Reversal of photodamage with topical growth factors: a pilot study.
BACKGROUND
Interest in the reversal of facial photodamage has increased significantly among patients and physicians in the past decade. Though surgical procedures may be very effective, the associated healing time and potential risks have spurred the development of non-surgical treatments. There has also been an increasing depth of knowledge regarding wound healing and its control by growth factors as well as its modulation by the topical application of growth factors. Bioengineered tissue cultures have resulted in the ability to collect naturally occurring human growth factors in their tissue concentrations.


OBJECTIVE
The objective of this study is to determine if the twice daily application of a combination of multiple growth factors to photodamaged facial skin results in any evidence of improvement after 60 days.


METHODS
Fourteen patients applied a gel containing a mixture of eight different growth factors (Nouricel-MD) to photodamaged facial skin twice daily. Prior to the study and at days there were clinical evaluations of photodamage (Fitzpatrick scale), 3 mm punch biopsies and optical profilometry. Patient questionnaires were answered at 60 days.


RESULTS
Eleven of 14 patients showed clinical improvement in at least one facial area. The peri-orbital region showed a statistically significant improvement (p = 0.0003). Optical profilometry showed a statistically significant reduction in Ra measurement (p=0.0075) and shadowing (p=0.02), both indicating a decrease in the depth and number of textural irregularities or fine lines. Biopsies revealed new collagen formation in the Grenz zone (37% increase in thickness) and thickening of the epidermis by 27%. Eight of 14 patients felt their wrinkles were improved, while 12 of 14 felt their skin texture was improved.


CONCLUSIONS
The application of a mixture of topical growth factors may stimulate the repair of facial photodamage resulting in new collagen formation, epidermal thickening and the clinical appearance of smoother skin with less visible wrinkling.
Fitzpatrick
Richard E
RE
Cosmetic Laser Associates, Scripps-XIMED Medical Center, La Jolla, CA 92037, USA. aandrews@dermassociates.com
Rostan
Elizabeth F
EF
D001706:Biopsy; D003094:Collagen / Q000096:biosynthesis; D004817:Epidermis / Q000187:drug effects* / Q000473:pathology*; D006133:Growth Substances / Q000627:therapeutic use*; D006801:Humans; D009824:Ointments; D017060:Patient Satisfaction; D010865:Pilot Projects; D015595:Skin Aging / Q000187:drug effects* / Q000473:pathology*; D013472:Sunlight / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D006133:Growth Substances; D009824:Ointments; D003094:Collagen