Anti-aging cosmetics: Facts and controversies
Introduction
In modern society, there is a great increase in the search for eternal youth and an insatiable appetite for methods which could turn back the clock. This has triggered an explosion in the cosmeceutical industry. The term “cosmeceutical” was coined by Albert Kligman at the national scientific meeting of the Society of Cosmetic Chemists in 1984, referring to topically applied products capable of making changes to the skin status that are not considered drugs nor cosmetics that are applied to the skin.1., 2. The term remains controversial, especially among European authors.2 In the United States and Europe, cosmeceuticals are commercialized as cosmetics, although in Japan “a novel category of quasi-drugs exists that encompasses these biologically active formulations sold directly to consumers.”3
In addition, technological advances in medicine for the prevention and treatment of deadly diseases help to increase life expectancy. The elderly population has increased significantly in recent years, both in developing and developed countries.4 As an example, the baby boomers, the 40 million Americans born between 1946 and 1963, are approaching that stage of life where youthful good looks are becoming more of a memory than a reality. Skin aging will come no matter what, and this population obviously cannot remain young forever, but a youthful appearance and good health are essential.4., 5.
These days, many cosmetic innovations come about through scientific investigations. A wide range of skin-care products and their uses have become so extensive and complex that physicians and consumers alike are often confused about their indications and effectiveness. In the cosmetic field, many materials are commercially used and claim to provide certain skin effects when used topically. In general, although the effects may be small, they are significant and can improve skin feeling and appearance with their continued use. It is difficult to compare and quantify the degree of the effects among the various materials, because there are so many variables: measurement of different specific end points; variation in equipment; sensitivity of methods and formulation types, which can affect material delivery into skin; and studies with different body sites.
Section snippets
Facial remodeling with the skin aging process
Ageing produces a number of changes to the face, starting from childhood, which transforms the rounded contours of a child's angelic face into a more angular face with defined features, which will characterize the individual from the teenage years through adult life. These changes occur in the structures responsible for the formation of the facial anatomy: skin, soft tissues, and bones.5., 6.
In childhood, the face, due to the great skin elasticity and distribution pattern of fat, presents a
Intrinsic and extrinsic aging
The two types of skin aging have distinct sources: the intrinsic and extrinsic; however, their results become synergistic, leading to the aged look of the skin.8., 9.
Current treatments for aging skin
Rabe et al.35 proposed the creation of 3 groups of strategies for planning the treatment and prevention of aging skin (Table 2). They are listed below:
- 1.
The first approach aims at preventing photoaging through the use of sunscreens with chemical or physical broad-spectrum filters. Gaining a more conscious behavior in relation to photo-exposure must also be stimulated in patients, in an attempt to prevent solar damage.
- 2.
The second strategy uses formulations with active substances to try to postpone
Retinoids
In the epidermis, retinoids normalize the life cycle of keratinocytes, reduce keratinocytic atypia, and normalize the spread of melanosomes. Dermal changes are represented by an increase of collagen, elastin, and glycosaminoglycans. Histopathologically, these changes are expressed by structural changes in solar elastosis and collagen degeneration, Langerhans cell restoration, and correction of dysplastic changes.28., 36., 37.
Retinoic acid (tretinoin) is considered one of the most powerful
Alpha hydroxy acids (AHA)
AHA were introduced by Eugene Van Scott in 1984.46 There are several types of AHA, with the most used being glycolic, citric, lactic, malic, pyruvic, and tartaric acids. They present an action mechanism that is not well-clarified, but one hypothesis suggests that AHA would reduce the concentration of calcium ions in the epidermis and, through chelation, would remove the ions from the cells' adherence, resulting in desquamation. The reduction of calcium ion levels tends to promote growth and
Moisturizers
Moisturizing agents are responsible for keeping water in the epidermis; besides promoting a protective film against water loss, they help maintain the barrier. They should be used in support of the use of home formulations for skin rejuvenation.49
Peptides
Peptides are part of a group of agents that seem to act as cellular messengers. They are formed from amino acids that mimic fragments of endogenous peptides with biological activity.64
There are three categories of peptides: carrier peptides (matrixyl), neuro-transmitters (argyreline), and enzyme modulators (rice and soy proteins).3 Opinions are still conflicting, and some people state that there is no significant evidence that they work better than moisturizers, although investigators claim
Hormone replacement therapy
Hypoestrogenism affects the skin, producing less hydration and thinning the skin; therefore, its replacement, when well prescribed, including hormones in topical formulations, is effective in rehydration, collagen increase, and dermal thickness.16
Long-term prospective, randomized, double-blind, placebo-controlled studies on hormone replacement therapy in women have shown that skin aging signs were reversed and skin elasticity, hydration, and thickness were significantly increased.67
Enhancing
Sun blockers
Sun blockers are essential for skin health and rejuvenation, given that they provide protection against the most important factor for skin aging: exposure to sunlight.
They must be of broad spectrum, that is, they must protect from both UVA and UVB. The photo-protection is physical when the sun blockers contain reflective agents such as zinc oxide or titanium dioxide. These substances are inert and present a lower possibility of causing allergic reactions. Chemical blockers absorb and react to
Conclusions
With the increasing longevity of the population worldwide, good health is essential for a better quality of life, even in advanced age, with more independence and sometimes with intense professional and social activity. Good health includes the improvement of the appearance of aged skin, with the possibility of using safer and more effective products and procedures to diminish unaesthetic aspects. The dermatologist needs to know the mechanisms of the cosmetics therapies available and the
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