title: The determinants of periorbital skin ageing in participants of a melanoma case-control study in the U.K.
abstract: BACKGROUND
  Skin ageing is said to be caused by multiple factors. The relationship with sun exposure is of particular interest because the detrimental cutaneous effects of the sun may be a strong motivator to sun protection. We report a study of skin ageing in participants of an epidemiological study of melanoma.
  
  
  OBJECTIVE
  To determine the predictors of periorbital cutaneous ageing and whether it could be used as an objective marker of sun exposure.
  
  
  METHODS
  Photographs of the periorbital skin in 1341 participants were graded for wrinkles, degree of vascularity and blotchy pigmentation and the resultant data assessed in relation to reported sun exposure, sunscreen use, body mass index (BMI), smoking and the melanocortin 1 receptor (MC1R) gene status. Data were analysed using proportional odds regression.
  
  
  RESULTS
  Wrinkling was associated with age and heavy smoking. Use of higher sun-protection factor sunscreen was protective (P = 0·01). Age, male sex, MC1R variants ('r', P=0·01; 'R', P=0·02), higher reported daily sun exposure (P=0·02), increased BMI (P=0·01) and smoking (P=0·02) were risk factors for hypervascularity. Blotchy pigmentation was associated with age, male sex, higher education and higher weekday sun exposure (P=0·03). More frequent sunscreen use (P=0·02) and MC1R variants ('r', P=0·03; 'R', P=0·001) were protective.
  
  
  CONCLUSIONS
  Periorbital wrinkling is a poor biomarker of reported sun exposure. Vascularity is a better biomarker as is blotchy pigmentation, the latter in darker-skinned individuals. In summary, male sex, sun exposure, smoking, obesity and MC1R variants were associated with measures of cutaneous ageing. Sunscreen use showed some evidence of being protective.
authors.affiliation: Section of Epidemiology and Biostatistics, Leeds Cancer Research UK. dr.marianosuppa@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Suppa
authors.forename: F
authors.initials: F
authors.lastname: Elliott
authors.forename: J S
authors.initials: JS
authors.lastname: Mikeljevic
authors.forename: Y
authors.initials: Y
authors.lastname: Mukasa
authors.forename: M
authors.initials: M
authors.lastname: Chan
authors.forename: S
authors.initials: S
authors.lastname: Leake
authors.forename: B
authors.initials: B
authors.lastname: Karpavicius
authors.forename: S
authors.initials: S
authors.lastname: Haynes
authors.forename: E
authors.initials: E
authors.lastname: Bakker
authors.forename: K
authors.initials: K
authors.lastname: Peris
authors.forename: J H
authors.initials: JH
authors.lastname: Barrett
authors.forename: D T
authors.initials: DT
authors.lastname: Bishop
authors.forename: J A
authors.initials: JA
authors.lastname: Newton Bishop
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000473:pathology; D015588:Observer Variation; D009915:Orbit; D044102:Receptor, Melanocortin, Type 1 / Q000235:genetics; D012867:Skin / Q000098:blood supply; D015595:Skin Aging / Q000235:genetics / Q000528:radiation effects*; D012878:Skin Neoplasms / Q000473:pathology*; D012880:Skin Pigmentation; D012907:Smoking / Q000009:adverse effects; D013471:Sunburn / Q000473:pathology; D013472:Sunlight / Q000009:adverse effects*
chemical_list: D044102:Receptor, Melanocortin, Type 1