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Metabolite mapping revealed limited biotransformation: the major species in plasma remained intact parent peptide, with minor degradation products formed by endopeptidases rather than DPP-4, corroborating the in vitro stability data [44]

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Similar findings were reported in prospective clinical studies.68,69 A large multicenter RCT (n=194), however, found no significant differences with placebo.70 A meta-analysis of the above findings for a total of 480 patients showed a favorable effect on facial appearance.70 Multiple oral antioxidants and anti-inflammatory agents, such as vitamins A, C, D, and E, green tea polyphenols, niacinamide, and trace elements such as zinc may help mitigate signs of skin aging

This is frequently caused by your bodys inability to maintain enough energy levels