Dermatology : Sun Protection/Photoaged Skin/Wrinkles

Topical application of niacinamide (such as in a 2% cream) has a stabilizing effect on epidermal barrier function, seen as a reduction in transepidermal water loss and an improvement in the moisture content of the horny layer, and it may be used as a treatment adjunct in atopic dermatitis. In aging skin, topical application of niacinamide improves the surface structure and pigmentary disorders, smoothes out wrinkles and inhibits photocarcinogenesis.

Cutis 2006 Jan;77(1 Suppl):11-6.

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Int J Dermatol 2005 Mar;44(3):197-202.

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J Cosmet Dermatol 2004 Apr;3(2):88-93

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Niacinamide can be combined with other active ingredients such as DMAE, sodium hyaluronate, benzoyl peroxide, or metronidazole in a customized medication that can be used as anti-wrinkle or anti-aging therapy or to treat acne or rosacea



Randomized, placebo-controlled, double blind study on the clinical efficacy of a cream containing 5% alpha-lipoic acid related to photoageing of facial skin.

Br J Dermatol. 2003 Oct; 149(4): 841-9

Beitner H.
Department of Dermatology, Karolinska Hospital, 17176 Stockholm, Sweden.

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Estrogen Therapy to Prevent or Reverse Skin Aging

Declining estrogen levels are associated with a variety of cutaneous changes, many of which can be reversed or improved by topical or systemic estrogen supplementation. Studies of postmenopausal women indicate that estrogen deprivation is associated with declining dermal collagen content, diminished elasticity and skin strength, loss of moisture in the skin, epidermal thinning, atrophy, fine wrinkling, and impaired wound healing. Keratinocytes, Langerhans' cells, melanocytes, sebaceous glands, collagen content and the synthesis of hyaluronic acid are under hormonal influence. Estrogen may attenuate inflammation in psoriatic lesions. Alone or together with progesterone, estrogen prevents or reverses skin atrophy, dryness and wrinkles associated with chronological or photo-aging. Estrogen and progesterone stimulate proliferation of keratinocytes while estrogen suppresses apoptosis and thus prevents epidermal atrophy. Estrogen maintains skin moisture by increasing acid mucopolysaccharide or hyaluronic acid levels in the dermis, and accelerates cutaneous wound healing.

Low estrogen levels that accompany menopause exacerbate the deleterious effects of both intrinsic and environmental aging. Estrogens clearly have a key role in skin aging homeostasis as evidenced by the accelerated decline in skin appearance seen in the perimenopausal years.

At Yale University School of Medicine, the effects of long-term hormone replacement therapy (HRT) on skin rigidity and wrinkling at 11 facial locations was assessed using the Lemperle scale by a plastic surgeon who was blinded to HRT use. Skin rigidity at the cheek and forehead was measured with a durometer. Demographics including age, race, sun exposure, sunscreen use, tobacco use, and skin type were similar. Rigidity was significantly decreased in HRT users compared to nonusers at both the cheek and forehead. Average wrinkle scores were lower in hormone users than in nonhormone users. The study concluded that long-term postmenopausal HRT users have more elastic skin and less severe wrinkling than women who never used HRT, suggesting that hormone therapy may have cosmetic benefits.

In another study, the dermal collagen of 15 postmenopausal women who had received systemic estrogen replacement was analyzed before and after using a topical 0.01% estrogen treatment. Epithelial and dermal thickness improved after topical estrogen therapy. Facial skin collagen significantly increased after 16 weeks of treatment. Systemic estrogen levels did not significantly increase after topical therapy.

Exp Dermatol. 2004;13 Suppl 4:36-40

Exp Dermatol. 2006 Feb;15(2):83-94

Eur J Obstet Gynecol Reprod Biol. 2006 Jun 22

J Am Acad Dermatol. 2005 Oct;53(4):555-68; quiz 569-72

Fertil Steril. 2005 Aug;84(2):285-8

Am J Clin Dermatol. 2003;4(6):371-8

Am J Clin Dermatol. 2001;2(3):143-50

J Dermatol Sci. 2005 Apr;38(1):1-7

In the following study, the effects of topical 0.01% estradiol and 0.3% estriol compounds were measured in preclimacteric women with skin aging symptoms. After treatment for 6 months, elasticity and firmness of the skin had markedly improved; wrinkle depth and pore sizes had decreased by 61 to 100%; skin moisture had increased; and wrinkle depth decreased significantly.

Int J Dermatol 1996 Sep;35(9):669-74
Treatment of skin aging with topical estrogens.

Schmidt JB, Binder M, Demschik G, Bieglmayer C, Reiner A.
Department of Dermatology, University of Vienna Medical School, Austria.

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A low-dose, topical gel form of diclofenac sodium has been developed in Europe for pain relief and reduction of redness after sunburn.

Eur J Dermatol. 2004 Jul-Aug;14(4):238-46
The efficacy and safety of low-dose diclofenac sodium 0.1% gel for the symptomatic relief of pain and erythema associated with superficial natural sunburn.

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