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The efficacy and choice of medical skin care products on skin disease barrier function

08/23/2018

With the improvement of living standards, people’s pursuit of skin health and aesthetics is getting stronger and stronger, and medical skin care products are getting more and more attention. Compared with traditional skin care products, medical skin care products have a certain effect on the physiological or pathological processes of the skin, and can be used for the auxiliary treatment of various skin diseases to increase the simpleness. The effects of medications and reduce adverse reactions or skin discomfort. Therefore, medical skin care products have become an important clinical aid for many dermatologists and have been widely loved and recognized.

1. The concept and characteristics of medical skin care products
Dermocosmetics Also known as cosme-ceuticals, it is a cosmeceutical. First proposed by Raymond in 1962 to describe “active” or “scientific” cosmetics. In 1970, Kligman defined it as a combination of cosmetic and dermatological external medicines, which combines the performance of cosmetics and certain drugs. Compared with traditional cosmetics, medical skin care products are characterized by efficacy, safety, specificity and professionalism.

1.1 Pharmacodynamics
Medical skin care products contain certain synthetic or natural drugs or similar pharmaceutical ingredients to enhance their auxiliary functions in addition to ordinary cosmetic modification, such as removing epidermal keratin, increasing skin hydration, improving skin barrier function, reducing skin sensitivity, and inhibiting Local inflammatory reaction and pigmentation, promote wound healing, etc., and thus have a certain auxiliary therapeutic effect on a variety of skin health problems or skin diseases, that is, have certain drug properties.

1.2 Security
Compared with medicines, medical skin care products usually do not have strict indications, and do not have a clear dosage or treatment cycle. They have cosmetic properties in use; and compared with ordinary skin care products, medical skin care products often contain Fewer pigments, flavors or preservatives. It requires a higher production process, has lower sensitization, is less prone to adverse reactions of general drugs or cosmetics, and has higher safety.

1.3 Targeted
Different medical skin care products contain different active ingredients and effects, and the applied objects often have certain differences. Therefore, the choice should be made according to the specific skin condition or disease state of the patient, and it is targeted on the object of use. Clinicians should strengthen their understanding and understanding of different medical skin care products in order to target the specific situation of patients.

1.4 Professionalism
Compared with ordinary skin care products, before the use of medical skin care products, most professional dermatologists need to carry out targeted professional guidance based on the patient’s skin condition or disease state; medical skin care products are also mostly sold in pharmacies, requiring dermatologists. Prescription purchase and use. Therefore, medical skin care products require the instructors, users and sellers to have a certain medical expertise.

2. Common active ingredients and effects of medical skin care products
Most medical skin care products contain some unique drugs or similar active ingredients to enhance their efficacy. Most of these active ingredients come from natural plants, animals or minerals, and have the advantages of high safety and less toxic side effects.

2.1 Natural flora and fauna
Common natural animal and plant ingredients include green thorn fruit oil, avocado oil, purslane and licorice extract, pumpkin seed oil, mushroom glucan, green thorn fruit oil, arbutin, ascorbyl glucoside, lanolin, etc., medicine These ingredients can be added to skin care products to achieve moisturizing, moisturizing, soothing, regulating sebum secretion and restoring skin barrier function.

2.3 Drugs or similar pharmaceutical ingredients
Drugs or similar pharmaceutical ingredients such as salicylic acid, nicotinamide (V.PP), vitamin C and derivatives, kojic acid and derivatives, UV sunscreen isolation system, etc., these ingredients can be added to medical skin care products to achieve keratin and promote skin excretion. It resists ultraviolet rays, prevents the formation of acne, and has functions such as anti-oxidation and whitening.

2.4 Minerals and others
Other ingredients such as natural spring water, zinc, glycerin, propylene glycol, urea, mineral oil, dimethicone, cyclomethicone, dipeptide, surfactant, etc., have cleansing, softening and exfoliating, and increasing the stratum corneum of the skin. Hydration and other functions, and can add essential vitamins and minerals to the skin’s metabolism.

3 The efficacy and choice of medical skin care products for special skin types or skin diseases

3.1Sensitive skin
Sensitive skin is a sub-health state of the skin. It usually means that the patient self-evaluation cannot tolerate larger environmental thorns (such as cold, heat, sun) or eating spicy food, or can not withstand ordinary skin care or cosmetics. Physiologically sensitive skin often has no specific cause, and secondary is often caused by certain primary skin diseases or inappropriate treatment, such as incorrect long-term use of facial hormones, inferior cosmetics or skin rejuvenation treatment. The incidence of sensitive skin is high, and in different countries and races, sensitive skin accounts for almost 1 / 4 to 1 / 2 of adults. Under the joint action of internal and external factors, the patient’s skin sensory nerve signal input impulse increases, the immune response is enhanced, the skin barrier function is impaired, and the oil and moisture content in the skin is lower than that of healthy skin. Therefore, sensitive skin should be selected from medical ingredients that are simple in composition, mild in nature, moisturizing and soothing.
Yang Guangzhi and other studies have confirmed that medical skin care products containing purslane extract can effectively reduce transdermal water loss (TEWL), increase stratum corneum water retention and sebum content in sensitive skin of patients with hormone-dependent dermatitis, and have no correlation. Adverse reactions indicate that the extract of Portulaca oleracea has a moisturizing effect and can effectively improve skin sensitivity caused by long-term topical corticosteroids. He Shengwen and other studies have also confirmed that the large amount of vitamin C, E, β-carotene and glutathione contained in the extract of Portulaca oleracea can effectively increase the activity of superoxide dismutase (SOD) and increase the skin’s oxygen free radicals. The elimination of oxidized lipids reduces the damage to the body and has anti-allergic and anti-inflammatory effects. In the study of living spring water, Li Li and others found that after 14 days of using live spring water, the skin inflammatory erythema, swelling, burning and tingling of the patients were alleviated or disappeared, and the water content of the stratum corneum increased, indicating that the living spring water helps to reduce Skin sensitivity can be used for adjuvant treatment of sensitive skin. Therefore, medical skin care products containing active spring water and purslane are useful choices for sensitive skin.

3.2 Dry Skin
Dry skin can be an idiosyncratic or a concomitant symptom of certain skin diseases, such as ichthyosis vulgaris, xeroderma pigmentosum, and the like. The moisturizing ingredients in medical skin care products can replenish skin lipids and moisture, restore skin barrier function, effectively correct skin dryness and improve patient quality of life.
The moisturizing ingredients contained in medical skin care products are mainly ceramide, hyaluronic acid, urea and some natural botanical ingredients. Among them, ceramide is the most widely used, it is an important component of human stratum corneum lipid, and has a strong moisturizing effect. Other natural plant moisturizers such as thorn fruit oil and avocado oil can directly replenish the oil content on the skin surface, inhibit local inflammation and promote endogenous humectant formation. Liu Shuzheng and other studies on the green thorn fruit confirmed that the unsaturated fatty acid content is very close to the lipid content of the stratum corneum of the skin, so it has a good moisturizing effect, and the moisturizing effect is almost equivalent to ceramide. Pang Qin et al confirmed that medical skin care products containing wild Camellia extract can effectively improve the moisture content and oil secretion of dry skin: after continuous use for 15 days, the two were treated by pre-treatment ( 20.74 ± 8.84) %, ( 1.77 ± 2.37) % increased to (30.46± 7.19) % , ( 7.59 ± 8.38) % , and the lesion dryness score decreased from 1.63 ± 1.10 before treatment to 0. 27 ± 0. 64.

3.3 Acne
Acne is a common disease in adolescence, mainly related to increased secretion of androgen in adolescence, hyperkeratosis of the epidermis, formation of hair follicles, and secondary infection with P. acnes and inflammatory response. A medical skin care product containing 2% nicotinamide, azelaic acid, zinc and a surfactant removes excess oil from the skin surface, keeps the skin clean, and inhibits bacterial growth. The medical skin care products containing salicylic acid, fruit acid and polyhydroxy acid can effectively inhibit the keratinization of the epidermis, remove the hair follicle plug, promote the discharge of foreign bodies, and reduce the formation of whiteheads and blackheads. The medical skin care products containing Shumin and soothing ingredients can also reduce the inflammatory reaction of acne, reduce local redness, promote inflammation repair, reduce pigmentation and scarring, and reduce anti-acne treatment drugs (such as vitamin A, peroxidation). Skin irritation caused by benzoyl, etc., increases patient compliance. In addition, although the skin of patients with acne is often greasy, medical skin care products with moisturizing ingredients are not unnecessary. For example, medical skin care products containing dimethyl siloxane, glycerin, hyaluronic acid and the like can help reduce the incidence of acne patients. Loss of skin moisture, which reduces skin sensitivity and inhibits acne production.

3.4 Atopic dermatitis, eczema and psoriasis, etc.
Repeated skin inflammation can lead to abnormal skin physiology, ceramide synthesis disorders in epidermal cells, lack of natural moisturizing factors, increased TEWL, loss of intercellular connections, and impaired skin barrier function. On the one hand, the patient has dry skin, desquamation, and even cleft palate; at the same time, the resistance to the outside is reduced, the pathogenic microorganisms are easy to invade, and the inflammatory reaction and damage are aggravated. Targeted selection of medical skin care products containing specific ingredients can not only moisturize, nourish and relieve itching symptoms, but also improve the quality of life of patients. The active factors can also regulate epidermal cell differentiation, inhibit scaly formation and reduce inflammation. .
Gayraud and Smirnova etc proven medical skin care products (atoderm) containing skin barrier repair ingredients for the treatment of atopic dermatitis and eczema clinical significant supporting role, patients can quickly relieve itching, skin lesions subsided accelerate and prolong relapse. Zhao and other studies have found that medical skin care products containing purslane can effectively promote skin lesion regression and pruritus control in patients with psoriasis vulgaris. The mechanism is related to the inhibition of NF-κB pathway in epidermal keratinocytes. The combination of alcohol cream can accelerate the clinical improvement of patients. Shuang other studies show that the combination of medical skin care products containing Portulaca oleracea extract can effectively increase the lesions of patients with psoriasis vulgaris of filaggrin (Filaggrin) and loricrin (loricrin) synthesis, inhibition of keratin K14 And K17 expression, which can improve clinical symptoms, and can reduce the amount of other therapeutic drugs, while alleviating adverse reactions such as skin irritation.

3.5 solar dermatosis
UVA and UVB in sunlight can cause skin congestion and edema, sunburn and pigmentation, and can induce skin cancer. The application of medical skin care products in solar skin diseases mainly includes: 1 Preventing the occurrence of sunburn, medical skin care products with sunscreen ingredients (such as dipeptide) can effectively block ultraviolet rays and prolong the time of sunburn erythema. Reduce sunburn on the skin. The sunscreen effect of skin care products is generally expressed by the sun pro-tection factor (SPF) and the UVA protection index (PA). SPF > 30 and PA ( 3 + ) medical sunscreens should be used in summer and highland areas; SPF > 10 and PA ( 2 + ) sunscreens should be used in spring, autumn, winter and plain areas, and recommended for long-lasting Outdoors, even on cloudy days, should use appropriate sunscreen products to prevent sunburn and photoaging. 2 promote post-sunburn repair, some natural botanical ingredients (such as purslane, thorn fruit oil and licorice extract) can effectively inhibit the inflammatory reaction after sunburn, reduce the symptoms of local burning, promote inflammation, and can Reduce symptoms such as pigmentation and desquamation caused by sunburn.
Some synthetic sunscreen ingredients such as p-aminobenzoic acid and its esters, anthranilate, p-methoxycinnamate, benzophenone and its derivatives, methane derivatives, etc., and natural sunscreen ingredients Extracts such as green tea, sea buckthorn, astragalus, aloe vera, etc., can be used for the prevention and treatment of light or photosensitive skin diseases (such as lupus erythematosus, pleomorphic sun rash, and pigmented dry skin). Disease, etc.), or to prevent the occurrence of light-sensitive phenomena that may result from taking photosensitizing drugs.

3.6 pigmented skin disease
Increased skin pigmentation can be caused by congenital or physiological factors (such as chloasma, freckles) and physical factors (such as sun exposure), but also secondary to various skin diseases, resulting in post-inflammatory hyperpigmentation. The activity of tyrosinase in skin melanocytes is enhanced, and pigment particle synthesis is accelerated to its pathophysiological mechanism. For pigmented skin diseases, you should pay attention to the choice of medical skin care products: 1 First of all, it is necessary to strengthen the skin’s cleansing, hydrating and moisturizing. Skin care products containing cleansing, moisturizing, moisturizing and soothing should be used to reduce the incidence of skin inflammation. Promote its rapid regression; 2Based on the former, the use of products with sunscreen function can reduce the increase of UV-induced skin pigmentation and reduce the occurrence of coloration; 3 Simultaneous use of medical skin care products containing whitening and freckle-containing ingredients, such as panthenium hydrazide Calcium ethyl sulfonate, tetraisopalmitate, licorice extract, nicotinamide, vitamin C and its derivatives, kojic acid and derivatives, arbutin, flavonoids, etc., can inhibit tyrosinase The activity further reduces the formation of melanin particles, thereby having a whitening effect. In addition, medical skin care products containing fruit acids and linoleic acid also have chemical exfoliation to remove pigmentation from aged skin.

3.7 Skin wound repair
Some active ingredients of medical skin care products (such as turmeric and aloe extract) also relieve pain, reduce postoperative erythema, swelling and itching, and can regulate collagen synthesis, promote wound healing, inhibit scar formation, and thus can be used for prevention. Reduce postoperative complications, shorten postoperative recovery time, and enhance cosmetic results.
Pincelli and other studies have confirmed that live spring water can be used not only for various inflammatory skin diseases, but also for various post-operative skin care (such as surgical resection and suture, electrocoagulation, photorejuvenation, etc.), which can reduce postoperative inflammatory response. Reduce pain and promote postoperative recovery. Mer-ial and other studies have found that spraying wound water every 4 hours after photodynamic therapy (PDT) can significantly reduce local pain from 3 to 6 days after surgery, and its mechanism and inhibition of degranulation and anti-inflammatory reaction of local mast cells. related. Larissa et al found that the extract of the genus Eugenia dysenterica is rich in polyphenols, which can effectively inhibit collagenase, elastase and tyrosinase activities, and promote the proliferation and wound healing of HFF-1 fibroblasts.

3.8 Skin aging
Aging is an irreversible process of organ development. In addition to having a huge impact on appearance, skin aging also increases the incidence of skin tumors. Skin aging is associated with the degradation of tissue matrix metalloproteinases (MMPs) and type I collagen, leading to thinning of the epidermis and atrophy of the dermis, resulting in wrinkles. Moisturizing and moisturizing ingredients (such as hyaluronic acid, collagen, etc.) contained in medical skin care products can effectively increase the water content in the epidermis and dermis, maintain skin elasticity, and improve wrinkles and skin lightness. Rouvrais and other studies have found that medical skin care products containing retinal, delta-tocopherol glucoside and bis-glycin oleic acid amide can effectively promote elastin, integrin b1, ankyrin and actin a2 in the extracellular matrix. It can increase the content of extracellular matrix; it can effectively enhance the damage of UV-induced elastin and fibrillin in dermal cells, thus delaying the occurrence of photoaging. Continuous use every day can effectively reduce the formation of facial wrinkles. In addition, the vitamins C and E contained in medical skin care products can also resist the superoxide anion and oxygen free radicals generated during the aging process by reducing the skin aging.

4.Conclusion
Medical skin care products are a new type of new product between medicines and skin care products. Due to the combination of cosmetic modification and pharmacological auxiliary effects, they have been widely used in the routine maintenance of normal skin and the adjuvant treatment of skin diseases. Correctly grasp the ingredients and effects of common medical skin care products. In clinical work, the skin condition or disease state of the patient is specifically combined, and the appropriate product type is appropriately selected or recommended, which helps to fully exert its auxiliary therapeutic effect and promote the skin. Health and disease recovery.

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