Improving Body Skin Quality: Evidence-Based Development of Topical Treatment and Survey of Current Options

The growing interest in improving the quality of body (as distinct from facial) skin may be in part attributable to the expanding use of noninvasive body contouring procedures. In this review, we describe a new framework characterizing the factors that define skin quality (including visual, textural, and biomechanical attributes) that provides a foundation for improved assessment of skin quality and its response to treatment. We then highlight critical biological pathways responsible for body skin restoration and maintenance that have been identified during the development of restorative topical products. Each of these pathways, including extracellular matrix support, suppression of lipogenesis, and enhancement of cellular/macromolecular recycling and clearance, lymphatic drainage, and lipolysis, is a potential target of 1 or more bioactive substances. A survey of available topical products marketed for skin quality improvement suggests that none target more than 2 of these pathways (including extracellular matrix support, lipolysis, and autophagy, a component of cellular recycling), leaving abundant opportunity for development of new topical formulations that target all or most of the critical pathways. Such formulations may provide improved outcomes when used as standalone products for general skin quality improvement and rejuvenation, in addition to their potential for post-procedure use, and also for pre-procedure skin conditioning. J Drugs Dermatol. 2022;21(6):653-658. doi:10.36849/JDD.6811.