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 The truth about cosmetics

Cosmetics are big business and most women use cosmetics at some time of their lives. However, choosing cosmetics is difficult because there are no standard measurements of effectiveness and no data from independent studies. It is therefore, difficult for anyone, including doctors even, to decide whether a product is potentially useful or not.

Cosmetics are legally defined as products whose sole purpose is cosmetic, i.e., to produce a superficial improvement. A drug or pharmaceutical, on the other hand, is intended for the purpose of altering the structure or function of the skin. Unlike cosmetics, drugs or pharmaceuticals have to satisfy stringent Ministry of Health (MOH) or Food and Drug Administration (FDA) regulations and cannot make any unsubstantiated claims. They cannot also advertise.

Choosing the right cosmetic

The right cosmetic can certainly enhance the appearance of the skin but how can you decide which is the best product for your skin. Unfortunately, you cannot go by advertising claims, you cannot go by pricing and there are no scientific data on effectiveness to go on either. So the only way - the difficult way is to learn how to interpret the ingredient list. Generally, the active ingredients are usually found among the first 5 items, the remainder are usually added to keep the product stable or make it look, feel or smell nicer. Remember too that price does not correlate with effectiveness and exotic products or exotic or scientific sounding names do not make a difference either. The table below lists the more common cosmetic ingredients according to function and the “special ingredients” are considered in a subsequent section. As you unravel the ingredients list, don’t be surprise if you end up deciding that the product is just a moisturiser (with or without sunscreens) because very often that is exactly what the product is.

Common cosmetic ingredients

Ingredient

Examples

Moisturisers

Moisturisers work by trapping water  in the skin. It can do this in two ways. It can occlude the skin with a waterproof layer so that the water cannot escape or it can bind the water and keep it in the skin. These two types of moisturisers are known as lubricants (or occlusives) and humectants, respectively.

Emollients are products which soften the skin. Many moisturisers soften the skin so the term emollient and moisturiser are often used interchangeably.

Lubricants (occlusives) or emollients

Mineral oil
Petrolatum (petroleum jelly)
Vaseline
Lanolin
Silicones such as dimethicone or cyclomethicone
Fatty acids such as stearic acid and isostearic acid
Fatty alcohols such as cetyl alcohol, stearyl alcohol and myristyl alcohol
Esters such as isopropyl myristate, spermaceti, octyl palmitate, isodecyl neopentanoate, butyl stearate and isopropyl isostearate Triglycerides such as sesame oil, palm, coconut, sunflower and avacado oil
Squalene

Humectants

Propylene glycol
Glycerin
Sorbitol
Gelatine
Pyrolidone
Lecithin
Urea
Lactic acid
Hyaluronic acid
Sodium pyrrolidone carboxylic acid (NA-PCA)
Phospholipids
Collagen
Elastin
Ceramide

Emulsifiers

Oil and water do not mix so ingredients known as emulsifiers or surfactants are added to enable the two components to mix together to form lotions and creams.

 

Amphoteric-9
Carbomer
Cetearyl alcohol and ceteareth-20
Cholesterol
Disodium monooleamidosulfosuccinate
Emulsifying wax
Lanolin
Lanolin alcohol (Laureths)
Lanolin, hydrogenated
Lecithin
Polyethylene glycol 1000 monocetyl ether
Polyoxyl 40 stearate
Poly sorbates
Sodium lauryl sulphate
Sodium laureth sulphate
Sorbitan esters
Strearic acid
Tea stearate
Trolamine
Esters such as glyceryl stearate or polysorbate 80
Polymers such as carbomer 934 or xanthum gum
Ethers like steareth-2 and laureth-4
Soaps such as beeswax borax or ammonium stearate. 

Preservatives

These prevent bacterial growth and along with anti-oxidants prolong the shelf-life of the product

Alcohol
Benzyl alcohol
Parabens (methyl-, propyl- or butyl-paraben)
Quartenium-15
Imidazolidinyl urea
Chlorocresol
2-bromo-2-nitropane-1,3-diol

Antioxidants

These prevent the product from going rancid

Ascorbic acid
Butylated hydroxyanisole (BHA)
Butylated hydroxytoluene (BHT)
Citric acid
EDTA
Propyl gallate
Tocopherol (vitamin E) 

Thickening, suspending agents, viscosity builders

These add thickness to the product.

 

Beeswax
Carbomer (polymers)
Cellulose derivatives
Cetyl esters wax
Dextrin
Polyethylene
Xanthum gum

Gellants

These are thickeners that when combined with alcohol, acetone or water, make transparent gels that liquefy (thin) when applied to the skin. 

Carbomer
Carboxymethyl cellulose
Hydroxymethyl cellulose

What about the special ingredients?

Cosmetic companies often claim that their products have special ingredients but do they work or are they nothing more than highly priced moisturisers? It is a difficult question to answer because claims of effectiveness are often based, not on scientific evidence but on traditional beliefs, observations or sometimes, ingredients are included just because they sound exotic or impressive. There are, a few exceptions however, such as the alpha-hydroxy acids (AHAs), beta-hydroxy acids (BHAs) and vitamin C. Caution however because merely having these as ingredients is not proof that they work. They must, first of all, be formulated properly and then they must be evaluated in scientifically designed clinical trials. Unfortunately, cosmetic companies often do not conduct these studies or only do such studies in-house where there is a possibility of bias. That's not saying of course, that all cosmetics containing these products do not work, but without the results of properly conducted studies, it is simply impossible to know? Cosmetic companies on the other hand, argue that they do not conduct independent studies because they are simply too expensive. Moreover, they are not marketing their products to doctors anyway. So we are none the wiser.

Look at the table below to learn about these so-called “special ingredients” and understand the basis for their inclusion in cosmetics and how they do or do not work.

Special ingredients

Amino acids/proteins

Amino acids are the building blocks of proteins which in turn, are the building blocks of our body. They are often added to cosmetics in order to “nourish” and rebuild the skin’s structure. The truth however, is they cannot penetrate the skin but remain on the surface and help the stratum corneum cells retain moisture and plump the skin up. In other words, they are good moisturisers.

Collagen
Collagen is the structural protein that lends support to the dermis and the overlying skin. Degeneration of collagen in the dermis results in wrinkles and sagging skin. However, collagen is a large molecule and cannot penetrate the skin. The only way collagen can get into the dermis is when it is injected. This is why doctors have to inject collagen into the dermis to efface wrinkles and scars. The collagen in creams merely plump up the stratum corneum and are, in actual fact, good moisturisers.
Elastin 
Elastin is a protein found in the dermis. However, like collagen, elastin is also too large to penetrate the skin. In other words, elastin too is a good moisturiser.
Vitamins
A great deal has been claimed about the beneficial effects of vitamins, especially the so-called anti-oxidant vitamins A, C, and E. Free radicals are oxygen with an extra electron. Because electrons like to exist in pairs, the extra free electron goes around looking for a partner and in the process, damages cell membranes and DNA and cause the cells to age and become vulnerable to disease. Free radicals are produced by a number of environmental factors such as UV rays, pollution and smoke, and by the body’s own chemical processes. The anti-oxidant vitamins are supposed to sponge up these free radicals before they cause damage. Recently, a number of vitamin C formulations have come into the market which are able to penetrate the skin but at the moment these are only available from doctors. Vitamin A compounds such as retinol, retanyl palmitate and retanyl acetate are found in so-called “anti-wrinkle” creams and may give the impression that they are the same as tretinoin (the active ingredient in Renova, Retin-A, Stieva A and  Airol) which has been proven to reduce wrinkles. The answer is they are not and most doctors believe that the concentrations are too low to be effective. The only effective form of vitamin A is tretinoin which has to be prescribed by a doctor. Although vitamin E or tocopherol acetate is an anti-oxidant, there is no proof that it actually works. Very often vitamin E is added to cosmetics as an anti-oxidant to prevent the product from going rancid and not for it’s activity. In such cases, you will usually find the name towards the end of the ingredient list. Vitamins have also been added for reasons of marketing since they may convey an impression of health benefits for the skin. Co-enzyme Q10 is another anti-oxidant that has been added to cosmetics to prevent the damage caused by free radicals.
Ribonucleic acid 

Ribonucleic acid (RNA) decreases with age so some cosmetics use RNA to supposedly, retard ageing. Again there is no evidence that they do. Brewer’s yeast is also rich in RNA and is sometimes included in cosmetics for this reason.

Minerals 

Trace elements are essential for health so they too have been added to cosmetics to give the impression of some health benefits. Selenium and zinc have anti-oxidant properties and have been added to cosmetics, as well.

Thymus extracts 

The thymus glands of some animals stimulate cell renewal and are sometimes added to cosmetics.

Placental extract 

The placenta is the lifeline for the developing baby and supplies all the nutrients and oxygen necessary for growth. Cosmetic products with placental extracts imply that they may maintain or promote youthfulness. The truth is they are moisturisers, nothing more.

Hormones

The skin degenerates after the menopause when the production of female hormones declines. Female hormones are therefore, included in some cosmetics to give the impression that they can delay the degeneration or ageing process. Unfortunately there is no proof that they do. This is why these hormones have to be taken by mouth, injected or implanted under the skin.

Plant extracts 

There are countless extracts from herbs and plants which have been included because of some traditional benefits. Examples include aloe vera, arnica oil, calendula oil, jojoba oil, carrot extract, chamomile, cornflower, cucumber extract, hayflower, horse tail extract, juniper extract, rosemary and thyme. Some of them have soothing and moisturising properties. But that’s all and don’t imagine that they cannot cause allergies because they are “natural”.

Allantoin 

Allantoin is a uric acid obtained from cows or other mammals. It has a long history of use in the treatment of wounds and ulcers so cosmetics include it because of its healing and soothing properties. It too is non-irritating and a good moisturiser. Allantoin is therefore, used in cosmetics for sensitive skin.

Phospholipids and lecithin 

Phospholipids are a component of cell membranes. The amount of phospholipids in ageing cells decrease and the cells lose moisture and become dehydrated. Phospholipids are added to to cosmetics to supposedly repair damaged cell membranes but are, in fact, just very good moisturisers. Lecithin is a type of phospholipid.

Cerebrosides and ceremides 

Cerebrosides are produced by the cells in the basal layer and become ceremides as these cells move towards the surface of the skin. They are also found in sebum and form part of the skin’s moisturising factors (NMFs). They have good moisturising properties, nothing more.

Liposomes 

Liposomes are microscopic spheres which can trap water soluble ingredients in the core or fat-soluble ingredients in the membrane. The membrane may be single or multiple layered and usually made of phospholipids and thus, similar to the cell membrane. It is believed that the liposomal membrane can fuse with the cell membrane and release the trapped ingredients. It is therefore, a very elegant type of delivery system. Liposomes have been used in medicine to deliver drugs, vaccines and even genes. Cosmetic also incorporate liposomes but how effective they are, is difficult to assess because these products have never been studied in a scientific manner. At the moment, all that can be concluded is that, being composed of phospholipids like the cell membranes, liposomes may be good moisturisers.

Hyaluronic acid 

Hyaluronic acid is a mucopolysaccharide and a component of the skin’s Natural Moisturising Factors (NMF). It surrounds the cells of the basal layer of the epidermis and is also fills in the gaps between the collagen and elastin fibres and gives substance to the dermis. Hyaluronic acid is reduced in ageing and may also contribute to wrinkles forming. It is also found in cosmetics but again hyaluronic acid cannot penetrate the skin. It is however, a very good moisturiser because it can bind a thousand times its weight of water in the skin. Hyaluronic acid is also being injected into the skin to improve wrinkles and scars in the same way as collagen implants. This is a new form of therapy which is not widely available yet.

Squalene 
Squalene is found in sebum and is basically a moisturiser. The shark liver is one of the richest sources of squalene which was why the shark was hunted down. Fortunately, squalene can also be obtained from vegetable oils and can also be synthesised.
Spermaceti 

Spermaceti is a waxy oil obtained from the sperm whale’s head so much so the whale became an endangered species. It is also a good moisturiser. Spermaceti can now be synthetically produced, much to the delight of conservationists.

What about over-the-counter anti-wrinkle creams?

Previously, the demarcation between cosmetics and pharmaceuticals was very clear. Cosmetics such as moisturisers and make-up moisturise and beautify the skin, respectively but have no effect on the structure and function of the skin. Recently, however, cosmetic products have been introduced containing ingredients such as alpha-hydroxy acids (AHAs) which, according to medical research, can stimulate collagen synthesis. This is clearly altering the structure or function and in that sense, AHAs should be considered drugs, should they not? Not quite because according to the law, cosmetics are still considered cosmetic as long as they do not make drug claims. This is why you won't find too many cosmetics that claim to remove wrinkles although many use terms such as “reduce the appearance of lines”, “produce younger looking skin” or “smoothen skin texture”. By avoiding making obvious medical or drug claims, cosmetics escape the stringent regulations required of a drug and also the enormous costs involved in evaluating the it for effectiveness and safety. Generally, established cosmetic companies will do their own in-house testing to make sure that their products are safe because it is clearly in their own interest. However, effectiveness is not tested as stringently as is required if they were to be classified as a drug. The term “cosmoceuticals” has sometimes been used to describe those cosmetic products which contain products such as AHAs which doctors believe can stimulate collagen synthesis (in other words, a drug effect). However, as was mentioned earlier, the health authorities still consider them cosmetics so long as they do not actually make a direct drug claim.

Cosmetic claims and labels

According to the law, cosmetics are actually not allowed to use terms such as anti-wrinkle, anti-ageing, rejuvenating, cell-renewal because such terms imply altering the structure or function of the skin which can be considered to be a drug claim. Some take the risk while others get around the problem by making obtuse claims such as younger looking skin, reducing the appearance of lines, and so on. In fact, these benefits can be achieved with a good moisturiser and that is exactly what most of these creams are. The main reason why cosmetic companies continue making such claims is because these products command a premium compared to moisturisers. Also, don’t imagine that the men and women featured in the advertisements have good complexions because they have been using the product(s) advertised. Cosmetic companies seek out actors, actresses and other individuals precisely because they had good skin to begin with. As a general rule, beware of products that make fantastic claims such as remove lines overnight because if you think about it logically, lines cannot be removed overnight because. The only way they can make lines “disappear” is to hide them by filling them up. This means that the product is actually a good moisturiser but you are most probably paying a high price for it. There are many other claims so it is useful to understand what they mean.

Hypoallergenic

Hypoallergenic means less likely to cause allergy. It does not mean no allergy. Hypoallergenic cosmetics usually omit one or more of the more common causes of allergy such as fragrance, lanolin and preservatives.

Natural ingredients

Natural, organic, herbal, botanical or plant extracts are often used to suggest that the product is safe. This is not true for a variety of reasons. Firstly, one of the commonest cause of severe allergic contact dermatitis, in fact, is a natural product - poison ivy. Secondly, chemicals are often used during the extraction of these “natural products”. Thirdly, natural products go bad so preservatives (chemicals) need to be added anyway.

Dermatologist-tested

This is another label that is used to convey the impression that the product must be safe. Not so because these products often do not indicate the name of the doctor who tested it, whether he is employed by the cosmetic company and how he tested the products.

Nourishing

This term might suggest that you can get nourishment from the product. You cannot because all the nutrients that you skin need which are oxygen, proteins and amino acids, carbohydrates, fatty acids come from the blood.