| FUTURISTIC APPROACHES TO SKIN CARE | arTicle
care product enriched with A. angustifolium extract produces improvement in skin irregularities and in global rejuvenation parameters.
Topical treatment of cellulite with retinol, caffeine, and ruscogenine combination A safe, effective treatment to improve the appearance of cellulite is needed because the condition is widespread and cosmetically distressing among women. Although the pathophysiology of cellulite is not completely understood, a variety of medical, mechanical, light-based, and surgical therapies have been described (37,38). The following paragraphs summarize the evidence supporting the efficacy and safety of a new topical formulation containing retinol, caffeine, and ruscogenine.
Retinol Also known as vitamin A, retinol has important regulatory functions in normal growth, reproduction, vision, and cellular (e.g., keratinoctye) differentiation and proliferation (39). Most of its biological activities are mediated by all- trans RA (tretinoin) which activates nuclear RA receptors. These receptors, through a series of binding reactions, reduce or enhance gene transcription. Retinol penetrates the skin more rapidly and it is less irritating to the skin than RA (38,40,41). Because of its superior penetration, retinol, though a weaker retinoid than RA, delivers a stronger retinoidal effect than RA (41). Retinol has also been shown in vitro to weakly inhibit proliferation of human adipocyte precursor cells but strongly inhibit their differentiation to mature adipocytes, suggesting that it may prevent cellulites (42). The landmark study of Kligman et al. (38) showed that
topical retinol (Johnson & Johnson, New Brunswick, NJ) improves the appearance of cellulite, probably by acting as a prodrug that the skin metabolizes to RA which, in turn, increases collagen deposition in photodamaged dermis (43–45). Increased collagen synthesis is important because it thickens and firms up the dermis, thus “capping” the underlying fat whose mobility, Kligman and colleagues postulate, is associated with the dimples of cellulite. Retinol also stimulates synthesis of GAGs in the space between collagen bundles. Since GAGs are hygroscopic, an increase in GAG synthesis would, in theory, increase dermal firmness by binding larger volumes of water (38). In their randomized, double-blinded study of 20 patients
with moderate cellulite, Kligman and colleagues treated the lateral thighs twice daily for six months, one thigh of each subject receiving 0.3% stabilized retinol cream and the other thigh receiving vehicle. Efficacy was evaluated in three ways: (i) measuring dermal thickness by ultrasound, (ii) determining blood flow by laser Doppler velocimetry, and (iii) assessing global improvement (none, fair, good, or excellent) by subjects and a dermatologist. On the retinol-treated thighs, dermal thickness increased from 1.44 to 1.60 mm; on the vehicle thighs, thickness was 1.47 mm before treatment and 1.44 mm after treatment. On the retinol side, blood perfusion increased from 30.8 to 35.2
Figure 3 The left cheek area of a 50-year-old woman at baseline (A) and 56 days after twice-daily application of cream containing extract of A. angustifolium (B). The post-treatment image shows a reduction in redness compared to the pre-treatment image
perfusion units, whereas on the vehicle side, it remained essentially the same (31.1–31.6 perfusion units). Thirteen subjects (68%) rated the retinol side more improved (1: excellent; 7: good; 5: fair) than the vehicle side, five rated improvement the same on both sides. One subject rated improvement on the vehicle side higher, and one withdrew for reasons not related to the study. Assessments by the dermatologist and investigators were in agreement with these results. These results showed that retinol appears to be effective in improving the appearance of cellulite.
Caffeine In addition to having diuretic effects, caffeine increases nervous system excitability, alertness, basal metabolism, and cardiac work (46). Its role in mobilization of free fatty acids has also been shown (46) and explained by the following mechanism: cyclic 3'5’-AMP, which facilitates lipolysis in fat cells, is inhibited by phosphodiesterase which, in turn, is inhibited by caffeine. As 3’5’--AMP accumulates in adipose tissue (due to caffeine-induced inhibition of phosphodiesterase), lipolysis is increased. Catecholamines also increase the concentration of cyclic 3’5’--AMP, and thus also promote lipolysis (47–49). Since caffeine affects the release of catecholamines (49), caffeine influences lipolysis by a second mechanism as well. Caffeine has also been shown to affect the gene expression of lipoprotein lipase, an early indicator of adipocyte differentiation (50).
also known as
vitamin a, retinol has important regulatory functions in normal growth, reproduction, vision, and cellular (e.g., keratinoctye) differentiation and proliferation.
prime-journal.com | March 2011 ❚ 31
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