praCTiCe managemenT | SKin Care ProDuCTS | is often the result of all of these
fibroblast-stimulating effects. ageing skin and fine lines are the complaints for which these types of products are recommended(4). irregular pigmentation is a primary
concern for many patients across all ethnic lines. Photoageing, post-inflammatory
probiotic cleansers that claim to
strengthen the immune system of the skin are now being offered for patients undergoing peels and nonablative laser resurfacing.
hyperpigmentation, and melasma are all medical conditions that may benefit from adjunctive use of skin care products (5). Primary recommendations include daily sun protection daytime and a hydroquinone plus retinoid prescription combination product at bedtime. Supplementing these agents with pigment reducing cosmeceuticals is a very popular protocol. Table 1 outlines ingredients that are prescribed for the lightening of pigment and reduction of sallow discoloration with regular use. Products that
facilitate
keratinocyte turnover and maturation, or act as keratolytics can improve the appearance of photoaged skin, discoloration, and acne(6). regular exfoliation using certain exfoliation actives increases dermal matrix hyaluronic acid and glycosaminoglycans, improving dermal
References
1. Duke D, Grevelink JM. Care before and after laser skin resurfacing. Dermatol Surg. 1998 24: 201–6.
2. Larsson P, Ollinger K, Rosdahl I. Ultraviolet UVA- and UVB-induced redox alterations and activation of nuclear factor-kappaB in human melanocytes-protective effects of alpha-tocopherol. Br J Dermatol. 2006 155: 292–300.
3. Katayama K, Armendariz-Borunda J, Raghow R. et al. A pentapeptide from type I collagen promotes extracellular matrix production. J Biol Chem. 1993 268: 9941–4.
4. Lupo MP. Peptides and proteins. In: Draelos ZD, Dover JS, Alam M. Cosmeceuticals. Philadelphia: Elsevier/Saunders, 2005, 119–24.
5. Rendon MI, Gaviria JI. Skin lightening agents. In: Draelos ZD, Dover JS, Alam M. Cosmeceuticals. Philadelphia: Elsevier/Saunders, 2005, 103–9.
6. Yu RJ, Van Scott EJ. Alpha-hydroxy-acids and carboxylic acids. J Cosmet Dermatol. 2004 3: 76–87.
7. Okana Y, Abe Y, Masaki H. et al. Biological effects of glycolic acid on dermal matrix metabolism mediated by dermal fibroblasts and epidermal keratinocytes. Exp Dermatol. 2003 12(Suppl 2): 57–63.
8.
http://www.aad.org/Forms/Policies/ar.aspx accessed February 22, 2011.
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thickness(7). exfoliation can aid in the turnover of keratinocytes in the pilosebaceous unit and diminish microcomedo formation thus improving acne. Table 1 lists cosmeceutical ingredients that act as exfoliants. Products that produce a mechanical exfoliation rather than a chemical exfoliation using abrasive particles can also improve the appearance of ageing or discolored skin and enhance penetration of prescription or dispensed topical skin-lightening agents.
Area-specific treatments Sometimes, patients’ complaints are specific to a particular region of the skin. Table 1 lists common area-specific cosmeceuticals. Due to the very thin skin around the eyes, fine lines and
discoloration can occur in even young patients. This area is often the first to concern a patient. Since lip augmentation is a very popular procedure performed in dermatologists’ office, lip products to plump or smooth lips is another popular skin care product. The body may have areas of blotchy pigmentation and loss of elasticity, especially on the neck and décolleté. Finally, no area other than the face shows the ravages of cumulative ultraviolet light exposure over a lifetime more than the hands. For all these reasons, many patients are desirous of area-specific products to address such issues. Consumer demand results in delivery of product when beauty is the issue, so neck creams, hand creams, and other treatments for the body (such as cellulite) are becoming more popular for sale to the public. Dermatologists also make cleanser
recommendations, especially for patients with eczema, contact dermatitis, and acne. ingredients that hydrate and soothe, formulas that do not remove surface lipids and are pH balanced, and those containing non-alkaline surfactants are typically offered by dermatologists. Procedures such as intense pulsed light, chemical peel, laser resurfacing, micro- dermabrasion, and aminolevulenic acid photodynamic therapy treatments all necessitate non-irritating cleansing to prevent redness, irritation, and flaking. one new trend is probiotic cleansers that claim to strengthen the immune system of the skin which are now being offered for patients undergoing peels and nonablative laser resurfacing.
Table 1 Common categories of complementary cosmeceuticals POPULAR ANTIOXIDANTS
Green tea extract Grape seed extract Genistein
Coffeeberry
Co-enzyme Q10 Idebenone Vitamin A Vitamin C Vitamin E
Pycnogenol Alpha lipoic acid
Dimethylaminoethanol Glutathione Catalase
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COLLAGEN-STIMULATING INGREDIENTS
Peptides (copper peptide, pentapeptides)
Amino acids Human growth factors Retinol
Niacinamide Coffeeberry
(transforming growth factor, epidermal growth factor)
AREA-SPECIFIC PRODUCTS Eye creams/gels
Lip plumper/softener Hand creams Cuticle oils
Neck creams Décolleté creams
Firming body lotions Anti-cellulite creams Foot creams
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