An Advanced, Physician-Strength Retinol Peel Improves Signs of Aging and Acne Across a Range of Skin Types Including Melasma and Skin of Color

Background: Facial chemical peels are highly sought after by patients with photodamage, acne, and melasma. An advanced, physician-strength superficial peel, containing 3% retinol with other firming and volumizing ingredients was developed to exfoliate, improve the appearance of fine lines and wrinkles, and plump and firm skin, while promoting a bright, even complexion. Objective: A clinical study was conducted to evaluate the tolerability, safety, and efficacy of the 3% retinol peel with a supportive homecare regimen across a range of peel candidates, females aged 18-65 years, with photodamage, acne, hyperpigmentation or melasma, and skin of color, over a series of 2-4 peels. Method: The 3% retinol peel formulation was administered under physician direction in 6-week intervals. Subjects with photodamaged skin, acne, hyperpigmentation/melasma, or skin of color (Fitzpatrick skin types IV-VI) received 2-4 peels along with a supportive homecare regimen. Dermatologist grading, self-assessment, and digital photography documented tolerability and efficacy parameters. Results: 24 subjects participated in the study with a total of 78 peels administered (Photodamage group, n=14 [with an Acne subgroup, n=5]; Melasma group, n=5; Skin of Color, n=5). The 3% retinol peel along with the homecare regimen was well tolerated under physician direction in all skin types and conditions assessed. Obvious peeling was noticeable in many subjects 3 days post-peel and resolved by day 7. In the photodamaged group, dermatologist clinical grading of fine lines, wrinkles, pore size, laxity, mottled pigmentation, lack of clarity/radiance, and overall photodamage was significantly improved (P<0.05). Benefits were observed in all groups and supported by self-assessment. Digital photography demonstrated tolerability in the days immediately post-peel, along with benefits to photodamage. Conclusion: The 3% retinol superficial peel was well tolerated and an efficacious cosmetic treatment under physician supervision in subjects of all skin types to firm skin, improve fine lines and wrinkles, and promote a bright, even complexion. J Drugs Dermatol. 2019;18(9):918-923.

A Firming Neck Cream Containing N-Acetyl Glucosamine Significantly Improves Signs of Aging on the Challenging Neck and Décolletage.

BACKGROUND: Noninvasive antiaging neck and décolletage treatments are highly sought after by aging patients. A topical cosmetic antiaging cream was formulated with skin matrix building and smoothing ingredients to help reverse visible signs of aging on the neck and décolletage, including laxity, crepiness, deep lines, and hyperpigmentation. OBJECTIVE: A clinical study was conducted to evaluate the efficacy and safety of the antiaging neck/décolletage cream over a 16-week treatment period. METHOD: Caucasian women with moderate texture (including wrinkles, fine lines, laxity, and/or crepiness) on the neck and hyperpigmentation on the décolletage used the test cream for 16 weeks. At weeks 0, 8, 12 and 16, the dermatologist investigator graded neck texture, décolletage texture and décolletage pigmentation using a 0-5 scale, and irritation/tolerability using a 0-4 scale. Subjects were photographed and provided self-assessment of their aging parameters as well as product tolerability. Chromameter measurements were collected in triplicate on the chest at weeks 0, 8, and 16 to quantitatively and objectively assess pigmentation. RESULTS: Forty-two women completed the study. All dermatologist-graded aging parameters were significantly improved at each time point, P<0.001. Chromameter measurements demonstrated significant improvements in brightness (L*) and redness (a*), P<0.05. Self-assessed aging parameters were significantly improved on the décolletage and neck, P<0.05. Digital photography demonstrated obvious antiaging effects including improved texture of neck and décolletage areas, reduced appearance of lines and wrinkles, reduced mottled hyperpigmentation, and a more youthful, firm appearance. The test cream was well-tolerated with no significant changes in irritation parameters throughout the study. CONCLUSION: The antiaging neck/décolletage cream delivered significant firming and smoothing effects with reduced appearance of hyperpigmentation and can be considered an effective topical homecare treatment option for patients seeking rejuvenation of this challenging area

A novel, volumizing cosmetic formulation significantly improves the appearance of target Glabellar lines, nasolabial folds, and crow's feet in a double-blind, vehicle-controlled clinical trial.

Facial lines and wrinkles are caused by many factors including constant exposure to external elements, such as UV rays, as well as the dynamic nature of facial expression. Many cosmetic products and procedures provide global improvement to aging skin, whereas injectable therapies are frequently utilized to diminish specific, target wrinkles. Despite their broad availability, some patients are unwilling to undergo injectables and would benefit from an effective topical option. A noninvasive option to volumize target wrinkle areas could also extend benefits of commonly used cosmetic anti-aging products. To this end, a two-step formulation containing the novel, cosmetic anti-aging ingredient, N-acetyl tyrosinamide, was developed for use on targeted wrinkle areas. The tolerability and efficacy of the serum plus cream were tested for 16 weeks in women with moderate facial photodamage on predetermined wrinkle areas (glabellar lines, nasolabial folds, under eye lines, and lateral canthal (crow's feet) wrinkles) in a single-center, randomized, double-blind, vehicle-controlled, clinical trial. Seventy women (47 Active group, 23 Vehicle group) completed the study. Digital photography, clinical grading, ultrasound and self-assessment scores confirmed improvement to wrinkle areas. The topical cosmetic formulation was statistically superior (P<0.05) to its vehicle in visually improving nasolabial folds, glabellar lines, crow's feet, and under eye wrinkles and in reducing pinch recoil time. Both the test formulation and its vehicle were tolerated well. The novel, two-step cosmetic formulation reduced the appearance of wrinkles and increased skin elasticity thus providing an effective anti-aging option for target wrinkle areas. This study suggests that in addition to its use as monotherapy for reducing targeted lines and wrinkles this cosmetic formulation may be also serve as an adjuvant to injectable therapies.

A double-blind, randomized clinical trial of 20% alpha/poly hydroxy acid cream to reduce scaling of lesions associated with moderate, chronic plaque psoriasis.

BACKGROUND: Salicylic acid is a topical keratolytic agent used to reduce scaling and hyperkeratosis associated with psoriasis vulgaris. However, its use is limited due to potential systemic toxicity. Hydroxyacids also modulate keratinization and desquamation. Therefore, they may serve a beneficial role in the treatment of hyperkeratotic conditions. To date, there are no clinical studies in the literature regarding the efficacy of hydroxyacids for psoriasis treatment. PURPOSE: To evaluate the therapeutic efficacy of topical 20% alpha-hydroxy/polyhydroxy acid versus standard salicylic acid to reduce scaling in patients with moderate, chronic psoriasis. METHODS: Twenty-five subjects with moderate, chronic psoriasis were enrolled in a 2-week, double-blind, left-right, randomized, bilateral comparison clinical trial to compare the efficacy of 20% alpha-hydroxy/polyhydroxy acid emollient versus 6% salicylic acid cream and 24 were randomized/completed. Clinical evaluations to assess the severity of psoriasis and scaling were performed using a 6-point scale prior to treatment, as well as following 1 and 2 weeks of therapy. RESULTS: Twenty-four participants completed the study. Both 20% alpha-hydroxy/polyhydroxy acid emollient and 6% salicylic acid cream were efficacious in reducing scale of psoriatic lesions. The topical 20% alpha-hydroxy/polyhydroxyacid reduced scaling at a faster rate; however, following 2 weeks of treatment the efficacy of both products were relatively the same. CONCLUSION: 20% alpha-hydroxy/polyhydroxyacid is as efficacious as salicylic acid in regards to the de-scaling of psoriatic plaques. Additionally, 20% alpha-hydroxy/polyhydroxyacid cream may yield quicker results and less toxicity than salicylic acid.

A high-potency, multimechanism skin care regimen provides significant antiaging effects: results from a double-blind, vehicle-controlled clinical trial.

Skin aging is a multifaceted biological process characterized by the appearance of wrinkles, pigmentation irregularities, and loss of firmness. These symptoms cannot be fully addressed by any single skin care ingredient or noninvasive cosmetic procedure. A comprehensive treatment approach, including the use of clinically proven topical skin care formulations, provides optimal antiaging effects. A high-strength skin care regimen (NeoStrata® Skin Active; NeoStrata Company, Inc, Princeton, NJ) was developed to deliver a combination of more than 35% active benefit ingredients, including the.

The use of fillers and botulinum toxin type A in combination with superficial glycolic acid (alpha-hydroxy acid) peels: optimizing injection therapy with the skin-smoothing properties of peels.

There are many procedures that a physician may utilize to improve the appearance and quality of the skin. Combining procedures can enhance the overall result and lead to increased patient satisfaction. Thus, it is important to choose procedures that will complement each other. Fillers or botulinum toxin type A (BTX-A) can plump the skin and smooth lines and wrinkles but will do little for uneven tone, skin laxity, or radiance and clarity. These signs of aging can be addressed with superficial glycolic acid peels. Methods of combining injectable compounds with superficial glycolic acid peels were discussed at a dermatologist roundtable event and are summarized in this article.

Evaluation of inherent differences between African American and white skin surface properties using subjective and objective measures.

Conflicting data have been published on the inherent differences in skin surface properties among various ethnic groups, though there is a widespread perception that differences exist. This study included subjective and objective assessments of skin surface properties in African American and white subjects. A dermatologist conducted visual assessments of photodamage and irritation. Instrumentation was employed to perform objective measurements of skin surface sebum level, pH, moisture content, and barrier function. In addition, resistance of skin to chemical challenge as a measure of barrier integrity was assessed in a subset of the populations. Results showed differences in photodamage and hyperpigmentation between the 2 ethnic groups tested, but no significant differences between the 2 groups were seen in the results of instrumental measurements for sebum, pH, corneometry (skin moisture), or transepidermal water loss (barrier function). These data help fill the gap in knowledge about photoaging-related differences in the skin of various ethnic groups, especially in textural and pigmentation parameters, as well as increase the knowledge base of differences in objective measures.

The use of polyhydroxy acids (PHAs) in photoaged skin.

The beneficial effects of alpha-hydroxyacids (AHAs) on skin were discovered by Drs. Van Scott and Yu in the early 1970s, including exfoliation, skin smoothing, and antiaging effects. A new generation of AHAs, called polyhydroxy acids (PHAs), was discovered that provide similar effects as AHAs but do not cause the sensory irritation responses that can limit the use of classical AHAs. PHAs have been found to be compatible with clinically sensitive skin, including rosacea and atopic dermatitis, and can be used after cosmetic procedures. PHAs provide additional humectant and moisturization properties compared with AHAs and can enhance stratum corneum barrier function, therefore increasing the skin's resistance to chemical challenge. Most PHAs also possess antioxidant properties. PHAs such as gluconolactone or lactobionic acid may be used in combination with other products, ingredients, or procedures such as laser and microdermabrasion to provide additional benefits to therapy or to enhance the therapeutic effect. Several studies were conducted in support of this, and methods and results are discussed. In summary, PHA-containing products were used in combination with retinoic acid in treating adult facial acne and were found to be well tolerated. PHAs plus retinyl acetate (pro-vitamin A) in a cream base exhibited significant antiaging skin benefits such as skin smoothing and plumping. PHAs plus hydroquinone showed excellent improvement in antiaging and skin lightening parameters. Finally, PHA-containing products were shown to be compatible with African American, Caucasian, and Hispanic/Asian skin and provided significant improvements in photoaging in these populations.

A polyhydroxy acid skin care regimen provides antiaging effects comparable to an alpha-hydroxyacid regimen.

There have been numerous clinical studies conducted to evaluate the beneficial effects of the polyhydroxy acids (PHAs) in skincare. Although there is significant evidence that PHAs provide antiaging effects to skin, a direct comparison between alpha-hydroxyacids (AHAs) and PHAs for these effects has not been conducted. This 12-week clinical study evaluated gluconolactone-containing products (PHAs) in comparison with glycolic acid-containing products (AHAs). Clinical grading of photoaging, as well as objective and subjective irritation, was conducted on the face at baseline and after 6 and 12 weeks of product use. Pinch recoil, silicone replicas of the crow's-feet area, and self-assessment of product efficacy and tolerance were also collected. Both regimens showed significant antiaging benefits to skin as measured by silicone replicas, clinical grading, and pinch recoil for skin resiliency. There were only 2 statistically significant (P < .05) differences between the regimens in antiaging benefits: (1) sallowness showed greater improvement with AHA use at week 12 only (AHA, 17. 1%; PHA, 12.4%), and (2) pinch recoil showed greater improvement with AHA use at week 12 only (AHA, 13.5%; PHA, 10.2%). Irritation grading and subject self-assessment showed that the PHA regimen was better tolerated than the AHA regimen. Stinging and burning were significantly worse for subjects in the AHA treatment group at both week 6 and 12, and degree of sensitivity was rated worse for the AHA regimen as well. The present study shows the enhanced mildness of PHAs and their equivalence in providing antiaging benefits compared with an AHA regimen.