The efficacy of glycolic acid for treating wrinkles: analysis using newly developed facial imaging systems equipped with fluorescent illumination.

The clinical characteristics of photodamaged skin, such as coarse and fine wrinkling, can not be quantitatively evaluated from ordinary photographic records. The purpose of this study was to assess the efficacy of glycolic acid (GA) peeling on facial wrinkling, using computer assisted image analysis. This was accomplished with reproducible imaging techniques, which allowed precise repositioning of the subject's face in front of the camera. Two parameters, the change in wrinkle number and the change in wrinkle length were assessed. Although the clinical improvement of wrinkles correlated with both parameters, wrinkle length more precisely reflected the degree of clinical wrinkles, because the wrinkle number appeared to increase as some shallow wrinkles divided into multiple smaller wrinkles during their improvement. Comparison of responses by different age groups showed that the reduction of total wrinkle length was observed in the order of: 50s>30s and 40s>60s>over 70>under 30. The lack of response by subjects over 70 might be due to the nature of their wrinkles being mainly coarse wrinkles rather than fine ones. We next compared the effect of GA by concentration (35, 50 or 70%), but found no significant differences. As the concentration of GA used for treatment was determined by each subject's erythema reaction, our present result suggests that erythema elicited by GA correlates with improvement of wrinkles and that these two phenomena can be induced by a common pathway of GA treatment. This quantitative analysis clearly shows the efficacy and limitation of GA treatment of wrinkles, and might help to disclose the precise mechanisms of GA effects on the skin structure and function.