TABLE 22.

1 botanical antioxidants

Cosmeutical Effect on skin physiology Patient selection comment

Soy Flavonoid antioxidant with estrogenic effect, Improves skin thickness

genistein and deidzein
Curcumin Polyphenol antioxidant with tetrahydrocurcumin , Slight burning sensation possible on
used as a natural preservative application

Green tea Polyphenol antioxidant with epigallocatechin Must be used freshly brewed or
stabilized with BHT as oxidizes to
brown color rapidly, useful as a
photoprotectant
Silymarin Flavonoid antioxidant with silybin , silydianin , and May be useful topically in
silychristine photosensitive individuals
Pycnogenol Phenol and phenolic acid antioxidant Useful in supplementing antioxidant
effect of vitamins C and E
Lutein and lycopene Carotenoid antioxidant Best consumed orally in fresh picked
ripe tomatoes
Rosmarinic acid Polyphenol antioxidant Found in high concentration in fresh
rosemary leaves
Hypericin (St john’s Polyphenol antioxidant Must not be consumed orally in large
wort) quantities
Ellagic Polyphenol antioxidant Marketed as potent antioxidant for
acid(pomegranate topical and oral use
fruit)
 Table 22.2 vitamin antioxidant

Cosmeceutical Effects on skin physiology Patient selection comments

Vitamin E Alpha tocopherol active primary skin Primary substances responsible for the
antioxidant form prevention of oxidation of cell wall lipids,
poor topical penetration
Vitamin C L-ascorbic acid, secondary skin Regenerates vitamin E to active form to
antioxidant from peroxidation prevent cell membrane lipid, poor topical
penetration beyond epidermis
Niacinamide Decreases protein glycation to Nonirriting exfoliant
function
Alpha-lipoic acid Antioxidant Synthesized by body in mitochodria , not a
true vitamin
Ubiquinone Antioxidant Synthesized by body, not a true vitamin,
regenerates vitamin E
Idebenone Antioxidant Newer from of ubiquinone with stronger
cutaneous antioxidant effects
Retinol Vitamin A May be irritating at high concentrate
above 1% must be stabilized for activity
Retinyl propionate Vitamin A ester Less irritating than other topical retinoid
Retinyl palmitate Storage from of vitamin A Weak biologic activity, sometimes used as
product antioxidant preservative
 Table 22.3 cellular regulators

cosmeceutical Effect on skin physiology Patient selection comments

Fibroblast growth factors Fibroblast spent culture media Unusual smell imparted to
containing numerous unknown moistorizer product, does
fibroblast secreted substances, not appear to promote
such as epidermal growth growth of other skin lesions
factor, transforming growth
factor-beta, and platelet-
derived growth factor

Signal peptides Pentapeptide pal- KTTKS, Used in 4-6 ppm in

collagen I fragment that moistorizers, clinical data
downregulates collagenase lacking
production

Neurotransmitter Hexapeptide argireline, inhibits Attempts to mimic of

peptides neurotransmitter release to botulinum toxin on muscles,
decrease muscle moverment clinical data lacking
and wrinkle
 Table 23.1 cosmeceuticals to minimize facial redness
cosmeceutical Effects on skin physiology Patient selection comments

Prickly pear Mucilage rich in mocopolysaccharides forms Extract used in moistorizers, usually
protective film does not provide mucilage properties
Aloe vera Mucilage containing 99,5% water and a Salicylate component function as
mixture of mucopolysaccharides and choline topical anti-inflammatory , since
salicylate mucilage properties lost in most
moistorizers formulations
Bisabolol Chammomile extract prepared by distillation Potent anti-inflammatory in
moistorizers
Allantoin Comfrey root or synthetic manufacture from Used commonly in sensitive skin
uric acid formulations
Panthenol Barrier enhancing humectant Used to hydrate the skin and prevent
barrier demage
Tea tree oil Polyphenols May cause allrgic contact dermatitis.
Evening primrose oil Polyphenols Purported to be of benefit in atopic
dermatitis
Ginkgo biloba Polyphenol fraction Ginkgolides, bilobalides are active
anti-inflammatories
Green tea Polyphenols Epigallocatechin , epigallocatechin-3-
gallate are active
Saw palmetto Polyphenols High concentration needed for
efficacy
St john’s wort polyphenols High concentration needed for
efficacy
Box 23.1 skin care ingredient recommendations for facial redness

1. CLEANSER SELECTION
Product selection:
Synthetic detergent mild liquid cleanser with excellent rinsability. Removal of any soap residue
is critical to preventing irritation. Recommend a product labeled as a sensitive skin foaming face
wash.

Cosmeceutical ingredient :
None in particular, since the short contact time during cleansing would do little for facial
redness

Rationale:
Mild cleanser to clean skin while minimizing barrier demage

2. TONER OR ASTRIGENT SELECTION

These are liquid products designed to remove any unwashed soap residue, increase sebum
removal, or provide a mild skin moistorizers. These products evaporate quickly from the skin
surface and may provide a sensory stimulus that results in flushing and redness. All sensory
stimuli should be avoided in patients with facial redness, and toners or astrigents are not
recommended.
3. MOISTORIZER SELECTION
Product description:
Cream rather than lotion with minimal water or other vehicle to evaporate
from face. Avoid propylene glycol , glycolic acid, salicylic acid, strong
fragrances, and and products with extensive botanical cokctails. These may
evoke facial stinging.

Cosmeceutical ingredients:
Allantoin, bisabolol, and panthenol.

Rationale:
Allantion and bisabolol form the basis for many of the sensitive skin claims
in moistorizers, time tested effective ingredients for reducing inflammation.
Panthenol is a nonsticky humectant to enhance stratum corneum hydration
and prevent or minimize barrier demage.
4. SUNSCREEN SELECTION
Product description :
Thicker lotion or cream sunscreen labeled for sensitive skin with SPF 30. avoid gels, water-resistant
products, and sticky high SPF product.

Cosmeceutical ingredients:
Zinc oxide or titanium dioxide

Rationale :
Chemical sunscreen absorb UV radiation and transform it to heat, which may invoke facial flushing and
vasodilation. Pjysical sunscreens mainly reflect UV radiation preventing photoaging without a sensory
component.

5. TREATMENT MOISTORIZERS SELECTION

Product description:
Cream moitorizer with petrolatum , dimethicone, low levels of glycerin to prevent transepidermal
water loss and increase skin hydration, thus enchancing the skin barrier.

Cosmeceutical ingredient :
Green tea

Rationale:
Of all the polyphenols, green tea is the most potent anti-inflammatory and demonstrate the highest
efficacy.
 Table 24.1 cosmeceuticals for dsypigmentation

cosmeceutical Effects on skin physiology Patient selection comments

Niacinamide Inhibition of melanosome No irritation, weak skin

transfer from melanocytes to lightening agent
keratinocytes

Retinol Inhibits tyrosinase , interferes Mild irritation, weak skin

with pigment transfer ligtening agent

Ascorbic acid(vitamin C) Interects with copper ions at Magnesium-L-ascorbic acid-

tyrosinase active site 2- phosphate is more stable
form, weak skin lightening
agent

Kojic acid Tyrosinase inhibitor from Mildly irritating and a

fungus possible allergen
Glabiridin Tyrosinase inhibitor from No cytotoxicity, no
licorice irritation, most common
skin lightener in US
cosmetics

Arbutin Glycoside that inhibits Less potent than kojic acid,

tyrosinase from bearberry must be used in
fruit combination with other skin
lightening agents

Paper mulbery Tyrosinase inhibitor from Low irritation, same potency

mulberry tree roots as kojic acid, not
commercialized in US

Soy Fresh milk inhibits PAR-2 Only present in fresh soy

pathway and melanosome milk, difficult to stabilize
transfer

Azelaic acid Dicarboxylic acid derived Slight stinging upon

from pityrosporum ovale application , effective skin
that is tyrosinase inhibitor lightening agent
Aloesin Aloe vera derivative that is Weak skin lightening agent
competitive inhibitor of
DOPA
oxidation,noncompatitive
inhibitor of tyrosine

Glycolic acid Sugar- derived alpha Irritating at high

hydroxy acid that increases
exfoliation of pigmented
skin, penetration enhancer
of other skin lightening
actives
concentrations, may induce
postinflammatory
hyperpigmentation

hydroquinone Tyrosinase inhibitor , Highly reactive radical, very

cytotoxic irritating, effective skin
lightening agent
 Table 26.1 cosmeceutical actives for dry skin
cosmeceutical Effect on skin physiology Patient selection comments

A : occlusive
moistorizing
Mineral oil Reduces TEWL by approximately 40% Less greasy than petrolatum, does not
cause acne
Lanolin Mimics human sebum Common cause of allergic contact
dermatitis, not used in hypoallergenic
formulations
Lanolin alcohol Similar to lanolin, but branched molecule provides Excellent at smoothing skin
smooth skin feel surface,common cause of allergic
contact dermatitis
Liquid paraffin Provides protective film, reduces TEWL Excellent hand and foot moistorizer for
hand dermatitis and dyshidrosis
Carnauba wax Provides protective film somewhat thinner than Same as liquid paraffin,naturaly
liquid paraffin derived ingredient
Dimethicone Reduces TEWL without greasy feel Excellent for acne and sensitive skin
patients, hypoalergenic,
noncomedogenic,nonacnegenic
Cyclomethicone Thicker silicone than dimethicone Same as dimethicone

petrolatum Rapidly reduces transepidermal water loss (TEWL) by Most effective for extremely dry
99% skin,greasy, decreases scaling
appearance
B: humectant
Propylene glycol Attracts water from viable Not good on abraded or
epidermis and dermis to sensitive skin as can cause
stratum corneum stinging
Glycerin Most effective humectant If used in too high
available to increase concentration will create
stratum corneum hydration sticky feeling on skin,
especially under high
humidity
Hyaluronic acid Used as a secondary may be used to supplement
humectant glycerin to decrease
stickiness
Panthenol Vitamin B is the most May be used to
effective vitamin supplement other
humectant humectants

Sodium PCA Considered part of natural May be used to

mostorizing factor for skin supplement glycerin to
decrease stickness
C : stratum corneum
modifying
Ceramides Naturally present as part of
intercellular lipids
Cholesterol Naturally present as part of
intercellular lipids
Urea Increases water binding sites Hydrates calluses and keratin
on dehydrated keratinocytes debris
Lactic acid Decreases corneocyte
adhesion
D : emollient
Cetyl stearate Smoothes desquamating
corneocytes
Dicaprylyl maleate Used to dissolve UV
sunscreens in moistorizing
formulations
C12-15 alkyl benzoate Fills in spaces between
desquamating corneocytes
Improves skin barrier in
atopic dermatitis
Should be balanced with
free fatty acids and
ceramides
Enhances desquamation of
corneocytes in ichthyosis
Most common emollient,
nongreasy skin smoothing
effect
Provides excellent smooth
skin feel
Less waxy feel on skin than
paraffin
 Tabel 27.1 cosmeceuticals for acne therapy
Cosmeceutical Effects on skin physiology
Salicylic acid Exfoliation induced on the skin
surface and in the follicular ostia,
anti-inflammatory
Glcolic acid Exfoliation on the skin surface
Lactobionic acid Exfoliation on the skin surface with
humectant and antioxidant effects,
lower irritation profile
Retinyl propionate Possibly converted to biologically
active retinoic acid in the skin, low
irritation profile, stable
Retinol Possibly coverted to biologycally
active retinoic acid in the skin, more
iritation posibble, less stable
Niacinamide Enhanced exfoliation without low Ph
due to NADPH
zinc Anti-inflammatory
Patient selection comments
Potent comedolytic suitable for
sensitive skin
Comedolytic best for
photoaged skin
Moistorizing and comedolytic
properties
Mild retinoid effect suitable for
sensitive skin
Mild retinoid effect suitable for
photoaged skin
Oil reduction and exfoliation
effects combined.
May be used both orally and
topically as antiacne treatment
 Table 25.1 cosmeceutical actives for oily skin
cosmeceutical Effects on skin physiology
Niacinamide Reduces amount of sebum colected on skin
surface
Polymer-absorbng Bead uses van der waals forces to absorb and
beads hold oil in polymer sphere
Salicylic acid Oil-soluble exfoliant that can enter sebum-
rich pore milieu
Witch hazel Astrigent containing tannins from leaves
obtained by steam distillation
Papaya Papain proteolytic enzyme removed from
fruit and applied to skin surface
Soy Fresh soy milk contains phytoestogen
genistein
retinol Naturally occuring form of vitamin A
functioning as a retinoid
Patient selection comments
Used topically in oil-reducing
moistorizers
Used in moistorizers to hold and
absorb oil that reaches the skin
surface
Used as an astrigent to remove
oily residue from skin surface
and follicular ostia
Used to remove excess sebum
from face in a tonc as an
astrigent
Enzyme removes oil and
desquamating corneocytes from
skin surface
Thought to be an antiandrogen
hormonally reducing oil
production
Thought to produce a drying
effect on skin similar to
precription retinoids on a lesser
level
 Box 25.1 flowchart for oil control
STEP 1 : CLEANSING
Saliycilic acid-containing foaming face wash

Rationale :
Mild synthetic detergent cleansing with oil-soluble chemical exfoliant functioning in and around the follicular ostia.

STEP 2 : TONER APPLICATION

witch hazel astrigent over oily T-zone (entire forehead, between eyebrows, and nose).

Rationale:
Additional sebum removal from oily facial areas missed by mild cleanser without damaging the barrier of drier facial sites.

STEP 3 : COSMECEUTICAL MOISTORIZER APPLICATION

Niacinamide and/or retinoid (retinol,retinyl propionate)moistorizer.

Rationale:
Decreased surface presence of sebum

STEP 4: OIL ABSORPTION

Polymer bead oil-absorbing cream

Rationale:
Polymer beads to hold sebum as secreted to minimize facial shine

STEP 5 : OIL CONTROL COSMETICS

Oil-absorbing facial powder

Rationale:
Talcum powder applied to absorb remaining sebum