Medesthetics

MAY-JUN 2016

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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RETURN TO BASELINE 38 MAY/JUNE 2016 | Med Esthetics Calming infl ammation is a key step in helping postprocedure skin heal properly. RESTORING THE BARRIER Because resurfacing procedures strip away the top layers of the epidermis, the skin barrier becomes damaged leading to redness, irritation and transepidermal water loss (TEWL). Occlusive topicals, such as petrolatum and silicone, help prevent moisture loss and keep environmental pollutants from entering the skin. Additional ingredients used to protect damaged skin and restore proper barrier function include lipids, ceramides and polyhydroxy acids (PHAs). "Lipid-rich oils, such as squalane, are reparative lipids. They seal the moisture barrier and protect it from losing water," says Jeannette Graf, MD, assistant clinical professor of dermatology at Mount Sinai Medical Center in New York City and partner at Omni Aesthetics MD. "Barrier repair ingredients are typically rich in lipids similar to the intercellular lipids found in skin," agrees Mostafa Omar, PhD, formulator and president of Phytoceuticals Skin Care. "Plant oils are popular for skin care because they are good sources of fatty acid lipids. Other barrier repair ingredients— such as silicone and petrolatum—work by providing a temporary thin coating over the epidermis that reduces the evaporation of water and protects impaired skin." Dr. Thornfeldt notes that there are about 20 herbal extracts including saffl ower, sunfl ower, mallow and avocado that have been proven to repair a damaged skin barrier and return its function to normal. He fi nds the most effective barrier repair ingredients are those that mimic the natural composition of healthy skin. "Cholesterol, 11 ceramides and linoleic acid (an essential fatty acid), as well as lauric, palmitic and stearic acids make up the protective stratum corneum permeability barrier. They are arranged in a brick- and-mortar pattern with layers of lipids compromising the mortar between corneocytes," he says. The goal of formulators is to combine those ingredients in ratios that mimic healthy skin. Though they don't seal off the skin like lipids and petrolatum, PHAs and bionic acids—such as gluconolactone and lactobionic acid—are nonirritating humectant compounds that moisturize and provide antioxidant benefi ts. Their ability to restore hydration and protect damaged skin makes them valuable postprocedure skincare ingredients, says Barbara Green, vice president of clinical research and business development at NeoStrata. "PHAs have been shown to help increase skin barrier function overall as well as protect against chemical irritant challenges via optimization of skin pH and lipids," she says. "These protective compounds also help to reduce MMP activity and nonenzymatic glycation to preserve the skin's essential foundation." CALMING INFLAMMATION Protecting a compromised barrier is key to preventing infection, environmental damage and moisture loss, but the most effective postprocedure products must also calm infl ammation to ensure optimal healing. "After any procedure, patients should be counseled to stay out of the sun or use sunscreen to protect the skin from UV rays, apply ice packs to help reduce infl ammation and take acetaminophen, depending on their level of pain," says Omar. "We also recommend hyaluronic acid-based products after noninvasive and minimally invasive procedures for their potent anti-infl ammatory properties, as well as other well-proven topical anti-infl ammatory ingredients, such as aloe vera gel, olive leaf extract, vitamin B 5 and zinc sulfate." Phytoceuticals' most popular postprocedure line, SUPERHEAL O-Live, is formulated with olive leaf extract. "It's also known as oleuropein, which has been used for centuries as a medicinal herb," says Omar. "It's packed with antioxidants and phytonutrients, and research has revealed signifi cant benefi ts for the treatment of skin conditions such as rashes, eczema and psoriasis. It also speeds up postprocedure healing because it reduces redness, infl ammation and irritation. The extract is antibacterial, antiviral and antifungal." Cell Protection Protein (CPP) is a relatively new, proprietary ingredient being used by LIFTLAB to calm infl ammation. "CPP has been clinically tested and proven to reduce erythema by 95%," says Elliot Entis, founder and CEO of LIFTLAB. "Not only does it address existing redness and irritation, it also helps to prevent infl ammation. When applied to the skin topically, CPP increases the production of 41 natural proteins found in the skin, including antioxidants and collagen- and elastin-stimulating proteins, which boost the skin's ability to renew while defending against pollutants and external aging factors." LIFTLAB combines CPP with the marine molecule adenosine. "It is naturally found in the skin cells and is the primary energy source to optimize protein production and prevent tissue damage," says Entis. "It's a powerful active to reduce skin reactivity." Dr. Graf recommends Avène Thermal Spring Water, which has anti-redness properties, as well as moisturizing and anti-infl ammatory coconut oil to her patients. © GETTY IMAGES

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