Assessment of Aging of the Human Skin by In Vivo Ultrasonic Imaging

The ultrasonic imaging technique that we have developed provides cross-sectional images of human skin in vivo with a resolution of about 80 μm axially (i.e., deep into the skin) and 250 μm lateral (parallel to the surface). In order to study aging skin, we obtained ultrasonic images from the mid-fore-arm (volar and dorsal sides) of 142 women. Ultrasonically, on the images, the dermis appears composed of two bands: a dark superficial one where the ultrasonic waves are propagated in a relatively homogeneous or non-echogenic medium, and a deeper one, which is lighter in color, suggesting a heterogeneous medium. Our results show that skin is thicker on the dorsal than on the volar forearm. In contrast to previously published results, skin thickness remains constant until the seventh decade of life, diminishing thereafter. The relative thicknesses of the two bands show marked variations with age: a progressive thickening of the dark band, from zero in infants to approximately 75% of total skin thickness in aged subjects, while the light band shows the inverse trend. Comparing the amplitude of the bands on the volar and dorsal forearm, the relative thickness of the dark band is larger on the dorsal (exposed) side and increases with age. These findings and the analysis of variously stained biopsies taken in some of our patients lead us to assign this dark band to a zone in the upper dermis where the collagen network is delicate, dense, and well organized. This is supported by some data in the literature. The thickness of this subepidermal non-echogenic band appears to be a far more sensitive marker of skin aging at the dermal level than is the measurement of skin thickness.