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.

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Background The efficacy of interventions that provide long-term relief of genitourinary symptoms of menopause (GSM) has yet to be determined. Objectives To evaluate the efficacy of radiofrequency (RF) and hybrid fractional laser (HFL) treatments for management of menopausal vulvovaginal symptoms. Methods 31 post-menopausal women completed all treatments and at least one follow-up. Outcomes included the Vulvovaginal Symptom Questionnaire (VSQ), Vaginal Laxity Questionnaire (VLQ), laxity measurements via a vaginal biometric analyzer probe, the Urogenital Distress Short Form (UDI-6), Incontinence Impact Questionnaire (IIQ-7), Female Sexual Function Index (FSFI), and gene expression studies. Results Mean VSQ score decreased 2.93 (p=0.0162), 4.07 (p=0.0035) and 4.78 (p=0.0089) among placebo, dual, and HFL groups three months post-treatment and remained decreased by 3.3 (p=0.0215) at six months for dual subjects. FSFI scores increased in the desire domain for placebo and dual groups and in arousal, lubrication, orgasm, satisfaction and pain domains for the HFL group three- and six-months post treatment. An average increase in VLQ score of 1.14 (p=0.0294) was noted at three months and 2.2 (p=0.002) at six months following dual treatment. There was also a mean decrease of 15.3 (p=0.0069) in IIQ-7 score for HFL subjects at three months. Dual, HFL and RF treatments resulted in statistically significant decreases in collagen I, elastin, and lysyl oxidase gene expression. Conclusions Several self-reported improvements were noted, particularly among HFL, dual and placebo groups at three and six-months post-treatment. Interestingly, objective biopsy analysis illustrated decreased gene expression, suggesting that treatments did not stimulate new extracellular matrix production.

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