"It is true that the physical presence of the product increases
volume in the skin. Our research makes clear that injection of the
product leads to creation of new collagen, which contributes to
reduction in creases and wrinkles in a person's aging skin," Voorhees
says.
The paper appears in the new issue of the journal Archives of
Dermatology. Funding was provided by the U-M Department of Dermatology
Cosmetic Research Fund, the Babcock Research Endowment at U-M and
grants from the National Institutes of Health.
While Medicis Aesthetics provided the
Restylane syringes used in
the study, the company (which makes
Restylane) had no involvement in
the collection, management, analysis and interpretation of the data.
The company also was not involved in the preparation or review of the
manuscript.
Restylane has been in the news frequently in recent months, in
part because of a competition between Medicis and Allergan Inc., the
maker of the dermal filler Juvederm. More than one observer has
compared the rivalry to the height of the "cola wars" between Coke and
Pepsi. These fillers are used to reduce the appearance of creases and
wrinkles on the lower part of the face.
The findings of the study are based on injections in 11
volunteers, ages 64 to 84 years, and the subsequent analyses of the
skin biopsies (including immunostaining and gene expression).
Some of the key findings relate to fibroblasts, which are in the
dermis, the layer of the skin below the epidermis (outer layer). In
young people, fibroblasts are stretched, and this produces enough
collagen to make the skin appear relatively smooth. As people age, the
fibroblasts become relaxed and do not stretch as easily, and therefore
do not release as much collagen, causing creases and wrinkles to
appear.
With the injection of Restylane in this study, the relaxed
fibroblasts were re-stretched, says lead author Frank Wang, M.D.,
research fellow with the U-M Department of Dermatology. In a sense,
this stretching encourages the fibroblasts to behave in the way they
do in younger skin and to release collagen.
Another factor is that in older skin, an enzyme called collagenase
breaks down the collagen in the skin. The research found that
injection of this dermal filler inhibits the breakdown of collagen by
collagenase, which also helps with the appearance of one's skin, Wang
says.
The study notes that procedures involving
dermal fillers are
increasingly common. Of the 12 million cosmetic procedures performed
annually in the United States, about 1 million currently involve the
class of injectable fillers that includes
Restylane, according to the
researchers.
In addition to Voorhees and Wang, authors of the study were Luis
A. Garza, M.D., Ph.D.; Sewon Kang, M.D.; James Varani, Ph.D.; Jeffrey
S. Orringer, M.D.; and Gary J. Fisher, Ph.D., all of the University of
Michigan Medical School, except Garza, now at the University of
Pennsylvania, Philadelphia.
Reference: Archives of Dermatology, Feb. 2007, Vol. 143, Issue 2,
pp. 155-163, "In Vivo Stimulation of De Novo Collagen Production
Caused by Cross-linked Hyaluronic Acid Dermal Filler Injections in
Photodamaged Human Skin."
Have you seen in your local paper an article, on the Internet,
Television that was taken from a publication and press release from
the University of Michigan Medical School in Ann Arbor's study on
Restylane? The headline reads, "Wrinkle injection may do more than
fill space." This enticing article can be used to help your patients
that are interested in the "science" of facial fillers decide on using
Restylane or any fillers contain hyaluronic acid. Click here to
download the Press Release
Copyright 2007 University of Michigan
Health System
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