title: The role of vitamin C in pushing back the boundaries of skin aging: an ultrasonographic approach.
abstract: BACKGROUND
  Imagistic methods stand as modern, non-invasive, and objective means of assessing the impact of topical cutaneous therapies.
  
  
  OBJECTIVE
  This study focuses on the evaluation, by high-frequency ultrasound, of the cutaneous changes induced by topical use of a vitamin C complex at facial level.
  
  
  METHODS
  A vitamin C-based solution/Placebo moisturizer cream was applied at facial level of 60 healthy female subjects according to a predetermined protocol. Ultrasonographic images (Dermascan C, 20 MHz) were taken from zygomatic level initially, at 40 and 60 days after therapy. The following parameters were assessed for every subject: thickness of the epidermis and dermis (mm), the number of low (LEP), medium (MEP), high echogenic pixels (HEP), and the number of LEP in the upper dermis/lower dermis (LEPs/LEPi).
  
  
  RESULTS
  LEP decreased significantly in all age categories during and after therapy, but especially in the first 2 age intervals, up to the age of 50 (P=0.0001). MEP and HEP, pixel categories that quantify protein synthesis also had an age-dependent evolution in the study, increasing significantly in all age categories but most of all in the first age interval (P=0.002). Our ultrasonographic data suggest that collagen synthesis increased significantly after topical vitamin C therapy, and is responsible for the increase in MEP and HEP and consequent decrease of the LEP.
  
  
  CONCLUSIONS
  Our study shows that topically applied vitamin C is highly efficient as a rejuvenation therapy, inducing significant collagen synthesis in all age groups with minimal side effects.
authors.affiliation: Clinic of Dermatology and Allergology, University Clinic Ulm, Ulm, Germany.
authors.forename: Diana
authors.initials: D
authors.lastname: Crisan
authors.affiliation: Clinic of Dermatology and Venereology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Iulia
authors.initials: I
authors.lastname: Roman
authors.affiliation: Clinic of Dermatology and Venereology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Maria
authors.initials: M
authors.lastname: Crisan
authors.affiliation: Clinic of Dermatology and Allergology, University Clinic Ulm, Ulm, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Scharffetter-Kochanek
authors.affiliation: Department of Clinical Imaging Ultrasound, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Radu
authors.initials: R
authors.lastname: Badea
keywords: ascorbic acid; collagen synthesis; rejuvenation; ultrasound