COSMECEUTICALS Topical preparations developed to improve the overall health and appearance of our skin and to rid it of certain imperfections by Lois W. Stern1 BEAUTY! It seems we are continually bombarded with new ideas, products and techniques to create it, maintain it, rejuvenate it. The myriad of choices – nowhere more apparent than in the world of cosmeceuticals - can literally confound us. So let’s begin by looking at a daunting list, representative of the different types of cosmeceuticals on the market today. WHAT YOU SHOULD KNOW Cosmeceuticals are most effective when combined with a healthy lifestyle. No smoking, a good diet, sufficient rest, plenty of exercise and drinking lots of water can do as much for the skin as most available preparations. While cosmeceuticals definitely can improve the appearance of your skin, neither deep wrinkles nor facial sagging will disappear with their use. None of the cosmeceuticals sold in the USA have been subjected to peer review. As a result, claims about the effectiveness of any given product are dependent upon the manufacturer’s ethics, its specific ingredients, and the strength of those given ingredients. The single most important cosmeceutical, the one you must apply to your skin every day without exception, is a good quality sunscreen. There is some relatively strong, supporting science to substantiate the effectiveness of cosmeceutical ingredients such as green tea, Idebonone, and hyaluronic acid. Again, none of these products have been subjected to peer review, so we are dependent upon each manufacturer’s ethics when conducting their internal studies. Popular over-the-counter cosmeceuticals often contain identical beneficial ingredients, but at weaker, less effective potencies. The consumer has no way of determining the strength of the ingredients within any product. That is why professional advice from a knowledgeable skin care specialist will yield the most beneficial results. Some touted products may turn out to be more ‘hope-in-a-jar’ than actual science. "The world of cosmeceuticals is dynamic, constantly growing as we learn through observation, experimentation and study. Science has taught us that one product cannot do it all. When working with cosmeceuticals, you need to layer. Research drives the development of new products each time it uncovers a new active ingredient with the potential to improve the skin.” 1 (Arena) UV PROTECTION Avoid prolonged time in the sun and use a good quality sunscreen on a daily basis. These two basics of skin care cannot be stressed strongly enough. You need to develop and maintain these habits on a daily basis to avoid skin cancers, sun damage, and premature aging of your skin. Sunscreens protect the skin from both UVA and UVB radiation. TYPES Chemical free sunscreens contain zinc oxide or titanium dioxide as their first listed ingredient. Sunscreens with chemicals typically contain avobenzene. COMMENTS UVA wavelengths penetrate deeply into the dermis, causing skin to wrinkle. UVB radiation is associated with many skin cancers. The SPF number on sun blockers only applies to UVB protection and has no connection with UVA protection. A SPF number of 15 is recommended for daily use. Higher numbers do not proportionately increase protection. RESULTS Protects skin from sun damage, skin cancers and premature signs of aging. SIDE EFFECTS Chemical free sunscreens may appear somewhat opaque on the skin, depending on the size of the suspended particles. Sunscreens are generally non-irritating, but may exacerbate acne. EXFOLIANTS Exfoliants remove dead cells and the outer layers of thickened skin, encouraging skin turnover. TYPES ALPHA HYDROXY ACIDS Lactic acid Glycolic acid BETA HYDROXY ACIDS COMMENTS (ALPHA HYDROXY ACIDS) Lactic acid is the active ingredient in Cleopatra’s famed sour milk baths. Glycolic acid, found naturally in sugar cane and fruit, are synthetically produced, typically containing 5-10 % AHA. RESULTS (ALPHA HYDROXY ACIDS) Softens fine wrinkles, lightens pigmentation spots, generally tightens and improves skin texture. Makes skin look healthier and more radiant. Stronger solutions applied by professionals reduce fine lines and brown spots and claim to increase collagen production and skin elasticity. SIDE EFFECTS (ALPHA HYDROXY ACIDS) Possible short term stinging upon application. Possible allergic reactions. BETA HYDROXY ACIDS COMMENTS (BETA HYDROXY ACIDS) A salycydic acid, sometimes used in combination with alpha hydroxy acid. RESULTS (BETA HYDROXY ACIDS) Opens pores, clears up pimples and eliminates scaling and roughness on skin. SIDE EFFECTS (BETA HYDROXY ACIDS) People sensitive to aspirin may have an allergic reaction to Beta Hydroxy Acids. Consult a skin care specialist before using. RETINOIDS Treats mild to moderate acne and photo-damaged skin, removes dead surface cells, and flattens the topmost layer of the skin, giving the complexion a more even tone and rosy glow. TYPES Tretinoin (RetinA, Renova) – synthetically produced products COMMENTS Retino, a naturally occurring lipid soluble form of vitamin A, is a weaker, over-the-counter retinal, with more subtle effects on the skin. RESULTS Claims to build collagen, regenerate the skin’s elasticity and reverse production of pigmentation spots SIDE EFFECTS Possible skin dryness and heightened sensitivity to the sun MOISTURIZERS Moisturizers smooth the surface of the skin, lubricate its outer layers, and lock in moisture. COMMENTS Often other products such as sunscreens and antioxidants already contain sufficient moisturizer for many skin types. Only apply moisturizer if your skin feels tight or dry. RESULTS Helps prevent the skin from drying out. SIDE EFFECTS Applying more moisturizer than needed can result in clogged pores, resulting in further damage rather than benefit to the skin. ANTIOXIDANTS Antioxidants, the ingredients meant to defend against free radical damage, have become the buzzword of skin care in this 21st century. Current belief is that antioxidants improve the health and appearance of our skin. Here is where professional advice about what works best for your skin can be of real value. A board certified dermatologist or well-trained esthetician can often provide valuable guidance in helping you determine what works best for your skin. Here is a list of the major players in this list of antioxidant ingredients and how they are thought to impact the skin. Products need to contain potent enough concentrations of any antioxidant to evaluate their effectiveness. Vitamin A – To help minimize the lipid peroxidation of cell membranes Alpha tocopherol (the active form of Vitamin E) – To inhibit enzymes which promote the breakdown of collagen and to protect cell membranes from oxidation Vitamin C (essential for collagen production) – To quench free oxygen radicals produced by ultraviolet radiation and to assist Vitamin E in protecting cell membranes Co-enzyme Q-10 (a component of all cell membranes) – To help regenerate other antioxidants present in cells Green tea (contain antioxidant polyphenolos) – To protect against redness and swelling induced by UV radiation Grape seed extract – a strong antioxidant in combination with other antioxidants Alpha Lipoic Acid (present inside of cells) - To protect delicate cellular membranes from free radical damage during cellular respiration Resveratrol and Polydatin (found in highest concentrations in grape skins) – To help inhibit lipid peroxidation similarly to Vitamins C and E Idebonone – The key ingredient in Allergan’s newest product, Provage - Helps repair skin damage and promote healthy skin growth Algae – To close up capillaries (a treatment for rosacea), lighten pigmentation, stimulate collagen Spin Traps – Know as the ‘intelligent antioxidant’. Spin traps do not destroy free radicals, but sense when molecules are off track, trap and detoxify them. As a result, they turn free radicals into useful oxygen to be used for tissue respiration. PEPTIDES In addition to antioxidants, peptides have now arrived on the scene. Peptides are proteins - tiny molecules that have a variety of effects on cell function. Many of the newer cosmeceutical formulations contain both synthetic and naturally occurring peptides. “There are some peptides that may stimulate skin metabolism and repair, while others may inhibit hyperpigmentation, slow the breakdown of collagen or lessen muscle movements. Argireline is one example of a peptide that has been developed to slow the neurotransmitters that control the muscles that work during the production of repeated facial expressions. Although Argireline can soften furrows substantially, it is not a replacement for Botox or Restalyne. But used in conjunction with these treatments, Argireline can extend the life of their effectiveness.” 2 (Arena) AN EFFECTIVE MORNING SKIN CARE ROUTINE Cleanse thoroughly Apply anti-aging products Apply moisturizer, only if needed Apply a good quality sunscreen AN EFFECTIVE BEDTIME ROUTINE Cleanse thoroughly Layer with other kinds of products beneficial to you skin type and conditions (Examples: You might need a mild exfoliant to remove dead surface cells or a preparation with hydroquinone to lighten pigmentation spots.) Apply anti-aging products COMMENTS ON COSMECEUTICALS “Know that different active ingredients require different delivery systems to accomplish their intended goals. For example, a sunscreen needs to sit on top of the skin to protect it from the sun; while ingredients that stimulates collagen production need to be absorbed into the skin. Varied delivery systems are being used to help the skin better absorb key ingredients, such as time release products and products whose active ingredients are in micro particles. Ultra Sound is a mechanical device sometimes being used to drive topically applied ingredients more deeply into the skin.” 3 (Arena) Footnotes 1, 2 and 3: Madeleine Arena has had a varied and well-respected career as a consultant and director of laboratories producing cutting edge cosmeceuticals. An important facet of her consultation services is educating her clients (physicians and estheticians) about the active ingredients and proper potencies of effective skin care products. This article is excerpted from a larger article written by Lois W. Stern, author of Sex, Lies and Cosmetic Surgery, for the Long Island Beauty Guide - 2007 annual edition. You have my permission to reprint this article in part or full providing it contains the following attribution: Lois W. Stern is the author of the award winning book, Sex, Lies and Cosmetic Surgery, (Infinity, 2006), soon to be republished in a revised edition with a CD enclosure. Lois invites prospective cosmetic surgery patients, physicians, and media to visit her website to read other articles and/or sign up for her monthly newsletter at: sexliesandcosmeticsurgery.com