Category Archives: Facial products

National rosacea awareness month

Rosacea affects 14 million people in the US, men more severely than women, including famous figures such as Bill Clinton and W. C. Fields. However, to this day, 78% of Americans have no accurate knowledge of this condition and wouldn’t know how to recognize it.

April is National Rosacea Awareness Month, which is the perfect excuse and opportunity to review this skin condition, and share some tips about how to best manage the symptoms of rosacea (unfortunately, there is no cure for rosacea).

Causes of rosacea: The pathogenesis of rosacea is multi-factorial (translated in English: we don’t really fully understand what causes rosacea). Indeed, rosacea is precipitated by multiple causes including:

  • Genetic factors
  • Vascular factors
  • Immune-mediated factors
  • Emotional factors
  • Environmental factors
  • Infectious factors

There are various triggers that will aggravate this condition, including:

  • Environmental stimuli:
    • Exposure to temperature extremes
    • Moving to a warm or hot environment from a cold one
    • Heat from sunlight and severe sunburn
    • Cold wind
  • Emotional stimuli:
    • Stress
    • Anxiety
  • Physiological stimuli:
    • Some foods and drinks, including alcohol, caffeine, spicy foods
    • Strenuous exercise
  • Exogenous stimuli:
    • Microdermabrasion
    • Chemical peels
    • Products containing alcohol, witch hazel, menthol, peppermint, eucalyptus, clove oils, and other irritants

Diagnosis of rosacea: When diagnosing rosacea, it is important to look for the following:

  • Presence of one or more of the following primary features:
    • Flushing (transient erythema)
    • Long-lasting erythema
    • Papules and pustules  (red or yellow little bumps)
    • Telangiectasia (visible broken red blood vessels)
  • May include one or more of the following secondary features:
    • Burning or stinging
    • Plaque
    • Excessive dryness
    • Edema
    • Ocular manifestations (burning, redness)
    • Peripheral locations (rosacea on areas other than face)
    • Phymatous changes (e.g. rhinophyma) enlarged nose extremity

Rosace is typically classified in three stages:

Stage 1: Mild rosacea

  • Predominantly vascular symptoms
  • Characterized by recurring flushing on the face, neck and upper chest
  • May include facial edema and erythema
  • Telangiectasia may appear

Stage 2: Inflammatory rosacea

  • This stage is marked by the appearance of follicular-based papules and pustules
  • In addition to the symptoms of Stage 1 rosacea, there are also increasingly prominent facial pores

Stage 3: Severe rosacea

  • Characterized by a proliferation of sebaceous, connective, and vascular tissue
  • Typically results in the bulbous hypertrophy of the nose known as rhinophyma
  • This stage is most commonly found in men

Treatment options The first treatment option is truly behavioral, focusing on avoiding all of the triggers identified above. A typical treatment course for severe rosacea will however also include medications, such as:

  • Oral antibiotics (tetracycline, doxycycline, minocycline)
  • Topical antibiotics such as metronidazole (Metrogel)
  • Topical azelaic acid such as Finacea (15%) or Skinoren (20%) may help reduce inflammatory lesions, bumps and papules
  • If papules and pustules persist, isotretinoin can be prescribed

Finally, for the treatment of the erythema and redness specifically, the pulsed dye laser remains the gold standard.

From a product standpoint, it is essential to use products formulated for sensitive skin and to avoid harsh ingredients such as acids or vitamin C (and certainly no peels!). Furthermore, vaso-constrictors (ingredients that tighten our red blood cells and protect their capillary walls) are ideal for rosacea-prone skin (think blueberries for example). Finally, from a cosmetic standpoint, makeup bases that have some green in them will help to alleviate the look of redness.

For a webinar on how to treat rosacea-prone skin, please click here.

Sources: National Rosacea Society, The Treatment of Rosacea with Glycolic Acid, Cleveland Clinic Foundation, JAAD, April 2002, Vol 46, Number 4, JAAD, June 2004, Vol 50, Number 6

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Antioxidants for anti-aging

At Alchimie Forever, we believe phyto-antioxidants are the most powerful way to prevent and repair signs of skin aging. Indeed, antioxidants are not new to beauty and skin care industries and have been on everyone’s lips over the last few years, touted to be the latest “miracle in a jar.” But what exactly are antioxidants? What do they do? How do they work? And which ones should you use?  

 To understand antioxidants we must understand oxidants

Oxygen, essential to life, is metabolized in the body by successive reductions, leading to superoxide anion (O2.-), hydrogen peroxide (H2O2), and hydroxyl radical (.OH) generation. These different molecules are named reactive oxygen species (ROS), or oxidants; some are free radicals (defined by the presence of an unpaired electron), whereas others are non radical (such as H2O2, singlet oxygen 1O2).

Oxidants, when present in significant quantities, lead to oxidative stress which in turns damages cellular structures.

Exposure of the skin to UV is the main cause of oxidative stress: UV exposure induces the production of high quantities of oxidants, which damage DNA, lipids, membranes, intracellular and extracellular proteins, and sugars. Oxidants have both immediate and long lasting deleterious effects to the skin, including the appearance of actinic keratoses,  a  citrin coloration of the skin (lipid peroxidation), a loss of collagen and elastin (protein alterations), and finally skin cancer (DNA alterations).

Antioxidants: a way to fight oxidants

Antioxidants, as their name indicates, are the opposite of oxidants. What oxidants break, antioxidants can repair.

Endogenous antioxidants

The first key distinction in the family of antioxidants is whether they are endogenous (those produced by the human body) of exogenous (those not produced by the human body). Indeed, human cells are equipped with a series of endogenous antioxidants to deal with the damages caused by oxidants. Such endogenous antioxidants include the following enzymes: superoxide dismutase, catalase, glutathione peroxidase, and thioredoxine reductase. As we age, these endogenous antioxidants are gradually depleted over time; this consumption is accelerated by an increased production of oxidants. Hence the importance of exogenous antioxidants.

Exogenous antioxidants

          Synthetic antioxidants: the case of Idebenone

Idebenone is one of the better known synthetic antioxidants. It is an organic compound of the quinone family and promoted commercially as a synthetic analog of coenzyme Q10 (CoQ10). Idebenone’s antioxidant role involves both the scavenging of oxidants as well as a preventative role in lipid peroxidation. It seems idebenone’s antioxidant properties function by virtue of the electron-donating properties of the hydroquinone form. 

Idebenone is present in skin care products from brands such as Prevage (owned by Allergan) and True (which licenses idebenone from Allergan).

          Phytoantioxidants

The alternative to synthetic antioxidants are natural antioxidants, namely those derived from plants. Plants, like human beings, suffer from UV-generated oxidative stress – they live in the sun after all! Plants are, however, unable to protect themselves by moving into the shade or by using sunscreen. Consequently, plants have developed effective antioxidant strategies to protect themselves against the oxidizing stress induced by their environment, in particular UV exposure.

Phytoantioxidants fall into four main groups, namely enzymes, terpens, polyphenols, and vitamins. Some of the best known, and most studied phytoantioxidants are carotenoids (a terpen), and flavonoids and anthocyanins (polyphenols).

Green tea

Green tea contains four major flavonoids: epicatechin, epicatechin-gallate, epigallocatechin, epigallocatechin-3-gallate. These molecules have the ability to scavenge oxidants including O2.-, .OH, H2O2 and 1O2. It has been shown that epigallocatechin applied topically with exposure to UVB inhibits the production of H2O2 in the dermis and epidermis. Numerous skin care brands use green tea, including Elizabeth Arden and Replenix.

Rosemary

Rosemary contains various antioxidants, in particular phenolic diterpens: carnosol and carnosic acid represent over 90% of the antioxidant properties of rosemary extract. These lipophilic molecules scavenge lipid free radicals, thereby enabling the reduction of lipid peroxidation and inhibiting oxidative damages to skin surface lipids. Carnosic acid also has photoprotective potential. Alchimie Forever and Clarins are two brands that use rosemary in their skin care products.

Grape seeds

Grape seeds are major sources of resveratrol and quercetin. The stilben resveratrol inhibits lipid peroxidation induced by UVB and significantly decreases UVB-induced skin thickness and oedema. The iron chelator flavonoid quercetin maintains and protects the activities of glutathione peroxidase, catalase, and superoxide dismutase after exposure to UV radiation. Caudalie is an example of a skin care brand using grape seeds (and grapes) as its signature ingredient.

Tomato

Tomato is rich in lycopene, a widely studied powerful antioxidant and anti-carcinogenic carotenoid with strong reducing ability and the most effective carotenoid in the scavenging of the oxidant 1O2. Lycopene also scavenges lipid radicals, reduces lipid peroxidation and prevents erythema caused by UV radiation on the skin. Kiehl’s and Alchimie Forever both use tomato extract in their products.

Antioxidants represent a key therapeutic approach to preventing skin aging. More specifically, research indicates that the combination of multiple antioxidants at low concentrations represents the most effective approach. Indeed, different antioxidants (whether synthetic or natural) have difference mechanisms of action and target different parts of the cell, thus offering synergies when combined. In the world of antioxidants, 1 + 1 is not 2 but rather 5. As such, the more antioxidant products you use, the better off your skin will be!

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