By Gordon H. Sasaki, M.D., F.A.C.S.
Skin is a sophisticated and dynamic organ that serves as a barrier with sensory and immunological functions and is also the most visible indicator of aging. The search for the fountain of youthful skin currently persists in the form of cosmeceuticals, approved drugs, nonsurgical and surgical treatments to roll back the effects of time.
In the U.S., the cosmeceutical market value is projected to grow to $20.1 billion this year. While the Federal Food, Drug, and Cosmetic Act (FD&C Act) does not recognize the term cosmeceutical, the cosmetic industry may refer to some cosmetic products as having both cosmetic and drug-like benefits. If a product makes such claims, it will be regulated as a drug. The FD&C Act strictly defines cosmeceuticals as products that intend to beautify and promote attractiveness, unlike drugs regulated by the Food and Drug Administration (FDA) that prevent/treat diseases and effect the structures and functions of the body. at being said, the developmental claims of new cosmeceutical ingredients—ranging from short chained synthetic peptides to plant and human conditioned media growth factors to regulated regenerative cells and platelet-rich plasma—are becoming commonplace for skin rejuvenation.
In peer-reviewed studies, medical scientists and specialists have begun to unravel molecular, cellular, and tissue changes that contribute to chronological (intrinsic) and photoaging (extrinsic) aging of skin. Investigators focus on factors (genetics programming, telomeric shortening, excess free-radical ions, smoking, and ultraviolet radiation) that begin at birth and progress throughout our life span. On a clinical level, aging skin can be characterized by ne and course wrinkles, roughness, laxity, sallowness, scaling, telangiectasias, and pigmentary changes including dermatologic disorders such as acne vulgaris and benign, premalignant, and malignant lesions.
Without question, analogues of vitamin A that activate skin retinoid receptors represent the gold standard for the treatment of aging skin and acne, specifically approved by the FDA for these indicated treatments. Beyond hydroxy acids, topical antioxidant scavengers, skin-lightening agents, hormone replacement therapy, and sunscreen blockers of both UVA and UVB, we await more evidence-based clinical studies on the safety, effectiveness, and costs of using growth factors, regenerative cells, and platelet-rich plasma for our patients’ pathogenic and cosmetic skin concerns.