Cited by 252Skin Protection and Agingmelanin and skin pigmentationDermatology and Skin Diseases

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Defining skin aging and its risk factors: a systematic review and meta-analysis

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Wong, Qi Yi Ambrose, Chew, Fook Tim·2021·Scientific Reports

DOI 10.1038/s41598-021-01573-zPMC PMC8586245

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Abstract

Skin aging has been defined to encompass both intrinsic and extrinsic aging, with extrinsic aging effected by environmental influences and overlaying the effects of chronological aging. The risk factors of skin aging have been studied previously, using methods of quantifying skin aging. However, these studies have yet to be reviewed. To better understand skin aging risk factors and collate the available data, we aimed to conduct a systematic review and meta-analysis. We conducted our systematic review in compliance with Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guidelines. Embase, PubMed and Web of Science databases were searched in October 2020 using specific search strategies. Where odds ratios were reported, meta-analyses were conducted using the random effects model. Otherwise, significant factors were reported in this review. We identified seven notable risk factors for various skin aging phenotypes: age, gender, ethnicity, air pollution, nutrition, smoking, sun exposure. This review's results will guide future works, such as those aiming to examine the interaction between genetic and environmental influences.

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Figure 1 PRISMA flow diagram (from Moher et al.12. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(7): e1000097. https://doi.org/10.1371/journal.pmed1000097).CC BY · PubMed Central

Figure 2 Forest plot for skin aging phenotypes and age as a continuous variable.CC BY · PubMed Central

Figure 3 Forest plot for skin aging phenotypes and male gender (female gender as reference).CC BY · PubMed Central

Figure 4 Forest plot for skin aging and HRT use.CC BY · PubMed Central

Figure 5 (a) Forest plot for skin aging and current smoking (non-smoking as reference). (b) Forest plot for skin aging and former smoking (non-smoking as reference). (c) Forest plot for skin aging and being a smoker (ever smoking or smoker = yes), with non-smoker as reference. (d) Forest plot illustrating dose response relationship for smoking (in pack-years) and wrinkling.CC BY · PubMed Central

Figure 6 (a) Forest plots for more than 1 h/day of sun exposure and skin aging. The comparison exposure for all odds ratio is 1 h/day of sun exposure. Model 1 and 2: Ernster et al.36 adjusted for age, BMI, and smoking exposure. Model 3 and 4: Ernster et al.36 adjusted for age, BMI, and smoking status. (b) Forest plots for more than 2 h/day of sun exposure and wrinkling (compared with less than 2 h/day of sun exposure). Model 1 and 2: Ernster et al.36 excluded from models. Model 3 and 4: included Ernster et al., 1995. (c) Forest plots for sunscreen use and skin aging.CC BY · PubMed Central

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Authors: Wong, Q. Y. A., & Chew, F. T.
Affiliations: National University of Singapore (SG)
Corresponding author: Chew, Fook Tim
ORCID: Wong, Qi Yi Ambrose
Chew, Fook Tim
Venue: Scientific Reports
Publisher: Springer Science and Business Media LLC
Published: 2021-11-11
Volume: 11
Issue: 1
Pages: 22075-22075
ISSN: 2045-2322 (ISSN-L)
DOI: 10.1038/s41598-021-01573-z
PMC: PMC8586245
OpenAlex: W3213583402
Cited by: 250
References: 103
Citations by year: 2026: 60 · 2025: 75 · 2024: 61 · 2023: 40 · 2022: 14
FWCI: 5.13
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0 (tdm)
creativecommons.org/licenses/by/4.0 (vor)
Locations: Scientific Reports (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
National University of Singapore (submittedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: Faculty of Science, National University of Singapore (N-154-000-038-001)
Ministry of Education - Singapore (R-154-000-191-112)
Biomedical Research Council (BMRC/01/1/21/18/077)
Singapore Immunology Network (SIgN-06-006)
National Medical Research Council (NMRC/1150/2008)
Agency for Science, Technology and Research (H17/01/a0/008)
Topics: Health Sciences › Medicine › Dermatology › Skin Protection and Aging
Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › melanin and skin pigmentation
Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
Keywords: skin aging, intrinsic aging, extrinsic aging, chronological aging, risk factors, air pollution, nutrition, smoking, sun exposure, gender differences, ethnicity, age
MeSH terms: Age Factors, Air Pollutants, Air Pollution, Humans, Risk Factors, Sex Factors, Skin, Smoking, Ultraviolet Rays, Skin Aging

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Defining skin aging and its risk factors: a systematic review and meta-analysis

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