FACE UP TO THE RIGHT SKIN CREAM 

Skin is so important and using a daily cream to help your skin keep healthy and reduce lines makes a lot of sense.

The trouble is there is a bewildering array of beautifully packaged products on the market, many claiming miraculous benefits and amazing new ingredients, so it can be all but impossible to know what one should buy and how much is worth spending.

Fashions come and go in skin creams as well as in clothing – remember cocoa butter and tea tree oil? But today enormous resources are used to develop new ingredients that make skin products more effective. As well as discovering new ingredients, cosmetic companies look for more effective ways of getting ingredients into the skin. For example, liposomes are now commonly used in face products.
These are tiny hollow spheres filled with active ingredients that are absorbed into the skin. They release their contents precisely where they are most needed - under the surface into the deeper layers of the skin.

Cosmetic skin specialist Dr Patrick Bowler (more information at bottom of article) looked into the subject for www.netdoctor and says that at the end of the day, you get what you pay for. Cheap skin-care products will use cheap ingredients. In the more expensive brands, you usually pay for the new ingredient or formula that is supposed to deliver the anti-ageing, anti-wrinkle, skin firming benefit. But price isn’t the only guide and the most expensive anti-ageing brands aren’t necessarily the best.

Dermatologists argue that skin products can achieve little except temporary moisturisation but one needs to understand there are different products on the market. Cosmetic products are not allowed to alter the structure or function of the skin; pharmaceutical products have to have their benefits proven before being marketed and are subject to tighter controls because they are more potent. There is a grey area between the two types of products.

In general face creams, there are a number of standard ingredients:

• Preservatives which prevent the growth of bacteria in cosmetics to extend the shelf-life of your cream. Examples are essential oils or synthetic parabens, including ethyls, propyls and butyls. Parabens are non-toxic and approved by the regulatory authorities.
• Emulsifiers which ensure a smooth mixture and consistency. An example is linoelic acid.
• Humectants which are commonly used derivatives of mineral oil. They act as a moisturiser by drawing water from the air to the skin's surface. They also prevent the product from losing water and drying out. Examples are glycerin and glycol.
• Silicone which gives the cream a pleasing texture and makes application easier.
• Sunscreens which protect the skin. Examples are octyl methoxycinnamate, titanium dioxide and zinc oxide.

Active ingredients vary

In addition to these general ingredients for skin-care products, specific substances are added in small quantities to give a desired effect. Some common 'active' ingredients include:

Alpha hydroxy acid (AHA)

AHAs, or fruit acids, include citric acid from citrus fruits, malic acid from apples and lactic acid from milk. As a group, no other cosmetic ingredients have been more thoroughly investigated.Glycolic acid derived from sugar cane is by far the most frequently used AHA.

In low concentrations, they act as exfoliators.  In higher concentration, AHAs have shown to be effective at reducing visible signs of ageing, treating acne and treating incrased pigmentation. Higher strength AHAs are available through beauty salons and cosmetic clinics. They must be used under professional guidance and with a sunscreen.

Amino acids (peptides)

The body's building blocks, amino acids make up proteins that are present in our skin and hair. There are claims that they can be absorbed by the skin to rehydrate and provide nutrients but it is difficult to find clear supportive evidence on this.

Antioxidants

Every breath we take leads to the formation of 'free radicals' that damage healthy cells. In the skin this leads to lines, wrinkles and loss of skin tone. Antioxidants can reduce the activity of these free radicals, so in theory antioxidants can help the body to repair itself.

At present there is limited evidence to back this theory, especially in topical (cream) form. Plenty of products contain antioxidants. In the ingredients list look out for pycnogenol (the active part of grapeseed extract) and vitamins A, C and E.

Ascorbic acid

This is the chemical name for the basic molecule of vitamin C, also known as magnesium ascorbyl phosphate. Derivatives are used in skin-care products because the pure vitamin is unstable and very irritating to the skin.

Vitamin C is an antioxidant that can lighten pigment, and is one of the most popular constituents in products today although in cream form, its effectiveness still needs further proof..

Beta hydroxy acid (BHA)

The most common BHA is salicylic acid. These acids are anti-inflammatory and exfoliating agents, so are useful in the treatment of spots and acne. BHAs cause sensitivity reactions if overused.

Ceramides

Ceramides are normally found in the skin and help it to retain moisture. Synthetic ceramides are one of the 'buzz' ingredients that claim to reverse the signs of ageing. Little science currently exists to back these claims, so judgment is out until more research has been completed.

Co-enzyme 10 (Q10)

Also an 'in' ingredient, Q10 occurs naturally in the skin and is an antioxidant and antibacterial agent. As we age, levels of Q10 decrease and this may play a part in skin ageing.

Idebenone (Prevage MD) is a more potent form of co-enzyme Q10. It is the most powerful antioxidant to date, and there is clinical data to support its benefit in ageing skin. It is produced by Allergan, the makers of botox.

Collagen

Collagen is a very large molecule and some reports say it doesn’t penetrate the skin, but can only sit on the skin's surface where it gives very little benefit.

Green tea

Green tea is a popular ingredient and can be found in everything from face creams to depilatory waxes.
It contains polyphenols that have antioxidant and anti-inflammatory properties. These effects may explain why cold tea bags are applied to the face to reduce swollen eyes. Research is promising but still undergoing.

Hyaluronic acid

An essential protein found in the skin. It has very powerful moisturising properties, able to attract over 100 times its weight in water, but it needs to be at the correct concentration to work.

Lanolin

Obtained from wool and used as a barrier to reduce water loss from the skin's surface. It is a frequent cause of sensitivity reactions to products, so read the ingredient list carefully.

Retinoic acid, retinol or retinyl palmitate

These are all derivatives of vitamin A. Retinoic acid (tretinoin) has convinced the medical profession that a topically applied cream can reduce the appearance of lines, wrinkles and pigmentation..

Tocopherol acetate

Vitamin E is a potent antioxidant and anti-inflammatory agent. Often this vitamin is put into sunscreens to fight free radicals made by sunlight. Some rigorous data is being collected about the benefits of topical and oral vitamin E on skin ageing, but little has been proved so far.

Choosing the right product

There are just so many different ingredients, and so many different products that choosing the right skin-care product can be all but impossible.

If possible, ask a skin-care professional for their advice as they do understand about the ingredients and their specific capabilities for different skin types. As we age, it is important to use an SPF factor cream every day if possible as ultraviolet light from the sun, even in cloudy conditions, is enormously damaging and one of the primary causes of ageing.

Don’t get too hooked into just one favourite product; advances and new products are coming out all the time and sticking to just one brand might mean you miss out on a new development that could be perfect for your skin.

And of course, more important than the best skin cream is a health life style – a healthy diet; adequate sleep and regular exercise will give your skin a glow that can rarely be achieved by face creams alone.


Dr Patrick Bowler MB.BS; LRCP; MRCS; DRCOG; is a founder and fellow of the British Association of cosmetic Doctors. He founded the Court House Clinics Group ( www.courthouseclinics.com ).

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