14. Cosmeceuticals and Other Office Products

Sammy Sinno, Zoe Diana Draelos

Cosmeceuticals is a term combining the concepts of cosmetics and pharmaceuticals. These products are over the counter and considered active cosmetics, delivering more to the skin than simply color or scent adornment. No U.S. Food and Drug Administration-recognized category for cosmeceuticals has been established.^1,2

■ Comprehensive treatment involves cleansing, moisturization, and photoprotection.

■ Treatments are aimed at improving the appearance of dry and aging skin.

■ Aging skin is induced by:³

• UV exposure

• The creation of dermal scars from reactive oxygen species

• Chronic inflammation inducing the activation of matrix metalloproteinases (collagenase, elastase)

■ Dry skin can be caused by excessive cleansing and low humidity conditions (air travel, forced-air gas heat).

CLEANSERS⁴

■ Main active ingredients are surfactants.

■ These surfactants may be formulated as bar cleansers or liquid cleansers (Table 14-1).

Table 14-1 Key Features of Surfactants

■ Patients with dry skin benefit from surfactants that remove less skin surface sebum (i.e., cleansing cream or oil).

■ High detergent surfactants may remove skin surface sebum and intercellular lipids, leading to barrier damage, inability of skin to hold water, and dry skin.

■ Cleansers remove sebum, perspiration, cosmetics, dust, and microorganisms.

■ Cleansers based on sodium cocoyl isethionate are low detergent and well tolerated in those with dry skin.

■ Individuals with dry skin may benefit from using cooler water when washing.

Best moisturizers contain occlusives and humectants.5,6

PETROLATUM (OCCLUSIVE)

■ Second most commonly used active ingredient (after water)

■ Very effective moisturizing agent, reducing transepidermal water loss by 99% (occlusive function)

■ When applied to wounded skin, enhances water retention thus improving fibroblast migration

■ Decreases fine rhytids of dehydration

■ Reduces pain and itching by forming an artificial barrier

■ Often criticized by patients for being too greasy

LANOLIN (OCCLUSIVE)

■ Derived from sheep sebaceous secretions

■ Contain cholesterol, which is a component of lipids in the strateum corneum

■ May be a source of allergic contact dermatitis

■ Lanolin alcohol used in some cosmetics

OILS (OCCLUSIVE)

■ Important in maintaining skin barrier

■ Include mineral oil, vegetable oils (safflower oil, sunflower oil, jojoba oil, hemp oil, grape seed oil, and olive oil), cetyl alcohol

■ Oils are hydrophobic and lipophilic

DIMETHICONE (OCCLUSIVE)

■ Also very common moisturizer

■ Silicone derivative

■ Can function as emollient, making skin smooth by filling spaces between desquamating corneocytes

■ Does not create greasy shine in patients with oily skin

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