Tretinoin peel: a critical view

The tretinoin peel, also known as retinoic acid peel, is a superficial peeling often performed in dermatological clinics in Brazil. The first study on this was published in 2001, by Cuce et al., as a treatment option for melasma. Since then, other studies have reported its applicability with reasonable methodology, although without a consistent scientific background and consensus. Topical tretinoin is used for the treatment of various dermatoses such as acne, melasma, scars, skin aging and nonmelanoma skin cancer. The identification of retinoids cellular receptors was reported in 1987, but a direct cause-effect relation has not been established. This article reviews studies evaluating the use of topical tretinoin as agent for superficial chemical peel. Most of them have shown benefits in the treatment of melasma and skin aging. A better quality methodology in the study design, considering indication and intervention is indispensable regarding concentration, vehicle and treatment regimen ( interval and number of applications). Additionally, more controlled and randomized studies comparing the treatment with tretinoin cream versus its use as a peeling agent, mainly for melasma and photoaging, are necessary.Univ Fed Sao Paulo UNIFESP, Unit Cosmiatry Surg & Oncol, Dept Dermatol, Paulista Med Sch, Sao Paulo, SP, BrazilUniv Fed Sao Paulo EPM UNIFESP, Paulista Med Sch, Dept Dermatol, Sao Paulo, SP, BrazilUniv Estadual Campinas Unicamp, Sch Pharmaceut Sci, Campinas, SP, BrazilUniv Fed Sao Paulo UNIFESP, Unit Cosmiatry Surg & Oncol, Dept Dermatol, Paulista Med Sch, Sao Paulo, SP, BrazilUniv Fed Sao Paulo EPM UNIFESP, Paulista Med Sch, Dept Dermatol, Sao Paulo, SP, BrazilWeb of Scienc

Estudo randomizado da eficácia clínica dos peelings superficiais de ácido láctico 85% versus ácido glicólico 70%

BACKGROUND: Peeling is a procedure which aims to accelerate the process of skin exfoliation. OBJECTIVES:Development of formulations containing lactic acid at 85% or glycolic acid at 70% and the evaluation of these formulations on clinical efficacy in reduction of fine wrinkles.METHODS:Preliminary stability tests were carried out and an in vivo study was performed with three groups with 9 representatives each. One was the control group, which used only sunscreen; another one used lactic acid+sunscreen, and the last group used acid glycolic+sunscreen. Clinical efficacy was assessed with a CCD color microscope, through the digitization of images before and after treatment. The applications were carried out by a dermatologist, once a mont h every 30 days, during 3 months. The area with wrinkles was calculated by planimetry point counting, in accordance with Mandarin-de-Lacerda.RESULTS:The formulations were stable in the visual and Ph evaluation. There was no improvement in the control group; for lactic acid, there was significant improvement after the second peeling application on the outer lateral area of the right eye and after the third application on the outer lateral area of the left eye. For the glycolic acid group, there was significant improvement in the outer lateral area of the left eye after the first application, and of the right eye region, after three applications. The formulations used must be kept under refrigeration and should be manipulated every 30 days.CONCLUSIONS:Both peelings were effective in reducing fine wrinkles of the outer lateral eye area after three applications (p≤0.05%). It was observed that peeling efficacy in the external-lateral region of one eye might be different compared with that in skin of the external-lateral region of the other eye, relative to the speed of skin improvement.FUNDAMENTOS: Peeling visa a acelerar o processo de esfoliação da pele. OBJETIVOS:Desenvolver formulações contendo ácido láctico a 85% ou ácido glicólico a 70% e avaliar sua eficácia clínica na redução de rugas finas.MÉTODOS:Testes preliminares foram efetuados e estudo in vivo foi realizado em três grupos com nove representantes cada, separados de forma randomizada. Um grupo foi controle, utilizando apenas fotoprotetor; outro utilizou ácido láctico e fotoprotetor; o último usou ácido glicólico e fotoprotetor. Para eficácia clínica, empregou-se microscópio CCD color, digitalizando-se as imagens do pré e do pós-tratamento. As aplicações foram realizadas por médica dermatologista uma vez por mês, a cada 30 dias, durante três meses. A área com traços de ruga foi calculada pela planimetria por contagem de pontos.RESULTADOS:As formulações foram estáveis na avaliação visual e de pH. Não houve melhora no grupo controle; para o grupo do ácido láctico, houve melhora significativa após a segunda aplicação do peeling na região lateral externa do olho direito e após a terceira aplicação na região lateral externa olho esquerdo. Para o grupo do ácido glicólico, houve melhora significativa na região lateral externa olho esquerdo após a primeira aplicação e, depois de três aplicações, na região lateral externa do olho direito. As formulações magistrais empregadas no estudo devem ser mantidas sob refrigeração e manipuladas a cada 30 dias.CONCLUSÕES:Tanto o peeling de ácido láctico quanto o de ácido glicólico foram eficazes na diminuição de rugas finas da região lateral externa dos olhos após três aplicações (p≤0,05%). Verificou-se que a eficácia dos peelings na região lateral externa de um olho pode ser diferente da eficácia na pele da região lateral externa do outro olho, em relação à rapidez da melhora da pele.Methodist University of Piracicaba Health Sciences Collegeaff02Federal University of São Paulo Institute of Environmental Chemistry and Pharmaceutical SciencesUNIFESP, Institute of Environmental Chemistry and Pharmaceutical SciencesSciEL

An overview about oxidation in clinical practice of skin aging

Free radicals are unstable chemical species, highly reactive, being formed by cellular entities of different tissues. Increased production of these species without proper effective action of endogenous and exogenous antioxidant systems, generates a condition of oxidative stress, potentially provider of skin disorders that extend from functional impairments (skin cancer, dermatitis, chronic and acute inflammatory processes) even aesthetic character, with the destruction of structural proteins and cellular changes with the appearance of stains, marks and lines of expressions and other signs inherent to the intrinsic and extrinsic skin aging process. The antioxidants are chemical substances commonly used in clinical practice for topical application and may contribute in the fight against the radical species responsible for many skin damage. This paper summarized the main evidence of the benefits brought by the topical application of antioxidants in the skin, considering the amplitude of the indicative performance of antioxidant activity by in vitro and ex-vivo tests as well as in vivo tests. It is recognized that a breadth of product performance tests should be explored to truly identify the effectiveness of antioxidant products for an anti-aging effect.Sao Paulo State Research Support FoundationNational Council for Scientific and Technological Development (CNPq)Univ Campinas UNICAMP, Fed Univ Sao Paulo UNIFESP, Postgrad Program Translat Med, Campinas, SP, BrazilUniv RUTGERS, New Brunswick, NJ USAUniv Fed Sao Paulo UNIFESP, Dept Med, Sao Paulo, SP, BrazilRutgers State Univ, Dept Pharmaceut, Ernest Mario Sch Pharm, New Brunswick, NJ USAUniv Estadual Campinas UNICAMP, Fac Pharmaceut Sci, Campinas, SP, BrazilUniv Fed Sao Paulo UNIFESP, Dept Med, Sao Paulo, SP, BrazilFAPESP: 2013-01118-5Web of Scienc

Safety assessment of cosmetic products, with emphasis on the ocular area: regulatory aspects and validation processes

Before marketing a cosmetic product, a series of biological assays, such as ocular irritation tests, must be conducted in order to prove that the product is safe. However, a few scientific articles mention the discussion and evolution of cosmetic products testing performed in the eyes area. the aim of this study was to review the available literature on the evolution of tests carried out with cosmetics, in the ocular area, as well as to describe the methodologies that have been used and that are currently accepted. in Brazil, tests performed on animals are still allowed. However, the international laws strongly recommend the use of alternative methods for evaluating the risk of cosmetic ingredients and products. Regulatory requirements involving the registration of these products also request safety support of them in human beings. To perform ocular tests in human beings, it is necessary to involve an ophthalmologist for conducting clinical protocols. These protocols signed by the expert physician are sent to the National Health Surveillance Agency in order to endorse the product manufacturer concerning its safety. the safety support of a cosmetic product is very important, taking into account that the consumer has free access to these products of widespread use in today's society.Universidade Federal de São Paulo, Inst Environm Chem & Pharmaceut Sci, BR-09913030 Diadema, SP, BrazilUniversidade Federal de São Paulo, Dept Med, São Paulo, SP, BrazilGrp Invest, Campinas, SP, BrazilTRIDSKIN Labs Ltda, Grp Invest, Campinas, SP, BrazilUniversidade Federal de São Paulo, Inst Environm Chem & Pharmaceut Sci, BR-09913030 Diadema, SP, BrazilUniversidade Federal de São Paulo, Dept Med, São Paulo, SP, BrazilWeb of Scienc

Characterization of women's young and mature skin by the 50 MHz high‐frequency ultrasound technique

sem informaçãoCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPnão tem2018/06973‐

Development of nanotechnology-based drug delivery systems with olive vegetable oil for cutaneous application

Liquid-Crystalline Systems represent active compounds delivery systems that may be able to overcome the physical barrier of the skin, especially represented by the stratum corneum. To obtain these systems, aqueous and oily components are used with surfactants. Of the different association structures in such systems, the liquid-crystalline offer numerous advantages to a topical product. This manuscript presents the development of liquid-crystalline systems consisting, in which the oil component is olive oil, its rheological characterizations, and the location of liquid crystals in its phase map. Cytotoxic effects were evaluated using J-774 mouse macrophages as the cellular model. A phase diagram to mix three components with different proportions was constructed. Two liquid crystalline areas were found with olive oil in different regions in the ternary diagram with two nonionic surfactants, called SLC1 (S1) and SLC2 (S2). These systems showed lamellar liquid crystals that remained stable during the entire analysis time. The systems were also characterized rheologically with pseudoplastic behavior without thixotropy. The texture and bioadhesion assays showed that formulations were similar statistically (p < 0.05), indicating that the increased amount of water in S2 did not interfere with the bioadhesive properties of the systems. In vitro cytotoxic assays showed that formulations did not present cytotoxicity. Olive oil-based systems may be a promising platform for skin delivery of drugs.Os cristais líquidos representam um sistema de liberação de substâncias ativas capazes de vencer a barreira cutânea, representada especialmente pelo estrato córneo. Água, óleo e tensoativos são misturados para se obter esses sistemas. Diferentes estruturas podem ser formadas nesses sistemas, as quais oferecem muitas vantagens para os produtos de uso tópico. Esse trabalho visou ao desenvolvimento de sistemas líquido-cristalinos preparados com óleo de oliva, sua caracterização reológica e a identificação das fases cristalinas no diagrama ternário. Efeitos citotóxicos foram avaliados usando células de rato como modelo celular. Construiu-se um diagrama de fases que mistura três componentes em diferentes proporções. Duas áreas de cristal líquido, denominadas SLC1 (S1) e SLC2 (S2), foram encontradas com óleo de oliva em diferentes regiões no diagrama ternário preparado com dois diferentes tensoativos não-iônicos. Esses sistemas mostraram fase cristalina lamelar, que permaneceu estável durante o tempo estudado. Os sistemas foram também caracterizados reologicamente e apresentaram comportamento pseudoplástico com tixotropia. Os ensaios de textura e bioadesão mostraram que as formulações foram similares (p < 0.05), indicando que o aumento da quantidade de água em S2 não interferiu nas propriedades bioadesivas dos sistemas. Os ensaios de citotoxicidade mostraram que as formulações não foram citotóxicas. Sistemas à base de óleo de oliva são interessantes para a liberação de fármacos na pele

Estimulação Elétrica Neuromuscular no Envelhecimento Facial: uma Revisão Integrativa da Literatura

Although a natural physiological process, aging isconsidered a degenerative process with evident effects onthe aging skin, such as reduced elasticity, wrinkles, reducedfacial fat and muscle tone, sagging, changes in facial contour,and sarcopenia on the face. These changes can generatesocial stigma, suffering, and psychological discomfort for thepatient. Thus, this study aimed to evaluate the effectivenessof Neuromuscular Electrical Stimulation (NMES), a techniqueused in physical therapy for muscle training, in attenuatingthe signs of facial aging. For this purpose, a scientific surveyof publications indexed on the Medline (PubMed), CINAHL,Embase, PEDro, Lilacs, ERIC, Scopus, Web of Science,and Google Scholar databases was conducted and, based onpre-established criteria, two relevant publications for the topicwere selected for discussion. The scientific literature regardingthe use of NMES to attenuate the signs of aging is still veryscarce. The survey showed the need to discuss the currentstate of knowledge. Our results suggest that, theoretically,NMES could be a promising method to attenuate the signs ofaging; however, there are still no conclusive results regarding the clinical effectiveness of using NMES in the facial muscles since fewstudies relate NMES to facial rejuvenation. More studies are needed,with greater methodological rigor and low level of bias, using precisetechniques in the evaluation and allowing to interpret with greaterscientific commitment the physiological mechanism of the muscularstimulus and its interrelation with the integumentary system, provingits effectiveness in the improvement of skin appearanceEmbora seja um processo fisiológico natural, o envelhecimento é considerado degenerativo. Seus efeitos são evidentes na pele envelhecida, que apresenta redução de elasticidade, gordura e tônus muscular, assim como rugas, flacidez, alteração de contornos e sarcopenia. Tais mudanças podem gerar um estigma social e desconforto psicológico para o seu portador. Nesse contexto, objetivou-se avaliar a eficácia do uso da estimulação elétrica neuromuscular (EENM), uma técnica utilizada na Fisioterapia para o treinamento muscular, visando à atenuação dos sinais do envelhecimento facial. Para isso, foi realizado um levantamento de publicações indexadas nas plataformas MEDLINE (PubMed), CINAHL, Embase, PEDro, LILACS, ERIC, Scopus, Web of Science e Google Scholar e, a partir de critérios preestabelecidos, foram selecionadas duas publicações relevantes sobre o tema. A literatura científica sobre o uso da EENM na atenuação dos sinais do envelhecimento ainda é escassa. O levantamento revelou a necessidade de uma discussão a respeito do estado atual do conhecimento. Os resultados desta revisão sugerem que a EENM pode ser um método promissor de treinamento muscular quando aplicado à atenuação dos sinais de envelhecimento. Contudo, ainda há poucas evidências quanto à eficácia da EENM na musculatura da face, visto que poucos estudos relacionam a EENM ao rejuvenescimento facial. São necessários estudos com maior rigor metodológico, a fim de minimizar vieses, e utilização de técnicas precisas de avaliação, permitindo a elucidação do mecanismo fisiológico do estímulo muscular e sua inter-relação com o sistema tegumentar e possibilitando a comprovação da eficácia da EENM na melhoria da aparência da pele facial.El envejecimiento es un proceso fisiológico natural,aunque se considera un proceso degenerativo. Sus efectos sonevidentes en la piel envejecida, que presenta disminución de laelasticidad, grasa y tono muscular, así como arrugas, flacidez,cambios de contorno y sarcopenia. Estos cambios pueden generarun estigma social y malestar psicológico para el portador. En esecontexto, el objetivo de este estudio fue evaluar la efectividaddel uso de la estimulación eléctrica neuromuscular (NMES),una técnica utilizada en Fisioterapia de entrenamiento muscularpara atenuar los signos del envejecimiento facial. Para ello, se realizóun relevamiento de las publicaciones indexadas en las plataformasMEDLINE (PubMed), CINAHL, Embase, PEDro, LILACS, ERIC,Scopus, Web of Science y Google Scholar, y, con base en criteriospreestablecidos, se seleccionaron dos publicaciones relevantes sobreel tema. La literatura científica sobre el uso de NMES en la atenuaciónde los signos del envejecimiento es aún escasa. La búsqueda reveló lanecesidad de una discusión sobre el estado actual del conocimiento.Los resultados de esta revisión sugieren que la NMES puede serun método prometedor de entrenamiento muscular cuando seaplica para atenuar los signos del envejecimiento. Sin embargo,todavía hay poca evidencia con respecto a la efectividad de NMESen los músculos faciales, ya que pocos estudios relacionan NMEScon el rejuvenecimiento facial. Son necesarios estudios con mayorrigor metodológico para minimizar sesgos y el uso de técnicas deevaluación precisas, que permitan dilucidar el mecanismo fisiológicodel estímulo muscular y su interrelación con el sistema tegumentarioy que permitan probar la eficacia de la NMES en la mejora delaspecto de la piel del rostro

Skin effect of facial cleansing combined with an electric sonic device

New technologies, such as sonic devices, have been developed to optimize the skin cleansing process and improve its efficiency. To evaluate the effectiveness of these cosmetic procedures, skin bioengineering is an objective method to assess the biophysical parameters of the skin. This study aimed to assess the effect of facial cleansing on the physiological properties of the skin by comparing a cleansing process with cosmetic product applied manually to cleansing with cosmetic product associated with the use of an electric sonic device. A gentle skin cleanser was applied to the entire face of 12 subjects; the sonic device was used on one half of the face and the manual process was performed on the other half. Instrumental skin analyses included sebummetry, corneometry, transepidermal water loss (TEWL), infrared thermography, and high‐frequency ultrasound and were measured before and up to 90 min after cleansing. Results were compared using two‐way ANOVA and Friedman tests. Data obtained from the statistical analysis of sebummetry, TEWL, thermography, and ultrasound parameters did not show any significant difference. When assessing the corneometry parameters, a significant reduction in hydration values (17.19%) was observed in the manual cleansing area, while the values remained similar to baseline values in the area where the sonic device was used. The cleansing process with a sonic device did not cause a significant hydration reduction, suggesting better preservation of skin homeostasis when compared to manual cleansingCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPnão tem2018/06973‐

Avaliação do comportamento reológico de diferentes géis hidrofílicos

The nature of polymers used in gel formulation may interfere in the rheological behavior and physical stability of the product, affecting the customer's acceptance. The rheology has been a great and important subject for cosmetic and pharmaceutical industries, considering that the product consistence and spreading must be reproduced each lot, assuring the technological quality of the finished product. The purpose of this research was to settle the rheological behavior of different hydrophilic gels: two gels prepared with carbomers and one with acrylates crosspolymer. For this study a Cone and Plate rheometer was used. The studied formulations were stored at 25º and 40 ºC and the samples were analyzed between 1 and 28 days. High temperature influenced the physical stability of all gels; the gel prepared with acrylates crosspolymer presented the greatest pseudoplastic while the ones composed with carbomers presented higher thixotropy.O tipo de polímero empregado na formulação de gel pode influenciar no comportamento reológico e na estabilidade física do produto e até mesmo, afetar a aceitabilidade deste pelo consumidor. A reologia tem sido assunto de grande e crescente importância para as indústrias cosmética e farmacêutica, tendo em vista que a consistência e o espalhamento dos produtos devem ser reproduzidos de lote para lote, assegurando a qualidade tecnológica do produto acabado. O objetivo desta pesquisa foi determinar o comportamento reológico de diferentes géis hidrofílicos: dois geis preparados com polímeros dos ácidos carboxivinílicos e um com polímero do ácido poliacrílico. Para este estudo utilizou-se o reômetro Cone & Placa. As formulações estudadas foram estocadas nas temperaturas 25 e 40 ºC e amostras destas foram analisadas nos tempos 1 e 28 dias. Pode-se verificar que a temperatura elevada influenciou na estabilidade física de todos os géis e que o gel preparado com ácido poliacrílico apresentou a maior pseudoplasticidade enquanto os constituídos de ácidos carboxivinílicos apresentaram maior tixotropia

Effect of ultrasound and dexpanthenol on collagen organization in tegumentary lesions

OBJECTIVE: To analyze the effect of ultrasound (US), dexpanthenol (d-P) and a combination of these treatments (US+d-P) on collagen fiber organization in tegumentary lesions in rats by birefringence analysis. METHODS: Wistar rats (50) were anesthetized (Thionembutal - Sodic = 50mg/Kg), 1cm² of dorsal region skin was removed, and the animals were divided into five groups: control (C), gel (G), US (3 MHz, 0.1 W/cm2, 1 minute, continuous), d-P (10%) and US+d-P. After daily treatment for 7 and 14 days, 6µm thick sections of lesioned areas were stained in picrosirius and measurements of the collagen birefringent area (µm²) were obtained using polarized light microscopy (Zeiss Axiolab-ZEISS- Germany) with histological image analysis software (KS 400 2.0 - Kontrol Eletronics, Munique, Germany). The means were compared by ANOVA followed by the Tukey test (p<0.05). RESULTS: The US+d-P group showed a significantly greater (p<0.001) birefringent area (1586.43±162.14) than the other experimental groups: C (139.36±35.35), US (317.55±129.9) and d-P (192.41±3657) by the 7th day of treatment, indicating acceleration of the wound healing process. By the 14th day of treatment, the US+d-P, US and d-P groups presented greater birefringence than the control group, but did not differ from each other. CONCLUSION: The combination of treatments (US+d-P) accelerated collagen fiber synthesis and organization in the early stages of cutaneous repair.OBJETIVO: Analisar o efeito do ultrassom (US), do dexapantenol (d-P) e da associação dos tratamentos (US+d-P) na organização de fibras colágenas na lesão tegumentar em ratos por meio da análise da birrefringência. MÉTODOS: Foram utilizados 50 ratos Wistar, anestesiados com Thionembutal Sódico (50mg/Kg), dos quais foi retirado 1cm² de pele da região dorsal, divididos em cinco grupos: controle (C), gel (G), US (3 MHz, 0,1 W/cm², 1 minuto, modo contínuo), d-P (10%) e US+d-P. Após sete e 14 dias de tratamento diário, foram removidos segmentos dessas áreas e obtidos cortes de 6µm de espessura que, posteriormente, foram corados em Picrosirius. Os cortes foram observados em microscopia de polarização utilizando um software responsável pela medida de birrefringência das fibras colágenas (KS400 2.0 - Kontrol Eletronics). As médias das áreas birrefringentes (µm²) de cada grupo foram submetidas à análise de variância pela ANOVA, seguida do teste de Tukey (p<0,05). RESULTADOS: A média de área birrefringente do grupo US+d-P (1586,43±162,14) foi maior (p<0,001) que a dos grupos experimentais (C: 139,36±35,35, US: 317,55±129,9 e d-P: 192,41±36,57) no 7º dia de tratamento, indicando uma aceleração na síntese e organização das fibras colágenas na região lesionada. No 14º dia de tratamento, os grupos US+d-P (2858,47±510,17), US (1779,94±482,78) e d-P (2546,88±304,45) apresentaram área birrefringente maior que a do grupo C, porém não diferiram entre si. CONCLUSÃO: A associação dos tratamentos (US+d-P) acelerou a síntese e a organização das fibras colágenas apenas no estágio inicial de reparo tegumentar.Universidade Metodista de Piracicaba Faculdade de Ciências da SaúdeUniversidade Estadual de Campinas Faculdade de Odontologia de PiracicabaUniversidade Federal de São Paulo (UNIFESP) Farmácia e BioquímicaUNIARARASUNIFESP, Farmácia e BioquímicaSciEL