Skin care is a dynamic, rapidly evolving market with increasingly fewer major players, a handful of aggressive, second-tier marketers, a group of established brands trying to reinvent themselves, and start-up niche brands, all looking to attract the attention of a highly informed and demanding consumer who wants more than just a garden-variety moisturizer. They want products that work quickly and reliably, look and feel good, and last well.
Along with function and performance, the products’ sensory and emotional benefits must complete the package to entice customers to buy them.
The cosmeceuticals industry is succeeding in delivering quality technology and ingredients that have enhanced efficacy, especially in the realm of sun care and antiaging. As a result, consumers’ attitudes have evolved so that more consumers today believe that using the right skin care products can make a visible improvement in their skin. Men and, surprisingly, young adults are also quickly increasing their use of cosmeceuticals.
Key trends include microsegmentation in the market driven by a strong consumer desire for multifunctional products. There is also an increased focus on natural or organic ingredients and brands, new launches of products and devices for home use that mimic clinical results, and more targeted products aimed at specific consumer concerns such as acne, rosacea and redness, and pigmentation.
Recent technological advancements have allowed skin care marketers to develop products that target more specific consumer needs. However, the proliferation of new ingredients and product ranges has increased consumer confusion and made physician selection more challenging.
“The scientific truth is that many of the ingredients found in products that tout age-fighting benefits lack sufficient clinical data to support their claims,” says Melanie Grossman, MD, a dermatologist who practices in New York City. “While manufacturers promise dramatic improvements, especially on wrinkles, relatively few products have been adequately studied.”
The Science of Retinol
Currently, the topical retinoids approved by the FDA for treating photodamaged skin include tretinoin 0.02% and 0.05% emollient cream, and tazarotene 0.1% cream. Retinol is converted to retinoic acid (tretinoin, Retin-A®) in living cells. Although its clinical effects are not as dramatic as retinoic acid, retinol is available without a prescription and has been incorporated into many skin care products.
To some degree, retinol has also been used in the management of acne and keratosis pilaris in topical creams. The increased skin exfoliation of vitamin A helps unclog pores. When applied to skin, retinol penetrates better than retinoic acid and does not produce the same irritating effects.
The University of Michigan Medical School, Ann Arbor, released a study that shows that wrinkles, roughness, and overall aging severity are significantly reduced in skin when treated with retinol. The research team tested the vitamin on the upper arms of women aged, on average, 87 years.
After a period of 24 weeks, they found that the retinol increased the production of glycosaminoglycan and procollagen, which are integral structural components of the skin. The proven antiaging benefits of retinol include the reduction in the appearance of wrinkles, hyperpigmentation, signs of photodamage, and pore size.
Retinol was pioneered and stabilized by RoC in 1995 and has been a leading antiaging skin care ingredient ever since. Current formulations of retinol range from the lowest strength on the market—about 0.15%—to 1.0%, which is the highest nonprescription strength available.
The Power of Peptides
Peptides are fragments or pieces of proteins that have a variety of effects on cellular function. Many cosmeceutical formulas include both synthetic and naturally occurring peptides shown in the laboratory to have a biologic effect on aging or sun-damaged skin. Certain peptides may stimulate skin metabolism and repair; others inhibit the breakdown of collagen; while other varieties decrease muscle movement, thus improving dynamic wrinkles.
UV-A organic filters1
- Benzophenone (oxybenzone, dioxybenzone, sulisobenzone)
- Avobenzone (Parsol 1789)
- Ecamsule (Mexoryl® SX)
UV-B organic filters
- Salicylates (octisalate, homosalate, trolamine salicylate)
- Cinnamates (octinoxate)
- Broad spectrum (titanium dioxide, zinc oxide)
Peptides may act as carrier agents to facilitate the delivery of other agents into the skin, such as copper, which serves a role in collagen production; as “signaling” molecules, by activating fibroblasts and inhibiting matrix metalloproteinases, which degrade collagen; and as inhibitors of neuromuscular transmission, by interfering with the activity of membrane proteins necessary for the release of acetylcholine. The most common peptides found in topical skin care products are acetyl hexapeptide-3, or Argireline®, and palmitoyl pentapeptide-3, also called Matrixyl®.
“Despite the popularity of peptides in topical skin care products, there are no well-controlled, convincing studies that demonstrate their efficacy as a treatment for wrinkles, says Leslie Baumann, MD, professor of dermatology, chief division of cosmetic dermatology, University of Miami, and author of The Skin Type Solution (Bantam, 2006). “This may be because it is difficult for the peptides to penetrate into the deeper layers of the skin.”
Glycolic Acids Take Center Stage
Glycolic acids, first popularized during the 1980s, have remained a steadfast favorite of physicians and consumers alike. They can jump-start the exfoliation process by dissolving the cellular glue that binds dead cells together to allow healthier living cells to reach the surface, providing a smoother, clearer complexion.
Glycolic acids are also keratolytics that absorb into the sebaceous follicle where the buildup of dead cells can contribute to aging and acne. Glycolic acid has superb water-binding capabilities that facilitate an increase in skin thickness.
The new physician-dispensed luxury skin care range, Vivité™(Allergan), contains the patented GLX Technology™, which pairs antioxidants with glycolic acids for the best of both worlds.
“GLX Technology is a specialized blend of glycolics and natural antioxidants that renews skin and enhances natural production of hyaluronic acid, stimulating epidermal growth factor and collagen,” says Jeanine Downie, MD, FAAD, a dermatologist who practices in Montclair, NJ. “The results of a 3-week, double-blind, clinical half-face study documented the benefits of using Vivité for 3 weeks to include a reduction in fine lines and dryness, and an increase in skin-moisture content and smoothness.”
Several antioxidants are used as ingredients in topical skin care formulations, including lycopene, grape seed extract, resveratrol, green tea, coenzyme Q10 (CoQ10), and lipoic acid. Each offers distinct advantages, yet they pose similar challenges in terms of harnessing their potency in topical products.
Antioxidants, applied topically, reduce free-radical damage, thus helping prevent cellular damage, collagen destruction due to inflammation, and immune suppression. Many researchers believe that a single antioxidant, no matter how stable or potent, is not as effective for skin as a group of antioxidants, because antioxidants in combination can exert a synergistic cumulative action on the skin.
“Oral and topical antioxidants should be a part of every antiaging skin care regimen,” Baumann says. “A combination of several types of antioxidants is preferred. Green tea is the most studied, but most topical products do not have a large-enough concentration of the active polyphenols.
“If green tea is used in the proper amount, the product has a brownish color. Coffeeberry, vitamin C, vitamin E, and coenzyme Q10 are other useful antioxidants.”
CoQ10 and idebenone. CoQ10, also called ubiquonone, is a powerful antioxidant that is found in all cells. It fights free-radical stress and assists in energy production, which is an important component of cellular metabolism that is thought to diminish in efficiency with age.
Levels of CoQ10 also decline with age. Topical CoQ10 has been shown to penetrate the viable layers of the epidermis and lower the level of oxidation, which suggests that topical CoQ10 may be effective in preventing and repairing photodamage.
Closely related to CoQ10, idebenone has been used for many years to alleviate the symptoms of Alzheimer’s disease. Idebenone is claimed to have antioxidant properties similar to CoQ10, and to be a more efficient free-radical scavenger.
According to Joe Lewis, founder of Priori Bioengineered Skincare, “Idebenone is bioengineered CoQ10. What makes it unique is that it is a mitochondria-targeted antioxidant.”
The highest strength of idebenone-based skin care is currently found in Prevage® MD (1% idebenone) Anti-Aging Treatment (Allergan), which is marketed exclusively through physicians. Elizabeth Arden Prevage contains 0.5% Idebenone and is available at prestige retailers and department stores. A newcomer, Priori® Bioengineered Skincare, has launched a novel range of idebenone products including idebenone supplements in 50-mg capsules, marketed through skin care professionals and spas.
Coffeeberry. According to David H. McDaniel, MD, FAAD, assistant professor of clinical dermatology and plastic surgery, Eastern Virginia Medical School, Norfolk, “There are significant benefits of coffeeberry clinically but also in vitro testing on human skin fibroblast cells for reducing the appearance of aging/photoaging, and for ‘protective’ benefits for free radicals and inflammatory response as well as collagen and dermal matrix.”
A 6-week, double-blind study took place to assess the effects of RevaléSkin Day Cream (Stiefel Laboratories Inc), applied once daily in the morning; Night Cream, applied once daily in the evening; and Facial Cleanser, applied once in the morning and once in the evening before applying the Day Cream and Night Cream. The study group consisted of 30 subjects aged 30 to 70, of which a randomized selection of 10 subjects participated in a split-face protocol.
“Energy-based treatments which produce cellular injury or thermal injury, such as IPL, laser, radio frequency, etc, can potentially benefit from coffeeberry as an adjunctive therapy,” McDaniel says. “The LED photomodulation is a bit different if the LED is a nonthermal and photobiochemical process. So in the case of these types of LED, [it] is also adjunctive in a beneficial way, but the free-radical-quenching ability becomes more important to neutralize environmental damage that is still occurring—rather than to defend and repair the damage from the light.”
Surprisingly, despite the media attention and physician warnings about daily sunscreen use, consumers continue to defy the message. Although the percentage of people using sunscreens has scored in the double digits in the last few years, a May 2007 survey from the Skin Cancer Foundation and iVillage reports some disappointing facts about current consumer attitudes.
For example, 40% of those surveyed never use sunscreen, 39% only use sunscreen outdoors, and only 11% use a daily SPF 15+. (To view the results of this survey, visit www.skincancer.org.)
The greatest strides cited in the development of sunscreen technology is the proliferation of enhanced UV-A protection and increased photostability. UV-A has a longer wavelength and penetrates deeper into the skin than UV-B.
The long-anticipated launch of ecamsule, or Mexoryl® SX (L’Oréal)—an agent that shields skin from short-wave UV-A rays and provides protection from the full range of UV-A and UV-B rays—raised the bar for newcomers. The purported benefits of this technology is that it does not break down as easily as some other products and offers longer-lasting protection. Sunscreens containing Mexoryl have been available in Europe, Asia, and Canada since 1993, but only received FDA approval in 2006.
Helioplex™ (OrthoNeutrogena) is considered the newest star on the horizon. It contains avobenzone combined with oxybenzone to enhance its stability. Avobenzone historically has been effective as a UV block, but its UV-A protection weakens after a few hours of sun exposure. Helioplex technology works with these key ingredients to provide high broad-spectrum photostable coverage for 4 or 5 hours.
Until recently, the FDA-approved method for assessing the efficacy of sunscreens is the sun-protection factor (SPF) rating. The SPF is measured by comparing the amount of time it takes to cause sunburn on protected skin versus the time it takes to cause the same reaction on unprotected skin.
A new method is emerging called the environmental-protection formula (EPF), which calculates the potency of antioxidant protection as well. EPF is to antioxidant environmental protection efficacy what SPF is to sunscreen UV protection efficacy.
|See also “The New Therapy Landscape” by Wendy Lewis in the April 2007 issue of PSP.|
For antioxidant efficacy protocols, each antioxidant is scored and the results are totaled on an equal-weighted basis. The overall total score for each antioxidant reflects the overall stress-protection capacity, or EPF. Consumers will now have a simple way to rate antioxidant strength and compare the efficacy of topical antioxidants.
“The causes of premature skin aging are external and internal oxidative stress,” Lewis says. “Sunscreens are not free-radical scavengers; they intercept UV light before free radicals are formed.
“SPF represents UV photoprotection,” he continues. “EPF represents the quantitative topical protective capacity of antioxidants. To achieve total topical skin protection, you need a combination of EPF plus SPF.”
Research is under way examining nannoparticle zinc oxide’s ability to enhance penetration and avoid the white appearance of previous zinc oxide formulations. However, there is a debate over whether these tiny particles can induce free-radical formation in the presence of light, which may damage these cells if the zinc oxide penetrated into viable skin cells. Current research seems to suggest that they remain on the surface of the skin and in the stratum corneum, but more studies are needed.
What’s Coming Next
The future lies in developing methods to rejuvenate the face and body on a cellular level, where it really counts. “I think we will see more superpotent antioxidants like coffeeberry, either synthetic or natural,” McDaniel says. “We are going to see more products based on science with good clinical studies, and there will be more interest at a cellular level of how these products actually work to protect and repair environmental damage even down to the gene-expression level.”
Wendy Lewis is a contributing writer for Plastic Surgery Products; author of Plastic Makes Perfect: The Complete Cosmetic Beauty Guide (Orion, 2007); and the editorial director for MDPublish.com, a medical marketing and publishing group. She can be reached via her Web site, www.wlbeauty.com.
- Draelos Z. Anti-aging photoprotection developments. US Dermatology Review. 2006;41-42.