Field Notes from the 75th Annual Meeting of the American Academy of Dermatology

Over 19,000 people attended the 75th Annual meeting of the American Academy of Dermatology, March 3-7 in Orlando, Florida, USA. Topics of interest for dermatologist and the cosmetics industry included the following.

Aging Skin

A popular theme dedicated to aging and the impact of aging to skin  is always well attended.    This year nine speakers explored a variety of approaches to treating the aging body.  Dr. Sabriba Fabi, a dermatologist from University of California, San Diego, suggested that people should start early to forestall the cosmetic effects of aging.  Most patients become concerned about the sign of aging, including lines, wrinkles and skin folds after they become visible.  Dr. Fabi suggested that the aging process begins at age 25, and by age 35 the bones have significant reduction in osteons that lead to decreased support of the muscles.  Dr. Qian Zheng, MD, PhD from L’Oreal Research & Innovation, presented evidence that cosmetic products, frequently referred to as cosmeceuticals can improve skin texture, repair skin damage and protect skin.  As examples of effective ingredients, she discussed hyaluronic acid, retinol/vitamin A to improve the density of skin and provide a more even complexion.  Dr. Zheng presented a new ingredient LR2412, a derivative of jasmonic acid that is claimed to significantly improve wrinkles, skin texture and pores. She commented that it is important to note that the vehicle and correct packaging are important factors that contribute to the efficacy of the “actives” in the product.

Color Cosmetics for Aging Skin 

From a cosmetics perspective, one of the most interesting themes is the use of color cosmetics for antiaging. Dr. Heidi A. Waldorf, dermatologist from Mount Siani Health, New York, suggested that addressing the appearance of aging should start with an assessment of the overall appearance of the patient.  She proposed that one should not change the overall look of patients, but rather make them look like younger versions of themselves.  She proposed treatment priorities should start with suggestion of changes in lifestyle, addressing skin color, texture, tone/laxity skin volume and proportion.   

Dr. Zoe Draelos, Wake Forest North Carolina, presented “What constitutes a functional cosmetic?”  An interesting topic that promotes the concept that cosmetics may provide a medically relevant dermatologic benefit to the skin with continued use.  Cosmetics can play an active role in the prevention of extrinsic aging using pigments.  Her rationale for these conclusions is that the electromagnetic spectrum is responsible for most extrinsic aging.  Functional cosmetics can prevent electromagnetic spectrum from encouraging extrinsic aging.  UVB, UVA, visible light, and infrared radiation (IRA) are all sources of electromagnetic radiation associated with extrinsic aging of skin. Dr. Draelos noted that titanium dioxide, zinc oxide, talc, iron oxides and reflective pigments containing mica are examples of cosmetic ingredients that have a potential to be functional.  Foundation coverage ingredients containing titanium dioxide and zinc oxide provide coverage to the makeup and may offer SPF protection as an additional benefit to skin.  Kaolin and talc may block visible light, an important need for Fitzpatrick skin types III through VI who are more sensitive to visible light than individuals with lighter skin types.  Reflective pigments have the potential to reflect IR, UV and visible radiation.  They can add facial luminosity, radiance and brightness to skin.   Facial powders may be functional by providing photoprotection against UV, visible and IR radiation, these products are not likely to have an SPF rating in the US, because the Food and Drug Administration (FDA) is not convinced that there is an accurate method to measure SPF for powders.  Lip products have the potential to provide SPF protection, lipsticks may provide a higher SPF than many lip balms currently in the market place.  Black mascara and eyeliner decrease light reflection into the eye, upper eye lid and lower lid facial foundation may provide better sunscreen than organic SPF products without the burning of eyes, according to Dr. Draelos.

Nanotechnology in Photoprotection

Dr. Adnan Nasir, University of North Carolina, Chapel Hill USA, presented advances in nanotechnology for photoprotection.  He stated that we now know that  sunscreens containing nanoparticles are generally safe and effective.  Coatings on nanoparticulate sunscreens contribute towards more stable formulations with reactivity mitigated through coatings that quench reactive UV particles, and have enhanced stability when properly formulated.  Dr. Nasir mentioned that many dermatologists are not aware of photo instability and photo degradation that may occur in improperly formulated sunscreen products.

Herbal Extracts for Hyperpigmentation

Dr. Carl Thornfeldt, a dermatologist from Fruitland Idaho presented novel herbal extracts for hyperpigmentation therapy.  He reported that 130 herbs claimed to lighten, whiten, brighten or depigment skin are currently identified, based on in vitro testing.  36 of the 130 herbs have documented efficacy in blinded prospective controlled clinical trials.  Approximately 23 herbs are commercially available in blends of multiple extracts.  Unique herbs specifically mentioned included apple (Malus domestica) containing malic, citric, lactic, ascorbic tannins and quercetin.  He reported it has anti-inflammatory and antioxidative properties, apricot (Prunus armeniaca) with quercetin, resveratrol, ascorbic acids, retinol, carotenoids and polyphenols, bamboo (Bambusa vulgaris) containing silicic acids, monosaccharides and polysaccharides, pea (Pisium sativum) containing phylates and alkaloids.  Dr. Thornfeld reported that a blend of these ingredients increased cell turnover by 84.7% within 5 days.  Another blend of sweet orange (Citrus sinensis) and bitter orange (Citrus aurantium) inhibited activators of melanin synthesis.  White water lily (Nymphaea alba) reduced gene expression for tyrosinase by 44%.  Other melanin synthesis inhibitors included Speed well (Veronica piperita), Meadowfoam (Limnanthes alba) and peppermint (Mentha piperita). His conclusion is that the extraction method used is important for the best results and that herbal blends can be comparable or even significantly superior to comparable gold standard treatments with superior safety for skin types I to IV and comparable for skin types V and VI.

Relevance of the Human Microbiome in Health and Disease

Dr. Heidi H Kong, National Institute of Health, Bethesda, MD, USA, presented her research on the human microbiome.  She defines the microbiome as a collection of microbes including bacteria, viruses and eukaryotes (fungi) and their collective genomes.  Dr. Kong is collecting superficial skin samples and conducting a DNA sequence analysis on the microbes found in the skin samples.  DNA analysis permits one to more accurately determine the distinctive microbial communities found in different body sites.  Current thought is that certain bacteria if present may result in better immunotherapy during cancer treatment.  Dr. Kong noted that this has recently become a hot area of investigation.  Dr. Kong noted that mice studies show that the appropriate microbes can restore immunity to germ-free mice, the microbes can tune the level of activation and function of skin-resident T cells and promote immunity to pathogens.  Dr. Adam Friedman, George Washington School of Medicine, Washington DC, US, mentioned that La Roche-Posay Dermatological Laboratories in collaboration with the University of Boulder in Colorado, US, is currently analyzing skin microbiomes in various facial areas of acne patients compared with acne-free patients.  Other companies are focusing on bacterial-derived nitric oxide (NO) and its antimicrobial activity and immunomodulatory properties.  Dr. Friedman reported that bacteria on skin can generate nitric oxide from precursors in sweat to fight off possible pathogens.  Further, numerous human cells have the capacity generate nitric oxide for the same reason as bacteria do.   AOBiome is a company currently evaluating “live-topical biologics” to address treatment of acne.  The study in progress is evaluating a live bacterium called B244 that converts ammonia from sweat into nitrite and NO.  The company is studying other inflammatory skin disorders.

Concluding Comments

Regarding the technologies presented, while much remains to be understood, this was an interesting meeting with numerous innovations for dermatology and the cosmetics industry to be available soon.

Howard Epstein

EMD Performance Products

Philadelphia, PA, USA