2006 ANNUAL SCIENTIFIC MEETING 207 0.25 C: 0.20 .. 0.15 Ql .:.c G 0.10 32 C: � 0.05 0.00 0 Wrinkling 10 20 30 40 50 60 70 80 Age 0.15 C: 0 LL 0.10 Ql 0.05 32 C: ·c: � 0.00 Wrinkling 0 10 20 30 40 50 60 70 80 Age In another cross-sectional survey, we measured facial wrinkling on 900 Caucasian women ages 10-70. Half the subjects lived in London, England and the other half lived in Rome, Italy. The graphs above show the data from that study. On the left, each point is the facial wrinkle measurement for each person in our study. Open circles show the facial wrinkling with smiling. Close circles show facial wrinkling without smiling. The graph at the right shows the best fit curves for these data segmented by city. Note that there was no difference in facial wrinkling at any age between Rome and London women when measured without smiling. However, when the subjects smiled, the Rome women showed significantly more facial wrinkles than the London women. It is not clear why a smiling facial expression increases facial wrinkling more in the women of Rome vs. their Caucasian counterparts in London. As we inspected the hundreds of images of women with smiling and non-smiling expressions, we noticed an interesting trend. For girls, those less than 15 years of age, we generally observed no clinically significant periorbital wrinkling with or without smiling. For the young women, those between about 20 and 35 years of age, most exhibited no clinically significant facial wrinkling with a non-smiling expression but did show some visible wrinkling in the periorbital region when they smiled. For the women over 50 years of age, clinically significant facial wrinkling was generally observed with or without smiling. This leads us to propose a simple 3-stage model for the age-related changes in facial wrinkling. In the first stage, there are no visible facial wrinkles with or without expression. In the second stage there is visible wrinkling only with expression and there is no visible wrinkling without expression. In the third stage, there is visible wrinkling with and without expression (persistent wrinkling). The lessening of facial wrinkling is an important unmet consumer need around the world. Indeed, Botox® Cosmetic was the most popular physician-administered aesthetic procedw-e in the United States from 2001-2005. This muscular new-otoxin from Clostridium botu/inum bacterium reduces the activity of the facial muscles that cause glabellar frown lines between the brows. Some people consciously try to not smile and frown to prevent their facial wrinkles from showing or out of fear the repeated expression will cause permanent facial lines in the future. Clearly then, facial expression should be considered when evaluating the clinical efficacy of topical products aimed at reducing the appearance of facial wrinkles. We therefore conducted a randomized controlled clinical study to measure the acute skin benefits of a facial moisturizer designed to reduce the appearance of facial wrinkling associated with facial expression. Toe study enrolled 19 Caucasian women between the ages of 25 and 45 years. Before product application, each subject's facial wrinkling was measured with and without smiling. The subjects then applied the test product (2 ug/cm2) to both sides of the face and waited 10 minutes. Facial wrinkling was measured again with and without smiling. The graph shows the results of this experiment The treatment had no effect on facial wrinkling without smiling. However, there was a significant and clinically noticeable reduction in facial wrinkling with smiling. Conclwions One of the first clinical signs of skin aging is the facial wrinkling associated with facial expression. The reduction of expression­ induced facial wrinkling was used to demonstrate the efficacy of a facial moistw-izer. Facial expression should be considered in the design of any clinical investigation of facial wrinkling. 0.12 �--------------� E 0.10 u � 0.08 u. ti � 0.06 ( � 0.04 C: � 0.0'l Before Treatment - Non-Smiling Smiling After Treatment 1. Hillebrand G. G., Levine M. J. and Miyamoto, K. 2001. The age-dependent changes in skin condition in African Americans, Caucasians, East Asians, Indian Asians and Latinos. IFSCC Magazine, 4( 4 ), 259-266.