SKIN AGING RESEARCH & DARK SKIN - Summit Events

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

AA20, November 3rd-5th 2020 2

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


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


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


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

12

SKIN COLOR HETEROGENEITY

Post inflammatory hyperpigmentation Post inflammatory hyperpigmentation: Pityriasis Rosea

Pigmented spotshttps://drthrowerskincare.com


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

15

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

16

SKIN COLOUR VARIES WITHIN THE SAME ETHNIC GROUP

AA20, November 3rd-5th 2020

FACIAL PIGMENTATION INCREASE AND AGEING


17

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


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.


19

AGING IN BLACK SKIN


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.







Fine wrinkles



UVA AND POLLUTION


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


27

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


0

20

40

60

80

100

120

140

160

180


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


J de Rigal, S Diridollou, V Holloway, Chicago 2005

Chicago area, Sebumeter

More active sebaceous glands in Afro-Americans


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


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…






Fine wrinkles



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)


33

CLINICAL STUDY OF TOPICAL 5 % VITAMIN C VERSUS 2%

HYDROQUINONE


• 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

34

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


36

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


37

THANK YOU FOR

YOUR ATTENTION


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SKIN AGING RESEARCH & DARK SKIN - Summit Events