Skin is a sophisticated and dynamic organ that serves as a barrier with sensory and immunological functions and is also the most visible indicator of aging. The search for the fountain of youthful skin currently persist in the form of cosmeceuticals, approved drugs, nonsurgical and surgical treatments to roll back the effects of time. In the United States, the cosmeceutical market value is projected to grow to 20.1 billion dollars between 2014 and 2019. While the Federal Food, Drug, and Cosmetic Act (FD&C) does not recognize the term “cosmeceutical,” the cosmetic industry may refer to some cosmetic products as having both cosmetic or drug-like benefits. If a product makes such claims, it will be regulated as a drug. The FD&C Act strictly defines cosmeceuticals as products that intend to beautify and promote attractiveness, unlike FDA-regulated drugs that prevent/treat diseases, and effect the structures and functions of the body. That being said, the developmental claims of new cosmeceutical ingredients that range from short-chained synthetic peptides to plant and human conditioned media growth factors along with regulated regenerative cells and platelet-rich plasma are becoming commonplace for skin rejuvenation.
In peer-reviewed studies, medical scientists and specialists have begun to unravel molecular, cellular, and tissue changes that contribute to chronological (intrinsic) and photoaging (extrinsic) aging of skin. Investigators focus on factors (genetics programming, telomeric shortening, excess free-radical ions, smoking and ultraviolet radiation) that begin at birth and progresses throughout our lifespan. On a clinical level, aging skin can be characterized by fine and course wrinkles, roughness, laxity, sallowness, scaling, telangiectasias, and pigmentary changes including dermatologic disorders such as acne vulgaris and benign, premalignant and malignant lesions.
Skin aging and acne formation accumulate throughout life. While sunscreens are a must for teens and beyond, selections should provide sufficient blockage with an SPF 30 against UV-A and UV-B and with minimal clogging of pores in acne-prone individuals. In the 30s, skin begins to exhibit slow skin renewal with the development of early wrinkles from excessive muscle activity and loss of collagen and elastin dermal content. Targeted Botox, fillers, and medical skin care agents can be useful to slow the development of wrinkle lines between the brows and crow’s feet at the corner of the eyes. In the 40s, the onset of deeper established wrinkles, duller skin and age spots can be treated with the addition of chemical peels, laser resurfacing, intense-pulsed light, and micro-needling with radio-frequency. In the 50s and beyond, sagging facial skin/neck muscles and deflated facial fat may be optimally managed by 1) non-invasive, 2) minimally-invasive (volumizers, fat) or 3) surgical procedures.
Without question, analogues of Vitamin A that activate skin retinoid-receptors represent the “gold standard” for the treatment of aging skin and acne, specifically approved by FDA for these indicated treatments. Beyond hydroxyacids, topical anti-oxidant scavengers, skin-lightening agents, hormone replacement therapy, and sun screen blockers of both UVA and UVB, we await more evidence-based clinical studies on the safety, effectiveness, and costs of using growth factors, regenerative cells and platelet-rich plasma for our patients’ pathogenic and cosmetic skin concerns.
