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Issue link: https://medesthetics.epubxp.com/i/111786
ANTIAGING SKIN CARE Shift in Focus Even skin tone may be replacing wrinkles as the greatest concern among aging women. Increased media attention to unwanted dark spots and sun damage have played a part in the shift as has a growing recognition of world standards of beauty, which place more emphasis on even pigmentation no matter what the skin color. Questions about the safety of hydroquinone have prompted a lot of this worldwide press coverage. ���We���ve learned that using hydroquinone for more Before After than three months can lead to photosensitivity and result in possible loss of melanin. It���s still a helpful drug but it must be used in a pulsed approach as part of an overall program promoting skin health,��� says Zein Obagi, MD, dermatologist, and founder and medical director of ZO Skin Health (zoskinhealth.com). ���We are currently focusing on pigmentation, speci���cally skin brightening,��� adds Rahul Mehta, PhD, vice president of research and development, SkinMedica (skinmedica.com). SkinMedica recently introduced Lytera Skin Brightening Complex, which the company calls ���a revolution in the management of hyperpigmentation.��� Lytera���s proprietary blend of ingredients was tested against 4% hydroquinone in a clinical trial published in the Journal of Drugs in Dermatology (December 2012). The randomized, double-blind, half-face study included 68 caucasian subjects and concluded that the new brightening formulation was as effective as the hydroquinone gold standard. Patient before and after 12 weeks of Lytera use. 38 MARCH/APRIL 2013 | MedEsthetics Trend 3: Holistic, Individualistic Approach Zein Obagi, MD, dermatologist, and founder and medical director of ZO Skin Health (zoskinhealth.com), ���nds both stem cell and growth factor technology suspect. ���Growth factors in skincare topicals have not been shown to penetrate in enough concentration to affect the dermis,��� he says. ���The same is true of stem cells. We really can���t say that we have an extract that can create collagen or ���broblasts. What we have are only pieces of the puzzle, not real answers. ���The skincare industry continues to sell dreams in a jar,��� he continues. ���I would like to see the entire industry come together to stop ���quick ���x��� products and, instead, address the functionality of skin as a whole. I don���t think all skincare companies are bad, I just think they are using the wrong concept. It is like losing weight���if you want to be ���t, you exercise, of course, but you also need to eat healthy, drink water and take appropriate supplements. Creating healthy skin requires the same approach. The entire body must be ���on program.��� I wish the industry would adopt this more holistic approach.��� What does work according to Dr. Obagi? ���At age 30, cellular function slows. That���s when you start to get wrinkles and laxity. If you want to improve the skin, you need to restore the normal function of the cells. You need to go down to the dermis and activate the cells. The most PHOTOS COURTESY OF SKINMEDICA Photographs of the participants taken at six months were later assessed by an independent panel of three dermatologists. As assessed by the investigator, photodamage parameters such as ���ne wrinkling, mottled pigmentation and tactile roughness signi���cantly decreased from baseline in the active group (26 subjects) after six months. Photographic evaluation showed a worsening of photodamage for the control group and either a slight improvement in photodamage after three months or substanitial prevention of worsening as indicated by a smaller change from baseline at six months. Participants with severe photodamage showed a statistically signi���cant improvement when using the active formula for six months. The most recent study of Neocutis Bio-restorative Skin Cream was reported in the June 2008 Journal of Cosmetic Laser Therapy. It involved 11 participants who applied the novel skin cream twice daily for six months. Punch biopsies were taken from the preauricular skin area of each before and after the treatment period. Clinical assessment recorded a 33% reduction in periorbital wrinkles and a 25% reduction in perioral wrinkles. Histologic evaluation indicated moderate changes in the epidermal thickness as well as an increased ���broblast density in the super���cial dermis at six months. Ultrastructural changes consistent with new collagen formation were shown by electron microscopy.