Based on a presentation by Joshua Zeichner, MD
Watch the video of this Skincare Academy presentation featuring Dr. Zeichner at https://jcad.tv/sca-josh-zeichner-hot-topics-in-cosmeceuticals/
Dr. Zeichner is Associate Professor of Dermatology at Mount Sinai Hospital in New York, New York. Dr. Zeichner is also Program Chair of the Skincare Academy Virtual Series.
Visible light protection and tinted mineral sunscreen
Let’s talk about visible light protection, looking at data from Beiersdorf. Visible light has a significant impact on the skin, and it can lead not only to redness, but also is a big contributor to hyperpigmentation, photodermatoses, and melasma. We know that the skin has endogenous antioxidants that protect us from visible light, but there are also several exogenous compounds that have been proven to protect the skin against the free radical damage caused by visible light. That includes compounds such as vitamin E, vitamin C, licochalcone A and glycyrrhetinic acid (which are both extracts of licorice root), and diethylhexyl syringylidenemalonate (DESM) (another proprietary antioxidant ingredient). We also know that the reason that some sunscreens have a tint is because they contain iron oxide pigments, and the iron oxide pigments have direct effects in protecting the skin against visible light as well. For a lot of my patients that have melasma or other issues with hyperpigmentation, I frequently recommend tinted mineral sunscreens because of the iron oxide.
There is clinical data looking at the development of hyperpigmentation or increased production of melanin using several different sunscreens in response to visible light exposure, including the test formula. This test formula is a tinted mineral sunscreen containing iron oxide pigments and a proprietary blend of antioxidants from Beiersdorf. Data showed that there was significantly less production of melanin in response or after exposure to visible light in the test formula group. These data demonstrate that the test formula sunscreen gave better visible light protection than the others tested, and better protection than unprotected skin.
Looking at erythema in response to that same visible light exposure, the Beiersdorf sunscreen (the mineral sunscreen with tint and the antioxidant complex) protected the skin better than four other test sunscreens after exposure to visible light. As such, this is definitely a sunscreen to consider in our patients with sensitivity and redness and patients who are at risk for hyperpigmentation.
Plant-derived exosomes and hair loss
Now, let’s talk about a big hot topic in cosmeceuticals: exosomes. I’m going to specifically present data on plant-derived exosomes from Nutrafol. Exosomes are thought to be involved in cell-to-cell communication, and originally, they were thought to be part of the waste system of the cell; in actuality, these vesicles contained within the cells that are then released play an important role in tissue regeneration, immune responses, gene regulation, and even wound healing. Early endosomes are processed, then released; that’s what we call the exosomes, and these vesicles are released from the cell where they can communicate with other cells.
Plant-derived exosomes are vesicles that come from a variety of different plants, such as grapes, broccoli, lemons, apples, and a whole bunch of other plant sources, that all have different effects on the skin. Data from Nutrafol shows that exosomes derived from ashwagandha seeds can be taken up at significant levels by human fibroblasts. In addition, there’s data showing that the ashwagandha-derived exosome vesicles promoted hair growth and increased the duration of the antigen phase of hair growth, which leads us to believe that it could be beneficial in patients who have thinning hair. There is also clinical data showing that a serum applied topically to the scalp with the ashwagandha-derived exosomes led to an increase in hair growth and hair density. These data illustrate that ashwagandha-derived exosomes are something late-breaking within the realm of thinning hair.
Lipid precursors in cleansers
In the realm of cleansing, we have data from Unilever on lipid precursors in cleansers. We all know about ceramides, which are natural fats that sit between the skin cells and the outer skin layer. Ceramides are like the mortar that sits between our skin cell bricks or the grout between tiles. The problem with ceramides is that they have a very large chemical structure, so they don’t penetrate through the surface of the skin; rather, they just sit on top of the skin.
Some of the Dove cleansers contain lipid precursors, such as stearic and palmitic acid, and because they have a smaller chemical structure, they have been shown to penetrate through the skin. As these lipid precursors penetrate through the skin, they elongate to make other skin-identical lipids. Instead of applying a ceramide to the skin that just sits on the surface, you can apply these ceramide precursors that are then converted into longer lipids, including ceramides.
Mineral Sunscreen for sensitive skin
Next, we’re going to look at some information from Burt’s Bees on the use of sunscreen designed specifically for people with sensitive skin. This is a mineral sunscreen that contains almost 17% non-nano zinc oxide. It contains humectant ingredients, such as glycerin, and emollients, like natural oils and squalene, as well as aloe and rice extract. In a study looking at transepidermal water loss (TEWL) in patients with sensitive skin using this sunscreen moisturizer, at four weeks, there was a decrease in TEWL levels, compared to baseline. That means less epidermal water loss and better skin barrier function.
Another study looking at cosmetic improvement in the skin after four weeks of using this moisturizing sunscreen product designed for sensitive skin showed there were improvements in radiance, texture, and overall healthy look of the skin. In a patient with cosmetic intolerance or sensitivity and significant redness at baseline, who used nothing else besides this moisturizing sunscreen, you can see significant improvements in facial redness after four weeks with daily use. Thus, this sunscreen improves redness while also providing broad-spectrum ultraviolet (UV) protection.
In another clinical study of this sunscreen over four days with exposure to visible light, there was no pigment darkening that you typically see in patients who are unprotected. This sunscreen, similar to some others, is appropriate for sensitive skin and giving visible light protection to prevent worsening of hyperpigmentation.
Skin Barrier Repair
Let’s explore new data on skin barrier repair and improvement in facial redness from EltaMD. EltaMD has a new line of products that contain what they’re calling a “Skin Recovery System” to help repair the skin barrier, reduce irritation and inflammation, renew skin cell turnover, and protect the skin. These three amino acids—taurine, arginine, and glycine—are the basis of the technology. A clinical study using the system’s toner, serum, and moisturizer showed significant improvements in skin hydration after eight days. Another study demonstrated that, even after two days of using this system with the amino acid base complex, there was significant improvement in redness. A clinical trial using the amino acid-based night mask showed that after 28 days, there was a significant reduction in TEWL, which is a surrogate marker for skin barrier function. With this new technology, we’ve seen improvements in barrier function, hydration, and redness, so this is a product that you want to consider in patients with sensitive skin, perhaps after laser devices, irritation, or sun exposure, and in patients with rosacea as well.
Acne treatment
Now, let’s move on to acne, which is one of my favorite topics. We have data from a one-week clinical study on a new product that contains sulfur and niacinamide for the treatment of acne, brought to us by Neutrogena. Niacinamide is a form of vitamin B3 that has brightening and soothing effects. Sulfur is included in the United States (US) Food and Drug Administration (FDA) monograph as an acne treatment, and it has antimicrobial and anti-inflammatory effects. It’s useful across all skin types, but particularly useful for people who have sensitive skin and can’t tolerate ingredients such as benzoyl peroxide. This study showed improvements in pimples from baseline after only one day. After seven days, there was complete resolution of the pimple. There were also significant improvements in redness, elevation, diameter, and patient discomfort over that seven-day period with use of the sulfur niacinamide-based serum. In terms of patient-reported outcomes, the serum was very well tolerated, and patients were really happy with the effects of the serum on the skin and how their skin looked.
Skin repair following laser treatments
Next, we have data on a dermocosmetic with skin repair properties after laser treatment from La Roche Posay. This Cicaplast Cream contains the hero ingredient panthenol. There is also shea butter, glycerin, dimethicone, and thermal spring water. This is commonly used by dermatologists and other dermatology practitioners across the country, including myself, for skin irritation and post-procedure.
In a study examining patients with acne scars who were treated with a resurfacing laser, after the laser, patients applied Cicaplast Cream. They experienced decreases in sebum production, improvements in water content, and decreases in TEWL. There were also improvements in erythema and hyperpigmentation. I recommend this product to my patients, and it’s something to consider after procedures in the office.
Personal Care products
Dandruff shampoo. To close out our hot topics, I will discuss updates about in personal care products, looking at data from Procter & Gamble. First, let’s talk about dandruff, which is an issue many people face. We often recommend products that contain zinc pyrithione, which is the active ingredient in dandruff shampoos that lower levels of yeast that drive dandruff. There are data from Procter & Gamble specifically looking at the spatial delivery of the zinc pyrithione into the skin from their “Head and Shoulders” shampoo. The zinc pyrithione in this shampoo has a patented spatial delivery system that allows for optimal coverage of the scalp. The particles aren’t too small or too big—they’re designed to evenly deposit on the scalp and cover the scalp. The technology that goes into the shampoo contains a cationic polymer, an anionic surfactant, and the zinc pyrithione. To simplify, when the shampoo is applied to the skin, the surfactant is removed and the polymer and zinc pyrithione remain on the skin so it can do its job, even after the shampoo itself or the cleansing ingredient is removed. It is important to know that if you are not using the right conditioner, you can wash away that deposited zinc pyrithione. If you’re using a Head and Shoulders shampoo, you also need to use a Head and Shoulders conditioner to make sure that you are not removing that zinc pyrithione.
Cleanser. Now let’s talk about cleansing, looking at data from Olay. We all have heard of micellar cleansers and micelles, which are these small cleansing ingredients that act like traps to lift oil and dirt from the skin. Since they’re very small, in some cases the micelles and cleansers can penetrate the skin. Instead of micellar cleansers, the body washes in this Olay line contain lamellar cleansers. These form sheets, or lamells, of the cleansing ingredients that sit on the surface of the skin without penetrating and causing irritation. They also contain emollient ingredients, such as petrolatum and a modified glycerin, that do not wash off of the skin, so they help give hydrating benefits in addition to the cleansing effects. Studies using these lamellar-based cleansers have shown that, with continued use, there is a decrease in TEWL, thereby improving barrier function, as well as increases in corneometry, which is a direct measure of skin hydration.
Deodorant-antiperspirant. Finally, I want to talk about sweating. Many of us think that you have to write a prescription-based antiperspirant to be effective. However, a study looking at a clinical strength over-the-counter antiperspirant from Secret, which uses 20% aluminum zirconium tetrachlorohydrex in a hydrating vehicle showed it was as effective as the prescription aluminum chloride, but much better tolerated.
The last tip that I want to give you is that if you are recommending an antiperspirant to your patients, tell the patients to apply the antiperspirant in the evening before bed because this is when we make less sweat naturally, body temperature is lower naturally, and the zinc salt in the antiperspirant can form the most effective plug possible to continue to help protect against sweat and prevent wetness the next day. If you need a little touch up or extra antiperspirant, you can apply it again in the morning. But data has shown that applying it in the evening is most effective, and applying it twice a day does not add that much more benefit.