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Volume 29, Issue 6, Pages 467-472 (November 2009)


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Perioral Wrinkles: Histologic Differences Between Men and Women

Emma C. Paes, MD1, Hans J.L.J.M. Teepen, MD, PhD2, Willemijn A. Koop, MD3, Moshe Kon, MD, PhD14Corresponding Author Informationemail address

Accepted 22 May 2009.

Background

Women tend to develop more and deeper wrinkles in the perioral region than men. Although much is known about the complex mechanisms involved in skin aging, previous studies have described histologic differences between men and women with respect to skin aging only incidentally and have not investigated the perioral region.

Objective

The purpose of this study was to investigate gender-specific differences in the perioral skin.

Methods

To determine wrinkle severity, skin surface replicas of the upper lip region in 10 male and 10 female fresh cadavers were analyzed by using the dermaTOP blue three-dimensional digitizing system (Breuckmann, Meersburg, Germany). In 30 fresh male and female cadavers, three full-thickness lip resections were investigated in a blinded fashion for specific histologic features. All results were statistically analyzed in a linear regression model with SPSS software (version 15.0; SPSS, Chicago, IL).

Results

The female replicas showed more and deeper wrinkles than the male replicas (P < .01). Histologic analysis revealed that the perioral skin of men displayed a significantly higher number of sebaceous glands (P = .000; 95% confidence interval [CI] 23.6–53.2), sweat glands (P = .002; 95% CI 2.1–8.1), and a higher ratio between vessel area and connective tissue area in the dermis (P = .009; 95% CI 0.003–0.021). The amount of hair follicles did not significantly differ between men and women, although the average number of sebaceous glands per hair follicle was greater in men (P = .002; 95% CI 0.33–1.28).

Conclusions

Women exhibit more and deeper wrinkles in the perioral region and their skin contains a significantly smaller number of appendages than men, which could be a feasible explanation for why women are more susceptible to development of perioral wrinkles.

Corresponding Author InformationReprint requests: Moshe Kon, MD, PhD, University Medical Center Utrecht, Department of Plastic, Reconstructive and Hand Surgery, PO Box 85500, 3508 GA Utrecht, the Netherlands

 DISCLOSURES

The authors have no financial interest in and received no compensation from manufacturers of products mentioned in this article.

Presented at the 20th Annual Meeting of the European Association of Plastic Surgeons, May 28–30, 2009, Barcelona, Spain.

1 Dr. Paes and Dr. Kon are from the Department of Plastic, Reconstructive and Hand Surgery, University Medical Center, Utrecht, The Netherlands.

2 Dr. Teepen is from the Department of Pathology, St. Elisabeth Hospital, Tilburg, The Netherlands.

3 Dr. Koop is from the Department of Plastic, Reconstructive, and Hand Surgery, University Medical Center, Leeuwarden, The Netherlands.

4 Dr. Kon is a member of the Dutch Society for Aesthetic Plastic Surgery.

PII: S1090-820X(09)00350-1

doi:10.1016/j.asj.2009.08.018


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