Tremendous leaps in the science of skin care. Higher levels of efficacy. Revolutionary formulations.

These statements accurately describe the impressive ascent of chemical and natural/organic formulations and a dramatic overall improvement in skin care products over the past few years.

To provide insight into this “formulation revolution,” PSP spoke with Jennifer Linder, MD, chief scientific officer at PCA Skin (Scottsdale, Ariz); Erika A. Mangrum, managing director, business development at USA IntuiSkin (Durham, NC); and Eric Viviant, managing director, skin care products, at IntuiSkin (Malaga, Spain).

PSP: What are the latest discoveries in skin care formulations?

Linder: Stem cell technology is being utilized for anti-aging topical products. Up until now, stem cells have been used in medicine to generate new cell growth in wounds and burns. This same thought process is now being researched for improving the appearance of mature skin. Stem cells never die, so the cellular proliferation they can provide would be incredible. By generating healthy cells in aging skin, products can potentially reverse some of the damage accrued over the years.

DNA-based lines are also being marketed. These lines claim to actually repair the DNA damage caused by UV, free radicals, and inflammation. Although it sounds appealing, the research is lacking and it would be difficult for these topical products to be able to reach the cells’ DNA.

Mangrum: The latest discoveries in skin care formulations include scientific advances on extracting proteins and enzymes from plants at their most efficacious state. [French-based] studies on regeneration of plants have yielded that plants are able to withstand extreme conditions, such as harsh wind, extreme heat, or cold. The plants are able to regenerate themselves when conditions change; and they have water. They also have specific protection systems such as:

  • Anabiosis, or the state of reduced metabolism. They become completely dry, like “dead”; and some molecules are synthesized to protect some cellular organelles or constitutive molecules.
  • Gallic acid, or organic acid, also known as benzoic, found in witch hazel, tea leaves, and more; reducing the rate of peroxidation of unsaturated plant membrane lipids.
  • Xyloglucan oligosaccharides, with immunostimulating and moisturizing properties; Trehalose, which has osmoregulating, membrane-stabilizing, and moisturizing properties; and Anthocyanins, specific pigments that shield chlorophyll in plants.

Like resurrection plants, skin may be exposed to strong contrasted condition— heat and cold, dry, airconditioned— or exposed to an aggressive environment, such as sea salt, pool chlorine, and pollution.

It is necessary to strengthen the skin’s resistance toward climatic changes and counterbalance the loss of moisturization. Cellular damage of the skin causes signs of aging. By protecting the skin at the cellular level, we can delay the signs of aging and skin damage. Isolating the most effective enzymes and molecules to effect change is the science behind [our products]. This is the process of identifying and isolating key ingredients from resurrection plants.

PSP: What can physicians and patients expect in the next few years regarding innovations and new formulations?

Linder: Antioxidants of all types continue to hold an important place in the treatment of visible aging, acne, hyperpigmentation, rosacea, and other inflamed skin conditions. As the consumer becomes more aware of the benefits of internal and topical antioxidants, demand is increasing. Potent antioxidants—such as resveratrol from grapes, goji berry extracts, turmeric root extract, and acai extracts— are being introduced to topical products to improve the health and appearance of multiple skin types, by quenching free radicals and reducing resultant inflammation.

Peptides continue to be some of the most innovative and effective topical ingredients available. New peptides, such as neuropeptides, are being developed and are thought to possibly contribute to a feeling of well-being. More studies are needed in order for their benefits to be proven, but we are sure to see more products containing different types of peptide technology in the future.

PSP: The issue of government regulation of organic and natural skin care products seems forever unresolved. What do you think has to happen in the United States to help define organic and natural skin care products? Should the FDA follow the example set by European regulators? Should there be any regulation at all?

Linder: Right now, there really are no regulations. Anyone can make natural or organic claims if only a small percentage of ingredients qualify. Consumers are absolutely confused by the information currently available here in the states and, as of now, organic or natural is more of a marketing claim than anything else.

The truth is that cosmetics, in general, are not regulated by the FDA. Unless steps are taken to increase their involvement in the cosmetics industry as a whole, I do not see how a claim such as this could be accurately regulated.

Mangrum: The question of regulation, the degree of regulation, and the entity that should regulate is forever a point of contention and likely will be in the foreseeable future. Consumers are more wary and savvy than in the past, and they expect their physicians to have a knowledge of natural as well as synthetic skin care products, and to make the best recommendation for their individual needs.

Viviant: Europe has harmonized organic personal care standards with the launch of the European Cosmetics Standards Working Group’s Cosmetics Organic Standard (COSMOS).

The group is open to public consultation from cosmetics manufacturers, certifiers, associations, and consumers. Its rules are: promoting the use of products from organic agriculture and respecting biodiversity; using natural resources responsibly and respecting the environment; using processing and manufacturing that are clean and respectful of human health and environment; and integrating and developing the concept of “green chemistry” instead of petrochemicals.

The group also establishes the five types of ingredients formulated in a cosmetic product, including: water, minerals, physically processed agro-ingredients, chemically processed agro-ingredients, and synthetic materials. The group establishes percentages to define if a product is natural or organic and can be labeled as such.

In the United States, cosmetics regulation falls under the governance of the FDA. Two important laws lay the foundation for the regulation: The Federal Food, Drug and Cosmetic Act; and the Fair Packaging and Labeling Act.

The Food, Drug and Cosmetic Act prohibits the marketing of adulterated or misbranded cosmetic products in the United States, while the Fair Packaging and Labeling Act requires manufacturers to declare ingredients, “allowing consumers to make informed purchasing decisions.”

PSP: Why should physicians choose organic skin care? Aren’t chemical-based products more effective?

Mangrum: In a nutshell, no. Chemical-based products are not necessarily more effective. Cellular damage can occur with a small amount of irritation to the skin. For example, a good trauma to the skin that is intended to damage tissues in a good way is a laser treatment. It helps to stimulate and repair. The process of the skin’s self-healing is where the benefits come in. The repair product to help the healing process makes a huge difference. If the ingredients are not tolerated well and cause further irritation, the progress can be impeded. If the tissue recognizes the ingredients as natural and aiding the process, the results are better. Physicians need clinical evidence to make the best decisions so they don’t have to discern the specific formulations.

Again, there’s the question of organic versus botanical. Organic products that are certified as free from pesticides and chemicals throughout the growing process mean that they are managed throughout the growing period and are harvested to ensure that and to be able to stamp it “certified organic.” Does this mean that a plant growing in the wild is less efficacious or more harmful? Certainly not. There’s a price tag associated with “certified organic” that everyone is not going to pay. The shelf life can also be an issue.

Viviant: Organic skin care is becoming a big business. When you are choosing skin care or cosmetic products, you should become a label detective. An organic certification on a product label is the only way to guarantee the integrity of a product. Certified organic products must contain a minimum of 95% organic ingredients, excluding water and salt/minerals, with a small allowance for natural, nonorganic ingredients that must comply with very stringent processing criteria.

There are two definitions of organic: Organic chemistry is concerned with substances that contain carbon. Carbon is present in all living things. Legally, the cosmetics industry is allowed to label any product that contains carbon as “organic.” If it contains petrol, it is organic. Methylparaben is derived from petrochemicals, which are derived from crude oil, which is derived from living matter. It is a widely used preservative in organic skin care products; therefore, effectively, methylparaben can legally be labeled as organic. Now, it is worth noting that a recent study reported traces of methylparaben in human breast cancer tumors.

The second definition of organic is, “The sustainable system of agriculture that uses natural substances and methods to create healthy nutrient-rich and fertile soils.” Today, we have chemical-based products [that provide] good results. This objective is to make a compromise between the two definitions.

PSP: Does the new wave of skin care formulations make use of ancient botanical “recipes”?

Linder: Botanicals have been used for centuries. Ancient civilizations documented the use of all kinds of plants to treat the skin and other illnesses. This, to me, is by no means new. When developing a product, I often look for ingredients that have been used for prolonged periods of time to ensure the results they provide are consistent and reliable.

The idea of recipes applies to any skin care formulations. A quality skin care line should be formulated so that each of the products work together to support one another and create the most dramatic results possible. The idea of using ancient botanical recipes seems to be more of a marketing idea rather than a new approach.

Mangrum: I wholeheartedly agree. The reason can be answered in three words: efficacy, efficacy, and efficacy. For instance, many of the ingredients [in our products] are derived from regeneration plants—plants that can sustain extremely harsh conditions, such as high heat or low temperatures, and regenerate themselves when the conditions are right.

The enzymes and proteins harvested from these plants have been around for centuries, yet they are highly potent, and the body recognizes them as natural substances; they also cause less irritation. Boswelia extract, Glycerrhetinic Acid and Azelaic Acid fight inflammation and work to calm the skin. Another example is Arbutin, which effectively lightens and removes pigment without the controversy of Hydroquinone.

Viviant: New technology gives us a chance to accelerate the performance of ancient botanicals. For example, we use a plant for hydration treatment. The main ingredient of PA Reviviscence is an antioxidant-rich extract of the Myrothamnus flabellifoli, and this is supplemented by oligosaccharides derived from xyloglucans found in tamarind (Tamarindus indica), a plant known for its immunostimulating and moisturizing properties; and trehalose, which also moisturizes and facilitates osmoregulation.

This plant, which grows on granitic soil in South Africa, has to contend with both the desert conditions and occasional torrential rain found in the region. In dry conditions, the plant has a defense mechanism that enables it to survive with greatly reduced water content in a suspended animation. However, as soon as rain falls, the desiccated plant is able to rehydrate very quickly and resume its normal cellular functions. This is why it is sometimes referred to as a “resurrection plant.”

The natural ingredients are gaining market share because they address consumers’ desire to find ancient botanicals that are not harmful to the environment and that meet their preference for natural products.

PSP: How easy or difficult is it to develop totally pure and ecofriendly skin care products?

Linder: I wouldn’t say it’s difficult, but it can be expensive, and that cost would then carry over to the consumer. Again, for me, I am looking for the best form of an ingredient. Be it natural or synthetic, I want what’s most compatible with the skin, what is most readily available year-round, and a form that will not change depending upon when it was sourced. For me, this is the safest and most eco-friendly ingredient to use. Often, naturally derived is not eco-friendly, as we are depleting natural resources. Many times, we have to discard large quantities of “unneeded” biomass to obtain the one necessary component. It is also very important to ensure that the source of your ingredient is not endangered in any way.

Mangrum: The greater challenge is to ensure that the plants are harvested at just the right time in just the right way for greatest efficacy. The enzymes and proteins must then be extracted under the right methodology in the labs.

“Totally pure” means having a cleanroom environment where no contaminants, including dust through ventilation systems, can get into the mixture. There are different grades of clean-room environments.

“Eco-friendly” also has varying degrees of definition. It can extend from the company’s recycling program to a requirement all along the supplier chain that every source of ingredients—the bottling manufacturer, and so on—comply with a list of standards developed and executed by the company in accordance with its own policies.

This gets back to the earlier question of what does this really mean, who polices it, and is the consumer willing to pay for the cost associated with the processes?

Viviant: It will be scientifically difficult to develop pure skin care products in conformity with the European legislation. The popularity of the Ecocert cosmetic standards and the publication of the NSF standards have increased the complexity of the organic formulation.

PSP: What are some of the marketing catchphrases that skin care companies use in their skin care products that doctors should know, and what do they mean?

Linder: “Chirally correct” is a big one, and although it is important to an extent, I feel it is being overused in the market. Chirality refers to the handedness of a molecule. Certain molecules have a right and a left side that are considered mirror images of one-another. The shapes of these molecules, as well as their “handedness,” will determine its action in the body. An ingredient being chirally correct indicates that the side of the molecule that is most appropriate and effective is being used in the formulation.

I feel that many companies place a lot of unnecessary emphasis on the chirality of their products for marketing purposes. Although there is scientific validity to the use of chirally correct ingredients, this is not the only thing [on which] to base a truly beneficial product line. In some circumstances, the chirally incorrect side of a molecule can be irritating or not as accepted or useful to the skin, but in many cases either side of the molecule is accepted and utilized properly. Ingredients that show no evidence of topical benefit simply are not beneficial, regardless of their chirality.

A well-formulated topical product should contain the most effective ingredients available. In some cases, this may include the use of chirally correct ingredients, but it is also imperative that proper molecule stabilization, effective delivery systems, and ingredients with scientific substantiation be used.

The “all-natural” and “organic” claims that we’ve been discussing are also, as of now, nothing more than marketing at this point. “Preservative-free” is another one. Preservatives are by no means a bad thing. They are necessary to keep products safe and effective. Without preservatives, products would be contaminated by a number of different bacterium, including pseudomonas. All water-based products, natural or not, must have some type of preservative system in place.

“Hypoallergenic” is another one. This does not mean nonallergenic. It is supposed to indicate less allergenic, but this is another term that is not regulated, so it is meaningless.

Mangrum: Skin care companies often use common phrases that have a wide range of meanings, and unless you explore them a little further you really have no idea how meaningful and relevant the information is or isn’t.

See also “Triple Threat” by Tor Valenza in the August 2008 issue of PSP.

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One is “clinically tested” or “clinically proven.” That can mean anything from the subjective “we gave it to a physician’s office and they liked it” to a more objective, proper study conducted with a control group over time and providing well-documented results.

The questions to ask are: “What does that mean?” and “Can you provide me with a copy of the study and the methodology used?” and “How many participants over what period of time?” and “What did the study actually prove?”

One of the most clever marketing tactics I’ve seen is to create a new name for a combination of ingredients, place a definition in Wikipedia and make a new word, then own the rights to that on Google and other search engines to get top placement. It’s really a combination of ingredients that have been around forever, but it sounds like breakthrough research when it’s “branded” as some new hot thing in skincare. It’s quite clever, really.

Rima Bedevian is a contributing writer for PSP. She can be reached at plasticsurgery@allied360.com.