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difference explained
There is perhaps equal measures of misunderstanding and misconception regarding the grades of skincare products,
particularly when the formulations approach dermatological effects.
This is not helped when new marketing terms are invented to imply performance. In this article we will look at the
definition of the two main classes of products that straddle the border between cosmetic and medicinal and their use
in Corneotherapy.
This article is a distillation and compilation of information sourced from colleagues who share my passion for
sharing knowledge. FBH
Let us be clear however: the term cosmeceuticals does not appear in the
European Cosmetic Directive, nor is recognised by the American FDA.
Regardless of it’s legal status or recognition, it makes sense to define the term,
particularly if a certain level of quality and performance is associated with it. So
when can we, or should we speak of a cosmetic ingredient that has a pharmaceutical
effect, AKA Cosmeceutical?
If the criteria mentioned above strictly interpreted, many highly praised and modern cosmeceuticals would just
fall through the cracks– either as a single substance or in a preparation combined with other substances.
As this type of formulation is not designed to act on the skin’s surface but destined to be effective in the deeper
layers of the skin, cosmeceuticals should in principle be free of any counterproductive additives. Consequently, the
inclusion of fragrance and allergenic preservatives do not fit the true concept of a cosmeceutical.
Equally; so as to avoid a washout of active agents and skin lipid components, non-degradable emulsifiers would be
taboo in the case of products to treat skin barrier disorders.
With cornification disorders such as acne, the use of paraffin oils, and comedogenic hydrocarbons in a formulation
does not correspond with cosmeceutical principles. While lipids should be avoided in formulations designed for
perioral dermatitis, minor doses are allowed with rosacea.
In summary, the matrix of a true cosmeceutical formulation should guarantee an excellent ease of use, correspond
with the physiology of the skin, be free of unnecessary additives and avoid adverse side-effects.
It can be said that these are the same, albeit often disregarded claims that are used for topical pharmaceuticals; a fact
that has contributed to the creation and justification of cosmeceuticals.
It can be concluded that while cosmeceutical products have fewer restrictions regarding the selection of their matrix
components, they are in no way inferior to pharmaceuticals.
While European skin care manufacturers have to comply with the EU Cosmetic
Directive, in the US and different countries of South East Asia particular products,
such as sun protection products, fall within the definition of “medical skincare”.
These products are submitted to a separate, complex and costly registration process.
The authorities in charge also routinely control the content of UV filters. The close
monitoring results from the fact that damage to the skin can still occur when
application dosages are disregarded and consumers rely on the information on the
labels.
For that reason, skin care concepts based on the types of creams used in dermatology (by a dermatologist) are
finding their way in to cosmetic skin treatments (By appropriately trained skin treatment specialists) that are
designed for intense skin care programs as well as supportive prevention strategies.
This type of approach is gaining more and more importance in today’s world where skin barrier disorders are
becoming more common.
These dermatological types of creams are known as Derma Membrane Structure (DMS), and can fulfil both the
dermatological and supportive prevention requirements for skin, and as the name suggests, DMS creams are
designed to be compatible to the physiological properties of the skin.
Skin treatment therapists use them as a base cream to apply separately (as a moisturiser) or in combination with
cosmetically active agents, while dermatologists and pharmacists utilize them as a pure base cream for prescriptions,
either individually or in combination with pharmaceutically active agents.
From a chemistry point of view, the criteria for dermatological cosmetics are that they are free of non-physiological
emulsifiers, preservatives, mineral oils, perfumes, dyes and additives.
When we consider at the ingredients used in conventional cosmetics (INCI), these important criteria that make
dermatological cosmetics true to their name cannot be ignored or taken for granted.
We have learnt in previous publications and education that the many emulsifiers that are not physiologically
compatible to the skin can cause neurodermatitis and similar barrier disorders.
As a matter of principle, any cosmetics designed from a dermatological approach should therefore be free of these
emulsifiers.
High concentrations of mineral oils and silicones in formulations may also impede the natural regeneration of the
skin; studies of renowned scientists have proven this.
Fragrances are mentioned as the number one sensitising substance in cosmetics today; and as with preservatives,
individuals with a very sensitive or even pre-damaged skin are mostly affected.
Dermatology deals with the needs of the skin itself. In all dictionaries and encyclopaedias the term “derma “directly
refers to “skin” with dermatology explicitly and exclusively signifying skin science.
Consequently, another feature of dermatological cosmetics is a potential supportive care and prevention of skin
disorders or even diseases. In this case, special emphasis is given on skin protection as described in the European
guidelines which consequently results in additional quality features such as:
• Skin-identical or skin-related components.
• Creams with a physical structure identical to the membrane-like composition of the skin barrier layers.
Cosmetic dermatology or dermatological cosmetics complements the fields of both conventional medicine and
traditional cosmetics/ skin care while extending their field of activity.
Aestheticians, skin treatment therapists, dermatologists and pharmacists with foresight already have realised
customers needs, and are now expanding their range of services appropriately.
As a result, more and more therapists are seeking information on dermatology; while dermatologists who deal with
cosmetics and pharmacists are improving their sales competence in Dermatics and cosmetics.
Dermopharmacy, cosmetic medicine, cosmeceuticals are the key words of today which refer to the fact that there is
no longer a clear dividing line between skin care, prevention,and treatment. Furthermore, many of the substances
are used as cosmetically and dermatologically active agents.
Two example of this are Urea and D-panthenol. Urea is an ingredient used in cosmetic formulations for dry, stressed
skin and in dermatology in creams for the treatment of neurodermatitis. D-panthenol supports the regeneration of
the skin in cosmetic applications and is used to accelerate healing in dermatology.
The key feature of Corneotherapy is that the primary task of any formulation or
treatment is to correct or create homeostasis in the skin so that it will then effect it’s
own repair.
This is particularly significant with the increasing number of skin conditions related
to, or exacerbated by barrier disorders of various types.
Without discussing the complicated biophysical processes in detail, in summary, it
may be said that corneotherapy aims at a recovery of the stratum corneum and above
all, that it improves the skin barrier function and consequently the homeostasis of the
skin.
It is well established that a healthy and properly functioning skin barrier inhibits
pathogenic germs, such as Staphylococcus aureus that is widely found in cases of
atopic dermatitis, from penetrating into the epidermis.
A disordered stratum corneum, however, tends to support recurrences. This example
shows the importance of avoiding counterproductive effects of skin care that has not
been created with skin barrier health in mind.
It has been known for quite some time, that skin cleanser components such as
sodium lauryl sulfate (SDS) may cause major skin irritations by firstly damaging the
barrier function and subsequently causing cellular reactions.
Furthermore, a SDS damaged skin barrier enables sensitizing substances that are
used to preserve and fragrance skin care products, to easily penetrate the skin.
Interestingly, SDS is widely used as a standard irritant in dermatological research.
Despite the effectiveness of Corneotherapy in the treating of many skin barrier related conditions and beyond, there
is only hope that it will (despite its relatively unspectacular procedures compared with conventional treatments) may
soon gain acceptance.
References
1. Dr Hans Lautenschläger; Dermatological cosmetics – linking cosmetics and medicine published in Kosmetische
Praxis 2005 (5), 12-14 http://www.dermaviduals.com/english/publications/products/dermatological-cosmetics-
linking-cosmetics-and-medicine.html
2. Dr Hans Lautenschläger; Highly effective – Cosmeceuticals- published in medical Beauty Forum 2014 (4), 16-
18
3. Lautenschläger H, The history and current aspects of corneotherapy, IV. International Symposium on Aesthetic
Medicine, Moscow, April 19-20th, 2005
4. Friberg SE et al., Water permeation of reaggregated stratum corneum with model lipids, J Invest Dermatol
1990;94:377-380
5. Lübbe J, Secondary infections in patients with atopic dermatitis, American Journal of Clinical Dermatology
2003;4(9):641-654
Addendum;
The United States (US) and European Union (EU) both work to ensure the safety of cosmetics for consumers
through rigorous regulation.
The 27 European Union Member States have transposed the European Union Cosmetics Directive, enacted in 1976,
into national law. Each Member State has health authorities that then regulate cosmetics within their respective
national boundaries according to the law.
In the United States, the cosmetics industry is regulated by the U.S. Food and Drug Administration (FDA) which
has been granted broad regulatory authority under the Federal Food, Drug, and Cosmetic Act, enacted in 1938.
See more at:http://www.cosmeticsinfo.org/Regulation-in-eu-us#sthash.zZIVVsk7.dpuf