Synergistic interaction of therapeutic physical factors in patients with accelerated skin aging associated with insulin resistance

Objective. To study the feasibility of cryotherapy, external laser blood irradiation and transcranial magnetic therapy in middle-aged women with signs of premature face and neck skin aging following insulin resistance. Material and methods. The study included 140 patients aged 35—45 years with insulin resistance and signs of premature skin aging. All patients received baseline therapy (intradermal hyaluronic acid with antioxidants). Patients were randomized into 4 groups: control (baseline therapy only), group 1 (additional whole-body air cryotherapy, TWAC), group 2 (TWAC+external laser blood irradiation, ELBI), and group 3 (TWAC+ELBI+transcranial magnetic therapy). Age-related skin change index, skin hydration and skin structure (ultrasound, corneometry), as well as metabolic, inflammatory, and oxidative blood markers were assessed. Statistical analysis implied Student’s t-test and correlation analysis. Results. The greatest therapeutic effect was achieved in group 4 (basic therapy+whole-body air cryotherapy+ELBI+TMT) with improvement of dermatological VAS score by 21.4%, age-related skin change index by 34%, quality of life by 17.4%. Insulin resistance index decreased by 16.3%, glucose by 8.78%, malondialdehyde by 23.5% and Schiff bases by 14.9%. Antioxidant protection increased by 39.3% (p<0.05). The effect of three factors is not a simple sum: supra-additive (mutually potentiating) synergism (coefficient >1) was found for 10 out of 20 parameters with the highest results for Schiff bases (17.5), malondialdehyde (4.53), glucose (4.12), and insulin resistance index (4.41). Significant correlations were established between improved skin status and reduced insulin resistance, atherogenicity, and oxidative stress (r from +0.396 to +0.754). Conclusion. Combination of three physical factors effectively slows premature skin aging in women with insulin resistance and simultaneously corrects metabolic disorders, potentially reducing the risk of cardiovascular disease. Theoretical propositions on synergism of physical factors, explaining high effectiveness of combination, are confirmed. A direct correlation between reduced insulin resistance and slower skin aging was proven. This justifies the need for a comprehensive assessment of systemic and local changes.