Cosmeceutical vehicles

Consumers will pay a premium for high-performance skin and hair care products. The demand exists, and in return for the high cost, consumers expect the product to perform as claimed and to meet aesthetic standards beyond many products found in the mass market. To be successful in this highly competitive market, products must function as claimed or consumers will not repurchase. Effective contemporary high-end products must be properly formulated in nonirritating vehicles that consumers will perceive as elegant.     

Ultraviolet A radiation: testing and labeling for sunscreen products

Conceptually, sunscreen products are quite simple. The ultraviolet (UV) filters in these products reduce the "dose" of solar energy to which the skin is exposed. Underlying this empirical notion are many complexities including measures of product efficacy and how to communicate this to consumers. The sun protection factor (SPF) test is and should remain the singular in vivo method for evaluating sunscreens. Additionally, substrate spectrophotometric measure of absorbance/transmittance and the calculation of the summary statistic, such as the critical wavelength (ie, lambda(c)), should be used as a means of evaluating broad-spectrum (ie, UVA) protection. Ideally, the photoprotective efficacy of sunscreen products will be communicated to consumers as an SPF no greater than 50 and a single designation of "broad-spectrum" to indicate long-wavelength UVA protection.     

Nickel,cobalt and chromium in consumer products: a role in allergic contact dermatitis?

In spite of the improved awareness of the potential for nickel, cobalt and chromium to en use skin allergy, the incidence of serialization to them is generally on the increase, especially for nickel. We review data from the literature and industry on transition metal contamination of consumer products and assess the hazard to man. Consumer products are defined as personal care items and detergent/cleaning products used regularly in domestic York. The analytical data demonstrate that consumer products are a relatively minor source of contact with nickel, cobalt or chromium. The traces found in consumer products will not be the primary cause of sensitization to these metals: levels will be too low and exposure too brief. A person sensitized to these metals has many other more significant sources of daily contact such as earrings, jewellery and metal objects. It is therefore necessary to focus on decreasing the high exposure to these transition metals from other sources rather than on possible trace amounts found in consumer products. Current good manufacturing practice ensures that trace nickel, cobalt and chromium concentrations in consumer products are less than 5 ppm of each metal, it is recommended that this be accepted as a standard for maximum concentrations and that the target should be to achieve concentrations as low as 1 ppm.     

Nickel dermatitis: how much nickel is safe?

The Nickel Directive will become law in the countries of the European Union in 1996. This directive slates that the concentration of nickel in post assemblies (used after ear piercing) may not exceed 0.05% that products which come into direct and prolonged contact with the skin. e.g. earrings, watchstraps or zippers, may not release greater than 0.5 μg/cm²/week, and that nickel release from coated products will not exceed this level after 2 years of normal use. The data relating to the threshold for reacting to nickel and the levels of nickel release from nickel-containing objects, are considered in this review. Although the level of 0.5 μg/cm²/week is one below, which a minority of nickel-allergic subjects will react, it is not safe in every nickel-sensitive individual, This level of nickel release is currently exceeded by many nickel-containing alloys and jewellery items that are made from high-sulfur stainless steel, and manufacturers are going to have to change the composition of jewellery to comply with the directive.     

Less-known botanical cosmeceuticals

ABSTRACT:  Complementary and alternative medicine (CAM) has become increasingly popular in the United States during the last 10–15 years. The use of oral and topical supplements falls within this framework. Most oral and topical supplements are based on or include several botanical ingredients, many of which have long histories of traditional or folk medicine usage. Several of the available products derived from botanical sources are touted for their dermatologic benefits. The focus in this discussion will be on a select group of botanical compounds that have been used for dermatologic purposes or show promise for such applications, including: rosemary, polypodium leucotomos, propolis, oatmeal, olive oil, grape seed extract, lavender, mushrooms, and coffeeberry. Other more commonly used products of botanical origin, such as arnica, bromelain, caffeine, chamomile, ferulic acid, feverfew, green tea, licorice, pomegranate, and resveratrol, are also briefly considered.     

Chemical peels

With so many new peel preparations on the market today, the dermatologist must ask himself basic questions concerning the products. The most important question is directed to the medical literature rather than the advertising or marketing campaign so common among market-driven cosmetic products. Since all peeling agents--superficial, medium depth and deep--are derived from basic chemicals known to cause exfoliation, destruction and/or inflammation of skin in a controlled manner, the clinician must ask what is new and better about the product. Peeling agents, regardless of their proprietary new name, fall into chemical families. The clinical evaluation of these generic agents is well documented in our literature as to efficacy, technical care and safety. In addition, combinations of peeling agents have been presented in the dermatologic cosmetic literature with scientific clinical trials and histology. These include: 1) The Gordon-Baker phenol peel; 2) Combination medium depth peeling; 3) Glycolic acid formulations. It is the responsibility of the dermatologic surgeon to be in control of his chemicals and his products. It is thus necessary for him to understand all the products and the peel formulation and be sure it has undergone the test of objective scientific study with clear clinical evaluations and histology. Only then will we truly know the effectiveness of the agents we are using for exfoliating and resurfacing.     

Cutaneous photochemoprotection by green tea: a brief review

Alarmingly increasing incidences of skin cancer are being reported from many countries where the majority of the population is Caucasian. According to projected estimates by the American Cancer Society, approximately 1.3 million cases of basal-cell and squamous-cell cancers, grouped together as nonmelanoma skin cancers, are diagnosed annually in the USA alone. It is clear that excessive exposure of the skin to solar radiation, particularly the UVB component, is responsible for these cancers. It is also important to mention here that among all the cancers, skin cancer is believed to be one of the most preventable and curable cancer types. While the surgical therapy for these skin cancers is highly effective, because of their recurrence and many other reasons, these cancers cause significant morbidity to the patients. One way to reduce the occurrence of these cancers is through chemoprevention. For the chemoprevention of photodamage and thus for photocarcinogenesis, we will use the term 'photochemoprotection'. In recent years, the naturally occurring compounds, especially the antioxidants, present in the common diet and beverages consumed by the human population have gained considerable attention as chemopreventive agents for potential human benefit. Many such agents have found a place in skin care products. Green tea, rich in polyphenolic antioxidants, is gaining increasing attention as a supplement in skin care products. In this short review, we will discuss the chemopreventive potential of green tea polyphenols against skin cancer, especially photocarcinogenesis. We advocate that the use of skin care products supplemented with agents such as green tea in conjunction with the use of sunscreens and educational efforts may be an effective strategy for reducing UV-induced photodamage and skin cancer in humans.     

Tachyphylaxis in 12-0-tetradecanoylphorbol acetate- and arachidonic acid-induced ear edema

12-0-Tetradecanoylphorbol acetate (TPA) applied to mouse ears rapidly induces an edema which is maximal by 6 hr but has substantially waned by 24 hr. (This is in contrast to many inflammatory agents that cause a prolonged edema lasting many days.) Reapplication of TPA at 16-24 hr will not provoke a second edematous response although increased erythema is evident. Arachidonic acid (AA) applied to mouse ears (4 mg) provokes an even more rapid edema which is maximal at 1 hr and has substantially waned by 6 hr. Reapplication of AA at 3-24 hr also will not provoke a second edematous response although, again, increased erythema does result. Pretreatment of ears with AA results in inhibition of the edema response to subsequent application of TPA, and TPA pretreatment moderately inhibits a subsequent response to AA. TPA-induced edema can be delayed by agents such as naproxen, an inhibitor of AA cyclooxygenase. In contrast, AA-induced edema is inhibited only by agents, such as phenidone, that inhibit both cyclooxygenase and lipoxygenase. The data suggest that the edemas result from interaction of the products of the cyclooxygenase and lipoxygenase pathways of AA metabolism. The lack of secondary edema response appears to be related to the inability of TPA or AA to reinduce vascular permeability. The effect is specific to AA and TPA; responses to xylene or anthralin are unaffected by TPA or AA pretreatment. It is postulated that the tachyphylactic effects observed involve lipoxygenase metabolites of AA.     

Review of abdominal solid organ transplantation in Jehovah’s Witness patients

Managing blood loss in Jehovah’s Witness (JW) patients is a matter of controversy. These patients will not accept transfusions of red blood cells, white blood cells, platelets or plasma, even if that is required to save their lives. There are many discussions regarding safety of operating upon JW patients in general surgical procedures, but in solid organ transplantation there is a paucity of literature on this subject. We have reviewed individual case reports and small series documenting on experience with solid organ transplantation in JW patients and the strategies adopted to facilitate that. It is clear that such patients require the surgical team to dedicate more time to ensure their safe management. This begins with a thorough, detailed consent of exactly which products and interventions they will or will not accept. Planning must begin weeks before surgery if possible. Each case must be assessed individually, but provided they meet fitness requirements, there are no absolute contraindications to abdominal organ transplantation.     

Cosmeceuticals: current trends and market analysis

The desire to maintain a youthful image combined with an emerging global market with disposable income has driven the development of many new industries. The cosmeceutical industry is based on the development and marketing of products that lie between cosmetics and pharmaceuticals. Today, there are over 400 suppliers and manufacturers of cosmeceutical products, and the industry is estimated to grow by 7.4% by 2012. Although a number of products advertise predictable outcomes, the industry is largely unregulated and any consumers of cosmeceutical products should consult a dermatologist prior to use. This review will provide a snapshot of the current trends of this industry and provide an analysis of this multi-billion dollar market.     

Cosmetics for the eye area after cosmetic surgical procedures.

Cosmetic enhancement of the eye area after esthetic surgery allows the patient to get back into the mainstream of life faster. It also improves their psychic state by blocking out discoloration, helping to disguise incision scars and artistically coloring the face to enhance the results of the surgery. The patients automatically feel better, when they look better. After a surgical procedure, there are temporary and permanent structural changes that appear with blepharoplasty and laser surgery. Although these surgeries will take away loose skin, puffy fat deposits and wrinkles, they do not change the bone structure or eye placement. Before starting a makeup application, analyzation of the eyes for their structural features help the artist know the value of colors to be used. The measuring points of the brow along with the importance of framing the eye will also be discussed. Once the brows and the eyes have been analyzed, the artist needs to take into consideration the personality of the patient. This helps the artist decide on the colors, value, intensity and design which will be applied to the patient. Before eye makeup can be applied, the use of primers, concealers and/or camouflage creams will be used to block out any discoloration in the eye area. We will look at concerns in formulation of products that will go around the eyes after surgery. The application of cosmetic products should be used as an accessory. Women have a variety of dress styles: casual, business or evening. The style of makeup application should work in conjunction with what they are wearing and how they are feeling at the time. Just as there are many facets to a woman, there are various styles of application to fit her personality.     

The selection of skin care products for use in hyperbaric chamber may depend on flammability acceptability indices score

PURPOSE: Current protocols call for stopping adjunctive skin care treatments during hyperbaric oxygen therapy (HBOT) because the hyperbaric environment is considered unsafe for skin care products. The elevated oxygen fraction and the increased pressure in the hyperbaric chamber dramatically increase the flammability potential of materials, leading to the need for rigorous standards to prevent flame ignition. A scientific method of evaluating the flammability risks associated with skin care products would be helpful. Several skin care products were tested, using established industrial techniques for determining flammability potential with some modification. The information obtained from these tests can help clinicians make more rational decisions about which topical products can be used safely on patients undergoing HBOT. METHODS AND MATERIALS: Wendell Hull & Associates conducted independent studies, comparing the oxygen compatibility for leading skin care products. Oxygen compatibility was determined using autogenous ignition temperature (AIT), oxygen index (OI), and heat of combustion (HoC) testing. AIT, a relative indication of a material's propensity for ignition, is the minimum temperature needed to cause a sample to self-ignite at a given pressure and oxygen concentration. OI, a relative indication of a material's flammability, is the minimum oxygen percentage that, when mixed with nitrogen, will sustain burning. HoC is the absolute value of a material's energy release when burning, if ignition occurs. Products with a high AIT, a high OI, and a low HoC are more compatible in an oxygen-enriched atmosphere (OEA). An acceptability index (AI) based on these 3 factors was calculated for the products, so the testers could rank overall material compatibility in OEAs (Lapin A. Oxygen Compatibility of Materials. International Institute of Refrigeration Commission Meeting; Brighton, England; 1973). RESULTS: Test results for the skin products varied widely. The AIT, OI, HoC, and AI were determined for each product under described circumstances. The AIT results indicate that all products in 99.5% oxygen concentration under pressure will ignite and that a pattern based on the absence or presence of petroleum-based ingredients does not seem to exist. Products containing petrolatum, mineral oil, paraffin, and paraffin wax had a HoC that equaled or exceeded the HoC of gasoline, whereas products without petroleum-based ingredients had a significantly lower HoC. The OI of skin products not containing petrolateum-based ingredients was significantly higher than the OI of products containing it. The AI values the OI as the most important value: the higher the AI, the more acceptable the product is for use with oxygen. The silicone-containing, petroleum-free products received an AI up to 25 times higher than the petrolatum-based products. These findings suggest a wide variation in the safety profiles of skin products. Skin products being considered for use in an OEA should be screened for flammability risks. This screening will allow informed decisions about the fire safety of the products. Further research is indicated.     

Allergic contact dermatitis to plants: understanding the chemistry will help our diagnostic approach

Allergic contact dermatitis due to plants is common. Potentially allergenic plants and plant products are found in many everyday environments, such as the home, the garden, the workplace, and recreational settings. By improving our knowledge of allergenic plant-derived chemical compounds, we will be better positioned to identify novel allergens. We review the most relevant chemical allergens that contribute to plant allergic contact dermatitis and propose a clinical classification system based on 5 major families of chemical sensitizers: α-methylene-γ-butyrolactones, quinones, phenol derivatives, terpenes, and miscellaneous structures (disulfides, isothiocyanates, and polyacetylenic derivates). We also describe the different clinical pictures of plant allergic contact dermatitis and review currently available patch test materials. A better understanding of the specific allergens involved in plant allergic contact dermatitis will help to predict cross-reactivity between different plant species or families.     

Allergic contact dermatitis from a pyridine derivative in polyvinyl chloride leather.

Antimicrobial coating of household products has gained wide acceptance in Japan in the past several years. Pyridine derivatives, used as antifungal or antibacterial agents in many common products, are known to cause contact dermatitis. We present a case of severe contact dermatitis caused by a pyridine derivative used as an antifungal agent in the polyvinyl chloride (PVC) leather of a chair. An open patch test was performed with each ingredient of the PVC leather. Other products were previously eliminated from consideration based on a series of negative patch tests. The PVC leather obtained from the patient's chair gave a ++ reaction with evident blistering, according to the International Contact Dermatitis Research Group standard. Fifteen ingredients of the PVC leather were open patch tested; a positive reaction was found with 2,3,5,6-tetrachloro-4 (methylsulphonyl) pyridine (1% in petrolatum). Clinicians should be aware that antifungal or antibacterial agents may be increasingly incorporated into common household products and should be suspected in cases of contact dermatitis.     

Comparison of different thread products for facial rejuvenation: Materials and barb designs

Background

In recent years, the thread-lifting technique has become widely used in clinical settings. Several thread products are used in clinical practice, and there are many differences between products in terms of many aspects.

Methods

Six commercial thread products were collected and evaluated. The general structure, microstructure, elastic modulus, and strength were evaluated using microscopies and tensile testing in vitro. Seventy-two female rats were divided into six groups. Tissue samples were harvested and histologically evaluated at 1st, 4th, 8th, and 12th week using hematoxylin and eosin and Masson's trichrome staining.

Results

There were differences between products in terms of barb shape, microstructure, elasticity, and strength, and that could be attributed to the materials and barb structures. All threads showed good biological safety, and the density of collagen area in the dermis was increased compared to that in the control group.

Conclusions

This study provided an objective evaluation of barbed thread products, which indicated that all products can be used safely with certain effects in different indications.     

Off-label-Use und G-BA

Off-label use of medicinal products, i.e. beyond their submitted, tested and approved indications, lies between 30 and 90%—depending on the indication. In dermatology, off-label use is of special importance, for even guideline-endorsed standard therapeutic approaches for common dermatological diseases like atopic eczema, psoriasis, or malignant melanoma are to some extent not licensed for these indications. In addition, many of the approximately 5000 dermatological diseases have a low prevalence. For many such orphan diseases, there are no approved drugs, and it is not feasible that licensing studies will be performed for these indications within a foreseeable time. A reliable legal framework for the reimbursement of medicinal products that are used off-label is essential both for patients and to allow physicians to choose the most adequate therapy. Therefore, off-label use expert groups have been convened by the Federal Ministry of Health (BMG) in order to improve patient care. So far this new and innovative approach has not provided any reasonable improvement for many patients with dermatological diseases whose treatment can only be off-label since a comprehensive evaluation of all off-label indications is not possible. The following statement of the former Federal Minister of Health, U. Schmidt, is particularly true for dermatological therapy: “Good oncologic care also requires a good drug treatment—especially in the outpatient setting. The use of drugs which are not or not yet approved for this indication is often required here”. Federal Minister of Health, Ulla Schmidt, 25th German Cancer Congress, 10 March 2002, Berlin.     

From the bottle to the skin: challenges in evaluating antioxidants

Endogenous production and ultraviolet-generated free radicals in the skin can lead to photoaging and even skin cancer. Topical antioxidants have been found to provide benefits against ultraviolet damage and these ingredients have been incorporated into various cosmetic products and claimed to have substantial effects. Currently, there is a lack in a standardized rating system to measure the concentration and activity levels of antioxidants in these products. As a result, it is difficult for consumers and clinicians to evaluate and select commercial products based on readily accessible evidence. In this review, we will describe four assays which have been used to measure antioxidants in various products, and the strengths and weaknesses of each test will be detailed. We will highlight key considerations for clinicians when interpreting the results of antioxidant tests when evaluating commercial products containing antioxidants.