Study

Clinical Evaluation of a Novel

Glycolic Acid/Antioxidant–Based
Antiaging Skin Care Regimen
Jeanine Downie, MD

A novel physician-dispensed glycolic acid/antioxidant–based topical skin care regimen consisting

of an exfoliating facial cleanser, a daily antioxidant facial serum, a night renewal facial cream, and a
revitalizing eye cream was evaluated with regard to its impact on skin surface hydration, fine lines,
and tactile roughness.
This was an open-label, single-center, observer-blinded trial. The study population consisted of
24 women, aged 35 to 55 years, with mild to moderate facial photodamage. Following a 3-day pretrial
conditioning period, subjects used the 4-product topical skin care regimen, as instructed, for 3 weeks.

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Efficacy parameters included periodic dermatologist and expert grader evaluations, skin surface hydra-
tion, and subject self-evaluation. Adverse events, if any, were also recorded.
The mean age of the 24 subjects was 45.4 years; 23 of the 24 subjects (96%) completed the study. As
assessed by both a dermatologist and an expert grader, there were significant reductions versus base-

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line in fine lines, dryness, and tactile roughness approximately 15 minutes after a single application of
2 products from the treatment regimen (the revitalizing eye cream and the daily antioxidant facial
serum). Modest additional improvements were reported by the dermatologist, and significant improve-
ments were reported by the expert grader, after 3 weeks of treatment with all 4 products. Skin surface
hydration measured by electrical conductance also was improved significantly immediately after appli-
cation of 2 of the 4 products and after the 3-week course of treatment. Subject satisfaction, as assessed
by a posttreatment questionnaire, was high, and no adverse events were reported.
This glycolic acid/antioxidant–based 4-product topical regimen is a safe and efficacious option for
patients who want to minimize the signs of photoaging.

O
ur hedonistic impulse to diminish the 2006 Americans spent just under $12.2 billion on cos-
signs of chronologic aging and photoag- metic procedures.1 Of the nearly 11.5 million surgical
ing has fostered a burgeoning cosmetics and nonsurgical procedures performed in the United
industry. According to the American States in 2006, nonsurgical procedures comprised 83%
Society for Aesthetic Plastic Surgery, in of the total.1 Although women continue to be the primary
users (.10.5 million cosmetic procedures), the market
Dr. Downie is Director, Image Dermatology, PC, Montclair, New for cosmetics-related procedures and products is increas-
Jersey, and Assisting Attending, Overlook Hospital, Summit, New ing among men as well as among ethnic minorities.1-3
Jersey, and Mountainside Hospital, New Jersey. Modern antiaging cosmetics go well beyond the simple
Dr. Downie is a consultant, lecturer, and researcher for, and a moisturizing function of traditional antiwrinkle creams.
stockholder of, Allergan, Inc. This study was funded by a grant from They perform complex functions in terms of skin pro-
Allergan, Inc. tection, nourishment, and removal of superficial layers;

168 Cosmetic Dermatology® • march 2008 • Vol. 21 No. 3

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 additionally, incorporation of excipients and controlled- incorporates GLX Technology with regard to its impact on
release carriers (eg, liposomes, nanosomes, etc) into the condition of facial skin during a 3-week period.
antiaging formulations provides for slow release and
long-lasting action.4 Such topical products as cleansers, Materials and Methods
photoprotectants, exfoliators, and moisturizers and emol- Vivité is a physician-dispensed product whose core sys-
lients are available to diminish fine lines and wrinkles, tem includes an exfoliating facial cleanser, a daily anti-
decrease redness, smooth texture, fade discoloration, oxidant facial serum, a night renewal facial cream, and a
and, in general, provide a more youthful appearance. revitalizing eye cream. The functional class of agents and
Functional classes of ingredients contained in these the specific ingredients are included in Table 1.
products include antioxidants, growth factors, peptides,
anti-inflammatories and botanicals, polysaccharides, and Study Design
pigment-lightening agents.4,5 This study, conducted in the late spring and early sum-
Channels of distribution of professional skin care mer of 2006, was an open-label, single-center, observer-
products include retail outlets (department stores, spe- blinded trial. Twenty-four healthy volunteers, aged 35 to
cialty stores, and the Internet), spas and salons, and 55 years, exhibiting mild to moderate facial photodamage
medical care providers and medical spas. Although retail were recruited for participation in this trial. Inclusion
outlets retain a sizeable share of the market, the medical and exclusion criteria are detailed in Table 2. The study
care provider’s share of the market is increasing. With was conducted in accordance with current Good Clinical
the plethora of retail products available and the extent Practices, current Good Laboratory Practices, and the
of unsubstantiated and unregulated claims attesting to COLIPA Guidelines for the Evaluation of the Efficacy of
product efficacy, patients often consult their physicians Cosmetic Products.

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(primarily dermatologists or, if they have undergone
cosmetic procedures, plastic surgeons) to understand Treatment Regimen
and avail themselves of noninvasive cosmetic products Prior to study initiation, all subjects underwent a 3-day
and procedures. An added advantage of using physician- pretrial conditioning period, during which they stopped
dispensed products is that there may be regulatory restric- the use of all moisturizing products on the face. Fol-

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tions (eg, restrictions imposed by the US Food and Drug
Administration) on the concentration of certain ingre-
dients that can be included in over-the-counter (OTC)
products. One such example is a-hydroxy acids (AHAs),
lowing the conditioning period, subjects were given a
skin care regimen comprised of 4 topical products to be
used as directed for a 3-week period: an exfoliating facial
cleanser to be applied once every 3 days in the evening,
which were the first molecules to start the cosmeceuti- an antioxidant facial serum to be applied once daily, a
cal revolution. Two factors determine their efficacy: renewal facial cream to be applied once every night, and
concentration and the pH of the preparation. The active a revitalizing eye cream to be applied twice daily. Subjects
ingredient in the preparation is the free acid, and the pH were allowed to use their current facial cleansers on the
of the preparation determines the proportion of free acid. 4 days of the week when they were not using the exfoliating
According to the Cosmetic Ingredient Review recommen- cleanser, but they were not allowed to use any new cleans-
dations, the concentration of AHAs in OTC cosmetics ers during the study period. Subjects were required not to
cannot exceed 10%, and the pH of the preparation cannot use any other moisturizers or topical medications, toners, or
be less than 3.5.6 Consequently, these OTC preparations astringent products on the face during the study; established
can offer only modest improvement at best. In contrast, makeup regimens could be continued, although subjects
the concentration of AHAs in physician-dispensed prod- were not allowed to change brands of makeup during the
ucts may exceed 10%. study. Subjects were instructed to avoid excessive sun expo-
GLX (glycolic acid/antioxidant) Technology is a propri- sure, and the use of tanning beds was prohibited.
etary technology that is a unique blend of AHAs (glycolic Each subject’s initial morning treatment regimen was
acid and ammonium glycolate) and natural antioxidants. performed at the laboratory under the supervision of
The formula matrix is designed to act as a catalyst for study staff to ensure adherence to the instructions for
penetration of the distinctive blend of AHAs and natural use. In addition, all subjects returned to the laboratory
antioxidants, which enhances the skin’s natural produc- on day 2 as well as on the days of their scheduled week 1
tion of hyaluronic acid and epidermal growth factor, and week 2 assessments and completed their morning
stimulates collagen, and protects epidermal cells. treatment regimens under supervision. Subjects were
This article reports on a study undertaken to evaluate the provided with a diary form to record the times of their
efficacy and tolerability of a novel skin care regimen that product applications.

Vol. 21 No. 3 • march 2008 • Cosmetic Dermatology® 169

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 GLX Antiaging Regimen

Table 1
Components of a Glycolic Acid/Antioxidant–Based
Antiaging Skin Care Regimen

Product Functionality and Constituents

Exfoliating facial Antiaging/exfoliation: glycolic acid, ammonium glycolate, and salicylic acid
cleanser Physical exfoliation: polyethylene spheres
Anti-irritant: sucrose polysoyate, PEG-120 methyl glucose dioleate, and Di-PPG-2 myreth-10 adipate
Humectant: sericin and Cassia angustifolia seed polysaccharide

Daily antioxidant Antiaging actives: glycolic acid, ammonium glycolate, and natural antioxidants
facial serum Antioxidant actives: olive leaf extract, Camellia oleifera leaf extract, and Punica granatum extract
Anti-inflammatory actives: licorice extract, chamomile extract, Aloe barbadensis leaf extract, and
yeast extract
Humectant: glycerin, sodium PCA, urea, trehalose, sodium hyaluronate, phospholipids, butylene gly-
col, Stevia rebaudiana (sweet honey leaf) extract, C angustifolia seed polysaccharide, and mannitol
Emollients: bis-hydroxyethoxypropyl dimethicone, phenyl trimethicone, cyclomethicone, and
dimethiconol

Night renewal
facial cream
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Antiaging: glycolic acid, ammonium glycolate, and natural antioxidants
Skin firming: algae extract
Humectants: glycerin, sodium PCA, urea, trehalose, sodium hyaluronate, pentylene glycol, saccharide
isomerate, and sericin

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Emollients: bis-hydroxyethoxypropyl dimethicone, cyclomethicone, cyclopentasiloxane, dimethi-
cone crosspolymer, octyldodecanol, hydrogenated cocoglycerides, and Irvingia gabonensis kernel
butter (wild mango)
Antioxidant: superoxide dismutase, olive leaf extract, tocopherol, and magnesium ascorbyl phosphate

Revitalizing
Antiaging: glycolic acid, ammonium glycolate, and natural antioxidants
eye cream
Reduce puffiness: caffeine
Tightening: palmitoyl tripeptide-3 and Ceratonia siliqua gum
Interference pearls: titanium dioxide, iron oxides, and silica
Humectants: glycerin, phospholipids, carrageenans (Chondrus crispus), hydrolyzed wheat gluten,
and glucose
Emollients: phenyl trimethicone, cyclomethicone, and dimethiconol

Outcomes Measures moderately visible (3–5), and obvious or very

Efficacy assessments were performed according to the marked (6–8). Visual assessments of skin dryness
schedule summarized in Table 3. were recorded as none (0), mild to moderate flak-
ing or scaling (1–5), and marked to severe scaling or
Dermatologist and Expert fissuring (6–8). Tactile roughness was evaluated in
Grader Evaluations terms of dryness, scaliness, wrinkles, and other surface
Dermatologist (investigator) evaluations and expert irregularities. Tactile roughness was graded as normal
grader (professional with a significant amount of expe- to slight roughness (0–2), moderate roughness (3–5)
rience in cosmeceuticals research) evaluations of skin and severe to extreme roughness (6–8). Discrete lesions,
surface fine lines, dryness, and tactile roughness were such as keratoses, nevi, and comedones, were not
scored qualitatively using 9-point scales. Fine lines or included when assigning grades 6 to 8. Photographs of
superficial wrinkles (ie, shallow indentations or lines) the left side of the face were captured using a Canon
were graded as not visible or slightly visible (0–2), EOS 20D digital camera.

170 Cosmetic Dermatology® • march 2008 • Vol. 21 No. 3

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 GLX Antiaging Regimen

Table 2
Study Inclusion and Exclusion Criteria

Inclusion Criteria Exclusion Criteria

Female, aged 35–55 y, in good general health Pregnant or nursing, or planning a pregnancy during the
study period
Mild to moderate photodamage on the face, as
determined by an expert grader Medical problems or poor general health

No participation in a study involving the face in Eczema, seborrheic dermatitis, psoriasis, or chapped skin
the past 30 d
Use of medications that might interfere with the study results
Willing and able to follow all study directions
Known sensitivities to cosmetics, soaps, moisturizers, etc
Willing to discontinue use of all moisturizing
products on the face 3 d before the first study Known sensitivity to a-hydroxy acid
visit and for the duration of the study Any other condition or factor that in the investigator’s opinion
may affect skin response or the interpretation of results

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Skin Surface Hydration site (suborbital and cheek areas), from which an average
Changes in skin surface hydration were measured utiliz- value for each site was computed.
ing an IBS Skicon-200 Conductance Meter equipped
with a Measurement Technologies probe. The ability of Subject Self-Assessment
an alternating current to flow through the stratum cor- Subjects were asked to complete a 1-page self-assessment

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neum is an indirect measure of stratum corneum water
content.7 For each measurement, a spring-loaded probe
tip was placed at the sample site, and 2 to 3 seconds
later alternating current conductance (expressed in units
questionnaire at the conclusion of the study (week 3).

Adverse Events
Tolerability was assessed 15 minutes postbaseline and
of millimho) was recorded. A total of 5 conductance after 1, 2, and 3 weeks. Subjects were observed as well
measurements at each time point were obtained at each as interviewed at each study visit to confirm tolerability

Table 3
Efficacy Parameters and Timelines for Evaluation

Parameter Timeline
Dermatologist evaluations (skin surface fine lines, dryness, Baseline; 15 min postbaseline; after 3 wk
tactile roughness)

Expert grader evaluations (skin surface fine lines, dryness, Baseline; 15 min postbaseline; after 2 and 3 wk
tactile roughness)

Skin surface hydration (as determined by Baseline; after 1, 2, and 3 wk

conductance measurements)

Subject self-evaluation After 3 wk

Vol. 21 No. 3 • march 2008 • Cosmetic Dermatology® 171

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 GLX Antiaging Regimen

Baseline Baseline
3.0 3.5
15 Minutes Postbaseline 15 Minutes Postbaseline
(Single Application of 2 Products) (Single Application of 2 Products)
2.5 † 3.0
Week 3 (Full 4-Product Regimen) Week 2 (Full 4-Product Regimen)
‡
‡ Week 3 (Full 4-Product Regimen)
2.5
2.0
2.0
Grade*

Grade*
1.5 †
‡
1.5
‡
1.0
1.0
‡
0.5 0.5
† †
0 0
Fine Lines Dryness Tactile Roughness Fine Lines Dryness Tactile Roughness
Parameter Parameter

Figure 1. Dermatologist evaluations of fine lines, dryness, and tactile Figure 2. Expert grader evaluations of fine lines, dryness, and tactile
roughness in subjects using a glycolic acid/antioxidant–based antiag- roughness in subjects using a glycolic acid/antioxidant–based antiag-
ing skin care regimen. Asterisk indicates scales for fine lines, where ing skin care regimen. Asterisk indicates scales for fine lines, where
0–25slightly visible, 3–55moderately visible, and 6–85obvious or 0–25slightly visible, 3–55moderately visible, and 6–85obvious or
very marked; dryness, where 05none, 1–55mild to moderate flaking very marked; dryness, where 05none, 1–55mild to moderate flaking
or scaling, and 6–85severe scaling or fissuring; and tactile roughness, or scaling, and 6–85severe scaling or fissuring; and tactile roughness,
where 0–25slight, 3–55moderate, and 6–85extreme; dagger, P,.05 where 0–25slight, 3–55moderate, and 6–85extreme; dagger, P,.01

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vs baseline; double dagger, P,.01 vs baseline. vs baseline; double dagger, P,.05 vs baseline.

of the skin care regimen. Adverse events, whether or not time points were compared with baseline values using
they were considered to be related to the treatment regi- paired t tests. A 2-tailed P,.05 was taken as the level of
men, were documented. significance for comparisons.

Statistical Analysis
Dermatologist evaluations, expert grader evaluations,
and conductance measurements at each of the follow-up
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Twenty-four healthy volunteers, aged 35 to 55 years,
exhibiting mild to moderate facial photodamage

1600 Suborbital Area

*
Cheek Area †
1400
Mean Conductance (mmho)

1200

1000 *
800 † † †
600

400

200

0
Baseline 15 Minutes Week 1 Week 2 Week 3
Postbaseline (Full 4-Product (Full 4-Product (Full 4-Product
(Single Application Regimen) Regimen) Regimen)
of 2 Products)
Time
Figure 3. Changes in electrical conductance in the skin as an indication of skin hydration in subjects using a glycolic acid/antioxidant–based
antiaging skin care regimen. Asterisk indicates P,.01 vs baseline; dagger, P,.05 vs baseline.

172 Cosmetic Dermatology® • march 2008 • Vol. 21 No. 3

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 GLX Antiaging Regimen

Table 4
Subject Self-Assessment Following Treatment With
a Glycolic Acid/Antioxidant–Based Skin Care Regimen

Responses, %
Very Satisfied/ Very Dissatisfied
Question Satisfied Indifferent /Dissatisfied*
Did the products reduce the appearance of 61 35 4
fine lines and wrinkles?
Did the products improve your skin’s softness 96 4 0
and smoothness?
Did the products improve your skin’s radiance, 61 39 0
tone, and clarity?
Did the products improve your skin’s firmness, 61 35 4
tightness, and elasticity?
Did the products improve the texture of your 61 39 0
sun-damaged skin?

overall appearance?
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Did the products improve your skin’s

Did the products improve your skin’s overall health?

83

70
17

30
0

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N524.
*None of the subjects indicated “Very Dissatisfied” as a response.

participated in this trial. The mean age of the regimen during 3 weeks resulted in a further reduction
24 subjects was 45.4 years; 23 of the 24 subjects (96%) in the mean scores for these parameters; however, the
completed the study. The efficacy of the GLX-based reduction was not statistically significant.
antiaging skin care regimen was evaluated based on
qualitative skin surface visual assessments performed Expert Grader Evaluations
by a physician (dermatologist) and an expert grader, Changes in the mean scores for fine lines, dryness, and
objective determination of skin surface hydration, and tactile roughness observed with treatment, as determined
self-assessment by the subjects (Figures 1-3; Table 4). by expert grader evaluations, are shown in Figure 2.
Digital photographs of the left side of the face at base- Scores for all 3 parameters were significantly reduced
line and after the 3-week, 4-product skin care regimen versus baseline (P,.01 for all) approximately 15 minutes
are presented in Figure 4. after a single application of 2 products from the treatment
regimen (the revitalizing eye cream and the daily anti-
Dermatologist Evaluations oxidant facial serum). Significantly reduced scores versus
Changes in the mean scores for fine lines, dryness, and baseline (P,.05) were also seen for fine lines at weeks 2
tactile roughness observed with treatment, as determined and 3 and for dryness at week 2.
by dermatologist evaluations, are presented in Figure 1.
There was a significant reduction versus baseline in Skin Surface Hydration
fine lines (P,.05), dryness (P,.01), and tactile rough- Changes in facial skin surface hydration observed during
ness (P,.01) approximately 15 minutes after a single the treatment period are depicted in Figure 3. Electrical
application of 2 products from the treatment regimen conductance measurements (higher conductance values
(the revitalizing eye cream and the daily antioxidant facial correspond to greater hydration) revealed an immediate
serum). Continued treatment with the full 4-product significant increase versus baseline (P,.01) in facial skin

Vol. 21 No. 3 • march 2008 • Cosmetic Dermatology® 173

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 GLX Antiaging Regimen

every night, and a revitalizing eye cream applied twice

daily. The GLX Technology on which these products
are based offers the proven benefits of AHAs and the
free radical protection of natural antioxidants. The
4 products contain ingredients that exfoliate the stra-
tum corneum, safeguard epidermal cells, protect plasma
lipoproteins, repair epidermal thinning, stimulate colla-
Figure Not Available Online gen deposition, enhance glycosaminoglycan production,
increase epidermal growth factor, and provide sustained
moisture release.
Significant increases in the understanding of the aging
process have permitted effective interventions that may
lead to therapeutic modalities that arrest the aging pro-
cess, help cells retain the ability to perform their dif-
Figure 4. Digital photographs of the left side of the face at baseline (A)
ferentiated functions, and, in general, better protect the
and after 3 weeks of treatment with a glycolic acid/antioxidant–based skin. The formula matrix in the products described in
antiaging skin care regimen (B). this study is designed to act as a catalyst for the deep-
est penetration of glycolic acid and natural antioxidants.
hydration in the suborbital and cheek areas approxi- It enhances the skin’s natural production of hyaluronic
mately 15 minutes after treatment with 2 products from acid, increases epidermal growth factor, stimulates col-
the treatment regimen (the revitalizing eye cream and lagen production, and protects epidermal cells. Three

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the daily antioxidant facial serum). Measurements in the of the 4 products in this skin care regimen contain
cheek area also showed significant though more modest high concentrations of unbuffered and buffered glycolic
increases versus baseline (P,.05) at weeks 1, 2, and 3. acid (10%–20%) combined with antioxidants and plant
In the suborbital area, a significant increase versus base- extracts. The products are formulated to facilitate deep
line (P,.05) was not seen again until week 3. It should be penetration of hydrating glycolic acid to improve skin

skin hydration. Do Not Copy

noted that the baseline conductance values for both areas
were exceptionally high, indicating a high initial level of
tone and texture, as well as deep penetration of natural
antioxidants to provide antiaging benefits. The regimen
evaluated in this study offers skin care practitioners and
patients a well-tolerated alternative to commonly used
Subject Self-Assessment stand-alone products, such as moisturizers, antioxidants,
Satisfaction results from the subject self-assessment ques- and retinoids.
tionnaire are detailed in Table 4. The majority of subjects In this study, dermatologist and expert grader assess-
were satisfied with the results of the 4-product topical ments of facial skin indicated that treatment with
skin care regimen in terms of the reduction of fine lines 2 products from the investigational regimen (the revital-
and wrinkles, the improvement of skin softness and izing eye cream and the daily antioxidant facial serum)
smoothness, and the improvement of the overall appear- resulted in an immediate improvement in the appearance
ance and health of their skin, among other parameters. of fine lines, dryness, and tactile roughness. Although
The subject self-assessment also included questions there were minor differences in the perception and evalu-
related to the subject’s history of skin care product use. ation of some efficacy parameters (Figures 1 and 2) by
Twelve of the 23 subjects (52%) indicated they had tried the dermatologist and expert grader, there was general
other antiaging treatments in the past. (Eleven subjects agreement that use of the full 4-product regimen during
had tried 1–3 treatments, and one subject had tried a 3-week period resulted in modest improvements in the
4–6 treatments.) Of those subjects, 6 (50%) indicated appearance of fine lines and dryness and, in the derma-
that the current investigational regimen was as effective tologist’s assessment, in facial roughness. While baseline
as or more effective than past treatments. skin hydration levels were high, immediate enhancement
in the level of skin moisture following a single treat-
comment ment with 2 products from the treatment regimen (the
This study involved a 3-week facial treatment regimen revitalizing eye cream and the daily antioxidant facial
that included an exfoliating facial cleanser applied once serum) was detectable by electrical conductance measure-
every 3 days in the evening, an antioxidant facial serum ments. Significant enhancements in skin hydration were
applied once daily, a renewal facial cream applied once also found following 3 weeks of treatment with the full

174 Cosmetic Dermatology® • march 2008 • Vol. 21 No. 3

Copyright Cosmetic Dermatology 2010. No part of this publication may be reproduced, stored, or transmitted without the prior written permission of the Publisher.
 GLX Antiaging Regimen

4-product regimen. Subject self-assessment data indi-

cated that the majority of subjects were satisfied with
treatment results. In addition, this regimen was well
tolerated, with no adverse events reported during the
study period. A limitation of the current study is the lack
of a placebo control. Future studies with a placebo may
further refine the findings of this study.

Conclusion
This physician-dispensed GLX-based antiaging facial
treatment regimen improved objective appearance, was
associated with satisfaction in the majority of those
treated, and did not lead to any safety or tolerabil-
ity issues in female subjects having mild to moderate
photodamaged skin. This regimen may provide a new
option for those seeking some control over the signs of
facial aging.

References
1. American Society for Aesthetic Plastic Surgery. Quick facts:
highlights of the ASAPS 2006 statistics on cosmetic surgery.
http://www.surgery.org/download/2006QFacts.pdf. Accessed

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January 24, 2008.
2. Hamilton MM, Hobgood T. Emerging trends and techniques in
male aesthetic surgery. Facial Plast Surg. 2005;21:324-328.
3. Downie JB. Esthetic considerations for ethnic skin. Semin Cutan
Med Surg. 2006;25:158-162.

Do Not Copy
4. Rona C, Vailati F, Berardesca E. The cosmetic treatment of wrinkles.
J Cosmet Dermatol. 2004;3:26-34.
5. Choi CM, Berson DS. Cosmeceuticals. Semin Cutan Med Surg.
2006;25:163-168.
6. Andersen FA. 34th report of the CIR Expert Panel: safety of alpha
hydroxy acid ingredients (glycolic acid, ammonium, calcium,
potassium, and sodium glycolate; methyl, ethyl, propyl and
butyl glycolate, and lactic acid, ammonium, calcium, potassium,
sodium, and TEA-lactates, methyl, ethyl, isopropyl, and butyl
lactate, and lauryl, myristyl, and cetyl lactates). Int J Toxicol.
1998;17(suppl 1):1-241.
7. Obata M, Tagami H. A rapid in vitro test to assess skin moistur-
izers. J Soc Cosmet Chem. 1990;41:235-242.  n

Vol. 21 No. 3 • march 2008 • Cosmetic Dermatology® 175

Copyright Cosmetic Dermatology 2010. No part of this publication may be reproduced, stored, or transmitted without the prior written permission of the Publisher.