JOURNAL OF COSMETIC SCIENCE 442 contained additional active ingredients). The published results considered in our systematic review included 172 participants in the fi ve studies (18–22) (Table I). All the studies were RCTs that were double-blinded to treatment. Four studies were single groups using “split” protocols for both test and comparator treatments in the same participants. All partici- pants were female of mean age 33.4 years. Three dosage forms were used [two studies used a cream (20–22), two used gels (18,19), and one study used a lipstick (19)]. Two cosmetic outcomes were identifi ed: four studied periorbital wrinkles (three beneath the eyes and four lateral angle) and one lip wrinkles (19). Two studies were unpublished masters thesis lodged in the Thai thesis database, whereas the remainder were full journal articles. QUALITY OF INCLUDED STUDIES For study quality, the risk of biases was mostly low (Table II), but two studies had “some concerns” due to potential bias from unclear randomization. In addition, Lee et al. (18) and Zhang et al. (22) had incomplete data reporting, making it diffi cult to quantitate conclusions. Figure 1. Flow of inclu d ed studies.

Table I Characteristics of th e Included Studies Author Gender (%)age, Mean y Number of samples (intervention: control) Area Type of control Details of treatment Details of outcome Treatment regimen Treatment detail Duration, w Outcome target Measurement tool Point of measure (at w) Ryu et al. (19) Female (100) 23.3 20–50 (25:25) Lip Placebo 0.2% asiaticoside lipstick Apply twice daily 8 Wrinkle color Five-point visual scoring scale Image analysis 0,4,8 Lee et al. (18) Female (100) 46.6 27 (27:27) Periorbital Vehicle 0.1% asiaticoside cream Apply twice daily 12 Wrinkle Visiometer SV 600 0,4,8,12 Tangsumroengwong (20) Female (100) 32 35 (35:35) Periorbital 0.02% tretinoin gel 5% CAa extract gel 0.25 g at bedtime 12 Wrinkle Visioscan VC98 0,4,8,12 RG5VSS Moisture Corneometer Satisfaction AE Tongsrikeaw (21) Female (100) 41.4 25 (25:25) Peri-orbital 5% Pueraria mirifi ca gel 5% CAa extract gel Apply twice daily 12 Wrinkle Visioscan VC98 0,4,8,12 Satisfaction AE RG5VSS Zhang et al. (22) Female (100) 19–71 35 Lateral angleVehicle Centella triterpenes cream® Applied 3x daily 12 Periorbital wrinkling Visioscan VC98 and dermatologist scoring 0,4,8,12 CA: C. asiaticaFTU: , fi ngertip unit (5 mm. of cream from the tip of the index fi nger to the fi rst top joint of the index fi nger). This study defi ned 1 FTU = 0.5 g. of cream. a CA extract was ordered for Chang Kaew Natural Company, Nontaburi, Thailand, containing deionised water 88.25%, allantoin 0.3, g 1.0, propylene glycol 2.0, carbopol 940 0.4, triethanolamine 0.4, aloe vera extract 1.0, cucumber extract 1.0, Centella extract 5.0, Glydant plus 0.2, Emulsogen HCO 040 0.45, shower fragrance, and green coloring. No description of how Centella extract was produced or standardized. EFFICACY AND SAFETY OF CENTELLA ASIATICA 443