skin aging research & dark skin - summit events
TRANSCRIPT
SKIN AGING RESEARCH & DARK SKIN
Dr Damilola FAJUYIGBE
Scientific & Medical Strategy,
L’Oréal Research & Innovation, Paris
1AA20, November 3rd-5th 2020
SKIN AGING: A MULTIFACTORIAL PROCESS
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1« Age and sun exposure-related widespread genomic blocks of hypomethylation in
nonmalignant skin ». Vandiver AR, IRIZARRY RA, Hansen KD, Garza LA, Li X, Chien AL,
Wang TS, Leung SG, Kang S, Feinberg AP. Genome Biol 2015
2 « Pollution and skin : from epidemiological and mechanistic studies to clinical implications »
Krutmann J, Liu W, Li L, Pan X, Crawford M, Sore G, Seite S. JDS 2014
MECHANISMS
CHRONOLOGICAL AGEING:
➢ Genetic / Phototype
➢ Skin color : a major influence
ENVIRONMENTAL AGEING:
➢ Stress
➢ Tobacco
➢ UVR
➢ Pollution
➢ Chronic diseases and pharmaceutical treatments
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HUMAN POPULATION IS A MOSAIC OF COLOUR
AGING IN DIFFERENT ETHNIC GROUPS
The major change of 20th & 21st century:
• Increase of life expectancy
• Decrease of infectious diseases
• Adaptation to city life
• Adaptation to pollution
• Emergence of lifestyle-related diseases
UVA Rays around the world
World’s Megacities
Lagos
Kinshasa
Johannesburg
POPULATION AGING
UVBUVAVL
Keratinocyte
Melanocyte
SebocyteEndodelial cellsFibroblast
Passeron T, Picardo M. Melasma a photoaging disorder. Pigment Cell Melanoma Res. 2018 ;31:461-465
SUN
EPIDERMI
S
DERMIS
Photosensitiser
Immunosuppression
Photoaging
DNA Damage
CPD, 6-4PP, 8oxoGua
Inflammation
Protein Oxidation
Loss of function
Gene & Protein Expression
Lipid Peroxidation
Membrane damage
Vitamin D Synthesis
Pigmentation
IR
CONSEQUENCES OF SUN EXPOSURE
STUDY: PHOTOPROTECTION BY CONSTITUTIVE MELANIN IN VIVO
Afr
ican
skin
Caucasia
nskin
Epidermis
DEJ
Dermis
Adapted from Vashi NA, de Castro Maymone MB, Kundu RV. Aging Differences in Ethnic Skin. J Clin
Aesthet Dermatol. 2016;9(1):31-38.
KEY CHARACTERISTICS OF BLACK SKIN AND THE DERMATOLOGICAL IMPLICATIONS
CHARACTERISTIC DERMATOLOGIC IMPLICATIONS
Increased tyrosinase activity leading to increased melanin content
Greater photoprotection, lower incidence of skin cancer, less pronouced photoaging, dyschromias
Larger, nonaggregated melanosomes Greater photoprotection, lower incidence of skin cancer, less pronouced photoaging, dyschromias
Labile melanocytes and slower melanindegradation
Dyschromias
Thick dermis Preserved skin elasticity, less pronoucedphotoaging
Larger, more numerous, multinucleatedfibroblasts
Preserved skin elasticity, greater prevalence of hypertrophic scarring and keloids
Deeper Convolution pattern of the dermal-epidermal junction
Slower and less pronouced photoaging
Important and homogenous distribution of dermal papillae
Slower and less pronouced photoaging
KEY MESSAGES FROM MY EXPERIMENTAL STUDIES
• Greater morbidity and mortality
• Increased rate of metasis
REMEMBER : There are many steps for skin cancer to form and dark phototype is a
spectrum. E.g. For Hispanics, KC is increasing
because of unawareness and late diagnosis.
Immunofluorescence DNA damage (CPD)
MED30 SED
0 SED15 SED
21.1 SED
42.4 SED 60 SED84.8 SED 120 SED
Picture from: Quora
2. There is very little UVR-induced DNA damage at the basal layer of black skin BUT there is damage the upper layers
1. Where there is sunburn, there is DNA damage
3. Skin Cancer & Black Skin
SPT I/II SPT VI
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TOP SKIN COLOUR-RELATED SKIN AGING CONCERNS
ALL AROUND THE WORLD, THE DESIRE IS FOR A SKIN COLOR THAT LOOKS UNIFORM, IS
CONSISTENT AND CLEAR: NO BLOTCHES, MARKS, PATCHES OR DARK CIRCLES, NO AGE SPOT)
L’OREAL RESEARCH & INNOVATION CONSUMER STUDIES
PASSERON ET AL., 2018. “DEVELOPMENT AND VALIDATION OF A MODEL FOR POST-INFLAMMATORY HYPERPIGMENTATION.” PIGMENT CELL
MELANOMA RES. [EPUB AHEAD OF PRINT]
SANCHEZ, MR. 2003. “CUTANEOUS DISEASES IN LATINOS.” DERMATOLOGIC CLINICS 21 (4): 689–697.
NOUVEA ET AL., 2016. “SKIN HYPERPIGMENTATION IN INDIAN POPULATION”. INDIAN J. DERMATOL. (5) 487-95.
HIGHLIGHTING TOP CONCERNS IN AGING FOR DARK SKIN
Skin Aging In Dark Skin Differs Dramatically From Skin Aging In Caucasians
Pigmentation heterogeneity
Darkening of convexities/accumulated pigmentation
Sagging of jaw lines, periorbital region
Fine wrinkles
Loss of facial volume
The negative perception of open pores
IN DARK SKIN POPULATIONS, FACIAL SKIN AGING IS 90% DUE TO ENVIRONMENT:
UVA AND POLLUTION
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SOLAR LIGHT INDUCED PIGMENTATION BY VISIBLE LIGHT AND ULTRAVIOLET A
✓ Visible light induces a hyperpigmentation
in skin type IV to VI by redistribution
✓ No pigmentation in skin type II
✓ Pigmentation more intense and sustained
compared to UVA1 even at lower doses
❑ Lower back of healthy volunteers were
exposed to UVA1 and VL. Pigmentation
was assessed by subjective and
objective methods
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SKIN COLOR HETEROGENEITY
Post inflammatory hyperpigmentation Post inflammatory hyperpigmentation: Pityriasis Rosea
Pigmented spotshttps://drthrowerskincare.com
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BE NEAT AND
PRESENTABLE
BEAUTY IS
HOLISTIC
LOOKING
ATTRACTIVE
NATURAL
BEAUTY
IDEAL BODY SKIN
FRESH BODY & NICE SMELL ALL
DAY LONG
SMOOTH & GLOWING
BODY SKIN
EVEN BODY SKIN TONE &
TEXTURE
MOISTURIZED BODY
IDEAL FACE SKIN
CLEAN FACE
ALL DAY LONG
SMOOTH FACE
EVEN FACIAL SKIN TONEregardless desired skin tone
MATTE FACE
AFRICAN CONSUMERS ASPIRATIONS
A SELF CONFIDENCE
BOOSTER & A SOCIAL
ELEVATOR FACTOR
INTERNAL BEAUTY IS AS
MUCH IMPORTANT AS
EXTERNAL BEAUTY
BEING APPEALING TO
MEN, RETAIN THEIR
HUSBAND
BEING NATURALLY
BEAUTIFUL
14
SKIN COLOR HETEROGENEITY:
FIRST REASON FOR MEDICAL CONSULTATION Prevalence of pigmentary disorders (excluding vitiligo) in skin of color
Davis EC, Callender VD. J Clin Aesthet Dermatol. 2010 Jul;3(7):20-31.
Halder RM, Ethnic skin disorders. J Am Acad Dermatol 2003; 48: 143-8.AA20, November 3rd-5th 2020
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EVALUATION OF SKIN COLOUR DIVERSITY
Standardised evaluation of skin colour : skin colour chart
• Image acquisition by Chromasphere
• Main parameters evaluated: Red/yellow balance and clarity
(lightness/darkness)
• 66 nuances of skin colour identified among 1000 Asian, Caucasian and
African women
Measuring skin colour to define
adapted makeup strategies
de Rigal et al. , Skin Research and Technology 2007; 13: 101–109
L Caisey et al. International Journal of Cosmetic Science, 2006, 28, 427–437AA20, November 3rd-5th 2020
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SKIN COLOUR VARIES WITHIN THE SAME ETHNIC GROUP
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FACIAL PIGMENTATION INCREASE AND AGEING
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INDIAN WOMEN ASIAN WOMEN
The pigmentary signs start to appear around 35
years and reach maximum at around 60 years old
The pigmentation of the tear trough
region increases significantly with age
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SKIN COLOR HETEROGENEITY
18
Post-inflammatory pigmentation
Creteil (France)
Europe/
North Africa
Creteil (France)
Caribbean
/Africa
Dakar
(Senegal)
Bamako
(Mali)
% p
ati
en
ts
- Very frequent dyschromias
- More pronounced on dark
phototypes
- France = Africa, role of UV light ?
Comparative study in France and Sub-Saharan Africa
Poli F, Faye O, Ly F, Le Thuaut A. Ann Dermatol
Venereol. 2014 May;141(5):336-45
SKIN BLEACHING IN AFRICA
Scientific paper Country Prevalence
Mahé et al. 1993[2] Mali 25% of women
Wone et al. 2000[3] Senegal67% of women in Dakar in
popular district
Traore et al. 2005[4] Burkina Faso 44.3% in Ouagadougou
Pitche et al. 1997[5] Togo 59% in Lomé
Adebajo, 2002[6] Nigeria 77,3% in Lagos
Prevalence in Africa
[2] Mahé A. Enquête épidémiologique sur l’utilisation cosmétique dépigmentant par les femmes de Bamako (Mali). Ann.Dermatol. Venerol 1993 ; 120(12) :870-3.[3] Wone I, Tal-Dia A, Diallo OF, Badiane M, Touré K, Diallo I. Prévalence de l’utilisation des produits cosmétiques dépigmentant dans deux quartiers à Dakar (Sénégal).
Dakar Med 2000 ; 45:154-7.[4]Traore A, Kadeba JC, Niamba P, Baroo F, Ouedrago L. Use of cutaneous de-pigmenting products by women in two towns in Burkina Faso ; epidemiologic data,
motivations, products and side effects. Int J Dermatol 2005; 44:30-2.[5]Pitche P, Afanou A, Amanga Y, Tchangaï-Walla K. Prévalence des accidents cutanés liés à l’utilisation de cosmétiques dépigmentant chez les femmes à Lomé(Togo).
Cahiers de Santé 1997 ; 7:161-4.[6] Adebajo SB, An epidemiological survey of the use of cosmetic skin lightening cosmetics among traders in Lagos, Nigeria, West Afr J Med. 2002 Jan-Mar;21(1):51-5
THE MOTIVATIONS OF SKIN BLEACHING
• Socio-economical status : symbol ofmodernity, of professional success, of wealth.
• Influence of fashion and models,« attractiveness to men », « to be and feelpretty ».
• Influence of close entourage and relatives
Harsh cleansing perception
Desire of an even skin tone : to reduce post-inflammatory hyperpigmentation, melasma,lentigos, skin aging symptoms etc…
Not only topicals but also IV treatmentsDavids LM, Van Wyk JC, Khumalo NP. Intravenous glutathione for skin lightening: Inadequate safety data, S Afr
Med J. 2016 Jul 6;106(8):782-6.
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AGING IN BLACK SKIN
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Alexis AF, Obioha JO. Ethnicity and Aging Skin. J Drugs Dermatol.
2017 Jun 1;16(6):s77-s80. PMID: 29028856.
Ki67: proliferation marker of basal keratinocytes
Epidermis
Dermis
Papillary fibroblasts involvement
Specific pattern of type VII collagen protein expression involved papillary fibroblasts
subpopulationS.Girardeau et al, Int J Dermatol. 2012
FROM MONOCELLULAR CULTURES TO FULL RECONSTRUCTED SKIN
Model
Results
S.Girardeau et al, Int J Dermatol. 2012
African skin : lower staining of the Basement Membrane ZoneDifferences in intercellular interactions between dermis/epidermis
Collagen IV
Collagen VII
African skin Caucasian skin
Dermal-epidermal junction
IN VIVO SKIN : HISTOLOGY AND PROTEIN IMMUNOSTAINING
In chronically photoexposed dorsal
forearm, significant impairment of all
biomechanical functions was identified,
with complete flattening of rete ridges
and marked depletion of elastic fibers
and fibrillar collagens. We conclude that
in skin of color, both intrinsic aging and
photoaging significantly impact skin
function andcomposition, despite the
additional photoprotective properties of
increased melanin.
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HIGHLIGHTING TOP CONCERNS IN AGING FOR DARK SKIN
Skin Aging In Dark Skin Differs Dramatically From Skin Aging In Caucasians
Pigmentation heterogeneity
Darkening of convexities/accumulated pigmentation
Sagging of jaw lines, periorbital region
Fine wrinkles
The negative perception of open pores
IN DARK SKIN POPULATIONS, FACIAL SKIN AGING IS 90% DUE TO ENVIRONMENT:
UVA AND POLLUTION
25AA20, November 3rd-5th 2020
According to the American Society of Aesthetic Plastic
Surgery, the number of surgical and nonsurgical cosmetic
procedures performed in the United States increased by
more than 30% between 2010 and 2016, with the
percentage of procedures performed in non-Caucasians
(non-white) increasing from 19% to 25%.
Fillers are a big deal!
Dr Bafounta, Hopital Ambroise Paré26AA20, November 3rd-5th 2020
FACIAL SEBORRHEA: AN AGING SIGN
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SEBUM EXCRETION RATE MEASUREMENTS IN FOUR ETHNIC GROUPS
0
20
40
60
80
100
120
140
160
180
Less 31 31 to 40 41 to 50 51 to 60 61 to 70 more 71
0
20
40
60
80
100
120
140
160
180
Less 31 31 to 40 41 to 50 51 to 60 61 to 70 more 71
0
20
40
60
80
100
120
140
160
180
Less 31 31 to 40 41 to 50 51 to 60 61 to 70 more 71
Chinese n=51
Caucasian n=49 Hispanics n=41
African-Americans n=50
Forehead ; Cheeks
0
20
40
60
80
100
120
140
160
180
Less 31 31 to 40 41 to 50 51 to 60 61 to 70 more 71
J de Rigal, S Diridollou, V Holloway, Chicago 2005
Chicago area, Sebumeter
More active sebaceous glands in Afro-Americans
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FACIAL SKIN PORES
• Size, density and skin coverage highly vary according to population skin type
• Plateau with age in most cases and basically reflect self-assessment by subjects, in particular among those with “enlarged
pores”, mostly Indian women.
• Inversely, Chinese women clearly differ from other groups by very low pore density and size
Skin area covered by pores (%)
Facial Skin Pores: a multi-ethnic study. F. Flament, G. Francois, H. Qiu, C. Ye, L. Colomb, T. Hanaya,
D. Batisse, S. Cointereau-Chardon, M. D. G. Seixas, S. E. Dal Belo, R. Bazin
Examination of 2585 women, 18-80y old, between 2009 and 2011, in various locations
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THE SUN IN AFRICA CAUSES BLACK
PEOPLE IN AFRICA TO AGE FASTER
THAN AFRICAN AMERICANS!
AGING FOR BLACK SKIN : SUN EXPOSURE
Evaluation on 260 African American women
living in Chicago and 120 South African women
living in Johannesburg, all aged 18-60 years
old.
400 Standardised clinical photographic images
were taken of face without any make up.
Grading by 14 trained experts against 16
clinical signs on the face and neck
18.1 How concerned are you about preventing or reducing the signs of ageing on your facial skin?Source: Sagaci Research analysis
NET Concerned
NET Not concerned
Somewhat unconcerned
80%
14%
8%
Not concerned at all 6%
Neither concerned nor unconcerned 7%
Somewhat concerned 30%
Extremely concerned 49%
7%
2%
5%
21%
65%
9%
86%
10%
6%
8%
27%
49%
15%
77%
10%
60%
21%
70%
19%
3%
8%
CIV (A)
838KEN (B)
881
NGA (C)
943RSA (D)
917
A, C A, C
B, DB, DD
B B
B, DB, D
A, B A, B, C
ABCD highlights sig. difference at 95%
CONCERNS ABOUT PREVENTING FACIAL AGING SIGNS IN AFRICA
All aging signs; sagging, pigmentation…
HIGHLIGHTING TOP CONCERNS IN AGING FOR DARK SKIN
Skin Aging In Dark Skin Differs Dramatically From Skin Aging In Caucasians
Pigmentation heterogeneity
Darkening of convexities/accumulated pigmentation
Sagging of jaw lines, periorbital region
Fine wrinkles
The negative perception of open pores
IN DARK SKIN POPULATIONS, FACIAL SKIN AGING IS 90% DUE TO ENVIRONMENT:
UVA AND POLLUTION
32SOLUTIONS & STRATEGIES : AVOIDING MALPRACTICES
BY SCIENTIFICALY DRIVEN PREVENTION
Creating new rituals : daily photoprotection
• 8 weeks study conducted during summer 2013 in Washington, USA
• 89 subjects with Fitzpatrick skin types IV-VI (Afro American/Hispanic)
• With mild to moderate uneven skin tone, dark spots, sun-induced pigmentation
and presence of PIH
• Sunscreen SPF30/UVAPF20 vs. SPF60/UVAPF25
Overall facial evaluation by investigator at week 8
- 81 % ↓ intensity of darkness of hyperpigmented macules of the
face
- 59% ↓ number of hyperpigmented macules
- 85% Overall lightening of facial skin
- Lightening of pre-existing facial and hand pigmentary lesions
(solar lentigines, PIH, melasma)
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CLINICAL STUDY OF TOPICAL 5 % VITAMIN C VERSUS 2%
HYDROQUINONE
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• Blind, randomized, paired, half-face comparative clinical study
• 44 African-American female subjects 19 – 61 years
• Twice a day application during 8 weeks :
- half-face: vitamin C 5 % lotion
- half-face : hydroquinone 2 % gel
• Stastistical improvement in both sides of
- skin mottling
- skin complexion
- skin pores
• Excellent skin tolerance
L’Oreal study, poster AAD 2006 – San Francisco
Vitamin C is a skin care ingredient effective in the treatment of uneven
pigmentation and dilated pores in African-American female population
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SOLUTIONS AND STRATEGIES : UV AND MELASMA
AMWC, November 5th-7th 2020
n = 200 New melasma occurrence
with sunscreen 2,7%
Usual cosmetic habits 53%
Well-balanced sunscreens in the prevention of melasma
Daily photoprotection with an effective protection against UVA rays
should be the main routine to prevent hyperpigmentary disorders
Clinical study on 200 pregnant
women with skin types from II to V ,
and clinical melasma
Daily application of a sunscreen SPF
50+ /UVA-PF 28
Lakhdar H, et al. J Eur Acad Dermatol Venereol. 2007;21:738-42.
Seité S, Park SB. J Cosmetics Dermatological Sciences and Applications 2013
In another similar study performed on 217 pregnant women with skin type
III and IV: daily application of a sunscreen product (SPF 50+, UVA-PF 30)
Only 1% of the women developed a melasma.
Dr Florence Poli
35
INVESTIGATIONAL PRODUCTS
Investigational Products ZnO TiO2 FeO
Banana Boat Mineral SPF50+ 4.5% 6.5% 0%
DB Flawless Creator (25N) Light 0% 27% 4.85%
DB Flawless Creator (45W) Medium 0% 18% 13.30%
DB Flawless Creator (85N) Dark 0% 0% 27.25%
High Energy
Visible (400 - 450nm)
Ultraviolet(290 – 400nm)
* DB Flawless Creator 45W not evaluated in the clinical study
Absorption Spectra of investigational products
*Full visible light absorption for products TBD
25N 85N45W
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Better insight in Skin colour diversity and specific skin
aging patterns of dark skin
Decypher skin adaptation to new urban life style
Partnering Clinical expertise with Science in Africa
Building bridges to communicate and support African
dermatology associations
Skin Education campaigns to avert dangerous practices
and safely prevent skin aging
Empower Skin Scientists and dermatologists in Africa
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THANK YOU FOR
YOUR ATTENTION
AA20, November 3rd-5th 2020