Assessment of Intraday Variations in Skin Indentation Resistance

Abstract

Introduction: Information about the mechanical properties of skin and their changes with age and other conditions is important to help characterize skin physiology and pathological changes. One method to obtain this information is to measure the force required to indent the skin to a specified indentation depth (FORCE). This process measures the tissue’s resistance to indentation or its compressibility and is related to the tissue's elastic modulus. Since such measurements are made in clinical and other settings at various times of day (TOD), it is useful to estimate the extent of intraday variations in FORCE that may be expected. This report focuses on this issue. Method: FORCE was self-measured on the volar forearm, 5 cm distal to the antecubital fossa, every two hours from 08:00 to 24:00 hours on two consecutive days by 12 medical students (six females and six males) who were trained in the measurement process using an indentation device (SkinFibroMeter). Variability in FORCE versus TOD was analyzed using the nonparametric Friedman test and differences between genders by the nonparametric Wilcoxon test. Differences between the first day (day 1) and the second day (day 2) were tested at each TOD. The whole-body fat percentage (FAT%) and water percentage (H 2 O%) were determined for each participant via bioimpedance measurements at 50 KHz. Results: The age and BMI of the combined group (mean ± SD) were 24.5 ± 1.5 years and 23.2 ± 3.3 kg/m 2. The overall average FORCE (mean ± SD) for the day over the 16 hours was 84.1 ± 22.7 mN and for day 2, it was 83.4 ± 28.5 mN with no significant difference between day 1 and day 2. For females, the overall two-day average FORCE (mean ± SD) over the 16 hours was 81.8 ± 20.3 mN and for males, it was 85.7 ± 30.1 mN with no significant difference between them (p = 0.271). Overall, there was no statistically significant difference in FORCE among TOD (p = 0.568). FORCE was not correlated with either FAT%, HTO%, or BMI. Conclusion: The findings indicate no statistically significant variation in indentation force in females, males, or combined concerning the TOD of the measurement or differences between consecutive days at corresponding times. This suggests that whether such measurements are done in a research setting or within a clinic, they can be done at various TOD with minimal expected variation for a given subject. However, an extension of these findings to persons with skin conditions or ages not herein evaluated must await further study.