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. 2013 Sep 27:6:221-32.
doi: 10.2147/CCID.S44686. eCollection 2013.

Effect of the sun on visible clinical signs of aging in Caucasian skin

Frederic Flament  1 , Roland Bazin, Sabine Laquieze, Virginie Rubert, Elisa Simonpietri, Bertrand Piot
Affiliations

Effect of the sun on visible clinical signs of aging in Caucasian skin

Frederic Flament et al. Clin Cosmet Investig Dermatol. .

Abstract

Objectives: AGING SIGNS CAN BE CLASSIFIED INTO FOUR MAIN CATEGORIES: wrinkles/texture, lack of firmness of cutaneous tissues (ptosis), vascular disorders, and pigmentation heterogeneities. During a lifetime, skin will change in appearance and structure not only because of chronological and intrinsic processes but also due to several external factors such as gravity, sun and ultraviolet exposure, and high levels of pollution; or lifestyle factors that have important and obvious effects on skin aging, such as diet, tobacco, illness, or stress. The effect of these external factors leads to progressive degradations of tegument that appear with different kinetics. The aim of this study was to clinically quantify the effect of sun exposure on facial aging in terms of the appearance of new specific signs or in terms of increasing the classical signs of aging.

Materials and methods: This study was carried out on 298 Caucasian women from 30 years to 78 years old. The participants were divided into two groups according to their sun exposure history: 157 women were characterized as sun-seeking, and the other 141 were classified as sun-phobic. This division was made possible by dermatologist grading of heliodermal status on the basis of several observations of classic criteria: wrinkles, sagging, pigmentation heterogeneities, vascular disorders, elastosis, and so on. This work was an opportunity to complete clinical photographic tools by adding in our portfolio new scales for signs observed in the two groups. Thus, 22 clinical parameters were investigated by a panel of twelve trained experts to characterize each woman's face regarding standardized photographic scales, and thus describe the aging process.

Results: By calculating statistical correlations between the four clinical clusters (wrinkles/texture, ptosis, vascular disorders, and pigmentation disorders), and real age and apparent age on the one hand and heliodermal status on the other hand, we identified a link between each clinical cluster and aging and the photoaging process. By comparing evaluations of clinical signs between the two groups for each 10-year cluster, we demonstrated that whatever the age, a prevalence of pigmentation disorders for the sun-seeking group (ie, pigmentation) is strongly linked to ultraviolet (UV) exposure. Meanwhile, clinical signs of ptosis are linked more to chronological aging and do not present differences between the two groups, nor, therefore, photoaging. Wrinkles and texture are affected by the two aging processes. Finally, clinical signs of vascular disorders present no evolution with age.

Conclusion: Clinical signs of aging are essentially influenced by extrinsic factors, especially sun exposure. Indeed UV exposure seems to be responsible for 80% of visible facial aging signs.

Keywords: UV; clinical evaluation; photoaging; pigmentation; ptosis; wrinkles.

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Figures

Figure 1
Figure 1
Clinical standardized photographic scale of pigmentation of malar area.
Figure 2
Figure 2
Clinical standardized photographic scale of cheek folds.
Figure 3
Figure 3
Heliodermal status grade (mean ± confidence interval) in each age cluster. All bars are significantly different from the other, with an exception being the comparison marked on the graph. The number of people in each cluster is indicated between the brackets. Abbreviations: yo, years, CI, confidence interval; NS, non significant.
Figure 4
Figure 4
Comparison of wrinkles and relief texture. Mean scores (± CI 95%) for each age cluster between S-S and S-P. Note: *Statistically significant difference. Abbreviations: S-P, sun-phobic; S-S, sun-seeking; CI, confidence interval.
Figure 5
Figure 5
Comparison of ptosis and sagging. Mean scores (± CI 95%) for each age cluster between S-S and S-P. Note: There is no statistically significant difference between S-P and S-S groups. Abbreviations: S-P, sun-phobic; S-S, sun-seeking; CI, confidence interval.
Figure 6
Figure 6
Comparison of pigmentation disorders. Mean scores (± CI 95%) for each age cluster between S-S and S-P. Note: *Statistically significant difference. Abbreviations: S-P, sun-phobic; S-S, sun-seeking; CI, confidence interval.
Figure 7
Figure 7
Comparison of microvascular disorders. Mean scores (± CI 95%) for each age cluster between S-S and S-P. Note: *Statistically significant difference. Abbreviations: S-P, sun-phobic; S-S, sun-seeking; CI, confidence interval.
Figure 8
Figure 8
Difference between apparent and chronological age for the S-S and S-P groups. Notes: *Statistically significant difference between bars. A positive difference means that the person looks older than their age. Abbreviations: S-P, sun-phobic; S-S, sun-seeking; SEM, standard error of the mean.
Figure 9
Figure 9
Percentage of sun damage is predictive of how old a woman looks.
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