Skin aging results in increased roughness, the appearance of new lines or wrinkles, sagging of the skin, irregular pigmentation and a loss of skin elasticity. This occurs when natural antiaging chemicals in the skin are depleted.

Medical scientists suggest there are two basic process that result in aging:

• Genetic programming for the aging process

• Environmental exposure to physical and chemical agents toxic to health:

• Ultraviolet radiation mainly from sunlight
• Cigarette smoking
• Wind exposure
• Exposure to harsh chemicals e.g. detergents

UV irradiation is a major cause of damage and it overwhelms the body’s natural antiaging chemicals, certain vitamins. Excessive sun exposure results in more rapid degeneration, particularly, in sun exposed areas of the body. The exposure to sunlight has an additive damaging effect especially, in the elderly. The more sun exposure you experience the faster aging occurs.

UV radiation causes damage by destroying the underlying skin collagen and structures that maintain elasticity.

Sunlight and other sources of UV radiation create high energy oxygen particles (reactive oxygen species-ROS). These chemicals include superoxides, peroxides and singlet oxygen particles. These reactive oxygen particles damage the DNA of skin cells and types 3 and 4 skin collagen. Destruction of collagen results in wrinkle formation. Collagen acts as reinforcement rods to give the skin tensile strength.

There is a constant attempt by the skin to repair and prevent damage by naturally occurring antiaging agents. The body has natural antioxidants which include Vitamins A, C and E. Squalene and Coezyme Q-10 also are naturally occurring antioxidants, in the skin.

Aging results in fewer available antiaging molecules in the skin. UV irradiation also results in a loss of these antioxidant molecules in the skin.

UV radiation also affects the chemical bonds in DNA. These UV induced DNA changes result in skin cancer, when the skin can no longer repair such damage. The more the exposure to sunlight the lesser is the skin’s ability to repair this DNA damage.

Many OTC skin antiaging products contain these natural skin antioxidants. The effect of these antioxidants present in creams in preventing skin UV damage has been not studied sufficiently to warrant any dramatic claim. Furthermore, the ability of these chemicals to reverse the damage to skin by UV irradiation remains an open question.

Cellulite is a common concern of adult women. It appears as unattractive indentations, especially, in the thighs and buttock regions.

Medical science has little understanding of the causes of cellulite or how to reverse it. Since there have been few scientific studies on this topic, treatments are usually a dismal failure.

An anticellulite cream was used in one study, 2005 that involved 40 women with a "moderate degree of skin indentations". The cream was applied each night for four weeks. These women wore Bioceramic-shorts to sleep. These shorts were used to increase the absorption of the cream through the skin.

There was a 62% improvent observed among these women, in appearance. The application and use of the cream and Bioceramic neopyrene shorts were found easy to use. The average reduction in cellulite size was approximately 2 cm.

The dermatologists involved in this study felt that the anti-cellulite cream used was effective in improving the appearance of skin riddled with cellulite. No side effects to the cream were reported, in this limited study. Most importantly, this study suggests that topical applications of anticellulite creams may be effective with continuous application, nightly.

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While this article describes some cellulite creams, it does point out that most cream products are used to make cellulite less noticeable as opposed to disappear permanently.

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Whilst even the most expensive store-bought creams and treatments won’t eliminate cellulite permanently, the appearance of cellulite can be improved with regular treatments, and this extends to in-home remedies. … Not only do they have a nourishing effect on their own, but some oils can be irritating when applied directly to the skin. This is especially true of sensitive skin types. Another point to consider is that the essential oils are usually quite thin compared to …

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Moisturizers act primarily to restore skin hydration. Hydration appears to be essential to healthy appearance. Poor hydration results in dryness. And dryness results in skin flakiness, dryness and roughness. Only a few skin moisturizers have been scientifically studied.

Petrolatum the most commonly used occlusive substance, is able to decrease water loss by about 50%. However, petrolatum does not produce any increase in hydration. Cells in the skin called corneocytes prevent water loss and help the to act as a barrier to the outside world. These cells or corneocytes also contain natural moisturizing factors that help hold water molecules.

Moisturizers are made with:

• Occlusives
• Humectants
• Emollients.

Occlusives prevent water loss and are made of oils or fats such as petroleum, lanolin, mineral oil, vegetable oil, or waxes.

Humectants are low-molecular-weight substances that attract water. Natural moisturizing factors are naturally occurring humectants. Common humectants used in moisturizers are glycerin, propylene glycol, and urea.

However, there have been few clinical studies demonstrating the hydrating effects of humectants. Gloor and Gehring demonstrated that a topical application of 85% glycerol emulsion for 3 weeks in volunteers with normal skin resulted in significant reduction in total water loss from skin.

Emollients have no hydrating properties, but they are often used in moisturizers to act as a filler between dead corneocytes thus making the skin smoother.

Scientific studies of moisturizers have been inconsistent. A study that used a moisturizer containing 20% glycerine showed no improvement hydration.

A vitamin B analog called nicotinamide has been shown to improve hydration. Nicotamide appears to work by stimulating corneycyte cells to make ceramid, glucosylceramide and sphyingomyelin. These are fats important to maintaining hydration in normal skin.

Fluorine containing creams may affect fertility in women.

Products containing these compounds:

• Skin creams
• Facial moisturizers
• Dental floss
• Non stick frying pans

A recent study by Chunyah Fei from UCLA suggests that women with above average levels of fluorine containing compounds, in their blood may take longer to achieve pregnancy. These chemicals are absorbed via the skin when creams or moisturizers are applied.

These scientists from the University of California at Los Angeles, did a study with 1,2400 women. The results suggest that compounds known as perfluroinated chemicals or PFCs affect hormones, in women, that are essential to pregnancy. The study has been published in Human Reproduction, a reputable medical journal.

Furthermore, these scientists did find that sperm many also be affected by PFCs.

These compounds, PFCs are used in a wide variety of everyday household products, including skin creams.

PFC’s remain in the body for several years. They are fat soluble compounds and are stored in the body fat. Therefore these compounds may have long term affects on fertility, in both women and men.

Most of us believe that skin creams are tested like common medications before sale to the public. Often, a number of misleading terms are stated such as "clinically proven" to imply the skin cream components, in its product form has been tested. Frequently, the term "clinically proven" is used to mean that one to a few of the ingredients in the cream have been tested scientifically. The ingredients that are listed in the labels usually have not been tested for results when present in the final product. It’s a scary fact to realize that most skin creams have not been clinically tested for efficacy (the ability to treat the skin condition stated) and even worse the side effects of such untested creams remain unknown. Yet these creams are used daily on a wide scale. Frequently, the safety of skin cream use for long periods is unknown.

What do we know about OTC Topical Anti-Aging Products?

Today there is a general trend to look younger by reversing the effects of aging by the use of antiaging skin creams. The trend is so widespread that today even younger individuals seek these products to prevent the effects of ageing. Thus the (OTC) anti-aging products have become a billion-dollar industry. Many OTC products claim exaggerated results, with little little scientific evidence to prove these claims. From a review of the medical literature of ingredients generally found in OTC anti-aging creams, it appears clear that the claims are unsubstantiated by scientific proof.

Treatment of infant skin has not been studied to any meaningful extent, to date. Moms are advised unknowingly to use emollient creams for which little or not evidence exists for benefits to children. What we know from a recent study of 173 infants on the use of skin treatment in infants is that treatments with olive oil had less side effects (dermatitis) that treatments with emollient creams. In this study neonates were treated regularly for periods of up to 4 weeks. The use of skin creams in children requires much further medical research.

Are there any promising Results from Skin Cream Studies?

There have been some promising scientific studies. Vitamin C and alpha-hydroxy acids are among the most widely studied skin cream products. There is some scientific proof that their anti-aging effects are possible.

Vitamin A and vitamin B derivatives also hold promise.

Moisturizers have been shown to increase skin hydration and improve the overall appearance of skin. Studies also indicate that pentapeptides can be effective in decreasing facial wrinkles and roughness. However, botanicals, which have become popular over the last few years, require significantly more research to formulate any positive conclusions for their topical application. As aesthetic surgeons, it behoves us to educate ourselves on the most common ingredients found in topical anti-aging products and their efficacy. (Aesthetic Surg J 2007; 27:402-412)

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