title: Perioral wrinkles: histologic differences between men and women.
abstract: BACKGROUND
  Women tend to develop more and deeper wrinkles in the perioral region than men. Although much is known about the complex mechanisms involved in skin aging, previous studies have described histologic differences between men and women with respect to skin aging only incidentally and have not investigated the perioral region.
  
  
  OBJECTIVE
  The purpose of this study was to investigate gender-specific differences in the perioral skin.
  
  
  METHODS
  To determine wrinkle severity, skin surface replicas of the upper lip region in 10 male and 10 female fresh cadavers were analyzed by using the dermaTOP blue three-dimensional digitizing system (Breuckmann, Meersburg, Germany). In 30 fresh male and female cadavers, three full-thickness lip resections were investigated in a blinded fashion for specific histologic features. All results were statistically analyzed in a linear regression model with SPSS software (version 15.0; SPSS, Chicago, IL).
  
  
  RESULTS
  The female replicas showed more and deeper wrinkles than the male replicas (P < .01). Histologic analysis revealed that the perioral skin of men displayed a significantly higher number of sebaceous glands (P = .000; 95% confidence interval [CI] 23.6-53.2), sweat glands (P = .002; 95% CI 2.1-8.1), and a higher ratio between vessel area and connective tissue area in the dermis (P = .009; 95% CI 0.003-0.021). The amount of hair follicles did not significantly differ between men and women, although the average number of sebaceous glands per hair follicle was greater in men (P = .002; 95% CI 0.33-1.28).
  
  
  CONCLUSIONS
  Women exhibit more and deeper wrinkles in the perioral region and their skin contains a significantly smaller number of appendages than men, which could be a feasible explanation for why women are more susceptible to development of perioral wrinkles.
authors: Department of Plastic, Reconstructive and Hand Surgery, University Medical Center, Utrecht, The Netherlands.
authors: Emma C
authors: EC
authors: Paes
authors: Hans J L J M
authors: HJ
authors: Teepen
authors: Willemijn A
authors: WA
authors: Koop
authors: Moshe
authors: M
authors: Kon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000706:statistics & numerical data; D002102:Cadaver; D005260:Female; D018859:Hair Follicle / Q000473:pathology; D006801:Humans; D008046:Lip / Q000033:anatomy & histology / Q000473:pathology* / Q000502:physiology; D008297:Male; D008488:Medical Illustration; D012044:Regression Analysis; D012307:Risk Factors; D012627:Sebaceous Glands / Q000473:pathology; D012727:Sex Characteristics; D012737:Sex Factors; D015595:Skin Aging / Q000473:pathology*; D013545:Sweat Glands / Q000473:pathology