HEALTHY SKIN AND INFLAMMATION

Inflammation describes the process by which our body heals itself.  Today, I’m going to discuss two different types of inflammation: Acute and Chronic.  And I’m going to define the role that inflammation plays in influencing the health of our body’s largest organ, the skin.

 

When your body is injured, an entire network of inner response “teams” is immediately triggered to help fix the injury, which is why you will notice swelling, tenderness and redness around the injury site.  This is the process known as Acute inflammation.  Acute inflammation is necessary to help the body heal its injury and protect against infection.  The pain response of acute inflammation is your body’s signal to stop what you are doing, to avoid further damage.

 

Then there is the process known as Chronic inflammation.  When constant injury or insult to our body is allowed to occur on a regular basis, our bodies are in an ongoing battle to combat the acute inflammatory process, which then becomes a chronic condition.  Chronic inflammation can be triggered by stress, being overweight, sun exposure, diet, exposure to pollution, smoking, hormones and disease, among other things.  Over time, excessive chronic inflammation also significantly increases your risk of several life-threatening or degenerative diseases such as arthritis, allergies, asthma, heart disease, diabetes and Alzheimer’s (source: Reinagel, Monica. The Inflammation-Free Diet Plan, 2006. McGraw-Hill).

 

So what effect does inflammation have on the health of your skin?

 

We learned the importance of a healthy skin barrier (those outer protective layers of your skin) in my last blog.  Having a healthy skin barrier helps protect you from environmental elements that trigger the inflammatory response in the skin.  However, if left untreated an ongoing inflammatory response will break down a healthy skin barrier. Chronic inflammation in the skin manifests itself with visible skin aging and skin diseases.

 

Acute inflammation happens in the form of sunburn when your skin is exposed to excessive sun without any protection (your skin turns red, feels tender and swells slightly).  But chronic inflammation actually occurs on a daily basis from sun exposure – even if you are not in the sun long enough to sunburn.

 

Applying some topical products, like harsh prescriptions or facial scrubs, can trigger inflammation in the skin as well.  Microdermabrasion and chemical peels will also trigger an acute response in the skin.

 

Keep in mind that not all inflammation in the skin is a bad thing.  Microdermabrasion or chemical peel treatments help remove the superficial outer layers of stratum corneum (the skin barrier), and help move fresh cells to the skin surface.  At the same time, collagen and elastin are stimulated in the dermis, to help plump and support the skin.  But you couldn’t microderm or peel your skin every day, or you could be left with one very damaged skin barrier!  It’s also important to protect your skin after one of these types of treatments, since leaving your skin unprotected invites harmful exposure to environmental elements (sun, microbes and bacteria).

 

People who choose to exfoliate on a daily basis (men exfoliate every time they shave their faces) should consider taking steps to repair and fortify their skin barrier after exfoliation, when freshly exposed skin is most vulnerable to damage or bacteria. 

 

Choose skin care products that are fortified with anti-oxidant and anti-inflammatory ingredients that strengthen and protect your skin barrier, to help slow the chronic inflammatory process in the skin.  Make it a habit to wear sunscreen every day; preferably a sunscreen that provides at least SPF 30, and is fortified with antioxidants to help fight free radical damage (remember sun exposure is the number ONE element that causes inflammation and visible aging in our skin).

 

To sum up, some acute inflammation may be helpful to trigger cell turnover and stimulate collagen and elastin, which can help keep our skin looking good – but too much extended and prolonged inflammation creates a damaging chronic process, which contributes to visible skin aging and skin disease.

 

What is the Skin Barrier?

Today, I’m going to talk about the skin barrier.  I’m going to define what it is, and why it plays an important role in the health of our skin.

First of all, when you think of your organs, you probably think: heart, lungs, liver, kidneys … generally you don’t think of your skin as an organ – but your skin is an organ — in fact, it is your body’s largest organ.  Your skin is a reflection of the health of your body – if your body is not healthy on the inside, it is reflected in the appearance of your skin on the outside.  As well, the healthier your skin is on the outside, the better job it can do to protect your insides. 

 

The Layers of the Skin

 

Your skin actually is made up of three distinct layers: subcutaneous (or Hypodermis, as shown above), dermis, and epidermis.  The subcutaneous or subcutis layer is the lowest layer.  The subcutaneous layer (sub means under and cutis means skin) is the fatty layer that provides protection and cushioning between the skin and muscle layers.  The dermis makes up a large portion of the skin, and is the layer between the subcutaneous and the epidermis.  The dermis is where collagen and elastin are formed.   

 

The epidermis is the outer layers of the skin, and is actually divided into several different sections, including the basal layer, which lays right on top of the dermis and is where new cells are formed.  These cells that are formed in the basal layer continue to multiply and migrate upward toward the surface of the skin. 

 

The very outermost layer of the epidermis, the skin surface, is called stratum corneum, or the skin barrier.  The stratum corneum, or skin barrier, is actually made up of 7-10 layers of dead skin cells – cells that began in the basal layer and migrated to the surface of the epidermis.  It’s a process that normally takes about 26-32 days in normal, healthy, young skin.  Those dead skin cells are stacked on top of each other and held together at the skin surface with a substance called intercellular lipids.  You may think of scales on a fish, for example, or another common comparison is bricks and mortar, which are the cells and lipids held together.

 

Even though these skin cells in the skin barrier are technically not living cells, they do play an important role in protecting your skin from outer bacteria and viruses.  As well, your skin barrier also holds water inside your body to protect your body from losing water (also known as trans-epidermal water loss, or TEWL).  Our adult bodies are actually about 60-70% water, so if you didn’t have these outer layers of skin barrier keeping water inside your body, you would literally dry up in a few hours, like a piece of dehydrated fruit!

 

Why is it important to keep your skin barrier healthy?

 

As we age, our skin barrier breaks down and our epidermis thins after constant exposure to environmental factors.  It’s not just a matter of looking good on the outside; a healthy, intact skin barrier protects you from environmental factors that contribute to visible skin aging and skin diseases.  A thinner epidermis due to exposure influences the breakdown of collagen and elastin in the dermis, which causes us to sag and wrinkle.  Things like sun exposure, pollution, topical prescriptions, stress and even strong ingredients such as alpha-hydroxy acids or retinols can affect the health of your skin barrier. 

 

When you make a skin care product decision, remember to choose products that are proven to safely help repair and fortify your skin barrier, to keep your largest organ, your skin, at its healthiest.  A healthy skin barrier is your protective shield against the harsh elements of the outside world.

 

* Image used from image.google.com accessed on 11/04/2008. 

Toners, Clarifiers, Astringents – Oh, my!

Do you really need to use a toner, clarifier or astringent?  Are any of these products really a required part of your personal skin regimen?  My answer is: well, it depends…

 

It depends on why you feel you need to use one of these products – do you feel you need an extra step to help with excess sebum production, or help clear blackheads, or help smooth your skin texture?  Or, do you feel you need a little extra boost of moisture, or something to help calm your itchy, sensitive skin?

 

Astringents were developed back in the days when most of us used bar soaps or Noxzema to cleanse our skin.  Bar soaps are so highly alkaline (our skin barrier is actually slightly acidic), astringents were formulated at a low pH to restore the skin’s acid mantle and help prepare the skin for the next treatment product or moisturizer.  Now, we have many pH-balanced cleansers to choose from, and if you are already using a pH-balanced cleanser, an astringent (now also known as a toner, clarifier, refiner or freshener) is really an optional step in your skin care regimen. 

 

Toners help remove excess cleanser or residue left after cleansing.  Well-formulated toners also contain humectant, anti-oxidant and anti-irritant ingredients, and help soothe sensitive skin.  Toners for oily/acne skin used in place of a moisturizer are also an easy step for teens who like to keep a simple skin care routine. The proper way to use a toner is to apply after cleansing, before serum or moisturizer.

 

Toners for drier/sensitive skin types will contain humectants, which attract moisture to the skin, and other soothing ingredients.  Look for ingredients such as butylene glycol, sorbitol, glycerin, bisabolol, azulene, chamomile, cucumber and date fruit extract.  Notable toners for drier or sensitive skin types include Epionce Rebalancing Clarifier, Paula’s Choice Moisture Boost Hydrating Toner, and SkinCeuticals Revitalizing Toner.

 

Toners for oilier skin types may have a temporary tightening effect on pore appearance, and contain ingredients that help control excess sebum production and kill surface microbes.  Look for ingredients such as witch hazel, grape seed extract, salicylic acid, willow bark extract, and citrus extracts such as lime, lemon or orange.  Notable toners for oilier or acne-prone skin types include Epionce Purifying Lytic Toner, Murad Clarifying Toner, and Paula’s Choice Healthy Skin Refreshing Toner.

 

Toners that contain ingredients such as glycolic or lactic acid also help to encourage cell turnover (when in a pH of less than 4), and are great for anti-aging and skin smoothing benefits.

 

To sum it all up, some people, including me, consider toner or clarifier an optional step; others want to have that little extra step to complete their skin regimen.  There are days, after I’ve shaved my legs or in the colder winter months, when I need a little extra boost of soothing moisture from Epionce Rebalancing Clarifier (it really helps itchy, dry skin).  And there are those “hormonal” days when I need a little spot treatment with Epionce Purifying Lytic Toner.  It really depends on you to decide what works best for you!

“Over-the-Counter” Skincare vs. “Cosmeceuticals” or “Pharmaceuticals” – What is the difference?

As a professional esthetician, we often hear these common questions from our clients: What is the difference between a “professional” skin care cosmeceutical vs. a brand you can find “over-the-counter” at a drug or department store?  Is there really a difference, or is it all a bunch of fancy marketing talk and pretty pictures?  Can you get nice results with drugstore cosmetic brands, or will your results be better with professional cosmeceuticals? Too often, consumers fall under the spell of cosmetic company marketing and advertising claims, and will spend a lot of money on expensive over-the-counter cosmetics that really don’t work in the skin.

 

The US Food and Drug Administration (FDA) divides skin care products into two distinct categories: pharmaceutical and cosmetic.  Topical pharmaceuticals penetrate through the layers of the epidermis and affect the structure and function of the skin (think of prescription topical steroids or Retin-A).  Cosmetics are defined as ” … articles intended to be rubbed, poured, sprinkled, or sprayed on, introduced into, or otherwise applied to the human body or any part thereof for cleansing, beautifying, promoting attractiveness, or altering the appearance …”  Pharmaceutical drugs may undergo more than 10 years of drug approval testing that may cost hundreds of millions of dollars — whereas, cosmetics do not have to prove their claims, but they can cite “scientific studies” of the ingredients used in their product formulations to validate the safety and efficacy of the ingredient formula.

 

Cosmeceuticals are the “happy medium” between a pharmaceutical and a cosmetic.  The word “cosmeceutical” really is not categorized by the FDA, but it is a word that is used in the professional skin care arena to describe a cosmetic that actually has biological action, but is regulated as a cosmetic — meaning, again, the formula does not technically have to prove efficacy or safety, but it does contain an ingredient that may have activity in the skin.

 

You will find many of the same catch phrases when you read an advertisement for skin care: “Dermatologist-Tested,” “Clinically Proven,” “Clinical Studies show that …,” “Clinically Tested.”  But interpret these phrases with caution, especially when trying to choose a skin care line that works best for your practice and clientele.  Since cosmetic companies really don’t have to prove efficacy claims, the special active ingredient touted in the formula only has to appear somewhere on the ingredient list — ingredients are listed in content order, from most to least, so if you see that “active” on the last half of the list (usually alphabetically) you can bet you are getting a tiny percentage (enough to be effective in the formulation?) of that specific ingredient. When you see these types of claims, start asking questions:

 

·     What was tested — an individual ingredient or the finished formulation?

·     How was it tested, in-vitro (in a test tube or petri dish, in an ideal environment), or was it tested in-vivo (on actual skin)?

·     Were the studies double-blinded (meaning, the person applying the product and the person evaluating the results each have no knowledge of what they are applying or evaluating; it is strictly objective)

·     Was the formula tested against placebo cream (like glycerin or petrolatum), or against nothing, or against another type of similar product?

·     How long was the test conducted?  On how many participants?

 

Because many consumers “self-diagnose” when choosing a skin care product to try from a drug or department store, these products must be made safely, meaning, big cosmetic companies cannot afford to have masses of consumers with issues from using very active products — so, that skin care product may feel good and smell good, but it likely won’t have a lot of activity in the formulation.

 

Over-the-counter cosmetics are also manufactured and distributed in very large batches, and are packed with almost as many preservatives as “active” ingredients!  In addition, many over-the-counter cosmetics simply do not penetrate the skin barrier, where the ingredient formula would have a therapeutic benefit to the health of the skin.   Remember too, it’s not just about one really fabulous ingredient — it’s the mixture of the right amounts of active ingredients working synergistically together that work best in the skin, similar to how oral multivitamins work internally in our bodies with a mixture of vitamins and minerals for best absorption.

 

It is important to note that many single ingredients that test very well in in-vitro testing actually have no function in human skin when mixed into a formulation — yet, we still believe the “clinical study” claims from in-vitro studies.  As well, many companies that cite clinical study results will not provide clinical study documentation.  Rare is the cosmeceutical company that tests their finished formulations and then offers full clinical study details for the public to see.  You will sometimes find peer-reviewed cosmetic formulation studies in dermatology or cosmetic surgery journals, which lends more credibility to the testing process.

 

Since licensed estheticians do not prescribe pharmaceutical products, offering a well formulated and tested cosmeceutical line is the next best option to pharmaceuticals.  Cosmeceuticals that are professionally recommended by a licensed esthetician, physician or other educated skin care professional generally have a higher amount of active ingredients with proven and safe formulations, and offer delivery systems that reach targeted cells in the skin.  In your search for safe and effective skincare for your clientele, try to find cosmeceutical companies that offer clinical testing information, and learn how to ask questions and interpret clinical study details.  As a licensed skin care professional, research is imperative to help make the best decision for your clients.

 

 

Special Skin Care Concerns – Treating Asian Skin

Our Japanese partners from Osaka were visiting our corporate office last week and I got to perform a facial on one of the women on the team, which was a very special privilege for me.  Here in Boise, I don’t get many chances to work on Asian skin very often.

 

Asian skin is very delicate skin, and Asian women are very concerned about keeping their skin as light as possible.  Products that help with hyperpigmentation are highly regarded and coveted especially in the Japanese-Asian skin care market – but those pigmentation treatment products must also be formulated for very sensitive skin as well. 

 

Years ago, renowned dermatologist Dr. Thomas Fitzpatrick created a way to classify skin type by the tendency to burn or tan when exposed to the sun.  This Fitzpatrick skin typing helped the skin care professional determine which types of treatments would be safe for certain skin colors, such as aggressive chemical peels or laser procedures.  The Fitzpatrick scale ranges from Type I, the fairest skin most susceptible to sunburn and sun damage, to Type VI, the darkest skin most resistant to sunburn and sun damage.  As well, darker skin types tend to be the most susceptible to pigmentation disorders, such as post-inflammatory hyperpigmentation (after a blemish or scab has cleared), or melasma.  Although Japanese skin is very fair, it must be treated as Fitzpatrick V, due to the tendency for sensitive Japanese skin to pigment easily.  Aggressive peels and laser protocols must be used cautiously as well.

 

Visible pigment is triggered by an inflammatory response in the skin, so it is important for Asian skin to use gentle products that help calm inflammation in the skin.  Remember that living life every day exposes your skin to factors that contribute to inflammation – from sun exposure and pollution to lifestyle and diet.  Skin care products that use a combination of anti-inflammatory ingredients along with antioxidants (to help protect against free radical damage) help to calm the inflammatory process, which in turn helps improve the appearance of visible pigmentation.

 

My lovely Asian “client” had beautiful skin to begin with, so I concentrated on giving her a gentle but thorough cleansing with Epionce® Milky Lotion Cleanser followed by Epionce® Gentle Foaming Cleanser, using my ultrasonic spatula for very light removal of dead surface cells.  I infused Epionce® Lite Lytic with ultrasound to further deep clean her pores, reduce any redness, and smooth her skin texture.  I followed with an application of Epionce® Enriched Firming Mask to add hydration and further soothe her skin.  While she masked and relaxed, I performed a hand treatment using Epionce® Rebalancing Clarifier and Epionce® Renewal Body Lotion, slipping her hands inside warm mitts.  We finished the facial with a light application of Epionce® Rebalancing Clarifier, Epionce® Renewal Eye Cream, Epionce® Renewal Facial Lotion and Epionce® Active Shield Lotion SPF30+.  She looked absolutely radiant when we were done!

 

The Japanese skin care market has the most stringent regulations in the world regarding ingredient formulations, and products imported from the US must undergo very extensive testing before they are brought into the Japanese market.  This process could take years before a US skin care manufacturer is allowed to retail its products in Japan. 

 

Epionce® products, formulated to nourish the skin with a blend of botanicals and antioxidants, and help calm inflammation in the skin, will be introduced to the Japanese market in the fall of 2008.

Other “beauty blog” sites

I found an interesting beauty blog website last week — it looked legitimate enough when I first started reading.  There were many different “consumer reviews,” including positive, negative and neutral posts on many different skin care lines — like Obagi, Skin Medica, Epionce, Dermalogica.  But it became quite apparent to me after reading several of the reviews that the website was in fact a sponsored website, obviously skewed in the direction of the sponsored product.

So what I would like to point out to the general public is this: when reading a weblog — do make sure that the “facts” and the “reviews” you are reading are true facts and true reviews, not fabricated “reviews” made up by some busy corporate marketing department.

I clicked on the links on this particular website, to try to find out more information about their touted ingredients, Matrixyl 3000 and Argireline.  I wrote to the company for more information on their “clinical results” and asked these questions:

• May I have information on your clinical studies?
• Were these double-blind, controlled clinical studies?
• What were the parameters tested (ie, fine lines and wrinkles, pigmentation, skin clarity, etc)?
• What was tested, the individual ingredient or the finished formula?  What was it tested against (placebo, regular moisturizer, glycerin, etc)?
• How long were the tests conducted?  How many participants were tested?

So … I eagerly awaited my email response … and recieved a form email which was basically another advertisement for Matrixyl 3000 and Argireline … NO answers whatsoever to any of the specific questions I asked — and “we hope this answers all your questions regarding x-y-z product.  Please feel free to contact us with any other questions or concerns that you may have concerning this product.”  Yeah, WHATEVER — thanks for nothing!!

Here’s a fun fact: Of all the ingredients the FDA tests for cosmetics, only 1 out of 350 ingredients actually have activity in the skin when mixed in a formula — so BUYER BEWARE!  Remember, it’s more than does the product feel good and smell good — does the product actually work?

So I used a different sunscreen this weekend …

I am known in the family as the “sunscreen Nazi.”  I spent my childhood summers on the beaches of Southern California, and I’ve now spent the last 10 years trying to undo all that damage (for me, as well as a ton of other women my age who spent their childhoods worshipping the sun)– so I try very hard to make sure my children and the rest of my family are well-protected against the sun (try explaining to your 18-year old daughter that “pale” is really the new “tan”).

Every day without fail, my morning routine includes applying Epionce Active Shield SPF 30+ to my face and neck, followed by a dusting of mineral makeup (with natural SPF 20).  I love Active Shield with micronized zinc oxide, homosalate and octisalate — it absorbs very well and it has just enough moisture for my oily skin that I don’t need a separate moisturizer product in the morning.  The tube is only 2.5 oz though, so I generally don’t use it on the rest of my body — I use a different product to cover body parts.

We went on our first river rafting trip on the Fourth of July, and I bought several different types of my favorite body sunscreen from Neutrogena to protect the family.  I purchased Ultra Sheer Dry Touch Sunblock SPF 45, along with Active Breathable Sunblock SPF 30 and Ultra Sheer Body Mist SPF 45.  I was intrigued by Age Shield Face SPF 55 with Helioplex technology (a combination of Avobenzone and Octisalate which helps boost UVA protection), so I decided to try it on my face that day … Well, unfortunately by the afternoon, my eyes wouldn’t stop watering (I thought it might have been the wind on the river) — then by the drive home, I was burning and tearing and fogging up (I wear contact lenses and didn’t pack glasses like I should have).  I couldn’t wait to get home, cleanse my face, and put in a new set of contacts.  After I cleansed, I finally felt better.  The rest of my skin was fine; in fact, I was the only one with a weird reaction to any of the sunscreens.  I think it might have been the Avobenzone that irritated my eyes — it is a good broad-spectrum sunscreen ingredient, but it does tend to cause reactions in some people (never happened to me before).

So … I’m going back to my tried and true Epionce Active Shield SPF 30+ for my face … and I will stick with Neutrogena for the rest of my body.