Cosmeceutical Antiaging Myths

Expensive moisturizers are more effective

For many consumers, price equates with quality. This may be true for some commercial purchases, but is not necessarily true for moisturizers. The most expensive part of any facial moisturizer is the fragrance, the bottle, and the packaging. None of these contributes to the efficacy of the moisturizer, only the aesthetic appeal. A quality moisturizer should cost less than $30 a bottle and products priced above this amount are selling more than skin efficacy. A quality moisturizer should contain an occlusive agent, a humectant, and some form of silicone. Ideally, it should also contain a sunscreen to provide the added benefit of sun protection. No moisturizer in any price range will improve the wrinkling on the lower face demonstrated in Figure 26.1 .

Moisturizers remove wrinkles

Moisturizers do not remove wrinkles, they simply minimize their appearance. The role of moisturizers in reducing wrinkles is primarily through increased skin hydration. The moisturizer contains an occlusive agent, such as petrolatum, mineral oil, or dimethicone, which prevents transepidermal water loss from the skin surface and increases the water content of the skin. This increased water content decreases or even eliminates wrinkles that are due to stratum corneum barrier defects. Barrier repair will prevent the wrinkles from recurring and the moisturizer creates an environment to initiate barrier repair. Thus, moisturizers do not remove wrinkles ( Fig. 26.2 ), they simply can provide an environment to reverse dehydration due to stratum corneum barrier defects.

There are some new moisturizers that are labeled ‘wrinkle blurs’. This clever terminology might indicate to the consumer that the wrinkles are somehow less visible. These products are based on silicone gel that fills in the depths of the wrinkles accompanied by small light reflective particles that decrease the appearance of the wrinkle depth. The optical effects of these products are quite remarkable, but they are only a cosmetic and the benefit lasts until the silicone product is removed from the face.

Cosmeceuticals can produce beneficial effects on facial muscles to improve skin tone

The first cosmeceutical introduced to produce an effect on facial muscles was DMAE, which is dimethylaminoethanol. It is a releaser of acetylcholine, a neurotransmitter required for muscle movement. DMAE was originally introduced as a homeopathic nutritional supplement for individuals with Alzheimer's disease and children with attention deficit disorder (ADD). The highest natural food source of DMAE is salmon, which explains the recent interest in diets incorporating several servings of the fish weekly.

The idea of using DMAE to improve the appearance of the facial skin is based on the concept that the facial skin must cover a bed of facial muscles. If the underlying muscle layer is contracted and firm, the skin has a better framework over which to lay. This may create an improved facial appearance, which is sometimes characterized by the cosmetic phrase ‘better skin tone’. The first several times that DMAE is applied a skin-tingling sensation is present; however, this disappears with continued use. It is unclear whether accommodation occurs to topical cosmeceuticals intended to alter muscle function with time.

Another group of cosmeceuticals, composed of engineered peptides, claims to interrupt the neuromuscular junction and relax facial muscles, functioning in a manner opposite to DMAE. The peptide is intended to mimic the effect of botulinum toxin.

In conclusion, much research and many clinical studies remain to be done on these cosmeceuticals designed to increase or relax facial muscle tone. Even facial exercising devices that are put in the mouth and squeezed by the lips do not appear to improve facial muscle tone.

Bleaching creams can improve brown spots quickly

Unfortunately, no botanical or hydroquinone-based bleaching cream can quickly improve the appearance of brown spots. Most products take at least 6 weeks and possibly even 3 months to work. This is because none of the bleaching cream actives is effective at removing melanin pigment from the skin. They all work by interrupting one step in the pathway of melanin synthesis or melanosome transfer. This means that the bleaching creams are shutting down new pigment production while the old pigment is being dispersed by traditional physiologic mechanisms.

Bleaching creams are most effective when used on the face due to enhanced penetration through thin skin. Neck, chest, and forearm hyperpigmentation responds even more slowly to treatment due to the decreased penetration of the active ( Fig. 26.3 ). Since the safety of hydroquinone has been challenged by the Food and Drug Administration (FDA), many new OTC botanically based bleaching creams have entered the cosmeceutical market. One such formulation contains hydroxyphenoxy propionic acid, ellagic acid, and salicylic acid formulation. The hydroxyphenoxy propionic acid decreases melanin production, the ellagic acid is an antioxidant, and the salicylic acid is a penetration enhancer. Another formulation is based on lignin peroxidase, an enzyme derived from the tree fungus Phanerochaete chrysosporium . Lignin peroxidase helps break down cell walls in decaying plant material, which are composed of lignin. However, lignin peroxidase is also able to break down melanin. Since pigment lightening is such an important cosmetic need, it is certain that other cosmeceutical formulations will be forthcoming.