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Kohala Coast, HI - The goal of cosmeceuticals used to be for decorating or adorning the skin, but new concepts in skin have changed that, according to Hilary Baldwin, M.D.
Kohala Coast, HI
- The goal of cosmeceuticals used to be for decorating or adorning the skin, but new concepts in skin have changed that, according to Hilary Baldwin, M.D.
The goals of a cosmeceutical are to protect from UV damage (sunscreen), reduce free radical formation (antioxidants), improve skin lipid barrier (moisturizers), brighten and unify color and tone (bleaching agents and antioxidants), and smooth texture, reduce pore size and decrease fine lines and wrinkles (retinoids and collagen stimulators), Dr. Baldwin explained while speaking at the Winter Clinical Dermatology Conference.
A truly scientific evaluation of such products may not be possible, however, because outcomes reveal very subtle changes that can’t hold up to the rigor of clinical trials or reach statistically significant results, she added.
In addition, cosmeceutical ‘science’ is mostly the study of biologically active ingredients in vitro, which does not prove in vivo success, "because everything has to get through the epidermis, whose job is to keep everything out," Dr. Baldwin said.
With regard to moisturizers, "what we’re really talking about is extraordinarily good moisturizers," Dr. Baldwin said.
Good moisturizers are composed of emollients and humectants. Emollients provide a sheen over the skin that stops transepidermal water loss, she explained.
Humectants, on the other hand, ‘gobble up’ moisture from wherever they can find it. The emollient over the top is what seals it all in, according to Dr. Baldwin.
Things to consider when choosing a moisturizer include location on the body, climate, level of xerosis, what the patient prefers and other issues, such as acne, sensitive skin or allergies, Dr. Baldwin said.
With regard to cosmeceuticals, "there are 70 botanicals in products that are already out there, and they can be categorized in two ways, based on their chemical descriptions or their activity," Dr. Baldwin said.
Antioxidants are necessary because oxidative stress occurs faster than our skin can keep up with, Dr. Baldwin added. The effect of topical antioxidants is to improve the intrinsic aging process as well as extrinsic.
Prevage (Allergan) has shown to be a stronger antioxidant than others. It has been shown to reduce fine lines and wrinkles, improve roughness and dryness, increase the hydration in the skin and improve the appearance of the skin, Dr. Baldwin said.
Collagen-stimulator cosmeceuticals, such as peptides, copper and human growth factors, activate the wound-healing process in our body. "Fibroblast stimulation will thicken the dermis by increasing collagen," she said.
Single peptides flood the dermis with fragments of collagen, which causes the fibroblasts to think there is a wound, and they jump into action to produce collagen, plumping up the skin.
Human growth factors are a great idea, but they are very large molecules, and there is no evidence that they are able to penetrate an intact dermis, according to Dr. Baldwin.
It’s also important to remember that no single cosmeceutical active is going to do everything.
"Combinations of retinoids, sunscreens, antioxidants, collagen-stimulating peptides, bleaching agents and hydroxyl acids will be more effective than any agent alone," Dr. Baldwin said.
Perhaps most the most important step in anti-aging is photoprotection. "Nothing is more important than obsessive-compulsive use of well-formulated sunscreen," she said. DT