Anti-Aging Products PDF

 Introduction ▪ It is known that young individuals have soft, smooth, and supple skin, which becomes less elastic, tougher, uneven, and wrinkled over the years. ▪ Skin aging is a complex biological process influenced by a combination of endogenous an...

 Introduction ▪ It is known that young individuals have soft, smooth, and supple skin, which becomes less elastic, tougher, uneven, and wrinkled over the years. ▪ Skin aging is a complex biological process influenced by a combination of endogenous and exogenous factors, which leads to structural and physiological alterations in the skin layers as well as changes in skin appearance, especially on the sun-exposed skin areas. ▪ Aging of the skin is influenced by two separate processes: Intrinsic skin aging or chronological aging process: which is genetically determined and occurs by the passing of time alone. Extrinsic skin aging: where the skin aging process induced by environmental factors. 2 Dr. Maha Abu Hajleh-AAU Dr. Maha Abu Hajleh-AAU 3  Aging of the skin ❑ Intrinsic aging occurs by the passing of time alone. However, people of identical chronological age may appear to have younger- or older-looking skin. The reason for this is their different genetic makeup, which plays an important role in intrinsic aging. Dr. Maha Abu Hajleh-AAU 4  Aging of the skin ❖ Intrinsic aging can be considered as a slow, continuous, and irreversible tissue degradation. ❖ It affects the skin on the entire body, including the photo-protected areas in a similar manner. ❖ Clinically, intrinsically aged skin is smooth, thin, pale, and finely wrinkled. ❖ Histologically, the intrinsically aged skin can be characterized primarily by functional alterations, such as thinning of the dermis, degeneration of the elastin network, and loss of hydration. Dr. Maha Abu Hajleh-AAU 5  Aging process  Thinning of the dermis is related to its collagen content.  Collagen synthesis gradually diminishes over time, which leads to a reduction in the amount of collagen in the skin.  As collagen is responsible for the strength of the skin and plays an important role in wound healing, its decreasing amount leads to reduced strength, atrophy (i.e., weakening and thinning) of the dermis, and a reduced rate of wound healing. Dr. Maha Abu Hajleh-AAU 6  Aging process ❖ The synthesis of elastin also decreases, which results in a loss of skin elasticity ❖ The superficial muscles on the face begin to shrink, which causes lines to appear. ❖ Typical facial wrinkles form in the areas where muscles contract to make facial expressions. These include “worry lines” spanning the forehead, “laugh lines” around the eyes and mouth, and “crow’s feet” radiating from the outside corners of the eyes. Dr. Maha Abu Hajleh-AAU 7  Aging process ❖ Additionally, the production of immune cells also decreases over time, which also contributes to the compromised wound healing properties. The loss of strength, thickness, and healing properties causes the skin to become more vulnerable. ❖ There is a gradual flattening of the wavy attachment between the epidermis and dermis due to reduced production of keratinocytes. ❖ It is believed that this flattening may contribute to the increased fragility of aging skin and may also lead to reduced nutrient transfer between the dermal and epidermal layers. Dr. Maha Abu Hajleh-AAU 8  Aging process ❖ With the onset of intrinsic aging, there is a decrease in the density of melanocytes. This decrease contributes to the pale appearance of older skin. ❖ Older patients are less able to protect themselves from the sun because of a decrease in melanin. Therefore, they are more susceptible to developing sun-induced cancers. Dr. Maha Abu Hajleh-AAU 9  Aging process Pale appearance of older skin is also related to a decrease in skin vascularity. With advancing age, both the mortar and bricks of the skin are affected, which leads to a reduction in the SC lipid content, damaged barrier functions, increased epidermal water loss, and drier skin. The number of sebaceous glands remains approximately the same throughout life, although their size tends to increase with age. As a result, the skin’s pores may widen. Dr. Maha Abu Hajleh-AAU 10  Aging process ❑ Extrinsic aging can be defined as the acceleration of intrinsic aging caused by exposure to various environmental factors. ❖ The primary factors causing human skin aging are: UV radiation from the sun (photoaging) as well as smoking. 1-Photoaging is a cumulative process, which means that exposure adds up over the years. Individuals who have outdoor lifestyles, live in sunny climates, and are lightly pigmented will experience the greatest degree of photoaging. It has been estimated that photoaging accounts for more than 90% of the skin’s associated cosmetic problems. Dr. Maha Abu Hajleh-AAU 11 Extrinsic aging Dr. Maha Abu Hajleh-AAU 12  Aging process Extrinsic aging 2-Smoking It has been known that smoking leads to premature aging, smokers in general look older than their chronological age. It is more interesting, however, that smoking has been shown to be a great contributor to facial wrinkling than sun exposure. Dr. Maha Abu Hajleh-AAU 13  Aging process Extrinsic aging ❑ In contrast to intrinsic aging, the extrinsically aged skin can be characterized by more visible morphologic and physiologic changes. ▪ Clinically, extrinsically aged skin can be described as a course skin with wrinkles, hyperpigmented areas, sallowness, increased fragility, textural roughness, and dilated blood vessels that are visible under the skin (which is referred to as “telangiectasia” as a medical term). Dr. Maha Abu Hajleh-AAU 14  Aging process Extrinsic aging ▪ The epidermal thickness may be increased or decreased, leading to thickening or thinning, respectively. ▪ Skin type significantly influences the clinical signs of photoaging. In general, the epidermis becomes thinner over the years with thicker, coarse areas. ▪ Blood vessels can be easily seen through the skin where it is thinner, and in these areas, the skin bruises and bleeds more easily than normal. ▪ Loss of Langerhans cells and immune cytokins can be observed in the case of photoaged skin as well, leading to compromised immune competency of the skin. Dr. Maha Abu Hajleh-AAU 15  Aging process Extrinsic aging ▪ Due to UV exposure and smoking, the skin starts to lose its normal pink glow and a sallow yellow color develops instead. In areas of the skin that are exposed to the sun, usually there is an increased number and activity of melanocytes. This is manifested by the appearance of darker spots (i.e., age spots) on the skin. ▪ Hypopigmented areas also often appear on photodamaged skin. ▪ Repeated exposure to such factors leads to the degradation of collagen and elastin and the accumulation of abnormal elastin (medically termed “elastosis”). The subcutaneous fatty layer decreases in thickness as well. All these result in decrease in the skin strength and elasticity as well as wrinkling and sagging. ▪ It has been shown that sun exposure significantly speeds up the rate of degradation of collagen, leading to dramatic structural changes in the exposed areas. Dr. Maha Abu Hajleh-AAU 16 A healthy skin barrier is an important protector against dehydration and penetration of various physical and chemical entities and contributes to skin regeneration, elasticity, and smoothness. Therefore, its daily maintenance is an essential part of the anti-aging therapy. A further step in the anti-aging therapy is to prevent or at least slow down the degradation of skin elements, such as collagen and elastin, which naturally occurs over time. Botanical extracts, antioxidants, proteins and peptides, retinoids, hydroxy acids (HAs), and sunscreens are claimed to prevent oxidative reactions and the formation of free radicals, resurface the epidermis, and promote the natural synthesis of collagen and elastin. Dr. Maha Abu Hajleh-AAU 17  Procedures for the prevention and/or treatment of aging skin ❑ Non-invasive technologies include primary prevention, such as healthy lifestyle, refraining from smoking, and using sunscreens, topical cosmetics and drug products applied directly to the skin, microdermabrasion, certain laser devices, as well as systemic treatments, including hormone replacement therapy. ❑ Invasive technologies include chemical peels, topical injections of chemicals, such as botulinum toxin and various dermal fillers, dermabrasion, various laser devices, as well as corrective surgeries. We will focus on the non-invasive treatment options, primarily on the topically applied products and their main ingredients. Dr. Maha Abu Hajleh-AAU 18  Ingredients Used in Topical Anti-Aging Products A-Botanical extracts Botanical extracts are naturally sourced ingredients with various, often, multiple effects, including: ✓ Antioxidation: such as coffee , green tea, grape-seed extract and pomegranate ✓ Photoprotection: such as black tea and olive. ✓ Smoothing, calming, anti-inflammatory effects: such as chamomile and various mushrooms. ✓ Skin lightening: such as blueberry and ginseng. ✓ Skin tightening: such as peppermint and witch hazel. ✓ Emolliating effect: such as jojoba and coconut extract. Most commonly, botanical extracts are used in combination with one another for their combined benefits. Dr. Maha Abu Hajleh-AAU 19  Ingredients Used in Topical Anti-Aging Products A-Botanical extracts These extracts are very popular today, and they are frequently used as bioactive ingredients in anti-aging products. However, there are some facts that should be kept in mind regarding these products: ❑ In general, herbal extracts exhibit more variation than synthetic products, regarding their ingredients. The constituents of herbs and other botanicals highly depend on multiple factors, including growing conditions, climate, weather, harvesting methods, and extraction methods. ❑ Herbal extracts are often used in very small amounts in cosmetic products, which fall far below their therapeutic ranges. Dr. Maha Abu Hajleh-AAU 20  Ingredients Used in Topical Anti-Aging Products A-Botanical extracts ✓ Although some extracts (including green tea) have been shown to be able to influence mechanisms in the skin that are beneficial for anti-aging via antioxidant and anti-inflammatory properties, there is only a limited number of clinical studies performed with topical formulations containing such extracts. ✓ For this reason, the real usefulness of such ingredients in providing anti-aging benefits is still questionable. Dr. Maha Abu Hajleh-AAU 21  Aging process ▪ Oxidative stress is considered to be the cornerstone of the biochemical pathways, leading to both chronological aging and photoaging. ✓ Human skin has an efficient antioxidant system, which is able to counteract the negative effects of oxidative stress. ✓ However, in the case of chronic or severe oxidative stress, this endogenous network is not effective enough; therefore, tissue damage may occur. ✓ According to the free radical theory of aging, oxidative stress increases with age and, at the same time, the endogenous antioxidant system becomes less effective. ✓ Developing free radicals promote degradation of collagen, elastin, and hyaluronic acid and cause signs of aging. ✓ Therefore, supplying the skin with antioxidants is believed to be beneficial in slowing down aging. Dr. Maha Abu Hajleh-AAU 22 Dr. Maha Abu Hajleh-AAU 23 Ingredients Used in Topical Anti-Aging Products B-Antioxidants Antioxidants protect the cells from damage by: ✓ Neutralizing the free radicals. ✓ Can stimulate collagen production and preserve hyaluronic acid levels in the skin. ✓ Exert anti-inflammatory effects. ▪ Commonly used ingredients include: ❑ Vitamins, such as vitamin C, vitamin B3, panthenol (provitamin of B5) and vitamin E. ❑ Botanical extracts, such as green tea and grape-seed extract. ❑ Other ingredients, such as resveratrol, lipoic acid, ferulic acid, and Dr. Maha Abu Hajleh-AAU coenzyme Q10 or ubiquinone. 24  Ingredients Used in Topical Anti-Aging Products B-Antioxidants In terms of preventing the effects of photoaging, it is not yet known which antioxidants are the most effective. It is believed that, for the best results, foods and drinks containing antioxidants should be consumed in addition to using topical products. Today, antioxidants can be found in an increasing number of cosmetic and OTC drug–cosmetic products and also in drinks and foods. Dr. Maha Abu Hajleh-AAU 25  Ingredients Used in Topical Anti-Aging Products C-Peptides and proteins Peptides and proteins are also very popular today as antiaging ingredients that are formulated into topical formulations as well as injectable products. They have multiple effects, including anti-inflammatory, wrinkle reduction by stimulating collagen production, thickening the skin and firming it; smoothing; moisturization; and skin protective effects. Examples for commonly used peptides and proteins include ✓ Natural ingredients, such as collagen, elastin, hydrolyzed wheat, and soy proteins. ✓ Synthetic ingredients, such as matrikines, neuropeptides (as botulinum toxin (Botox)); and a variety of enzymes (such as proteolytic enzymes). Dr. Maha Abu Hajleh-AAU 26  Ingredients Used in Topical Anti-Aging Products C-Peptides and proteins Delivery of peptides and proteins can be very challenging due to their solubility, charge, and size. Additional challenges include their limited stability in aqueous environments as well as their high cost. It has been shown that the addition of a lipophilic chain to the molecule highly increases the penetration. Additionally, using advanced delivery systems, such as liposomes, may also help in penetration. Dr. Maha Abu Hajleh-AAU 27  Ingredients Used in Topical Anti-Aging Products D-Retinoids Retinoids are a class of substances comprising vitamin A and its derivatives. Topical derivatives that are used in antiaging formulations include retinol, retinoic acid, retinaldehyde, retinyl esters and oxiretinoids. These ingredients are incorporated into both prescription only medications and OTC drug–cosmetic products. Dr. Maha Abu Hajleh-AAU 28  Ingredients Used in Topical Anti-Aging Products D-Retinoids In general, retinoids are lipophilic molecules that can penetrate the epidermis and enter the dermis. Retinoids work at the molecular level through receptors in the skin cells. Their effects include: ✓ Improvement of surface roughness, ✓ Reduction of fine lines by decreasing the amount of collagen breakdown. ✓ Stimulating the production of new collagen. Dr. Maha Abu Hajleh-AAU ✓ Their effect also includes improvement of age spots. 29  Ingredients Used in Topical Anti-Aging Products D-Retinoids Retinoic acid was originally intended for acne treatment. Clinical studies, however, demonstrated that it is not only effective in treating acne but also prevents both skin aging and improves the already damaged skin. It has been extensively studied since then and used as an effective topical treatment for photoaging, acne, and other dermatological disorders. Retinoic acid and its derivatives adapalene, tazarotene, and bexarotene are registered prescription drugs. Dr. Maha Abu Hajleh-AAU 30  Ingredients Used in Topical Anti-Aging Products D-Retinoids One of its major drawbacks is that : ✓ It can be irritating to the skin, and the condition developed is usually referred to as “retinoid dermatitis” or “retinoid reaction,” which limits its use. ✓ The topical effects, such as the burning sensation, redness, and peeling, mainly occur in the first weeks of the retinoic acid treatment and are almost always transient and diminish with continued application. However, many patients discontinue the therapy upon appearance of such symptoms. Dr. Maha Abu Hajleh-AAU 31  Ingredients Used in Topical Anti-Aging Products D- Retinoids One of its major drawbacks is that : ✓ An additional side effect associated with retinoid therapy is photosensitization, which normally occurs at the beginning of the therapy. However, after a few months of therapy, the skin’s response to UV radiation returns to normal. ▪ Retinoids are photo-inactivated, meaning that direct sunlight will break them down and make them less effective. Dr. Maha Abu Hajleh-AAU 32  Ingredients Used in Topical Anti-Aging Products D-Retinoids Therefore, patients on retinoid therapy are advised to: Use retinoids at night and avoid excessive sun exposure. Use of sunscreens for sun protection. Use moisturizers is also often recommended by dermatologists to prevent dryness. Over the past decades of research, no systemic side effects on long-term treatment with topical retinoids have been observed in young adults. This is related to the insignificant systemic absorption of the applied doses of retinoids. Nevertheless, pregnant women are generally advised to cease topical retinoid treatment during pregnancy. Dr. Maha Abu Hajleh-AAU 33  Ingredients Used in Topical Anti-Aging Products Retinoids ▪ Retinaldehyde and retinol are gentler derivatives of retinoic acid, which are also scientifically proven to deliver anti-aging effects. ▪ Both retinaldehyde and retinol are precursors of retinoic acid (i.e., they are converted into retinoic acid, the biologically active form of vitamin A in the skin). ▪ They are available without prescription. ▪ Currently, retinol is the most often used retinoid, which has been shown to have positive effects not only on extrinsic aging but also on intrinsic skin aging. Dr. Maha Abu Hajleh-AAU 34  Ingredients Used in Topical Anti-Aging Products Retinoids Dr. Maha Abu Hajleh-AAU 35  Ingredients Used in Topical Anti-Aging Products E-Hydroxy Acids (HAs) HAs are naturally occurring organic carboxylic acids, which have attracted much interest over the past decade in the treatment of aging. They include: Alpha hydroxy acids (AHAs), such as lactic acid, glycolic acid, malic acid, tartaric acid, and citric acid. Beta hydroxy acids (BHAs), such as beta-hydroxybutonic acid; Polyhydroxy acids (PHAs), such as gluconolactone; Bionic acids (BAs), such as lactobionic acid; Aromatic hydroxy acids (AMAs), such as salicylic acid. These organic acids are normally synthesized; but some of them can be derived from natural sources, such as sugar cane, sour milk, apples, grapes, and citrus fruits. Dr. Maha Abu Hajleh-AAU 36 Dr. Maha Abu Hajleh-AAU 37  Ingredients Used in Topical Anti-Aging Products E-Hydroxy Acids (HAs) HAs can deliver numerous skin effects, including exfoliation, moisturization, anti-inflammatory properties, and antioxidative effects. One of their major beneficial effects is the improvement of photoaged skin. Visible results include a decrease in roughness, decrease skin discoloration and overall pigmentation, an increase in total skin thickness and in the density of collagen, and an improved quality of elastic fibers, which makes the skin look firmer. In low concentrations (4–10%), HAs are components of nonprescription creams and lotions that are promoted as being effective for skin aging. In high concentrations ( > 20%), they can be used as chemical peels to treat various conditions and diseases, including calluses, acne, and photoaging. Dr. Maha Abu Hajleh-AAU 38 Ingredients Used in Topical Anti-Aging Products ❑ AHAs ▪ Glycolic acid and lactic acid are widely used in skin care products to provide exfoliation (as a chemical peeling agent) and skin resurfacing. ▪ Citric acid is widely used in topical formulations as an antioxidant and pH adjustor, as well as an anti-aging ingredient. ▪ Dr. Maha Abu Hajleh-AAU 39 Ingredients Used in Topical Anti-Aging Products ❑ PHA ▪ Gluconolactone, a PHA, is also commonly used in cosmetic formulations since it strengthens the skin barrier function, and it is a gentle moisturizing and antioxidant substance. ▪ In addition, it delivers anti-aging benefits. An advantage of this ingredient is that it does not lead to an increase in sunburn after UVB irradiation, which is known to occur with glycolic acid. ▪ Gluconolactone can also be formulated with oxidative drugs, such as benzoyl peroxide, to help reduce irritation potential and erythema caused by the oxidative drug. Dr. Maha Abu Hajleh-AAU 40 Ingredients Used in Topical Anti-Aging Products ❑ BAs ▪ BAs are hygroscopic materials, and their aqueous solution turns into a gel at room temperature since water evaporates from it. This gel can provide protective and soothing effects for inflamed skin; therefore, it can be used after cosmetic procedures that weaken the skin’s barrier, such as superficial chemical peels. ▪ Lactobionic acid, a BA, also provides significant benefits against sun-initiated damage of the skin, preventing wrinkle formation, skin laxity, and the formation of visible red spots. Dr. Maha Abu Hajleh-AAU 41 Ingredients Used in Topical Anti-Aging Products ▪ Aromatic hydroxy acids (AMAs), such as salicylic acid. ▪ Salicylic acid, an AMA, is also a widely used ingredient in OTC and prescription-only cosmetic preparations for a variety of applications. ▪ Salicylic acid is a lipophilic (i.e., fat soluble), which makes it useful in subjects with oily skin. It has keratolytic (peeling) effect and has antibacterial properties. Dr. Maha Abu Hajleh-AAU 42  Ingredients Used in Topical Anti-Aging Products E-Hydroxy Acids (HAs) Side effects of AHA would include burning, rash, pigmentary changes, peeling, and itching. One of the major concerns with regard to the use of AHAs is that they can increase the skin’s UV sensitivity. FDA studies concluded that sensitivity is reversible and does not last long after discontinuing the use of the AHA cream. The FDA has the following labeling recommendation for topically applied cosmetics containing AHAs: “ Sunburn Alert: This product contains an alpha hydroxy acid (AHA) that may increase your skin’s sensitivity to the sun and particularly the possibility of sunburn. Use a sunscreen, wear protective clothing, and limit sun exposure while using this product and for a week afterwards.” Dr. Maha Abu Hajleh-AAU 43  Ingredients Used in Topical Anti-Aging Products F-Sunscreens Sunscreens provide photoprotection by physically blocking the sunlight or absorbing and transforming it in the skin. Although there are several treatments available for aged skin, prevention of extrinsic aging remains the best approach to prevent aging. This includes: ✓ Avoiding sun exposure and using sunscreens when sun exposure cannot be avoided. ✓ Avoiding smoking and pollution. ✓ Preventing unnecessary stretching of the skin. ✓ Eating a diet rich in vegetables and fruits. ✓ Consuming antioxidants and using topical antioxidants. Dr. Maha Abu Hajleh-AAU 44  GLOSSARY OF TERMS ❑ Intrinsic aging: Aging that is genetically determined; it affects the skin on the entire body, including the photoprotected areas in a similar manner. ❑ Chronological aging: A synonym for intrinsic aging. ❑ Photoaging: Aging caused by the sun. ❑ Photosensitivity: Oversensitivity of the skin to sunlight. ❑ Extrinsic aging: Acceleration of intrinsic aging caused by exposure to various environmental factors, such as sun, wind, smoking, and air pollutants. Dr. Maha Abu Hajleh-AAU 45  GLOSSARY OF TERMS ❑ Liposome: A microscopic spherical vesicle made of phospholipids that has a lipid bilayer structure resembling the natural structure of the biomembranes. ❑ Oxidative stress: It is considered to be the cornerstone of the biochemical pathways, leading to both chronological aging and photoaging ❑ Hydroxy acids: A class of chemical ingredients that consist of a carboxylic acid substituted with a hydroxyl group. They are commonly used in anti-aging products and anti-acne products due to their exfoliating, moisturizing, anti-inflammatory, and antioxidative effects. ❑ Antioxidants: Ingredients often used in antiaging products since they can protect cells from oxidative stress by neutralizing free radicals. Dr. Maha Abu Hajleh-AAU 46 Dr. Maha Abu Hajleh-AAU 47