336 Pages
English

You can change the print size of this book

Cosmeceuticals E-Book

-

Gain access to the library to view online
Learn more

Description

Improve your knowledge and treat patients with confidence using today’s most advanced cosmeceutical treatments and expert guidance from author Zoe Diana Draelos, MD. Cosmeceuticals, 3rd Edition, a volume in the Procedures in Cosmetic Dermatology Series, covers cutting-edge content, keeping you up to date with developments in this rapidly-moving field so you can offer your patients the latest cosmeceutical therapies with optimal results.

  • Consult this title on your favorite e-reader.
  • Stay on top of more than "just the basics" concerning cosmetics and skin care and deliver the state-of-the-art expertise your patients are looking for.
  • Expand your repertoire and refine your skills with a wealth of color illustrations and photographs depicting cases as they appear in practice.
  • Learn new uses for botanicals, including soy and green tea, as well as vitamin antioxidants, peptides, growth factors, and stem cells.
  • Find what you need quickly with new summaries and keypoints at the start of each chapter.

Subjects

Informations

Published by
Published 26 September 2014
Reads 0
EAN13 9780323340502
Language English
Document size 4 MB

Legal information: rental price per page 0.0451€. This information is given for information only in accordance with current legislation.

C o s m e c e u t i c a l s
PROCEDURES IN COSMETIC
DERMATOLOGY
3RD EDITION
Edited by
Zoe Diana Draelos MD
Consulting Professor, Department of Dermatology, Duke University School of Medicine,
Durham, North Carolina, USA
Series Editor
Jeffrey S. Dover MD FRCPC FRCP
Associate Clinical Professor of Dermatology, Yale University School of Medicine;
Clinical Professor of Surgery, Dartmouth Medical School;
Adjunct Associate Professor of Dermatology, Brown Medical School;
Director, SkinCare Physicians, Chestnut Hill, MA, USA
Associate Editor
Murad Alam MD MSCI
Professor of Dermatology, Otolaryngology, and Surgery;
Chief, Section of Cutaneous and Aesthetic Surgery,
Northwestern University, Chicago, IL, USATable of Contents
Cover image
Title page
Procedures in Cosmetic Dermatology
Copyright
Series Preface
Preface
Contributors
Dedications
List of Videos Online
Part 1 Defining the Cosmeceutical Realm
Introduction
1 Cosmeceuticals: Function and the Skin Barrier
Introduction
The function of the stratum corneum
The stratum corneum structure
The mechanics of dry skin
Effects of the environment on SC function
The barrier is a challenge for cosmeceuticals
Future prospects
References and further reading2 Cosmeceutical Formulation Considerations
Introduction
Vehicles
Emulsions
Serums
‘Balm’ products
Delivery systems
Additional formulation considerations when developing cosmeceutical products
Conclusion
3 Evaluating Cosmeceutical Efficacy
Introduction
Instrumental methods that are related to visual assessments
Instrumental methods related to tactile assessments
Instrumental methods based on physiologic processes
Instrumental measurements based on physical properties
Conclusion
References and further reading
Part 2 Cosmeceutical Actives
Introduction
4 Retinoids
Introduction
Molecular biology of retinoids
Metabolism of cutaneously delivered retinoids
Conclusion
Further reading
5 Cosmeceutical Vitamins: Vitamin C
IntroductionOxidative stress, aging skin, and vitamin C
Vitamin C: effects on collagen and elastin synthesis
Photoprotection by vitamin C
Vitamin C as an anti-inflammatory
Vitamin C inhibits melanogenesis
Delivery and metabolism of L-ascorbic acid and derivatives
Clinical studies confirming antiaging benefits of topical vitamin C
Conclusion
References and further reading
6 Cosmeceutical Vitamins: Vitamin B
Introduction
Niacinamide
Panthenol
Discussion
Further reading
7 Physiologic Lipids for Barrier Repair
Introduction
Dynamics of barrier recovery
Clinical applications of the cutaneous stress test
Lipid composition of lamellar membranes
Lipid synthesis and requirements for the barrier
Nonphysiologic lipids: mechanism of action
Rationale for barrier repair therapy
Deployment of barrier repair therapy
Conclusion
References and further reading
8 Cosmeceutical Botanicals
IntroductionMost widely used herbs
Conclusion
References and further reading
9 Marine Cosmeceuticals
Sea water
Sea mud
Algae extracts
Chitin and chitosan
Marine collagen
Conclusion
Further reading
10 Cosmeceutical Metals
Introduction
Zinc in cosmeceutical products
Copper in cosmeceutical products
Selenium in cosmeceutical products
Aluminum in cosmeceutical products
Strontium in cosmeceutical products
Summary
References and further reading
11 Moisturizer and Barrier Repair Formulations
Introduction
General principles of fundamental skin care
Maintenance of normal skin integrity and water content
Physiologic epidermal barrier repair
Clinical impact of moisturizers
Significance of moisturizer application frequency
Significant components of moisturizer formulationsCharacteristics and aesthetic properties of formulations
Vehicle delivery characteristics
The role of specialized ingredients in moisturization vs barrier repair
Therapeutic significance of moisturizer use
Conclusion
Further reading
12 Skin Lightening Agents
Introduction
Skin lightening cosmeceuticals
Methods to improve product delivery
Laser therapy
Conclusion
Further reading
13 Antiaging Benefit Ingredients: AHAs, PHAs, and Bionic Acids
Introduction
Alpha-hydroxy acids
Polyhydroxy acids and bionic acids
Gluconolactone: the most widely used PHA
Lactobionic acid: a polyhydroxy bionic acid
Maltobionic acid: a plant-derived bionic acid
Increased synthesis of dermal matrix components by PHAs and bionics
Antiglycation effects of PHAs and bionic acids
Use of PHAs and bionics in the dermatologist's office
Conclusion
References and further reading
14 Stem Cell Cosmeceuticals
Introduction
Types of stem cells and their sourceSkin stem cells
Use of stem cells in cosmetics
Human adipose stem cells in cosmetics
Human embryonic stem cells in cosmetics
Conclusions
References and further reading
15 Nutritional Antioxidants
α-Lipoic acid
Ubiquinone (coenzyme Q10)
Genistein
Conclusion
References and further reading
16 Endogenous Growth Factors as Cosmeceuticals
Introduction
Photodamage effects on skin tissue
Biochemical pathways of skin aging
Growth factors in skin repair
Treating photodamaged skin
Topical application of growth factors
Combination: laser plus growth factors
Combination: growth factors plus antioxidants and retinoids
Sources of growth factors
Other delivery methods
Risks associated with growth factors
Maintaining growth factor stability
Conclusion
Further reading
17 SunscreensIntroduction
Chemical sunscreens
Physical sunscreens
Rating efficacy
Photostability
Dosage and usage
Adverse events
Sunscreen controversies
New research
Further reading
18 Cosmeceuticals and Contact Dermatitis
Introduction
Vitamins
Hydroxy acids
Botanicals
Fragrances
Preservatives
Sunscreens
Emergent allergens
Patch testing
Further reading
Part 3 The Application of Cosmeceuticals to Dermatologic Practice
Introduction
19 Wrinkles and Fine Lines
20 Facial Redness
21 Dyspigmented Skin22 Oily Skin
23 Dry Skin
24 Acne
Part 4 Cosmeceutical Myths
Introduction
25 Acne Cosmeceutical Myths
Cosmeceuticals do not produce acne if labeled noncomedogenic and
nonacnegenic
Mineral oil is comedogenic
Sunscreens produce acne
Vitamin E capsules improve the appearance of scars
Glycolic acid application can reduce pore size
Tretinoin topically aids in the treatment of acne scarring
A complex skin care regimen of multiple cleansers, moisturizers, and ancillary skin
care products is necessary for clear skin
Breakouts after the age of 30 in women are rare and will benefit from special skin
care
Cosmeceuticals cannot undergo reliable comedogenicity testing
Over-the-counter scar gels can aid in improving acne scars
26 Cosmeceutical Antiaging Myths
Expensive moisturizers are more effective
Moisturizers remove wrinkles
Cosmeceuticals can produce beneficial effects on facial muscles to improve skin
tone
Bleaching creams can improve brown spots quickly
Glycolic acid peels must hurt to be effective
Cosmeceuticals need to penetrate the skin barrier to work
Topical formulations of vitamins and supplements are similar to pills in
effectiveness for skin improvementVitamin-containing products can reverse photoaging
Retinol in over-the-counter preparations works like prescription tretinoin
A sunscreen with an SPF above 15 does not provide additional photoprotection
Self-tanning cosmeceuticals provide sun protection
Nanoparticles increase antiaging cosmeceutical efficacy
Scarce cosmeceutical ingredients add cutaneous benefit
Lip plumping cosmeceuticals increase lip size
27 Botanical Cosmeceutical Myths
Hypoallergenic botanical cosmeceuticals do not produce allergic reactions
Preservative-free botanical cosmeceuticals produce fewer skin reactions
Botanical cosmeceuticals are natural
Botanically derived fragrances do not cause allergic contact dermatitis
Botanical cosmeceuticals can reduce sebum production
Antiperspirants contain chemicals that are not naturally derived and are therefore
damaging to the sweat glands
Botanicals and mineral cosmetics are safe and do not cause acne
Face masks with botanicals improve skin tone
All natural ingredients are safer in skin care products
Numerous botanicals in cosmeceuticals are better
Cleansers with ground botanical materials are good for deep cleaning pores
Topical botanical cosmeceuticals minimize postmenopausal skin changes
Part 5 New Research in Cosmeceuticals
Introduction
28 Gene Array Technology and the Search for Cosmeceutical Actives
Introduction
Basic principles of gene array analysis
Application of gene arrays to the identification and characterization of antiaging
and anti-inflammatory bioactive molecules
Gene arrays and the search for aging genes: the caloric restriction modelConclusion
References and further reading
29 Future Cosmeceuticals of Dermatologic Importance
Introduction
Antioxidants
Polyphenols
Genistein
Idebenone
Global rejuvenation agents
Nanotechnology
Conclusion
Further reading
Summary: What is the Next Horizon for Cosmeceuticals?
IndexProcedures in Cosmetic
Dermatology
Series Editor: Jeffrey S. Dover MD FRCPC FRCP
Associate Editor: Murad Alam MD MSCI
Botulinum Toxin
Third Edition
Alastair Carruthers MA BM BCh FRCPC FRCP and Jean Carruthers MD FRCSC
FRC(Ophth) FASOPRS
ISBN 978-1-4557-2781-0
Soft Tissue Augmentation
Third Edition
Jean Carruthers MD FRCSC FRC(Ophth) FASOPRS and Alastair Carruthers MA BM
BCh FRCPC FRCP
ISBN 978-1-4557-2782-7
Lasers and Lights
Third edition
George Hruza MD and Mathew Avram MD
ISBN 978-1-4557-2783-4
Treatment of Leg Veins
Second edition
Murad Alam MD and Sirunya Silapunt MD
ISBN 978-1-4377-0739-7
Photodynamic Therapy
Second edition
Mitchel P. Goldman MD
ISBN 978-1-4160-4211-2
Chemical PeelsSecond edition
Rebecca C. Tung MD and Mark G. Rubin MD
ISBN 978-1-4377-1924-6
Non-Surgical Skin Tightening and Lifting
Murad Alam MD MSCI and Jeffrey S. Dover MD RCPC FRCP
ISBN 978-1-4160-5960-8
Scar Revision
Kenneth A. Arndt MD
ISBN 978-1-4160-3131-4
Hair Transplantation
Robert S. Haber MD and Dowling B. Stough MD
ISBN 978-1-4160-3104-8
Liposuction
C. William Hanke MD MPH FACP and Gerhard Sattler MD
ISBN 978-1-4160-2208-4
Body Contouring
Bruce E. Katz MD and Neil S. Sadick MD FAAD FAACS FACP FACPh
ISBN 978-1-4377-0739-7
Advanced Face Lifting
Ronald L. Moy MD and Edgar F. Fincher MD
ISBN 978-1-4160-2997-7
Blepharoplasty
Ronald L. Moy MD and Edgar F. Fincher MD
ISBN 978-1-4160-2996-0
Body Shaping: Skin Fat Cellulite
Jeffrey Orringer MD, Murad Alam MD MSCI and Jeffrey S. Dover MD FRCPC FRCP
ISBN 978-1-323-32197-6C o p y r i g h t
© 2016, Elsevier Inc. All rights reserved.
First edition 2005
Second edition 2009
Third edition 2016
No part of this publication may be reproduced or transmitted in any form or by any
means, electronic or mechanical, including photocopying, recording, or any
information storage and retrieval system, without permission in writing from the
publisher. Details on how to seek permission, further information about the
Publisher's permissions policies and our arrangements with organizations such as the
Copyright Clearance Center and the Copyright Licensing Agency, can be found at
our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under
copyright by the Publisher (other than as may be noted herein).
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress
Notices
Knowledge and best practice in this field are constantly changing. As new research
and experience broaden our understanding, changes in research methods,
professional practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and
knowledge in evaluating and using any information, methods, compounds, or
experiments described herein. In using such information or methods they should be
mindful of their own safety and the safety of others, including parties for whom
they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are
advised to check the most current information provided (i) on procedures featured
or (ii) by the manufacturer of each product to be administered, to verify therecommended dose or formula, the method and duration of administration, and
contraindications. It is the responsibility of practitioners, relying on their own
experience and knowledge of their patients, to make diagnoses, to determine
dosages and the best treatment for each individual patient, and to take all
appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors,
or editors, assume any liability for any injury and/or damage to persons or
property as a matter of products liability, negligence or otherwise, or from any use
or operation of any methods, products, instructions, or ideas contained in the
material herein.
ISBN: 978-0-323-29869-8
ebook ISBN: 978-0-323-34050-2
eBook ISBN: 978-0-323-37669-3
Senior Content Strategist: Belinda Kuhn
Senior Content Development Specialist: Ailsa Laing
Project Manager: Sukanthi Sukumar
Designer: Miles Hitchen
Illustration Manager: Emily Costantino
Multimedia Producer: Jonathan Davis
Printed in Canada
Last digit is the print number: 9 8 7 6 5 4 3 2 1


/

Series Preface
Seven years ago we embarked on an e ort to produce Procedures in Cosmetic
Dermatology, a series of high quality, practical, up-to-date, illustrated manuals. Our
plan was to provide dermatologists, dermatologic surgeons, and others dedicated to
the pursuit of functional knowledge with detailed portable books accompanied by
high quality ‘how to’ DVD's containing all the information they needed to master
most, if not all, of the leading edge cosmetic techniques. Thanks to the e orts of
world class volume editors, master chapter authors, and the tireless and
extraordinary publishing sta at Elsevier, the series has been more successful than
any of us could have imagined. Over the past seven years, 15 distinct volumes have
been introduced, and have been purchased by thousands of physicians all over the
world. Originally published in English, many of the texts have been translated into
di erent languages including Italian, French, Spanish, Chinese, Polish, Korean,
Portuguese, and Russian.
Our commitment has always been to ensure that the practical, easy to use
information conveyed in the series is also extremely up-to-date, incorporating all the
latest methods and materials. To that end, given the rapidly changing nature of our
subspecialty, the time has now come to inaugurate the third edition. During the next
few years, re ned, enlarged, and improved texts will be released in a sequential
manner. The most time-sensitive books will be revised first, and others will follow.
This series is an ever evolving project. So in addition to third editions of current
books, we are introducing entirely new books to cover novel procedures that may
not have existed when the series began. Enjoy and keep learning.
Jeffrey S. Dover MD FRCPC FRCP, Murad Alam MD MSCI

P r e f a c e
The realm of cosmeceuticals is assuming even greater importance now than when the
rst two editions of this text were published. New delivery systems for healthcare are
taking shape worldwide in developed countries, as mounting costs are becoming a
prime driver. Increased healthcare premiums, higher patient out-of-pocket costs per
physician visit, and di cult access to medications through compacted formularies
and prior approval regulations are making access to prescription treatment
challenging. This means that many patients must turn to over-the-counter solutions
to alleviate dermatologic disease with products known as cosmeceuticals. This means
that the dermatologist must understand how to e! ectively use this category as an
increasingly important part of therapy.
Moisturizers are one of the most potent therapeutic formulations with proven
efficacy in dermatology. The dry itchy skin associated with eczema, xerosis, psoriasis,
and atopic dermatitis can be improved with moisturizer use alone. Proper use of
these moisturizers requires an understanding of barrier function accompanied by
formulation guidelines and testing methodologies for e cacy. These concepts are the
basis for Part One of the text.
Part Two builds on this understanding of moisturizers to expand into the complex
arena of actives, substances that are added to a moisturizer vehicle to increase
e cacy. Some of the actives are designed to aid in the management of dry skin, such
as physiologic lipids, while others are designed to provide photoprotection, such as
sunscreens. Other ingredients, such as growth factors, nutritional antioxidants, stem
cells, metals, marine botanicals, and vitamins, are designed to address the functional
and appearance issues associated with aging skin. Finally, all cosmeceutical
ingredients must be evaluated for safety and their ability to induce irritant and
allergic contact dermatitis.
The application of these concepts is elucidated in Part Three where speci c skin
conditions are addressed in written text and also in video presentations. These videos
are an aid to engaging patients in discussions regarding the use of cosmeceuticals as
part of a treatment regimen. This is a nice transition into Part Four that addresses
common patient misconceptions regarding the use of cosmeceuticals. Finally, Part
Five examines some of the new cosmeceutical research.
The dividing line between cosmeceuticals and pharmaceuticals is becoming



increasing blurred; however, the main distinguishing characteristic between
cosmeceuticals and pharmaceuticals is the precise dose required for e cacy and
safety. We know that modern day cosmeceuticals are cosmetic formulations that can
a! ect the structure and function of the skin, which contradicts the original de nition
of a cosmetic, yet we do not administer cosmeceutical ingredients based on dose.
One of the main reasons this cannot be accomplished is that it's hard to characterize
the active agent of many substances that form the basis for cosmeceutical
formulations. For example, chamomile is a known anti-in, ammatory when applied
topically to the skin. It is included in many moisturizers labeled for sensitive skin.
The active agent in chamomile is known as bisabolol, but how much chamomile is
necessary to deliver the proper dose of bisabolol to the skin is challenging to
determine as the constituents of botanical extracts are determined by the growing
conditions of the plant to include temperature, soil conditions, water availability,
etc.
A further problem a! ecting botanicals, nutritionals and marine materials
commonly incorporated into cosmeceuticals is the possible presence of a variety of
contaminants, including heavy metals, pesticides and fungal toxins. Contaminants is
not an issue in pharmaceuticals that are synthesized under careful laboratory
conditions; however, when plant materials are concentrated, so are the
contaminants. For example, green tea, a potent antioxidant, may be contaminated
with pesticides, since pesticides are used to prevent leaf damage in the elds. It is
not possible to remove the pesticides completely from the leaves and the botanical
extract represents a concentrated use of the dried leaves.
Will it ever be possible to make pure quanti able e cacious cosmeceuticals that
provide skin improvement similar to pharmaceuticals? Most de nitely. The
development of plant stem cell derived ingredients is one example of how
technology is improving the science behind cosmeceuticals. Stem cells derived from
plants can be cultured under optimal conditions to yield a more standard
composition than those grown outdoors. Consistency is key to obtaining a reliable
extract for reproducible results. Stem cells also provide for purity that was previously
not achievable. This is but one example, with many others presented in the text, as
to how cosmeceuticals are emerging as important players in the dermatologist's
armamentarium.
It is my hope that you enjoy reading this text as much as I have enjoyed the
learning journey with all of the many talented authors who contributed their time
and expertise. Cosmeceuticals are fun because they allow creativity and diversity not
possible in pharmaceuticals. While reading this text, you will discover the limitless
potential for cosmeceutical development!
Zoe Diana Draelos MDContributors
John Bajor PhD, Senior Principal Scientist, Personal Care Category, Unilever
Research and Development, Trumbull, Connecticut, USA
Karen E. Burke MD PhD, Assistant Clinical Professor, Department of Dermatology,
Mount Sinai Medical Center, New York, USA
Jonn Damia AS, Technical Support Specialist, cyberDERM Inc., Media,
Pennsylvania, USA
Bivash R. Dasgupta PhD, Principal Scientist, Personal Care Category, Unilever
Research and Development, Trumbull Connecticut, USA
James Q. Del Rosso DO, Clinical Associate Professor, Department of
Dermatology, University of Nevada School of Medicine, Las Vegas, Nevada, USA
Zoe Diana Draelos MD, Consulting Professor, Department of Dermatology, Duke
University School of Medicine, Durham, North Carolina, USA
Peter M. Elias MD, Professor of Dermatology, University of California; Staff
Physician, Veteran Affairs Medical Center, San Francisco, California, USA
Patricia K. Farris MD, Clinical Associate Professor, Department of Dermatology,
Tulane University School of Medicine, New Orleans, Louisiana, USA
Richard E. Fitzpatrick MD, Director, Dermatology Division, La Jolla Cosmetic
Surgery Centre, La Jolla, California, USA
Bryan B. Fuller PhD, Adjunct Professor, Department of Biochemistry and Molecular
Biology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma,
USA
Dee Anna Glaser MD, Professor and Vice Chairman, Department of Dermatology,
Saint Louis University School of Medicine, Saint Louis, Missouri, USA
Barbara A. Green RPh MS, Vice President, Clinical Research & Business
Development, NeoStrata Company Inc., Princeton, New Jersey, USA
Gary L. Grove PhD, Vice President of Research and Development, cyberDERM
Inc., Media, Pennsylvania, USA
Tim Houser MS, Senior Research Scientist, cyberDERM Inc., Broomall,
Pennsylvania, USA
Nils Krueger PhD, Chief Operating Officer, Rosenpark Research, Darmstadt,
Germany
Bradley B. Jarrold MS, Senior Scientist, Beauty Care Technology Division, Procter
& Gamble, Cincinnati, Ohio, USA
Sarah Malerich DO, Intern, LewisGale Hospital-Montgomery, Blacksburg, VA, USA
Dawn J. Mazzatti PhD, Senior Principal Scientist, Personal Care Category, UnileverResearch and Development, Trumbull, Connecticut, USA
Rahul C. Mehta PhD, Senior Scientific Director, Research and Development,
SkinMedica Inc., Carlsbad, CA, USA
Kevin J. Mills PhD, Principal Scientist, Beauty Technology Division, The Procter
and Gamble Company, Cincinnati, Ohio, USA
Suzanne R. Micciantuono DO, Chief Resident Dermatology, Wellington Regional
Medical Center, Wellington, Florida, USA
Manoj Misra PhD, Global Measurement & Modeling Leader, Discover, Personal
Care, Unilever, Trumbull, Connecticut, USA
Christen M. Mowad MD, Professor, Department of Dermatology, Geisinger Medical
Center, Danville, Pennyslvania, USA
Gabriel Nistor MD, Vice president, Research and Development, NeoStem
Oncology, Irvine, California, USA
John E. Oblong PhD, Principal Scientist, Beauty Care Technology Division, Procter
& Gamble, Cincinnati, Ohio, USA
Irwin Palefsky, Chief Executive Officer, Cosmetech Laboratories Inc., Fairfield,
New Jersey, USA
Aleksandra J. Poole PhD, Senior Scientist, Product Manager, NeoStem Oncology,
Irvine, California, USA
Marta I. Rendon MD FAAD FACP, Associate Clinical Professor of Dermatology,
University of Miami, Miami, Florida; Associate Clinical Professor, Department of
Biomedical Sciences, Florida Atlantic University, Boca Raton, Florida; Medical Director,
The Rendon Center for Dermatology & Aesthetic Medicine, Boca Raton, Florida, USA
Holly A. Rovito MS, Principle Researcher, Personal Beauty Care Technology
Division, Procter & Gamble, Cincinnati, Ohio, USA
Yamini Sabherwal PhD, Research Scientist, Cell Culture Laboratory, NeoStrata
Company Inc., Princeton, New Jersey, USA
Neil S. Sadick MD FACP FAACS FACS FACPh, Clinical Professor of Dermatology,
Weill Medical College of Cornell University, New York, USA
James R. Schwartz PhD, Research Fellow, Victor Mills Society, Procter & Gamble,
Sharon Woods, Technical Center, Cincinnati, Ohio, USA
Lauren N. Taglia MD PhD, Resident, Geisinger Health System, Danville, PA, USA
Carl R. Thornfeldt MD FAAD, Founder and Chief Executive Officer, Episciences,
Inc., Boise, Idaho; President, CT Derm P.C., Fruitland, Idaho, USA
Charles Zerweck PhD, Director of Clinical Studies, cyberDERM Inc., Media,
Pennyslvania, USAD e d i c a t i o n s
I dedicate this third edition to the three men in my life: Michael, Mark, and Matthew. I
affectionately call them my 3Ms. Michael is my loving husband and fellow physician
who has been a sounding board for me during the process of revising this text. I
appreciate both his medical input and emotional support, always ready to provide
advice from a fresh perspective. Mark and Matthew are my two sons, both currently in
MD/PhD programs, who inspire me to effectively teach and explain new medical
material to naïve ears. They remind me that the best explanations are simple and
direct including details, as appropriate, to encourage intellectual growth. My efforts
preparing this text have been magnified by their enthusiasm for medicine and pursuit
of excellence.
Zoe Draelos
To the women in my life: my grandmothers, Bertha and Lillian, my mother, Nina, my
daughters, Sophie and Isabel, and especially to my wife, Tania. For their never-ending
encouragement, patience, support, love, and friendship. To my father, Mark – a great
teacher and role model; to my mentor, Kenneth A. Arndt for his generosity, kindness,
sense of humor, joie de vivre, and, above all else, curiosity and enthusiasm.
Jeffrey S. Dover
Elsevier's dedicated editorial staff has made possible the continuing success of this
ambitious project. The new team led by Belinda Kuhn have refined the concept for the
third edition while maintaining the series' reputation for quality and cutting-edge
relevance. In this, they have been ably supported by the signature high quality
illustrations and layouts that are the backbone of each book. We are also deeply
grateful to the volume editors, who have generously found time in their schedules,
cheerfully accepted our guidelines, and recruited the most knowledgeable chapter
authors. And we especially thank the chapter contributors, without whose work there
would be no books at all. Finally, I would also like to convey my debt to my teachers,
Kenneth Arndt, Jeffrey Dover, Michael Kaminer, Leonard Goldberg, and David Bickers,
and my parents, Rahat and Rehana Alam.
Murad AlamList of Videos Online
Introduction video
Chapter 19 Wrinkles and Fine Lines
Chapter 20 Facial Redness
Chapter 21 Dyspigmented Skin
Chapter 22 Oily Skin
Chapter 23 Dry Skin
Chapter 24 Acne
Closing videoP A R T 1
Defining the
Cosmeceutical Realm
OUTLINE
Introduction
1 Cosmeceuticals: Function and the Skin Barrier
2 Cosmeceutical Formulation Considerations
3 Evaluating Cosmeceutical Efficacy
!

!
!

I n t r o d u c t i o n
Part 1 of this text presents the elements necessary to understand the cosmeceutical
realm. The functioning of these biologically active ingredients on the skin barrier
and the health of the skin characterize the cosmeceutical realm. The ability of these
ingredients to enhance skin functioning depends on how they are formulated into
creams, lotions, etc. that can maintain the integrity of the active, deliver it in a
biologically active form to the skin, reach the target site in su cient quantity to
exert an e ect, and properly release from the carrier vehicle. Cosmeceuticals are sold
as cosmetics, making marketing an important consideration. These marketing claims
must be substantiated by clinical testing; however, clinical testing is also important
to establish cosmeceutical e cacy. Most companies that market in this realm do
extensive safety and clinical testing on new formulations as a wide range of
potential consumers may use these products. The recognition that there are
limitations on e cacy claims means that cosmeceuticals can only be assessed in
terms of their ability to improve skin appearance, but not function. Appearance
claims are not as robust as function claims, but do not imply the cosmeceutical does
not work. For example, the claim ‘improves wrinkles’ is a drug claim that is not
allowed, but the claim ‘improves the appearance of wrinkles’ is a cosmetic claim.
When the word ‘appearance’ is used, it does not imply any functional change, but
only indicates that the eye perceives something di erent. Visual improvement is the
domain of cosmeceuticals.
From a regulatory standpoint, there is no such thing as a cosmeceuticals.
Cosmeceutical are cosmetics and nothing more. Around the world, however,
cosmeceuticals are recognized and go by such terms as ‘active cosmetics’ and
‘quasidrugs’. These terms imply something more sophisticated than a cosmetic, but
something less e ective than a drug with a better safety pro, le. Herein lies the
challenge of defining the cosmeceutical realm.This page contains the following errors:
error on line 1 at column 2117: Unexpected '[0-9]'.
Below is a rendering of the page up to the first error.
1
Cosmeceuticals
Function and the Skin Barrier
Bivash R. Dasgupta, John Bajor, Dawn J. Mazzatti, Manoj Misra
Summary and Key Features
• Stratum corneum (SC) is one of the largest organs of the body, protecting us
against external environmental stresses to regulating water and heat and also
serving as an immunological barrier
• While there is a host of different processes and functions that occur in skin, there
are broadly five key processes for the formation and functioning of the SC
• SC structures range in size from sub-nanometers (lipid bilayers) to several tens of
microns (glyph lines)
• Cosmetic dry skin has thicker SC with a weaker barrier quality and lower natural
moisturizing factor and cohesivity levels
• Exposure to UV rays from sun, use of harsh surfactants during cleansing,
temperature extremes, changes in humidity and pathogens are some of the
salient environmental insults on the SC
• While small molecules (2
Cosmeceutical Formulation Considerations
Irwin Palefsky
Summary and Key Features
• Delivery systems are intended to maximize performance and provide consumer-perceivable benefits with excellent aesthetic attributes to
provide a unique feel and form.
• Successful delivery systems must consider pH, solubility, compatibility, stability, and preservation.
• Emulsions are the major delivery system and can be divided into two major forms to include oil-in-water and water-in-oil.
• Serums are thin liquids that can be clear, translucent or opaque and are dispensed from airless pumps or dropper bottles.
• Balms are a subcategory of emulsion products designed to provide specific skin care benefits.
• Polymer encapsulation systems can fully isolate and deliver bioactive ingredients working with hydrophobic materials to isolate and
selectively deliver ingredients.
Introduction
The success of e' cacious skin care ‘antiaging’ formulations, commonly referred to as ‘cosmeceutical’ products, presents the cosmetic chemist
tremendous challenges and opportunities in developing formulations that deliver consumer perceived e' cacy. These challenges and
opportunities have resulted in the development of new and unique formulations that are intended to:
▪ address the aesthetic aspects that consumers desire (application, feel, smell, etc.)
▪ maximize the performance of the product
▪ offer the consumer options that provide enhanced aesthetic attributes that make the experience enjoyable.
While the formulations are an integral part of the delivery systems that are intended to maximize performance and provide
consumerperceivable bene. ts, the aesthetic attributes, unique feel and unique forms, are an increasing factor that consumers are using as a reason to
choose their skin care products.
This chapter discusses some of the unique and di/ erent formulations that are being developed and are becoming a part of the skin care
regimens.
Vehicles
The primary purpose of the vehicle is to optimize the delivery of ‘cosmeceutical’ bene. ts to the consumer. These usually involve providing
immediate or short-term bene. ts as well as ‘long-term’ bene. ts that take 30–60 days to manifest. It is also imperative that the consumer has
a positive, if not a pleasurable, experience while using the products so they continue to use them. It is the continuous use of ‘cosmeceutical’
products that are essential to getting the maximum bene. ts that are to be provided. All this is done while insuring that the formulations are
safe for use as well as effectively preserved against potential microbial contamination.
The most common, and still the most e' cacious, vehicle is the emulsion. This category has seen tremendous growth and change with the
increased use of di/ erent emulsion types, such as silicone-in-water emulsions, water-in-silicone emulsions, liquid crystal emulsions, etc. The
presence of silicone and silicone polymers and elastomers has allowed the consumers a wider choice of feels and forms to choose from when
selecting the skin care products.
In the past several years we have seen an increased use of a category of products called ‘serums’. They have become an addition to the
skin care regimen and provide targeted specific treatment elements.
As of this writing we have also seen the introduction of specialty ‘balm’ products under the category of ‘BB’ and ‘CC’ creams, which will be
discussed later in this chapter.
While there is a lot of publicity about the increased use of ‘natural’ ingredients, consumers have decided, by their purchasing choices, that
formulations using various silicones are the products of choice for aesthetics.
Another signi. cant factor in the development process is the complex international regulations that are in place regarding the use of
ingredients that must be followed if a company is looking to expand the global availability of their products. This area could take up a full
book on its own. Let's review the various product forms that comprise the skin care regimen.
Emulsions
Oil-in-water emulsions
The increased use of silicone and silicone polymers in these types of formulations, as well as the use of nontraditional emulsifying systems
(more ‘naturally’ based emulsi. ers, EO- and pentylene glycol (PEG)-free emulsi. ers and liquid crystal forming emulsi. ers) has opened up
the opportunities in the oil-in-water (O/W) emulsion category to o/ er di/ erent feels and forms to the consumer. The desire to use more
‘skin friendly’ emulsi. ers that do not disrupt the barrier properties of the skin or emulsifying systems that work in high silicone-based
formulations are changing some formulation strategies. The challenge in this area is making sure that the formulations that are developed
using these new emulsifying systems are stable formulations and meet the accepted criteria for shelf life.
The choice of ingredients needs to consider the e/ ect on performance as well as aesthetics. Figure 2.1 is an O/W emulsion in which the
predominant components of the oil phase are a blend of silicones. This emulsion can be modified with the addition of bioactive ingredients –antioxidants and skin-soothing ingredients. The other aspect of this formulation that is worth noting is the use of an emulsion-stabilizing
system that can be added at the end. This ingredient serves a dual function – adjusting viscosity and improving emulsion stability. Care
must be taken, however, because these emulsion-stabilizing systems can also affect the feel of the product.
FIGURE 2.1 An oil-in-water (O/W) emulsion
Water-in-oil and water-in-silicone emulsions
Water-in-oil (W/O) and water-in-silicone (W/S) emulsions, sometimes referred to as ‘inverse emulsions’, are formulations in which the
internal or dispersed phase is a water phase, and the oil (or silicone) phase is the continuous or external phase. While still much less popular
than O/W emulsions, recent advances in silicone-based emulsi. er systems have caused an increase use of these types of formulation. The
formulation from Grant Industries (Fig. 2.2) demonstrates the use of these newer emulsi. er systems in a typical ‘BB’ cream formulation.
They have become increasingly useful when developing water-resistant sunscreen products and when looking to incorporate more lipophilic
(oil-loving) functional materials into formulations that deliver skin care bene. ts such as barrier protection. The formulation from
Momentive (Fig. 2.3) is an example of an ‘anhydrous’ emulsion that can be used as a delivery system for cosmeceutical ‘actives’ that have
stability issues in water (i.e. ascorbic acid – vitamin C).FIGURE 2.2 Age Defying BB Cream G3075-253.02 (Grant Industries, with permission)FIGURE 2.3 An anhydrous emulsion (reproduced with permission from Momentive, Wilton, CT)
Serums
Serums are generally thin liquids that can be clear, translucent or opaque and are generally dispensed from airless pumps or cosmetically
elegant ‘dropper bottles’. There is no clear de. nition of what a serum must contain or look like and unlike emulsions, which contain two or
more phases, serums can be single phase or multiphase formulations.
The initial serum formulations were developed for use in the eye area to deliver bioactive materials to treat dark circles, ‘bags’, . ne lines
and wrinkles. They were usually designed to be quick absorbing so they can be used under makeup or facial moisturizers. Newer serums
have been designed as spot treatments for ‘age spots’, ‘acne outbreaks’ as well as all-over facial serums to enhance the cosmeceutical
bene. ts of bioactive ingredients that are used both in the serum formulations or the facial moisturizer used in conjunction with the serums.
The formulation from Grant Industries (Fig. 2.4) demonstrates a serum formulation designed to provide pore re. ning bene. ts. This serum is
a translucent thin emulsion.FIGURE 2.4 Pore Refining Serum G1181.1671.06 (00014192) (Grant Industries, with permission)
‘Balm’ products
From a formulation perspective balms are really a sub-category of emulsion products, as they can be O/W or W/O emulsion products that
are designed to provide specific skin care benefits.
‘BB’ creams came out of the Asian market (primarily Korea) where they are used as all-in-one skin care products and are generally o/ ered
in one or two color shades. They are designed to provide moisturization, sun protection, and even makeup foundation and primer benefits.
‘CC’ creams were the next generation of balm products, designed to provide more corrective bene. ts. ‘CC’ can be de. ned as either ‘color
correcting’ or ‘color control’ and these products frequently contain ingredients that a/ ect and treat uneven skin tones and skin redness. As
with ‘BB’ creams they are frequently offered in one or two shades and also provide moisturization and sun protection.
Delivery systems
As we continue to highlight, the success of ‘cosmeceutical’ formulations is dependent on two very critical factors – the aesthetics of the
formulation and the performance of the products. The aesthetics (color, odor, feel, application, etc.) are the properties of a formulation that
will determine whether the consumer will continue to use the formulation as directed. If the consumer does not ‘like’ the product, she (and,as of this writing it is still primarily women who use ‘cosmeceutical’ skin care products) will not use it. As with any skin care or topical
treatment the results will only be obtained with regular use of the product.
Performance and delivery of the claimed bene. ts are the second part of the equation. To maximize the performance of the products, and
the ability to deliver the claimed bene. ts in the shortest period of time, formulators have started to look at enhanced delivery systems.
Delivery systems also serve to protect cosmeceutical ‘actives’ and help with product and ingredient stability. We will review several of these
types of delivery system and discuss the ways they enhance the performance of the ‘cosmeceutical formulation’.
Polymeric entrapment/encapsulation systems
In recent years a number of companies have introduced polymeric encapsulation systems that can fully isolate and deliver bioactive
ingredients. All of these encapsulation systems work with hydrophobic materials and to varying degrees can truly isolate and selectively
deliver ingredients to the skin through various mechanisms.
In particular, with the increasing use of retinol as a skin care active ingredient, encapsulation technologies have been very e/ ective in
signi. cantly enhancing the stability of retinol in treatment products (Fig. 2.5). These entrapment systems release their actives during
application of the product to the skin.
FIGURE 2.5 Polymer entrapment technology ‘Tagra microencapsule’ (Grant Industries, with permission)
Frequently referred to as ‘microsponge’ entrapment systems, these polymeric systems can be visualized as a sponge with a very high
internal volume that allows for entrapping up to 50% of hydrophilic (water-loving) or lipophilic (oil-loving) materials (Fig. 2.6). The
primary release mechanism is di/ usion, in which the entrapped material slowly di/ uses out from the crevices of the polymer. This allows
for a time release of materials so that the bene. ts can be extended over a longer period of time, rather than getting a ‘bolus’ e/ ect where
the entire ‘active’ is released all at once. Entrapment systems can also extend the stability and protect ‘functional’ materials that have a
tendency to degrade, such as retinol and benzoyl peroxide. One of the polymer systems used is allyl methacrylate copolymers. Because of
their microsponge nature they can also provide oil-absorbing benefits when applied to the skin.
FIGURE 2.6 Microsponge
Liposomes and other nano delivery systems
We are all familiar with liposomes. They are microscopic spherical vesicles that are formed when phospholipids are hydrated. Typically,
liposomes are 200–800 nm in size. They are designed to entrap and deliver into the skin both hydrophilic and lipophilic ingredients. The
core of a liposome contains water-soluble material and the ‘wall’ that makes up the liposome contains oil-soluble ingredients. Nanoparticles
are liposomal structures in which the lipophilic material is entrapped in the core and the hydrophilic material is entrapped in the ‘walls’
(Fig. 2.7). The primary issue with liposomes, much less than with nanoparticles, is that they are very sensitive vesicles that can be destroyed
by a number of factors (e.g. pH, type of emulsi. er used, solvents, etc.), but, because their structure is very compatible with the lipid
composition of the skin and with cell membranes, they are excellent transdermal delivery systems.