I
AMMONIO LATTATO "ATTIVATO"
LA RISPOSTA DERMATOLOGICA
ALLE IPERCHERATOSI
Ipercheratosi intrinseca
Ipercheratosi estrinseca
"ACTIVATED" AMMONIUM LACTATE
THE RIGHT REPLY TO HYPERKERATOSIS
Emulsione - Ammonio Lattato 14%
Emulsione - Ammonio Lattato 8%
Ammonio Lattato 7%
i
Oli i lineari e ramificati - Ammonio Lattato 5%
\Wcw n u
localmente 2 volte al dì.
A NEW MAVICEUT/CAl®
Dermatologically tested
123
• Effective for initial .and maintenance therapy ( • • l
• Compatible with all the drugs and cosmetics
• Formulated to treat mild-to-moderate inflammatory acne,
indispensable for patients with sensitive skin
CLINICAL RESULTS< 1 •2 •3 ,
ACTIVITY CARRIED OUT BY KERATOTAL ACNE ON THE
LINOLEIC ACID ANO SQUALANE CONTENTS OF SURFACE
LIPIDS IN SUBJECTS AFFECTED BY ACNE JUVENILIS
REDUCTION OF SURFACE LIPIDS DURING THE TREATMENT
WITH KERATOTAL ACNE
go..--
n=30
-n·_ lO_ _ _
P_
<0_
005
_Wl
_il*lg
~uMeoted------
4,0
3,5
z 60+--- - -- - - -
~ 3,0
0
t
so+ - - - - - - -
fil
0::
40+ - - - - -
=>
~
!Z
2,5
2,0
~ 1,5
z
';!! 30+--->---
8 1,0
20
..,. 0,5
10
6
10
15
20
giorni
Ilii Untreated
lii Treated
25
l
=> Decreases the Squalene content of
10
settimane
30
=>
lliil Squalene • Llnoleic Acid
12
l
Reduces excess lipids
acne affected skin
EFAITG
z
o
90+------------------~
~
85
~
80+-------------~
J:
z
75+-------+-------~
~
70+--------#-------~
:;::
0,5
WEEK1
=>
Significantly reduces EFAITG ratio
::>
WEEK2
lncreases skin hydration by 97%
Please see a brief summary of prescribing information on next page
~
BRIEF SUMMARY
KfRATOJ'ALACNE .
THE GENTLE ANTIACNE
TREATMENT WITH
NO-DRUG CONTENT
DESCRIPTION
Keratotal Acne is a special fat-free lamellar
phosphatidylcholine emulsion developed
for the treatment of acne. lt is delivered in a
special phospholipidic-vehicle linoleic acid
rich which contains glicolic acid and salicilic
acid partially neutralized by a special
patented blend of aminoacids
INDICATIONS
Keratotal Acne is indicated for the
treatment of acne. Absolutely necessary as
a cosmetic substitute or support in presummer and summer periods, when
treatment with conventional keratolitic
agents (benzoil peroxide, retinoic acid,
ecc.) is not recommended. Penetrates
pores to eliminate excess sebum, most
acne blemishes, acne pimples, blackheads
and whiteheads in a short period treatment.
lts continously use helps to prevent the
development of new acne efflorescences
For more information
cali to:
Mavi Sud Sri
V.le dell'Industria 1
04011 Aprilia (LI)
ltaly
Tel.+39.6.92.86.261
Fax +39.6.92.81.523
E-Mail:[email protected]
URL=http://www.colosseum.it/st81/mavi
ADVERSE REACTIONS
In the first days of application transient
effect such as stinging or itching may be
observed
HOWTOUSE
Twice a day. Before applications cleanse
the skin thoroughly; if stinging occurs,
reduce application to once a day for the first
ten days of treatment
REFERENCES:
1,2 - Data on file Mavi Sud
- M. Ghiczy, H.P. Nissen, H. Biltz (1996) The treatment of Acne Vulgaris by phosphatidilcholine from
Soybeans, with a high conteni of linoleic acid. J. Appl. Cosmetol. 14, 137-145
3
A NEW MAVICEUTICAL®
Lip protective with Glycoaminoacids<*>
INDICATIONS
Cosmetic adjuvant in all the forms
of cheilitis and lips dryness caused
by:
Such as
• Retinoids
• • • Cheilitis or chapped lips
• UV rays
• • • Actinic cheilitis (acute and chronic)
• Wind
• • • Allergie cheilitis
• Weather
• • • ,Exfoliative cheilitis
• Environmental pollutants • • • Angular cheilitis
HOW TO USE
Use day and night as a regular lipstick
(*) partially neutralized by a special patented blend of aminoacids
Please see a brief summary of prescribing information on next page
~
BRIEF SUMMARY
KERATOTAlLABBRAM DESCRIPTION
Lip protective with
Glycoaminoacids<·>
IN ALL THE DISORDERS OF THE
MUCOCUTANEOUS INTEGUMENT OF
THE LIPS
Keratotal Labbra is a fasta c ti n g, uncoloured
treatment to protect the lips
from premature ageing and
skin cancer due to UV rays.
lt helps to keeps the lips very
moist and well protected
from the dryness caused by
UV, wind, weather and
environment.
INDICATIONS
In ali forms of dryness
caused by the use of
retinoids or other drugs, or
by environmental pollutants.
To avoid the premature
lips ageing caused by
UV activity.
ADVERSE REACTIONS
No adverse reactions to the
use of this product are
known.
For more information cali to:
Mavì Sud Sri
V.le dell'Industria 104011 Aprilia (Lt) ltaly
Tel. +39.6.92.86.261
Fax +39.6.92.81.523
E-Mail:[email protected]
URL=http://www.colosseum.it/st81/mavi
(•)partially neutralized by a special
patented blend of aminoacids
HOWTOUSE
Apply as a regular lipstick.
Keratotal Labbra is intended
for round-the-clock use.
PUfOLIC®
Integratore dietetico
di acido folico, magnesio
e di acidi grassi polinsaturi 0)-6 ed
20capsu/e
ro-a
PUFOLIC®
BRIEF SUMMARY
Dietary supplement with Folic Acicl, Magnesium ancl
Polyunsaturatecl Fatty Acicls omega-6 ancl omega-3
what?
Dietary supplement with Folic Acid, Magnesium and
Polyunsaturated Fatty Acids omega-6 and omega-3, which
have a high content of DHA (docohexaenoic acid).
when?
Fundamental for an optium development of the brain and retinai
structures in the fetus.
where?
• Activates synapsis and promotes neuron growth;
• controls erythropoiesis;
• optimizes membrane formation by protecting the internal
structures of cells;
• acts within the synthesis of proteins, particularly keratins,
thanks to its optimum, balanced content of folic acid, magnesium, omega-6 and omega-3 (DHA) in 1:4 ratio.
why?
Before, during and after pregnancy, to prevent deficiencies due
to poor intake, absorption and use of FOLIC ACID, OMEGA-6,
OMEGA-3 and MAGNESIUM
and to reduce the risk of
• functional neurologie disorders in the fetus;
•
•
•
•
•
How to use
tn7.
mav1
THE EVOLUTION IN
COSMETIC SCIENCE
spina bifida;
gestational hypertension;
uterine hypercontractility;
skin diseases (psoriasis, atopic eczema, alopecia, etc.);
imbalances among HDL, LDL, VLDL and cholesterol that may
be caused by a deficiency in the above essential nutrients.
1 to 2 capsules daily, according to a physician's directions.
For more information cali to:
Mavi Sud Sri - Viale dell'Industria, 1 Aprilia (LT} ltaly
Te/. +39.6. 92.86.261 - Fax +39.6. 92.81.523
E-Mail:[email protected] URL:http://www.cofosseum.it/stB 1/ mavi
Trimestrale di Dermatologia Cosmetologica
Quarterly Review of Cosmetic Dermatology
EDITOR
P.MORGANTI
PhD.
SECRETARY GENERAL
INTERNATIONAL SOCIETY of COSMETIC DERMATOLOGY
Via Innocenzo Xl, 41 - 00165 Roma ( haly) • Fax +39-6-63.80.839
ASSOCIATE EDITOR
S.D. RANDAZZO
M.D.
Profcs.<;or of DERMATOLOGY
UNIVERSITY OF CATANIA
Via lacona, 7 • 95124 Ca1ania (h aly) ·Fax +39-95-7159894
ASSISTANT EDITOR
M.B.JAMES
M.D.
PROGRAM DIRECTOR
INTERNATIONAL SOCIETY of COSMETIC DERMATOLOGY
JAMES CLINIC
Sui1c 1076 Tanncry Lane Camdcn. Maine 04843 USA· Fax 001-407-9972137
SECRETARY EDITOR
M. PASCOLI
Via Innocenzo Xl, 41 · 00165 Roma (haly) ·Fax +39-6-92.81.523
EDITO RI AL AOVISORY
BOARO
P. AGACHE
G. BELLOMONTE
W.F. BERGFELD
B. BERRA
R.CAPUTO
O. CAR LES IMO
D. CERIMELE
E. CHIACCHIERINI
I .COTTE
M.A. DINA
G. FAB RIZ I
J.A. GRAHAM
L. GAGLIARDI
B. GUARNERI
AJ. JOUHAR
F.H. KEMPER
A.M. KLIGMAN
N. LOPRIENO
S. MADDIN
G. PUGLISI
C.L. MENEG HI NI
N. ORENTREICH
E. PANCONESI
R. PAOLETTI
W.E. PAR ISH
L. PUGLISI
W. RAAB
G. RABB IOSI
A. REBORA
V. RIZZA
G. SALVATORE
A.SANNA
P. SANTOIANN I
H. SCHAEFER
A. SERTOLI
A.STAMMATI
H. TRONNIER
V. VA LKOVIC
MD. Prof. of Dcm1a1. Ccni rc Hosp. Rcgional dc Bcsançon (F)
CChcm, Prof. ofChcm., Food Dcpan ISI. Sup. Sani1à • Romc ( I)
MD. FACP Cleveland Cl inie Ohio (USA)
DSc. Prof. of Biol. Chcm. Un iv. of Mi lano (I)
MD. Prof. and Chainnan. Dcpan of Dcnn:ll. Univ. of Milano ( I)
MD, Prof.. Dcpan. of Dcnn:ll. Univ. of Romc (I)
MD, Pror. and Chainmm. Depart . of Dcm1at. Catholic Univ. of Romc (I)
CChcm. Prof. and Chainnan. Dcpan. Tcchn. of Commcrcc Univ. of Romc (I)
DSc, Prof. of Cosmc1. IPIL Lyon (F)
MD. Prof. and Chainnan. Dcpart. of Phruol. Anal. Catholic Univ. of Romc (I)
MD. Ass. Prof. of Paedria1ic Dcm1a1ologiS1, Ca1hol ic Univ. of Rome (I)
B.Sc, PhD. Dcp1. Dcrma1ology Un iv. of Pennsylvania (USA)
D.Ch. Dcpan. of Pharm. Chcm. ls1. Sup. Sani1à of Rome ( I)
MD, Prof. and Chairman. Dcpan. of Derma!. Univ. of Messina (I)
M.B.MRSC Beacoosfield (GB)
MD. Emeri1us Prof.. Pharmacology & Toxicology. Univ. MunSlcr (D)
MD, PhD, Prof. of Dcrmalol. Univ. of Pennsylvania Philadclphia (USA)
DSc, Prof. of Gene1ica Univ. of Pisa (I)
MD. ERCP Clin. Prof. Dcrma1ol. Div. Dcrmai. Univ. BR. Columbia, Vancouver (C)
CChem. Dcpan. of Phannacol. and Tox. Univ. of Catania ( I)
MD. Prof. and Chairman, Dcp>n. of Derma!. Univ. of Bari ( I)
MD. Clin. Prof. of Dem1a1. New York (USA)
MD. Prof. and Chainnan, Dcpan. of Derma!. Univ. of Firenze (I)
MD. Prof. and Chainnan. Dcpart. of Phannacol. and Tox. Univ. of Milano (I)
MA, PhD. BVSc. Hcad of Environmcn1al Safe1y Division. Unilcvcr Research Schan brook (GB )
DSc. Prof. of Pharmacognosy Univ. of Milano (I)
MD, Prof. and Chaim1an, Dcpan. of Derma!. Univ. of Wien (A)
MD. Prof. and Chairman. Dcpart. of Dcm1a1. Univ. of Pavia (I)
MD, Prof. and Chairman. Depan. of Derma!. Un iv. of Genova (I)
PhD. Prof. of Biol. Chcm. Univ. of Ca1ania (I)
CChcm. Dcpan. ofToxicol. lsl. Sup. Sani1à of Rome (I)
MD, Prof. and Chainnan. Dcpan. of Microbio!. Catholic Univ. of Rome (I)
MD, Prof. and Chainnan. Depan. of Dcnna1. Uni v. of Napoli (I)
Ph.D., Prof. and Scicn1ific Oircclor L'Oreal, Paris (F')
MD. Assoc. Prof. of Allergie and Occupa1ional Dcm1a1. Univ. of Firenze (I)
DSC, Dcpan. ofToxicol. lns1. Sup. Sani1à of Rome (I)
MD. Emcri1us Prof.. Derma1ology.. Univ. Wiuen-Herdccke (D)
Ph.D. Prof. of Physic Rudcr Boskovic lnsl. of Zagrcb (CRO)
GENERAL INFORMATION
The JOURNAL OF APPLIED COSMETOLOGY is an international journal devoted to publisching originai
papers, reviews and other materiai which represent a useful contribution to research on the sk in and on cosmetics.
It is aimed at cosmetic chemists, dermatologists, microbiologists, pharmacists, experimental biologists, toxicologists, plastic surgeons, and ali other scientists· working on products which will come into con.taci with the
skin and its appendages.
The Journal is publisched quarterly in English. It is -distributed to cosmetic chemists, dermatologists, plastic
surgeons, medicai and pharmaceutical schools, medicai libraries, selected hospitals and research institutions
throught the world, and by subscription to any other interested individuals or organizations. Statements and
opinions expressed are persona! to the respective contributors and are nor necessarily endorsed by the
Editor(s), Advisers, Publishers of Distributors of this Journal.
COPYRIGHT
Submitted materiai must be the originai work of the autor(s) and must not have been subm itted for publication
elsewhere.
By submitting a manuscript, the authors agree that the copyright for their articles is transferred to the publisher
if and when the article is accepted for publication. None of the conteni of this publication may be reproduced
in whole or in part, translated, stored in a retrieval system, or transmitted or distributed in any form or by any
means (electronic, mechanical, photocopy, recording or otherwise) without the prior written permission of the
Publishers.
Sections of Journal
The following sections will be features of the Journal:
Originai Laboratory Studies: descriptions of originai investigative laboratory research in cosmetics and related areas.
Special Reports: Items of special interest to the readers, including reports on meetings, societies, legislation, etc.
Generai Artic/es: scientific articles of generai interest to our readers will be considered for publication. These
articles should be concerned with newer developments in such related fields as dermatology, biology, toxicology, etc.
Slzort Communications: the lenght should not exceed S typewritten pages with not more than 3 figures
included. Headings ("Materials", "Discussion", etc.) as well as Summaries are to be omitted. If accepted, these
submission will appear in print in a very short time.
Letter to the Editor: comments on Journal a1ticles are invited as well as brief contributions on any aspects of
cosmetic science. Letters may include figures, and/or references, but brevity is necessary.
Guest Editorials: concise, authoritative, substantiated commentary on specific topics of contemporary interest.
Book Reviews: book and monographs (domestic and foreign) will be reviewed depending on their interest and
value to subscribers. Send materiai for review to the Editor, Dr. P. Morganti. No such materiai will be returned.
Address:
ali papers should be submitted to:
Dr. P. Morganti
INTERNATJONAL EDIEMME
Via Innocenzo Xl, 41
00165 Rome - Italy
Te!. 0039/6/393.78.788
Fnx. 0039/6/63.80.839
INFORMATION FOR AUTHORS
Papers must be submitted in Eng lish. Authors whose mother tongue is not English should arrange for the ir
manuscripts to be written in proper English prior to submission.
Procedure of Submissio11 of Manu scripts: submit three cop ies of both the manuscript and all illustrati ve
materiai to the above address.
Orga11izatio11 of the Ma11uscript: investigati ve studies s hould be organi zed as follo w: title, abstract page,
introducti on, materi ai and method s, results, d iscussion. acknowledg ments, references, legend for figures,
tables. All pages should be numered consecuti vely starting with the abstract. The entire manuscript is to be
typewritten, d ouble-spaced, and with 3 cm margins.
Tracie names must be capitalized: the common name for compounds may be used if the formai chemical name
as established by international convention is g iven after the first use. Any abbrev iations other than those which
are generall y accepted must be d efined. In the text, references to dual authors will use both surnames throug hout. For mul tiple authors, use the surnames o f al! authors at the fi rst refcrence and onl y the first author fol lowed by "et al." thereafter. Please mark in the marg in o f the manuscri pt the desired position o f the fi g ures and
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Title page: list the title, name(s) and degree(s) of author(s). department(s) and institution(s) at which the work
was done, city, state, and postai code. Any preliminary report or abstract of the work should be re ferred to as a
footnote to the title.
Summary: each paper must be headed by an English lang uage title of not aver 70 c haracters (including spaces) suitable far use as a running head and must also be proceded by an Eng lish summary not exceeding 300
words ty ped double-spaced. The summary wi ll include statements of the problem, method of study, results,
and conc lusions. S ince this summary w ill be used by astracting journals, it must be self- explanatory aild
should not inlcude abbreviations, footnot es, and references.
Foot11otes: should be li sted consecutively at the bottom of the page on which they fall , designateci by the fo llowing symbo ls in a rder *,+,+,§. II,**, etc.
Key Words: key words far computerised s torage and retrieval of in fo rmatio n should be incorporated in the
summary.
Refere11ces: the references have to be abbreviateci as listed in the lndex Medicus. The style of the references
must conform to thc examples given below:
I) Robbins CR, Ke llych ( 1970) A mi noacid composition of human hair. Text Res J 40:89 1-896
2) Strehler BL ( 1977) Time, cells and agi ng 2nd edn. Academic Press, New York
3) Ebling FJ. Rook ( 1972) Ciclic acti vity of the fo llicle. In : Textbook of dermatology 11 , Blackwell , Oxford, p.
1567-1 573.
Illustratio11s: fig ures should be numbered co nsecutively using Arabic numerals Tables should be numbered
consecut ively, using Roman numerals. Ali photographs should be black and white, g lossy and unmounted. The
number and size of illustration s hould be restricted to the minimum needed to clari fy the text. Authors requi ring extra space far illustrations w ill be charge accordingly. This is also the case for color illustrations. All
fi gures, photographs, graphs, or diagrams s hould be submitted on separate sheets .
A nimai Experiments: descriptions o f animai experi ments should include full d etails of the types of animai
used (inbred, etc.) and the conditions under which they were kept (standard diet , etc .)
Trade Names: all common cosmetic ing red ients should be re ferred to by the ir generic names, as indicatcd in
the latesr editi on of CTFA Cos metic Ing redienr Dicti onary, and the European Pharrnacopeia. Ifa material s i ~
not li sted , then the trademarked name can be used, with the chemical composition given in footnotes.
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Quarterly Review of Cosmetic Dermatology
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Trimestrale di Dermatologia Cosmetologica
Quarterly Review of Cosmetic Dermatology
Contents
Generai Articles
115
125
Biologica! functions and therapeutic properties of urea.
W. Raab
Practical treatment of dry skin.
W. Raab
Originai Laboratory Studies
133
A comparative double - blind within subject study of the efficacy and
tolerability of two different derivatives of Vitamin A on skin thickness and
elasticity: retinoic acid and conjugated retinyl palmitate.
139
147
E. Thom
A new cosmeceutical tor the "orange peel" skin.
P. Morganti. S.D. Randazzo. G.Fabrizi, C. Bruno
Enhancing the glycolic acid efficacy by piezoelectric vibrations.
P. Morganti, S.D. Randazzo, G.Fabrizi
Notes
160
1997 Awards.
Book Review
161
Mechanism of transdermal drug delivery.
Drug and Pharmaceutical Sciences. Series/8
Russel O. Pohs a nd Richard H.Guy Editors
Index
162
lndex to Volume 15, 1997
XIX
Announcements
Clinica! Design Group lnc. - Seminar Series for Medicai Devices
San Diego, CA . January 13/ 22, 1998
6th Congress of European Society for Pediatrie Dermatology
Rom e, ltaly. September 14-1 8, 1999
•
,.,,_lh,........
CARTA ECOLOGICA· ENVIRONMENTALLY PAPER • PAPIER ECOLOGIQUE • PAPEL ECOLOGICO
~
~
J Appl Cosmetol 15, 115-123 (October-December 1997)
BIOLOGICAL FUNCTIONS ANO THERAPEUTIC
PROPERTIES OF UREA
W, Raab*
·Allergy Clinic 'lnnere Stadt' in Vienna, Austria
Received: October 25, 7995
Key words: Urea, Dry skin, Atopy, Glucocorticoid, Moisturizer,
Synopsis
Although urea is know for about 50 years, its use as a topica! drug or as an adjunct is obtaining
more and more attention in topica! dermatotherapy, Urea is absolutely non-toxic, undesirable actions occur only, if skin state and concentration of urea are on a disbalance. Urea proved to be a
most valuable substance for restoring hydration in dry skin and in eczemas due to skin dryness. Therefore, urea ranks among the standards in atopy, for the treatment of eczema as well as for the interval care.
Riassunto
Sebbene si conosca l'urea già da circa 50 anni, il suo uso come farmaco o cosmetico topico sta ottenendo sempre più attenzione nella dermoterapia topica.
L'urea è assolutamente atossica e si possono verificare effetti indesiderati solo nel caso in cui le
condizioni della pelle e la concentrazione di urea siano sbilanciate.
L'urea ha provato di essere una sostanza di grande valore per il ripristino dell'idratazione nella cute
secca e negli eczemi causati dalla cute secca. L'urea si colloca quindi tra le scelte standard nei casi
di atopia, per il trattamento degli eczema e per le terapie di intervallo.
115
810/og1cal funct1ons and therapeutic propert1es of urea
INTRODUCTION
Urea (carbamide), the diamide of carbonic acid.
is a naturally occ uring degradation product of
various prote ins in man. Up to 30 g were produced dail y. Urca is found in ali organs and body
liquids. On thc skin s urface, urea is an important component of the natural moisturi zing factor containcd in the hydrolipid e mu lsion.
About 50 years back, urea was reccommended
for the top ica! treatm e nt of hand eczema but
onl y 30 years back. the first experimental data
were collected on its biochemical and pharmacolog ical acti vi ti es. The moi sturiz ing capacity
of urea in the s tratum corneum, especia lly in xerotic states, was discovered. In 1988, a symposium was he ld in Salzburg, Austria, the proceedings of which contain all the information available on the various acti ons of urea in dermatology and cosmetol ogy ( 1). The more recent pubblications are compi led in a rev iew article published 1993 (2).
Today, urea belongs to the standard s ubstances
used in dermatolog ica! therapy and skin care.
TOXICITY
Urea lacks any systemic tox ic ity. Urea formerly
was used as a diurctic drug; doses up to I .O g/kg
bodyweight were given intravenously, without
any undesirable action.
Therefore, fo ll owing absorption from exte rnal
pre paration s, no tox ic effects o f urea can be
found.
T he tolerance of urea de pends on the state of the
skin and on the concen tration of urea. The vehi cle applied may influence the tolerance, too. On
health y s kin , urea may be used in concentra tion s up to 20% . Most products, however, contain 5- 10% of urea, onl y, as iffitating effects on
slightl y da maged s kin s hould be avoided. S uch
e ffec ts might develop as a co nsequence of
osmotic act ivity.
116
BIOCHEMICAL FUNCTIONS
OF UREA ON THE SKIN
Urea is an important component of the natural
mo is turi z ing factor of the stratum corne um.
Water is bound by a n inc lusion in the c rysta l
s tru ct ure o f urea and o nly s lowly liberate d.
Urea s tems from the sweat a nd from the process o f keratinization. The natural moi s turi z ing fac to r co ns is ts of va ri ous ions (24%),
py rrolidone carbo xy lic acid ( 12%). va riou s
o the r ca rb oxy l ic ac id s (50%), am ines and
am ides ( 17%) and urea (7%). One s hou ld not
undcrsti mate the amount of natural mo is turi z in g fac to rs in the s tratum corneu m w ic h
make up abou t 25% of the d ry weig ht of the
total horny layer.
S tratum co rn e um of health y sk in co ntain s
about 40 M urea per lo M amino acids w hich
co rrespo nd s to about 28 µ g/2.5 c m2 (2). In
dry sk in , urea conte nt is signi ficant ly lowe r
(50% in some ins tances, only). C lin ically normai s kin of a topic individuals cont a ins o nl y
30% urea compared to normai va lues. In c li ni c all y d iseased s kin (a topi c eczema), urca
co nte ni is lowered to 20% of no rm a i va lu es
(Fig. 1, 2).
From these data the co nc lu sion may be reached tha t urea is one of the m ost im portant
components of the natural moi sturizing factor
of human sk in.
MOISTURIZING ACTIVITY OF
UREA
Urea exerts a wide ra nges of pharmacological
acti vities when applied on the skin:
- moisturi z ing acti vity,
- desquamating actio n (lysis of cementing subs tance),
- an timicrobial action (uptake of wate r in terferes with the growth requirements of microorganisms),
WRaab
U RF. \ IN HUMA'I SKI:\
µg/ 2.5 cm.!
30
29.8
lo~d pm cm 2
27.9
25A
20
16.1
13.7
12.3
10
Tot:.tl
Fcmalc'
10-'
Normai SkinO
Fig. I
UREA IN ll U\l AN SKIN, R EI.ATEO TO AGF. A'> D DRYNESS
25
µg/2.5 cm'
20
15
IO
101
IOOOmin
··-----··
16 - 20 a
lleallhJ Sk in
0
.11 - 40 a
21 - 30"
Skin of Alopic l'cr~ons
A•-----.t.a
0
Atopic Ectcma
O
Fig. 2
60
••t------i••
1orr urca in \\ ater-i n-oil emulsion
"•1ter-in -oil emulsion <ilone
trilialcd "ater alone
Fig. 4: The influence of ureo on the water binding copocity of humon strotum corneum (Wohlrob from 3).
%"/n \\:ll cr u ptnkc
50
40
30
20
IO
Il
20
34
Normai
o
23 38
P,orimic
nd: noi done
Pl:iin \\'::Her
O
4Mll glJcerol
O
o
nd 58
lchthyo1ic
5.1\111 urca
13
Fig. 3: Water uptoke of normai, psoriotic, ond ichfhyotic
strotum corneum following immersion in vorious solutions
(Swonbeck, from 3).
- "antiinfl amma to ry" acti o n (antipro li fe rat ive,
anti edcmatous, antipruritic).
- enzyme inh ibiting actio n (mostl y against proteases) and
- keratolyt ic act io n (true ke ratinolys is occurs
under the influence of urea in a concentration
o f 40%).
T he mos t impo rtant (and therapeuticall y most
w ide ly used) ac t ion of urea is its moist uri z in g capac it y. By imm e rs ing s t ra tu m co rne um fro m dry skin (psoriati c, ic hthyotic) in
S M ure a/ I, the uptake of water could be sig nifi cantly inc reased. In these experimen ts,
urea sho we d definite ly high e r a c tivity t han
g lyce ro l, a hum ectant whi c h is w ide ly used
in cosme ti c produc ts. In another se ries of e xpe rime nts, tritia ted wa te r was applie d o n the
s kin s ur face in th e fo rm of a wa te r-in -oi l
117
81olog1col tunct1ons and theropeut1c propert1es of ureo
emulsion with 10% urea . The water retention , judged b y ho w long tritiated wa ter
could be detected and in which amount, was
s ig nificantly higher than in the controls with
the vehicle alone. (Fig.4).
The application of urea containing emuls ions
decreases skin roughness due to the mo isturizing action of urea; maybe, the desquamating
action of urea contributes to this effect. In
atopic skin, this decrease in roughness, judged by the repli ca method , was expec ia ll y
pronunced. (Fig. 5, 6).
A vast number of experiments has been conducted to ascertain the moisturizing property
of urea (figures 3, 4, 5, 6). Various methods
have been used to probe this effect: corneometry, measurement of conductivity, evaporimetry and profilometry. By electron microscopy,
a loosening of the Jayers within the stratum
corneum could be demonstrated, indicating a
moisturizing effect (2) . Cf. Fig. 7 , 8, 9.
In diseased skin , too, experimental investigations have been performed to demonstrate the
moisturizing (and antieczematous) action o f
urea. In the European Study (Barcelona, Hamburg, Vienna) a statistically significant increase in mo isture and a statisticall y significant
decrease in TEWL occu rred following a fo ur
week treatment of atopic eczema with a preparation containing I 0 % urea (4 ). Cf. Fig. I O.
% decrease of roughness parameters
30
20
IO
Placebo
Stan
Urca cream
Fig. 5: Decreose of skin roughness porometers RZ ond RA
60 min. otter the oppticotion of o silicone-contoining woter-in-oil emutsion with 5% ureo os compored to the vehicle without ureo. Meon volues of ten normai individuo/s
were given (Puschmonn from 3).
% dccrease or roughness parameters
30
20
KERATOLYTIC ANO
DESQUAMATING PROPERTIES
OF UREA
In concentrations up to 20%, urea exerts a concentration-depending desquamating action on
the stratum comeum. By this effect, skin penetration is facilitated. Cf. Fig. IO, 11.
In a 40% concentration, urea has been shown to
exert true keratinolytic properties. Nail plates in
fungal diseases may thus be dissolved.
118
10
Stan
I day
5 day
8 day
Fig. 6: Decreose of skin roughness porometers RZ ond RA
following the use of o silicone-contoining woter-in-oil
emulsion with 5% ureo. Meon volues of 9 o topic individuols were given (Puschmonn, from 3).
W Roob
140
,.--~~~--t•t-~~~-·~~~---i·---------.
130
''
120
..:':
''
''
:,,'
'
'' '
110
'
''
'
'
''
"
'
.......... .. .. ...... ..
-·------ --------·------------..... -------------·------------··:&
60
90
75
105
120
time/min
••1----~•• Oil-in-water emulsion with 5% urea
•a-----..,••
Oil-in·water emu lsion without 5% urea
••1----~•• Untreated control site
Fig. 7: Skin moisture ofter opp/icotion of o silicone-contoining oil-in-woter emulsion with ond without 5% ureo. meosurement by determinotion of the dielectric constont. Meon volues of 35 heolthy individuols were given. (Puschmonn,
from 3).
140
130
120
110
100
90
IO
Pre-treatment phase
.Àr.ol~----•• Placebo
15
Treatment phase
••1-----••
25
Post-treatment phase
days
5 % Urea
Fig. 8: Skin moisture following the opp/icotion of o silicone-contoining oil-in-woter emulsion with ond without 5% ureo
tor two weeks. Meon volues of 6 heolthy individuo/s were given (Puschmonn, from 3).
119
Biologica! functions and therapeutic properties of urea
Fig. 9: Hyperkerototic skin in chronic eczema before ond offer the opplicotion of ureo 10% + solicylic acid 5% tor 10 days.
REM materio/ from biopsies, mognificotion 2.5(),J x.
From 2, with the permission of the outors Plugshoupt ond FrCih.
European Study
10% Urea in Chronic Eczema
Hydration
TEWL
+80%
69U(!)
+30%(!)
Start
4 wceks
Start
C oncomitant cli11ical ammelioration
Fig. 10
120
D
4 wceks
WRaab
ANTllNFLAMMATORY
ACTIONS OF UREA
USES OF UREA
IN DERMATOLOGY
An antiproliferative effect of urea has been demonstrated in states of accelerated cellular turnover (e.g. psoriasis vulgari s) but no atroph ogenic effect in norma i skin could be observed.
The antiedematous ac tion of urea is c onnected
with its diuretic acti vity. In states of lymphostasis, a dramatic response can be evoked by topic a! applications of I 0% urea.
The antipruritic acti vity of urea mainl y is due to
its moisturi zing capacity. On the other hand , a
directed influe nce of urea on those enzymatic
activ ities whi ch provoke itch could be de monstrated.
Urea alone
ANTIMICROBIAL ACTIVITY
OF UREA
By its strong wate r binding capac ity, urea inhibits the growth of mic roorganisms. Therefore,
urea may be regarded as a preservative-saving
substance.
Dry skin , old skin , photodamaged skin.
Atopic skin , (therapy and interval skin care).
Psoriasis vulgaris and other scaly derm atoses.
Ichth yosis and ichthyos iform skin c onditions,
hype rkeratoses, keratose s.
Onycholysis (40%!)
Urea in combinations
With glucocorticoids (hydrocortisone, halc inonid): atopic eczema, chroni c dry eczema, Psoriasis vulgaris, ali old, hype rkeratoti c, scaly, resistant inflammatory skin lesions. (5-1 0% urea,
O, 1- 1% steroid).
With anthralin ( 17% urea + 0,5-2% a nthral in):
Psoriasis v ulgaris, prolonged app licati ons or
short contact therapy.
M"ale score
Trnnsmissio n ( 1apc mcthod )
UREA COMBINED WITH
OTHER DRUGS
Via three mechanisms, urea increases the pharmacological acti vities of othe r simul taneously
applied drugs:
- v ia its moi sturizing ca pac ity (inc re ased absorption),
- via its desquamating properties (increased absorption) and
- vi a the formation of hydrophilic adducts (incre ased re lease from the pre paration and in creased uptake by the skin).
Lastly, synergistic effects much be mentioned
between urea and some topically applied drugs
with antiinflammatory or ke ratolyti c acti on. An
e xample is shown in Fig.9.
80
2.5
60
~o
1.5
20
0.5
O
C
\'
J'k U IOL
C: Control
V: Vehicle
Fig. 11 - Desquamating action o f urea
12 1
81olog1col funct1ons ond theropeut1c propert1es of ureo
With polydocanol (5% urea + 3% polydocanol): atopic eczema, treatment and interval skin
care.
With tretinoin (10% urea + 0,03% tretinoin):
non-inflammatory, non-erythrodermic ichthyosis.
With salicylic acid (10% urea + 5% salicylic
acid): stubborn hyperkeratosis, corns, eventually warts.
With bifonazole (40% urea+ 1% bifonazole):
onychomycosis.
Among the combinations of urea with other
drugs, the preparations containing urea and a
glucocorticoid have found widest application.
Urea increases the biovailability of the steroid
("hydrocortisone develops into triamcinolone")
but does not alter the incidence and severeness
of undesirable effects.
122
W Raab
REFERENCES
1. Raab, W. (Editor) (1989), Harnstoff in der Dermatologie, Hautarzt 40, Suppi. IX.
2. Raab, W. (1993), Harnstoff in der Dermatologie, TW Dermatologie 23: 257-269.
3. Raab, W. (1990), Use of urea in cosmetology, Cosmet. Toiletr. 1054: 97-102.
4. Vilaplana, J. et al. (1994), Jnternationale, multizentrische Prilfung der Wirksamkeit und Vertraglichkeit der externen Therapie chronischer Ekzeme mit ei nem 10% igen Harnstoffpraparat,
Akt. Dermat. 20: 227-231.
Author Address:
Univ. Prof Dr. W. Raab
Walfischgasse 3
A - 1010 Vienna, Austria
123
J. Appl Cosmeto/. 15, 125-131 (October-December 1997)
PRACTICAL TREATMENT OF DRY SKIN
W. Roab•
· Medicai Director, Allergy Clinic ' lnnere Stadt' Vienna , Austria
Received: October 25, 7995.
Key words: Dryness, Moisture, Ultraviolet, Age, Phot odamage, At opy.
Synopsis
Dry skin rnay result of exogenous or of endogenous factors. Exogenous fac tors may be excluded by
informing the patient of his fa lse behaviour. If endogeno us factors are the cause of the dry skin state,
reasonable measures of skin cleansing, skin care and skin protection sho uld be considered.
Riassunto
La pelle secca può essere il risultato di fattori esogeni o endogeni. I fattori esogeni si possono eliminare facendo presente al pazie nte il suo comportamento errato. Nel caso invece in cui siano fatto ri
endogeni la causa della secchezza della pelle, dovranno essere prese in considerazione misure adatte
per la sua de tersione, cura e protezione.
125
Proct1cal treatment of dry sk1n
INTRODUCTION
Water is the softener of the horny layer and sec ures smoothness, elasticity and suppleness.
Under normai conditions, water enters the
horny Iayer via transdermal diffusion (TEWL).
The evaporation of water from the skin surface
is prevented by the action of the natural moistourizing factors (NMF). The water balance of
the horny layer is depicted in figure 1, the composition of the NMF is shown in figure 2.
Dry skin is either caused by external factors or
by endogenous changes.
EXTERNAL CAUSES
OF DRY SKIN
Among the external causes of dry skin, abuse of
soaps and detergents must be mentioned on the
first hand.
But often a prolonged contact with water is the
reason for skin dryness, as the NMF is dissolved
and rinsed off.
For facial skin, prolonged exposure to a dry environment causes skin dryness, unless the water
loss is prevented by the application of moisturizing skin care products.
ENDOGENOUS REASONS
FOR DRY SKIN
Water balance of the horny layer
Evaporalion
~
D
Drv, air movement
fewNMF, large surrace
Fig. 1
NMF of Human Skin
There are three endogenous reasons for dry skin:
- constitution, especially atopy,
- genetic ageing and
- photodamage.
In atopy, the disturbed barrier function must be
regarded as the main reason for skin dryness.
Furthermore, there is almost always some inflammation present which causes skin dryness.
In senile skin, water Ioss is increased due to the
numerous wrinkles and folds wh ich increase the
surface. Furthermore, water supply is decreased
as generai circulation is reduced and an atrophy
of rete plugs occurs (reduced size of the contact
area with the supplying derma! tissues).
In photodamage, the surface is even more increased than in senile skin as there are numerous wrinkles and deep folds (elastosis); solar
keratoses provoke a further increase in water
loss. - The mechanisms for endogenous dry skin
are depicted in figure 3.
SIGNIFICANCE OF DRY SKIN
Fig.2
126
For the patient, dry skin causes an unpleasant
"old and neglected" appearance. Steady application of skin care products is needed to counteract
W Raab
itch and tension. From the dermatologica! point
of view, dry skin often is the cause of eczemas
and infections, especially in older persons.
REGIMEN IN DRY SKIN
Three important measures have to be taken to
cou nteract dry skin and to prevent the disturbing consequences of this skin state:
- mild, non-alkaline skin cleansers,
- regular application of O/W or W/0-emulsions
with moisturizing compounds, and
- skin protection against ali kinds of environmental influences (ultraviolet, heat, cold).
CLEANSING MEASURES
IN DRY SKIN
Skin cleansing may be effectuated by the application of
- natural (soaps) and synthetic detergents (syndets),
- adsorptive cleansing agents (e. g. oatmeal),
- desquamating agents ("exfoliation") and peeling agents,
- dermabrasive agents, e. g. polyethilene granules (cf. 2,5).
The best way of cleansing dry skin is the use of
slightly acid, mild detergents. In cases of very
sensitive skin, in atopy or in atrophic skin, the
use of adsorptive complexes should be preferred. Oatmeal extracts, prepared for cleansing
purposes, contain complexes consisting of polysaccharides, oligosaccharides, oils and proteins.
That means that the complex exhibits lipophilic
and hydrophilic groups on its surface thus permitting the removal of lipophilic and hydrophilic "dirt" (substances from the environment, decomposition products of sweat, sebum and topically applied preparations) by adsorption.
Figure 4 demonstrates the roughness of the skin surface following the use of soaps, detergents or adso1ptive cleansing agents with smoothing additives.
Fig. 3
SKIN ROUGHNESS AFTER CLEANSING
20-
15
10- - - -
~-
Sta ri value
- - - - - -
5-
------------------------- ----------------·
/
Soap
O il bath
Sinder and additives
Adsorptive cleanser
and addith·es
Fig. 4: Skin roughness affer different forms of cleansing, determined by the colour retention method
127
Proct1col treotment of dry sk1n
SKIN HYDRATION
Skin hydration may be effectuated by the appl ication of e mollients (pseudo-occlusi ve effect
closi ng small clefts on the surface of the stratum
co rne um), by the a ppli cation of mois turin g
compounds, or by the increase of oxygen tension in the stratum corneum. The various possibilities of increasing hydration in the stratum
corne um are depicted in figure 5.
Among the moisturizers, humectants (e. g. glycerol) and moisturizers have to be me ntioned.
Mo isturi ze rs s uc h as mucopol ysacch arid es
(hyaluronic ac id) are preferable as they retain
water even in a dry environment and offer it to
the horny layer. Under such unfavorable cond iti ons, humectants may eve n wi thdraw water
fro m the skin (cf. fig ure 6).
T he obse rva ti o n that oxygen tens ion in th e
horn y layer decreases steadily wi th inc reas ing
age (figure 7) has provoked investigations of the
changes in dry skin follo wing the application of
oxygen de livering preparations ( 1).
In fac t, applications of a cream containing oxygen (4,5%) in 10% perfluordecaline signi ficantly increases oxygen tension in the horny layer
as compared to the vehicle (6,7). Cf. figure 8.
Para llel to the increase in oxygen tension an increase in moisture was noted (figure 9). Furthermore, wrinkle number and depth decreased under the influe nce of an oxygen de!ivering cream
(figure I 0).
Fig.5
WATER UPTAKE (g/lOOg)
100%
Relali"e humidity: 33%
I
Rela ti"e humidity: 75%
I
80%
60%
P) rolidone carbo~y l ic acid
O
Glycerol
O
Fig. 6: Water uptoke by different moisturizing compounds. hmuectonts ond true moisturizers depending upon the humidity in the environment
128
W Raab
OXYGEN IN AGEING SKIN
40
""
~
=
=
30
o
............
Q.
20
-----.:::':"::".:":~:::::::o=:'lll'9~..............
~~~~~~~~~~~~
Rise factors for microangiopathia
----------
IO
age
o
20
30
50
40
60
Fig. 7: Oxygen pressure in the skin, depending upon age. Note the reduced oxygen pressure in persons with risk factors
for micorangiopathis such as cigarette abuse
OXYGEN IN HUMAN SKIN
40
4.5% 02 in PerOuordecaline (hvice daily)
30
20
days
IO
8
12
16
20
24
28
Fig. 8
90
SKIN MOISTURE
::=
~
~
~
80
70
~
STOP
~
3
E
o
u
4.5 % 02 in 10 % Perfluordecaline (twice daily)
60
50
40
days
JO
4
12
16
20
24
28
Fig. 9
129
Proct1col treotment of dry sk1n
SKIN PROTECTION
Most forms of environmental stress increase
skin dryness. Therefore, protection against physical influences or, even better, avoivance of
those plays an important role in treatment and
prophylaxis of dry skin states. Ultraviolet irradiation , UVB as well as UVA, provokes skin
dryness due to alterations of the epidermis and
the dermis over the years (3, 4). As it is non realistic to try to keep people out of the sun, doctors should advise their patients to apply sun
protecting creams in a reasonable manner.
DEPTH ANO NUMBER OF WRINKLES
AFTER OXYGEN SUPPLY (14d )
30
15
20
10
10
5
Fig. 10
130
Number
Deplh
W Raab
REFERENCES
1. Artmann, C. et al.(1993), Sauerstoff in der Haut. Ein neuer Parameter der Hautalterung, SOFW
J ournal 1993 15, l -5.
2. Raab, W. (1990), Skin cleansing in health and disease, Wien. Med. Wschr. 140, Suppi. 108.
3. Raab, W., Zeitalterung und Umweltalterung der Haut, hautnah 611994 Dermatologie, 589-594.
4. Raab, W. (1994), Reinigung, Pflege und Schutz der Altershaut, Handbuch der Gerontologie. Bd.
7, 365-388, Fische1; Stuttgart, l ena, New York.
5. Raab, W. und U. Kindl (1997), Pflegekosmetik. Fischer und Covi, Stuttgart und Eschhorn (2 11d
ed.).
6. Stanzi, K. et al.(1993), A new cosmetic product containing molecular oxygen, Eurocosmetics
1993 l , 1-6
7. Zastrow, L. et al., The effectiveness of molecular oxygen in cosmetic form ul ations, In press.
Author Address:
W. P. Raab, M. D., FAAD
Professor in Dermatology
3, Walfischgasse
A-1010 Vienna, Austria
131
'
J. Appl Cosmetol. 15, 133-138 (October-Oecember 1997)
A COMPARATIVE OOUBLE-BLINO WITHIN
SUBJECT STUOY OF THE EFFICACY
ANO TOLERABILITY OF TWO OIFFERENT
OERIVATIVES OF VITAMIN A ON SKIN THICKNESS
ANO ELASTICITY: RETINOIC ACIO
ANO CONJUGATEO RETINYL PALMITATE
Erling Thom, Ph,D, •
"Medstat Research Ltd, Lillestn2im, Norway
Received: June 78, 7997.
Key words: Retinyl palmitate. Retinoic acid. C omparative study, Skin elasticity, Skin thickness.
Synopsis
A randomized comparative double-blind within subject study of topica! administration of two differe nt Vitamin A preparations - conjugated retinyl palmitate, RP (0,2%) and retinoic acid, RA
(0.025%) for 3 months in 20 females caused significant changes in skin thickness and elasticity as
well as in the participants own judgment of skin improvement using visual analogue scales.
The results indicate that both galenica! formulations exert a comparable effect, while the tolerability
of the RP formu lation was significantly better. It might be of great importance for the efficacy of the
RP cream that the compound is conjugated and thus hav ing a better skin biovalability than unconjugated RP has. Whether the clinial effect is due to metabolism of RP to RA or re tino! in the skin can
not be answered by this study, but should be subject to further percutaneous absorption studies.
Othe r studies indicate that the mechanism of action for RP creams might be due to biotransformation to retino! rather than to RA.
Riassunto
Uno studio randomizzato a doppio-cieco è stato condotto per tre mesi su 20 donne utilizzando due
divers i preparati a base di vitamina A: retini! palmitato coniugato (RP 0,2%) ed acido retinoico (RA
0.025%). Le due formulazioni hanno provocato cambiamenti significativi sia nello spessore che nella elasticità della pelle .
I risultati indicano che entrambe le formulazioni galeniche svolgono un'attività paragonabile, ma la
tollerabilità della formul azione RP è stata significati vamente maggiore. Potrebbe essere di grande
importanza per l'efficacia della formulazione RP il fatto c he la miscela sia coniugata ed abbia perciò
una biodisponibilità cutanea migliore rispetto ad un RP non coniugato. Questo studio non ha potuto
rispondere al quesito se l'effetto clinico sia dovuto al metabolismo dell'RP che si trasforma in RA o
in retinolo nella pelle. Questo argomento dovrebbe essere oggetto di ulteriori studi sull'assorbimento
percutaneo. Altri studi indicano che il meccanismo d'azione delle creme RP può essere dovuto alla
biotrasformazione in retinolo, piuttosto che in RA.
133
A comporot1ve double - blmd wlfh1n sub;ect study of the eff1cocv ond tolerob111tv.
INTRODUCTION
Data has previously been reported on the efficacy and tolerability of a skin cream containing
conjugated Retinyl palmitate (RP) (1,2). The
aims of these two studies were to investigate the
effect of the cream on skin thickness and elasticity and in add ition to study the duration of the
effect after treatment was stopped. From these
studies we have clearly documented that use of
conjug ated RP results in an increase in ski n
thickness and an improvement in skin elasticity.
These observations have been co nfirmed by
others (3,4) using other measuring techniques.
RP is a widely used ingredient in cosmetic formulations. Because it is the most stable of the
available vitamin A esters it can be directly incorporateci into an anhydrous base or the oi l
base of a cos metic c ream or lotion. RP is li pophilic and photostable. Ofter products containing RP are advertised as having benefica) effects on the appearance of the skin. A great
number of products containing RP are marketed. Previous studies suggest that enzymes present in the skin metabolize RP during skin absorption. Esterase activity hydrolyzes RP to retino) (Vitamin A), wich is oxidized in many tissues to Retinoic acid (RA) primarJy by alcohol
dehydrogenase. RP can therefore be class ified
as a prodrug where the inactive RP is transformed to active substances by metabolic biotransformation reactions in the skin.
Recently a number of studies have been carried
out with RA c reams showing that this compound has a positive effect on photo-aged skin
(5-8). Preparations containing RA have been registered in some countries as e thicaJ drugs for
treatment of aging skin. However, one main
drawback with this type of treatment is that a
number of patients (4-10%) develop soreness in
and miscolouring (redness) of the skin (6).
As mentioned above RA has been convincingly
documented as having an effect on the treatment
of the aging skin and retino) is also a compound
with know pharmacological activity (9). Pre-
134
vious studies have shown the formation of alltrans-retinoic acids after topica) application of
ali-trans-retino! in vivo in hairless mouse skin
(10). Recently, however, a study showed that retino! was the onl y de tectabJe metabolite following administration of RP both in guinea pig
and human skin, while no retinoic acid was detectable ( 11 ). About 30 and 18% of topically applied RA were absorbed from an acetone vehicle by hairless g uinea pig and human skin, respectively. Less than I% of the applied dose of
RP diffused from the s kin into the receptor
fluid. In human skin, 44% of the absorbed RP
was hudrolyzed to retino!.
An essential prerequisite for an optimaJ pene tration of the lipohilic RP into the skin is to modify che solublity of the compound by the use of
tweens ( 12, 13). The producer of the RP preparation used in this srudy has developed a process
where RP in conjugated with a complex polysaccharide thereby making the compound water
soluble. In thi s way the penetration of RP through the skin and into the diffusion celi receptor
fluid is enhanced. The same technique has been
used succesfull y to enhance the bioavailability
of drug substances both administered perorally
as well as topicall y ( 14).
Based on the abovementioned infonnation and
our previous experiences with conjugated RP, we
decided to carry out a clinica) comparison on skin
thickness and skin elasticity following treatment
with an cream containing either RA or conjugated
RP in order to gain an indirected impression of
the bioequivaJency of these two substances.
MATERIAL ANO METHODS
The study was carried out as a randomized double-blind study in 20 femaJes with each participant using both formulations one on the right
and the other the left volar (protected) part of
the forearm, respectiveJy. The administration of
the formu lations was randomized, such that haJf
of the partici pants used formu lation A on th e
E. Thom
right arm and formulation B on the left ann and
vice a versa for the other women. The tota!
treatment period was 3 months and administration was b.i.d. (in the morning and evening) during the study period. The study was carried out
in accordance with the Declaration of Helsinki.
The investigational formulations
The two formulations used in this study were: A
conjugated RP cream made by Pedersens Laboratorium, Vejle, Denmark, containing 0.2% RP
and a cream containing 0.025% RA made with
the same cosmetic properties and apperance as
the conjugated RP cream. Formulation A is
identica! to the marketed preparations Sincera®,
Demelle®, Luscinia® and Rebilt®. The investigational products were packed in identica! packages in order to keep the study blinded.
Measurements of skin thickness
and skin elasticity
The measurements of skin thickness and skin
elasticity were performed by ultrasound using
Dermascan A and Dermaflex instruments, respecti vel y (Cortex Inc. Aa rhu s, Denmark).
Measurements were carried out at baseli ne, after
1 month and after 3 months, by the same person
(ET) on ali three occasions and measurements
were performed at the mid-region of the volar
part of the forearm. Ali measurements were in
triplicate and average values used for statistica!
evaluations.
Se/f-eva/uation
by the partecipant
At the same time as each ultrasound measures
was made, participants made a self evaluation
of skin quality using visual analogue scales of
10 cm with endpoints of "no change" and "very
pronunced change". Subjects were asked to sco-
re the global change in skin quality by placing a
mark on the line between the endpoints. The distance from the zero point (" no change") to the
mark was used as the score for the subject.
Statistica/ methods
A significance level of 5% was used in the tests
and two-tailed tests were applied. Mean was
used for estimation of continous and near continous variables, and Student procedure was used
for construction of confidence interval of the
mean. The one-sample t-test was used analysing
change over time within groups. Analysis of cavariance and two-sample t-test were used to
compare arms with regard to continous variables.
RESULTS
20 females aged between 40 and 60 years (mean
51.4 yrs) were included in the study and ali participants were compliant with the protocol. Ali
participants gave their infonned consent to take
part in the study after having received written
and verbal infonnation about the study.
Efficacy parameters,
skin thickness and e/asticity
The resu lts from the skin thickness measurements are shown in Table I. Formulation A resulted in a average increase in skin thickness of
3 1% compared with 33% for formu lation B.
This increase in skin thisckness was significant
(p<O.O 1) for both formulations, while the difference between the two formulations was not significantly different.
In Table II the viscoelastic properties of the skin
following administration of fonnulations A and
B, respectively, are presented. The results show
that formulation A improved the elasticity by
19% on average, compared with 20% for B.
135
A comparative double - blind within subject study of the eff1cacy and tolerability ...
Both formulations improved the elasticity of the
skin significantly (p<0.01), but again the difference in elasticity improvement between the
two formulations was not significant.
Efficacy parameters,
self-evaluation by use of VAS
The VAS results are shown in Table III.
A significant impro vement (p<O.O 1) in skin
quality was reported for both forearms. The difference in skin improvement between the two
formulations is, however, not significant.
Table I
Changes in skin thickness (mm) after administration of conjugated RP
(A) and RA (B) creams for 3 months, respectively (N=20)
Formulation
Mean (SD)
Range
Mean (SD)
Range
A
B
Initially
0.90 (0.12)
0.71-1.24
0.88 (0.15)
0.70-1.25
After I month
1.01 (0.17)
0.74- 1.27
1.02 (0.15)
0.76-1.30
After 3 months
1.18 (0.1 5)
0.90-1.34
1.1 7(0.17)
0.90- 1.37
Table Il
Changes in skin elasticity (%) after administration of conjugated RP (A)
and RA (B) creams for 3 months (N=20)
Formulation
Mean (SD)
Range
Mean (SD)
Range
A
B
Initiallv
59.3 (7.9)
44.3-81.0
60.0 (7.5)
45.4-80.8
After 1 month
65.2 (8.2)
50.2-81.2
67.2 (8.0)
46.4-81.6
After 3 months
70.6 (8.4)
51.3-85.0
7 1.2 (8.6)
52.4-86.0
Table lii
Changes in VAS scores (cm) after administration of conjugated RP (A)
and RA (B) creams for 3 months (N=20)
Formulati on
A
B
136
Mean (SD)
Range
Mean (SD)
Range
After I month
1.8 ( 1.2)
0.0-3.5
1.9 ( 1.5)
0.3-3.4
After 3 months
6.3 (1.6)
1.0-8.3
6.5 (1.8)
1.2-8.6
E Thom
Tolerability
At each v isit subjects were asked if they had
had any problems and/or side-effects with the
treatments they had used.
Seven of the subjects reported skin soreness after using the RA formulations and 2 of these
aJso reported a considerable redness in the skin
I/2- 1 hour after application. The reported sideeffects are, however, transient and none of the
subjects stopped the treatment due to the sideeffects. One subject reported redness of the skin
following administration of the conjugated RP
formulation.
The tolerability was significantl y in favour of
formulation A, the conjugated RP formulation.
This is also revealed in the preference choice
from the users (see below).
Preference choise from the
subjects
On completion, subjects were asked to give a
preference for one of the two creams they had
used taking into account the effect, the tolerability and the cosmetic properties of the creams.
Thirteen subjec ts prefered the conjugated RP
cream, formu lation A, whi le 4 prefered the RA
cream, and 3 subjects had no preference. The
difference in preference is significantly in favour of the conjugated RP formu lation.
DISCUSSION
the conjugated RP is significantly better than
the RA, the conjugated RP may represent a valuable alternative to RA.
As have been stressed by other investigators
(3,4) it is of utmost importance that the RP is in
a form allowing skin penetration. In a previous
comparative study we reported a significant difference between conjugated and non-conjugated
RP in the effect on the skin parameters (1). The
change in solubility of the RP is probably essential for making the ester available in sufficient
concentration.
To our knowledge no percutaneous absorption
and metabolism studies have been carried out
with conjugated RP. Such studies are needed in
order to explain the mechanism of action behind
the effect seen in skin parameters measured.
The minimal conversion of retino! to RA may
not be relevant to the application of formu lations containing RP to the human skin.
Both retino! and RA can have pharmacological
effects on human skin. Retino! is about 50% as
potent as RA in inducing epidermal hyperplasia
in the hairless mouse ( 11 ).
It has, however, been shown that retino! is formed in hairless guinea pig and human skin after
topica! application of RP, but if further metabolism to R occurs, it is to small to detect. Any
biologica! response of skin treated with retinyl
palmitate formulations may be due to ester hydrolysis of the parent compound to retinol. The
use of RP in cosmetic formu lations may result
in a significantly improved delivery of retino!
into the skin.
In recent years knowledge of the effect and metabolism of vitamin A derivatives in the human
skin ( 15, 16) has been accumulating.
The results from the present study indicate that
both, the 0.025% RA cream and a 0 .2% conjugated RP cream bring about a comparable effect
in skin composition and morphometry. No significant differences could be detected either in
sk in thickness or elasticity improvement
between the two creams. As the tolerability of
137
A comporot1ve double - bilnd wlfhin sub;ect study of the eff1cocy ond tolerobillfy .
REFERENCES
1. Thom E (1993), Skin treatment with two different galenica! fonnulations of retinyl palmitate in
humans,J.Appl. Cosmetol. 11, 71-76.
2. Thom E (1994), Long-tenn effects after topica! application of active retinyl palmitate, J.Appl.
Cosmetol. 12, 45-50.
3. Counts DF, Skreko, Mcbee J, Wich G (1988), The effect of retinyl palmitate on skin composition and morphometry, J.Soc.Cosmet.Chem. 39, 235-240.
4. Fthenakis CG, Maes DH, Smith WP (1991), In vitro assessment of skin elasticity using ballistometry, J.Soc.Cosmet.Chem. 42, 211-222.
5. Kligman AM, Grove GL, Hirose R, Leyden JJ (1986), Topica! tretinoin for photoaged skin,
J.Am.Acad.Dermatol. 15, 836-859.
6. Weiss KS, Ellis CN, Headington JT, Hamilton TA, Vorhess KK (1988), Topica! tretinoin improves photoaged skin: a double-blind vehicle controlled study, JAMA 259,527-532.
7. Bhawan J, Gonzales-Serva A, Nehal K, Labadie R, Lufrano, Thorne G et al. (1991), Effect
of tretinoin on photodamaged skin, Arch.Dermatol. 127, 666-672.
8. Rafal FS, Griffiths CEM, Cherie MRCP, Ditre M, Finkel LJ, Hamilton TA et al. (1992), Topica! tretinoin (retinoic acid) treatment for liver spots associated with photodamage, New Engl J
Med. 6, 368-374.
9. Gilchrest BA (1992), Retinoid phannacology and the skin. In H. Mukhtar (ed.) Phannacology
of the skin, CRC Press, Boca Raton, 167-181.
10. Connor MJ, Smit MH (1987), The fo rmation of all-trans-retinoic acid from ali-trans-retino! in
hairless mouse skin, Biochem Pharmacol 36, 919-924.
11. Boehnlein J, Sakr A, Lichtin Leon J, Bronaugh RL (1994), Characterization of esterase and
alcohol dehydrogenase activity in skin. Metabolism of retinyl palmitate to retino! (Vitamin A)
during percutaneous absorption, Pharm Res 8, 1155-1159.
12. Jarrett A, Jackson RJ (1980), The effect of vitamin A on the skin and istrole as a cosmetic
agent. Abstract 11 th lnternational I FSCC Congress Research and Technology. Venice 23-26 Sept.
13. Spearman RIC, Jarret A (1974), Biologica! comparison of isomers and chemical fonns of vitamin A (retino!), Br J Dermatol. 90, 553-560.
14. Paginton JS (1987), Beta-cyclodextrin: the success of molecular inclusion, Chemistry in Britain 23, 455-458.
15. Wolf G (1996), A history of vitamin A and retinoids, FASEB J 10, 1102-1104.
16. Fisher GJ, Voorhees JJ (1996), Molecular mechanisms of retinoid actions in skin, FASEB J 10,
1002-1013
Author Address:
Erling Thom, Ph.D.
P.O. Box 210
N-2001, lillestrç!Jm, Norway
Fax: (+47)63.81.92.50
138
J Appl Cosmetol 15. 139-145 (October-December 1997)
A NEW COSMECEUTICAL FOR THE "ORANGE
PEEL" SKIN
P, Morganti", S.D. Randazzo .. , G.Fabrizi ... end C. Bruno••••
• President/Director, R & D Mavi Sud S.r.l,, Viale dell'Industria l, 04011 Aprilia (LT), ltaly,
Department of Dermatology, Dermatologists Training School, Il University of Naples, ltaly,
•• Department of Dermatology, University of Catania, ltaly.
••• Department of Dermatology, Catholic University of Rome, ltaly.
•••• Physiology lnstitute, University of Urbino, ltaly.
Received: May 7, 1997
Presented at 2sd Symposium on Cosmetic Efficacy - New York, 28-30 Aprii, 7997.
Key words: TCDS, Cellulitis, Orange-peel skin, Skin hydration, TEWL, 3C System®, Dermoscan
e
Synopsis
"Cellulitis" represents an unaestheticism capable of modifying the harmony of the figure referring to
modem rules. The skin opaque, arid, scabrous and painful to the touch is characterized by a rugged
appearence known as "orange peel skin".
The present study was designed to evaluate the activity of a new Transdermal Cosmetic Delivery
System (TCDS) on the anterior lateraJ surface of the thighs of 30 female volunteers (aged 18-30)
presenting cutaneous signs of "cellulitis" of different degrees of intensity, treated each night for 21
days with this special patch in a double blind study.
Before and after the study the thickness of the cutaneous tissue was controlled by the Dermoscan C®
(Denmark, vers ion 3 at 20-MHz) and skin hydration and TEWL by 3C System®(Rome, Italy). The
TCDS caused a both a decrease of skin thickness, and of the cellulitic layer thickness and a contemporary high increase of skin hydration and TEWL (p<0.005).
No adverse reactions were observed. The obtained results seem to prove the validity of this new cosmeceutical device for the treatment of the so called "cellulitis".
Riassunto
La "cellulite" rappresenta un inestetismo capace di modificare l'armonia della figura secondo i parametri moderni. La pelle opaca, arida, scabra e dolorante al tatto è caratterizzata da un aspetto ruvido
noto come "pelle a buccia d'arancia".
Con il presente studio si è voluta valutare l'attività di un nuovo cerotto transdermico denominato
Transdermal Cosmetic Delivery System (TCDS). La valutazione é stata effettuata sulla superficie
antero-laterale delle coscie di 30 donne volontarie (di età compresa tra i 18 e i 30 anni), che presentavano segni cutanei di una cellulite con diversi gradi di intensità, trattate ogni notte per 21 giorni
139
A new cosmeceut1cal tor the "orange peef" sk1n
con questo speciale cerotto in uno studio a doppio cieco.
Lo spessore della pelle è stato controllato prima e dopo lo studio tramite il Dermoscan C3 (Denmark, versione 3 a 20 MHz), l' idratazione della pelle e la TEWL per mezzo del 3C System*. Il
TCDS ha provocato una diminuzione dello spessore della pelle, una diminuzione dello spessore dello strato di cellulite ed un contemporaneo aumento sia dell 'idratazione cutanea globale (p<0.005) da
addebitarsi essenzialmente all 'attività occlusiva esercitata dal cerotto, che del TEWL.
Non sono state rilevate reazioni collaterali.
I risultati ottenuti sembrano provare la validità di questo nuovo mezzo cosmetico per il trattamento
della cosiddetta "cellulite".
140
P Morgonlt, SO Rondozzo. G Fobrtzt, C Bruno
INTRODUCTION
"Cellulitis" represents an unaestheticism capable of modifying the harmony of the figure referring to modem rules. The skin opaque, arid,
scabrous and painful to the touch is characterized by a rugged appearence known as "orange
peel" skin (1 -3).
STUDY DESIGN
The present study was designed to evaluate the
acti vity of a new Transdermal Cosmetic Delivery System (TCDS) on the anterior lateral surface of the thighs of 30 fornaie volunteers (aged
18-30) presenting cutaneous signs of cellulitis at
d ifferent degrees of intensi ty, localized on the
a nterio r-lateral surface of thighs, treated each
nig ht fo r 21 days with this special patch (4x4
cm ) in a double blind study.
In order to eli minate possible extemal influences 15 women were randomly treated on the ri ght or on the left thigh with both the active-patc hes or with the vehicle-patches (contro! ), the
othe r side serv ing as untreated contro!. In this
way both the active and the con tro! patches
were indifferently applied both on the right and
the left ti gh.
The selected subjects were not taking drugs for
systemic administration or ant i-cellulitis topic
products and, moreover, had not undergone specific diets before a nd during the clinica! trial 's
period.
INSTRUMENTAL
MEASUREMENTS
Ulfrasound-8-mode imaging
This two-d imensional B-scan procedu re gives
ultrasounds single lines (A-Scan lines) corresponding to a cross-sectional image of the skin.
In fac t when a beam of ultrasounds passes through the differe nt layers of the skin, different
echoes are produced depending on the acoustic
c haracteristics of the exam ined areas ; those
echoes are recorded by the instrument and vi sualized on the screen as peaks (A-Scan). By
measuring the dista nce among the peaks, it is
possible to determine the th ickness of the different structural components of the skin (I 0).
Before and after the study the thickness of the
subcutaneous tiss ue was controlled on 3 points
of skin surface for both the thighs by the Dermoscan C®, (Denmark) version 3, at 20-MHz.
Skin hydration and TEWL were controlled by
3C System®, (Rome, Italy) wh ich was previously used by our team (I I).
3C System®
This computerized system through the capacitative resistance permits a simple and quick contro! of surface lipids, skin hydration and TEWL
The 3C System® collects up to 10/15 measure-
MATERIALS ANO CHEMICALS
I. 4x4 cm patch with acrylic base (vehicle-contro l B);
2. 4x4 cm patch enriched with centella asiatica
and fuc us ves icolosus extracts so that each
plaster contains a tota! of I O mg active compounds, 0.2 mg/cm 2 of whic h are centella tri-
terpens (4-9).
3C System®
141
A new cosmeceutrcal far the "orange pee/" skrn
ments over 25 seconds sampling period and records the mean value automatically standardizing the environmental conditions (RH=50%,
T=22°C). Measurements were performed on lst
day (baseline) and after 7, 14, 21, 28, 35 days.
TEWL is expressed as the amount of water evaporated per unit of surface in 1 hour gr/m2/h
and the system collects up 10/15 measurements
over 25 second sampling period and record the
mean value automatically (11).
Statistica/ analysis
Differences in TEWL, skin hydration and subcutaneous tissue thickness were examined for
statistica! significance using the non-parametric
Friedman test. When the Friedman test revealed
significant values between the treatments, multiple comparisons of all groups were conducted
by the Wilcoxon-Wilcox tests.
RESULTS
Tue obtained results are reported in Fig. 1, 2 and 3.
COMMENTS
As already proven by our group and by other
authors the scan-ultrasound tecnique seems to
be the best methodology feasible for measuring
the variations of the cellulitic layers during an
anti-cellulitis treatment (12-18).
As it can be seen on Fig. 1 patch application on
day 21 highlights a remarkable change in the
thickness of the cutaneous layer (p<0.005) before and after the treatment. This change is surely
due to the activity carried out by the used active
ingredients, since the sole vehicle has proved to
be ineffective.
It is also interesting to point out that the patch-
SUBCUTANEOUS TISSUE THICKNESS BEFORE ANO AFTERTREATMENT
BY AN "ANTl-CELLULITIS" PATCH
Time
=21 days (One patch daily)
- n
=15
- RH
=50% - t =22 •e
5,70
5,65
5,60
5.545 :!: 0.521
5,55
5,50
~
5,45
5,40
5,35
5,30
5.2A5 :!: 0.641
5,25
5,20
5,15
Baseline Mean Value
Untreated
Final Mean Valuo
Vehicle Patch
Final Mean Value
Active Patch
Active-Patch values are highly significant as Baseline and Vehicle (p <0.005)
Fig. 1
142
P Morgont1, SO Rondozzo G Fobnz1 C Bruno
TEWL OF THIGH-SKIN TREATED BY "ANTl-CELLULITIS" PATCHES
UNTREAi ED
2
0 +-~~~~~+-~~~~~+-~~~~~+-~~~~~+-~~~~--l
o
14
7
I
c:=Juntreated Skin A rea
Untreated Versus Patch-Treated (Vehicle and Active)
28
21
- - - Vehicle Patch-Treated
35 DAYS
........... Aclive Patch-Treated
I
=p < 0 .005 - Active-Patch Versus Vehicle-Patch =ns
Fig , 2
HYDRATION OF THE THIGH-SKIN TREATED BY "ANTl-CELLULITIS" PATCHES
n
=15 - RH =50% - t =22 •e
70
60
56,7 :t 1
50
w
(/)
~
40
"'
u
;!!;
z 30
o
~
o
>:z:
20
....
10
o
o
7
14
21
28
35 DAYS
I-+- VEHICLE PAT CH ..... ACTIVE PATCH I
Patch-Treated versus Baseline = p < 0.005 - Vehicle-Patch versus Active-Patch = ns
Fig , J
143
A new cosmeceutical for the "orange pee/" skin
treatment causes the TEWL to increase considerably (p<0,005), indipendently from the presence of the active ingredient. This means that it
acts by changing the stratum corneum barrier.
That should be the reason why the active ingredients seem to be able to easily reach the hypoderm. By interrupting the treatment TEWL gets
back to normai values (p<0.005) (Fig. 2).
Also concerning the cutaneous hydration the increasing problem is due also to the occlusive effect caused by the patch (p<0,005) (Fig. 3).
No adverse reactions were observed.
Obtained data seem to confirm what we previously proved (4-8), i.e. that the TCDS (Transdermal Cosmetic Delivery System) is an helpfui cosmeceutical device, easy and quick to use,
and capable of giving good results in the treatment of the cutaneous unaesthetism called "cellulitis".
Aufhor Address:
P. Morganti, PhD - Research and Development
MAVI Sud srl - Via del!' Industria I,
04011 Aprilia (LT) , ITALY
Phone: + 39 06 9286261
Fax:+ 39 06 9281523
[email protected]
URL=http:// www.colosseum .itlst81 /mavì
144
P Morgant1. SO Randazzo. G Fabnzi. C Bruno
REFERENCE
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2. Binazzi M., Papini M. (1983), Aspetti chimico-istomorfologici. In: (Ribuffo-Bartoletti eds) La
cellulite, Ed. Salus Internazionale, Roma, Italy
3. Scherwitz C., Braun Falco O. (1978), So-called cellulitis, J.Dermatol.Surg.Oncol. 4, 230-234
4. Morganti P., Celleno L. and Vasselli A. (1995), A new Transdermal Delivery Cosmetic System
to contro! the skin localized lipodystrophy, J.Appl.Cosmetol. 13, 15-20
5. Morganti P. (1995), Nuove applicazioni di principi attivi vegetali: il cerotto cosmetico, Cosm.
News, 107-109
6. Morganti P., Tiberi L., Vasselli A., Tolaini M. V., Serafini G., Celleno L. (1995), Transdermal
Cosmetic Delivery System: a new device for cosmetic use. Evaluation of its effects in the treatment of so called "cellulitis", Presented at IFSCC Congress, Montreux, Switzerland, 18-21 September 1995
7. Morganti P. (1996), The cosmetic patch: a new frontier in Cosmetic Dermatology, Soap, Cosm.
Chem. Special. (February), 48-50
8. Morganti P, Fionda A., Tiberi L. (1996), The TransdèrmaJ Cosmetic Delivery System: A new
cosmeceutical device, Presented at Active lngredients Conference, Paris 13-14 November 1996,
in print on Cosmetics & Toiletries.
9. Morganti P., F ionda A., Tiberi L., Icare M., Rusch F., Elia U. (1996), Extraction, analysis by
HPLC of cosmetic active ingredients from an anti-cellulitis transdermal delivery system, Submitted for pubblication.
10. Seidenari S. (1995), Ultrasound B-mode imagine and in-vivo structure analysis. In: Non invasive methods and the skin (Serup and Jemec Edrs.), CRC Press !ne., Bocaraton, Florida, p. 257
11. Cardillo A., Morganti P. (1994), A fast non-invasive method for skin hydration contro!,
J. Appl.Cosmetol. 5, 105-120
12. Webb S. (1990), "The Physics of medicai imaging", Ed. Adam Hilger, Bristol.
13. Edwards C. (1988), Non invasive in vivo measurement of dimensions and properties of stratum
corneum and epidermis by A-Scan ultrasound, 15th IFCC /11tematio11al Congress 4, 263-4
14. Pugliese P.T. (1989), Use of ultrasound in evaluation of skin care products, Cosm. Toil. 104, 61-76
15. Armengol R., Girones E., Belles A. et al. (1992), Quantitative evaluation of the anti-cellulitis
efficacy by scan-ultrasound and its relation with clinic studies, 17th IFCC lnt. Congr. Voi. 3,
1218- 1240
16. Fornage B.D. and Anderson M.D. (1995), Ultrasound examination of the skin and subcutaneous tissues at 7 .5 to I O MHz. In: Non-invasive methods and the skin (Serup and Jemec Eds.),
CRC Press lnc., Bocaraton, Florida, p. 279
17. Agner T. (1995), Ultrasound A-mode measurement of skin thickness. In: Non-invasive methods
and the skin (Serup and Jemec Eds.), CRC Press Inc., Bocaraton, Florida, p. 289
18. Morganti P. (1997), A new peloid mask of Etruscan origin. Presented at IN-COSMETICS Conference, Di.isseldorf, May 6. Published on the Conference Proceedings "Modem challenges to
the Cosmetic Formulations", p.451-456, J. Appl.Cosmetol. 15, I 09
145
. ~"
....
J. Appl. Cosmetol. 15. 147-159 (October-December 1997)
ENHANCING THE GLYCOLIC ACID EFFICACY
BY PIEZOELECTRIC VIBRATIONS
P. Morgonti", S.D. Rondozzo•• ond G.Fobrizi***
• President/Director, R & D - Mavi Sud S.r.l., Viale dell'Industria l, 04011 Aprilia (LT), ltaly.
Department of Dermatology, Dermatologists Training School, Il University of Naples, ltaly.
•· Department of Dermatology - University of Catania, ltaly.
••• Department of Dermatology, Catholic University of Rome, ltaly.
Received: May 7, 7997
Presented at 2sd Symposium on Cosmetic Efficacy, New York, 28-30 Aprii, 7997.
Key words: Glycolic acid, Piezoelectric vibration, Skin
sticity, Skin hydration, Surface lipids, TEWL.
Maste~.
Skin ageing, 3C System®, Skin ela-
Synopsis
As it is well known, AHAs improve skin hydration by binding water to the stratum corneum.
In addition, when applied topically in concentration between 8% and 70% they decrease corneocyte
cohesion and stratum corneum thickening, including various levels of epidermal separation. Among
the various AHAs available, glycolic acid has enjoyed the greatest popularity.
Its higher concentrations (from 50% to 70%) are being used for superficial skin peeling,meanwhile,
iow concentrations (from 8% to 30%) have been reported to act as moisturizing agent capable of
causing a decrease in corneocyte attachment. The glycolic acid activity is always correlated to some
degree of irritation, and stinging or burning is its common side effect-especially at the begining of
treatment. This study investigates and compares the effect of a 20% glycolic acid product, partialiy
neutralized at 4,5 pH with a special blend of aminoacids, used as "lunch time peel" on skin degreased by a cleansing lotion combined with or without a new "piezoeiectric technology" called "Skin
Master®". Skin Master® activity is based on mechanical energy trasmitted to the skin by a series of
ultrasound vibrations. Through the Skin Master® device, a significant exfoliation of the horny layer
is obtainable together with a contemporary micromassage of the skin with an evident hyperemia. In
this way, it is possible to enhance the glycolic acid absorption and its activity at medium/low concentrations. In order to explore the activity of this 20% glycoiic acid-containing product and to verify the real use of the Skin Master®, Skin Elasticity (RER by Dermafiex®), Clinica! Scoring (CS)
(according to Effendy et al.), Stratum Corneum Turnover Time (SCTT) by the Dansylchioride
Methodology (Jansen at al.), TEWL, Superficial Skin Lipids and Skin Hydration were controlled by
3C System®Technology (Rome, ltaly) on 30 women aged 35-56 who were observed weekly for 3
months. No significant adverse reactions were noted during the 90-day study.
The obtained results indicate a significant reduction (p<0.005) of SCTT (+ 20%), substantial modification of TEWL, and an increase of superficial skin lipids ( + 27% ), skin hydration ( +70%) and
skin eiasticity (+ 12%).
These benefits were significantly (p<0.05) improved (+ 25%) when the Skin Master® was used.
147
Enhancing the glycoilc acid efficacy by piezoelectnc vibrat1ons
Riassunto
Come è noto gli alfaidrossiacidi aumentano l'idratazione cutanea legando l'acqua allo strato corneo.
Inoltre, quando sono applicati topicamente in concentrazioni tra 1'8% ed il 70% fanno diminuire la
coesione dei corneociti e l'inspessimento dello strato corneo, accelerando a vari livelli la div isione
cutanea. Tra i vari AHA disponibili, l'acido glicolico è quello che gode della più grande popolarità.
Le sue alte concentrazioni (dal 50% al 70%) sono utilizzate per il peeling cutaneo superficiale, mentre le basse concentrazioni (dall '8% al 30%) sono risultate agenti idratanti in grado di causare anche
una diminuzione nella coesione dei corneociti .
L'attività dell'acido glicolico è sempre correlata a qualche tipo di irritazione, ed il prurito e l'arrossamento ne sono comuni effetti collaterali, soprattutto all'inizio del trattamento.
Con questo lavoro si sono voluti valutare gli effetti di un prodotto contenente una percentuale del
20% di acido glicolico, parzialmente neutralizzato ad un pH 4,5 tramite una speciale miscela di am inoacidi. Il prodotto viene utilizzato come "lunch time peel" sulla pelle precedentemente detersa con
una lozione detergente, in combinazione o no con la nuova tecnologia piezoelettrica denominata
"Skin Master®".
L'attività dello Skin Master®è basata sulla energia meccanica trasmessa alla pelle da una serie di vibrazioni ad ultrasuoni.
Con l'uso dello Skin Master® si ottiene una significativa esfoliazione dello strato corneo, insieme ad
un contemporaneo micromassaggio della pelle con evidente iperemia. In questo modo è possibile
aumentare l'assorbimento dell'acido glicolico e la sua attività a concentrazioni medio I basse.
Per analizzare l'attività di questo prodotto e per verificare il reale uso dello Skin Master0 , sono state
controllate settimanalmente e per tre mesi 30 donne di età compresa tra i 35 e i 56 anni con la tecnologia del 3C System® (Rome, Italy). I valori controllati riguardavano l'elasticità della pelle (RER
Derrnaflex®), il grado di eritema della cute (Clinica! Scoring - CS secondo Effendy et al. ), il rinnovo
delle cellule cutanee, Stratum Corneum Turnover Time (SCTT) con la Dansylchloride Methodology
(Jansen et al.), la TEWL, i lipidi cutanei di superficie e l' idratazione della pelle.
Durante la durata dello studio (90 giorni) non sono stati riscontrati significativi effetti collaterali.
I risultati ottenuti indicano una riduzione significativa (p<0.005) dello SCTT (+ 20%), una modifica
sostanziale della TEWL, ed un aumento dei lipidi cutanei di superficie (+27%), dell'idratazione cutanea (+70%) e dell'elasticità della pelle (+12%).
La positività dei dati è risultata significativamente più elevata (+ 25% p<0.05) nelle aree trattate con
lo Skin Master®.
148
P Morgant1, S.O Randazzo, G.Fabriz1
As it is well known AHAs improve skin hydration and photo-induced skin ageing by binding of water to the stratum corneum ( 1-1 7).
In addition, when applied topically in concentration between 8 and 70% they decrease corneo c y te cohesion and s tratum corneum
thickenig, including various levels of epidermal separation, Among the various AHAs
available, glycolic acid has enjoyed the greates t popularity, Its high er concentration s
(from 50 to 70%) are beeing used for superficial skin peeling meanwhile low concentrations (from 8 to 30 %) have been reported to
act as moisturizer agent capable also to cause
a decrease in corneocyte attachment (18-21).
The glycolic acid activity is always correlated
to some degree of irritation and stinging or
burning is its common side effect, especially
at the beginning of treatment (22),
These side effects are linked to its own irritant properties as acid, but are also based on
the following factors: concentration, pH, percentage and type of neutralizers used to adjust
acidity, vehicle form ul ation, cleaning and/or
degreasing treatment used, period of time the
acid remains on the skin, skin area and skin
type (23).
Because of glycolic acid known ability to be
effective on some photodamage, pigmentation, scarring condition and fine wrinkles improvement, physicians and aestheticians are
using it primarily in high/medium concentrations, For these reasons the use as "refresher
peel" of a glycolic acid solution at medium
degree concentration of simpler use should be
interesting fot both the medicai community
and aestheticians, particularly if without side
effects.
This study investigates and compares the effect of a 20% glycolic acid-peel, partially
neutralized at 4.5 pH with a special blend of
aminoacids (*), used as "lunch time peel", on
skin degreased by a cleansing lotion or by a
new "piezoelectric technology" called Skin
Master"'.
STUDY PROJECT
In order to verify the real use of th e Skin
Master® and to explore the activity of this 20%
glycolic acid-peel, Stratum Corneum Tumover
Time (SCTT). Skin elasticity, Clinica! scoring
and TEWL were controlled on upper forearm;
Skin lipids and Hydration were controlled on the
face.
Skin Master8
3C Systerrf'
CHEMICALS
Gel A:
water gel of glycolic acid 20% (lml = g 0,224
of GA) partially neutralized by Na OH (pH 4.5)
GA.
GelB:
water gel of glycolic acid 20% (lml = g 0,224
of GA) partially neutralized by aminoacids (pH
4.5) GA-Arg/Gly (*).
(*) Trade nome: Keratotal"' Peel
149
Enhancmg the glyco/1c ac1d eff1cacv by p1ezoelectnc v1brat1ons
Cleansing Lotion:
(pH 4.5) Aqua, Ceteareth-6, Isopropyl myristate, Octyl steara te , Lactic acid , Sorbito!,
Propylene glycol, Glycerin, Gelatin-Glycine(IJ,
Hydrolyzed collagen, Tocophery I ace tate,
Retinyl palmitate, Linoleic acid, Linolenic acid,
Disodium EDTA, Imidazolidinyl urea,
Methylparaben, Parfum (*).
TEST PROCEDURE ON THE FACE
Patients
Skin Master®'s activity is based on mechanical
energy transmitted to the skin by a series of
ultrasound vibrations of its special actuator.
The extreme part of the actuator, induced to
vibrate by piezoeletric device, produces compression and decompression on the skin surface.
The outcome of this treatment is a smooth
relaxed and cleaned skin and toned musculature.
Fourthy healthy women volunteers, age range
35 to 56, skin type III/IV, part!cipated in the
study. Each woman had at least a moderate
degree of photodamage as defined by an overall
score of 5 with separate scores for each side of
the face on a visual analogue scale of O (none)
to 10 (severe).
The number of actinic keratoses and wrinkling
improvement were also counted.
No topica! retinoid use or other topica! medications or cosmetic antiaging products were
allowed for 1 month prior to study initiation.
The subjects were observed daily or weekly for
three months (January-March) always by the
same investigator.
Patients were randomly divided into four treatment groups of 1O individuals. After baseline evaluation, one group was treated twice a week by a
20% glycolic acid "refresher peel" (partially neutralized by aminoacids at pH 4.5) (Gel B) for 2
months, after cleansing the face with a Cleansing
Lotion (TS Gentle Cleansing) (Group 1).
The second group was treated with the same
peel, after cleansing the skin, previously wetted
with distilled water, by using the Skin Master®
(Group 2).
The thirth and the fourth group were respectively treated as the first and the second but used
also a phospholipid-based moisturizing lotion
twice daily.
3C System®
Procedure
This computerized system through the capacitative resistance permits a simple and quick contro! of surface lipids, skin hydration and TEWL.
The 3C System"' collects up to 10/15 measurements over 25 seconds sampling period and
records the mean value automatically standardizing the environmental conditions (RH=50%,
T=22°C) (11).
To perform the peel the following procedure
was utilized: the Gel B (glycolic acid peel) was
applied uniformly over the entire face after the
skin was cleansed with Gentle Cleansing or
Skin Master®.
Application times were started at 15 minutes
for each peel treatment.
Gel-Vehicle:
water, propylene glycol, xantan gum (pH 4.5).
Moisturizing Lotion: Soybean liposome containing l 0% lecithin frac ti on with 80% phosphatidylcholine linoleic acid-rich.
Skin Master®
Technical specifications
Actuator frequency: 25.000 Hz+/- 10%
Vibration at time actuator: 30 micron pp
Frequency: O.I - IOOOHz
Work cycle: 5 sec.
Maximum of current: 10-600 microA
(*) Trade nome: TS Gentle C/eansing
150
(1) USA patented n °4806525/ Feb.2, 7989
P Morgont1. S D. Rondozzo. G.Fobnz1
SKIN FACE HYDRATION OF PATIENTS TREATED BY A 20% GLYCOLIC ACID·PEEL
PARTIALLY NEUTRALIZED BY AMINOACIDS·ARG/GLY AT pH 4.5
n = 40 • RH = 50% • t = 22 ·e
100
80
w
cn
<
w
60
a:
40
~
20
~
w
cn
<
w
~
/
o
·20
-
/
~
~
~
~
~
~
I--
Sili
-
~
-
~
f-
:I
~ldl
~
~
-
-
a:
ow
e
~
-60
·80
-100
15
~
30
CL+GA+M
~
-
60
45
~
SM+GA+M
CL+GA
75
~
SM+GA
90
I
DAYS
Treatment period: 2 Months (Twice a Week) with and without using a molsturizlng lotlon (Twice a Day)
All p values are highly s ignificant (p < 0.005) as to Baseline
Fig. I
Abbreviations: CL=Cleansing Lotion, GA=Glycolic Acid, M=Moisturizing Lotion, SM=Skin Master
SKIN FACE LIPIDS OF PATIENTS TREATED BY A 20% GLYCOLIC ACID·PEEL (PARTIALLY
NEUTRALIZED BY AMINOACIDS·ARG/GLY AT pH 4 ,5) ANO BY MOISTURIZING CREAM (TWICE A DAY)
n =40 • RH = 50% -t= 22 •e
w
~
w
a:
o
~
15
+ - - - ----11--:.,,c-- - - + - -- - + -- - =
10 +-------lf------+''-"';""'""'--~
11.1:t1
~
O +------l-----+----+------11-------+----~
o
15
I•
30
SM+GA
•
45
CL+GA
A
60
CL+GA+M
•
75
90
DAYS
SM+GA+M
Peel-Treatment period: 2 Month (Twice a Week) with and without a moisturizing lotion (Twice a Day)
All p value are highly significant (p < 0.005) as to Baseline and Groups
Fig. 2
Abbreviations: CL=Cleansing Lotion, GA=Glycolic Acid, M=Moisturizing Lotion, SM=Skin Master
151
Enhancmg the glycollc ac1d eff1cacy by p1ezoelectnc v1brat1ons
SKIN FACE CLINICAL SCORE ASSESSMENTS AT WEEK 12 OF PATIENTS TREATED (TWICE A WEEK) BY A
20% GLYCOLIC ACID·PEEL PARTIALLY NEUTRALIZED BY AMINOACID-ARG/GL Y
n
= 40 • RH = 50% • I = 22 ' C
FINE WRINKLING
AROUND EYES
6
CREASE LINES AROUNO MOUTH
AND CHEEKS
5
4
3
2
o
SM + GA
CL+ GA
SM+GA+M
CL+GA+M
~ Baseline Before ~ After al Week 12
SM+
CL+
GA·GLY/ARG GA·GLY/ARG
~ Baseline Before
SM+GA
·GLY/ARG
+M
GA·GLY/ ARG
+M
[ill After al Week 12
All p values are highly significant (p < 0.005) as to Baseline and to Groups
Peel-Treatment perio d: 3 months (Twice a Week) wlth and w lthout using a moi sturlzing lotlon (Twlce a Day)
Fig. 3
Abbreviations: CL =Cleansing Lotion, GA=Glycolic Acid, M=Moisturizing Lotion , SM=Skin Master
Every two weeks at I 0.00 a.m. surface lipids, sk.in
hydration, the number of crease lines and the degree of wrinkling improvement were controlled.
Tue obtained results are reported in Fig l ,2,3.
TEST PROCEDURE ON THE
FOREARM
Strafum corneum turnover time
(SCm
Tue right or left foream1 was marked with 7 areas
of 2cm2 each, treated in this way:
AREA I Cleansed with Cleansing Lotion
AREA 2
Skin Master
AREA 3
AREA 4
AREA 5
Cleansing Lotion
Skin Master
AREA 6
+ Gel A
+ vehicle Gel
+Gel A
+ vehicle Gel
+Gel B
+Gel B
AREA 7
UNTREATED
152
Areas treated by S kin Maste r* were previously
we tted with distill ed water.
Prior to treatme nt the stratum corne um was labelled with dansyl c hloride according to Jansen
et al. (24) methodology. According to Effendy
et al. (25) dansyl chloride was finely triturated
into white petrolatum at 5% (w/w) and applied
to right volar fo rearm of the volunteers under
semi-occlusive dressing for 24 h. Subseque ntly,
after remove of a ny excess materiai with soft
tiss ue pa pe r, and afte r c leansing the a rea by
cleansing lotion or by Sk.in Master*, test substances were applied. The clearance of the fluorescence was exami ned under UV illumination.
SCTT was the time in days be tween staining
(day 0) and fluorescence disappearance.
O, l ml. of g lycolic acid-Gel-B (pH 4.5), g lycoli c acid-Gel-A (pH 4 .5) and ve hic le ( pH
4.5) were applied respecti vely to the d ansyl
c hl oride-labelled areas pre-treated by C leans ing Lo tion or S kin Maste r4'> volar fo rearm
a reas using p olypropyle ne cha mbers ( 19 mm
P Morganti. S D. Randazzo, G.Fabnzi
STRATUM CORNEUM TURNOVER TIME (SCTT) ANO SCTT 50 OF FOREARM SKIN TREATED
BY A 20% GLYCOLIC ACID-PEEL PARTIALLY NEUTRALIZED BY NaOH OR AMINOACID-ARG/GLY (pH 4,5)
n = 40 - RH = 50% - t = 22
SM + GA
+NaOH
SM+GA
-GL Y/ARG
CL + GA
-NaOH
ID
CL+GA
-GL Y/ARG
SCTT 50
•
•e
SM+
VEHICLE
SCTT
CL+
VEHICLE
CONTROL
UNTRATED
I
Ali p values are highly significant (p < 0.005) as to Control values and Groups
Fig. 4
Abbreviations: CL=Cleansing Lotion, GA=Glycolic Acid, M=Moisturizing Lotion, SM=Skin Master
ERYTEMA/SCALING SCORE OF FOREARM-SKIN TREATED BY A 20% GLYCOLIC
ACID.PEEL PARTIALLY NEUTRALIZED BY NaOH OR AMINOACID-ARG/GLY
n
3,0
= - RH =50% - T =22 ·e - pH =4,5
~----~------r-----~-----.,.--------,
10
5
• SM+GA-NaHO (Gel A)
.6 CL+GA-NaHO (Gel A)
e
15
SM+GA-ARG/GLY (Gel B)
+ CL+GA-ARG/GL Y (Gel B)
*
25
20
TIME (Days)
SM+VEHICLE
X CL+VEHICLE
Ali p values are highly significant (p < 0.005) as to Baseline and Groups
Fig. 5
Abbreviations: CL=Cleansing Lotion, GA=Glycolic Acid, M=Moisturizing Lotion, SM=Skin Master
153
Enhonc1ng the glycot1c ac1d ett1cocy by p1ezoelectnc v1brot1ons
SCALING:
O = no scale
I
minimal, fi ne
2
moderate
3
Jarge flakes, intense peeling
di ameter) on paper adhesive tape for 15 min.
Once daily (5 consecutive days for 2 weeks)
according to the metho~ described by Effendy
et al.
Chambers with an erythema score of 3.0 or greater were not reapplied. Vehicle Gel served as
contro!. Untreated skin served as a contro! site.
The obtained results are reported in Fig. 4 and 5.
Skin elasticity
Skin elasticity has been controlled weekly I Oa.m.
to ali patients on a marked forearm area by Dermaflex" A( (Cortex Technology, Hadsund, Denmark) (26). Tue evaluation of the skin was determined electronically by measuring electric capacitance between the marked skin surface and the
electrode placed in the top of the suction chan1ber.
The parameters used were: suction 450m bar, suction period 20s, number of cycles 5.
The obtained results are reported in Fig. 6 and 7.
ERYTHEMA SCALING SCORES
Each test site was always examined and graded
for erythema and scaling according to:
ERYTHEMA:
O = no erythema
0.5 =
I =
2 =
3 =
4 =
equivocai reaction
slight erythema
moderate, uniform erythema
intense
fiery redness with edema
DISTENSIBILITY OF FOREARM-SKIN TREATED BY A 20% GLYCOLIC ACID.PEEL
PARTIALLY NEUTRALIZED BY NaOH OR AMINOACID-ARG/GLY (pH 4.5)
n = 40 - RH = 50% - t = 22 •e
6
.
/
5
4
4.4 ±0.3
,,. -
:::::::::;:
4.5± 0.2
e=-
4 .6 ± 0.3
4 .6± 0.4
::::=-
~
~ -
-
;
3
v-
2
v-
'---
'
'
vo
'
'·•
-
'
CL +
GA-NaOH
~
.'
;
CL+
GA-Gl Y/ARG
li
-- -
SM +
GA·NaOH
-
- - - -
SM+
GA-OLY/ARG
.::::::::;;
-
1
.,
4 .3 :t0.4
4 .2± 0.3
'"----
.-
:
SM+
VEHICLE
L-
:
-.....
CONTROL
UNTRATED
All p value are NOT significant as to Untreated Contro! and Groups
Fig. 6
154
Abbreviations: C L=Cleansing Lotion, GA=Glycolic Acid, M=Moisturizing Lotion, SM=Skin Master
P Morgant1. S D. Randazzo. G Fabrw
RELATIVE ELASTIC RETRACTION (RER) OF FOREARM-SKIN TREATED BY A 20% GLYCOLIC
ACID-PEEL PARTIALLY NEUTRALIZED BY NaOH OR AMINOACID ARG/GLY (pH 4,5)
n = 40 • RH = 50% • t = 22 ·e
9 O/
80 V
7o v
60
50
88 j 0.93
84± 0.91
~~
A
AA
75 ± 0.90
72±0.87
~
65 ± 0.95
v-
"'
f---
-
/-
~
40
,..'--
30
,..'--
-
20
,..-
-
10
o
~
(/~
=
....,..,_
CONTROL
UNTRATED
SM +
VEHICLE
..__,:-;:-:I
I
CL +
GA·NaOH
SM +
GA·NaOH
I
~.,.,
CL +
GA·GLY/ARG
~
SM +
GA· GLY/ARG
All p values are highly significant (p < 0.005) as to Untreated and Groups
Fig. 7
Abbreviations: CL=Cleansing Lo1ion, GA=Glycolic Acid, M=Moisturizing Lotion, SM=Skin Mas1er
TEWL, SUPERFICIAL SKIN
LIPIOS ANO SKIN HYORATION
RESULTS ANO OISCUSSION
Eryfhema and Scaling
TEWL, skin Jipids and hydration were controlJed weekly on the skin face by the 3C System"'
methodology (Dermotec, Rome, Italy) (27).
Thi s computerized system permi ts a simple
and quick determination of TEWL, superficial
ski n lipids, hydration and pH, whi le the environmental conditions are automatically standard ized (50% RH and 22°C) by the use of
proper correction factors.
TEWL is expressed as the amount of water evaporated per unit of su rface in 1 hour gr/m2/h
and the system collects up 10/ 15 measurements
over 25 second sampling period and record the
mean value automatically.
The obtained results are reported in F ig. 1, 2
and 8.
As expected the Gel A application (20% glycolic acid partially neutralized by NaOH at pH
4.5), compared to its vehicle (p<0.005), caused
a strong erythema (2nd degree) from the second
day of treatment on the cutaneous area already
cleansed with cleansing lotion. This erythema
turned out even stronger when the cleansing
was carried out by us ing Skin Master"' (3 degree), that, as expected, allowed the glycolic
acid to pass through the cutaneous Iayers even
quicker.
The Gel B application (20% glycolic acid partially neutralized at pH 4.5 by aminoacids) has
recorded, on the contrary, only a slight erythema
fro m day 8 to day I O as compared to its vehicle
155
Enhoncing the glycolic oc1d eff1cocv by piezoelectr1c v1brot1ons
TRANSEPIDERMAL WATER LOSS OF FOREARM·SKIN TREATED BY A 20% GLYCOLIC
ACID·PEEL PARTIALLY NEUTRALIZED BY NaOH OR AMINOACID-ARG/GLY (pH 4,5)
n =40 • RH = 50% • t = 22
•e
~:-,~~~~e::==:==~ ===~F==:
2+-~~~-+-~~~-+-~~~-+-~~~-+-~~~--+-~~~-<
o
2
10
5
15
• SM+GA-NaOH
e
.6. CL+GA-NaOH
+ CL+GA-ARG/GLY
SM+GA·ARG/GLY
*
20
25
DAYS
SM+VEHICLE
X CL+VEHICLE
All p values are highly significant (p < 0.005) as to Vehicle and to Groups
Fig. 8
Abbreviatio11s: CL=Cleansing Lotion, GA=Glycolic Acid, M=Moisturizing Lotion, SM=Skin Master
(p< 0.005), and produced evident scaling from
day 1O to day 18. This did not occur with the
vehicle (Fig. 5).
TEWL
In accordance with Effendy et al. TEWL at the
GA-treated area increased on day 10 and maintained significantly hi gher levels than the untreated or vehicle-treated skin (p<0.005). Only
the areas treated with g lycolic acid partiall y
neutralized with ARG/GLY aminoacids showed
TEWL levels similar to the vehicle.
These levels were higher only when the skin
was pre-treated by Skin Master®, and when glycolic acid (GA) partially neutralized with NaOH
was used, implying that the water barrier of Stratum Comeum is altered by the glycolic acid treatment more or less clearly not only in relation to
the quantity of free glycolic acid, but also to the
kind of used neutralizer and to the intensity of the
cleansing treatment used. What seems even more
156
interesting is the fact that the alterati on of the
barrier seems not to be dependent from the pH,
as often asserted by different authors (15,19, 2122), but from the kind of neutralizer used (Fig.
8). The glycolic acid used, neutralized by a mix.ture of aminoacids, acted in a way fairly similar
to the vehicle (Fig. 8), unlike the same glycolic
acid neutralized by NaOH.
SCTT
G lycolic ac id has significantly reduced SCTT
and SCTT-50 with respect to the veh icle and
the contro! (Fig. 4), both when partially neutralized with NaOH ( 14.0±7, p<0.005) and by
aminoac ids ( 14.0±1, p<0.005)), after cleansi ng previously the skin with C leansi ng Lotion. The use of the Skin Master®has furtherly
reduced the SCTT (GA-Arg-Gly 13. 1±0.9 and
GA-Na OH 12.9±0.9) (p<0.005), proving that
this type of cleansing helps the absorption and
therefore the activ ity of glycol ic ac id and of
P. Morganti, S.D Randazzo, G.Fabriz1
active ingredients in generai. These results
prove, as already ver ified by ourselves and
other authors, that glycolic acid acts as Stratum Corneum cel I renewal accelerator, and
that the inten s ity of activ ity a nd the the
erythema degree is strictly related also to the
means of cleansing used and to the used chemical neutralizers (Fig. 4 and 5). It seems not
to depend, therefore, only on the free glycolic
ac id.
Superficial skin lipids, hydration
and e/asticity
As it is known and as can be seen the everytwo-week treatment with glycolic acid, considerably improves the skin elasticity (RER) (Fig. 7)
(pH<0.005 with regard to contrai), but not the
skin distensibility (Fig. 6).
Concerning hydration and surface lipids (Fig. I
and 2) it is evident that the peeling reduces the
skin hydration and seems to have an influence
a lso on superficial skin lipids thanks to the
exfoliating activity ca used by g lycolic acid if
used in 20% concentrations without the use of
emollients. When the treatment is integrated by
the use twice a day of an emollient cream results invert.
CONCLUSION
As already supported by several authors g lycolic acid carries out an interesting biologica! activity, w hi ch is not completely explained yet.
From these first data, however, it seems possible to say that it obtainable an interesting increase of celi turnover by using lighter and simpler peeling, that can be performed also by expert aestheticians. It is of extreme importance to
perform before the treatments a careful cleansing. and it is fundamental not only the product's pH and the neutralizing degree, but the
kind of neu tralizer used, that affects also the
erythemigenic components and the stinging activity carried out by this AHA.
It is also fundamental the use of moisturizing
c reams after the peeling treatments, in ordcr to
improve the appearance of photoaged sk in by
reducing fine wrinkling and crease lines and to
en hance the radiance of the skin giving complexion a fresh, youthfu l glow.
Finally, we found highly interesting the use of
the Skin Maste~ as new cleansing means, to be
used to deeper cleanse the ski n when there is a
need to accele rate and improve the absorption
and the activity of AHAs or other cosmetic active ingredients.
Aufhor Address:
Clinica/ score assessmenf
Before (Day O) and after 12 weeks of treatment
clinica( score assessment was checked by the
same dermatologist for all patie nts GA-treated
(p<0.005). The individuai signs of fine wrinkling around eyes and crease lines around mouth
and cheeks were scored on 0-10 visual analogue
scales with separate scores for each side of the
face. The patients treated also w ith the post-peel
moisturizing cream (twice a day)and pre-treated
by Skin Master~ demonstrated the highest improvement on wrinkling and crease lines also at
week 4 and 8 (p<0.05) in respect to other groups (Fig. 3).
P. Mmga11ti, PhD - Research and Development
MAVI Sud srl - Via del!' Industria 1,
04011 Aprilia (LT), JTALY
Phone: + 39 06 9286261
Fax:+ 39 06 9281523
E-maiI=mavi@colosseum .iI
URL=h1tp ://www.colosseum .itlst81 Ima vi
157
Enhoncing file glycolic oc1d eff1cocv by p1ezoelectnc vibrot1ons
REFERENCES
1. Van Scott EJ, Yu RJ. (1974), Control of keratinization with alpha hydroxy acids and related
compounds: l .topical treatment of ichtyotic disorders, Arch.Dermarol. 110, 586-590.
2. Van Scott EJ, Yu RJ. (1984), Substances that modify the stratum comeum by modulating its
formation. In: Principles of Cosmetics for the Dermatologists. (Frost, SN Horwitz, eds.) CV
Mosby Co., St. Louis, p.70-74
3. Van Scott EJ. (1988), The unfolding therapeutic uses of alpha hydroxy acids, Med guide to
Dermatol., 3, 1-5.
4. Van Scott EJ, Yu RJ. (1989), Alpha hydroxy acids: therapeutic potentials, Canadian f. Dermatol. 1, 108-112.
5. Dahl MV, Dahl AC. (1983), 12% lactate Iotion for the treatment of xerosis, Arch Dermatol.
119, 27-30.
6. Buxman M, Hickman J, Ragsdale W, et al. (1986), Therapeutic activity of lactate 12% lotion
in the treatment of ichthyosis. Active vehicle and active vs. a petroleum cream, f. Am. Acad.
Dermatol.15, 1253-1258.
7. Van Scott EJ, Yu RJ. (1989), Alpha hydroxy acids: treatment of the Aging Skin with Glycolic
Acid procedures for use in clinica] practice, Cutis. 43, 122-128.
8. Moy LS. (1990), The use of gJycolic acids in the treatment of various skin disorders. Communication at the l 7th Annua! Clinica! and Scientific Meeting of the American Society for Dermatologie Surgery. Reported in Canadian Medicai News, July 27.
9. Dial W.F. (1990), Preparations prescribed in anti-wrinkling therapy, Cosmet Dermatol. 3, 32-34
10. Ridge J.M., Siegle R.J., Zuckerman J. (1990), Use of alpha hydroxy acids in therapy for photoaged skin, J. Am. Acad. Dermatol. 23, 932
11. Hermitte R. (1992), Aged skin, retinoids and alpha hydroxy acids, Cosmet. Toilet. 107, 63-66
12. Vilaplana J. (1992), Clinica! and non-invasive evaluation of 12% ammonium lactate emulsion
for the treatment of dry skin in atopic and non-atopic Subjects, Acta Dermatol. Venero/. 72, 28-33
13. Wehr F.R. (1991), A controlled comparative efficacy study of 5% ammonium lactate lotion vs.
an emollient control lotion in treatment moderate xerosis, J Am. Acad. Dermatol. 25, 849-851
14. Morganti P., Persechino S. and Bruno C. (1994), Effects of topica! AHAs on skin xerosis,
J.Appl. Cosmerol. 12, 85-90
15. Smith W.P., Smith W. (1994), Hydroxy acids and skin aging, Cosmet. Toilet. 109 (9), 41-48.
16. Morganti P., Randazzo S.D., Bruno C. (1996), AJpha hydroxy acids in the cosmetic treatment
of photo-induced skin aging, J.Appl. Cosmetol. 13, 1
17 Morganti P., Bruno C. and Randazzo Sd (1997), Stratum comeum turnover time in aged skin,
Cosmet. & Toilet 112, July, 61
18. Moy L.S., Murad H., Moy R.L. (1993), Glycolic acids peels for the treatment of wrinkles and
photoaging, J.Dermatol. Surg-Oncol. 19 (3), 243-6
19. Di Nardo J.C., Grove G.L.,Moy L.S. (1996), Clinica! and histological effects of glycolic acid
at different concentrations and Ph levels, Dermatol. Surg. 22 (5), 421-4
20. Clark C.P. (1996), Alphahydroxy acids in skin care, Clin.Plast.Surg. 23 (1), 49-56
21. Becker F.F., Langford F.P.,Rubin M.G. Speelman P. (1996), A hystological comparison of
50% and 70% glycolic acid peels using solutions with various pH, Dermatol.Surg. 22 (5), 463-5
22. Harris D.R. (1994), Treatment of the aging skin with glycolic acid. In: Evaluation and treatment of the aging face (Elson Ed.) Springer-Verlag, New York, p.26
158
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23. Brody H.J., Hailey C.W. (1986), Medium depth chemical peeling of the skin: a variation of superficial chemosurgery,J.Dermatol. Surg. Onco!. 72, 1268-75
24. Jansen L.H., Hojyo-Tomoko M.T., Kligman A.M. (1974), Improved fluorescence staining technique for estimating tumover of the human stratum corneum, Br.J.Dermatol. 90, 9-12
25. Effendy I., Kwangsukstith C., Lee J.Y. and Maibach H.I. (1995), Functional changes in human stratum corneum induced by topica! glycolic acid: comparison with ali-trans Retinoic
Acid, Acta Derm. Venereo!. (Stochk) 75, 455-458
26. Elsner P.E. (1995), Skin elasticity. In: Bioengineering of the skin: methods and instrumentation. (Beradesca et al. Eds) CRC Boca Raton, USA p.58
27. Cardillo A., Morganti P. (1994), A fast, non invasive method for skin hydration contro!,
J.Appl. Cosmetol. 12, 11
28. Morganti P., Fabrizi G. Randazzo S.D. and Bruno C. (1996), Decreasing the stinging capacity and improving the antiaging activity of AHAs, J.Appl.Cosmetol. 14, 79-91
159
Notes
1997 AWARDS
1997 can be considered particularly successful by Pierfrancesco Morganti, Ph.D., Editor in Chief of
our Joumal. Dr. Morganti, Jeading an outstanding team of cosmetic and pharmaceutical scientists,
accepted two coveted awards during this year.
Their work, "The transdermal cosmetic delivery system: a new cosmeceutical device" was awarded
"The Elegance Engineering Innovation Award" by Cosmetics & Toiletries magazine. This award
was announced and publicly presented to Dr. Morganti during the I 997 Advanced Technology Conference in Dusseldorf, Gennany on May 3, I 997.
The European Academy of Dermatology and Yenereology (E.A.D.Y.) Poster Prize was awarded and
presented to Dr. Morganti by Prof. W.J.Cunliffe during the 6° E.A.D.Y. Congress in Dublin, lreland
on September 15, 1997. The title of the poster was "A new cosmeceutical far all year round acne
therapy".
Congratulation from the entire editoria! staff of the Joumal to the Secretary General of Intemational
Society of Cosmetic Dermatoly far such outstanding success. This reflects well on both the Society
and the Joumal. Many of our membership rnay have equally significant honors, and we wou ld be
pleased to announce them here, also.
Editoria! Staff of the Journal of Applied Cosmetology
The Elegance Engineering lnnovation Award
from Cosmetics & Toi/etries® magazine
and >ponsorcd by Amcrchol Corp.
D1: P.Morgami receiving his Award
from TJ.Malafronte President of Amerchol
160
BookRev1ew
MECHANISM OF TRANSDERMAL DRUG DELIVERY
Drug and Pharmaceutical Sciences. Series/8
Russel O. Pohs and Richard H. Guy Editors
Published by Marce/ Dekker, New York - 376 hard bound, il/ustrated
ISBN: 0-8247-9863-5 • US$ 750.00 Price subject to change without notice
Marce! Dekker Inc., 270 Madison Avenue - New York, NY 10016-0602
This new book about transdermal delivery has surely hit the target, providing the readers with a fu ll
survey of the mechanisms that are at the basis of Transdermal Delivery. This relatively new methodology was developed, as it is known, through three steps or generations, that gradually led to the
realization of a better regulation, a better dosage and a better end-user comfort. The objective of the
development was the improvement of the transfer and absorption mechanisms through the use of
particular ingredients (or enhancers), the redacti on of the patch 's dimensions, the improvement of
the outward appearance to the advantage of portability.
This new book edited by Pohs and Guy in the "Drugs and Pharmaceutical Sciences" series of Marce! Dekker highlights "what is known", giving a "summary of what is happening now", together
with "a perceptive look at what is to come in the area of mechanism and enhancement of molecular
transport accross the stratum comeum" It begins by highlighting al i the most sophisticated technologies used to enhance the path ways of transdermal Stratum Comeum penetration including the usage
of Penetration Enhancers, as new chemical molecules, of Orthophoresys and Sonophoresys, based
on the use of ultrasonic energy. It is necessary to remind the reader that the need to stay in depth,
improve and widen the knowledges and practical uses of drugs with controlled release arises from
different requirements, and among those from the request of chemists of improving client's compliance towards the drugs (e.g. by decreasing the number of daily adm inistrations) and making more
steady the hematic and topica! leve! of active ingredients. For these purposes patches are used to obtain a steady release of the drug in the space of a day or more, and an extreme user-friend ly product.
Naturally, it is necessary to evalute the safety of this new device and to determine the degree of risk
connected to its use.
Ali the methodolog ies this interesting book deals with, those concerning the contro] of Stratum Corneum 's bilayers lipids, as well as those about th newest systems for the contro! of the drug release at
cutaneous leve!, are described with plenty of detai ls and bibliographic notes. This book makes a
useful reading for researchers who know the technological development wh ich patches have undergone in these last years, for graduates in medicine, biologists, pharmacists and students willing to
learn the basis and the mechanisms of activity that regulate cutaneous absorption and the release of
drugs and cosmetics through the organ skin.
P. Morganfi, Ph.D
Editor in Chief
161
lndex to Volume 15, 1997
lndex to Volume 15, 1997
Biologica! functions and therapeutic properties
of urea.
W. Raab
Contents
115
Practical treatment of dry skin.
Note
W. Raab
125
1997 Awards
160
Book Review
Originai Laboratory Studies
Russe! O. Pohs and Richard H. Guy Editors
An in vitro selection of new cosmetic active
compounds: from screening tests on monolayered fibroblast culture to efficiency study on 3-D
Derma! Equivalent.
161
C. Augustin, V. Frei. E. Perrier, A. Huc, O. Damour
Mechanism of transdermal drug delivery,
Drug and Pharmaceutical Sciences. Series/8
1
Generai Articles
Demonstration of the anti-wrinkle efficacy of a
cosmetic product.
Correlation between clinica! observations and
instrument methods.
Skin care products and evaluation of few skin
parameters: is the future already here?
J.G. Camarasa, P. Anthoine, M.J. Tribo Boixareu, E. Serra
M,G, Tucci, C. Zucchini, G, Ricotti, A Fionda, L. Morresi.
13
Baldrich. L. Aubert
S. Scrrcsi, A. De Benediuis, G. Biagini
43
Effect of phosphatidylcholine linoleic acid-rich
and glycolic acid in acne vulgaris.
Contact allergy to preservatives and perfumed
compounds used in skin care products.
centi, L. Tiberi
G. Angelini, G.A. Vena, C. Foti, M. Grandolfo
21
P. Morganti, S.D. Randazzo, A. Giardina, C. Bruno, M. Vin-
49
The use of a capacitance dev ice to evaluate the
hydration of human skin.
Role of topica! g lycolic acid and phosphatidylcholine linoleic acid-rich in the pathogenesis of
acne. Linoleic acid versus squalene.
V. Zuang, C. Rona, F. Distante, E. Berardesca
P. Morganti, A. Agostini , C. Bruno, G . Fabrizi
95
33
A new peloid mask of etruscan origin.
Hirsutism. Profile 011 Egyptian Females
G. Fabrizi , P. Morganti
H. M. El-Kahky, A. Imam, M. El-Okbi
109
59
162
lndex to Volume 15, 1997
Clinica] and instrumental evaluation of the activity of an anti-wrinkle cosmetic product on
cutaneous relief and photoaged skin.
E. Berardesca, F. Distante, P. Anthoine, G . Rabbiosi,
L. Aubert
69
Topica! tretinoin for photoaging. The China experience.
Xinghua Gao, Hong-Duo Chen, Albert M. Kligman
77
Human skin fibroblast culture to test glycolic
and lactic acid solutions.
M. Mattioli Belmonte, MG. Tucci , E . Vellucci, R. Solmi,
G .Ricotti, O. Talassi, G. Biagini , P. Morganti
85
Clinica! evaluation of two baby wipes in a
cross-over study.
C. Feliciani , M. Di Carlantonio, R. Bellucci, M. Guarracino,
P. Amerio
103
A comparative double - blind within subject
study of the efficacy and tolerability of two different derivatives of Vitamin A on skin thickness and elasticity: retinoic acid and conjugated
retinyl palmitate.
E. Thom
133
A new cosmeceutical for the "orange peel" skin.
P. Morganti, S .D. Randazzo, G.Fabrizi, C. Bruno
139
Enhancing the glycolic acid efficacy by piezoelectric vibrations.
P. Morganti , S.D. Randazzo, G.Fabrizi
147
163
Author index
Author lndex
Agostini A., see Morganti P., 33
Amerio P., see Feliciani C., 103
Angelini G., Contact allergy to preservatives
and perfumed compounds used in skin care products, 49
Anthoine P., see Camarasa J.G., 13; see Berardesca E., 69
Aubert L., see Camarasa J.G. , 13; see Berardesca E., 69
Augustin C., An in vitro selection of new cosmetic active compounds: from screening tests
on monolayered fibroblast culture to efficiency
study on 3-D Derma! Equivalent., 1
Bellucci R., see Feliciani C., 103
Berardesca E., Clinica! and instrumental evaluation of the activity of an anti-wrinkle cosmetic product on cutaneous relief and photoaged
skin, 69; see Zuang V., 95
Biagini G., see Tucci M.G., 43; see Mattioli
Belmonte M., 85
Bruno C., see Morganti P., 21; see Morganti P.,
33
Camarasa J.G., Demonstration of the antiwrinkle efficacy of a cosmetic product. Correlation between clinica! observations and instrument methods, 13
Damour O., see Augustin C., 1
De Benedittis A., see Tucci M.G., 43
Di Carlantonio M., see Feliciani C., 103
Distante F., see Berardesca E., 69; see Zuang
V., 95
El-Kahky H.M., Hirsutism. Profile on Egyptian
Females, 59
EI-Okbi M., see El-Kahky H.M. 59
Fabrizi G., A new peloid mask of etruscan origin,
109; see Morganti P., 33; see Morganti P., 147;
see Morganti P., 139
Feliciani C., Clinica! eval uation of two baby
wipes in a cross-aver study, 103
Fionda A., see Tucci M.G., 43
Foti C., see Angelini G., 49
Frei V., see Augustin C., 1
164
Giardina A., see Morganti P., 21
Grandolfo M., see Angelini G., 49
Guarracino M., see Feliciani C., 103
Hong-Duo Chen, see Xinghua Gao, 77
Huc A., see Augustin C., 1
Imam A., see El-Kahky H.M. 59
Kligman A.M., see Xinghua Gao, 77
Mattioli Belmonte M., Human skin fibroblast
culture to test glycolic and lactic acid solutions, 85
Morganti P., Effect of phosphatidylcholine linoleic acid-rich and glycolic acid in acne vulgaris, 21; Role of topi ca! glycolic acid and phosphatidylcholine linoleic acid-rich in the pathogenesis of acne. Linoleic acid versus squalene.
33; see Fabrizi G., 109; A new cosmeceutical
far the "orange peel" skin, 139; Enhancing the
glyco lic acid efficacy by piezoelectric vibrations, 147; see Mattioli Belmonte M., 85
Morresi L., see Tucci M.G., 43
Perrier E., see Augustin C., 1
Raab W., Biologica! functions and therapeutic
properties of urea, 115; Practical treatment of
dry skin, 125
Rabbiosi G., see Berardesca E., 69
Randazzo S.D., see Morganti P., 21; see Morganti P., 139; see Morganti P., 147
Ricotti G., see Tucci M.G., 43; see Mattioli
Belmonte M., 85
Rona C., see Zuang V., 95
Serra Baldrich E., see Camarasa J.G., 13
Serresi S., see Tucci M.G., 43
Solmi R., see Mattioli Belmonte M., 85
Talassi O., see Mattioli Belmonte M., 85
Thom E., A comparative double - blind within
subject study of the efficacy and tolerability of
two different derivatives of Vitamin A on skin
thickness and elasticity: retinoic acid and conjugated retinyl palmitate, 133
Tiberi L., see Morganti P., 21
Tribo Boixareu M.J., see Camarasa J.G., 13
Tucci M.G., Skin care products and evaluation
of few skin parameters: is the future already
here?, 43; see Mattioli Belmonte M., 85
Vellucci E., see Mattioli Belmonte M., 85
Vena G.A., see Angelini G., 49
Author index
Vincenti M., see Morganti P., 21
Xinghua Gao, Topica! tretinoin for photoaging.
The China experience, 77
Zuang V., The use of a capacitance device to
evaluate the hydration of human skin, 95
Zucchini C., see Tucci M.G., 43
165
Sub1ect tndex
Subject lndex
3C System®, 21, 24, 139; computerized system
for measurements of skin parameters, 141
Acne, 21; and squalene, 36; papules, 26; pustoles, 26; and phosphatidylcholine, 27; and skin
hydration, 29; and sebum secretion, 35; and hyperkeratosis, 35; and oleic acid, 35; and TEWL,
36; and linoleic acid, 36
Acne-affected skin, and squalene concentration, 38
Acne juvenilis, therapy by phosphatidylcholine
cream, 35
Acylceramide, of comedones, 23
Age-spot, treatment of, 149
AHAs, 85
Alfa-amyl cinnamaldehyde, 51
Alphahydroxy acid, 85
Anthralin, and urea, 121
Anti-cellulitis, treatment by a natural mud, 111
Anti-wrinkle, efficacy, 13
Ascorbic acid, 4
Baby wipes, evaluation, 103
Benzalkonium chloride, 45
Benzylparaben, 54
Bifonazole, and urea, 122
Bioengineering instrument, 95
Biopeptides, 3
Biotechnology, 3; innovative, 1
Bronopol, 51
Butylhydroxyanisole, 51
Butylhydroxytoluene, 51
Butylparaben, 54
Cadmium chloride, 45
Capacitance, 95
Carbamide, 116; toxicity of, 116; moisturizing
activity of, 116; biochemical functions of, 116;
Keratolytic and desquamating activity of, 118;
antimicrobial activity of, 121; in Dermatology,
121
Celi, proliferation, 3, 86; morphology, 89; contro! by SEM, 91
Cellulitis-patch, 140
Cellulitis, 109, 139; treated by a natural peat
mud, 112
166
Ceramide-1, and linoleic acid, 23
China, photoaging in, 77
Chinese, 77
Chloracetamide, 51
Chlorexidine digluconate, 23, 35
Cholesterol, 110
Chondroltin-4-Sulphate, ~
Cinnamaldehyde, 51
Cinnamic alcohol, 51
Comedone, open and closed, 26
Contact allergy, 49
Contact dermatitis, and fragrances, 50; eyelids, 50; hands, legs and face, 50
Contrast microscopy, semiquantitative celi
contro!, 89
Corinebacterium acnes, 35; count and phosphatidylcholine, 39
Corneometer®CM 820, 95
Corneosurfametry, and skin care products evaluation, 44
Cosmeceutical, a new, 21, 33; glycolic acid
peel as, 147
Cosmetic, efficiency of, 1; moisturizing agent, 9
Cream, pH, 85
Cutaneous relief, 15
Dansylchloride, 147
Depilation, 60
Derma! equivalent, 3
Derma! matrix, 3
Dermoscan®C, 139
Diapers, 104
Dimethylthiazol diphenyltetrazolium bromide, 45
Dry skin, and urea, 121; significance of, 126;
extemal causes of, 126; endogenous reason for,
126; regimen in, 127; cleansing measures in,
127; and environmental stress, 130
Dry-roughness, 77
Dyspigmentation, 77
EFA, deficiency, 35
Elastin, soluble fraction of, 4; synthesis, 7
Electrolysis, 66
Emulsion science, 3
Epidermal lipids, linoleic acid, 21
Epidermolysis, 86
Subject Jndex
Epilation,60
Ergosterol, 110
Erythema, 154
Essential fatty acids, deficiency, 35
Ethylparaben, 54
Eugenol, 51
European Community, cosmetics directive of,
3; directive 93/35, 95
Extracellular Matrix, neosynthesis of, 6
Face, 77
Fibroblast, human, 4, 85; proliferation rate of,
S, 14, 90; culture, 8, 86; morphology, 89;
Formaldehyde, 51
Freeze fracture, 45
Geraniol, 51
Glucocorticoids, and urea, 121
Glycolic acid, 21, 85, 147; and phosphatidylcholine, 27, 33; and skin ageing, 147; 20%
treatment, 147; and photodamage, 149; low
concentration of, 149; increases skin elasticity,
155; reduction of SCIT by, 156
Glycosaminoglycans, 4; synthesis of, 5; realised, 6; electrophoresis of, 7
High-moor Peat, 109
Hirsutism, on egyptian females, 59; grading,
63; and electrolysis, 66
Hydroxycitronellal, 51
Hyperkeratosis, 35
Hyperkeratinization, provoved by FFA, 35
Image analysis, 18
Imidazolidinyl urea, 51
Interleukin-6, 45
Isoeugenol, 51
Isothiazolinones, 55
Kathon CG, 51
Keratinocytes, 3
Keratosis, 86
L-Glutamin, 3
Lactate dehydrogenase, 45
Lactic acid, 85
Laser, confocal scanning microscopy, 45
Lauryl sulphate, 45
Linoleic acid, cosmetic activity of, 21, 33; content in a natural mud, 111
Liposome,21,33,45;soybean,23;
Magnetic resonance, 46
Mavigen, ldroschiuma, 24, 35
Melanocytes, 3
Methylparaben, 54
Milk, 3
Monolayered culture, 3
Mud, a natural ancient, 109; cosmetic use of a, 111
Natural Mud, 109
Oak moss, 51
Oleic acid, increase, 23
Orange-peel, skin, 139
Orthophoresys, 161
Parabens, 51
Patch, anti-cellulitis, 140
Peat Mud, 111; characteristics, 110; Ashes' analysis, 110; fatty acids content, 110, 111; sterol content, 111
Peloid, 109; peat etruscan mud, 109; Ashes' analysis, 110; fatty acid content, 110; sterol content, 111
Penetration Enhancers, 161
Phosphatidylcholine, 21; in acne therapy, 21,
33; and surface lipids, 27; and glycolic acid, 27;
topica! activity, 28; and p.acnes counts, 39; cosmetic activity of, 21, 33
Photoaging, in Orientals, 79
Photodamage, 77; treatment of, 149
Pigmentation, treatment of, 149
Polydocanol, and urea, 122
Premature aging, 77
Preservatives, contact allergy to, 49
Proline, incorporation, 6
Propionibacterium acnes, 30
Propylparaben, 54
Quaternium 15, 51
Retin-A"', 77
Retinoic acid, 133
Retinyl palmitate, 133
Rheology, 3
Salicylic acid, 23, 35; and urea, 122
Sallowness, 77
Scintillation counter, 4
SCTT, 149
Sebum, linoleic acid concentration in, 21
Sitosterol, 111
Skin, reconstructed, 3; aged, 8; evaluation, 15;
167
Sub1ect lndex
tolerability, 15; replica, 17; surface lipids, 24;
free fatty acids/triglycerides ratio, 24; hydration,
25; surface, 26; topography, 44; equivalent, 44;
fi broblasts, 45; photoaged, 69; roughness, 81;
pH measurements, 106; microbiology evaluation, 107; hydratation, 128; thickness and elastic i ty, 135; thi ckn ess, 142; hydratation a nd
TEWL, 143; ageing treatment, 147; elasticity,
154
Skin ageing, 147
Skin care, products evaluation, 43
Skin lipids, reduction of, 27
Skin Master~, 147
Sodium metabisulfite, 51
Sonophoresys, 161
Soya, 3
Stratum Corneum Turnover Time, 147
Squalene, increase, 23; concentration in acne,
38
TC DS, 139
TEWL, 35, 139, 149; measurements of acne affected patients, 36; skin, 143
Thymidine, tritiated, 88
Transderma l Cosmetic Delivery System, 141
Transdermal delivery, mechanism of, 161
Tretinoin, topica!, 77; and urea, 122
Triclosan, 51
Urea (carbamide), toxicity of, 116; moisturizing
activity of, 116; biochemical functions of, 116;
Keratolytic and desquamating activity of, 118;
antimicrobial activity of, 121; in Dermatology,
121
Vitreoscilla filiformis, 70
Wa rts, 86
Wheat, 3
Wrinkle, depth, 17; treatment, 77
Wrinkles, 77
168
Announcement
6fh Congress of European Society
tor Pediatrie Dermatology
Rome, September 14-18,1999
Catholic University of Rome
Auditorium of Congress Center
This Scientific Congress has been organized by:
"Centro Internazionale Studi e Ricerche in Dermatologia"
"lslilufo di Oinica Dermatologica dell'Università Cattolica del Sacro Cuore"
"Gruppo Italiano di Dermatologia Pediatrica"(GIDEP)
under the patronage of:
"Società Italiana di Dermatologia e Venereologia" (SIDEV)
lf you wish to receive further information, please contact:
G.Fabrizi, MD - lst. Clinica Dermatologica Univ. Cattolica del Sacro Cuore
Tel./Fax: +39-6-30.13.250
Announcement
Announcement
Clinica/ Design Group /ne
Seminar Series tor Medicai Devices
BIOCOMPATIBILITY TESTING & MANAGEMENT:
Material/Device biological safety
January 73-74, 7998 •San Diego, CA
GOOD MONITORING PRACTICES:
lmplementing clinical trial
January 75-76, 7998 •San Diego, CA
CLINICAL' TRIALS DESIGN:
Designing protocols and IDEs
January 79-20, 7998 •San Diego, CA
INTERNATIONAL CLINICAL TRIALS:
Regulations from a round the world
January 27-22, 7998 •San Diego, CA
(STAY FOR THE SUPERBOWL!)
sm
•
Regislration Fee: European venues
up to 30 days before the event. S10901hereafter. VAT not applicable.
Can't attend? &ly 1he book! $250 + shipping.
Cali Nancy Stari< at Oinical Design Group lnc for catalog containing full
course descriptions and registration information.
2 128 W Evergreen Ave
Chicago, IL é/:XJ22
Phone:
Fax:
773/489-5721
773/489-4281
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Notes
Notes
Chiuso in tipografia: December 16, 1997
Journal of Applied Cosmecology published quarrerly by INTERNATIONAL EDIEMME, Via Innocenzo XI, 4 1
00165 Roma Icaly. Direccore responsabile: P. Morganci. Direzione, Redazione ed Amminiscrazione: Via Innocenzo Xl, 4 1
00165 Roma Iraly. Scampa: Grafica Flaminia, Roma. Impaginazione: GRAFO' Comunicazione visiva, Roma. Copercina:
Dr.ssa M.G. Tucci - Dip. Ricerche INRCA -Ancona Iraly. ISSN 0392-8543 Spediz. Abb. Poscale 70% Filiale di Roma
Auc. del Trib. di Roma n. 3 173/83 del 8-7-83.
THE ANTIAGING LINE
GLYCOLIC ACID ACTIVATED BY
GELATIN - GLYCINE®
TO NORMALIZE THE SKIN TURNOVER
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LA LINEA ANTIAGING
CON ACIDO GLICOLICO H ATTIVATO"
PER NORMALIZZARE
IL TURNOVER CUTANEO
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maVI
La Ricerca Scientifica
nella Dermocosmesi
MAVI SUD s.r.l. Aprilia (LT) · ltoly
THE EVOLUTION IN COSMETIC SCIENCE
ACROMOS®
DEPIGMENTANTE
CUTANEO
CON IDROCHINONE,
ACIDO GLICOLICO
E SCHERMO FISICO
Primo del tra/lomento con Acromos
Before the lrealmenl with Acromos
Dopo l mese di troffo~enlo con Acromos
Affer one mounth of lrealmenl with Acromos
SKIN LIGHTNER
WITH HYDROQUINONE,
GLYCOLIC ACID AND
NON·CHEMICAL UVA SCREEN
Una risposta ottimale
alle ipermelanosi cutanee
Indicazioni:
lpermelanosi acquisite di origine
metabolica, endocrina, nutriziona le,
chim ico-fisica, ecc.
Modo d'uso:
l-2 volte al dì per non meno di 8 settim ane
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mavt
La Ricerca Scientifica
nella Dermocosmesi
MAVI SUD s.r.l. Aprilia ILT)-ltaly
THE EVOLUTION IN COSMETIC SC/ENCE