The role of vitamin C in pushing back the boundaries of skin aging: an ultrasonographic approach

Diana Crisan,1 Iulia Roman,2 Maria Crisan,2 Karin Scharffetter-Kochanek,1 Radu Badea31Clinic of Dermatology and Allergology, University Clinic Ulm, Ulm, Germany; 2Clinic of Dermatology and Venereology, 3Department of Clinical Imaging Ultrasound, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, RomaniaBackground: 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.Conclusion: 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.Keywords: ascorbic acid, rejuvenation, ultrasound, collagen synthesi