Cosmeceuticals are topical products that claim to rejuvenate the skin, and imitate the effects of facial peels, injectables and other mostly aesthetic treatments. While the word cosmeceutical is nothing more than a marketing term, some products encompassed by this category can impart beneficial effects, according to Jason Emer, M.D., a dermatologic surgeon in Beverly Hills, Calif.
“There are a ton of cosmeceutical companies out there, but no real clinical trials backing them up,” he began. “However, there is a lot of anecdotal information on how some products can decrease inflammation, which could be very good for addressing acne, eczema and rosacea. They might also be advantageous for people with sensitive skin that want alternatives to retinol and actives like glycolic or salicylic acid.”
Among the cutting-edge skincare products that could benefit from additional commercialization and clinical studies, one that holds a vast amount of potential is cannabis oil, or hemp seed oil, which contains cannabidiol (CBD) and acts as an emollient to smooth rough cells on the skin’s surface and offers moisturizing benefits. Unlike marijuana, which has psychoactive side effects, hemp seed oil is a common source of naturally anti-inflammatory cannabinoids.
“Consumers are using these products and loving them,” Dr. Emer reported. “In my practice, we put some people to the test. They used it for a few nights in a row just around the face and they noticed softer skin, fewer fine lines, less puffiness and fewer dark circles. If consumers are saying that after just a few applications, then it is probably something that people are going to want.”
Although several CBD-based topicals are on the market (mostly online), Dr. Emer stressed that patients have to be careful when they initially start using them because there is a high risk of allergic reaction, even if it is a good, high-quality product.
“A lot of the CBD is mixed with botanicals and even though people say it is organic and natural, there are a lot of people that contract allergies from botanical products,” Dr. Emer elaborated. “Other inactive ingredients could cause problems, too.”
Another area of commercial development revolves around the use of probiotics in skincare, which has flourished as scientists perform research on the skin’s microbiome. Although research is in early phases, some products appear to act as antibiotics, while others claim to instigate healing processes without the need to create injury to the skin.
“Applying probiotics topically is still something of a mystery,” noted Dr. Werschler. “The average person has a skin flora that is well established; that is your staph and strep and pityrosporum, plus all those bacteria that live under your skin, but basically provide a first line of defense. I don’t think there is much noise in the market regarding what these topical probiotics do at this time. We don’t really know much about them, yet.”
Coming full circle back to personalized skincare, an emerging trend in precision bespoke treatments involves skincare therapies based in part on genetic information. While the commercialization of gene (or DNA)-based skincare seems fairly unorthodox, even in the world of aesthetics, genetic testing can be integrated into a physician’s all-inclusive evaluation of patients, in order to derive the best overall solution to many conditions – medical, aesthetic and otherwise.
Dr. Pearlman is one of the most prominent developers of this brand of truly holistic assessment and therapy, in which she conducts genetic screenings of patients. “We look at vitamin A and metabolism, which can demonstrate or suggest deficiencies in a patient’s ability to manage things like sun exposure, his or her increased risk of skin cancer and advanced aging of the skin,” she reported.
Dr. Pearlman’s evaluation looks at cellulose membranes and the skin barrier’s effectiveness, among other things. “Your genetics are the first chapter in a very long book of life, but it is only one driver. Interpreting genetics and other factors is important for me when shaping a health plan for the skin,” she said.
In addition, hormonal therapy (HT), which has been controversial in the past, is re-emerging as an important aspect of the personalized skincare trend. For instance, estrogen plays a large role in female skin health, with decreased estrogen levels resulting in reduced capillary blood flow to the skin.
“For women, hormones are a major determining factor regardless of genetics, nutritional status or their skin’s aging,” Dr. Pearlman pointed out. “The telltale sign of hormonal aging and estrogen loss in women is the occurrence of advanced perioral lines – a hallmark of low estrogen and other aspects of hormonal status.”
With customized solutions emerging as the future of skincare science, it is important to determine what kind of combined aesthetic therapies will work well with procedures like facial fillers and energy-based treatments.
“Treatment approaches would vary with each patient, which could be a very different concept for many physicians,” Dr. Emer maintained. “These are inventive combinations of modalities to quickly and effectively treat skin problems – holistic treatments that mix modalities, not one-off procedures.”
There is not one combination treatment that works for everyone, Dr. Emer continued. “In general, with skincare what people need – and this is based on clinical studies – is an antioxidant, typically vitamin C; a glycolic or alpha hydroxy acid; then at night, some sort of growth factor-based cream. With those you are hitting all levels of anti-aging. You want products that increase collagen production, and growth factors that basically reverse sun damage.”
This type of customization is also internal, he added. “You can’t really see it, but think of customized oral supplements designed to help people that are prone to diseases like diabetes, arthritis or skin cancer. These approaches are transforming medicine as we know it. It is time to get on the train to a better future in skincare and aesthetics.”