2 = 0.33). Scores were also evaluated based on sun exposure history, of which there were no significant differences. Conclusions The results illustrate that an imaging system can be used to reliably determine objective scores correlating to Glogau photoaging evaluations. Results also supported that aging more closely resembles an exponential process. Collectively, these findings will prove useful to those hoping to further investigate facial aging and therapeutic options available for facial skin rejuvenation and objectively assessing their outcomes.

Objectives Facial actinic irregularities are frequent targets for noninvasive, energy‐based treatment. These irregularities are multifactorial and driven by both intrinsic factors such as aging, genetics, and hormone exposure, and extrinsic factors, such as UV exposure. Clinically, this photodamage manifests as dyschromic skin disorders like melasma and actinic features such as solar lentigines. Fractionated 1927 nm (f1927 nm) nonablative lasers are suitable for targeting epidermal lesions and have been shown to be effective in resurfacing photoaged skin as well as addressing pigmented lesions without exacerbation. The purpose of this study was to quantify the magnitude and duration of actinic pigment and photodamage response in patients of Fitzpatrick Skin Phototypes (SPT) I–IV who underwent two treatments with a fractionated, nonablative 1927 nm thulium laser (MOXI™, Sciton). Methods The authors conducted an IRB‐approved, single‐center, prospective, nonrandomized study to evaluate the efficacy of f1927 nm nonablative lasers in the treatment of diffuse dyspigmentation and actinic irregularities. Patients underwent two treatments with f1927 nm nonablative laser at a 1‐month interval. F1927 nm treatment and energy parameters included a pulse energy of 15 mJ, density of 15% with 15% coverage, and six total passes. The primary endpoint for this study was pigment response after treatment, measured using the VISIA Skin Imaging and Analysis System (Canfield Scientific). Pigmentary lesions measured and analyzed included spots, UV spots, and brown spots. The Physician's Global Assessment Scale was used by plastic surgeons to provide a subjective clinical assessment of melasma response. Nonparametric testing was used to assess and compare VISIA results across the study period as well as clinician evaluations. A p value ≤ 0.05 was considered statistically significant. Results Twenty‐seven patients underwent two treatments with nonablative, f1927 nm laser in May and June 2022. Ninety‐six percent of patients (n = 26) completed 1‐month follow‐up and 89% of patients (n = 24) completed 3‐month follow‐up. The study cohort was 100% female, with a mean ± SD age of 47.0 ± 11.5 (range: 29–74), and a mean Fitzpatrick SPT of 2.8 (range: I–IV). No serious adverse events were observed during study treatment or follow‐up. Overall, analysis showed statistically significant improvements in dyspigmentation at 1 month and an increase in pigment toward baseline at 3 months. At 1 month, there was a statistically significant decrease in spots (p = 0.002), UV spots (p < 0.001), and brown spots (p < 0.001) compared to baseline. At 3 months, Brown spots remained significantly improved compared to baseline (p = 0.05). Analysis showed 9.9% improvement in pigment on the left (p < 0.0001) and 7.5% improvement in pigment on the right (p < 0.0001) face. Right dyspigmentation remained significantly improved at 3‐month follow‐up (p = 0.02). Subjectively, clinician evaluators' mean Physician's Global Assessment Scale score was 3.4 (p < 0.0001) at ...

Background While validated scales must be created in order to systemically evaluate patients and quantify outcomes of aesthetic hand treatments, scales currently available are limited to analysis of volume loss alone. Objectives The purpose of this study was to develop three validated scales for the assessment of dorsal hand aging that also take into consideration wrinkling and pigmentation. Methods Fifty (50) healthy volunteers (40 females, 10 males) with Fitzpatrick skin types I-IV were recruited, and standard photographs of their left and right dorsal hands were taken with a Nikon D7100 (Nikon; Minato, Tokyo, Japan) camera. Using 25 randomized photographs, eleven Plastic Surgery physicians (three chief residents, six senior residents, and two aesthetic surgery fellows) were trained on the three scales under investigation, as well as the already-validated Merz Hand Grading Scale. The evaluators then viewed the remaining 75 photographs independently and assigned a grade for each of the four scales to each photograph. Interrater variability was calculated for each scale. Results The Kappa score for the Merz Hand Grading Scale was 0.25, indicating fair agreement, 0.40 for wrinkle scale, indicating fair agreement, and 0.48 and 0.46 for the pigmentation density and intensity scales, respectively, indicating moderate agreement (p&lt;0.001). Conclusions The results show that after receiving training, the interrater agreement for the three scales under investigation was similar or slightly higher than that for the Merz Hand Grading Scale. These three photographic classification systems can be used consistently and reliably to characterize multiple signs of dorsal hand aging.