In experiment 1, participants were 14 (5 male, 9 female) elders. The number of elderly people was 1 person at 60 years, 11 people at 70 years, 2 people at 80 years. Cognitive function was measured by Mini Mental Scale Examination (MMSE). The range of scores is from 0 to 30 points. The range of scores was from 23 to 30 point, and the mean MMSE score was 28. Generally cognitive function was normal. They were elders in elder’s college in a university. So, they could move freely and almost healthy. Inclusion criteria were: 1) Elders could complete the questionnaire; 2) They could communicate with others. Exclusion criteria were that elders had skin troubles.

In experiment 2, the same participants of experiment 1 without 3 participants received. The reasons for dropout were as follows: One caught a cold, and two had something to come up. Then, 11 participants had second session as experiment 2. participants were 11 (4 male, 7 female) elders. The number of elderly people was 1 person at 60 years, 8 people at 70 years, 2 people at 80 years.

The therapist was certified by Shiseido company with training. The cosmetic therapy included the following program. 1) Explanation about expected effects cosmetic therapy both on physical and mental aspects; 2) Relaxation including stretch; 3) Skin care using all in one gel and massage of face stimulating parotid gland or submandibular gland, stimulating face skin; 4) Make up using eyebrow, lipstick, and cheek. The instructor often talked with elders warmly. After makeup, elders looked themselves with mirror. They completed questionnaires pre and post. Staff took pictures pre and post. So, it was 60 minutes in total.

We used the following questionnaires.

1) Automatic nervous system: We used the “Hirou stress kei MF100” (Fatigue Stress Measurement MF100) made by Murata Manufacturing Co., Ltd. A participants griped the instrument using both right and left thumb, the instrument measure heartbeat, and analyzed and translated into automatic nervous system. It measures sympathetic nervous system Low Frequency (LF) which is sympathetic nervous system and High Frequency (HF) which is parasympathetic nervous system. The LF/HF shows the balance of automatic nervous system.

2) Profile of Mood Scale 2 (POMS 2): POMS 2 was developed by [5] and translated by [16]. The POMS consisted of 7 factors: Tension-Anxiety (TA), Anger-Hostility (AH), Fatigue-Inertia (FI), Viger-Activity (VA), Confusion-Bewilderment (CB), Depression-Dejection (DD), and Friendship. The Friendship was not related to total mood disturbance, we did not include. Then, there are 5 question items about 6 factors, a participant measure using from 0 (not experience) and to 4 (often experience). The only VA shows positive mood, so the Total Mood Disturbance was calculated (TA + AH + FI + CB + DD) − VA). We used the TMD as indication of well-being of mood. High score means high mood disturbance.

3) The psychological well-being from cosmetic therapy. We referred to [14]. We chose 4 questions (Motivation, Waking up, Comfort, and Vigor) which showed significance between pre and post cosmetic therapy in [14].

Participants evaluated each question by 10-point Likert scale.

We recruited participants in elder college by flyer. In experiment 1, 14 healthy elders received cosmetic therapy once and a researcher measured automatic nervous systems by an instrument. It measured LF (Low Frequency), HF (Hight frequency), and LF/HF which means balance of LF and HF and high score show high activity and well-being. We used this indication.

In experiment 2, the same elders without three elders received cosmetic therapy as second session and completed the Mood by the Profile of Mood Scale 2 (POMS 2) and questions about impression for cosmetic therapy in “Motivation”, “Waking up”, “Comfort”, and “Vigor” by 10 Likert scale.

As measurement condition of automatic nervous system, the study was conducted from 10:00 AM to 15:00 PM, there was no special restriction such as meal or sleep time. Duration of measurement of the instrument in each session was 90 seconds.

We conducted the basic statistics and conducted the Wilcoxon signed-rank test as a non-parametric test between pre and post cosmetic therapy.

We performed this study in accordance with the Declaration of Helsinki. This study was approved by the Research Ethics Committee of Nisikyusyu University (25AVX22).

In experiment 1, elders received cosmetic therapy once, and the score of LF/HF significantly increased. LF/HF means activity and balance of nervous system. It shows that only one-time cosmetic therapy was useful to improve elder’s activity. It may be because that high tension or anxiety reduced by “touch” or “massage” in cosmetic therapy. Also, the make up with cheek or lipstick changed from flat color to bright color in face, elder’s mind activated. That is, participants’ negative tension decreased and activity increased, then the balance of automatic nervous system work week. So, LF/HF might increase.

In experiment 2, the score LF/HF also significantly increased pre and post, and it means that long term cosmetic therapy also promoted activity and balance of nervous system. This fact is different of [17] in which there was no significance in physiological aspect measured by blood pressure, pulse, surface temperature pre and post after three months cosmetic therapy for healthy female elders or elders with dementia. This difference might be caused by duration of cosmetic therapy or instruments of measurement. We need to investigate these points.

As for mood of the POMS 2, TA significantly decreased. [15] said that by touching the skin, the physiological substance called oxytocin is secreted in the brain, and it promotes relaxation and helps to build relationships. Thus, touching and talking with the cosmetic therapist promoted relaxation and TA might decrease.

Moreover, TMD (Total Mood Disturbance) significantly decreased. It showed that elders experienced comfortable mood state totally and increased well-being. Integrating the increase of LF/HF and decrease of TMD score, cosmetic therapy affected both physiological and psychological state at the same time. This result supports a previous study. Maintaining a positive emotional balance has been shown to play a key role in psychological well-being and its increasingly regarded as a determinant of healthy aging ([2]). [12] also suggested importance of physical interaction and mental. In future, nervous and neuroimmune systems to achieve more integrated and holistic effects ([4]) will be investigated.

As for impression, the score for “Motivation” 7.46, the “Waking up” 7.34, the “Comfortable” 7.45, the “Vigor” 7.55 of 10 full points. Totally elders seemed to have good impression. Comparing [14], the score of “Motivation”, “Waking up”, “Comfortable”, were about 50 point and the “Vigor” 40 point in 100 VAS (Visual Analog Scale). The impression points in the present study were higher than [14]. The reason for this difference might be from participant. Participants in [14] were healthy young women, and those in the present study were elders of 70 years old including male and female. Cosmetic therapy might be fresh and have impact on elderly people.

Previous study showed that the impact of skin aging may extend beyond physical health, potentially affecting social interactions and self-esteem ([11]). We need to study much more effects on physical and psychological aspects.

As limitation, we did not establish a control group. So, the effect of cosmetic therapy in this therapy is not really validated. And the number of participants was small and we need to include many more participants.