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WHAT ARE MEDICAL SKIN
CARE TREATMENTS?
Medical skin care treatments (also known
as cosmeceuticals) include products which fall somewhere
between cosmetics and drugs.
Many of these products are available
'over the counter'. However, some products are only
available from physician-led clinics where expert advice
on product choice and safe use can be combined with
careful monitoring of side effects and benefits. This
may be because they contain active ingredients in levels
significantly higher than levels allowed in over-the-counter
preparations, or they are prescription only items.
These treatments are still required
to meet rigid chemical, physical and medical standards.
AGING AND HOW MEDICAL ANTI-AGING TREATMENTS
WORK
There are 2
types of skin aging:
Intrinsic aging is genetically programmed skin aging
and occurs all over the body. The skin becomes thinner,
drier and slower to regenerate. It is not possible to
delay intrinsic aging.
Photoaging occurs to skin at exposed
sites on our bodies and is a direct result of ultraviolet
(sun) radiation. Photoaging is the main cause of the
cosmetic change to our skin. Photodamage causes loss
of collagen and normal elastin; a build up of abnormal
elastin which no longer has 'springy' properties; irregular
pigmentation production; and irregular thickening of
the epidermis. All this adds up to a sallow complexion,
roughened texture, mottled pigmentation, coarse wrinkling,
sagging and 'broken capillaries' (telangiectasias).
Sunlight damages the skin in 2 ways;
by direct damage to the cellular DNA (the material which
programmes how the cell behaves) and by creating superoxides
(also known as free radicals or reactive oxygen species)
which then damage DNA and important proteins.
Superoxides are created as a by-product
of normal cell metabolism but their numbers rise enormously
in skin exposed to ultraviolet light, as well as in
cigarette smokers. Whilst our bodies have repair mechanisms,
over time the damage outweighs the repair and becomes
permanent. These damaged skin cells 'misbehave' resulting
in reduced production of collagen and elastin, irregular
thickening and mottled pigmentation mentioned above.
Medical skin treatments work by helping
to prevent photodamage or reverse the effects of it
in the following ways:
• Neutralise excess superoxides (antioxidants)
• Normalise the cell behaviour
• Suppress over active pigment production.What do these
treatments include?
• Sunscreens
• Vitamin A derivatives (retinoids)
• Antioxidant vitamins C and E
• Hydroxy acids
• Depigmenting treatmentsSunscreens
Whilst not physician only products,
these are included because cosmetic doctors universally
agree that adequate sun protection is the most important
step in keeping skin young and healthy. In addition,
products containing vitamin A derivatives or hydroxy
acids make the skin more sun sensitive and must be used
with adequate daily sunscreens.
The sunscreen must contain both a UVA
and UVB block and must be re-applied every 2 hours to
be effective. Whilst moisturisers and cosmetics containing
SPF are great for day-to-day use, they will not adequately
protect your skin in strong sunshine.
VITAMIN A DERIVATIVES
(RETINOID)
Retinoids are an incredibly exciting
group of chemicals which send messages to DNA in skin
cells and help correct the behaviour of damaged cells.
Epidermal cells thicken and shed more
regularly giving a softer texture and creamier complexion
whilst also reducing blocked pores.
Collagen and elastin production increases
resulting in a stronger dermis and reduced wrinkling.
Pigment production becomes less patchy.
ANTIOXIDANT VITAMINS C and E
These vitamins help to neutralise excess
superoxides before they can cause damage to skin cells.
Whilst these vitamins are very important in our diet,
much higher levels can be achieved in the skin by applying
them topically.
Vitamin C is water soluble and must
be applied in its stable form: L-ascorbic acid. In the
form of magnesium ascorbyl phosphate, vitamin C is also
a mild pigment suppressor.
Vitamin E is lipid soluble and known
as tocopherol, it penetrates easily into the skin. It
is also a good moisturiser and has anti-inflammatory
effects.
HYDROXY ACIDS
These chemicals are used in skin peels at higher strengths
but may also be found in cleansers, moisturisers and
treatment creams.
There are 2 types of hydroxy acid: alphahydroxy acid
(AHA) and betahydroxyacid (BHA). There are several AHAs
which include glycolic acid (derived from sugar cane)
and lactic acid (derived from milk) but only one BHA
which is salicylic acid and the only lipid soluble hydroxy
acid.
Both these types of acid act as chemical exfoliants
by dissolving the lipid glue between epidermal cells.
This results in increased production of fresh new epidermal
cells. There is evidence that they can also increase
collagen production and even out mottled pigmentation.
Salicylic acid, being lipid soluble, penetrates deep
into the pores to exfoliate and is, therefore, particularly
useful in treating blocked pores and acne. Salicylic
acid also has anti-inflammatory properties.
Hydroxy acids will enhance the penetration of other
treatments and are often used in combination creams.
DEPIGMENTING TREATMENTS
These treatments are used to lighten pigmentation resulting
from photodamage, hormones (melasma) and inflammation
(e.g. acne). Some of these treatments may be combined
with glycolic acid or vitamin A derivatives to enhance
their effects.
Depigmenting ingredients include:
• Kojic acid
• Azelaic acid
• Hydroquinone
• Mulberry extract
• Magnesium ascorbyl phosphate (stable form of vitamin
C)
• Glabridin (liquorice extract)
• Arbutin |
