Rosacea has probably been one of the most misdiagnosed and misunderstood skin disorders in the history of the human race. The symptoms of Rosacea are so variable that many people have been treated for it when they were in fact suffering from some other skin disorder and many people who had rosacea were treated for common acne. The term Acne Rosacea was a common medical diagnosis a few years ago. Now it is no longer considered a valid disorder under that name.

Most severe skin disorders put fear into Aestheticians, who have been taught to refer the client to a Dermatologist immediately, the feeling being, that the Doctor will magically sort the problem out with treatments that are beyond the therapists skills. Rosacea, however, does not fall into this category. I can boldly say that there has been as much success in treating various symptoms of rosacea by advanced skin therapists as there has been by physicians. This is due, in part, to the variety of symptoms of rosacea and the fact that the scientific world has no set rules on the origins or causes of rosacea.

Several researchers have theorized that rosacea is brought on by a species of mite, the Demodex Follicuorum (a microscopic mite) or Helicobacter Pylori (a type of bacteria). Other skin experts claim facial erythema due to oedema and leading to papules and pustules is really rosacea by other names and still other opinions say rosacea is pharmacologic (such as in response to topical steroid use). There is evidence that harsh wind, sun exposure and dietary factors exacerbate rosacea and there is promising research into the immunologic arena.

Drugs and Rosacea

The therapist must be aware that certain prescription drugs for problems not related to rosacea may cause flushing and redness more readily. In these cases the above type of treatment may be the ONLY type of treatment possible until the client is off the drug. Vasodilator drugs to watch out for can include: Griseofulvin, Chlorpropamide and Antabuse

Couperose Skin:

Medical doctors are uncomfortable with the term couperose but therapists internationally are familiar with the term and there are many approaches to treating it. The correct medical term for couperose is Telangiectasia, which in actual fact is also becoming popular with therapists lately.

The Beauty Therapy profession for many years has used diathermy, Schlerotherapy and other methods. Now, there is a nicotinic acid crème that will flush out capillaries in the skin that have become pinched or congested at their branch connections, thus swelling them up to where they can be viewed through the translucent layers of the epidermis. I know the word flushing seems contradictory for a rosacea category like telangiectasia, but this is a localized action applied directly to the problem area and seems to work extremely well. This type of crème contains niacin derivatives, which are known for their roborant (strengthening) effect on weak capillaries.

Cases Not Treatable by a Beauty Therapist

There is one symptom called Rhinophyma that requires medical attention. I have seen this disorder on many male clients, especially in Ireland for some reason (maybe the Guinness?) The nose is grossly swollen, deep red and sometimes has actual fissures in the skin and swollen veins. Another symptom called B-conjunctivitis should be avoided as it deals with the eye tissue, thus making any topical beauty therapy treatment a risky option. If these symptoms are present, immediately recommend a medical specialist. I have personally taken on clients with these disorders over the years, but in general, it is risky business.

Basic Symptoms of Rosacea

Flushing (treatable by therapists)
Erythema (treatable by therapists)
Papules (treatable by therapists)
Pustules (treatable by therapists)
Oedema (treatable by therapists unless chronic)
Rhinophyma (medical treatment only)
B/Conjunctivitis (medical treatment only)
Kerstitis (treatable by therapists unless drug related)
Comedones (treatable by therapists)
Scarring (treatable by therapists trained in scar revision techniques)

Can Rosacea Be Cured?

Controlled Remission would be a better term rather than say cured. Using the ‘cure” word to a client suggests that all problems will be sorted out forever. This is totally unrealistic in almost all skin disorders, including aging skin.
Only once in my 37 plus years career did I actually take part in what could remotely be called a cure.
A middle aged, attractive woman in Northern California came to one of our skin specialists with inflamed rosacea. She was to preside over a 20-year high school reunion which involved seeing people she had not seen for years. She gave us three months to remove her problem.

Taking up the challenge, we did every treatment we knew on her skin. We went through skin blow-ups to skin peeling off like a snake. She bravely bore it all and suddenly, six days before the reunion date she started to clear up. By the evening of the reunion, she possessed porcelain skin and our team all sighed with relief! I have seen a lot of uncanny remissions in my time but this was the fastest response I have ever witnessed. The fairy tale ending was; there was a man at the reunion that had been madly in love with her in high school. To him, she had not changed a bit when he saw her at the function.

He later proposed and they married. And so it is that even in skin therapy we not only may change people’s skins, but also their lives. Unfortunately these cases are rare. Clients viewing before and after photos of extreme makeover successes almost always assume that they too will become nearly flawless in a few weeks. It is vital to remember that counseling a rosacea client about the many irregular factors that go into treatments determines the outcome. These may include genetic, lifestyle, age and any mental attitudes that they have regarding their condition.

In the last analysis, I believe that the root cause of rosacea is the Demodex mite, a tiny parasite living in the sebaceous glands. Chronic conditions either are viral or parasitic, not bacterial, bacteria being easy to eliminate. The fact that we can clear up rosacea with alkaline washes and aggressive, rather than calming treatments has convinced me of this reality.

Written By Danné Montague-King

For the last ten years the word “peel” has been a banner for anti-aging treatments, suggesting that the human skin be like an onion. Simply peel off an outer layer and viola! New and younger skin!

There have been many approaches to peels from “medium to deep peels” to superficial peels. But all of these types of peels promise the same thing, newer and younger skin. here is very little advertisement, however, on what the client does AFTER these peels, except to apply conventional cosmetic crèmes and sunblocks. It is almost as if all a therapist or doctor has to do is to perform a peeling treatment on their client and everything else takes care of itself.

The actual scientific facts however, present a totally different picture. The human skin is in fact not like an onion at all but more like an egg! The inside of the skin being a matrix of glycoaminoglycans and essential fatty acids and the outside of the skin a much tougher “shell” or corneum. This corneum, which is made up of dead and dying skin cells, is not in definite layers that can just be peeled off. It is the outer portion of the epidermis and has hundreds of biological functions on it’s own—far from the “dead cell layer” that a lot of practitioners assume.

But before we take a look at what actually happens with various peels, let’s identify the general range of peeling procedures.

MEDIUM TO DEEP PEELS;

As far back as the 1800’s physicians discovered that applying a variety of irritating chemicals to the skin could be used to reduce age-related skin disorders, freckles and acne. All of these chemicals burned but as the skin healed, many changes were observed. These changes were thought to be beneficial. They still are thought of this way today. But the opposite is the real truth.

The chemicals were principally acids such as salicylic acid, trichloracetic acid and phenol acids.
The peels were (and still are) classified medium or deep according to the depth of their penetration, blistering effects and inflammation. Most people assumed that the “deeper the peel” the better the result. In fact Doctors seemed very preoccupied about “penetration and depth”. (sounds almost sexual!) It was at this point the mistakes and misunderstandings started and still exist.

WHAT ARE ACIDS?

According to the pH scale, acidity is expressed on a 14-point scale using units called pH, each unit representing a ten-point difference in acid concentration. The pH scale ranges from 0 (highest acidity such as battery acid) to 14 (lowest acidity such as lye, which is alkaline). When the pH is less than 7 on the scale, it ceases to be alkaline and starts to become acids. Each small change down the scale results in enormous change in acidity. For example, a solution with the pH of 4 is 1000 times more acid than one with a pH of 7.

In simple terms, acidity or pH measures the concentration of positively charged ions (H+) in water. The first thing an acid will do when applied to the outer skin or the corneum is to harden the dead cells. They become brittle and break away from the surface of the skin. Some acids, such as Alpha Hydroxy Acids, are also hygroscopic in nature and will pull available water or moisture present in the skin up into the dead cells which resemble old, dry mini-sponges. Like dry sponges that are soaked in water the dead cells puff up, overload with fluids and burst. The cell fragments then detach from the surface of the skin. Constantly applying these types of acids not only harden the skin but dehydrate it as well.

Regular acids such as phenols and TCA’s also stimulate the skin into producing new cells faster—thus promoting younger and newer skin. At least this was the opinion of thousands of doctors and therapists all over the world. But again, the opposite was actually true.

THE REGULATORS AND IMMUNE SYSTEMS OF THE SKIN.

What most people failed to realize is that when under attack from any type of deep trauma, the skin tries to defend itself. This defence varies depending on how deep the attack is. Medium peeling agents (weaker, less concentrated acids with a pH of 3.8) may arouse on minimal defences such as epidermal dehydration. This happens when moisture is rushed to the surface very quickly and then evaporates. Another defence system that may occur from medium peels is melanin, the skin’s primary defence against cancer and UV rays. When there is any type of trauma or irritation to the skin beyond a certain point, melanin rushed to the surface in a desperate effort to protect new skin cells.This can create inflammatory hyperpigmentation.

These defence systems at the superficial level leap into action simply because the receptors of the skin (ganglia) send out a signal of stress or trauma. Neither the protective fluids of the skin nor melanin has a brain that lets it know whether the trauma to the skin is from a chemical, a burn or the sun. They just react because they are forced to.
At the deeper peel level however, much more is going on. Strong concentrated acids with very low pH will destroy many of the regulatory cells of the skin as they penetrate deep into the epidermis and even down into the dermis. We call these regulatory cells the “policeman of the skin”. Their job is to regulate the rate of ascent or proliferation of new, baby skin cells to the surface. If they are weakened, destroyed or compromised in any way, new, baby cells will rush headlong to the skin’s surface far too fast for the normal remodelling of new skin. They become SCARS. Scars are simply new skin cells that have nothing to keep them in line or in a normal form. They have rushed to the surface in an attempt to keep the skin breached against invasive bacteria and virus.

The regulatory cells begin with the desmesomes deep in the skin. These cells link the skin cells together and release the skin cells at the time they are needed in a rythematic fashion. Laser resurfacing or very strong acids destroy Desmesomes. In this case ALL the new cells in the area rush to the surface at the same time.

Collagenase is an enzyme that regulates collagen fibres and determines how much collagen is needed at any given time in the skin. Certain strong retinoid peels and the drug Ro Accutane (RETINOL taken orally) will destroy the enzyme collagenase — thus leaving the skin very susceptible to scarring.

The last possible regulating cell that can save the skin against trauma even if the other two “policeman” are compromised is the Langerhans cell. Conveniently located right in the epidermis, this octopus-like organism has long tentacles called dendrites that are capable of not only reaching out and destroying invasive virus or bacteria that tries to get into the skin, but it can stop new cells that are rushing to the surface too fast and slow them down to a normal, non-scar producing rhythm. It also reduces erythema (redness) and edema (swelling) whenever these are trauma. There are ways to stimulate this immune system cell to keep it strong and active. We employ such treatments on laser clients or clients who have had very invasive peels.

STOPPING THE SKIN DAMAGE.

While it is true that in order to get a successful result from a peeling acid the pH of the solution must be very low and the concentration high, there are better methods of removal of the dead cell build up on the skin—particularly for Chinese people who are simply NOT candidates for medium or deeper peels. For Oriental and Asian skins we have discovered enzymatic therapy far more effective than acids and without any of the damage and inflammation that acids can do on Chinese skins.

However if acid treatments or laser resurfacing are performed on clients, there is ways to stop the skin from damaging itself.

PRE-TREATMENT:

A series of the correct type of enzyme treatments combined with properly formulated retinoid products (vitamin A) will strengthen the skin and bring it to optimum health.
At this point the skin will be better able to maintain its integrity when assaulted by an acid peel or laser.

POST TREATMENTS;

After the peels or laser the skin is totally vulnerable. The immune system of the skin must be quickly raised. We have already discussed the powerful Langerhans cell and it’s ability to destroy free radicals, virus and bacteria. And we looked at the fact that it also can help regulate the proliferation of new cells to the surface to avoid scarring. The main ingredients that completely revitalize the Langerhans cell and keep it strong are the Beta Glucan class yeast cell wall extracts. These extracts are expensive to produce but worth it. Beta Glucans stimulate a weakened Langerhans cell within 30 minutes after being applied to skin that has been burned by laser, sun or acids.

The skin contains several types of nerve receptors that send different signals to the brain. These are called nocireceptors from the Latin word nocre. One of these special receptors is called a class C nociceptor. The class C transmits signals of stinging and burning to the brain. It also triggers redness, swelling and inflammation. Class C nociceptors are distinctly different than class monitors sharp, pricking sensations and other normal, tactile sensations.

Type C nociceptors alert a person to potentially dangerous chemical exposure, but they can also actually damage the skin when they over react to chemicals that do not directly harm the skin.
Research recently has discovered a compound that reduces the sensitivity of the class C nociceptors and part of this compound is present in our own body!

I refer to the trace metal element “STRONTIUM, element #38 in the periodic table. Present in our bodies, strontium, which is similar to calcium, will actually turn down the sensitivity control of class C nociceptors reducing inflammation and burning sensations in the skin.

We are currently working on the ideal, topical delivery system for this common but remarkable and unique trace metal.

SUMMARY;

To achieve any result in skin resurfacing at all, acids at high concentrates and low pH must be used.
The actual result of this use is from excessive stress and trauma to the skin, compromising or destroying the regulatory factors in the skin that determines the rate of new cell proliferation.

Most results are simply skin in a rapid healing mode. The skin looks tight and bright and younger at first due to erythema and edema. But six months to one year later the true picture of the skin emerges. At this point the damage can be observed. In Chinese skin, redness becomes nearly chronic and the skin has an unnatural plastic and porous (coarse) appearance.
Hyperpigmentation or hypopigmentation are almost certainties when these acids are used on Chinese skins. Many times the hypopigmentation does not show up until after a year—especially in the case of laser resurfacing.

Removal of skin problems common to Chinese skin is best achieved with enzyme, protein/amino acid therapy, correcting the acid mantle of the skin, inhibiting melanogenisis while performing correct hyperpigmentation treatments and properly formulated retinoid compounds.

Written By Danné Montague-King

Modern skin specialists in the medical and aesthetics fields are constantly being led to believe by manufacturers that “peeling” of the skin is top of the line when it comes to removing wrinkles, hyperpigmentation or superficial scars. The real truth is; the removal of dead and dying skin cells is only step one in effective skin revision.

New skin cells are partially controlled by desmesomes. The proliferation of new skin cells to the surface of the skin has a definite pattern or rhythm. When the skin is attacked too aggressively with high potency acids, lasers or high velocity microdermabrasion devices, the desmesomes release new skin cells which rush to the surface in defense of the skin. This occurs much faster than their normal rhythm. The result is usually more of a controlled scar instead of normal skin revision.

Fortunately there is a removal system that also rebuilds at the same time and works very well with the new enzymatic lifts currently stunning the beauty therapy world.

REMOVAL SYSTEMS:

Although I have researched many alternative removal systems around the world, there is a procedure that closely resembles the effects of the CO2 laser but without the temporary contraindications and potential hypopigmentation that often accompanies laser surgery. I call this technique “Liquid Laser” and find it extremely effective as both a removal and rebuilding treatment due to its high vitamin A content.

Vitamin A has long been used as a cell renewal vitamin both internally and topically, especially in the case of acne clients. Over the years, particularly in the 1980’s, retinoids (derivatives of vitamin A) were used widely as peeling agents. The popularity of the drug Retin-A swept across America like a storm leaving a lot of skin damage in its path due to the indiscriminate use of the drug by persons who did not respond well to its principle ingredient, tretinoin.

Retinoids however, come in various strengths and each has a slightly different effect in the skin. Tretinoin is the strongest, hence its drug status in the USA. But strong does not always mean the most effective. Other combinations of retinoids, when properly formulated, can gently remove dead skin cells without contraindications and provide energy that helps the DNA of the cells keep the cell alive much longer. Certain retinoids mixed with combinations of vitamin C stimulate fresh, new collagen fibers in the skin which can tighten and firm aging skin progressively.

The retinoid family consists of Tretinoin, Retinyl, Retinal, Retinoic Acid, and Retinol. There are other combinations, but these are the major ones. If combined with Beta Carotene, Retinyl Palmitate, small amounts of Resorcinol and Potassium Sorbate, Retinol becomes a non-invasive but near miraculous removal tool. Further research has shown that if the above combinations are blended into a transdermal lotion (a water soluble vegetable lipid base) the entire formula will store in the voids of the skin after daily application for hours, gently detaching the dead and dying cells from the underlying epidermis while depositing the regenerative powers of vitamin A into the newer, living cells. This duel action treatment is mainly performed at home by the client after an initial clinic treatment and followed by a final visit to the clinic for what I call the ‘lift off treatment.’

The ART OF CONVERSION

A new approach to making sure the receptor specific openings that line the cell wall membrane do not become overloaded and toxic (vitamin A can become toxic in higher concentrations becoming popular in the beauty therapy field).

Conversion simply means combining two or more ingredients together that, when applied topically to skin, convert to another ingredient or action within the skin, using the skin’s own enzymatic processes to accomplish this. Beta Carotene is non-toxic to skin cells in any concentration, but does not become vitamin A until it is inside the skin (or your body). Once the skin’s own enzyme processes convert it to vitamin A, it deposits just enough into the cell wall membrane to be beneficial to the life of the cell and then exfoliates dead cells on its way out of the epidermis—a “remove and rebuild” action.

THE TREATMENT:

On the day of the Liquid Laser Treatment, the client’s skin is cleansed with a low pH, preferably a natural surfactant cleanser. White Oak Bark, Yucca plant extract and other types of saponin are often used in this type of cleanser.

Following the cleansing, the client has an “occlusion” masque application. This is accomplished by simply applying a low strength and low pH Alpha Hydroxy Acid blend to the client’s face, neck, decollate and even the backs of the client’s hands if needed. A surgical swab is preferred for this step. Swabs have more control into getting the AHA serum down into deeper wrinkles than brushes and are more professional.

The serum used should NOT depend solely on glycolic acid, due to its small molecular size and its bad habit of wandering around unpredictably in areas of the skin that can become irritated. This would include the nostrils of the nose, mouth and even the eyes.

I have found that combining Lactic acid with Glycolic acid and Malic acid makes a much better serum. Adding a little citric acid (a chondroitan sulfate) helps to maintain dermal hydration as AHA’s are hydroscopic in nature and are known to dehydrate skin. The pH of this type of serum should not be above 3.02 on the pH scale. If its pH goes much higher, the AHA’s turn to organic salts and will have little effect on the skin.

After the entire area is coated with the serum, plastic wrap is then laid on the client’s face, neck and decollate etc. and molded into place for about ten minutes. After the time has elapsed, the serum is washed completely from the skin and the skin is patted dry.

The next step is to lightly massage the “Liquid Laser” retinoid lotion into the skin, covering the same areas as were covered in the Occlusion Masque. The client may experience a slight tingling or itching sensation at this point. This is normal and means the ganglia (nerve endings) are responding to the message that dead cells are slowly being detached from the underlying tissue.

If the client is having this treatment on a sunny day, a final application of a grease-free Transdermal Sunblock, SPF 30 is advised. Although non-traumatic, the liquid laser treatment is highly active. Any unusual activity in the skin cells will encourage pigmentation problems if exposed to too much sun. Sun radiation creates a yellowish substance called LIPOFUCHIN in the skin, which then becomes a free radical and attacks all the normal cell activity in the skin.

The client then takes a bottle of the retinoid lotion home with them and applies it every night religiously. For about two days the client will not notice difference in their skin or any massive “peeling”. But they must be cautioned that all at once they will turn darker, with a yellowish tone to their skin. Tissue around the eyes and mouth will suddenly look much more wrinkled and older, noticeable to their spouses or friends.

Actually this is merely old dead cell material and other impurities lifting up from the corneum base, anything dead and dry with a protein nature will turn dark and wrinkled looking. This is a good sign the treatment is working effectively, but if you do not counsel your client in advance that this may occur, they will complain that you “ruined” their skin and even panic. I have found that they still panic, even with an explanation; therefore we always monitor clients daily until the treatment is completed.

Normally by the seventh to tenth day of nightly application of the “liquid laser” lotion the client starts seeing brand new, pink and firm skin appearing as the older epidermis falls away in the shower or while they wash their faces in the morning. However we have also discovered that the older the client is, the faster results appear.

I had a thirty-year-old woman in Germany take up to 17 days to exfoliate completely. When she started the treatment she had only a few tiny lines on her face and uneven, coarse skin tone. By the time she was at the tenth day, she looked around sixty years of age and her husband phoned me in Los Angeles from Hamburg in a state of anger and panic. I calmed him down and promised to speak to the doctor who had performed the treatment, a man who was on our German Research team and an expert. In about another week she had her final “lift off” treatment and her skin looked like a porcelain doll.

Written By Danné Montague-King 

Confused by those “miracle” ingredients in skin care products? Danné Montague-King de-mystifies them and tells you what they are, what they do and whether they work. …

I was recently asked, upon returning from a lecture tour of Russia, whether there is any difference between the Russian approach to aesthetics and that of the US. I replied that they were like night and day!

The Americans market beauty therapy goods and treatments based on the merits of a single ingredient or machine — as if each new “breakthrough” was a one-off miracle.

I have suffered through (and fought) the acid craze years, the AHA phenomenon, the microdermabrador blitz, the vitamin C controversy, all of which my colleagues and team members have utilised and even helped to pioneer for nearly 40 years. My suffering springs from the fact there is no one single ingredient or device that will fix all problems in the skin.

The fight has been to put every tool in nature’s pharmacopoeia into its proper prospective. The Russians, on the other hand, seem to realise that concepts and philosophies of science are more important than products or equipment, the latter being merely tools to work with. But then a great many Russian beauty therapists are “dermatologues” (medical doctors) who discovered at the end of the Cold War that more money could be made pushing beauty treatments than practicing socialised medicine.

The Americans, on the other hand, have been taught to look for the “quick fix”, the end-all product that will do all the work for them without the bother of endless education and actual research. To be fair, there are a few exceptions. Arising from this morass of “what’s the newest thing selling” are a plethora of self-styled gurus and even some physicians waving their MDs as a banner of validation and assurance. Their products are hawked to the little beauty therapists whose money goes towards paying for the doctor’s new Porsche.

To cut to the chase, it is the duty, nay, the obligation of eccentric scientists such as myself, who have somehow managed to get journalistic privileges and (gasp) a large audience of readers over the years, to search for the truth.

Speaking of years, I look back on all 60+ of them and realise I have seen everything in beauty therapy come and go and return again — the same old half-baked theories just tarted up in new, high-tech drag. I used to ponder this phenomenon and wonder that while we all know oxygen crèmes (as one example) are fake, then why are they on sale again. The answer being, of course, that new therapists are being born every year, and they just don’t know!

As I totter into antiquity, as the professionals’ advocate I feel compelled to take a closer view into the world of so-called “breakthroughs” and “new” ingredients in order to at least partially arm the discriminating therapist with enough knowledge to wade through increasingly murky waters of a “cosmeceutical” world.

Cosmeceuticals, MediLift, Cosmedics, Physicians Formula — do these names sound familiar?

These products may indeed have a medical doctor who has at least invested in the range, but in no way must they be taken as better or more effective than any other well-formulated product. The medical profession does not endorse these products or companies in general and even the word “cosmeceutical” is not recognised by any governing medical body.

It is, in fact, a word coined to describe products or treatments that border on medical but still come under the cosmetic blanket, as far as most regulatory bodies are concerned. This does not mean treatments described in this manner are not good or effective to some degree. In my opinion it is misleading and if not dishonest to lead therapists and doctors to believe that such products are backed by some bona fide medical body.

Paramedical aesthetician This title is not so bad and, in fact, describes any licensed or qualify therapist who has been trained to perform treatments that are alternative and adjunctive to medical procedures. Many such therapists are working alongside physicians or referring back and forth with a doctor. It is a growing field that still needs more regulation and education. However, beware of any course that offers paramedical aesthetic training and does not spend at least one entire day covering concept, theory, chemistry, anatomy and physiology. We might add immunology to this, considering the new mutations of virus currently swarming the globe.

Vitamin C

Forty years ago, a mentor pointed out the importance of vitamin C in skin to me. Pulling out a huge copy of Gray’s Anatomy, he showed me a picture of the fibroblast cell making collagen fibres like a little factory. The boss of this factory was Mr Vitamin C.

Over the years, we have expanded on this fact both in formula and research. In a way, we were voices crying in a wilderness (except for Nobel Prize winner, Linus Pauling) and little attention was paid to vitamin C in the cosmetics industry. I would like to be vain enough to think that my years of articles and lectures on the subject helped give birth to the current craze over vitamin C, but knowledge is knowledge and should be shared.

Since I did not invent vitamin C (although there are some lately who have claimed to), I can only say that what is real and what works will eventually come out. However, in an effort to outsell competitors touting this common and generic vitamin, many cosmetic entrepreneurs claim to have a better or more stable vitamin C. Then there is the mysterious “designer” vitamin C called Ester C or C’ Ester. This is the funniest scam of all because the ester of ascorbic acid (vitamin C) is common ascorbyl palmitate, well known to the food industry for years, but scorned by the naïve cosmetic industry decades ago because it has a bad habit of turning crèmes slightly yellowish.

I never cared about the colour of crèmes only their therapeutic effects, so I always included ascorbyl palmitate in any vitamin C formula. Recently an American dermatologist, known for writing a wrinkle book, hawking goods on the Internet and eating salmon several times a day to stay young, tried to sue a cosmetic company using ascorbyl palmitate. He claimed to have “discovered” its topical use, but when confronted by some heavy duty medical researchers called by the defendants, the suit was withdrawn.

Here’s the truth about vitamin C. The word unstable is not a bad word to a chemist, only to a psychiatrist. Many times an unstable ingredient may be the most powerful. It denatures quickly when exposed to oxygen or does not “stay in solution” (chemspeak for things that will not stay dissolved).

Plain old L-ascorbic acid is such an ingredient. It’s unstable but is also the most powerful vitamin C of them all. The much advertised stable vitamin C’s are weaker but last longer in a product. Crèmes keep vitamin C longer due to their lipid base while gels or serums, often water-based, lose the strength of vitamin C quicker, once opened. The most used “stable” C’s are ascorbyl magnesium phosphate and old fashioned ascorbyl palmitate.

Forty years ago, I just thought I would mix all three together for maximum protection and surround them with a calcium ion like horses in a corral! It seemed logical chemistry to me at the time so you can imagine my shock at all the hoopla over these “special” vitamin C products popping up years later!

DHEA Dehydroepiandrosterone is a hormone without a function and the most abundant steroid in our body. Laboratory tests on rats show it will suppress some tumour formations, guard against diabetes, obesity and some immune and heart diseases. But as a topical hormonal anti-aging ingredient for the skin? Not a chance!

DMEA Dimethylaminoethanol is still under investigation as an oral supplement even while it is being sold like crazy as an anti-aging miracle (along with eating salmon). The nature of its complex transference through the cells of the body is not duplicated through the skin from the outside.

Like the theophylin thigh crème of yesteryear, DMEA crèmes start out active at the lab, but quickly denature before reaching the market. I think the anti-aging brainstorm properties “discovered” by the US dermatologist was loosely based on the fact that DMEA converts in the body to choline. This stimulates neurotransmitters or brain energy in other words. Choline also forms phosphalidylcholine which is a primary phospholipid of cell membranes –hence the alleged skin rejuvenation myth.

Super Antioxidants

Most of our cells manufacture their own antioxidants which transform oxygen radicals into something less harmful. The antioxidants we produce are super oxide dismutase (SOD) glutathione, glutathione peroxidase and catalase. Unless there is a gross deficiency of these enzymes in our systems, taking them as supplements is like carrying coals to Newcastle.

They certainly do nothing for the skin when they are topically applied. Antioxidant defences made by our bodies are not the same as antioxidants we get from food. Vitamin E is the primary antioxidant that is needed internally and for topical application. Like little lipid soldiers, the tocopherol army (vitamin E) wards off attack from fierce free radicals which have already robbed many healthy cells of their electrons. Standing behind the E soldiers should be vitamin C, not a primary antioxidant as often thought, but a free radical scavenger ready to grab any little monster that breaks the E line.

Then we have the air force! Super antioxidants called proanthacyanidines. These come from pine bark (one known as pycnogenol), grape pips and even red wine. However, red wine has as many free radicals as antioxidants which enhance histamine in the wine. Take an antihistamine to ward off a wine hangover!

All of these antioxidants really are necessary to preserve cell life against the rusting and anti-aging effects of free radicals and can be topically applied as well. Sun screens could theoretically be included on this list as help to protect the skin from forming lipofuchin from the sun, a yellowish free radical “soup” found in skin.

Beta Glucans

Here is an ingredient that we can get our teeth into! Or at least our Langerhans cells like to get their teeth into beta glucans. It makes them as strong as Popeye the sailor on spinach and they can lash out with their long dendrite arms with those hungry little macrophage mouths on the end and gobble up anything that is not supposed to be in the skin.

For many reasons beta glucans are nature’s miracle. Gleaned from yeast cell wall extracts, these expensive little healers can reduce inflammation from severe sunburn in less than 30 minutes. You should see what they can do on post-surgery scars and second-degree burns. We are researching slowing down the plaque-like lesions of psoriasis using beta glucans. The reason would surprise you because it has nothing whatsoever to do with beta glucans’ healing power.

Essential Fatty Acids (EFAs)

EFAs are number one on my list of things that really do work on the skin from inside out.
The research and proof of the powers of EFAs are massive and irrefutable. A great portion of the very matrix in which all our cells float is made of EFAs. Also the thickness of skin, especially the bounce and turgidity we enjoy in youth, is due to the presence of EFAs. This decreases with time and the skin becomes thin and crepey. Like any other “essential”, these fatty acids can only be ingested into the body through foods or supplements.

Topical application of EFAs does nothing for the skin. Pure and powerful EFAs help to relieve acne due to the hormonal regulatory aspects of many of these oils, principally Evening Primrose oil. Psoriasis and eczema are also treated this way with great results. I have been increasing my daily dose of Evening Primrose Oil since age 55 and have noticed that not only is the skin on the backs of my hands younger and smoother, but my hair and nails seem to explode into volume and length almost overnight!

But not all Evening Primrose oils are full strength and pure. After exhaustive investigation, I discovered a source of Evening Primroses grown in the rich volcanic soil of the Canterbury Plains in New Zealand. A fabulous golden oil is extracted with a special process that retains 100% of its remarkable properties.

Lycopene

This final “latest breakthrough” is comic relief, leaving me to shake my head with disbelief over how far some cosmetics companies will go to make a dollar. The primary source of lycopene comes from tomatoes and one company actually used a photo of a big, red tomato as being the latest anti-aging breakthrough.

Fortunately for the intrepid researcher, there is the CTFA International Buyers’ Guide, which is US FDA-controlled. This reference guide to the personal care products industry includes all ingredients allowed in the formulation of cosmetics, the nature of the ingredients and the safety data. Lycopene is listed only as an orange colorant. To be sure, there is solid evidence that lycopene is a prophylactic against male prostate cancer, but that is a long way from treating skin on the face! Although, it is sometimes is hard to tell the difference with some of my clients.

In summary, be sceptical about any new breakthrough treatment that hinges on a single ingredient. Learn what the differences are between “essential” chemicals, natural or otherwise, and what our body already produces on its own. Familiarise yourself with delivery systems into the skin and know which ingredients can be topically applied with a chemical reaction that takes place and which ingredients must be taken orally. Probably the ideal crème would be a mixture of salmon, DMEA, vitamin C, antioxidants and beta glucans, with a pinch of lycopene for colour. Then spread it on toast like Vegemite and eat it three times a day!

Written By Danné Montague-King

My college house mate’s mother worked as a butcher at a local market. Hers was a wonderful job for us because she brought us home fine steaks night after night. The meat needed to be disposed of anyway, because it was too old to be legally sold. It tasted fine just the same.

I remember quite well that this meat always had a rather peculiar appearance. Before cooking, it was faintly brown on top as if had been lightly seared. Meat changes colour as it is cooked, of course, becoming golden then brown, and I know that this old stored meat had undergone very slowly some of the same chemical reactions that meat goes rapidly during cooking. And as surprising as it may seem, we undergo some of these same chemical changes as we age, we brown.

Meat browns and we brown because of glucose, the other major molecule of aerobic metabolism. This peculiar phenomenon was discovered in 1912 by Louis Maillard, a French chemist, who observed that a mixture of glucose to protein components, when heated, would turn from clear to yellow to a deep brown. This was subsequently called the Maillard Reaction and has ever since been of great interest to food chemists concerned with making food tasty and tempting in appearance as possible.

The Maillard Reaction is just the chemical attachment of glucose to proteins at places it doesn’t normally belong, which makes a yellow brown product. Glucose is sticky stuff, so it attaches spontaneously, given the appropriate temperature and amount of time.

Until recently, however no one understood that this same process could occur at any body temperature. But in the 1970’s it was noticed that people who have high levels of blood glucose due to poorly controlled diabetes also have glucose attached to some of their haemoglobin, a protein. That is their haemoglobin is modified as if by a Maillard Reaction. Doctors had noticed for years that uncontrolled diabetics seemed to undergo something resembling accelerated aging. Many of the common ailments of aging, such as cataracts, atherosclerosis, heart attacks, strokes, Lung and joint stiffening, appeared earlier in diabetics together with the Maillard Reaction and concluded that aging itself might be partially due to Maillard, or Browning products accumulating at a slow rate in the body. What’s more, he noted that the end result of this reaction was a series of unalterable new chemical structures in our tissues, which he called AGE’s, a clever acronym from his more opaque chemical term, Advanced Glycosylation End-products.

But why would simply, attaching glucose to proteins at places it doesn’t belong lead to the sort of deterioration we call aging?

The first reason is that some proteins form the structure and support of our bodies. Many of the most important structural proteins, such as my opossums’ collagen, live for decades in our bodies without their molecules turning over. Apparently general characteristics of aging take place in exactly those tissues that are stuffed with long-lived, non-renewing cells and molecules.

So let’s think about collagen again. Remember that it is a flexible protein composed of three strands coiled around one another like a cable. Its flexibility is what makes it so useful for forming the foundation of arteries, veins, lungs and skin; for making tendons and ligaments that twist and bend without breaking; for forming cartilage that cushions our joints with its resiliency. But as glucose attaches to collagen, it forms bridges or cross-links between strands of a single molecule and between molecules.

As these bridges multiply over time, collagen’s flexibility gradually disappears. It turns yellow and stiff and no longer makes such wonderful lungs, tendons, ligaments or support for artery walls. What’s more, collagen, with attached glucose in the walls of the arteries, acts like an opened-jawed bear trap. It seizes and holds on to passing proteins. In this fashion browning may play a part in trapping and accumulation of LDL cholesterol in the artery walls-an early stage of atherosclerosis.

Proteins do many things in the body besides provide its body structure. They turn genes on and off, direct cell replication, and chaperone other molecules to their appropriate site of action. As enzymes, they are essential for virtually all of the chemical activity of a cell. The fidelity with which proteins carry out the functions they were designed for depends on their being chemically unaltered.

When sugars attach to protein inappropriately, they can impair their function and therefore disrupt the proper working of the cell. Attached sugars also make proteins less soluble in the body more likely to solidify and become non-functional, and less likely to be broken down by chemicals designed to destroy damaged molecules.

Solidified proteins glued together into large masses, as it turns out, composed the characteristic brain lesions of Alzheimer’s disease, which will arguably become the most serious problem of aging over the next several decades. Alzheimer’s disease and other mental debilitation increase dramatically with age, particularly after age 50. The risk of mental debilitation doubles about every five years in late life-faster than the overall mortality-doubling rate, which is seven to ten years. By age 85, as many as half of us will be mentally impaired to some degree.

Therefore, as populations around the world live longer over the next decade, the number of people who will be unable to take care of themselves, unable to recognise their spouses or children and unable to control their own bodily functions will increase at a depressing rate unless new medical treatments are developed.

The damaging brain lesions of Alzheimer’s disease-so called tangles and plaques-consist of proteins that are common and normal in the brain and that become damaging only when they solidify and aggregate into these gluey masses. Recently, browning products have found in both tangles and plaques, and it may be that browning products themselves are involved in development of the plaques and tangles.

The impairment of proteins isn’t the only potential problem associated with glucose. Glucose can also bind directly to DNA, although it does so more slowly than it binds to proteins. Nevertheless, in non-dividing cells, such as those composing much of the brain and heart. DNA is a long-lived molecule on which AGEs can potentially accumulate. In principle, AGE Attachment to DNA could disrupt the production of new cellular proteins, could interfere with DNA repair, and could even cause mutations. As of now, however, relatively little is known about these particular processes.

Chemical theorists tell us that the Maillard Reaction should proceed at a rate pretty much determined by the concentration of sugars and proteins, and the temperature at which these ingredients are kept.

To the extent that browning is a central process of aging, the anti aging impact of caloric restriction might be partially explained by a reduced browning rate. If you feed laboratory rats only 60 percent of the calories they would eat if given unlimited food supplies, their blood glucose level is reduced by about 25 percent, their body temperature declines by several degrees, and their aging is retarded by about 20 to 25 percent.

But the larger picture is more complex. Most mammals maintain about the same concentration of sugars and proteins in their bodies and live near the same 98.6 degrees that humans do, and yet some mammals accumulate browning products rapidly and live only a year or two, while others brown slowly and live many decades.

How can this be?

As was the case with oxidants, the production rate of browning products is apparently only part of the story. If they accumulate at different rates in different species, then there must exist protective mechanisms-anti-aging processes-that are well developed in some species and poorly developed in others. Discovering the nature of these anti-aging processes, and being able to modify them pharmaceutically, should hold great promise for understanding and modifying the age rate itself.

Currently, we know very little about these processes. We know that certain natural plant compounds, as well as synthetic drugs, can inhibit the formation of browning products in a test tube. So it seems likely that our bodies will also contain an array of anti-browning chemicals, although they are as yet unknown. But at least one of the body’s phagocytes, or scavenger cells, seems specialised too devour proteins or cells that have been “browned”.

If oxidation and browning are two important general processes of aging, it might come as no surprise that they seem to operate cooperatively to our detriment. The damage caused by one affects the other. So glucose and it’s derivative products can react with other chemicals to produce free radicals, and free radical can accelerate browning. Also, glucose can attach to cellular antioxidant enzymes and by doing so inactivate them leading to higher levels of free radicals and the damage they cause.

These two processes are likely to be centrally involved in aging, but there is no reason to expect that they completely explain it. Evolutionary theory suggests that there will be many mechanisms of aging. Browning and rusting may just be among the most general and easiest to identify. One other general process that has short-term benefits but long-term hazards is the continuing ability of cells to divide throughout life. The failure of proper regulation of this process leads, of course to cancer, which turns out to be perhaps them most general disease of aging in the animal kingdom.

Written By Dr. Danné Montague King