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

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. 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.