After a proper analysis reveals areas of dry, oily, or aging skin, we can provide the appropriate correction for each skin type in a cosmetic base containing the exfoliants, emollients, and micronutrients necessary for cellular repair.
Antioxidants such as Alpha Lipoic Acid (ALA) and Ascorbyl Palmitate (Vitamin C Ester) are vital to the energy production of skin cells and formation of collagen. Alpha Lipoic Acid promotes optimum efficiency for production of energy and removal of intracellular waste products, essential for cellular healing and elimination of wrinkles and facial scars. Ascorbyl Palmitate also inhibits the body’s production of inflammatory arachidonic acid, which plays a role in the development of psoriasis and the micro-scarring that leads to the formation of wrinkles. Molecular biologist Olga Marko, Ph.D., found that Ascorbyl Palmitate stimulates the growth of fibroblasts which help to produce collagen and elastin in human skin. Studies have shown that antioxidants can be delivered percutaneously to directly supplement the skin’s antioxidant reservoir. Oral supplementation has not been successful in raising levels of antioxidants in the skin.
Retinol assists in the rejuvenation process that leads to a more youthful appearance and provides the same benefits to skin as retinoic acid, but in a more gradual, gentle manner. Retinol works with Alpha Lipoic Acid to provide maximum benefits, effectively and gently. Alpha and beta hydroxyl acids may be used to exfoliate the skin, increase cell turnover, and reduce fine wrinkles and mottled pigmentation.
Amino acids such as DMAE (2-dimethylaminoethanol; deanol) tone and add firmness to the skin, prevent age spots, and aid in healing the micro-scarring which causes wrinkles. The benefits of DMAE include a potential anti-inflammatory effect with possible improvement in underlying facial muscle tone. In a randomized clinical study, 3% DMAE facial gel applied daily for 16 weeks was shown to be safe and efficacious in the mitigation of forehead lines and periorbital fine wrinkles, and in improving lip shape and fullness and the overall appearance of aging skin. These effects did not regress during a 2-week cessation of application. Long-term application of DMAE gel for up to 1 year was associated with a good safety profile.
Am J Clin Dermatol. 2005;6(1):39-47
Cosmetically appealing preparations
Compounding pharmacists continue to develop new bases to improve both the aesthetic and therapeutic aspects of compounded medications. For example, anhydrous gels deliver medications which facilitate rapid absorption of the active ingredient into the skin and prolonged retention of the drug in the stratum corneum and epidermis, with minimal systemic transport of active drug. These cosmetically appealing gels are very stable and well accepted by patients.
Chemical peelings with kojic acid, glycolic acid, and trichloroacetic acid (TCA), alone or in combination, are available for treatment of hyperpigmentations. Research has concluded that dermatologists should have a choice of formulations to satisfy individual patient needs.
We can compound sunscreen formulations with low-allergenicity UVB protectors in combination with chemicals such as oxybenzone that extend protection to UVA wavelengths. For broad spectrum coverage that blocks or reflects UVA and UVB, physical sunscreens containing titanium dioxide or zinc oxide may be preferable. When vitamin C or a combination of vitamin C and E is formulated with a commercial UVA sunscreen (oxybenzone), an apparently greater than additive protection is noted against the phototoxic damage.
Increases or decreases in skin pigmentation can be due to many conditions (such as acne, pregnancy, cirrhosis, chronic renal failure, celiac disease) or use of medication. Most types of skin discoloration are harmless from a medical viewpoint, but they may be cosmetically unacceptable. The goal of therapy in hyperpigmentation disorders is to lighten the skin so it blends into the surrounding normal skin. Most preparations that are used to lighten the skin contain the drug hydroquinone. Other commonly used medications include azelaic acid, glycolic acid, hydrocortisone, kojic acid, and tretinoin. Our compounding pharmacy can prepare customized dermatologics to meet each person’s specific needs. It may take three to six months of therapy before improvements in pigmentation are noticed. These preparations may increase sensitivity to the sun, so ask our pharmacist about an effective sunscreen.
Customized Topical Therapy for Cellulite
Cellulite describes dimpling of skin, caused by the protrusion of subcutaneous fat into the dermis. "Cellulite is hereditary, so much so that the indications of who will get it, and to what degree, are present almost from birth," noted dermatologist Amy Newburger, MD, director of Dermatology Consultants of Westchester in Scarsdale, N.Y. Newburger says that creams and lotions whose key ingredient is a methylxanthine such as caffeine may be beneficial. "Caffeine creams work great to pull fluids out of the spaces between cells and induce lipolysis - fat burning in the layer just below the skin's surface." Newburger says a good delivery system to drive the creams into the cells, like liposome technology, is also important.
Caffeine is effective in reducing the appearance of cellulite, improving micro circulation, and strengthening skin tone and firmness. Researchers have found that caffeine creams reduce fat cells in skin, with visible results in about eight weeks. In a double-blind, single-center, placebo-controlled study, a liposome-encapsulated caffeine-based cream was found to significantly reduce the thickness of the adipose tissue in all areas of the body. In addition, the more concentrated cream was significantly more effective than the less concentrated cream in the areas of the hips and the triceps.
Dermatol Surg. 1999 Jun;25(6):455-62
Gotu Kola (Centella Asiatica) has a long history as a traditional medicine for improving skin tone and firmness. Studies show that Gotu Kola can reduce the appearance of cellulite by preventing and reversing the formation of fibrous connective structures that "trap" fat. Grape Seed extract is well known for its antioxidant properties and has been shown to improve circulation, strengthen connective tissues, and reduce the effects of aging on the skin. It also inhibits the enlargement of fat cells and the accumulation of fat tissues, thus improving the appearance of cellulite.
It is very important that preparations are massaged into the skin. Hygroscopic moisturizers are also recommended.
Harry’s Cosmeticology, 8th Ed. (Rieger)
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