FutureDerm.com

Perspectives from a future dermatologist

A New Favorite: MaMa Lotion - Mandelic and Malic Acid

Ah, just when I think I’ve heard it all, I run across MaMa Lotion ($44.50, Cosmeticville.com). A dermatological-grade potent combination of 20% unique alpha hydroxy acids (10% mandelic acid, 10% malic acid), MaMa Lotion has what it takes to become a new regular in my skin care line-up, reducing the appearance of fine lines and wrinkles, freckles, acne blemishes, acne scarring, hyperpigmentation, enlarged pores, melasma, ingrown hairs, and rough skin.

One of the main ingredients in MaMa Lotion, mandelic acid, is an alpha hydroxy acid derived from almonds. According to research published in the journal Tetrahedron, mandelic acid is a potent antioxidant, preventing skin lipid peroxidation when applied topically. A review in Clinics in Dermatology further affirms that mandelic acid is an AHA tat is able to treat signs of photoaging (including skin roughness and fine lines). Interestingly enough, mandelic acid is also used at 0.5% in antimicrobial solutions as an activating solution for 0.1% sodium chlorite.

Malic acid (hydroxybutanedioic acid) is an alpha hydroxy acid that is found naturally in apples. In the Journal of Dermatology, a published study found that a combination of malic acid and glycolic acid increased cell proliferation and functional activation of fibroblasts, indicating that the ingredient is effective in stimulating collagen production. Although it has been reported in the International Journal of Skin Science that malic acid is somewhat less effective than the alpha hydroxy acids glycolic acid and lactic acid, in combination with other AHAs (like the mandelic acid in MaMa Lotion), malic acid has been reported to have great efficacy in treating skin roughness, fine lines, and hyperpigmentation. Unlike the other AHAs, malic acid has also been demonstrated to have some level of anti-microbial activity, as reported in The American Journal of Enology and Viticulture.

Skin following 1 month treatment with MaMa Lotion.

MaMa Lotion is a very strong and effective product, with 20% AHAs and a pH of 2.5. For this reason, special instructions are necessary for those using MaMa Lotion; namely, MaMa Lotion should not be used more than twice a week for the first few weeks, and usage can then be increased to every other day or everyday, depending on the skin’s tolerance of the product. A gentle, broad-spectrum sunscreen, like LaRoche Posay, should be used everyday in conjunction with the product, and other products with AHAs, retinol, and the sun should be avoided. Those with darker skin should additionally consult this page for further instructions.

Although MaMa Lotion goes on very thick, it absorbs into the skin within 10-15 minutes, leaving the skin extremely smooth. The treatment can also be used on rough areas like the knees, elbows, and feet (with appropriate sun protection on these areas, of course!) With that said, I love MaMa Lotion. Although the very potent product does need to be used with caution, when used properly and in conjunction with proper sun protection, it really gives skin a fantastic glow! Product rating: 9.5/10. (High concentration of effective ingredients: 3+/3. New technology or unique formulation: 3/3. Value for the money: 3/3. Sunscreen: 0.5/1; there is no sunscreen in this product, but it should only be used at night anyway, so it is only a 0.5 deduction).

If you would like to try MaMa Lotion, Cosmeticville.com is currently giving away a free sample of MaMa lotion with any purchase! In the comments box at checkout, put - MaMa Lotion Sample. For more information, please visit Cosmeticville.com.

Ingredients in MaMa Lotion

Water, Mandelic Acid, Malic Acid, Algae Extract, Polyacrylamide, Potassium Hydroxide, C13-14 Isoparaffin, Ubiquinone, Dimethicone, Cyclomethicone, Fragrance, Squalane, Laureth-7, Tetrasodium EDTA, Isopropylparaben, Isobutylparaben and Butylparaben.

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June 2nd, 2008 Posted by futurederm | Acne Treatments, Anti-Aging Treatments, Best Products, Best Products, Best Skincare Gifts, Firming Treatments, Hyperpigmentation Treatments, Offers and Promotions, Pore Size Treatments, Product Reviews, Special Offers, Wrinkle Treatments | 22 comments

Spotlight On: Glutathione

The pathway of glutathione oxidation-reduction. Source: The Robert Edwards Group.

Glutathione is a potent antioxidant that is naturally found in the skin. Unfortunately, according to The Prescription for Nutritional Healing, glutathione levels decrease 30-35% over the course of one’s lifetime with normal aging. In the body, glutathione acts as an antioxidant and detoxifier, most prominently in the liver, kidneys, and bone marrow.

In the skin, glutathione has been found to be more prevalent in the epidermis (outermost layer of skin) than the dermis. Together with vitamin C, glutathione is actually one of the major water-soluble antioxidant metabolites naturally found in the cell, according to Dr. Rafaela M. Quiroga in the textbook Cosmetic Dermatology. Glutathione protects cells after an enzyme known as glutathione peroxidase catalyzes the reaction between glutathione and hydrogen peroxide, ultimately forming water and oxidized glutathione, which is a stable compound.

It has also been well-established that glutathione levels decrease with exposure to UV light, according to The Journal of Investigative Dermatology (amongst other sources), in a manner that is similar to other antioxidants, like vitamin C or vitamin E. With continued exposure to UV light, the lower levels of glutathione increase the skin’s susceptibility to UV-induced damage, as findings reported in Photochemistry and Photobiology suggest.

To supplement levels of glutathione, N-acetylcysteine is often taken as an oral supplement, which is converted to glutathione in the body. While typical dosages of N-acetylcysteine range from 250-1500 mg/day and no toxic level has been established as of yet by the FDA, check with your doctor to be safe, as side effects have been reported in some individuals.

Glutathione has also been shown to be an effective antioxidant when topically applied to the skin. However, the effects of glutathione can be enhanced by either lipoic acid or vitamin C, because these ingredients effectively recycle the antioxidant power of glutathione. For this reason, glutathione is best used in formulations with lipoic acid and/or vitamin C. One excellent formulation is Perricone Pore Refining Concealer ($35.00, Sephora.com), with glutathione and lipoic acid. Another is Philosophy When the Hope is Not Enough Facial Serum ($38.00, Sephora.com), with glutathione and vitamin C.

Overall, glutathione is a promising antioxidant. Because its levels naturally decrease with age, leaving the skin more susceptible to UV-induced damage, I think it seems like a good idea to use a cream or serum with glutathione. As always, consult with your derm if you have any concerns! :-)

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May 15th, 2008 Posted by futurederm | Anti-Aging Treatments, Antioxidant Treatments, Cosmetics, Dry Skin Treatments, Pore Size Treatments, Spotlight On... | 7 comments

Product Review: Avon Clinical Advanced Dermabrasion System

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Photo courtesy Avon.com

Avon Clinical Advanced Dermabrasion System ($28.00, Avon.com) claims to combine “increasing intensities of Dermatologist-Grade Polishers” with an “Advanced Skin Conditioner” to give a “whole new level” of “youthfully radiant ” skin. Yet, how effective is Avon Clinical Advanced Dermabrasion System? Does it really measure up to dermatologists’ polishers?

Similar only to a “superficial” dermatologist’s peel

According to this study in the journal Dermatological Surgery, microdermabrasion with aluminum oxide crystals (similar to those found in Avon Clinical Advanced Dermabrasion System) is “the equivalent of a superficial chemical peel” and is less effective than resurfacing with the CO2 laser or Er:YAG laser. Unfortunately, according to the text Photoaging, microdermabrasion from a dermatologist’s office comes from a high-pressure device that uses a self-contained vacuum to remove dirt and shed skin, so it is impossible to adequately compare Avon Clinical Advanced Dermabrasion System to a dermatologist’s microdermabrasion, even if both use aluminum oxide crystals. (For the record, dermatologists may alternatively use sodium chloride or sodium bicarbonate.)

How effective is microdermabrasion with alumina from a dermatologist?

In this study from Dermatological Surgery, fourteen patients aged 40-75 underwent microdermabrasion once every 2 weeks over the course of 12 weeks at a dermatologist’s office. By patient assessment, there was a statistically significant improvement in skin’s roughness, mottled appearance, and overall appearance. There was also some improvement in age spots. However, acne scars were not improved with the treatment, and required deeper resurfacing. These facts are confirmed in the book Photoaging, which states that microdermabrasion may be used to treat “photoaged skin, comedonal acne, lengitines, striae (stretch marks), scars, palmoplantar keratoderma, Darier’s disease, and actinic keratoses.” A second study in Dermatological Study also found improvements in oiliness, thickness, and dilated pores.

Use with sunscreen!

Although this product contains moisturizing ingredients, it is not to be used alone. Because dermabrasion makes the skin more sensitive to the sun, use the product at night, and wear a broad-spectrum UVA/UVB sunscreen during the day. Otherwise, you could be aging your skin more.

Not a great moisturizer

Although this is an excellent scrub, the excellence of the moisturizer was lost a bit in the “2-in-1″ deal. The moisturizer namely does not contain any proven anti-aging or repairing ingredients like peptides, retinol, hydroquinone, or sunscreen. It is hydrating, with glycerin, petrolatum, dimethicone and cetyl alcohol, amongst other ingredients. It is also somewhat soothing, with bisabolol. According to the text Marine Nutraceuticals and Functional Foods, corallina officialis extract is a calcified red algae that contains the carotenoid pigment zeaxanthin, so the moisturizer may have a bit of antioxidant properties here. Crataegus monogina fruit extract also contains carotenoids, and has antioxidant properties substantiated by Nahrung/Food, amongst others.

Overall…

A great scrub for your face, neck, upper chest and hands. It may help with stretch marks as well. Used twice a week in conjunction with sunscreen, it should resurface the skin superficially and make it appear more smooth. However, do not expect the results of microdermabrasion from a dermatologist’s office. Also, don’t forget to wear sunscreen religiously while using this product! Overall rating: 8/10 (good scrub)

Ingredients (courtesy Avon.com)

WATER/EAU
ALUMINA
POLYETHYLENE
DICAPRYLYL MALEATE
GLYCERIN
HYDROGENATED POLYDECENE
PEG-20 METHYL GLUCOSE SESQUISTEARATE
CETYL ALCOHOL
METHYL GLUCOSE SESQUISTEARATE
CORALLINA OFFICINALIS EXTRACT
CRATAEGUS MONOGINA FRUIT EXTRACT
BISABOLOL
PANTHENOL
DIMETHICONE
PHOSPHORIC ACID
CARBOMER
PETROLATUM
ACRYLATES COPOLYMER
LAURAMIDOPROPYL BETAINE
SODIUM HYDROXIDE
DISODIUM EDTA
PHENOXYETHANOL
METHYLPARABEN
ETHYLPARABEN
PROPYLPARABEN
PARFUM/FRAGRANCE

MAY CONTAIN:
MICA
IRON OXIDES

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February 11th, 2008 Posted by futurederm | Best Products, Best Products, Hyperpigmentation Treatments, Pore Size Treatments, Product Reviews | 3 comments

Spotlight On: Azelaic Acid

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BENEV Azalex Gel contains 10% azelaic acid over-the-counter. Photo courtesy Amazon.com.

Azelaic acid (like kojic acid) is a bleaching agent that is commonly used in alternating four-month cycles with hydroquinone (Cosmetic Dermatology). Azelaic acid has also been found to be effective as an acne treatment, and, to a lesser extent, a rosacea treatment. However, how effective is azelaic acid? Could you use it instead of hydroquinone? And is it safe? For these answers and more, read on.

How effective is azelaic acid as a bleaching agent?

According to a double-blind study in the International Journal of Dermatology, over the treatment period (24 weeks), a 20% azelaic acid cream yielded 65% good or excellent results. In fact, 20% azelaic acid had “no significant treatment differences” observed when compared to 4% hydroquinone (the prescription level) with regard to overall rating, reduction in lesion size, and pigmentary intensity. Side effects, such as allergic sensitization or exogenous ochronosis (associated with hydroquinone) were not observed with 20% azelaic acid.

Should I consider azelaic acid over hydroquinone if I have dark skin?

Yes (i.e., typically Hispanic or Black skin tones). Ochronosis, a darkening of the skin that is caused by a build-up of phenylalanine or tyrosine, has been linked to hydroquinone use, but primarily in those with darker skin. In fact, according to the American Journal of Clinical Dermatology, the majority of patients with ochronosis are Black, but it has been reported to occur in Hispanics and Caucasians as well. Exogenous ochronosis is prevalent among South African Blacks, but is relatively uncommon amongst this population within the U.S. As such, those of African-American descent may wish to take extra precautions in avoiding products with resorcinol and excessive sun exposure when using hydroquinone products.

Can azelaic acid be used to treat acne?

Yes. According to a 1996 study in the journal Cutis (Cutaneous Medicine for the Medical Practitioner), 20 percent azelaic acid alone is effective in mild to moderate forms of acne, with an overall efficacy comparable to that of tretinoin (0.05 percent), benzoyl peroxide (5 percent), and topical erythromycin (2 percent). For moderate to severe acne, 20 percent azelaic acid may be favorably combined with minocycline with 90 percent good/excellent results, and may contribute towards reducing recurrences following discontinuation of systemic therapy (maintenance therapy with azelaic acid). Further, according to this 1989 study, 20% azelaic acid cream was not only equally as effective as 0.05% tretinoin cream, but was also better tolerated, causing fewer local side effects than the topical retinoid.

Can azelaic acid be used to treat rosacea?

Yes, and significantly so. According to a 1999 double-blind, randomized, multicenter study in Acta Dermato-Venereologica, treatment with 20% azelaic acid twice daily for 3 months resulted in significantly more favorable overall improvements than vehicle in both physician and patient ratings. In addition, more than 90% of patients rated the overall local tolerability of their treatment as good or acceptable. In addition, a separate study in the Archives of Dermatology found that 15% azelaic acid was significantly more effective than 0.75% metronidazole in improving the inflammatory lesions and erythema of rosacea.

A side note: Does hydroquinone (an azelaic acid bleaching alternative) really cause cancer?

Hydroquinone is currently the most commonly used bleaching agent in the United States. Although it is a metabolite of benzene and therefore exhibits potential carcinogenic properties, most studies that suggest a link between hydroquinone and cancer are those in which hydroquinone is applied in impractically high concentrations. In fact, according to Dr. Susan C. Taylor, M.D., a Philadelphia-based dermatologist in the October 2007 issue of Elle magazine,”The maximum levels of hydroquinone currently allowed (2 percent for over the counter, 4 percent for prescription) aren’t dangerous. At worst, it might cause redness or irritation, but only if your skin is sensitive or allergic to the medication.” Dr. Leslie Baumann further adds in Cosmetic Dermatology, “The most serious human health effect seen in workers exposed to hydroquinone is pigmentation of the eye and, in a small number of cases, permanent corneal damage.”

In what products is azelaic acid found?

20% azelaic acid is available by prescription only in Azelex. 15% azelaic acid is also available by prescription only in Finacea. Over-the-counter, the best product I could find, with 10% azelaic acid, is BENEV Azalex Gel ($80.00, Amazon.com). Although SD alcohol 40 is the main ingredient (never a good thing), it also contains more hydrating glycosaminoglycans, glycerin, and butylene glycol. I do wish the product didn’t contain the alcohol, though! A second excellent product is Mychelle Clear Skin Serum ($23.25, Amazon.com), which contains a seemingly high unspecified concentration of azelaic acid, and also niacinamide and retinol. Unfortunately, Mychelle Clear Skin Serum also contains low-molecular weight alcohols, which can be drying, and ylang-ylang/patchouli essential oils, which may make some individuals break out. At any rate, these are two sources of azelaic acid available over-the-counter.

Overall…

I love azelaic acid! Research shows 20% azelaic acid to have the bleaching efficacy of prescription-strength hydroquinone, without the negative side effects for darker skins. Research has also shown acne-fighting effects similar to prescription-strength tretinoin (and we all know how I love tretinoin!) Finally, the ingredient helps some signs of rosacea. I give this ingredient an enthusiastic thumbs-up, and will post as more companies release over-the-counter products with more azelaic acid.

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February 9th, 2008 Posted by futurederm | Acne Treatments, Best Products, Best Products, General Cosmetic Dermatology, Hyperpigmentation Treatments, Pore Size Treatments, Product Reviews, Rosacea Treatments, Spotlight On... | 2 comments

Product Review: Peter Thomas Roth UnWrinkle Peel Pads

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Peter Thomas Roth UnWrinkle Peel Pads ($45.00, Amazon.com) claim to “gently exfoliate skin and stimulate cell turnover, while protecting skin from environmental damage and boosting moisture.” Based on the formulation, is this product as effective as it claims? Furthermore, do Peter Thomas Roth UnWrinkle Peel Pads make a visible difference in the skin after a month of use? To answer that question, FutureDerm has teamed up with the very awesome Beauty411 blog to give an in-depth, ingredients-and-trial analysis. For more, read on…

An incredible source of AHAs

Peter Thomas Roth UnWrinkle Peel Pads contain two alpha hydroxy acids in high concentration: glycolic acid and lactic acid. Glycolic acid is the most common of all the alpha hydroxy acids in skin care products. Used in concentrations 20 to 70 percent at the dermatologist and up to 10 percent over the counter, glycolic acid peels exfoliate and smooth the skin, quicken the rate of cell turnover (which is reduced by up to 7% every ten years), decrease small wrinkles and increase the fibroblast proliferation of collagen. Treatment with glycolic acid peels has also been shown to increase expression of Type 1 Collagen mRNA and hyaluronic acid content in the dermis of the skin. Although the percent glycolic acid in the product is not provided, its location on the ingredients list suggests a high concentration (my best guess would be 8-10%, but again, this is only a guess).

The second AHA, lactic acid, is usually used to treat dry skin, not signs of aging. For anti-aging treatments, glycolic acid is usually preferred to lactic acid because it is smaller and penetrates the skin more easily, and also because glycolic acid has been found to increase the thickness and firmness of the skin, but lactic acid does not. At any rate, this product is an excellent source of AHAs.

May not be right for sensitive skin

This product certainly takes an aggressive approach against wrinkles and rough skin, including not only a high concentration of alpha hydroxy acids, but also retinol. Although the exact concentration of retinol in the product is not provided, based on the ingredients list, my best guess (please note this is only a guess!) would be <0.025%, similar to the level of retinol in Neutrogena Healthy Skin Anti-Wrinkle Cream SPF 15 or RoC Anti-Wrinkle Treatment for All Skin Types. Again, however, this is only a guess. :-)
While this is a relatively small amount of retinol compared to other sources on the market (Skinceuticals 0.5 and 1.0 contain 0.5% and 1.0% retinol, while Green Cream Level 6 and 9 contain 0.6% and 1.0% retinol, respectively), this still may upset those with sensitive skin. In fact, dermatologists consulted for the December 2007 issue of Allure magazine recommended alternating use of AHAs with retinol rather than using them together. If you have concerns, talk to your dermatologist about use of this product with your specific skin type.

Antioxidants vitamin E, vitamin C, and green tea

This product also contains a fair concentration of antioxidant vitamin E as tocopheryl acetate, which has been found to have a high antioxidant capacity compared with kinetin, ubiquinone, vitamin C (as L-ascorbic acid) and lipoic acid. Again, not the highest antioxidant capacity in skin care (think CoffeeBerry, green tea, idebenone) but still good. The product also includes vitamin C as sodium ascorbyl phosphate, and a low concentration of antioxidant green tea. I think I’m falling in love…

When do I use this product? What other products should I use it with?

According to Amazon.com, the product is a “daily” treatment. However, considering that the product is very strong, with both alpha hydroxy acids and retinol, I personally use the product once/week at night (in place of my normal retinol cream) and before my moisturizer. Nancy from the Beauty411 Blog has chosen to use the product 2-3 times/week, with excellent results. As with most products, if your skin is red and irritated after use, it is generally advised for you to wait until the symptoms clear and then to try again, gradually building up use of the product to the desired frequency. However, in some cases, a product is not right for your skin, in which case an application of the product never fails to induce redness. As always, if you have concerns, consult your dermatologist.

In addition, I would not use this product during the day because both AHAs and retinol have been found to make the skin more photosensitive, i.e., more susceptible to sun damage. In fact, a study conducted by Tsai et. al found that pre-treatment with 10% glycolic acid caused an increase in UVB sensitivity in white and Asian subjects, and an increase in UVA sensitivity in Asian subjects.

As such, whether used during night or day, this product should definitely be used in conjunction with a broad-spectrum, UVA/UVB sunscreen.

How soon should I see results?

Check out the Beauty411 Blog for a glowing review from a fellow blogger who has been using this product 2-3 times a week for a full month!

Overall opinion?

One of my all-time favorite products - however, due to its potency (AHAs and retinol) and the need for sunscreen to be used in conjunction with it, I use it only once/week at night and before special occasions for a smoother look. A great exfoliating treatment - just be careful if you have sensitive skin, and don’t keep using it if the product irritates your skin. Product rating: 9/10 (I wish there weren’t AHAs and retinol, which is a strong combination! At any rate, a superb peel.)

Ingredients

Water, Glycolic Acid, Ethoxydiglycol, Sodium Hydroxide, Sodium Lactate (Lactic Acid), Rosa Centifolia Flower Water, Hamamelis Virginiana (Witch Hazel) Water, Ppg-5-Ceteth-20, Butylene Glycol, Arginine, Linolenic Acid (Vitamin F), Gamma-Aminobutyric Acid, Tocopherol (Vitamin E), Retinol (Vitamin A), Cholecalciferol (Vitamin D), Alanine, Sodium Ascorbyl Phosphate (Vitamin C), Zingiber Officinale (Ginger) Root Extract, Citrus Medica Limonum (Lemon) Peel Extract, Chamomilla Recutita (Matricaria) Flower Extract, Symphytum Officinale Leaf Extract, Camellia Sinensis Leaf Extract, Aloe Barbadensis Leaf Juice, Salicylic Acid, Caprylic/Capric, Triglyceride, Propylene Glycol, Methylparaben, Propylparaben, Diazolidinyl Urea.

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January 31st, 2008 Posted by futurederm | Best Products, Best Products, Best Skincare Gifts, Firming Treatments, Pore Size Treatments, Product Reviews | 4 comments

A New Favorite: Green Cream - High Potency Retinol

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Recently, I have been blogging about retinol creams a lot, and for good reason. As Jenny Bailly, a freelance beauty writer writes in the December 2007 Allure, “If dermatologists ever wrote an ode, it would probably be to retinoids — with an opening line stolen from Elizabeth Barrett Browning: ‘How do I love thee? Let me count the ways…’” Put simply, retinoids are a favorite, doing everything from regenerating collagen to softening wrinkle appearance to unclogging the pores. For more, read on about my latest discovery, Green Cream!

How do Green Cream 3, 6, and 9 compare to other retinol creams on the market?

Green Cream cleverly uses “levels” to denote the percentage of retinol in the product. So, Green Cream Level 3 ($35.95, SkincareRx.com) contains 0.3% retinol, Green Cream Level 6 ($42.95, SkincareRx.com) contains 0.6% retinol, and Green Cream Level 9 ($49.95, SkincareRx.com) contains 0.9% retinol. This is significant, as there are few products on the U.S. market with similar levels of retinol (for instance, Neutrogena Healthy Skin, an excellent and effective product, has less than 0.2% retinol.) In fact, only Skinceuticals 0.5 and Skinceuticals 1.0 compare to the level of retinol in Green Cream (at 0.5% and 1.0% retinol, respectively), and only Skinceuticals 1.0 contains more retinol than Green Cream Level 9.

How do the anti-aging ingredients in Green Cream and Skinceuticals 0.5 compare?

Green Cream Level 3 contains a fairly high concentration of vitamin E as tocopheryl acetate, which has a higher environmental protection factor (a measure of antioxidant capacity) than most, but not all, other antioxidants. Green Cream Levels 6 and 9 also contain vitamin E, although in less high concentrations. To soothe (retinol can be irritating), Green Cream contains a high concentration of soothing aloe vera gel and cucumber extract in all levels.

On the other hand, Skinceuticals 0.5 does not contain anti-aging vitamin E, but instead contains ceramides 2 and 3. An article in the International Journal of Cosmetic Science reports that ceramides replenish reduced ceramide levels (particularly the phytosphingosine-containing ceramides) and levels of long-chain fatty acids in dry skin. However, according to this 2000 study by the same author, it was found that moisturizers incorporating ceramide 3 had no greater effect on transepidermal water loss (TEWL) than ordinary lotions without ceramide 3. To soothe, Skinceuticals 0.5 contains bisabolol and chamomile, although in fairly low concentrations.

Therefore, those with dry skin may like the slight hydrating effect of ceramides from Skinceuticals 0.5, but overall, the antioxidant benefit of vitamin E in Green Cream has more established anti-aging benefits. Both are great products, but due to the vitamin E and extra soothing ingredients in Green Cream, I give it a 9.5 to Skinceuticals’ 9.

Personal Opinions

After using Green Cream Level 6 for two weeks (with 0.6% retinol), I personally see an improvement in the smoothness of my skin. Previously, I was using Neutrogena Healthy Skin Anti-Wrinkle Cream SPF 15 ($24.23 for two, Amazon.com), with a high concentration of green tea and less than 0.2% retinol, and I see a difference from the switch. I plan to use Green Cream Level 6 for a few months to let my skin tolerize, and then move on to Green Cream Level 9.

Where can I find more information about retinol?

For information about retinol use, please visit this post.

For information about Philosophy Help Me Retinol or Neutrogena Healthy Skin with Retinol, please visit this post.

For information about Skinceuticals 0.5, please visit this post.

Overall…

It was hard to do, but Green Cream has triumphed as my favorite retinol cream to date! Product Rating: 9.5/10

Level 3 Ingredients List

Water, ethanol, glycerin, octyldodecanol, aloe vera gel, butylene glycol, cucumis sativus extract, tocopheryl acetate, cetyl dimethicone copolyol, retinol, polysorbate 20, PEG-7 glyceryl cocoate, acrylates/C10-C30 alkyl acrylate crosspolymer, tea-carbomer, propylene glycol, diazolidinyl urea, propylparaben, methylparaben, disodium edta, may contain FD&C yellow 5, red 40, blue 1, red 3

Levels 6 and 9 Ingredients List

Water, ethanol, glycerin, octyldodecanol, retinol, polysorbate 20, cucumber extract, butylene glycol, cetyl dimethicone copolyol, PEG-7 glyceryl cocoate, tocopheryl, acrylates/C10-C30 crosspolymer, tea-carbomer, propylene glycol, diazolidinyl urea, propylparaben, methylparaben, disodium edta, may contain FD&C yellow 5, red 40, blue 1, red 3.

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January 22nd, 2008 Posted by futurederm | Antioxidant Treatments, Best Products, Pore Size Treatments | 3 comments

Quick Question: Does Cold Water Really Close Your Pores?

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According to dermatologist Dr. Mary P. Lupo in the January 2007 issue of Allure magazine, pores cannot open and close because they have no muscular attachment. So when people say that cold water will close your pores, it isn’t true. According to Lupo: “Cold water can keep your pores from producing excess oil, but they will never close. Alternately, steam won’t cause them to open, but it will stimulate the oil glands.”

So why do pores appear to have different sizes?

Lupo states pores are pouches of skin into which the sebaceous gland excretes sebum (oil) to keep the skin from drying out, and which also regulate the body’s temperature. Their size is often determined by genetics, but pore size is also affected by the sites in which the oil glands are the most active, which is why pore size appears larger on the nose and forehead in many individuals.

So how can I get rid of large pores?

My blog entry from December 14, 2007 states that retinoids/retinol, Estée Lauder Idealist Pore Minimizing Skin Refresher ($46.50 for 1 oz., EsteeLauder.com), 2% salicyclic acid, and photodynamic therapy may help, and provides appropriate support for each. In addition, Lupo suggests daily sunscreen application, as she states, “Years of sun exposure can permanently dilate the pores…And over time, as you start to lose the collagen and elastin that is supporting the pore, it begins to stretch and sag around the edges. That’s why pores and acne scars often appear larger after age 45.”

As a result…

Don’t believe the myth that cold water or alcohol-based treatments (which dilate the skin around the pore) actually shrink the size of your pores. Instead, use SPF daily, and if pore size is especially bothersome, consider talking to your dermatologist and looking into retinoids/retinol, Estée Lauder Idealist Pore Minimizing Skin Refresher ($46.50 for 1 oz., EsteeLauder.com), 2% salicyclic acid, and photodynamic therapy.

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January 2nd, 2008 Posted by futurederm | Pore Size Treatments, Quick Questions | no comments

How to Get Rid of Enlarged Pores

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Photodynamic therapy decreases the size of the pores by emitting light at a wavelength corresponding to a peak of the porphyrin excitation spectrum in tissues, which generates a therapeutic effect.

Many women covet smaller pores. Yet, pore size increases with smoking, sun exposure, and age. According to Mount Kisco, New York dermatologist David E. Bank, M.D.: “UVA rays and free radicals degrade collagen, the skin’s support fibers, and decrease elasticity. The goal is to keep pores clean and at their smallest.”

How can pore size be reduced?

1. Retinoids. According to a 2002 study in the Archives of Dermatology, the prescription retinoid cream Tazorac (0.1% tazarotene) was found to decrease pore size. Dr. Bank affirms this: “You have to increase cell turnover [with retinoids] and strengthen the tissue to see results.” Strengthened tissue means tighter skin, and tighter skin means smaller pores.
2. Estée Lauder Idealist Pore Minimizing Skin Refresher ($46.50 for 1 oz., EsteeLauder.com). According to Nicole Catanese for Elle magazine, the product contains the enzyme melanase, which eliminates some pigment buildup; glucosamine, a sugar derivative that helps to break down blockages; and light-reflecting polymers that help diffuse microshadows caused by aged, stretched out pores. According to Estée Lauder’s published reports, subjects observed a 69 percent reduction in pore size after four weeks of twice-daily application.
3. Salicyclic acid based products (2% salicyclic acid). Salicylic acid is an oil-soluble chemical exfoliant that can remove debris from the pore, creating the appearance of skin smoothness. However, according to Dr. Diana Draelos, an associate professor of dermatology at Wake Forest School of Medicine, it cannot measurably reduce pore size, only cleanse the area. Still, according to Dr. Bank: “The goal is to keep pores clean and at their smallest,” so salicyclic acid is excellent to use to clean the pores. However, salicyclic acid does not actually change pore size; rather, it cleans the pores, which enables them to then be closed after cell turnover is increased, etc.
4. Photodynamic Therapy (PDT). According to a study in the Journal of Dermatologic Surgery, over ninety percent of 49 subjects who underwent four or more full-face treatments at 3-week intervals showed visible improvement in pore size, wrinkling, skin coarseness, irregular pigmentation, and telangiectasias. According to eMedicine.com, PDT consists of two steps. In the first step, a photosensitizer is administered to the patient by one of several routes (eg, topical, oral, intravenous), and it is allowed to be taken up by the target cells. The second step involves the activation of the photosensitizer in the presence of oxygen with a specific wavelength of light directed toward the target tissue. This process minimizes damage to adjacent healthy structures. PDT has been shown to kill bacteria associated with acne (P. acnes) and shrink the oil glands, so the pores appear smaller. Unfortunately, PDT is not cheap: $1800 for three sessions. In addition, it is unknown if the effects or permanent, and if not, for how long they last.

What doesn’t work?

1. Alcohol-based “pore minimizing” toners. These substances contain high contents of alcohol to temporarily inflame the skin, which puffs it up, making the pores surrounding it look temporarily smaller. However, unless the sebum and bacteria are removed from the pores, and cell turnover and strength is increased, pores do not look smaller.
2. Glycolic acid-based treatments. According to Dr. Diana Draelos, an associate professor of dermatology at Wake Forest School of Medicine, there are several reasons why glycolic acid does not reduce pore size. One is because glycolic acid cannot enter the oily milieu of the pore and thus does not exfoliate within the pore. Glycolic acid may improve the smoothness of the skin surface, creating the illusion of reduced pore size, but it cannot actually reduce pore size. In fact, according to Draelos, no cosmeceutical ingredient can measurably reduce pore size.
3. Heat steaming and cooling the skin. According to Dr. Bank, “Heat softens sebum to reduce clogging, while cold water constricts blood flow and tightens skin. But neither changes a pore’s size.” Just as with alcohol, any improvement in pore size is only a temporary illusion, and the actual size of the pore is unchanged.
4. Tanning. Not only is tanning just about the worst thing you can do for your skin (other than smoking), but any pores that appear smaller only appear that way because the skin around them is rough and inflamed. Stay away from the sun more than 10-15 minutes without sunscreen twice a week.

So what can I do to improve the size of my pores?

First, see your dermatologist for personalized recommendations. Research from dermatological journals shows that pore size is increased by sun exposure, smoking, and aging, but that first keeping pores clean (perhaps with a salicyclic acid cleanser like Neutrogena Oil Free Acne Wash and/or Estée Lauder Idealist Pore Minimizing Skin Refresher to remove blockages) and then hitting the pores with prescription-strength retinoids to administer a one-two sucker punch of increasing the rate of cell turnover and strengthening the skin should help to close up those pores. PDT therapy, administered by a dermatologist, appears to be promising for reduction of pore size as well, but is costly. Finally, for a temporary fix, alcohol-based toners and heating and steaming the skin may work, but do not actually close up the pore.

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December 14th, 2007 Posted by futurederm | How to Get Rid of..., Pore Size Treatments, Spotlight On... | 2 comments