Classification of facial wrinkles among Chinese women

It is generally recognized that Caucasians and Asians have different skin aging features. The aim of this study was to develop a facial wrinkle grading scale for Chinese women. Standard photographs were taken of 242 Chinese women. Six sets of 0 to 9 wrinkle scales with reference photographs and descriptions were selected, including grading scales for resting and hyperkinetic crow＇s feet, frontalis lines, glabellar frown lines, and nasolabial folds. To identify the scale by objective quantitative measurement, skin surface measurements from the Visioscan~ VC98 were used. To test the reliability and validity of our wrinkle scale, a multi-rater consensus method was used. A double-blind, randomized, vehicle-controlled 12-week study was conducted to use this clinical photo-score to evaluate the efficacy and safety of Centella triterpenes cream~ in treating crow＇s feet. A newly developed 10-point photographic and descriptive scale emerged from this study. The final atlas of these photographs contained a total of 6 sets with 10 pictures each. From 0 to 9, surface evaluation of smoothness （SEsm） parametric measurements decreased progressively, indicating that the scale increased inversely. Weighted kappa coefficients for intra-assessor were between 0.75-0.87. The overall Kendall＇s coefficient is 0.86 on the first rating and 0.87 on the second rating. Thirty- six volunteers were recruited and 35 subjects completed a 12-week trial. Clinical photo-score by investigator showed a significant difference （P 〈 0.05） between the treatment side and control side after 4 weeks. Use of these scales in clinical settings to evaluate facial wrinkles in Asians individuals is recommended.

The Neglected Importance of Sleep on the Formation and Aggravation of Facial Wrinkles and Their Prevention

The duration of sleep and the position of the face while resting on a pillow have a negative impact on the facial skin appearance and may lead to the formation of sleep wrinkles. Sleep lines occur when there is repetitive, long-term tension on the facial skin, which pushes or pulls the skin in a direction that is perpendicular to the direction of the muscles of the face. These lines tend to be more vertically oriented than expression lines and can be found on the forehead, around the eyebrows, the eyes, the cheeks, the chin, and the nasolabial folds. Our studies revealed that the average reduction of wrinkles in total investigated area of the face (expressed as the density of wrinkle per surface skin) was approximately 12% after 28 days of sleep on a specially-designed pillow. The specially designed anti-wrinkle pillows eliminate the pressure on the cheeks, the eyes and the mouth during sleep. Many such pillows have been designed to reduce the aging process and to encourage users to sleep in specific positions. Evidence supporting the claim that a special pillow prevents wrinkles was presented. Nevertheless, prolonged human studies are required to further elucidate the role of sleeping on appearance of facial wrinkles.

Office-based facial plastics procedures:Neuromodulators

Botulinum toxin is a potent neuromodulator commonly used for cosmetic applications in the clinic.In this article,we reviewed the various formulations of botulinum toxin type A commercially available in the United States,as well as clinical pearls for preprocedural planning,common in-office injections,and management of complications.