Home' Clinical Aesthetics : CA issue - 2 Contents and even modify a cell’s protein or DNA.
“Latest research in the US has found
that low-level inf lammation w ill lead to the
formation of enzymes (collagenase, elastase
and hyaluronidase) that break down the
structure of the skin.
“Dehydration, inflammation and
oxidation always occur together and are
causally linked. They are often claimed to
be the three main causes of skin ageing.”
Another contributing factor, ironically,
can be the very anti-ageing treatments sought
to combat ageing, such as too-harsh or
inappropriate peels for a patient’s skin type.
They do trigger change, but at the
cost of keeping skin in a constant state of
The two main formulation types for skin
creams are oil-in-water (water-based) and
water-in- oil (oil based). For a skin cream to
be truly biomimetic it needs to be oil-based,
according to Paul Fister.
“Scientific research has proven that they
hydrate the skin longer and better, and
therefore protect it better from dehydration,
inflammation and oxidation,” he continues.
“Studies have shown that they also
generally deliver a higher proportion of
active ingredients and require less potent
emulsifiers – ergo, interfere less with the
skin’s natural environment.
“Finally, bacteria prefer a water-based
environment over oil, so water-based creams
require higher levels of preser vatives.”
"The best anti-ageing results can only
be achieved with a ` layer cake' approach,"
says cosmetic surgeon Dr William Mooney,
founder of Face Plus medispas. " The
market is flooded with lotions and potions
that do achieve real results. We use the Dr
Spiller range at Face Plus as it is a bespoke,
medical-grade cosmeceutical range with
"But truly beautiful skin come from
the inside, too. We look closely at patients'
diet and lifestyle choices, supplements and
even their happiness levels. With an holistic
approach the skin can truly glow."
BY VIVIEN GARDNER
he signs of ageing we see in the skin are
the results of chronic inflammation.
Mostly due to longterm UV exposure,
other intrinsic and environmental factors
are also involved.
Changes in texture and laxity are the
most obvious signs, as well as chronic
discolouration such as dyspigmentation
The arrest of skin deterioration is
possible – some changes such as texture and
discolouration are even reversible – when one
understands the inflammatory process and
the topical agents required to intervene in the
inflammatory cascade, something that is core
to the philosophy of Jan Marini skincare.
Like other organs of the body, the skin
functions dynamically through a complex
series of actions and reactions at a bio -
Much research is being done in this area
at leading medical institutes (Gallo, Miller,
Nakatsuji, Nestle, Yamasaki, Hornyak et al).
For example, of the 1200 peptides so
far identified as hav ing a role in epithelial
function, cathelicidins have been shown
to be upregulated in the onset of rosacea.
Whether their role is proactive or reactive
has yet to be determined.
Several scholars have described the
importance of the skin’s microbiome. Anti-
microbial peptides (AMPs) are produced
not only by keratinocytes - including by
non-viable cells in the stratum corneum
– but by endogenous microf lora like
st aphylococcus epidermidis.
Altering the skin’s microbiome through
use of topical bacteriocides can be counter-
productive. Inducing dysbiosis results in
inflammation on the skin’s sur face, which
leads to recruitment of immune sentinels in
the epidermis and dermis.
Activation of Toll-like receptors, T- cells
and dendritic cells all play a role in chronic
inflammation and the cascade signals result
in many of the issues we see clinically.
This brings us to skincare. In the rush
to meet market demands for “natural”
or “preservative-free” products, many
manufacturers turn to bacteriocides to prevent
microbial proliferation in their products.
The most commonly used bacteriocides
in the “clean” product market are essential
oils such as orange (bergamot), lavender
or tea tree.
When applied reg ularly, these can affect
the microbiome and sensitise the skin by
disturbing the balance of endogenous
bacteria, resulting in a decline in the
normal production of AMPs and a cascade
of inflammatory signals.
Essential oils are also powerful solvents,
hence their inclusion in many household
cleaning products. One of the other
contributors to skin homeostasis is the free
fatty acids (FFAs) produced by sebocytes in
the sebaceous glands. Frequent application
of essential oils to the skin may affect the
ability of FFAs to contribute to the skin’s
In conclusion, when we consider the
barrier function of skin we should also
take into account the normal synthesis of
agents that protect against proliferation of
opportunistic pathogens and regulate the
When recommending topical
management, it’s important to ensure
short-term solutions are not fraught with
Daily use skincare w ill only improve the
appearance of skin by not disturbing the
anti-inflammatory action of keratinocytes
and skin commensals.
* Vivien Gardiner R N co-founded Erase Aesthetic
Services clinic in Malvern, Melbourne, in 1997 and
is the distributor in Australia of Jan Marini skincare.
Insidious Toll of Skinflammation
CLINICAL AESTHETICS | 27
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