INDUSTRY INSIDER | COSMECEUTICALS | acne and eczema. ‘Inflammation and oxidative damage


are the root cause of so many evils in our bodies, including photo-damage. Probiotics and anti-inflammatory supplements may therefore have a role in anti-ageing; anything you do for your body should benefit its largest organ, which is the skin,’ she says.


skin types IV-V can develop melasma like hyperpigmentation upon exposure to visible and infrared light. The only ingredient available that can block these wavelengths is iron oxide. This ingredient is present in Fallene’s Tizo3 that is a very elegant tinted physical block that I dispense in my office. Another popular product that I recommend is Lytera by SkinMedica which is a non- hydroquinone lightening cream proven to be highly effective.’ According to Dr. Alexis, ‘New proprietary products are


under development containing novel ingredients that target multiple steps in the hyperpigmentation pathway.’ Dr. Desai noted that Afamelanotide (Clinuvel®), which is a prescription drug for vitiligo, may show promise in this area. Several new natural ingredients targeting pigment are also on the horizon, adds Dr. Rao, ‘However the problem is not how to get rid of pigmentation, it is how to prevent it from happening again.’


Pigment game changers Pigmentation presents unique challenges for patients seeking treatment from dermatologists and aesthetic surgeons. In the past several years, we have seen a proliferation of new pigment lightening ingredients and combinations of ingredients entering the professional skin care landscape that have demonstrated efficacy with consistent use. In the minds of many physicians, however, hydroquinone is widely considered the gold standard. According to Dr. Waldorf, ‘Unfortunately, hydroquinone is still the most effective. Everything else is a distant second.’ The way our patients perceive pigmentation is also


changing, says Dr. Berson. ‘They are looking to brighten their skin and improve radiance. Pigmentation has become a bigger buzzword for us. Under the umbrella of pigmentation, you can include photo-damage, freckling, lentigines, post-inflammatory hyperpigmentation from acne, and melasma. Melasma and hair loss are our holy grails, though exciting research and newer treatments and in the pipeline for both.’ She continues, “Using a combination of ingredients with


different modes of action is becoming more common. Kojic acid, azelaic acid, vitamin C, and licorice extract interfere with tyrosinase activity, while niacinamide and soy inhibit melanin transfer. Retinol and AHAs help exfoliate superficial pigment. SkinMedica’s Lytera is a perfect example of a product that contains a combination of ingredients which help brighten the skin.’ Dr. Perez explains that there is new information about


hyperpigmentation and potentially a new way of preventing it. ‘It has been demonstrated that patients with


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Skin care tolerability According to Dr. Berson, ‘Much attention is being paid to epidermal lipids and barrier function. If you have a good barrier in the epidermis, you will have pliable skin that is more elastic. Many brands are now including hyaluronic acid, ceramides, and niacinamide. For example, Skinceuticals Metacell® Renewal B3 contains peptides, niacinamide, and glycerin, so it is great for younger women who want an entry level anti-ageing moisturizer. It is also ideal for acne-prone adults because of its light, non-greasy vehicle. SkinMedica will also be introducing a topical product containing high concentrations of epidermal hyaluronic acid.’ Patients are demanding products that have efficacy, but


SIX HOT CATEGORIES


1 Multi-masking,


notably hailing from Korea


CC creams, merging of skin care plus color cosmetics)


2 Asian beauty 3 Multi-tasking


products (BB creams,


ranges that address thinning, dandruff, and itching


the form of oral


offer protection from infrared rays (IR-A)


6 Sunscreen January/February 2016 | prime-journal.com 4 Therapeutic hair care


5 Ingestible beauty in supplements and drinks


formulations that


for the face, eyes, hands, and feet


products, most targeted sheet masks


also tolerability and cosmetic elegance. For the most part, they are not willing to live with redness, flaking, and irritation, mainly because they don’t have to anymore as new formulations have become increasingly more appealing to use. ‘Whenever I give a patient a retinoid, for photo damage


or acne, I also have them use an emollient first when they start it because studies have shown that they will still get the same efficacy but there is better tolerability. The key is to get a patient to be compliant with a regimen, and if they get irritation, they won’t continue using it,’ says Dr. Berson. Retinoids have maintained their rightful place as the


dermatologists’ ‘go-to’ ingredient for addressing ageing skin and acne, but there are still some lingering misconceptions among consumers. Dr. Baumann explains, ‘I am always surprised how many people still believe that retinoids make you sun sensitive. They actually protect you from UV damage by turning on protective genes and turning off deleterious genes. Adding barrier repair and anti- inflammatory ingredients to a skin care regimen and combining these with the correct non-foaming cleanser will help patients tolerate retinoids better. There is some exciting technology being developed at the University of Michigan that will decrease some of the side effects of retinoids by blocking gene expression of the gene that gets turned on that leads to the irritation.’ Clearly, there is no one size fits all skin care range.


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