<scp>TriHex</scp> Technology and Reversal of Solar Elastosis: Dispelling Some Myths

BACKGROUND: Solar elastosis (SE) is the end result of long-term sun damage, characterized by a buildup of dystrophic material in the extracellular matrix (ECM) surrounded by fragmented collagen and dysfunctional, aggregated elastin. This degenerative process was once thought to be irreversible but is now recognized as dynamic, with the potential for regenerative change through appropriate interventions. New stains also enable the detection of newly formed elastin and collagen as part of this reversal process. MATERIALS AND METHODS: A retrospective analysis of multiple clinical studies (624 patients, 80 biopsies, 31 reported solar elastosis) was conducted, focusing on the use of TriHex and TriHex+ peptide-based technology (Alastin Skincare Inc., Carlsbad, CA). Biopsies were evaluated using novel histologic stains, including Herovici and Movat, alongside conventional Hematoxylin & Eosin (H&E) and CD44. Markers such as Collagen IV and Laminin at the dermo-epidermal junction (DEJ) were also assessed to identify evidence of regenerative reversal of solar elastosis, ECM remodeling, and new elastin formation. RESULTS: The regenerative reversal of solar elastosis was observed across multiple clinical trials. The TriHex formulations consistently produced significant improvements in ECM structure. Reported histology in 74% of cases showed clear removal of amorphous elastotic deposits and restoration of the ECM, including new elastin fiber formation, strengthening of the DEJ with increased Collagen IV and Laminin, new rete ridge architecture, and positive hydration effects evidenced by increased CD44 staining. CONCLUSION: This review positively challenges a long-standing myth and clearly establishes a new perspective: solar elastosis is reversible. The peptide-based TriHex Technology can remove the elastotic amorphous material from the ECM and rebuild it with new elastin and collagen fibers. Clinically and histologically, this shows that chronic sun damage can be repaired in the dermis, supporting a shift from superficial treatments to a more targeted regenerative approach focused on restoring the structural integrity of the skin.