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Conflict of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper

Chronic inflammation Chronic inflammation is a slow process that operates in silence, with clinical consequences only apparent at later stages when the damage and resulting clinical sequelae are often irreversible (42)

extracellular matrix components including, but not limited to, collagen III the evaluations included the assessment of the subject's face by trained investigators for fine lines and coarse wrinkles in the pen-orbital area, fine lines and coarse wrinkles in the pen-oral area, tactile roughness, mottled hyperpigmentation, redness and telangiectasia, skin pores and pore size, skin tone, and for global skin damage using visual severity scores