Chemical Peels & Professional Treatments

First, we need to find out from the patient why they are seeking chemical peel treatments. Most of the time patients seek chemical peels because they think it will help to “even out” their skin. Our peels will not make normally pigmented skin match the depigmented skin. Additionally, vitiligo is an autoimmune disorder and needs to be medically treated. There are topical prescription tacrolimus medications (Protopic® or Elidel®) that suppress the immune function in the skin, and they have demonstrated the ability to help with re-pigmentation. There have also been some positive strides made with the Excimer Laser, so suggest to this client that they do some research with their physician about this option. Typically heat, friction and stress can stimulate this condition, so those things should be avoided as much as possible. That said, we cannot say yes or no to our peels being safe for the vitiligo patient, or that their expectations will be met. Even though they are safe and gentle, they do induce some heat within the skin. It is a case by case basis, should be approved by their physician, and most importantly, finding out what the patient is hoping to accomplish.

Here is a great resource for both our clinicians and their patients. Dr. Pearl Grimes is a pigmentary specialist in Torrance, CA and there is a lot of great information on her website: PearlGrimesmd.com.

We have not done testing on this peel for body use. We can confidently say that this is not a good choice for neck and chest treatment. The main concern would be the migration of the product to sensitive areas that were not intended for treatment. For now, we are recommending this solely for facial application. However, we have anecdotal information that some practices have used both the 6% or 4% to treat PIH on the back and body.

Microcurrent uses electrical frequencies close to the normal electric frequencies produced by the body to lift and tone the musculature of the face. Since it doesn’t compromise the integrity of the skin, peels should be fine as long as they follow the microcurrent treatment. The clinician should be diligent in removing any traces of the base solution applied to the skin during the microcurrent treatment before applying the peel.

We recommend waiting one day before shaving after a peel. Also, shaving before the peel on the same day would be similar to microdermabrasion with a peel or dermaplaning with a peel. It would increase peel penetration because you are removing a certain amount of the stratum corneum which will increase penetration. Care should also be taken when shaving over peeling skin, as irritation may occur.

There is no set time, but it’s estimated that the peel neutralizes somewhere between 4-6 hours minimum. It’s best if the patient can wait until the next day to wash their skin, since water can reactivate the peel and cause irritation.

We do not currently have any data that supports this. We do know that the actives will likely concentrate after evaporation, which could lead to less than predictable results. Ultimately, the clinician should make the choice.

Shingles is related to chickenpox and herpes and should definitely not be peeled. The patient should be referred to their physician.

Members of PCA SKIN’s advisory board of dermatologists agree that wearing a personal protective mask immediately following a superficial chemical peel service is safe for the guest’s healing skin and is appropriate for the continued health and safety of the guest and those around them.

The following is a safe and effective way to dispose of unused/unwanted peel solution.

Supplies needed:

  • 3 qt disposable plastic bowl
  • baking soda
  • tap water
  1. Put three cups (approx. 24 oz.) of tap water in the bowl.
  2. Add one tablespoon of baking soda for every 1oz. of chemical peel that needs to be neutralized.  Stir with a spoon until dissolved.
  3. Add chemical peel slowly and in small portions, approximately 1/4 oz. at a time and stir after each portion. After all peel has been added fill the empty peel bottle with water and add to the bowl, repeat this two times.
  4. Now the peel has been neutralized and the contents of the bowl can be safely disposed/flushed down the toilet. The bottle is now also safe and can be disposed of or recycled .

Treatments can begin once the condition presents itself only with the consent of the parents. The clinician can also consult with the child’s pediatrician to determine the best treatment and daily care options. We recommend beginning with our less active treatments and increasing progressively as needed.

The application of some correctives, the Calming Balm and even the hydrate step can sting or burn after a peel due to a drop in the pH of the skin. When a peel is applied to the skin, the pH drops below its normal range. There is a hydrogen component to the peel, as well as the corrective products, and if the peel hasn’t been completely absorbed into the skin, adding a product containing water creates hydronium, causing the pH to drop. Hydrogen is attracted to hydrogen, so the “H” in H20 (water) is attracted to the “H” in C02H (carboxylic acid in a peel), creating hydronium. This is the same reason there is a ‘flash’ of heat when neutralizing a single acid peel. As we apply the products eventually the pH will rise and the stinging will subside.

SPFs occlude the peels; they do not neutralize them. The application of SPF following any minimally invasive professional treatment is non-negotiable and does not affect the treatment outcomes in any negative ways.

Daily Care

There is no way for us to confirm specifically that there is no nickel present. If a patient has a severe allergy that leads to anaphylaxis, it is best for them to find a line of products that specifically claim to be nickel-free. If the allergy is milder, we recommend patch testing a small area to check for a reaction prior to regular use.

“Medical Grade” typically refers to products used by / dispensed by physicians.

Unfortunately, no. Some ingredients can come from a variety of sources, although once the substance is removed from its source it typically does not retain the characteristics of that source. That said, raw materials are typically not 100% of the ingredient. The final raw material may contain several percentage points of ‘impurities’ (other components from the source). These could be any protein or substance from the original source. It is highly unlikely that this would cause a reaction, but the best course of action would be to patch test prior to use. If someone has a dramatic allergy that leads to anaphylaxis, it is best to find products that are specifically “free” of that ingredient. For a company to claim “free” of any ingredient it requires specific manufacturing procedures be followed and sometimes even dedicated facilities are used. If the allergy is more topical and they may develop a rash but no anaphylaxis, the best choice is to patch test with the product and question to see if there is a reaction. We do not claim that any of our products are “free” of any ingredient – gluten-free, vegan or vegetarian, soy-free, wheat-free, etc., as we simply don’t manufacture to those specifications. There is of course a lower risk if the ingredient to which they are allergic is not listed on the ingredient list.

If there is a question about one product we can often look into the formula and be more certain, although even then, a manufacturer can change the source of an ingredient if it is the same molecule they are using. This is not common, but could happen. We do not manufacture under any restrictions to ensure non-cross contamination of lines – even though they are always cleaned thoroughly between runs. We cannot safely and in good conscience claim that we are “free” of any specific category.

Those oils are saponified to make the soap.

Soap is made by a chemical reaction called saponification. The oils are starting ingredients, but they are not actually what makes up the soap. The oil gets transformed during the reaction.

As far as IR/HEV and blue light, there are no FDA monographs covering these benefits for any SPF, so making claims or marketing that an SPF currently on the market protects against these is actually against FDA regulation. Antioxidants protect against these and our sunscreen all contain silymarin or ubiquinone, in the case of Sheer Tint. We will not make those claims, though, as we closely follow all FDA regulations for OTC drug products. There are new ingredients that are being shown to protect against IR and HEV that we are researching.

All of our products are formulated to allow the important active ingredients to exert the action for which they are intended in a product. In the case of the Hydrator Plus SPF 30, the humectant ingredients in the formulation add the action of drawing moisture up into the upper layers of the epidermis and the lightly occlusive ingredients function to help trap this moisture with the skin. The humectants are not impeded by the inclusion of the sunscreen ingredients and the necessary occlusion is only enhanced with the inclusion of zinc oxide. Feel sure that this product delivers balanced and effective skin moisturization as well as broad spectrum protection for any patient.

Although we have many anecdotal testimonials from staff, customers and friends, we do not specifically formulate, test or market our products specifically for babies or toddlers. If anyone asks if our products are safe for babies or toddlers, let them know that they are not made specifically for children nor are they marketed as such. This is the same procedure that is recommended with pregnancy and lactation: consult with the attending physician or OB. We want to always first suggest that a parent speak to their pediatrician prior to using any products on their young children. We are happy to provide ingredient listings for any products they would like to share with their child’s pediatrician.

Although we have seen improvement in many forms of skin discoloration with the use of Intensive Brightening Treatment, we can only refer to its ability to improve discolorations, create a luminosity and a radiance in the skin. It does also reduce redness and the age-related yellowing of the skin.

https://jddonline.com/articles/dermatology/S1545961616P0863X

Efficacy and Tolerability of a Skin Brightening/Anti-Aging Cosmeceutical Containing Retinol 0.5%, Niacinamide, Hexylresorcinol, and Resveratrol
July 2016 | Volume 15 | Issue 7 | Original Article | 863 | Copyright © July 2016

Patricia Farris MD,a Joshua Zeichner MD,b and Diane Berson MDc

aTulane University Medical Center, New Orleans, LA
bMount Sinai Hospital, New York, NY
cWeill Medical College of Cornell University, New York Presbyterian Hospital, New York, NY

Peptides on their own are hydrophilic and don’t penetrate all that well. Argireline is the hexapeptide bound with acetic acid, which gives it a lipophylic-tail to help it penetrate.

We always recommend applying prescriptions first, on clean skin. This holds true for prescription hydroquinone. Patients would apply the HQ to the areas to be treated and then follow with a full-face application of Intensive Brightening Treatment. This is a strong combination and should only be applied several days a week until the skin is accommodated. Causing undue irritation will worsen the condition rather than improving it.

The ingredient Argireline’s (acetyl hexapeptide-8) mechanism of action is to mimic the protein SNAP-25 that interacts with the SNARE complex that is responsible for releasing the neurotransmissions that lead to muscle contraction. By competing with the natural SNAP-25, it effectively reduces these neurotransmissions and, therefore, the muscle contractions that lead to wrinkling. Argireline is a great peptide that works with regular application – twice daily. We see proof of this with the use of Exlinea® in clinical trials and on ourselves.

We at PCA SKIN® are diligent in our discussion of just what topical products can and can’t do.  We know that ExLinea® is not “better than Botox®”, or other neurotoxin products, but what it can do is still of great benefit to the skin’s health and appearance. For those who do not want injections, it can help to stave off excessive wrinkling due to facial muscle contractions. For those who do get injections, it will support that investment with use at home.  We do not want to say it will make the Botox or other neurotoxin last longer, as we have no clinical data that proves this at this time. ExLinea® Peptide Smoothing Serum is an important part of the PCA SKIN® line and an excellent addition to any anti-aging regimen.

It isn’t separating. We have noticed during the development process that some tubes of IBT develop a small amount of liquid – this seems to be related to temperature, and also due to the lipid content in the product. Depending on when the tube was filled within the batch, there have been a few tubes here and there that have more of this oil than others.  It is not a common or widespread problem. However, once this small amount of liquid develops, it does not increase over time (demonstrated in accelerated stability). We have also assayed the retinol and confirmed that its percentage and activity remains unchanged. So, it is not product separation, rather a small lipid release, which seems to stay within boundaries and does not affect the product performance. This is not an issue of the product going bad.

When it comes to comedogenicity, we have to look at the formulation as a whole. The way an individual ingredient will behave when applied to the skin is very different compared to a finished formulation. For example, Vitamin E is comedogenic. Of course, Vitamin E is found in many non-comedogenic products and is even used as an adjunctive treatment for acne.

The “wipe” is 100% cellulose and therefore is biodegradable.

Dispose of the makeup removing wipe in the trash, do not flush the used wipe down the toilet. This product has not been tested or deemed safe on septic systems

In these formulas, L- ascorbic acid is “packed” in a polysilicone (anhydrous) polymer. Upon contact with skin, and with the friction of rub-in, the matrix “breaks” in the upper layers of the skin to release the L-ascorbic acid. Here it meets interstitial water (especially water from the follicles), which dissolves L- ascorbic acid – a hydrophilic molecule – and takes it further from there. When this dissolution in water happens, as L-ascorbic acid is an acid, pH is very temporarily lowered and that is tingling felt by patients – release of L-ascorbic acid from the polymer carrier into the water in the skin.

Lipophilic molecules enter the skin more easily than hydrophilic, so water-based vitamin C is not only unstable, but also does not have great penetration through the lipid surface of the skin. Our lipophilic polymer delivery system behaves as a kind of dermal patch, carrying the hydrophilic molecule into the skin. In addition to the stabilization it provides, it also releases the L-ascorbic acid once it encounters the water environment in the skin. Once the hydrophilic vitamin C is beneath the surface, it penetrates well on its own, as water content increases.

OTC (over the counter) ingredients are drugs that are approved and regulated by the FDA to treat a specific skin disease or that create change in the skin, such as BPO, salicylic acid, sunscreen, etc. These need to be labeled with a Drugs Facts Box to contain specific directions, warnings, etc. as mandated by the FDA.

Pharmaceutical grade refers to ingredients that are of a quality standard that would be suitable to use in a drug product, but are not necessarily drugs on their own. This is primarily a marketing term.

Cosmeceutical, is a word that is not officially recognized. It was crafted as a way to indicate an ingredient that has both cosmetic benefits and does create change in the skin. Unfortunately, if you prove too strongly that a cosmetic ingredient does create change in the skin, a company can be forced to submit to a New Drug Application, which can cost millions of dollars.

Retinyl palmitate is in this formulation in a miniscule amount to act as an antioxidant for the product. It does not play an active role in the formulation on the skin.

The excellent results that we see with Hydrating Serum are primarily based on two ingredient blends: One is primarily sodium hyaluronate, wheat amino acids, sodium PCA, panthenol and botanicals; and the other is niacinamide and sodium PCA. They are designed to act not only as humectants, but also as film formers and moisture regulators. They improve barrier function and reduce transepidermal water loss (TEWL). The moisture that is drawn into the epidermis from the dermis is safely trapped within the skin.

Hyaluronic acid (HA) is an ingredient that attracts and holds 1000 times its weight in moisture. High percentages are not needed. Also, HA by nature is viscous, similar to when you open an aloe leaf. If you had very high percentages in a product it would be thick, sticky and not cosmetically elegant.  We use traditional HA, at appropriate percentages, that does its work on the surface due to its large molecular weight. To create a well-rounded product, we also use hydrolyzed HA that is a smaller molecule, so it penetrates deeper into the skin to hydrate lower in the epidermis. Then, we also add the HA pro complex™ that stimulates the production of our body’s own HA and other glycosaminoglycans. Our formula is proprietary, but it is effective and well designed.

Alcohol plays a number of different roles in product formulations. Typically, the alcohol you see listed is not an ingredient that is added on its own but is a component of some other finished raw material that is included in a formulation. Alcohol is also an ingredient that can play a role in the final feel and “finish” of a product on the skin.  Because Total Strength Serum is a formulation that is specifically targeted toward those with aging skin, and was designed with that in mind, the customer can feel confident that the alcohol included is not something about which to be concerned.

All PCA SKIN® sunscreens are “Broad Spectrum” sunscreens, which means they provide protection against both UVA and UVB rays. In the United States, in order to state your sunscreen provides “Broad Spectrum” protection/coverage, you have to pass a test called “Critical Wavelength” in addition to the SPF testing. The test is a pass or fail test, so we don’t get a specific “UVA Rating” or “UVA Protection Number” that we can share.

Outside of the United States, primarily in Asian countries, they have different regulations which require a test called “UVA Protection Factor”. This test provides more information on the UVA protection, including a numerical rating. This is most likely what they are asking for. We have not conducted this test on any of our sunscreens. We have done all testing required by the FDA and additional tests needed to receive the Skin Cancer Foundation’s Seal of Recommendation. Neither of these agencies currently accept the “UVA Protection Factor” test as evidence that the product is effective at blocking UVA rays.

Please note that the Skin Cancer Foundation only provides their Seal of Recommendation to products which they feel provide adequate UVA protection.

pH can only be measured in water solutions, and while bars contain water, they are solid substances (soaps), where pH cannot be measured, hence it is not part of specifications. Once mixed with water and a solution is made, such solutions will have a pH, but each individual makes a different solution every time they wet the bar, so it is meaningless to define the pH of a solution when it is something made completely individually by the customer and can vary greatly.

Some other products where we cannot measure pH are anhydrous products such as  C&E Advanced, C&E Strength and C&E Strength Max, and water-resistant SPF products, which are water in oil emulsions (that is what makes them water-resistant) so we do not have the water environment necessary for a pH test.

This is a known issue and is not truly “grit.” As the formula is filled into the tubes, there are some variations in temperature. This product is very temperature sensitive and the tubes that are filled during the cooler intervals sometimes contain what feels initially like grit, but it is simply portions of the formula that are cooled during filling. Once applied to the lips, it melts immediately and does not leave any “grittiness” behind. At this time, there is no solution to the temperature oscillation, but it is not an indication of anything being wrong with the product. It should disappear upon contact with warm skin.

Skin Concerns & Conditions

If the seborrheic dermatitis is under control, Sensi Peel is the best choice when it comes to professional treatments. They actually may help keep the condition at bay as long as it isn’t flaring up. This is a chronic condition and unfortunately, at this time, there is no cure. We do know that stress and irritants (detergent, fragrances, allergens in the air, pollution, etc.) can make the condition worse. Professional treatments should never be performed on compromised skin, so if the condition is active, it is best to avoid professional treatments such as peels.

Patients should steer clear of acne control products; however, Clearskin would be an excellent choice for nighttime hydration. Rebalance, Hydrating Serum and Anti-Redness Serum are also appropriate for daily care and should help.

CliniCalm® is actually an OTC drug for poison ivy, among other things. This is what is on the drug facts:

Uses: For the temporary relief of itching and discomfort associated with minor skin irritations and rashes due to eczema, psoriasis, insect bites, poison ivy, poison oak, or poison sumac, soaps, detergents, cosmetics, jewelry, seborrheic dermatitis, etc.

Therefore, a great choice for treating poison oak and poison ivy!

Lupus is an autoimmune disease that presents in many different ways. The skin is often red and irritated and dry. We do not have any written protocols, and the patient should get recommendations from their physician first.  Once that is obtained, we could recommend products that would fit those recommendations, and then provide the ingredient lists to be approved by the physician.

A nodule is a solid, dome-shaped or irregularly-shaped lesion. Nodules are characterized by inflammation, extending into deeper layers of the skin and may cause tissue destruction that results in scarring. A nodule may be very painful.

A cyst is a sac-like lesion containing liquid or semi-liquid material consisting of white blood cells, dead cells, and bacteria. It is larger than a pustule, may be severely inflamed, extends into the deeper layers of the skin, may be very painful, and can result in scarring. Cysts and nodules often occur together in a severe form of acne called nodulocystic. Systemic therapy with isotretinoin is sometimes the only effective treatment for nodulocystic acne. Regardless of terminology, this is a severe form of acne that is often resistant to treatment and likely to leave scars after healing.

Scleroderma is a serious skin condition that results from dysfunctions of collagen that leads to its uneven distribution, as well as abnormal calcium deposits. All product usage should be approved by the patient’s physician before starting any new products.

There really is no way for us as a company to make a determination of what caused someone to have a reaction, even if they have provided photos. Doing so would not be responsible or helpful to the customer or their patient. We can absolutely provide guidance for the customer to help manage complications post-treatment, such as keeping the skin hydrated, protected and soothed with products from the post-procedure kit. It is also helpful to educate the customer on ways to avoid reactions such as pre-treatment, conducting a thorough consultation, and patch testing prior to treatment. Following these guidelines definitely lowers the risk of reaction, but even a patch test cannot guarantee that someone on any given day may react differently. The skin is a dynamic system that is always shedding and renewing itself, so there are even instances where the same person will react differently to the same product or treatment on different days.

If the customer would like to return any products about which they are concerned, we can always accommodate them. In this case, please initiate the adverse reaction procedure.

Dermatographia is a condition also known as skin writing. When people who have dermatographia lightly scratch their skin, the scratches redden into a raised wheal similar to hives. These marks usually disappear within 30 minutes. The cause of dermatographia is unknown, but it can be triggered in some people by infections, emotional upset or medications such as penicillin. Most people who have dermatographia don’t seek treatment. If the signs and symptoms are especially bothersome, the physician may recommend allergy medications such as diphenhydramine (Benadryl).

PCA SKIN® does not have treatments specifically for this condition, but patients may ask their physician about using daily care products. Professional treatments should not be applied to skin that has any rashes or inflammation present.

Glycation is a reaction that happens both inside and outside of our bodies. It is a process by which sugars (primarily fructose and glucose) bond with proteins and fats to form advanced glycation end-products, or A.G.E. These pro-inflammatory compounds can cause the all-important collagen and elastin in our skin to become weak and stiff, accelerating the visible signs of aging. Although a certain amount of sugar is necessary for healthy body function, it has been asserted that a low glycemic diet is a beneficial part of any anti-aging regimen.

Because these A.G.E. also induce a browning reaction (called a Maillard reaction, as it was discovered by chemist Louis-Camille Maillard in 1912), they are often added to many foods we consume to improve their color, taste and appearance. Unfortunately, this is clearly a sales and marketing benefit, not a health benefit. High levels of A.G.E. are being studied for their role in type II diabetes, ocular diseases and heart diseases. Below is a list of some ingredients that help fight the visible skin aging that can be exacerbated by glycation and the PCA SKIN® products in which they are found:

  • Aminoguanidine (Nutrient Toner)
  • Arginine (Body Therapy)
  • Niacinamide (ReBalance, Rejuvenating Serum, Hydrating Serum, Intensive Brightening Treatment, Clearskin, Vitamin B3 Brightening Serum, Pigment Bar®, Activator (Step 1 from the Oxygenating Trio®)
  • Green Tea Extract, Flavonodis, Antocyans – different polyphenolics (these are found in a wide range of PCA SKIN productts
  • a-Lipoic Acid
  • Hexylresorcinol
  • Terminalia chebula fruit extract

Perioral dermatitis is a rash that causes bumps around the mouth, and can also appear around the eyes, nose or forehead. The exact cause is unknown, but it may result from makeup, moisturizers or topical steroid use when treating other conditions.

Prescription medications can be helpful, but no topical steroids should be used. PCA SKIN® Creamy Cleanser and Anti-Redness Serum are safe to use for daily care, but chemical peels are not recommended.  It is recommended to seek a medical diagnosis before treating with any products.

Ingredients

Comedogenicity is a very elusive concept that was introduced in medicine and the cosmetic industry a few decades ago but was recently re-evaluated, and today is rarely used in science.

The concept of “acne cosmetica” was developed to link the use of certain ingredients to comedo formation. Animal models (rabbit ear test) were originally used to determine the comedogenic potential of ingredients, with the assumption that finished formulations containing these ingredients would also be comedogenic.

Those models proved to be unreliable, and different results were obtained by different researchers for the same ingredients. The link between ingredients and finished products was not established – finished products using ingredients determined as “comedogenic” were not necessarily comedogenic. Many “comedogenic ingredients” lists have been revoked by researchers who originally published them upon new results and re-evaluation. One of the most well-known cases happened when Dr. Kligman revoked his own claims on comedogenicity of petrolatum.

We now know that it is unrealistic to try and determine “comedogenicity” simply by looking at the ingredient listing of a product. The properties of a particular finished product depend on the formulation, dosage form (cream, lotion, gel, solution…) and amount. It is impossible to determine from the ingredient listing if something is used at 1% (or more) or, for example, at 0.001%; those two concentrations will behave very differently.  If some ingredients were truly determined to cause clogging of pores and breakouts, nobody would use them – no one wants something that makes them breakout no matter how dry their skin. That being said, some patients simply do not react well with certain products. Testing on “comedogenicity” is generally done on rabbit ears, which we do not perform.  All our finished products are tested on patients before launch (and we continue with ongoing testing), which enables us to establish any possible undesirable link between a specific product and acne cosmetica/comedo formation.

PCA SKIN® and our raw material supplier have no expected issues with Sodium Carrageenan in Daily Defense Mist. In addition, polysaccharide gums (in which sodium carrageenan falls under) were evaluated by the CIR (Cosmetic Ingredient Review) in 2015. This evaluation had no mention or concern regarding allergic reactions. For the Taraxacum Officinale (Dandelion) Extract in Daily Defense Mist we are using a material which has specifically extracted the allergens. It’s not a general extract of the plant, but a specific fraction rich in oligosaccharides with MW between 180 and 4760d, being mainly rich in fructans sugar type molecules. In addition, the Daily Defense Mist final product goes through HRIPT testing and has been shown to be a non-primary sensitized or allergen. Specifically, under the conditions of this study, test material indicated no potential for dermal irritation or allergic contact sensitization.

We cannot claim that any of our products are gluten-free (or vegan or vegetarian or “free” of anything), as that requires specific manufacturing processes. That said, in order to affect a person with celiac, the gluten needs to reach the upper intestine. The only product we know that should be avoided is Peptide Lip therapy, as it contains a barley ingredient and is applied to the lips, so could be ingested. Everyone has their own guidelines of what is to be avoided.

We currently do not use any ingredients of animal origin. There are a few ingredients we use which CAN come from animal sources (glycerin, hyaluronic acid, stearic acid and other different fatty acids and esters…) but we use synthetic forms of these ingredients. However, we do not have any vegan certification so cannot make this claim.

There are currently no regulations pertaining to the percentage of preservatives required in a formulation in either the USA or Canada. The EU has certain regulations and PCA SKIN® products are conforming to those regulations (we have a good number of products with positive EU safety assessments). The appropriate amount of preservatives must be determined for each particular formulation and depends on multiple factors (% of water, pH, type of emulsion etc). When the product is formulated, the preservative system is validated at a third-party lab to ensure it provides proper protection for the consumer (this is the Preservative Efficacy Test). Preservatives are an important part of a safe skin care product.

Globally, skin care companies do not typically purchase raw materials directly. As with the majority of skin care companies around the world, PCA SKIN® procures materials from our selected distributors or vendors in the US commercial market based on our guidelines. Where skin care companies vary is on the standards, guidelines and restrictions they impose on what materials are acceptable and unacceptable to include in their products. We impose restrictions and guidelines that only allow for the highest quality of ingredients to be purchased and used in our formulations.

The highest quality and best known raw material manufacturers are large chemical companies with decades or even centuries of history and tradition, and often have a presence on all continents.

PCA SKIN® does not perform or condone animal testing. We are also obligated to adhere to the guidelines of governing bodies where our products are sold.

Peptides used in cosmetic products are synthetically made. In the lab we can attach one amino acid to another and create peptides and proteins; either exact copies of naturally occurring or something novel with enhanced action.

Growth factors can be isolated from human tissue, and some products on the market contain growth factors derived in this way. PCA SKIN® products do not contain any peptide or growth factor isolated from human tissue, all of our peptides and epidermal growth factors (EGF) are developed in a lab.

Butyrospermum Parkii (Shea Butter) is butter from the nut of the Mangifolia tree in Central Africa. It’s also called Karite Butter or African Shea Nut Butter. Shea butter is high in triglycerides, has a high content of vitamins A, E & F and will soften and maintain moisture to the skin without greasiness. Many ingredients are not single molecules, but mixtures.

It is important to understand that although the names sound similar, these two molecules are not the same. Lactic acid is a small carbon-based molecule that is produced in the body when sugars are broken down for energy. Lactose, on the other hand, is a milk-derived sugar. Lactose intolerance is a result of the body not producing enough lactase, the enzyme that breaks down this sugar. Ingesting lactose in the absence of adequate lactase leads to digestive distress. A person being lactose intolerant has no bearing on whether they can apply or ingest lactic acid.

Sodium benzoate is a commonly used preservative in cosmetic products, fragrances and some food products. The FDA deems this ingredient as Generally Recognized as Safe (GRAS). It is a salt derivative of benzoic acid and although it is a more effective preservative, sodium benzoate is more commonly used as a food additive because benzoic acid does not dissolve well in water. Benzoic acid is found naturally in some berries, apples, plums, cinnamon, cloves and milk. Sodium benzoate is the result of mixing benzoic acid with sodium hydroxide.

Concentration as a preservative is limited by the FDA in the U.S. to 0.1% by weight. The International Programme on Chemical Safety found no adverse effects in humans at doses of 647–825 mg/kg of body weight per day. Studies performed with lab rats and mice using varying concentrations of sodium benzoate show the toxicity and carcinogenicity is rather low.

This ingredient recently got some media attention because Whole Foods pulled “Skinny Girl”® Margarita mix from their shelves for having the preservative, but mainly because the product claims it’s all natural and apparently their sodium benzoate is synthesized.

As for forming benzene when present with ascorbic acid, this was connected with certain soft drinks, which are different systems compared to topical products/emulsions. In addition, the amount of benzene was linked both to specific manufacturing procedures (which again is different from manufacturing topicals), and also analytical procedures which were producing benzene on their own, so this artificially added to real results (change of analytical procedure led to lower results).

In conclusion, the soft drink story cannot be related to topical products since it’s a different system, manufactured in a different way. To the best of our knowledge, only soft drinks showed this problem. Sodium benzoate and benzoic acid are widely used food preservatives, and also topical product preservatives, approved worldwide.

This material can potentially offer similar benefits as far as hydration but has less data/ clinical studies when compared to HA. Some studies suggest it can offer great moisturization to top skin layers whereas HA comes in various molecular weight sizes that can penetrate into deeper skin layers.

That deeper penetration offers additional anti-aging benefits. We are in the process of evaluating this material, but today definitely don’t have equal support as we do for HA.

Chemical transport through the skin is notoriously complex due to the presence of multiple parallel and serial penetration pathways, each with its own governing biophysics. Unfortunately, there is no general rule or straightforward answer.  Each instance is complex and depends not only on the physical and chemical properties of the substance we want to transport through/into the skin, but also the active ingredient’s target in the skin, and also the condition of the individual’s unique skin surface.

There are different pathways depending on the substance being applied – lipophilic (through lipids), hydrophilic (through water/cellular pathway) and through appendages (with its own rules).

The way substances interact with either the lipid or water phase of the SC is through solubility – lipid substances dissolve in the lipid phase of the SC, and water-soluble substances dissolve in the  water phase, and then continue partitioning and moving through the layers.

As for penetration enhancers, there are many of them, and how to choose them again depends on the substance one wants to transport into the skin; its properties, and also the expected skin condition, as well as the conditions of usage. Water is certainly a good choice, but lipids can be as well – there is no simple answer to this; it all depends on the nature of the active ingredient one wants to transport into the skin, where in the skin the intended target of that particular active is located, and the formulation as a whole. Sometimes other solvents are used (ethanol, acetone), or detergents (as in cleansers) or specially created delivery systems.

Here is the technical information:

Formal skin absorption pathways: for a substance to be transdermally absorbed,  some key events must take place:

  1. The substance interacts with the stratum corneum;
  2. Diffusion of the substance through stratum corneum;
  3. Crossing from the lipophilic stratum corneum to the more aqueous viable epidermis;
  4. Continuing from the avascular epidermis to the highly perfused dermal tissue; and
  5. Uptake through microcirculation to the systemic circulation

The permeability coefficient increases as lipophilicity increases. A lipophilic substance would easily cross the stratum corneum, but the permeation rate would decrease as it reaches the hydrophilic epidermis and the diffusion of the substance would slow down. The consequence is a temporary deposition (reservoir effect).

Substances are expected to move between compartments based on plain diffusion along the concentration gradient, though movement from one compartment to another will also depend on lipophilic characteristics. If the concentration gradient becomes sufficiently large, the hydrophilic substance might get forced into the skin membrane, but then instantly continue to the more hydrophilic receptor chamber. In contrast, lipophilic substances will be expected to stay in the skin compartment until the concentration gradient is large enough for the substance to pass through.

Substances soluble in the lipophilic layer, as well as in the more aqueous structures at the same time, that have a small molecular size, have the best permeability.

A high lipophilicity as well as high hydrophilicity limits the skin penetration (the skin is a multicomplex membrane that changes from lipophilic to a more aqueous structure. (Too high as well as too low lipophilicity may limit the rate and degree of skin penetration). Penetration of hydrophilic compounds will be limited; more lipophilic compounds will prefer to remain in the lipophilic skin compartments; it is a matter of balance. Uncomplicated penetration of substances requires solubility in both the lipophilic environment and in the more aqueous environment.

The PCPC (Personal Care Products Council) that designates what INCI names are required for each ingredient to be appropriately labeled for global sale says that you either list every component of a fragrance ingredient (natural or synthetic) or you can choose to shorten your list and simply use the word fragrance. If the aroma blend is proprietary to a fragrance house, we list “fragrance” even though it is a blend. We don’t use a lot of fragrances in our products, but when we do, the more sophisticated, subtle, but still natural aromas are typically proprietary thereby being listed as fragrance. This is the case in HydraLuxe. In the Daily Cleansing Oil there is both a proprietary blend “fragrance” and an additional botanical aroma blend that is listed out by ingredient. These botanicals also add additional benefits to the end user experience.

Peptides are linear chains composed of amino acids. When we are speaking of shorter chains (up to 50-100 amino acids) we call them peptides. Bigger chains (could be up to several thousand amino acids) are called proteins. So, peptides are “smaller cousins” of proteins.

There are many peptides naturally present in the body and they typically perform signaling and/or hormonal function. Examples are insulin, endorphin, oxytocin, angiotensin.

Peptides in skin care:

Natural turnover of skin proteins involves degradation of old collagen, elastin and other proteins and synthesis of new molecules. The skin contains enzymes that degrade – or cut into smaller pieces – those larger proteins. Small molecules that result from cutting the bigger one, let’s say collagen, are actually peptides (shorter protein chains or “smaller cousins” of proteins) which are called matrikines. Those matrikines are able to react with specific receptors on dermal cells and trigger the production of new collagen (or other proteins).

To summarize: skin proteins are naturally degraded by enzymes, and the products of such degradation are peptides called matrikines, which in turn trigger synthesis of new proteins, to replace degraded ones. This process obviously gets slower and less efficient as we age, which contributes to the visible signs of aging.

Peptides used in skin care mimic those matrikines, so when applied to the skin, they trigger the synthesis of new collagen, elastin and other skin proteins, hence their anti-aging effect (they build the dermis, epidermis, and lead to increased volume and smoothing of wrinkles).

Some cosmetic peptides might have a different mode of action; here are the classifications of the most used:

  1. Signaling peptides – stimulate receptors and consequently biochemical reactions for synthesis of dermal and epidermal components (so called filler-like peptides) – these are the peptides explained above;
  2. Carrier peptides (delivery systems);
  3. Neuropeptides that help relax wrinkles (like Argireline in ExLinea) (so called botox-like peptides); and
  4. Enzyme-inhibiting enzymes that improve under-eye bags, circles (like Eyeseryl or Eyeliss) or hyperpigmentation.

When we talk about peptides in skin care, most of the time we talk about signaling peptides (filler like).

Besides ingredients which are called “peptides”, growth factors (epidermal growth factor, fibroblast growth factors etc) chemically also belong to the peptide group. They are signaling to trigger cellular replication, and in that way they increase the thickness of epidermis (epidermal growth factor) and dermis (fibroblast growth factor).

The ingredients in the HA-Pro complex are proprietary, but it contains several ingredients that work in concert to stimulate the skin to produce more of its own glycosaminoglycans, hyaluronic acid (HA) being one of them. One ingredient has shown a 24-hour moisturization capability, while another increases the skin’s suppleness and resistance. This complex is not HA and does not contain HA, yet the ingredients are mostly small oligosaccharides with a structure similar to HA fragments, which is why they are able to act on HA receptors and stimulate glycosaminoglycan (GAG) / HA synthesis. They complement HA and hydrolyzed HA in the formula by stimulating the skin to produce more of its own endogenous GAG and HA.

Para-aminobenzoic acid (PABA) was among the first chemical sunscreens to be approved by the FDA. While it is an effective UVB absorber, PABA has become nearly extinct in current sunscreen preparations due to photoallergy concerns. Octyl dimethyl PABA, or Padimate O, is an aminobenzoic acid derivative that was introduced as a less sensitizing alternative to PABA.  Other PABA derivatives, such as glyceryl PABA (glyceryl aminobenzoate) and padimate A (amyldimethyl PABA) are available in other countries but are not FDA-approved. PABA-free marketing claims have ultimately led to decreased use of PABA derivatives throughout the industry.

PCA SKIN® does not use this ingredient in our SPF products.

It’s important first to note that there is no definition of “natural” by any government office (FDA, Health Canada, etc.). At PCA SKIN®, we choose ingredients based on safety and effectiveness, with high standards of purity. Many highly effective ingredients are bioengineered rather than sourced from nature. Safe and effective ingredients are the standards to which we adhere, rather than “natural” ingredients, which again, is hard to really define.

We also do not use any ingredients of animal origin, or those unethically obtained.

Our EGF is a synthetic 53 amino acid chain. sh-Oligopeptide-1 (EGF) – the INCI name indicates that this substance is a synthetic human oligopeptide, meaning that the small section of synthesized DNA (that is identical to human) that is responsible for coding epidermal differentiation and growth is inserted into bacteria; when fed glucose, these bacteria become factories that produce these epidermal growth factors, which are identical to those in human skin; they interact with the receptors in the skin and begin the cascade that leads to epidermal growth.

Most commercially available resveratrol is synthesized. It is not economically or environmentally viable or sustainable to source it from botanical sources.

We typically do not use palm oil as an ingredient. The palm oil in Total Strength Serum is a small portion of another raw material that provides tocopherol and tocotrienols. It is in the formula at less than 0.09%. We confirmed the manufacturer is eco conscious. This is their environmental statement:

“Plantations on peninsular Malaysia are not newly deforested areas, but legally designated agricultural land that have been worked on over three to four 25-year cycles. Our customers can be assured that our products do not come from palm trees grown on new plantations or plantations from recently cleared rainforest, which are more prevalent in Borneo and Indonesia. We do not purchase palm oil from Indonesia or Borneo.”

(1) After the saponification process, the oils are no longer oils. Their chemical structure is different. That is why the name changes. Palm Kernel Oil is saponified to form Sodium Palm Kernelate. Sodium Palm Kernelate is not an oil. Sodium Palm Kernelate is a fatty acid salt, it is water soluble, and it acts as a cleansing surfactant. It will not clog your pores, but it will help to unclog them!

(2) A Comedo or Comedones are typically thought to be caused by oils or debris blocking the pores, although there are other causes. However it is also known that some oils have a very high potential to be comedogenic, while others are not comedogenic at all. You can find these comedogenicity tables all over the internet where various oils are rated. The truth is, it’s not well understood why some oils are very comedogenic and others are not.

(3) A product can contain comedogenic ingredients and still be non-comedogenic. I always give the example of Vitamin E. You will find a lot of information on the internet about Vitamin E being comedogenic and how you shouldn’t use it if you have acne, but you will also find manuscripts of studies run by dermatologists where Vitamin E creams were used as an effective treatment for acne. A finished formula is more than the sum of its ingredients.

Protocols

We don’t have any approved protocols / products / treatments for either of these modalities. We invite people – clinicians, physicians, educators, etc. – to share what they have done or are doing that have been successful. We just don’t know the long-term effects, so can’t make a call either way.  It’s all largely anecdotal at this point.

This protocol is strictly anecdotal, and there are no claims made as to efficacy and safety.  This protocol has been performed successfully in other practices and by clinicians who combine microneedling with PCA SKIN® daily care and professional products.

Cleanse
1. Facial Wash Oily/Problem – Cleanse the area of treatment thoroughly, remove with warm water and pat dry.
Prep
2. Smoothing Toner – Apply with a cotton pad to prep the skin. Allow the skin to dry. This product may sting or tingle on some individuals. Asses sensitivity by asking the patient, “On a scale of one to ten, ten being extremely active, how do you rate this sensation?”
Numbing
3. Apply preferred numbing cream to area of treatment according to manufacturer instructions.
Cleanse
4. Facial Wash Oily/Problem – Cleanse the area of treatment thoroughly, remove with warm water and pat dry.
Treat
4. Microneedling – Administer over the entire area of treatment at 0.5 mm depth or less using Hydrating Serum.
5. Sensi Peel® (this step is not recommended if 0.5 mm depth was exceeded) – Before using, gently agitate the product. Apply the solution to a cotton pad by placing the neck of the bottle directly onto the pad, spacing it to give a sufficient working area to complete a full-face treatment (about four to five spots on the pad). You may also apply the solution using a mask brush if preferred. Maximum one layer of Sensi Peel® is recommended when used in conjunction with microneedling. Use the scale of 1 to 10 to gauge sensitivity.
Correct
6. ExLinea® Peptide Smoothing Serum – Apply one to two pumps to areas of facial expression wrinkling to reduce the depth of fine lines and wrinkles.
7. Hydrating Serum – Apply two pumps to increase long-term hydration.
8. Vitamin b3 Brightening Serum and Total Strength Serum – Blend one to two pumps of each serum in gloved hands and apply to the area of treatment to reduce fine lines and wrinkles, and improve skin discoloration, redness and glycation-related skin yellowing.

Retinoid booster (optional)
9. Advanced Treatment Booster – Dispense two pumps into gloved hands. Gently spread the product over the area of treatment, keeping application even and thin.
• Use the scale of one to ten to gauge sensitivity. Most patients will not have any sensitivity to this product.
• The maximum number of layers is one.
Hydrate and Protect
10. ReBalance and Sheer Tint Broad Spectrum SPF 45 – Complete the treatment with this combination to calm, hydrate and protect the skin from UVA/UVB rays.