It seems a hot new skincare ingredient is touted in the news almost daily. This is overwhelming for both the public and medical and esthetic professionals. We are literally surrounded by a sea of literature, and we need to educate ourselves so we can best separate the substance from the hype. As more and more of my patients bring in bags of different products to ask my advice on which ones they should use, I wanted to write a series of articles here to help people understand cosmetic ingredients.

Defining Cosmetic Chemistry

Cosmetic ingredients can be divided into categories of activity: cleanse, repair, protect and nourish. Ingredients are then evaluated by how well they perform these tasks, and what level of performance they achieve.

Cleanse
In the cleansing category, you have your Cleansers and Toners. Cleansing is a critical step in a skin care routine. The function of a cleanser is to remove surface debris and makeup without causing any destruction to the delicate acid mantle of the skin. Harsh surfactants that rest at a pH of alkaline (8 to 9+) used daily will disrupt the acid mantle. It is best to use an acidic cleanser so the skin can rebalance itself to a normal pH, between 4.5 and 5.5. Reputable cleansers are in the acid range and can be easily tested by putting a drop on the forearm and dipping a simple pH pencil or litmus paper into the product.

I recommend non-foaming cleansing lotions, as the ingredients make maximum contact with the skin and gently, yet effectively, remove dirt and build up. Foaming cleansers tend to overstrip the skin of its natural oils, causing excess sebum production or irritation. However, if you must use a foaming cleanser, use one with low-foaming surfactants.

Toners work to refine skin texture, lift off any residual impurities, and in some cases, tighten pores. Avoid ones that contain high concentrations of alcohol as they will unnecessarily dry and irritate the skin. Instead, look for bases of witch hazel or purified water.

Proper cleansing and toning of the skin leaves your face clean, pH-balanced and receptive to the next step of your routine, and depending on the time of day, it could be Protecting, Moisturizing or Repairing.

Protect
Always, always, always wear sunscreen. Even on overcast days, 80% of ultraviolet light still filter thru the clouds. An SPF 15 is adequate for normal everyday wear. However, look for higher SPFs if you will be outdoors for longer periods of time playing sports, spending time at the beach, exercising, etc. Physical sunscreens, such as titanium dioxide and zinc oxide work far better in protecting against UVA and UVB rays than chemical sunscreens. Also, a great ingredient to look for in your daily moisturizer is SmartVector UV. This is a patented ingredient that activates the sunscreen once you are exposed to UV light. Since sunscreens begin to decompose the second they touch your skin, SmartVector UV keeps the product intact until you are physically exposed to sunlight. For many of my patients, they start their skincare routine early morning, but don’t go outside until the afternoon to grab lunch or run errands. For SPF moisturizers that contain SmartVector UV (try kaplanMD Day Cream SPF 15), they activate once you go outside, giving you longer- lasting sun protection.

In addition to an SPF moisturizer, also wear wide brim hats, long sleeve shirts, and sunglasses that cover the entire orbital region. Remember to apply SPF on the tops of your ears, back of your neck, back of your hands and décolleté. I see too much sun damage, and non-melanoma skin cancers, in these areas.

Repair
In the repair category, you find your antioxidants, vitamins and peptides. The best vehicle to deliver reparative ingredients is the Serum. Unlike creams, serums come in a variety of viscous, semi-clear liquids. The best serums have a sodium hyaluronate (hyaluronic acid) base, which can more effectively disburse peptides* and antioxidants into the skin (See kaplanMD Perfecting Serum). Whether incorporating a serum into a day or night time regimen, allow 30 to 60 seconds for absorption before applying another cream or makeup foundation.

Also, since the skin loses the most water during the night, evening is the best time for intense hydration, skin repair and rejuvenation. Night creams usually contain the most variety of anti-aging ingredients because the cream stays on your skin for the maximum amount of uninterrupted time. Good night creams at a minimum should contain reparative agents such as vitamin A (retinol), Vitamin C, and at least 1 peptide to promote cell repair and turnover.

*Part 2 of this series will list critical peptides, antioxidant and moisturizers.

Nourish
Ingredients in the repair category work to replace nutrients, boost cell renewal, or fight free-radical damage. Nourishing ingredients on the other hand work to hydrate and lubricate the skin. Obviously, the more categories each of your skincare products can fit into, the better for your skin. In other words, look for products that have an all-in-one approach where they combine multiple categories into each product. For example, a Day Cream that moisturizes, protects AND has anti-wrinkle ingredients. This allows more active ingredients to effectively penetrate your skin without a lot of filler material blocking their path.

Nourishing, moisturizing ingredients* range from simple oils like Shea Butter, Coconut Oil and Squalane to more exotic and complex ingredients, such as Acai, Seabuckthorn, Marine Collagen Spheres and Hawaiian Algae. It is hard to suggest the best moisturizer because you need to factor in how dry a person’s skin is and what other categories are being included in the moisturizer. The best suggestion in finding the right moisturizer is to try the product first. This will help ensure there is no irritation, and there is adequate hydration without a heavy, greasy after feel.

*Part 2 of this series will list critical peptides, antioxidant and moisturizers.

First, decide your skincare goal ~ whether you are looking to prevent acne, balance skin tone, or start a preventative regimen to fight skin aging, it is important to define what type of results you want.

Second, select skincare products that contain ingredients designed to help treat your specific skincare goal. Remember, ingredients alone do not make a good skin care cream. Formulation and concentration of those ingredients are key in providing results.

As an aside, keep in mind that one “star” ingredient cannot make a quality skin care product. The most effective formulations combine multiple patented ingredients so you get widespread benefits with minimal side effects. Quality skincare formulations should meet 4 criteria for competence:

1. The careful selection of the right ingredients
2. Key ingredients are in the effective concentration
3. Formula is blended into a stable, physiologically compatible formulation (texture and absorption)
4. Contains a delivery system that gets functional actives to the right place at the right time.

And the third step in defining your skincare regimen is establishing a skincare routine. Don’t make it too difficult or inconvenient. Choose products that fit into a routine that mirrors your lifestyle. For example, if you barely have enough time in the morning to wash your face, don’t pick a product line that has 2-3 steps for cleansing.

There are 2 categories of skin cancer – non-malignant and malignant. Non-malignant skin cancers include Basal Cell Carcinoma and Squamous Cell Carcinoma. If detected early, these type of skin cancers are not life threatening, and can be removed as an out-patient procedure. Dr. Kaplan performs Mohs Surgery to remove Basal and Squamous Cell Carcinomas right in his dermatology office.

Melanoma is a malignant type of skin cancer. A 2007 study showed that melanoma accounts for up to 3% of all pediatric malignancies, including about 2% of malignancies in those aged younger than 20 years and 0.3%-0.4% of malignancies in pre-pubescent children. The study also showed that melanoma diagnoses are seven times more common between the ages of 10 and 20 years than between 0 and 10 years (J. Clin. Oncol. 2007;25:1363-8).

Furthermore, the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) database showed an increased incidence of nearly 3% per year during 1985-2003 in those aged 1-19 years in the United States.

Yet there remains a lack of awareness of the prevalence of melanoma in children, and some physicians, including dermatologists, still believe that children don’t get the disease.

Those who believe that children don’t get melanoma are doing their patients an injustice, and such thinking is largely to blame for the fact that diagnosis and treatment are delayed in 40% of childhood melanoma cases. A review of 13 melanoma cases in children younger than 17 years showed that 85% of the cancers were nodular in type and had a mean thickness of 3.2 mm when diagnosed; 5-year survival was a mean of 59% in the children (J. Am. Acad. Dermatol. 2005;53:816-22). The authors concluded that “the lack of awareness and reluctance to diagnose pediatric melanoma can lead to higher incidence of thick melanomas.”

It also is important to keep in mind that childhood melanoma occurs most often in white patients, with only 6.5% of cases occurring in nonwhites, which is a higher percentage than seen in adults. Also, unlike adults, there is a higher predominance of cases in females, with 56%-61% of pediatric cases occurring in girls. Further, the incidence of melanoma is increasing at a faster rate in girls aged 10-19 years than among boys in that same age group, which may reflect the popularity of tanning beds among girls.

In regards to where malignant melanoma lesions appear in children, studies show 20% of cases occur on the head and neck, and 80% occur on the trunk or extremities. The study also showed that younger children tend to get skin cancers on their head and neck; of those aged 1-4 years, 39% presented with head and neck cancers, compared with only 12% of those aged 5-19 years.