SEP 2017

MedEsthetics—business education for medical practitioners—provides the latest noninvasive cosmetic procedures, treatment trends, product and equipment reviews, legal issues and medical aesthetics industry news.

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CUTTING-EDGE INGREDIENTS 32 SEPTEMBER 2017 | Med Esthetics "The jury is still out on a lot of these new actives," says Michael Gold, MD, founder of Gold Skin Care in Nash- ville. "Most people are offering them as a 'try this; it's new' or using them in combination with retinoids. We need more clinical data and we have to see how they perform over time." We spoke with chemists and physicians and asked them to share their thoughts on which new topical ingredients show the greatest promise of living up to their hype. NEXT-GENERATION RETINOIDS Retinoids (tretinoin or retinoic acid or non-prescription retinol) remain the gold standard in antiaging skin care. "If we are talking about the prevention of skin aging, sunscreen remains absolutely essential," says John Kulesza, PhD, chemist and founder of Young Pharmaceuticals. "When it comes to treatment, retinoids are the No. 1 class of ingre- dients that are proven to make people look younger." These vitamin A-derivatives have a long history in dermatology and are the only drugs approved by the U.S. FDA to treat skin aging. New retinoid esters being used in cosmetic formula- tions may offer the antiaging benefi t of retinoids without the downsides of skin irritation and infl ammation. "They are very interesting and may be superior to [non-pre- scription] retinol," Kulesza says. Retinoid esters—which include hydroxypinacolone retinoate, ethyl lactyl retinoate and glycerol retinate— are created by reacting fatty alcohols with retinoic acid. "They are used in several cosmetic products and repre- sent a new generation of retinoids that appear to work and may be more gentle than some of the older reti- noids," says Kulesza. The theory is that while these retinoid esters are recognized by receptors in the fi broblasts, melanocytes and keratinocytes—similar to retinoic acid and retinols— they are not well recognized by receptors in skin cells that mediate infl ammation. "And that is the goal: to fi nd compounds that do the good things, such as stimulating collagen production and regulating pigmentation, but don't do as much of the bad things, such as causing red- ness and infl ammation," says Kulesza. DEFENSINS Peptides have become key ingredients in antiaging skincare, where they are used to signal a number of skin-repair mechanisms. One group of peptides, defensins—which play a key role in wound healing—has generated a great deal of interest among dermatologists and skincare professionals. A new company, DefenAge, has developed a propri- etary peptide complex called Age-Repair Defensins. "It includes naturally occurring peptides that stimulate the LGR6+ stem cells in the hair follicle to make new kerati- nocytes," says Leslie Baumann, dermatologist, author of Cosmeceuticals and Cosmetic Ingredients and CEO of Skin Type Solutions. "The defensins are packaged in a molecule that helps them penetrate into the hair follicle where they stimulate the patient's native LGR6+ stem cells." "This is an interesting product," says Michael Gold, MD, founder of Gold Skin Care in Nashville. "The actives are alpha-1 and beta-2 defensins, which are a component of some of the things skin loses as we age. The company just presented a placebo-controlled study that showed some really nice results." The results of the multi-center, placebo-controlled study—presented at Vegas Cosmetic Surgery in June 2017—revealed that the treatment group had increased epidermis thickness, a greater number of proliferating cells, "There is interesting science, but a lot more work needs to be done to prove these things work." © GETTY IMAGES

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