N° 3 - Salute per tutti

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G. Calabrò, E. Fiammenghi, V. Lo Conte, S. La Bella, F. Ayala
ageing like a progressive atrophy of derma of
ipoderma and of the structures of support. 3
Extrinsic factors are mainly UV radiation,
which is a major cause of skin ageing 4 and also
of actinic keratoses, skin carcinomas and melanomas.
The primary environmental factor that
causes human skin aging is UV irradiation from
the sun. This sun-induced skin aging (photoaging),
like chronological aging, is a cumulative
process. However, unlike chronological aging,
which depends on the passage of time per se,
photoaging depends primarily on the degree of
sun exposure and skin pigment. 5 Therefore, the
most appropriate treatments may then be offered
to the patient. This comprehensive approach
to care requires knowledge of the mechanisms
of skin ageing and the advantages and
drawbacks of the different therapeutic approaches
available, in order to arrive at the best therapeutic
strategy and to meet patient expectations.
The use of chemical peeling agent, laser
resurfacing or topical retinoids can reverse same
of the signs of photoaging. Chemical peeling
continues to be the gold standard in cosmetic
2, 6, 7, 8
enhancement of facial skin. The word ‘p e e l s’
covers several kinds of treatment that, by application
of a chemical agent, causes destruction
of a part of entire epidermidis, with or without
the dermis, leading to exfoliation and removal
of superficial lesions, followed by regeneration
of new epidermal and dermal tissue. These are
classified as superficial, medium-depth or deep
peels. 9 The level of penetration, destruction and
inflammations determines the level of peeling.
All types of peels may produce mild irritation or
predispose to herpes infection. The agents most
often used for superficial peels are the alphahydroxy
acids, such as glycolic, lactic, malic,
tartaric, citric and salicylic acids. They are
widely used of their exfoliating and rejuvenating
effect on photo-aged skin. Although the
literature is replete with the use of alphahydroxy
acids, there is dearth of published data
regarding the efficacy and safety of salicylic
used. 10 Salicylic acid is an excellent “keratolitic
agent” because of its exfoliating and rejuvenating
effect on photoaged skin. It is though to
function through solubilisation of intercellular
cement, thereby reducing corneocyte adhesion.
It is a beta-hydroxy acid, an hydroxyl derivative
of benzoic acid and represent a carboxylic
acid attached to an aromatic alcohol, phenol.
Recently, a lipophilic derivative of salicylic acid
known in the literature as 2-hydroxy-5-octa-
Journal of Plastic Dermatology 2008; 4, 3
noyl benzoic acid or !-lipohydroxy acid (!-
LHA) (Figure 1), has been tested as a superficial
peel at concentrations of 5% to 10% LHA TM . 11
Developed by an advanced re s e a rch team, the
L H A T M molecule (lipo-hydroxy-acid) is a lipophilic
derivative of salicylic acid that incorporates a
fatty chain for improved affinity with the epidermis
allowing for faster skin re g e n e r a t i o n .
The aim of the study has been to evaluate the
cosmetic efficacy on ageing skin (chrono- and
photo-damaged) of !-LHA, a new superficial
peeling.
aterial and Methods
M
A total of 20 volunteers women aged
between 45 to 65 years who attended our dermatological
clinic in Naples with marked signs
of chrono and photoaging including presence,
on the face, of fine lines and wrinkles, dry skin
and mottled pigmentation, constituted the
subjects for this study. Before starting therapy,
for all patients, anamnesis was carried out and
the following factors evaluated: age, sex, eventual
pathologies and therapies in progress, photoageing
and chronoaging status and skin
typing according to Fitzpatrick’s classification.
Pregnant and lactating ladies, patients having
known sensitivity to acetylsalicylic acid and
other salicylates (like aspirin), wounds skin and
impracticable photoprotection, and those with
a known keloidal tendency or having active or
past herpes simplex infection, were excluded.
The volunteers applied a solution containing 5
and 10 % salicylic acid derivative, !-lipohydroxy
acid (LHATM , BIOMEDIC LHA-PEEL ® )
(Figure 1) to the face. The face is previously
degreased by scrubbing with a cotton gauze
piece soaked with a solution with absolute ethanol
and acetone (50%/50% v/v).
Figure 1.
Chemical structure of
!-lipohydroxy acid (!-LHA).