Health Features

Heroes or Wannabes?

Talk shows and advertisements throw so many ‘super’ ingredients and miracle lotions at us for taking care of our skin that it’s hard to keep track. Natural! Organic! Exotic! But are the anti-aging, rejuvenating benefits of these products plausible or too good to be true? “Whatever the product du jour is, the first thing to remember is that one of the skin’s primary jobs is to protect us from outside molecules,” says Dr. Dee Anna Glaser, a SLUCare dermatologist. “We have to understand the likelihood of something penetrating the skin in sufficient amounts to have a positive benefit.” Many skin care products, of course, are heartily endorsed by dermatologists who can point to scientific research supporting their efficacy. But in truth, Glaser notes there are not going to be dramatic improvements. “These products are more about maintenance and longevity,” she says. “It may take years to see the effects.” We asked local skin care experts to weigh in on various ingredients.

The all-time champion of dermal care is sunscreen, says Dr. John Chi, a Washington University Physicians facial plastic surgeon. “Several factors are involved in the skin’s aging process: genetics, sun exposure, hormone changes and metabolic changes,” he notes. “Sun exposure appears to be the main controllable factor. It can lead to increased risks of skin cancer and cosmetic skin changes like splotchy color, leathery texture, wrinkling and sagging.”

“There are two main types of ultraviolet radiation, UVA and UVB,” Chi says. “An effective sunscreen should provide broad-spectrum protection against both. It should have an SPF (sun protection factor) of 15 or greater and should be reapplied every hour or so or after vigorous activity, swimming or excessive sweating.”

Even seemingly modest exposure like working near a window, driving a car or going outside on a cloudy day can be harmful and worthy of sunscreen, he says. And sunscreen alone can’t protect everyone. “Sun avoidance and protective clothing are probably the best options to protect infants and individuals outdoors for an extended period of time,” Chi notes.

retinoids and glycolic acid 
These are good choices for repairing sundamaged skin, Chi says. “The retinoid category includes vitamin A (retinol), retinaldehyde, retinoic acid, retinyl esters and other synthetic derivatives,” he says. “Topical retinoids work by thickening the outer layer of skin, tightening the surface, and building up proteins and carbohydrates in connective tissue. All of these functions lead to improved wrinkles, texture and elasticity. Typically, retinoids must be used for months before results are seen.” He also notes that there are some potential harmful side effects like skin irritation, itching, redness and inflammation.

Glycolic acids can be found in chemical peels applied at a physician’s office or in home exfoliation products, Chi says. “These peels are simple and fairly inexpensive with minimal downtime,” he notes. “They are frequently used for acne, scars, sun damage and melasma. Although they may appear to be very simple, nonmedical procedures, safe and effective use requires the appropriate concentration.”

Over-the-counter products may contain low concentrations, he says. “These can resurface the outermost layer of the skin through exfoliation and newer, firmer skin development. After any resurfacing procedure, care should be taken to protect the skin as it recovers.”

vitamin c
“If there is one ingredient that might really be the fountain of youth, it’s Vitamin C,” says Carol Anderson, RN, CANS, certified aesthetic nurse specialist and owner of Nouveau MedSpa. “Aging is a process of oxidative ‘insults’ to the body, including sunlight, smoking and ozone pollutants. Vitamin C interferes with these processes and preserves our youth.”

Topical Vitamin C has been found to neutralize reactive oxygen species in the body, protect against UVA and UVB damage, regenerate Vitamin E and other antioxidants, stimulate collagen growth, prevent UV light from suppressing the immune system and promote anti-inflammatory functions, she says.

“The key to effective Vitamin C use is absorption,” Anderson says. “Pure L-ascorbic acid is the key ingredient and is the only form of Vitamin C the body can use. Studies show that a topical product must be at least 15 percent and preferably 20 percent pure L-ascorbic acid to have a substantial effect.”

Ceramides are natural oils that prevent dryness, itching and irritation. “We do know that ceramides are important in moisturizing and fluid retention,” Glaser says. “If you have a lotion you like with ceramides in it, use it.” However, it’s uncertain how much they pass through the skin.

She suggests ceramides can be added to skin care basics, which are things we know have proven benefits. “Make sure the product is doing other duties for your skin like moisturizing or working as a sunscreen,” Glaser says. “Most ceramides are in a lotion or cream, so select one that is appropriate for your skin type. Make sure it doesn’t contain anything harmful to the skin. Then think about the cost; you probably don’t need to spend a lot of money on a product just because ceramides are in it.”

This chemical can be applied to even out sun spots, blotches and mottled skin. It fades hyper-pigmentation by blocking the enzyme that triggers melanin production.

“Hydroquinone works by inhibiting the enzyme tyrosinase, which is necessary to form melanin in the melanocytes (melaninforming cells),” Anderson says. “It should be alternated with other lightening agents such as azelaic acid, kojic acid and arbutin every four months. I prefer to use products with these lighteners or Lumixyl, a product found to be safer that produces the same or better results than hydroquinone.”

green tea extract
Green tea extract is potentially a hero of skin care, says Dr. Mary Noel George, a dermatologist at Dermatology St. Louis on the SSM Health DePaul Hospital campus. “It’s one of the most heavily researched antioxidants,” she says. “A 2010 study on oral and topical administration of green tea extract demonstrated that it may protect the skin against the harmful effects of ultraviolet damage, including sunburn, skin cancer and aging.”

However, she continues, “Few over-the-counter products that contain green tea extract have been tested in controlled trials, and their concentration is too low to have any real efficacy. In 2006, the FDA approved a drug called Veregen, derived from green tea extracts, to treat genital warts. While there is promise in oral and topical applications of green tea extract for photo-protection and antiaging benefits, more studies are necessary to determine the concentration needed to achieve an effect.”

b vitamins
B vitamins have not undergone as much research as some other topical skin ingredients, but there has been promising work, Chi says. “Topical vitamin B3, known as niacinamide, has been shown to improve fine wrinkles and skin color and texture,” he says. “The studies that demonstrated these effects were performed by scientists in the cosmeceutical industry, but the results were published in peer-reviewed scientific journals. The proposed mechanism of benefit is that they improve collagen formation and control the amounts of protein and carbohydrates in the connective tissue of the skin.”

That means, he says, that overall, they improve the color and texture of skin. They also improve pore size, oil production and redness. “Topical Vitamin B3 appears to be better tolerated with fewer side effects than retinoids,” Chi says.

What could be better than all-natural products that smell good, too? Well, how about knowing which ones are effective? “For centuries and possibly millennia, botanicals have been used for medicinal purposes both internally and externally with successful results,” Anderson says. “Many current pharmaceuticals are derived from botanical extracts, concentrated and then applied in manufactured products, both drugs we ingest and those we use topically.”

Of course, not all natural substances are beneficial. “The key to using botanical compounds in cosmetic formulations is understanding their physical and chemical properties and how those properties are affected when they are compounded into a product,” Anderson says. “Like the requirements for effective Vitamin C, there are requirements for effective application and absorption of all cosmeceutical products. It is important for skin care specialists to be knowledgeable not only about various product lines but also about their ingredients. Healthy skin can absorb 60 percent of what is applied, so be conscientious about it.”

collagen and elastin
The epidermal and dermal layers don’t have a chance at a healthy appearance without great collagen and elastin. So why not wipe some on?

“Collagen is the structural backbone of the skin, and elastin is like a rubber band, allowing the skin to be stretched before contracting back to normal,” George says. “Older skin sags and hangs because we lose collagen and elastin as a result of sun damage throughout our lifetime. Creams with these ingredients promise to tighten, plump and lift the skin.”

But we return to the reality that one of the skin’s main jobs is preventing outside molecules from passing inside. “Applying these directly to the top of the skin as creams will do nothing,” George says. “Collagen and elastin molecules are too large to penetrate the skin surface to achieve any benefit, so throw these collagen creams away and save your shelf space for what will help preserve your collagen and elastin: sunscreen.”

our panel of skin care experts: