Blackheads and Whiteheads

trooper-vader

 

Sometimes I am white, sometimes I am black,
You can get rid of me but I come back
I was born from oil and i don’t recoil
I keep my head up high, who am I?

Ok, clearly I was not born to be a poet nor a rapper. But here I am to talk about white- and blackheads, or if you prefer about Darth Vader and the troopers…that is always an interesting topic!

I am sure many of you know a lot about Anakin and Star Wars, but what can you tell me about blackheads and whiteheads?
If your reply is “Whatevvva, they are just annoying”, stick around.

Time to put on our smart glasses and take out our lightsabers.

What are black and whiteheads?

Scientifically, blackheads and whiteheads are called comedones or comedos and that is why sometimes you hear about comedogenicity of cosmetics. That is a big word to simply say the tendency of some cosmetics to clog pores.

Clogged pores, that is what they are.

How do pores get clogged?

Keratin (component of the skin) and sebum (oil secreted by the sebaceous glands) create a plug that clogs the hair follicle (pore). When this plug is covered by skin, you have a whitehead. When the plug is not covered and exposed to air it gets oxidized and appears black.

Some cosmetic ingredients might clog pores and they are then said to be comedogenic
Over the internet you will find many sites with a list of comedogenic ingredients. This list is based on a study that was carried out by Kligman in the 70’s and known as the Rabbit Ear Model.

Rabbit Ear Test – Shut up!

The test carried out in the 70’s generated a list of ingredients that are classified for their tendency to clog pores in a scale from 0 to 5, 0 being “you can bathe in it”, 5 being “don’t even dare to think about that ingredient… pop pop pop, zit zit zit!”

Ok, now that you went to look for this list and carefully saved it in your files, go ahead and trash it!

Why?

If only it were so simple…Ingredients themselves cannot really be labeled as comedogenic or not; it really depends on their concentration and purity in the cosmetic formulation.

Ingredients such as isopropyl palmitate and butyl stearate were  tested at 100% concentration, meaning that they were applied pure, without mixing them with other ingredients.

According to the list, after 4 weeks their mean score was 3.3 and 4, respectively.

Yet, tests were rerun using these ingredients in concentrations of 1%, 10% and 25%, mixed with petrolatum. The results were totally different: scores decreased to an average of 1 to 2

Now, as ingredients in cosmetics are never found at 100% concentration, but we always apply some concoction of some sort, it is difficult to judge the comedogenicity of a cosmetic, based on that list.

Even more, human skin is less sensitive to clogging than rabbits’ skin and when pores get clogged, they do way faster than in rabbits case, a matter of days vs. weeks.

The clogging of pores also depends on each individual skin, the size of pores and the sebum composition.

Different people react in different ways to the same cosmetic.

What can you do to prevent black and whiteheads?

  • Cleansing the face is very important. As much as not overdoing it! Stripping the face of its oil will result in a rebound effect where your skin will produce even more oil.
  • Your best friend is exfoliation, but again don’t overdo it. Once or twice per week is enough. Instead of mechanical exfoliation like beads etc, choose a chemical exfoliation. To clean pores the best are products with salicylic acid. This BHA cleans the pore from the oil.
  • You could also use glycolic acid because it exfoliates by loosening keratinocytes (skin cells) and hydrates the skin.
    Just make sure you are gentle with your skin and don’t irritate it.
  • Retinoids (Vitamin A) are also useful in improving the way skin grows and especially the way it sheds the dead cells
  • Use clay masks, especially green clay, as they are purifying and help cleaning. If green clay is too drying you can mix it with kaolin for a milder effect. When you apply clay masks make sure not to keep them for too long so that they won’t dry on your skin.
  • To avoid scars and further inflammation, you should never squeeze black and whiteheads…Hahaha, easier said than done, I know you can’t resist!
    If you cannot leave it alone, at least use two cotton swabs or tissues and clean hands!
    Be gentle, if it does not come out immediately, just let it be for few days more.
  • Last but not least, clean often face towels, bedding and whatever comes close to your skin, including your mobile phone!

What is your secret weapon against blackheads and whiteheads?

new-piktochart (4)

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How to read a Cosmetic Label

blueberry ingredients.png

Sometimes it seems easier to solve the mystery of Tutankhamun rather than deciphering cosmetic labels.

Marketing of products surely doesn’t help. Mostly they try to attract us with glamorous packaging, great, alluring claims and the feeling that higher prices correspond to premium products.

We are basically believers and thus we do want to believe that all the promises will come true. Who does not want to believe in magic?

Some of them will tell us that their products are free of chemicals.
By definition there is no such thing as “chemical-free”, in fact, even water- H2O- is a chemical molecule.
So, when someone tells you: “it is chemical-free” just reply: “ YOU KNOW NOTHING JOHN SNOW”… and walk away for a more dramatic effect!

Others will tell us what IS NOT included. “This and that free”, they claim, but who tells us WHAT IS in a product?
By law, we must be informed with a List of Ingredients (LOI), also known as INCI (international nomenclature of cosmetic ingredients).


Ingredients never lie!

So we better learn how to read those labels and here is some help.

The first two rules you should know are:

  1. Ingredients are listed in descending order, meaning that the first ingredient is the one that makes up most of the product. Usually this ingredient is water (Aqua).
    Sometimes you might find Aloe vera juice, that is anyhow made out mostly of water (99.5% water and 0.5% Aloe extract).
  2. The ingredients that have a concentration lower that 1%, meaning 1 g in 100g of product, can be listed in random order. So for instance, if a product contains 0.5% of fragrance and 0.3% of an herbal extract, companies are allowed to list the herbal extract ahead of the fragrance, even if in minor amount.
    Exception  are the colorants that are always found at the end of the list

When you hear about concentrations or percentages of use, that means how much of the ingredients is present in 100 g (about 3.5 oz) of product.
Example: 3% shea butter means that there are 3 g of this ingredient in 100 g of product.

Ok, we set these two main rules. Now let’s see what we can expect to find in moisturizers; then we will look in more detail the typical amount of ingredients used.

What to expect in a Moisturizers?

  • Water

  • Gelling agents
    These are used to make the water become like a gel.
    Here some examples and use levels:

    Xanthan gum, usually 0.3%, maximum 1%
    Carbomer (various types), anyhow about 0.2-0.4%
    Hydroxyethylcellulose 2%
    C10-30 Alkyl Acrylate Crosspolymer 0.3% 
  • Humectants (Hydrators)
    These are ingredients that attract water from the environment and release it to the skin, keeping it hydrated.
    Here some examples and their typical use levels in cosmetic formulations: Glycerin maximum 3%
    Hyaluronic acid 1 or 2%
    Sodium PCA  2%
  • Emollients
    These include oils and butters. Examples are Jojoba oil, Argan oil, mineral oil, caprylic/capric triglyceride, shea butter, cocoa butter, etc. The percentage of these fatty ingredients depends on whether the moisturiser is meant for face or body and the skin type.
    Moisturizers for oily skin type are usually defined as “oil free”, even when they contain a very small amount of oils.
    Anti-oxidants such as Vitamin E are used to delay oils from becoming rancid.

    Usually, a blend of oils and butters is used, each in a concentration that goes from 0.5 to 10%, depending on the properties and sensorial feeling that the product must impart.Anti-oxidants like Vitamin E (Tocopherol) or Tocopheryl acetate are used in concentrations from 0.1 to 0.5.

If Vitamin E is used as active ingredient (when products are marketed as “rich in Vitamin E”), I would expect 1-2%

  • Emulsifiers
    These are vital ingredients for creams and lotions.
    Have you ever tried to mix water and oil?
    They really don’t like to mix, intact after some time they come apart and you will see again “oil puddles” floating on water

    The function of emulsifiers is to link and bind water based ingredients with oils. Emulsifiers are usually used in combination. Some examples are:Ceteareth 20 1-3%
    Glyceryl Stearate and Cetearyl Alcoho 2-10%
    Cetearyl Alcohol (and) Polysorbate 60 5-10%
    Behentrimonium Methosulfate and Cetyl Alcohol and Butylene Glycol 1-10%
    Glyceryl Stearate and PEG 100 Stearate 1-5%
    Cetearyl Olivate and Sorbitan Olivate 4-8%Glyceryl stearate is  also often found in combination with cetyl alcohol or cetearyl alcohol
  • Actives
    These are ingredients that give a specific purpose to the product. For instance anti-age actives as Niacinamide, Peptides or soothing actives like Allantoin and panthenol. Herbal or fruit extracts also belong to the “Actives” category.
    Concentration really depends on the active. As an example:Panthenol 2%
    Herbal/fruit extracts 0.5%
    Allantoin 0.3%It must be noted that some actives, like allantoin, are effective at low doses and it is easy to find them in the second half of the LOI.
  • Preservatives
    Where there is water there is bacteria, mold and yeast growth. No exception!
    I will never stress this enough: please, please make sure that the products you purchase do include preservatives. In fact, this is required by law to guarantee product safety.

    Believe me, you don’t want to smother nasty bacteria on your skin. These are far more dangerous than preservative systems that are used in tiny concentrations.This been said , if you don’t feel comfortable with “traditional” preservatives like parabens, you can look for ECOCERT preservatives, such as Dehydroactic acid,  Benzyl alcohol, Salicylyc acid, Potassium Sorbate, Sorbic Acid etc.But again: please, make sure there is some preservative in what you buy.
    Serious cosmetic manufacturers not only include these ingredients in their products but they test them for safety, with tests that are called Preservative Efficacy Tests (PET).Preservatives must be active against Gram-positive and Gram-negative bacteria, yeasts and mold.
    Typical preservatives and their concentration:Phenoxyethanol up to 1%
    Benzyl alcohol and Dehydroacetic acid up t0 1% (usually 0.6-0.8%)
    Potassium Sorbate 0.1-0.5% active mostly against yeast and mould
    Sodium benzoate up to 1%. Mostly active against yeast and mold.

    Parabens (from 0.01-0.3%) like:
    Methylparben 0.2%
    Propylparaben 0.1%
    Butylparaben 0.14%

    Formaldahyde Releasers
    Diazolidinyl Urea and Iodopropynyl Butylcarbamate 0.05-0.2%
    DMDM Hydantoin 0.1-0.6%
    Imidozolidinyl Urea 0.2-0.4%
    Diazolidinyl Urea 0.1-0.3%

    Often these preservatives are combined together, for instance parabens with formaldehyde releasers or phenoxyethanol

    As a side note, did you know that honeysuckle contains natural parabens?

  • pH Adjusters
    Our skin has a PH of about 5.5. If we apply products with a PH that is too acid or too alkaline we can damage our skin barrier and disrupt the delicate skin balance. Thus pH adjusters are used to make sure that moisturizers have a pH of about 5.5.
    Examples are lactic acid, citric acid, sodium hydroxide (lye solution) or triethanolamine (TEA).
    These are used in concentrations up to 1% 
  • Fragrance
    This is used to give a good smell to products. They can sensitise and  give allergies, so often you will see products that are fragrance free.
    As a side note, sometimes manufacturers claim to have preservatives free products. In reality they are using preservatives that are classified as fragrances/parfums. An example is Natacide.
     
  • Chelating agents
    These are ingredients that bind to metal ions (like iron), isolating them and preventing them to stick to the skin. They are used to boost the efficacy of preservatives. 
    A typical chelating agent used in cosmetics is Disodium EDTA. The concentration of use is 0.2%

In general, you can expect a moisturizer  to be made of:

Up to 80% water
Up to 1% gelling agents
Up to 3% – 4% humectants
Up to 15% oils and butters
Up to 6%-8% emulsifier
0.3% to 1% preservative
0.1%-0.5% Chelating Agents
Up to 7%-8% Actives
Up to 1% Fragrance
Up to 1% pH adjusters

All the ingredients in the formula will sum up to 100%

How can I find the 1% threshold (2nd rule)?

I would usually look for preservatives, as these are rarely used up to 1%. Below those you can be sure that ingredients are used in concentrations below 1%

If you want to buy a product that is marketed as “rich in Argan oil” or “rich in Vitamin E”, you want to find them in the first places of your LOI. If you find them in the second half of the list, you are basically paying money and you are not getting what you are looking for.

Let’s see two examples

THE BODYSHOP-Coconut hand cream

Aqua/Wate, Glycerin (Humectant), Caprylic/Capric Triglyceride (Emollient), Prunus Amygdalus Dulcis Oil/Prunus Amygdalus Dulcis (Sweet Almond) Oil (Emollient), Sodium Polyacrylate (Gelling Agent), Parfum/Fragrance (Fragrance), Cetyl Alcohol (Emulsifier), Pentaerythrityl Distearate (Emollient), Phenoxyethanol (Preservative), Caprylyl Glycol (Emollient, actually used to boost the preservative efficacy), Cetearyl Alcohol (Emulsifier), Cetearyl Glucoside (Emusifiert), Glycine Soja Oil/Glycine Soja (Soybean) Oil (Emollient), Orbignya Oleifera Seed Oil (Emollient), Cocos Nucifera Oil/Cocos Nucifera (Coconut) Oil (Emollient), Butyrospermum Parkii Butter/Butyrospermum Parkii (Shea) Butter (Emollient), Myristamidopropyl PG-Dimonium Chloride Phosphate (Emollient), Sodium Stearoyl Glutamate (Emollient), Xanthan Gum (Gelling Agent, Disodium EDTA (Chelating Agent), Myristyl Alcohol (Emulsifier/Emollient), Stearyl Alcohol (Emollient), Coumarin (Fragrance Ingredient), Linalool (Fragrance Ingredient), Limonene (Fragrance Ingredient), Citric Acid (pH Adjuster), Caramel (Colorant), CI 14700/Red 4 (Colorant).

The phenoxyethanol (in bold) shows the 1% line. After that ingredient all the rest is in concentrations below 1%, including the coconut oil…you would expect a higher concentration in a “Coconut hand cream”

JERGENS-Wet Skin Moisturizer with Refreshing Coconut Oil

Water, Glycerin (Humectant), Mineral Oil (Emollient), Ethylhexyl Isononanoate (Emollient), Ethylene/Propylene/Styrene Copolymer(gelling agent), Acrylates/C10-30 Alkyl Acrylate Crosspolymer(gelling agent), Ceteareth-20 (Emulsifier), Methylparaben (Preservative), Butylene/Ethylene/Styrene Copolymer(gelling agent), Phenoxyethanol (Preservative), Fragrance, Magnesium Aluminum Silicate (gelling/thickening agent), Ethylparaben (Preservative), Sodium Hydroxide (pH adjuster), Cocos Nucifera (Coconut) Oil (emollient).

Again in bold is where the preservatives start. In this case Methylparaben is probably used around 0.2%. The ingredients following are supposed to have a concentration equal or lower to 0.2%, but because of rule number 2, the other ingredients might have been listed in “random” order, as long as their concentration is lower than 1%. So, for instance, this product might contain 0.2% Methylparaben and 0.5% Phenoxyethanol.

One thing is sure, also this moisturizer, marketed as “with refreshing coconut oil” contains very little of it, and it is mainly water and mineral oil

…And that is why we cannot base our choices only on marketing and packaging.

What are your thoughts and experiences?

How to read a cosmetic label Infographic

Winter is coming…along with cracked hands. What are the best cosmetic ingredients?

winter is coming-cracked hands

Winter is coming… yes, we heard this many times and yet every year we get cracked, dry hands.

What is Melisandre’s cure for our hands? How can we resuscitate them to a better life?

Here are few tips and ingredients that we should use in our potions, if we want them to work.

Hands and feet are covered in the thickest skin we have around the body. Skin is usually a great barrier; however, when it is dry and cracked the defence it provides is impaired and infection can occur. This is why we have to take good care of skin and repair it.

Of course, also in this case, the best cure is prevention!

What are the best steps when hands are already dry and cracked?

  1. Try not to expose hands to degreasing and strong chemicals: when you wash dishes, clean home etc use rubber gloves to protect your skin
  2. Use delicate cleansers to wash your hands. Delicate means avoiding Sodium Lauryl Sulfate (SLS) and Sodium Laureth Sulfate (SLES). These ingredients are usually too degreasing, unless formulated in the proper way.
    So, as a rule of thumb stay away from them. Avoid also soap bars, often they are too alkaline compared to skin’s pH and therefore drying.
  3. When you go out and the temperature is merciless, use some nice warm gloves
  4. If you really need to wash hands often, avoid drying them with hot air or your skin will dry out even more
  5. After washing them, to trap in the water use a good moisturiser.These tips are good also for prevention!

So, what is a good moisturizer?

For dry, cracked hands you need three types of ingredients:

  • Humectants /hydrators. These are ingredients that attract water from the air and bring it to your skin. Examples of good humectants are glycerin (or glycerol), hyaluronic acid (or sodium hyaluronate), sodium PCA, aloe vera gel.
  • The skin continuously “breathes”, meaning that it absorbs water and loses it with the Transepidermal Water Loss (TEWL). To prevent losing water and to limit TEWL you need an emollient or occlusive ingredient.
    Be aware that occlusive does not mean clogging! Occlusive just means that the ingredients form a protective film over your skin, decreasing TEWL and locking moisture in your skin.
    Occlusives are petrolatum, vaseline, mineral oil, silicones and vegetable oils. Several studies show that there is no difference between paraffin oil and vegetable oils in terms of penetration and occlusiveness.

    The difference is that vegetable oils have components similar to those that make up our sebum (triglycerides, wax esters, squalene and free fatty acids), so skin uses those components to strengthen the barrier lipids. On the other hand paraffin, mineral oils etc are inert and skin does not process them. This allows the latter to stay occlusive for a longer time.

    Silicones are porous and considered semi-occlusive, however many of them are not water soluble, so they stick to the skin for a long time. As an example, a study showed that 42% of cetyl dimetichone stays on the skin, even after washing it three times with soap and water.There is a whole debate concerning silicones. They are mostly considered safe both for the person and environment (here two more additional studies: 1,2), however some countries limit the concentration of some silicones (Cyclosiloxanes), as being considered endocrine disruptors or linked to benign uterine tumours
    Environment Canada concluded that cyclotetrasiloxane and cylcopentasiloxane are mainly released in air, but when dispersed in water they are not biodegradable and have potential to bioaccumulate in aquatic organisms.

  • Ingredients that accelerate healing such as aloe vera (further studies: 3,4), olive oil, panthenol , honey and allantoin

In a nutshell

Besides taking care of how you wash, dry your hands and the use of gloves, moisturize them with a product that contains humectants (e.g. glycerin), vegetable oils for occlusion plus barrier strengthening and/or petrolatum for protection, and healing ingredients.

And again, always remember to prevent!

Now get that hot chocolate, you deserved it!

Cracked hands Infographic

Cellulite, tatata bala tu! What really works and what is just marketing?

cellulite minions

Dimple dimple little star, how I wonder what you are?

It’s on the mouth of most…or better it is on the buttocks of many.
To be precise, about 85% of women suffer from cellulite and yet it is a great taboo, the big shame.

Suffer from cellulite”, I think I never chose a better combination of words. Cellulite is not only a beauty problem, it is a condition that can have emotional and social repercussions.
And if this sounds exaggerated, check how many think of it as the “despicable thing”.

Let’s try to understand what is cellulite, what options we have and what we can do about it.
Whether treatments work or not, keep in mind that you are not alone!

What is cellulite and what causes it?

Medically, it is known as gynoid lipodystrophy or dermopanniculosis. Some consider it a disease due to the fact that severe stages can present:

Painful nodules and increased local temperature, which are suggestive of an inflammatory reaction occurring in the dermis and in the underlying subcutaneous adipose tissue.

Some others consider it just a normal condition that has been marketed as disease.

Cellulite is described as:

A complex problem involving the microcirculatory system and lymphatics, the extracellular matrix and the presence of excess subcutaneous fat that bulges into the dermis…Differences in the fibrous septae architecture that compartmentalize the adipose tissue have recently been reported in women with cellulite compared with men.

In other words the fat cells present in the hypodermis, or the subcutaneous adipose tissue (SAT), grow in volume and become “compressed” by collagen walls (septae) that separate different chambers in the adipose tissue. Fat cells then push upwards into the connective tissue (dermis) and create the infamous bumps.

Why this happens has not been determined with absolute confidence, however rather than a single cause there are many triggers, a multi-cause.

Genetics

Tendency to cellulite has been attributed to specific genes. People with these genes have higher chance to develop cellulite.

Hormonal

Hormones, especially oestrogen’s have a big part in skin and they stimulate lipogenesis (the formation of fat). In fact, that is one of the reasons why cellulite is mostly a condition for women rather than men.
It is reported that fibroblasts activated by oestrogen increase Glycosaminoglycan (GAG) that leads to water retention. In this way blood vessels are compressed, leading to tissue hypoxia (when tissues are deprived of oxygen) and intercellular oedema (swelling). 

Lifestyle

Lifestayl is a very important factor in cellulite formation and it is often disregarded. No treatment will be effective if bad habits are not changed.
A non balanced diet with excessive consumption of carbohydrates and poor in fibers leads to the “hypertrophy of fat tissues” (increase in fat cells volume). 

A sedentary lifestyle, smoking and wearing tight clothes decrease blood flow and venous return, contributing to the formation of cellulite.
The most evidence-based way of improving blood circulation is physical exercise. A study showed that blood flow in the fat tissue is higher near contracting muscles than resting ones. 

A flavonoids-rich diet (blackberries etc) can also improve blood circulation. Researchers showed that a 45 days consumption of chokeberry juice resulted in considerable reduction of oedema. 

Connective tissue structure

The structure of the connective tissue differs from men and women.

Women have a higher percentage of vertical septae (the walls that separate different chamber-like structures in the fat tissue), while men have a mostly horizontal ones.
Vertical septae favour the vertical expansion of fat cells towards the dermis, while horizontal septa favour the expansion of fat cells internally to the fat tissue and laterally.

Microvascular alterations

Cellulite is associated with micro-circulation problems and venous insufficiency: when the superficial blood and lymph circulation is impaired, this can result in swelling between cells in the connective tissue.
Circulation problems have been theorised as possible cause of cellulite but this hypothesis has never been proven. Yet, often cellulite and poor micro-circulation are related.

Classification

Cellulite is classified according to the Nürnberger-Mülle scale.

Stage 0

No dimpling when the subject is standing and lying. The pinch test reveals “folds and furrows”, but there is no orange peel-like appearance.
In this stage, blood and lymph vessels supply the fat tissue with nutrients and remove toxins. Fat cells (adipocytes) have regular size.

Stage 1

No dimpling while the subject is standing or lying, but the pinch test reveals the orange peel-like appearance.
The blood vessels are more fragile, their walls cannot retain fluids and leak plasma in between cells, causing swelling. The lymphatic system is not able to completely remove fluids.
Adipocytes become bigger and clump together, hindering blood flow.

Stage 2

Orange peel-effect appears spontaneously when standing and not lying down.
Fat cells form micro-nodules and dermis and epidermis (first 2 layers of skin) become thinner, allowing cellulite to become visible.

Stage 3

Orange peel-effect is visible both standing and lying down.
Micro-nodules come together to form larger sized macro-nodules and are surrounded by stiff collagen and fibers.

Stage 4

Nerves might be compressed by the macro-nodules leading to painful spots.

The first stages are believed to be reversible to a certain extent while the more severe stages are considered resilient to treatment.

In general, there is no cure for cellulite, however many treatments have been developed that give somewhat short or long term effects, but no permanent solution.

What are the available treatments?

Cosmetic ingredients

The most used ingredients in topical cosmetics are xanthines, retinoids, and plant extracts.

The new trend is to apply anti-cellulite cosmetics and use neoprene shorts overnight to provide occlusion. In topical cosmetic the most important factors are the concentration of active ingredients and how they are delivered and reach where needed.

Usually, the effects regress as soon as these treatments are stopped.

Xanthines

These are very common and include caffeine, aminophylline and theophylline. Their effect is to break fat, often referred to as lipolysis.
Amynophylline are however the least promising, showing almost no effect

Retinoids

Retinol at 0.3% has been used over a period of 6 months and was reported as effective. It is absorbed and transformed into retinoid acid. This improves the collagen and elastic fibers.
At cellular level, it has also the ability to reduce fat through cellular heat dissipation, in other words “burning” fat locally.

Plant Extracts

Anti-cellulite creams often use plant extract like Centella asiatica
, butcher’s broom, horse chestnut, ivy, Ginkgo biloba, Witch hazel, white oak, green tea, lemon, kola, fennel, algae, barley, sweet clover, etc… The strength of these extracts is their molecules, like flavonoids or terpenes. Their main action is that of enhancing the peripheral circulation of blood and lymph. Some algae such as fucus vesiculosus, laminaria flexicaulis, and ascophyllum nodosum are used to improve skin texture.

Cryolipolysis

In simple words, this means fat freezing. This kind of non-surgical procedure is used for localised fat. A device cools down the treated area to about 4 degrees Celsius and is kept on spot for about 45 minutes-1hour. The technique uses a combination of acoustic waves and cryolipolysis. The shock waves improve the appearance of cellulite by remodelling collagen, while the freezing of fat cells in the subcutaneous layer initiates an inflammatory response that destroys fat cells. Cryolipolysis improves also skin tightness.

TriActive

TriAcrive is a technique that combines suction, massage, low-level laser light, and contact cooling.
A study reports the improvement of cellulite, skin texture and tone. The subjects with light to moderate symptoms showed the greatest improvement.

VelaSmooth/VelaShape

VelaSmooth and VelaShape use both infrared light (700 − 2000 nm) and radiofrequency (RF) energy. Many studies reported its effectiveness, where up to 90% of subjects, with moderate cellulite, noticed an improvement. As a side effect some patients experienced bruising. The effects regressed to an average 25% cellulite  improvement after 6 months.
Another study compared TriActive to VelaSmooth. The results with the two techniques were very similar, except that subjects experienced more bruising with VelaSmooth.

Shock wave therapy (SWT)

A device produces shock waves or acoustic waves that propagate into the skin and improve collagen structure.
Several studies showed that SWT helps prevent fibrosclerosis, the hardening of fibers and that:

An amazing induction of neocollageno- and neoelastino-genesis is observed within the scaffolding fabric of dermis resulting in increased thickness of the dermis.

Fat is not reduced but collagen synthesis is promoted and becomes denser and firmer.

In general, this technique has been proved to show good temporary results.

Lasers

This kind of technology, known as Cellulaze or CelluSmooth, requires only one treatment however it is invasive: a very thin fiber with aNd:YAG 1440 nm laser is inserted in the skin, breaks down fat and the septae that pull down the skin. Several studies reported that this procedure:

Produced significant improvement in cellulite with one treatment after 6 months of follow up.

Radio Frequency (RF)

RF is used to treat cellulite by heating the dermis and hypodermis.
RF thermal stimulation is believed to result in a microinflammatory process that promotes new collagen.
A study affirms that:

RF treatment on cellulite produces a decrease in lipid content of cells as well as changes in the adipocyte membrane which will lead to cell rupture and the death and extrusion of lipid content out of the cell.

Physiotherapy/Massage

Treatments like deep massage, manual and pneumatic lymph drainage are more effective in the initial stages of cellulite as they stimulate blood and lymph flow, help in removing toxins and fluids in between fat cells and delay the formation of fibrosclerosis and nodules.
Research showed that:

Deep mechanical massage enhances the presence of longitudinal collagen bands whereas distortion and disruption of adipocytes was noted.

In other words, massage helped to brake fat cells and enhance horizontal septae (collagen bands) instead of vertical ones that are related to cellulite.

Endermologie

Endermologie is based on the theory that devices that use massage techniques can improve cellulite.
The skin is massaged and kneaded by the device to increase lymph drainage and affect the skin architecture (collagen bands etc…)
Though Endermologie is a popular treatment, the available scientific results are controversial and feelings are mixed. Some studies report a certain degree of improvement, whereas other studies only very modest results 

In a nutshell

Of the topical cosmetic solutions, retinoids are your best bet.

Among the non invasive treatments:

  1. Cryolipolysis is effective against localised fat, however it needs shock waves or other to be effective against cellulite.
  2. VelaSmooth/VelaShape results are comparable to TriActive, except that VelaSmooth can cause more bruising
  3. Shock waves and RF work mainly by boosting collagen production. The thickening of skin can improve cellulite appearance.
  4. Massages can moderately help by improving microcirculation and mildly affecting the collagen structure, this is valid also for Endermologie.
  5. Laser fibers procedures are costly and invasive but effective in reducing cellulite. This does not mean that all the dimples will disappear and your skin will be smooth as silk.

All the treatments depend on the ability of the technician that applies them. All have a temporary effect.
Yet, there is no cure or miracle for cellulite. You cannot eliminate it but you can improve its appearance.

My firends, after so much information it is time to say Poopaye!

Home made remedies for stretch marks. Do they really work?

insharepics.info

insharepics.info

Over the internet, I read many articles on home remedies, and bloggers that swear on their efficacy.

What I learned is that you have to take things with a pinch of salt.

There was that time, during my teenage days, when I tried a face mask based on baking soda. I cried huge tears when I took it off and my face was…not red, but purple because of showing capillaries!
I thought it would never go away. Luckily, after about one hour my face went back to normal.
Believe me, that taught me a lesson: even the most innocent and natural ingredients can be dangerous if you don’t know their properties and don’t know what you are doing! (Hemlock, anyone?)

Sometimes I want something to be true so badly that I allow my self to believe in exaggerate cosmetic claims or improbable home remedies. Something like:

“Please, please, please let it be true! It has to work… I am going to buy it/try it!”

Usually though, I try to base my decisions not on wishes expressed upon a shooting star, but on scientific back up, or at least some sort of acceptable reason.

What are stretch marks and where do they originate?

First of all we have to understand our “enemy”: what are stretch marks and where do they originate?

Fact: the skin is made out of 3 layers. The most external layer being the epidermis, the middle layer called dermis and the deepest layer, hypodermis.

Stretch marks are formed in the dermis, then as a ripple effect they show on the epidermis as red or white strikes.

This being said, it is important to know that most topical solutions do not go past the epidermis, after all the function of the skin is being a barrier.

How stretch marks originate is not fully understood, however it is supposed to happen due to collagen, elastin and connective tissue damage in the dermis.

This damage is due to several factors:

  1. Hereditary: there are certain genes that give predisposition to stretch marks
  2. Hormonal: a certain kind of hormones (corticosteroid) can damage collagen
  3. Pathological: stretch marks could be a symptom of Cushing syndrome

A genetic study affirms that stretch marks occur in presence of damage to collagens, elastin, and fibronectin (an extracellular matrix protein)

It is likely that variations in the elastic fiber component of the skin extracellular matrix contribute to the development of stretch marks. The expression of collagens, elastin and fibronectin is also decreased in striae, which could be linked to the reorganization and overall loss of elastic fibers in skin affected by stretch marks.

Nowadays, most of the treatments focus on increasing collagen.

What can home remedies do for us? Do they really work?

Two scientific studies report positive effects in preventing stretch marks.
The first study found a link between low levels of Vitamin C in blood and stretch marks.
The second study found that a topical cream with hydroxyprolisilane-C, rosehip oil, Centella asiatica triterpenes and vitamin E:

Proved to be effective in reducing severity of the striae during pregnancy, prevents the appearance of new striae and halts progression of those already present. In women who had no striae at baseline, use of the anti-stretch mark cream was more effective than placebo in preventing new stretch marks.

I read about remedies on how to prevent and how to even “erease” them, once you get them.
These are some of the most common I found on the net.

Olive Oil

Olive oil is often mentioned to reduce the appearance of already existing stretch marks or prevent new ones.
Now doubt that olive oil has many benefits: it is mainly composed by oleic acid (55 to 83%), linoleic acid (3.5 to 21%, palmitic acid (7.5 to 20%) and it is rich in anti-oxidants, namely vitamin E, phytosterols and polyphenols like hydroxytyrosol.
Yet, several studies (1, 2, 3, 4, 5) showed that it is not effective in treating or preventing stretch marks.

Cocoa butter

Cocoa butter is another top ingredient often used in cosmetics for stretch marks.
A study claims that the polyphenols contained in cocoa butter promote skin restructuring, improving skin tone and elasticity.
On the other hand, two specific studies (6, 7) done on stretch marks affirm that cocoa butter has no effect in preventing them.

Aloe vera

Aloe vera is a good ingredient because of soothing properties, but even more thanks to its hydrating power, due to its water binding properties. It is composed of vitamins, enzymes, minerals, sugars, fatty acids and among others, amino acids.
In general it can be good for skin and a study shows that it enhances wound healing.
However no study proved its efficacy in treating nor preventing stretch marks.

Lemon juice

Sometimes I come across very convincing posts on the benefits using lemon juice on skin. Apparently, it is a holy grail in reducing stretch marks, and acne scars, if not even acne itself.

And that is when I shiver…What? NO, please NO.

Just to make it clear, in case someone is looking into pretty lemony pictures: lemon on skin is a potent IRRITANT.

The pH of lemon is very low (pH2) and citric acid in lemon juice is present at high concentration. If that is not enough,  with exposure to sun, high concentrations of limonene in lemon can cause phytophotodermatitis (PPD).

In few words, that is a very bad idea, especially if you are using it on already damaged skin like stretch marks.

Egg wites

Egg whites contain proteins and amino acids that could be beneficial for skin. Most doctors though speak about short term effects of skin tightening that disappear as soon as the egg whites are removed.

Two studies (8, 9) showed that both hen egg white and a peptide obtained by ostrich egg white are involved in wound healing.

Yet, there is no scientific proof that specifically links this ingredient to the prevention or treatment of stretch marks.

Almond oil

A study found out that:

A 15 minute massage applied with almond oil during pregnancy reduced the development of striae gravidarum (pregnancy stretch marks), but using bitter almond oil had no effect on this in itself.

In a nutshell:

Olive oil, cocoa butter and almond oil have been proven to not prevent nor treat stretch marks. So, they are not useful home remedies. However, massaging almond oil for 15 minutes gave positive results.

A benefit of the doubt could be given to aloe vera and egg whites because they were linked to wound healing, yet no scientific study proved a positive effect on stretch marks.

Absolutely, do not use lemon juice. It is not effective and it can irritate the skin, even causing dermatitis.

Stretch Marks Infographic

Stretch Marks Infographic

Sesame Street VS Alphabet Creams. BB-CC-DD-EE creams, which to use?

alphabet creams post

If you want to teach your kids the alphabet you can either let them watch Sesame Street or show them your make up stash.
No doubts that after the great success  of BB, CC, DD and EE creams we will one day arrive to ZZ.
Some consider them just a marketing hype, some the “where have you been all my life” products.

So what is the difference and which should you consider?

BB cream

BB stands for Blemish Balm or Beauty Balm. In origin, it was meant to treat skin recovering from surgical procedures.

BB creams are supposed to be packed with moisturizing ingredients and even out the skin tone by offering a coverage that can vary from sheer to medium.
They are often formulated with sheer micas to lend a dewy look, and silicones to “fill” in skin texture, giving a smoother appearance.
Another very important characteristic is that they offer protection from sun damage. To this regard, we have to raise a warning sign, not all BB creams are equal!

A study compared 21 commercial BB creams and tested them in order to reply to these 2 questions:

  1. Does the claimed sun protection correspond to reality?
  2. What is their photostability: how well do they keep protecting from sun during sun exposure?

In few words, do they work well and do they keep performing after some time from application?

The study found that:

It was shown that 70% of the products tested have an SPF which matches the SPF displayed on the product. For the remaining 30%, it can be seen that products have SPF values of between 2 and 10 times lower than those indicated on the products. It can also be noted that there is a large disparity in terms of photostability since, under the same experimental conditions, however, some products only lose 5% of their photoprotective efficacy, whereas others lose 60%)

When to use: Best for dry skin, looking for sheer coverage, sun protection and moisturizing ingredients

CC cream

CC stands for Colour Correcting. Their texture is lighter than BB creams and absorbs quickly, being many times oil free.
They contain pigments to correct discolouration, brighteners like Vitamin C, anti-oxidants like Vitamin E and other anti-ageing ingredients.

It is not rare to find green CC creams against redness or purple, against sallow complexion.

As BB creams, they also contain sunscreen and soft-focus ingredients, to diffuse light and even out skin tone.

When to use: Best for oily skin and skin with light blemishes.  Aimed to neutralise discolouration like redness or sallowness.

DD Cream

Initially, DD –Daily Defence– creams were heavy moisturizers for body and feet. Then the meaning of DD got somehow associated to “Dynamic Do all” and they became face cream products. They are kind of in between BB and CC creams, with anti-oxidant and colour correcting ingredients. They also include ingredients that defend from sun damage and pollution.

When to use: Best for dry to normal skin and for whom wants a hybrid between BB and CC creams with protection from sun and pollution… city boys and girls, I am looking at you!

EE creams

Of course EE creams were also introduced to the market…except no one really knows what they are.
In fact, there is no common definition and you can find very diverse products, ranging from the EE –Even Effect– skin tone corrector by Estée Lauder to the EE –Extra Exfoliating– cream by the Jojoba Company.

Dear cosmetic industry, make up your mind! Otherwise there is no way you can convince us we need yet another alphabet cream.

So, what is your opinion on the alphabet creams? And, is FF cream going to be “fast and fabulous” or “for fools”?

Alphabet creams

Hydroxy Acid exfoliation: AHA, BHA and the newcomers LHA and PHA. Which to use and when?

Barbie face crop

We all heard about Alpha Hydroxy Acids (AHAs), Beta Hydroxy Acids (BHAs) and now even the newcomers: Lipo Hydroxy Acids (LHA) and Poly Hydroxy Acids (PHA). The net is full of information, yet how much confusion!
Bits of information here and there, but in the end what is best to use for your concern?

Let’s try to make some sense out of all this chaos.

First of all, what do they have in common?

They are all used as exfoliants.
They are able to dissolve the “glue” that keeps together corneocytes, the dead cells that constitute the outermost layer of the skin. When the dead layer is removed, new cells surface giving the appearance of lighter, smoother skin and an overall fresher look.

They have all natural sources (sugar cane, milk, plants etc…) however, most of those found in cosmetics are synthesised in labs.

Used correctly they can provide great results, else they can damage the skin, causing irritation and even burns. Hydroxy acids are generally safe when used in cosmetics as they have a low concentration and a pH between 3-4. At high concentrations they must be handled by dermatologists or trained aestheticians/therapists.

Now let’s see in what they differ and when to use them.

What are AHAs, BHAs, LHA, PHA and what is their difference?

AHAs

The most common AHAs used in cosmetics are glycolic acid and lactic acid. Besides being exfoliants, they also are humectants, meaning that they attract water from the environment and deliver it to the skin.
They differ in molecule size and this characterises their preferred use.

Glycolic acid’s molecule is smaller than lactic acid’s, therefore it can penetrate deeper into the skin. This acid is famous for its ability to trigger collagen regeneration, to thicken skin, even out skin tone, reduce fine lines, address sun damage and inhibit melanin formation (Ref 1-6).
Yet, scientific studies demonstrated that it can increase photosensitivity, so it is best to use by night or followed by the application of a good sunscreen.

Although glycolic acid’s small molecules deliver good results in a short time, they can be harsh on skin. In this case lactic acid, that has a similar but slower outcome,  is a better option for sensitive skin. Lactic acid is also a better humectant.

BHA

Technically, salicylic acid is not a BHA, but still commonly classified as one. It has similar effects to AHAs and is also an exfoliant, so what is the difference with AHAs?

The main distinction is that AHAs are water soluble while BHAs are oil soluble, and that is why they   are effective in addressing different issues.

LHA

LHAs, Lipo Hydroxy Acids, are BHAs similar to salicylic acid but more lipophilic; yet, their penetration depth is smaller. This and the fact that they are active at pH 5.5, same pH of skin, makes them more gentle and less irritating.

PHA
PHA stands for Poly Hydroxy Acids and they are a kind of AHA, except that they have many (poly) hydroxyl groups. This characteristic makes them more hydrating compared to AHAs and way less irritating, still providing similar anti-ageing effects.
The main PHA used in cosmetic is Gluconolactone.

When to use them?

AHAs are great for dry skin in need of brightening and rejuvenation, in fact they are active against surface wrinkles, skin pigmentation due to sun damage (dark spots etc…) and collagen generation.

BHA is preferred for treating oily skin, acne, blackheads and whiteheads. Being oil soluble, salicylic acid can easily penetrate into pores and unclog them from sebum and dead cells.
Compared to AHAs, it is active already at low concentrations (1-2%) and it is also an anti-bacterial and anti-inflammatory ingredient (Ref 7-8), therefore suitable for sensitive skin. On the other hand it is less suitable for fading uneven pigmentation.
Also in this case the use of a sunscreen is a must.

Products with salicylic acid should be avoided by allergic persons and during pregnancy.

LHAs are preferred in case the main issue are plugged pores/acne and the skin is very sensitive. It is also suggested for skin conditions as rosacea. Besides being anti-inflammatory and anti-bacterial (Ref 9), LHA has a very interesting property: it mimics the effect of tretinoin (active ingredient in Retin-A, Avita, Renova etc…).
In few words, LHAs not only exfoliate dead cells and unclog pores but, to a certain extent, they also stimulate and enhance living cells’ production (Ref 10).

The PHA Gluconolactone should be used when looking for a gentle exfoliant that offers the same rejuvenating effects of glycolic acid (Ref 11), yet not only for that purpose: gluconolactone provides another advantage!

A study (Ref 12) showed that as benzoyl peroxide, 14% concentration of gluconolactone greatly reduced the skin lesions due to acne, however with less side-effects.

In a nutshell

Choose AHAs when you want to address fine lines, hyper pigmentation and sun damage. In particular use lactic acid instead of glycolic acid in all cases of sensitive skin.

Choose PHA, gluconolactone, when you want to gently obtain results similar to AHAs and also address lesions due to acne.

Choose BHA when you want to treat oily, sensitive or acne prone skin.

Choose LHA when you want to gently exfoliate very sensitive acne prone/impure skin or exfoliate with conditions like rosacea.

Note that one type does not exclude the other, as a matter of fact they can be complementary. For instance, salicylic acid can be used to treat acne and has a drying effect on the skin while the lactic acid is a humectant and valid ally against uneven pigmentation.

References:

1) Pubmed 18505512
2) Pubmed 14756525
3) Pubmed 11359487
4) Pubmed 14756523
5) Pubmed 9793513
6) Pubmed 8784274
7) JCI 19143
8) Eurekaselect 66119
9) Pubmed 17348998
10) Pubmed 9252775
11)Pubmed 15002657
12)Pubmed 1303072

Infographic- Hydroxy Acids exfoliation: which to use and when

Infographic- Hydroxy Acids exfoliation: which to use and when