Free Skin Care Tips
DermCareMD™ is the leader in the anti aging skin care industry, creating the highest quality, most scientifically researched and documented anti aging skin care treatments available exclusively through plastic surgeons and dermatologists.
Today our products are available directly to you through our Web site. The formulations for the DermCareMD™ skincare treatments were developed from the research of thousands of independent physicians and scientists from major research centers and universities, such as: Harvard University, Johns Hopkins University, Cleveland Clinic, M.D. Anderson Cancer Center, Mayo Clinic and National Institutes of Health (NIH).
DermCareMD™ skin care treatments are based on independent medical and scientific studies published by the National Library of Medicine. This research led to the breakthrough development of DermCareMD™ skincare treatments. This, and our patent-pending technologies, set DermCareMD™ skincare products from all others to restore and maintain healthier, younger-looking skin.
Physician tested and recommended
All DermCareMD™ anti aging skin care products are physician tested and recommended to be safe and effective. Each product is specially formulated with our patent pending Nutrient Delivery System Technology.
In addition, the Anti Aging Advanced Facial Treatment, Eye Treatment, Moisturizing Rejuvenation Treatment and the Hyperpigmentation Lightening Age Spot Treatment are paraben free, dye free, fragrance free, alcohol free, Petrolatum free, lanolin free, hydroquinone free, endocrine disruptor free and propylene glycol free. DermCareMD™ products are also made with medical grade plant based ingredients and are hypoallergenic, non-comedogenic, non-irritating, pH balanced and manufactured in the USA under strict GMP Certified Quality Controlled Standards.
DermCareMD™ products are based on the most up-to-date science and medical information available. We used the research of thousands of physicians and scientists from hundreds of prestigious universities and research centers, such as Harvard University, The Johns Hopkins University, the Cleveland Clinic, Stanford University, and the M.D. Anderson Cancer Center. As you can see there is real science behind how skin responds to the topical application of many nutrients in optimum forms and correct concentrations. DermCareMD™ has taken this incredible research and created products that are safe and effective.
We invite you to read synopses of the peer-reviewed scientific and medical articles listed as references in our online Medical References Library.
You can access each article via the World-Wide Web by clicking on the title in the reference. That takes you to the article through the PubMed portal provided by the National Library of Medicine.
Why DermCareMD
Healing skin is what a scientifically prepared product should do. Each ingredient must be grounded in sound science in published medical research.
We want to educate you of the most common dangerous compounds that are often found in cosmetics.
These compounds are often known by a pseudo-scientific name Cosmeceuticals and include a form of vitamin C (Ascorbyl Palmitate, C-Ester), peptides, Retinoic acid, alpha hydroxy acids, some sunscreen chemicals, paraben (the harmful form of preservatives), and other cosmetic compounds to which you've probably frequently exposed your skin.
The Parabens (Hydroxy-Benzoates): Methyl-Paraben, Ethyl-Paraben, Butyl-Paraben, Propyl-Paraben, Isobutyl-Paraben; Dangerous Preservatives Absorbed through the skin.
Parabens are readily absorbed through the skin, and are in many cosmetics and lotions. They are also absorbed through the intestinal tract since many packaged foods use them as preservatives.
Parabens are irritating to the skin; they cause a contact dermatitis (skin allergic reaction):
"Parabens have been implicated in numerous cases of contact sensitivity associated with cutaneous (skin) exposure."
Parabens are Endocrine Disruptors and are EstrogenicAll the Parabens bind (attach) themselves to the Estrogen Hormone active receptors, and have Estrogen (female hormone) activity.
Parabens harm the male reproductive system
Parabens decrease the size of the male reproductive (sexual) organ size (testes, prostate, and seminal vesicles). They also decrease the sperm count and motility of those sperm.
"Parabens had an adverse effect on the male mouse reproductive system and that damaged the late steps of spermatogenesis (sperm production) in the testis."
Parabens can exert an adverse effect on the male reproductive system at doses that are well below those of the accepted daily intake."
The sperm are damaged so severely that it "could be developed as a new vaginal contraceptive."
Parabens also reduce the sperm count.
Parabens damage liver cells.
Parabens cause time dependent death to liver cells (hepatocytes) and their mitochondria (energy producing intra-cellular particulate bodies)."
Parabens damage white blood cells (lymphocytes).
All the Parabens "caused a concentration-dependent diminution of the secretion of lysosomal enzymes (a main intra-cellular defense mechanism).
Parabens are capable of affecting cellular function at concentrations, which are likely to be reached in blood or tissues under conditions of common use."
Parabens cause tumors. Tumors of the lung, blood, and soft tissue (muscle) have been caused by consistent absorption.
Why are these dangerous Parabens still on the shelf?
Because Parabens have been used for more than 50 years as an anti-microbial (germ killing agent) in foods, drugs, and cosmetics, it was in common use before the FDA began its regulation of preservatives. Therefore it was "grandfathered in" as acceptable, and did not have to prove its safety, as do all new preservatives. Only if it was obviously poisonous (example: arsenic) would it have been automatically prohibited from the use in foods, cosmetics, and drugs as a preservative.
Do you recall the very dangers herbal ingredient Ephedra? One of us, and hundreds of others have written to the FDA over 10 years ago concerning the obvious (to us) dangers of Ephedra (with its adrenaline and amphetamine-like activity), but it took too many deaths, including of young athletes, before more hearings resulted in its being banned in the United States.
The Parabens do not cause such a severe problem. Its dangers are there, but the public (you) were not aware of the many dangers. Most inexpensive, as well as a very expensive "skin care products" contain one or more Parabens. Read the labels.
A very few well-formulated products avoid them, and use the much safer (and FDA approved).
Any new (for you) product should always be patch tested. This means to put a few drops on the inside of your upper arm or inner thigh, and wait for one day to be sure that you are not that one person out of thousands who might have an unusual skin sensitivity.
Hydroquinone Is DangerousHydroquinone is used as a cosmetic skin-bleaching agent, but in some countries it is banned because it can cause white patches on the face (leukoderma) with confetti-like depigmentation and subcutaneous (below the surface of the skin) dark collections of pigment (exogenous ochonosis).
Furthermore, according to researchers, long-term effects, including cancer are most likely. Kidney tumors and leukemia (white blood cell cancer) occurred in animal experiments, which have exposed its carcinogenic and nephrotoxic (kidney-damaging) properties. It has also been show to cause DNA damage.
Daily use causes it to accumulate in the body by absorption through the skin faster than it can be excreted in the urine. In 2001, it was banned in The Netherlands.
Ascorbyl Palmitate (C-Ester) is a dangerous form of Vitamin C for your skinToxic to skin cells when exposed to sunlight (UVB irradiation).
Although more stable than Ascorbic Acid (Vitamin C), it is not as stable long-term as the safe and effective form of Vitamin C: Magnesium Ascorbyl-Phosphate.
In November 2002 Doctors in the Department of Dermatology of the prestigious Mayo Clinic, published the results of their studies of topical Ascorbyl Palmitate (also known as C-Ester, and Ascorbic Acid-6-Palmitate). They noted that Ascorbic Acid-6-Palmitate degenerates when exposed to sunlight (UVB) on skin and is "toxic to epidermal (skin) cells. Our data suggest that, despite its antioxidant properties, Ascorbic Acid-6-Palmitate may intensify skin damage following physiologic doses of ultraviolet radiation" (what most people are normally exposed to). The reason for this double-edged sword is that the fatty acid component (Palmitate) reacts with the sunlight to become oxidized. This results in lipid peroxides. "End products of lipid peroxidation, such as 4-hydroxy-2-noneal, have been reported to mediate (cause) stress-activated protein kinase activation and cell toxicity (poisoning) in epithelial cells" (upper skin layer cells).
In referring to the use of Ascorbyl Palmitate in cosmetic products, these prominent Mayo Clinic doctors and scientists noted "its widespread use in numerous over-the-counter topical skin care products and sunscreens. These products contain concentrations of Ascorbic Acid-6-Palmitate as high as 15% (360 mM), thus "exceeding the dose range used in our experiments by a factor of 1000."
If the Ascorbyl Palmitate concentration in a topical lotion, serum or cream was 1.5%, for example, then that product would exceed the Mayo Clinic's study cyto-toxic epidermal (poisonous to skin cells) level BY A FACTOR OF 100. That is 10,000% more than the concentration of Ascorbyl Palmitate these Mayo Clinic doctors documented killed skin cells.
When used at night it is safe, but never in the daytime since ultraviolet light also continually penetrates glass windows.
These Mayo Clinic doctors noted the reason for this research study: "Even though the antioxidant effect of Ascorbyl Palmitate (Ascorbic Acid-6-Palmitate) has been recognized, its interaction with cellular lipids (fatty components, including the cell membrane) and its effect on intra-cellular signaling and cell viability (survival) following UV (ultraviolet: sunlight) irradiation have not been studied."
Now this synthetic antioxidant has been properly studied and found to kill skin cells when topically applied and exposed to sunlight. Not what you were led to believe. Do you put this cell toxic compound on your skin? Read all your labels.
What we find very disturbing is that 5 years after the 2002 published study, Dermatologists, skin care chemists and companies still use and promote the "safe and effective" use of Ascorbyl Palmitate without any WARNING about its skin cell dangers in sunlight, and even include it in some sunscreen products.
Unlike Ascorbyl Palmitate, Magnesium Ascorbyl Phosphate does not contain any lipid (fatty acid) component to react negatively with ultraviolet light (sunlight). Both Magnesium and Phosphate components are not organic. It does not have the biochemical characteristics to become a cell poisoning and cell destroying oxidized lipid.
Phosphate is not organic. It does not contain any carbon atoms. It cannot be oxidized or degenerate into lipid peroxide. Phosphate is a Phosphorus atom bound to four Oxygen atoms. It is connected to the Ascorbyl (Vitamin C) molecule, and Magnesium is ionically bound by its positive charge to the negatively charged Ascorbyl-Phosphate.
Although Ascorbyl Palmitate is more stable than Ascorbic Acid which is very unstable unless dry in a capsule or tablet; studies have shown that long-term stability of Ascorbyl Palmitate "was not adequate". This was in contrast to "Ascorbyl-Phosphate, which was stable".
In contrast to the stable Ascorbyl-Phosphate: "Esterification (molecular attachment) with Palmitic Acid in 6 position (on the Ascorbic Acid molecule) did not prevent hydrolysis (decomposition when wet) of the molecule (Ascorbyl Palmitate)". Magnesium Ascorbyl-Phosphate is very stable: "the introduction of the Phosphoric group in 2 position (on the Ascorbic Acid molecule) protected the molecule (Magnesium Ascorbyl-Phosphate) from break-up". This "confirms Magnesium Ascorbyl-Phosphate as a very stable derivative of Vitamin C that may be easily used in various types of cosmetic products."
Ascorbyl-Phosphate is a hydrophilic derivative of Ascorbic Acid, which has improved stability arising from its chemical structure. It is used in cosmetic and pharmaceutical preparations because it has many favorable effects in the skin, the most important being antioxidant action. Unlike Ascorbyl Palmitate, Ascorbyl-Phosphate protects skin cells in sunlight.
Studies from the prestigious Department of Carcinogenesis of the M.D. Anderson Cancer Center proves that when Ascorbyl Palmitate is applied to the skin before a known carcinogen (cancer-causing agent) and without sunlight, it will inhibit its cancer-causing effect (decreased the cancer inducing enzyme Epidermal Ornithine Decarboxylase activity) to 59%. But they demonstrated that topical Alpha Tocopherol (Vitamin E) also inhibits that cancer-causing enzyme, and does so to 70% inhibition. Plus, Alpha-Tocopherol in its topical therapeutic concentration does not cause skin cells to become injured. Furthermore, Alpha-Tocopherol was more effective than Ascorbyl Palmitate in preventing the growth and number of skin tumors (papillomas).
Therefore, based on all the credible and reliable science, there is no reason to use Ascorbyl Palmitate in any topical preparation. Unfortunately, many cosmetic products still use the outmoded "technology", some of which cost up to $570.00 for a 2-ounce bottle and also includes Neuropeptides, Tocopherol Acetate, (form of Vitamin E), Propyl-Paraben, Isopropyl-Paraben, and Methyl-Paraben, of which we do not recommend for all the specific reasons.
In oral therapy, Ascorbyl Palmitate is a safe and effective (but unnecessarily expensive) source of Vitamin C because sunlight cannot reach your internal organs, and it is hydrolyzed (split apart in water) into Ascorbic Acid (Vitamin C) and Palmitic Acid, a fatty acid that your body can "burn" for energy. Plus, in a dry capsule or tablet, it has a long shelf life. Just do not use it in a topical lotion or cosmetic product unless you limit its use only after sundown.
Are Peptides And Neuropeptides Safe?Do you know where all the Peptides and Neuropeptides in cosmetics come from?
How safe are they? In 2005, a Medical School Dermatology professor published a very scholarly article: "Cosmeceutical Peptides" that had the shocking conclusion, which in essence noted that you could very well become an unwitting and unpaid volunteer of cosmetic manufacturers by testing (buying and using) cosmetics containing Peptides, in order for most companies to avoid the cost of obtaining FDA approval.
Here are her exact words:
"The question then, finally, may be asked that if such a product (referring to biologically active Peptides) is available, is it truly a cosmeceutical or is it a pharmacologic agent (drug) because it is altering physiologic (active biological) processes in the skin? It seems that effective cosmeceuticals lie in a gray area between cosmetics and drugs. Even the with products clearly beneficial to the skin, it most cases, manufacturers make a calculated decision not to make claims that will result in scrutiny by the US Food and Drug Administration (FDA) of the product as a drug. Clinical testing (done as an official company sponsored a research study) could also draw the attention of the FDA, so some manufacturers opt instead to allow the consumer arena (unwitting guinea pig customers: you) to become the test market. If improvement of the skin is seen, the product would be a commercial success without the cost of FDA approval. However, if true physiologic changes are occurring with these products as it seems for some, it is only a matter of time before FDA scrutiny occurs to evaluate the effectiveness, safety, and potential toxicity (poisonous and dangerous biological activity) of these new ingredients.
Do NOT become a Guinea pig testing any Peptides. You will learn of some of the many concerns and dangers we have based on the little that is medically and scientifically known about "natural" and synthetic Peptides, which are amino acids attached together, like links in a chain. Some of these Peptides have their amino acid contents and order of linkage fully identified, while some do not. Neither makes them safe and not toxic to your skin, and to your entire body, if they are absorbed. These are biologically active compounds.
Peptides are fragments of larger proteins in nature. Most often they come from meat. Which meat? From what country of origin? Have they been thoroughly tested for Mad Cow Disease prions (the infective agent that causes Mad Cow Disease, which cannot be destroyed by heating or other forms of sterilization in common use)? Have they been thoroughly tested for such viruses as Bird Flu and bacteria such as Tuberculosis Bacillus? Have they been sterilized for these germs? We have been unable to find any medical or scientific published studies to answer our questions. We do not recommend their use until their safety is proven 100%.
Synthetic Neuropeptides also have biological actions that have not passed the scrutiny of the FDA. One hexapeptide (a Peptide containing six amino acids) can penetrate the skin and cause muscle paralysis. Somewhat like the effects of the injectable drug Botox. But a paralyzed muscle loses its thickness (muscle mass) and thereby atrophies (shrivels up). This is exactly the opposite of what a youthful and plump muscle appearance has to offer you. Concave (inward collapsing) is the appearance of "old age". Youthful faces have convex (outward bulging) contours from active healthy facial muscles. In addition, we have been unable to find any studies of the internal effects on the body, including the heart (which is a muscle) from this muscle paralyzing hexapeptide. What amount of this drug is actually absorbed? And how will its cumulative absorption, if any, effect your body?
Likewise, where do the Neuropeptides found in some cosmetics come from? Brains and spinal cords have the highest concentration of Neuropeptides in your body and that of all animals, including cows, where the Mad Cow Disease prions are in highest concentrations. If any Neuropeptides come from bovine (cow) sources, that poses a serious problem. In 2004 the FDA warned against the use of topical Collagen because of the potential danger of catching Mad Cow Disease. But Neuropeptides from cow brains and spinal cords pose a much greater danger. Furthermore, what country do they come from? England has the highest Mad Cow Disease rate and deaths from this neuro-degenerative disease in the world. They had routinely fed their cows the renderings (left over body parts, including brains and spinal cords) in their animal feed. And by its nature, this prion caused Mad Cow Disease takes years to develop.
Many Peptides in your body have active biological properties, including hormone-like effects. In our opinion your safety is paramount. Anti-aging and wrinkle prevention and reversal is so effectively treated by safe and beneficial alternatives, such as Glucosamine Sulfate and Magnesium-L-Ascorbyl-Phosphate, we cannot recommend the topical use of any Peptides and Neuropeptides.
500 Peptides also come from a yeast (fungus) Saccharomyces crevisiae. These include Superoxide Dismutase, which is very safe and effective when applied topically to your skin. Three others include Heat-Shock Protein 12, Ubiquitin and Acyl-CoA. These four have been studied together and have been able to accelerate wound healing in diabetic mice. These compounds are known as "Stress Proteins" because they are "induced in response to several agents that cause cellular injury such as heat, free radicals, heavy metals, ischemia (impaired oxygenated blood flow), and toxins (poisons)."
Although the original yeast extract that was first discovered in 1901 was responsible for the rapid growth of yeast, and that it was found helpful in treating hemorrhoids in the 1930s, we have been unable to document its use on skin to treat wrinkles and the effects of aging, except for Superoxide Dismutase.
Furthermore, these isolated Peptides from the original yeast brew are hundreds of times more potent. We have not seen any studies on all the safety issues such concentrated extracts raise in our minds. In fact the author of a 2004 published medical article raises the same point that we just made: "Further clinical studies will provide data currently lacking for peptide technology." "Peptides are being studied that act as growth factors via activation of Protein Kinase C (PKC), a key enzyme for cell growth and migration."
However, our research has documented that Protein Kinase C (PKC) is a key enzyme for the growth of cancer cells and the spread ("migration") of cancer cells. Being a Guinea pig for these Peptides, with a let's see if they work, and avoid all the safety tests, because they cost money, to us is immoral and very dangerous to your skin.
The Neuropeptide Gastrin-Releasing Peptide (the stomach hormone that causes the stomach to make lots of acid for digestion) was experimentally shown to stimulate human skin epidermal cell (keratinocytes) in vitro (laboratory test tubes), and some have recommended that it should be rubbed onto your skin. Just the thought gives us a "stomach ache". Do you know what else it could do on and in your skin? And what it could do if it were to be absorbed into your bloodstream?
In one study, a hexapeptide (which only means that it contains six amino acids), this one containing the amino acids Valine-Glycine-Valine-Alanine-Proline-Glycine (VGVAPG) was found to stimulate the human dermal (deep skin layer) fibroblasts while down-regulating (decreasing; inhibiting) Elastin production. But Elastin is an essential elastic fiber component of your skin, which is responsible for its youthful elasticity. And another study of this same VGVAPG Peptide stimulated skin biological processes (triggered cell signal pathways) that resulted in the up-regulation (increased production) of Matrix MetalloProteinases 1 and 3 (MMP-1 and MMP-3), which resulted in the protein in skin being digested (proteolytic and inflammatory damage). With cosmetic Peptides like these, why ever worry about "flesh eating disease" (Streptococcal bacterial spreading fasciitis).
Another Peptide (Lysine-Therine-Lysine-Serine) has been implicated in regulating Collagen synthesis by increasing production of the extracellular matrix proteins (such as: Collagen, Hyaluronic Acid, and Elastic Fibers). However, this same Peptide containing these amino acids has been link to Palmitic Acid, a fatty acid, in order to improve its ability to penetrate into the skin. It is being sold now in cosmeceutical products. Unfortunately, Palmitic Acid, when exposed to sunlight (ultraviolet irradiation: UVA and UVB) kills skin cells, (it is toxic to keratinocytes) as determined by the prestigious Mayo Clinic in 2002, in their study of Ascorbyl Palmitate. These experts in the skin science documented the fact that sunlight causes the Palmitic Acid to become very toxic to these skin cells even at very low concentrations of Palmitic Acid, at (doses that were more than 10,000% less than in commercial use.
These are a few examples of "synthetic" functioning untested for total safety, even when some of their dangers could be anticipated, as we have described.
Finally, if Peptides stimulate the enzyme Telomerase, it can significantly increase your risk for developing cancer. The frayed ends of every chromosome limit the number of cell divisions. Cancer cells possess the enzyme Telomerase which repair the frayed ends of chromosomes, thereby allowing these cells to duplicate themselves, forever. We have been unable to find any research on the effects of Peptides and Neuropeptides on the enzyme Telomerase and cancer cell division.
The Hippocratic Oath of doing no harm that Medical Doctors take goes beyond harm to your wallet. We will not recommend any topical nutrient until it has been studied sufficiently (by independent researchers) to prove to us that it is safe and effective. When that occurs we will update our formulations for your optimum skin care.
Alpha Hydroxy Acids and Glycolic AcidThe most commonly used cosmetic Alpha Hydroxy Acid is Glycolic Acid. The others are Citric Acid, and Lactic Acid. Malic Acid and Tartaric Acid also are Alpha Hydroxy Acids but are not used in cosmetic preparations.
Although Glycolic Acid comes from cane sugar, it is also synthesized. In addition to cosmetics, its main use is in industry where it is commonly used:
In the leather industry and fur dressing because of its ability to dissolve calcium salts, and because of its metal chelation properties in alum and chrome baths;
As an acid cleaner for removing scale and milkstone in dairies;
Cleaning heat exchangers and boiler scale;
Polishing copper;
Etching lithographic plates;
Electropolishing baths for stainless steel;
Electroplating;
Metal pickling; and
Textile dyeing.
How Alpha Hydroxy Acids and Glycolic Acid workThe healthy "glue" that holds your epidermis together is eroded by these acids, loosening these protective cells. That leagues to "exfoliation" (the loss of your superficial epidermal cells). It also removes your natural oils.
What about the claims that Alpha Hydroxy Acids increase the skin's production of Collagen? Some do, but at concentrations in which they also cause damages. Concerning the research on the Collagen stimulation production; after a detailed search of all the world's literature we have discovered the following:
One article described the use of 20% Glycolic Acid on the forearm of volunteers twice a day for three months. This was not done on the more sensitive facial skin. These researchers made the following guess: "Longer treatment intervals MAY result in Collagen deposition."
The next study used 25% Glycolic, Lactic, or Citric Acid for 6 months, and again to the forearm and not the face. Some increase in skin thickness was noted along with a greater density of Collagen. These patients were under the direct supervision of doctors.
The third and final study involved the use of 15% Glycolic Acid for 10 weeks on the skin of mice. Citric Acid is not a true exfoliator. It is an antioxidant and weak bleach of discolored skin.
How Glycolic and Hydroxy Acids reduce the appearance of wrinklesRemember when you injured yourself, such as a sprained ankle or wrist? It swelled up because of that trauma (injury to your flesh). That swelling (edema) is composed of salt water, of which your body holds 4 quarts in your blood stream, and 15 quarts in the fluid between all your cells (interstitial fluid). The medical term for the abnormal fluid accumulation in your skin is called "edema", and also commonly seen in heart failure, kidney failure, and some circulation problems.
These acids cause a chemical burn to your skin, which causes this edema to accumulate. This temporary swelling of your skin stretches it from within, eliminating the appearance of wrinkles. But does not affect the permanent cross-linking of your Collagen (fibrous flesh) in your dermis and epidermis unless used daily or twice a day, and at very high (and more dangerous) concentrations. And now with the outer layer of your epidermis gone, you are much more susceptible to accelerated damage from the millions of free radicals generated by the unobstructed sunlight, and the lack of protective oils. That's why all those products warn you to avoid the sun, use at least 25 SPF ("Sun Protective Factor") or greater, use a "moisturizing cream", and that you may even have to avoid all your cosmetics and cleansing soaps. F.Y.I. SPF only refers to blocking the UVB sunlight rays, not the dangerous UVA ultraviolet sunlight irradiation.
Your natural body armor has been destroyedSome products claim to have "buffered" the acid (chemically treated to reduce their acid content with a chemical "base" such as lye), to reduce its caustic (burning and corrosive) side effects "without effecting its efficacy". That is false, since it works through it acidic properties.
There are no long-term studies over 10 to 20 years to look for the serious damage that can result, including increasing the risk of developing skin cancer, as well as the very deadly Malignant Melanoma cancer, plus shortening the limited lifespan of your only skin.
One safer way to eliminate wrinkles is to cause trauma by repetitive slapping, but that is not an acceptable form of "Treatment", plus there are no studies for that unconventional form of wrinkle treatment, which we do not recommend. Just like we cannot support the use of any skin burning (peeling) method.
Retinol, Retinaldehyde, and Retinyl-Esters Versus Retinoic Acid sold as Retin-A (Tretinoin)There is an almost universal confusion concerning about what is Vitamin A. Retinoic Acid (Tretinoin) is Vitamin A but you should never put it on your skin, unless you are a masochist. It is very irritating. However, the good news is that it has non-irritating precursors - biological compounds that your skin can easily and safely convert into Vitamin A once they are inside your skin where they are needed. And these precursors are not irritating. Retinol and Retinaldehyde are safe and effective biological precursors of Vitamin A. In extensive testing they have been determined to be non-irritating.
Vitamin A, Retinol and Retinaldehyde are stored in your skin as Retinyl-Esters. And as more Vitamin A is needed, these Retinyl-Esters convert back to Retinol and Retinaldehyde, where your body uses these precursors of Vitamin A to make that essential skin protective vitamin for you.
How Botulinum Toxin worksThe junction where one nerve stimulates a muscle is called a synapse. This is the cholinergic neuro-muscular junction. The Botulinum toxin (poison) saturates this pre-synaptic terminal (end of the nerve). After it binds to this nerve terminal ending, it is repetitively recycled back into that nerve's ending, resulting in a long-standing paralysis of the muscle from lack of energetic stimulation.
Technically, it attaches to the nerve ending's acetylcholine containing storage vesicles (microscopic intra-cellular chemical containers). There the Botulinum toxin blocks the exit of this muscle stimulating acetylcholine. It does not affect the storage of acetylcholine, or the propagation of nerve impulses.
Consider the following analogy: Your brain sends a signal, which eventually travels along this peripheral nerve (located outside of the brain and spinal cord). Although the signal passes rapidly along the nerve there is the equivalent of an insulating material between the end of the nerve and one of your facial muscles that blocks that conduction. The connection is disrupted.
This paralysis is reversible by time. The amount of paralysis depends on the dose injected into each muscle. The usual peak of the paralysis occurs within five to seven days after it is injected into each muscle. Examining a biopsy of your facial muscle at that time would reveal muscle atrophy (degeneration appearing as loss of muscles substance), and demyelenation (loss of the outer insulation sheath) of that peripheral nerve's terminal ending. A slow recovery then occurs, with the nerve ending sprouting at its neuromuscular junction, which has an appearance like an onion bulb. Although the maximal recovery is usually seen after six to nine months after the injection of the Botulinim toxin, the muscle strength (function) may not return to normal. And progressive weakening of the muscle may develop with additional injections.
As you may already know from your own exercise routines, the failure to continue vigorous exercise resulted in a fairly significant loss of your strength. However, those muscles still were used during your activities of daily living. Therefore, their atrophy was only back to their pre-workout level. However, with paralysis, the muscle atrophy (shriveling up) would be much more profound. Some of the muscle fibers would actually be replaced by scar tissue (fibrosis) of their substance and/or the flesh surrounding them.
When patients are paralyzed from injury, it is essential to work their joints passively to maintain a normal range of motion. The failure to do that basic physical therapy results in joint contractures (stuck in a progressively flexed position) because of those paralyzed muscles becoming replaced by scar tissue, which has a natural tendency to contract. In addition to range of motion physical therapy, electrical muscle stimulation is often used on a daily basis to keep each muscle fiber alive, with the hope that eventually the damaged nerve (like a cut wire) will somehow heal, bringing their body's natural "electricity" (release of acetylcholine at each neuromuscular junction), causing the muscle to contract before excessive and irreversible fibrosis (scarring) develops.
We are not aware of any ongoing medical practice to have each patient who has their facial muscles paralyzed by the use of Botulinum Toxin be aided by electrical stimulation done on a daily basis in the privacy of their own home, to prevent long-term permanent weakness, progressive sagging skin, and an aged appearance.
A paralyzed muscle also loses its bulk, and therefore goes from the youthful convex (outward bulging) shape, to the atrophic convexity (inward collapsing) shape of advanced aging.
Additional injection risksThere is a small risk of infection. One of the most severe infections is Necrotizing Fasciitis ("flesh eating disease"). Bleeding and subsequent scarring is always possible, since the needle is inserted "blindly" into the flesh, and there are innumerable at risk blood vessels coursing within. Anticoagulants (blood thinners), including Coumadin (warfarin), and even one aspirin taken within one week of any injection increases the risk of internal flesh hemorrhage. Furthermore, since bovine (cow) serum (blood plasma fluid derivative) albumin is used as the fluid carrier protein in Botox, there is a theoretical risk of catching "Mad Cow Disease" from the transmission of those prions (infective-like proteins), which are not denatured (sterilized) by heat. This has not "yet" been reported, but it takes many years for that brain wasting disease to develop.
Injectable Collagen causes severe inflammationIn a study, Collagen was taken from three sources and compositions including: "a sponge formulation and a thin film composed of Type I Collagen from bovine (cow) Achille's tendon (at the rear of the ankle), and a membrane prepared from bovine derma (skin)," were injected. All caused a significant inflammatory response and cell membrane breakdown. This was confirmed by measuring the inflammatory agent produced by the body: PGE-2 (Prostaglandin E-2). These scientists noted that "hydrolysis (breakdown) of exogenous Collagen (from an external source) starts shortly after it is kept in contact with tissues and evokes a local inflammatory response."
Collagen is a deadly poison Collagen from different animal sources were tested and all had the same final result: death. As these doctors stated in their published a study, "Different preparations of soluble Collagen, from rabbit skin, rat skin, rat tail tendon, and guinea pig skin, produced respiratory distress, agitation, convulsions, and finally death when infused intravenously in lethal doses." Blood tests noted that "damage to the liver occurred as a result of Collagen infusion." And when they looked at the organs under the microscope (histopathological examination) "confirmed that damage has occurred to the lungs and livers of these animals. The source of Collagen did not appear to influence its toxicity (poisonous effect) at the tissue level".
Obviously a doctor will not knowingly inject any Collagen into a vein, but with the multiple sticks and hundreds of small to large veins in the skin and just below its deeper layer (dermis), accidents can happen. Furthermore, all Collagen from exogenous sources (not made by you inside your skin) will be absorbed over weeks to months, and has the potential to cause some degree of liver and lung injury.
Why would anyone subject themselves to this procedure that has risks (scarring, bleeding, infection, and now even more potential risks) when there are safer (topical) ways to stimulate your own body to produce a more of its own Collagen (Magnesium Ascorbyl Phosphate and Ursolic Acid, plus Glucosamine Sulfate to significantly increase the amount of Hyaluronic Acid in your own skin) safely.
Information about "Static" Wrinkle InjectionsThe source of the Dermal (Skin) Fillers "material": Autogenic (from you), Allogenic (from other humans), Xenogenic (from animals), and Synthetic (laboratory made):
Autogenic Skin Fillers: Fats, Plasma, and Cell Culture Grown Fibroblasts (Your Skin's Cells That Produce Collagen):
Fat: Body fat is removed during liposuction, or a mini-liposuction procedure. It is then injected under the skin to replace the lost volume to correct static wrinkles. There can be problems at the donor site including pain, infection, bruising, bleeding, and scarring. At the injected sites your body's fat, now separated from its natural blood supply (its small arteries, and veins) will usually become gangrenous (necrotic) or undergo a fatty-scar tissue (lipogranulomatous) degeneration. This results in a lumpiness feeling to your skin.
Autologous Plasma: Your blood is removed using a needle and syringe (phlebotomy). Using an F.D.A. approved kit (PlasmaGel and Fibrel), your plasma (the clear fluid part of your of your blood) is separated from the red and white blood cells, and used for injection into the static wrinkles. However, the problem is that its effects are very short lived.
Cell Fibroblast Culture: A punch biopsy (small pinch of skin) is removed, and your skin fibroblasts (the cells that produce and secrete Collagen, one of the main components {matrix} of skin) are grown in a laboratory in sterile bottles (cell culture). This is not cloning. Then they are collected using a product and technique called Isolagen. Your own fibroblasts are injected into your wrinkles. Only one biopsy is needed for an unlimited future supply of your own fibroblasts, if they do not become contaminated. However, this process is expensive, and time-consuming.
Allogenic Skin Fillers: This source of human Collagen comes from the skin of cadavers. Their skin is processed into a product without cells, but with the same components including Collagen, Elastin, and Proteoglycans (mostly Hyaluronic Acid). This is marketed under the brand name Alloderm. Its micronized (chopped into finer particles) product is Cymetra. In addition, another product, Dermalogen, comes from human skin, while Fascian is derived from human fascia (the fibrous gristle surrounding muscles).
Unfortunately it is absorbed over months. Since it comes from humans, it does not cause an allergic reaction like that Collagen from animals (xenografts). There is a concern that with any flesh that is not your own, infections with viruses (if there is any failure of the sterilization), and even prions (the proteins that cause Mad Cow Disease which cannot be destroyed by sterilization) can be transmitted to the recipient.
F.D.A. approved human Collagen products are Cosmoderm, and Cosmoplast, which has the Collagen molecules cross-linked (attached) with the chemical glutaraldehyde. That cross-linking increases its strength and possible longevity in your skin. Since it is of human origin, no prior skin test is needed to check for any allergic reaction. These products are injected into your wrinkles through multiple punctures ("serial-puncture technique"). It is immediately massaged to help spread it evenly, and to try to avoid lumps and bumps.
Then there is a the question that if one were to receive live transplanted cells from another human, would they survive long enough to function? This survivability of allo-transplanted (same species) live cells was studied by using prepared porcine (pig) cells, and injecting them into another pig. At three days some cells were detected. But none were found intact after just seven days using the most sensitive DNA testing (polymerase chain reaction analysis). But unlike the use of injected live cells, injected Hyaluronic Acid has been found to attract the recipient's own cells (chemotactic to mesenchymal cells) and profoundly promotes new blood vessel growth (pro-angiogenic). See this book's chapter on Glucosamine Sulfate for the best alternative, so that with its optimal concentration applied topically (on your skin's surface), it is well absorbed so that you can produce your own Hyaluronic Acid, at the maximum amounts, just as you did many years ago.
Xenographic (Animal Source) Skin Fillers: These non-human sources of Collagen and Hyaluronic Acid have been available from cows, pigs, and roosters for years, and Hyaluronic Acid is also bioengineered through the use of specialized bacteria.
Although the Collagen from animal sources is similar to your Collagen, it is not identical. Therefore there is a real risk of an immediate as well as a delayed allergic (hypersensitivity) reaction. Skin testing for immediate and delayed hypersensitivity reactions is mandatory. Therefore, treatment must be delayed for weeks. In 3% of patients the skin test is positive, but 1.2% of patients who tested negative may eventually develop an allergic (immune) reaction.
Bovine Collagen is absorbed over months and found in the following products: Restoplast, DermaDeep (this creative name reminds us of the movie Jaws), Duraplast, Zyderm, and Endoplast-50. Bovine (cow) Collagen is used as a "carrier" molecule for some synthetic materials, which you will soon read all about, below. We have a safety concern about any cow derived Collagen source.
Endoplast-50 mentioned above is Elastin suspended in bovine Collagen. This lasts about one year, and is "believed" to also work by stimulating your fibroblasts (the cells that make and secrete Collagen).
Fibrel is a product containing porcine (pig) Collagen combined with aminocaproic acid and your plasma. It is "believed" to work by the Collagen creating an immediate sort of scaffold or structure in which your plasma forms a clot. The aminocaproic acid (correctly called varepsilon-aminocaproic acid) inhibits your body from dissolving the newly formed clot. Then your fibroblast cells migrate into this Collagen-clot substance (matrix {not the movie, but it is futuristic}), and produces Collagen. 67% of the correction remains after five years. Unfortunately, the longer a substance remains, the longer any negative reactions (complications) will also tend to last.
DermiCol is a product under testing. It cross-links (attaches) Collagen molecules together creating a larger (but stiffer) molecule, which decreases its degradation and absorption. Its half-life (the point at which one-half is gone) is about two years.
Hyaluronic Acid skin fillers: Hylaform, Restylane, PerlaneHyaluronic Acid does not require any skin testing for its molecular allergenicity because whether it comes from rooster combs (cartilage) (Hylaform) or performed by a bacterial fermentation process, it is the same as in our skin. But if you are allergic to chickens, caution is needed with Hylaform because there may be some other chicken natural molecules mixed in with the Hyaluronic Acid. After injection, it has been shown to cause abscesses.
Hylaform comes in three densities: Hylaform Fineline whose particles measure 300 um (micro-meter = millionths of a meter: yard), Hyaline Regular at 500 um, and Hylaform Plus measuring 700 um. The finer particles are used for finer lines, but for the wrinkles, which are deeper, the larger particle size is used. However, if the thicker viscosity (larger size particles) are used for fine wrinkle lines, they will appear more lumpy.
Restylane, the bacterial fermented Hyaluronic Acid comes as Fine Line with its particle size of 150 um, and Restylane at 250 um. One milliliter (one-thousandth of a liter/quart) contains 100,000 particles.
Recent severe reactions to the Restylane Hyaluronic Acid product have been reported: Sarcoidosis is an auto-immune disease in which the body reacts against components of its own flesh. In one published medical study in 2005 in the International Journal of Dermatology, a patient developed biopsy proven Sarcoidosis four months after her facial injections of Restylane. In another 2005 study published in the Journal of Ophthalmological Plastic Reconstructive Surgery it stated: "A 62 year old woman received injections of Restylane, cross-linked Hyaluronic Acid, for the cosmetic filling of facial rhytids (wrinkles) and developed a severe dermal (deep skin) inflammatory reaction."
Perlane is made by the same bacterial fermentation process, but has larger particles measuring 1,000 um, and one milliliter contains 10,000 particles. This is a more highly concentrated form of Hyaluronic Acid, and swells more by its attraction of more water. The manufacturer warns that the patient should not expose the injected area to intense heat or cold for a few days in order to reduce the degree of inflammation.
In case you wanted to know how it is injected into your flesh, the needle's full-length is inserted into your skin the entire length under the wrinkle, and these products are injected as the needle is slowly pulled backward.
Permanent Injectable Skin Filler: ArtecollArtecoll is an injectable wrinkle filler that is made from highly purified polymethyl methacrylate (PMMA) particles which are suspended in bovine Collagen. To this is added to a local anesthetic (numbing agent like your dentist uses). Each particle is a microsphere measuring 30 to 40 um, and has a smooth residue free surface. They are too large to be eaten by your body's scavenging cells (macrophages), but small enough to be an injected through a 27-gauge needle (whose opening is about a width of a hair).
The body's reaction and the cosmetic changes are unique to this product. In the first few weeks the Collagen is eaten by your body's macrophages, and the PMMA particles form clusters. After four weeks the wrinkles will reappear, and the injected lips will return to their pre-injected (normal) state. After the fibroblastic (scar tissue causing) activity reaches its peak, the wrinkle lines will gradually begin to fill in. This process becomes complete at 3 months. Final correction may require two or even three injections, each going through this same process. The final result may take up to 1 to 2 years to complete.
Because the product must be delivered with bovine Collagen as the carrier, a skin allergy test is required. The same theoretical Mad Cow Disease potential exists. There is also the risk for a delayed hypersensitivity allergic reaction, even with a negative skin test.
The technique of how it is injected into your flesh is even more critical with this filler than others, because of the permanent nature of the PMMA particles. Here the product is injected into the deep layer of your skin, with the needle kept in constant motion, in a scaffolding pattern. Because of this constant needle (think very sharp) wide penetration, bruising is an increased risk. And there is a tendency for the Artecoll or skin to plug the needle requiring its removal, and reinsertion. If the doctor just pushes harder on the plunger of the syringe to clear the needle's block, too much can shoot into a localized area.
No matter what the cause, if too much of the Artecoll product is injected into one area, you initially can't feel that material as a bump, but it can develop into a permanent nodule. That nodule can become deformed over time, and easily felt in your lips, as well as sometimes even becoming visible. Six to twelve months after the injection, an inflamed lump of this material in scar tissue (granuloma) can result. This can occur at all implant sites simultaneously. These can grow to the size of a bean. An injectable steroid such as Kenalog can be used to try to soften the resulting scar tissue, but it can cause atrophy (thinning) of the overlying skin. Surgery may be required to remove these granulomas and nodules that do not respond to the injection of steroids.
One physician tested 10 injectable fillers in the skin on your forearm, and then had a biopsy at each of these 10 sites done at 1,3,6, and 9 months (40 biopsies): the results of this study:
Collagen (Zyplast) was gone in 6 months;Hyaluronic Acid (Restylane) gone at 9 months; Artecoll (PMMA microspheres) was completely enclosed by scar tissue and macrophages (the body's scavenger cells), as well as giant cells (which are seen in chronic foreign body inflammatory reactions);Silicone Oil was not felt inside the skin clinically, but this never to be used and banned substance caused a chronic foreign body reaction;New-Fill (polylactic acid microspheres) caused a mild inflammatory response; it disappeared clinically (not felt any longer) at 4 months;Reviderm Intra (dextran microspheres) caused a pronounced foreign body reaction (inflammation), and was gone at 6 months;Dermalive (polymethylacrylate particles) caused the lowest cellular reaction, but had disappeared at 6 months;Aquamid (polyacrylamide) was well tolerated it his arm, and was still able to be felt, although to a lessening degree, the entire 9 months. By microscopic examination, it was removed by the body slowly, but was held in place through fine scar tissue covering it;Evolution (polyvinylhydroxide microspheres suspended in acrylamide) was well tolerated, and slowly diminished over the 9 months;Radiance RN (calcium hydroxylapatite microspheres) caused almost no foreign body reaction, but the skin absorbed it at 12 months.
Stated in October 2003: "Since the mechanism of late inflammation or granuloma formation is still unknown, early histological (biopsies examined under the microscope) are not useful in predicting possible late reactions to filler substances".
Skin Peels, Laser Resurfacing, and DermabrasionThey burn and remove your epidermis, and some cause deeper (dermis) damage than others.
Basic information about skin burns:A First Degree Burn is causing redness to the skin, without blisters. The most common cause is excessive sunlight. Chemicals and heat are frequent other causes.A Second Degree Burn causes blisters to form. The epidermis (top layer) is so severely damaged that it dies, and your body's blood serum weeps into the dead space formed beneath what was your epidermis and above your live dermis.A Third Degree Burn results from the death of both the epidermis and the dermis, the deep area of your skin, between the epidermis and the fat and muscles below. This dead dermis is replaced with permanent scar tissue, not new skin.
If a second degree burn becomes infected, the dermis can also begin to die. That means the risk of intentionally creating a second degree burn is that it can become infected and cause a third degree burn. Also, if the depth of the skin injury is not correctly calculated because of doctor error or inexperience, or because of the thinness or sensitivity of your skin or impaired blood supply, and it becomes infected or traumatized too soon (exposure to sunlight, harsh chemicals, or irritating cosmetics), it can be transformed into a third degree burn.
The goal of the skin peel, whether by chemical burning or laser burning (vaporization), is to remove the epidermis with its imperfections and hopefully allow the dermis to regenerate a new and healthier, smoother, and younger epidermis.
The deeper the epidermis is destroyed, the greater the risk for scarring, infection, uneven coloration, and longer time for recovery. Very superficial peeling and laser ablations (skin destruction) take several days to two weeks to recover. But deep peels and deep laser "resurfacing" procedures take weeks to months for complete recovery, during which time very careful attention must be paid to your deep facial blisters. One slip-up can cause irreversible scarring. Your self-care is a major commitment, and often work must be put on hold.
The deeper the peel, the longer it will last. Superficial peels have to be repeated every few months. Medium peels can last up to a year. And the deepest - and most painful and dangerous - peels can last a lifetime, as do their bad results.
The deeper peels also have a risk of activating herpes skin ("cold sore") infections. If these spread to your eyes, blindness can result.
Superficial peels require no anesthesia. Medium peels are painful and require oral sedatives. But the deepest peels are the most painful ever and often require intravenous (by vein) sedatives or even general anesthesia.
Chemical peels
SuperficialThese are 10% strength (concentration of 10 grams per 100 milliliters [3.3 ounces]) of non-prescription Alpha Hydroxy Acids (Glycolic) or Beta Hydroxy Acid (Salicylic Acid). These are sometimes referred to as "luncheon peels," and are commonly done in salons. But as we noted earlier in this Chapter, the published studies on humans used 15% or 25% Glycolic Acid daily or twice a day for three to six months.
Strong SuperficialThese are only prescription strength and applied by Dermatologists and some Plastic Surgeons. They use 30% to 70% Alpha Hydroxy (Glycolic) Acid, 20% to 30% Salicylic Acid, or 10% TriChloroAcetic Acid (TCA).
MediumThese use 20% to 40% TCA or the highest (70%) Glycolic Acids.
StrongPhenol (Carbolic Acid) is the strongest skin burning chemical used to achieve the deepest peeling. Intravenous fluids are used as well as a heart monitor. Immediately afterward, petroleum jelly must be applied and reapplied for 48 hours. Severe redness, peeling, and scabbing are to be expected for each session. Yes, each session. And each session lasts 60 to 90 minutes.
LasersThere are different types of lasers (Light Amplification by Simulated Emission of Radiation), depending on the depth and coloration to be destroyed.
Originally there was only the CO2 laser, and it was very harsh on the skin. It burned deep, and the depth was hard to control.
More recently, the Erb:Yag (Erbium: Yttrium-Aluminum-Garnet) laser was developed, along with the Nd:Yag (Neodymium:Yag) laser. The Nd:Yag laser's single wavelength targets just the brown and black discolored areas in the skin. The Erb:Yag laser's wavelength targets fine lines and wrinkles.
The Alexandrite Laser removes tattoos and unwanted hair, while the Ruby Laser eradicates the fine "spider" veins. Diode Lasers are the latest devices. These are smaller and being used to remove hair and spider veins.
A newer version of the CO2 laser, the "superpulsed" CO2 laser, is used for deeper burning into the epidermis.
Just like chemical skin peels, the deeper the burn, the greater the risks, the greater the pain, the longer the recovery period, and the longer the results last - both good and bad.
DermabrasionThese are electric sanders used to remove the epidermis. Unfortunately, the control of the depth has been imperfect in too many hands, resulting in too much depth of skin removed. The bleeding skin can interfere with the precision necessary for an even depth of epidermal skin removal. Unlike dermabrasion skin sanders, lasers usually seal blood vessels exposed by their powerful vaporizing effect.
"Power Peeling" is a misnomer. It is rather gentle and only removes the very top dead layer (stratum corneum) of the epidermis. It uses very fine Aluminum Oxide crystals for its abrasion but that increases the risk of injury from the sunlight, cosmetics, and skin dehydration.
The Facts about SunscreenSome sunscreens increase the growth of Breast Cancer and can cause Uterine Enlargement Doctors at the Institute of Pharmacology and Toxicology at the University of Zurich "examined frequently used UVA and UVB screens for estrogenicity (female hormone activity) in vitro (laboratory test tubes) and in vivo (live animals)." Five sunscreens "increased breast cancer cell proliferation (multiplication), with median effective concentration values between 1.56 and 3.75 microMolar (one millionth its molecular weight per liter of volume)." These sunscreens were: benzophenone-3 (Bp-3), homosalate (HMS), 4-methyl-benzylidine camphor (4-MBC), octyl-methoxycinnamate (OMC), and octyl-dimethyl-PABA (OD-PABA). In live female immature mice "uterine (womb) weight was dose-dependently (more had a greater effect) increased by 4-MBC, OMC, and weakly by Bp-3. Dermal (topical) application of 4-MBC to immature hairless rats also increased uterine weight. There is possible long-term effects in humans."
Unlike these absorbed chemicals into your body, Titanium Dioxide, which is an excellent sunscreen and sun block against UVA and UVB, is not absorbed. It is non-toxic, and our choice for your benefit. Avobenzone (Parsol 1789) used for UVA protection has problems.
The UVA protection you expect from Avobenzone (Parsol 1789) does not last. In fact, a study in 2005 documented that "after two hours of sunlight, the preparation containing the Avobenzone (Parsol 1789); 4-tert-butyl-4'-methoxy-dibenzoyl-methane {BM-DBM}) lost 85% of its UVA absorbance."
Another 2005 research study of Avobenzone showed that instead of preventing free radical (oxidant) generation after UVA irradiation, these researchers discovered that "this product produced free radicals detected by Electron Spin Resonance (ESR) spectroscopy that persisted even after the exposure had ended."
That's not "fun in the Sun" with loss of protection, and which generates persisting free radicals, even after you go indoors.
Avobenzone (Parsol 1789) did not prevent biochemical damage. Without any protection: "UVA exposure induces significant cell mortality, decrease in protein concentration, release of LDH (an enzyme inside cells that is only released on cell injury or death), increase in apoptos
Today our products are available directly to you through our Web site. The formulations for the DermCareMD™ skincare treatments were developed from the research of thousands of independent physicians and scientists from major research centers and universities, such as: Harvard University, Johns Hopkins University, Cleveland Clinic, M.D. Anderson Cancer Center, Mayo Clinic and National Institutes of Health (NIH).
DermCareMD™ skin care treatments are based on independent medical and scientific studies published by the National Library of Medicine. This research led to the breakthrough development of DermCareMD™ skincare treatments. This, and our patent-pending technologies, set DermCareMD™ skincare products from all others to restore and maintain healthier, younger-looking skin.
Physician tested and recommended
All DermCareMD™ anti aging skin care products are physician tested and recommended to be safe and effective. Each product is specially formulated with our patent pending Nutrient Delivery System Technology.
In addition, the Anti Aging Advanced Facial Treatment, Eye Treatment, Moisturizing Rejuvenation Treatment and the Hyperpigmentation Lightening Age Spot Treatment are paraben free, dye free, fragrance free, alcohol free, Petrolatum free, lanolin free, hydroquinone free, endocrine disruptor free and propylene glycol free. DermCareMD™ products are also made with medical grade plant based ingredients and are hypoallergenic, non-comedogenic, non-irritating, pH balanced and manufactured in the USA under strict GMP Certified Quality Controlled Standards.
DermCareMD™ products are based on the most up-to-date science and medical information available. We used the research of thousands of physicians and scientists from hundreds of prestigious universities and research centers, such as Harvard University, The Johns Hopkins University, the Cleveland Clinic, Stanford University, and the M.D. Anderson Cancer Center. As you can see there is real science behind how skin responds to the topical application of many nutrients in optimum forms and correct concentrations. DermCareMD™ has taken this incredible research and created products that are safe and effective.
We invite you to read synopses of the peer-reviewed scientific and medical articles listed as references in our online Medical References Library.
You can access each article via the World-Wide Web by clicking on the title in the reference. That takes you to the article through the PubMed portal provided by the National Library of Medicine.
Why DermCareMD
Healing skin is what a scientifically prepared product should do. Each ingredient must be grounded in sound science in published medical research.
We want to educate you of the most common dangerous compounds that are often found in cosmetics.
These compounds are often known by a pseudo-scientific name Cosmeceuticals and include a form of vitamin C (Ascorbyl Palmitate, C-Ester), peptides, Retinoic acid, alpha hydroxy acids, some sunscreen chemicals, paraben (the harmful form of preservatives), and other cosmetic compounds to which you've probably frequently exposed your skin.
The Parabens (Hydroxy-Benzoates): Methyl-Paraben, Ethyl-Paraben, Butyl-Paraben, Propyl-Paraben, Isobutyl-Paraben; Dangerous Preservatives Absorbed through the skin.
Parabens are readily absorbed through the skin, and are in many cosmetics and lotions. They are also absorbed through the intestinal tract since many packaged foods use them as preservatives.
Parabens are irritating to the skin; they cause a contact dermatitis (skin allergic reaction):
"Parabens have been implicated in numerous cases of contact sensitivity associated with cutaneous (skin) exposure."
Parabens are Endocrine Disruptors and are EstrogenicAll the Parabens bind (attach) themselves to the Estrogen Hormone active receptors, and have Estrogen (female hormone) activity.
Parabens harm the male reproductive system
Parabens decrease the size of the male reproductive (sexual) organ size (testes, prostate, and seminal vesicles). They also decrease the sperm count and motility of those sperm.
"Parabens had an adverse effect on the male mouse reproductive system and that damaged the late steps of spermatogenesis (sperm production) in the testis."
Parabens can exert an adverse effect on the male reproductive system at doses that are well below those of the accepted daily intake."
The sperm are damaged so severely that it "could be developed as a new vaginal contraceptive."
Parabens also reduce the sperm count.
Parabens damage liver cells.
Parabens cause time dependent death to liver cells (hepatocytes) and their mitochondria (energy producing intra-cellular particulate bodies)."
Parabens damage white blood cells (lymphocytes).
All the Parabens "caused a concentration-dependent diminution of the secretion of lysosomal enzymes (a main intra-cellular defense mechanism).
Parabens are capable of affecting cellular function at concentrations, which are likely to be reached in blood or tissues under conditions of common use."
Parabens cause tumors. Tumors of the lung, blood, and soft tissue (muscle) have been caused by consistent absorption.
Why are these dangerous Parabens still on the shelf?
Because Parabens have been used for more than 50 years as an anti-microbial (germ killing agent) in foods, drugs, and cosmetics, it was in common use before the FDA began its regulation of preservatives. Therefore it was "grandfathered in" as acceptable, and did not have to prove its safety, as do all new preservatives. Only if it was obviously poisonous (example: arsenic) would it have been automatically prohibited from the use in foods, cosmetics, and drugs as a preservative.
Do you recall the very dangers herbal ingredient Ephedra? One of us, and hundreds of others have written to the FDA over 10 years ago concerning the obvious (to us) dangers of Ephedra (with its adrenaline and amphetamine-like activity), but it took too many deaths, including of young athletes, before more hearings resulted in its being banned in the United States.
The Parabens do not cause such a severe problem. Its dangers are there, but the public (you) were not aware of the many dangers. Most inexpensive, as well as a very expensive "skin care products" contain one or more Parabens. Read the labels.
A very few well-formulated products avoid them, and use the much safer (and FDA approved).
Any new (for you) product should always be patch tested. This means to put a few drops on the inside of your upper arm or inner thigh, and wait for one day to be sure that you are not that one person out of thousands who might have an unusual skin sensitivity.
Hydroquinone Is DangerousHydroquinone is used as a cosmetic skin-bleaching agent, but in some countries it is banned because it can cause white patches on the face (leukoderma) with confetti-like depigmentation and subcutaneous (below the surface of the skin) dark collections of pigment (exogenous ochonosis).
Furthermore, according to researchers, long-term effects, including cancer are most likely. Kidney tumors and leukemia (white blood cell cancer) occurred in animal experiments, which have exposed its carcinogenic and nephrotoxic (kidney-damaging) properties. It has also been show to cause DNA damage.
Daily use causes it to accumulate in the body by absorption through the skin faster than it can be excreted in the urine. In 2001, it was banned in The Netherlands.
Ascorbyl Palmitate (C-Ester) is a dangerous form of Vitamin C for your skinToxic to skin cells when exposed to sunlight (UVB irradiation).
Although more stable than Ascorbic Acid (Vitamin C), it is not as stable long-term as the safe and effective form of Vitamin C: Magnesium Ascorbyl-Phosphate.
In November 2002 Doctors in the Department of Dermatology of the prestigious Mayo Clinic, published the results of their studies of topical Ascorbyl Palmitate (also known as C-Ester, and Ascorbic Acid-6-Palmitate). They noted that Ascorbic Acid-6-Palmitate degenerates when exposed to sunlight (UVB) on skin and is "toxic to epidermal (skin) cells. Our data suggest that, despite its antioxidant properties, Ascorbic Acid-6-Palmitate may intensify skin damage following physiologic doses of ultraviolet radiation" (what most people are normally exposed to). The reason for this double-edged sword is that the fatty acid component (Palmitate) reacts with the sunlight to become oxidized. This results in lipid peroxides. "End products of lipid peroxidation, such as 4-hydroxy-2-noneal, have been reported to mediate (cause) stress-activated protein kinase activation and cell toxicity (poisoning) in epithelial cells" (upper skin layer cells).
In referring to the use of Ascorbyl Palmitate in cosmetic products, these prominent Mayo Clinic doctors and scientists noted "its widespread use in numerous over-the-counter topical skin care products and sunscreens. These products contain concentrations of Ascorbic Acid-6-Palmitate as high as 15% (360 mM), thus "exceeding the dose range used in our experiments by a factor of 1000."
If the Ascorbyl Palmitate concentration in a topical lotion, serum or cream was 1.5%, for example, then that product would exceed the Mayo Clinic's study cyto-toxic epidermal (poisonous to skin cells) level BY A FACTOR OF 100. That is 10,000% more than the concentration of Ascorbyl Palmitate these Mayo Clinic doctors documented killed skin cells.
When used at night it is safe, but never in the daytime since ultraviolet light also continually penetrates glass windows.
These Mayo Clinic doctors noted the reason for this research study: "Even though the antioxidant effect of Ascorbyl Palmitate (Ascorbic Acid-6-Palmitate) has been recognized, its interaction with cellular lipids (fatty components, including the cell membrane) and its effect on intra-cellular signaling and cell viability (survival) following UV (ultraviolet: sunlight) irradiation have not been studied."
Now this synthetic antioxidant has been properly studied and found to kill skin cells when topically applied and exposed to sunlight. Not what you were led to believe. Do you put this cell toxic compound on your skin? Read all your labels.
What we find very disturbing is that 5 years after the 2002 published study, Dermatologists, skin care chemists and companies still use and promote the "safe and effective" use of Ascorbyl Palmitate without any WARNING about its skin cell dangers in sunlight, and even include it in some sunscreen products.
Unlike Ascorbyl Palmitate, Magnesium Ascorbyl Phosphate does not contain any lipid (fatty acid) component to react negatively with ultraviolet light (sunlight). Both Magnesium and Phosphate components are not organic. It does not have the biochemical characteristics to become a cell poisoning and cell destroying oxidized lipid.
Phosphate is not organic. It does not contain any carbon atoms. It cannot be oxidized or degenerate into lipid peroxide. Phosphate is a Phosphorus atom bound to four Oxygen atoms. It is connected to the Ascorbyl (Vitamin C) molecule, and Magnesium is ionically bound by its positive charge to the negatively charged Ascorbyl-Phosphate.
Although Ascorbyl Palmitate is more stable than Ascorbic Acid which is very unstable unless dry in a capsule or tablet; studies have shown that long-term stability of Ascorbyl Palmitate "was not adequate". This was in contrast to "Ascorbyl-Phosphate, which was stable".
In contrast to the stable Ascorbyl-Phosphate: "Esterification (molecular attachment) with Palmitic Acid in 6 position (on the Ascorbic Acid molecule) did not prevent hydrolysis (decomposition when wet) of the molecule (Ascorbyl Palmitate)". Magnesium Ascorbyl-Phosphate is very stable: "the introduction of the Phosphoric group in 2 position (on the Ascorbic Acid molecule) protected the molecule (Magnesium Ascorbyl-Phosphate) from break-up". This "confirms Magnesium Ascorbyl-Phosphate as a very stable derivative of Vitamin C that may be easily used in various types of cosmetic products."
Ascorbyl-Phosphate is a hydrophilic derivative of Ascorbic Acid, which has improved stability arising from its chemical structure. It is used in cosmetic and pharmaceutical preparations because it has many favorable effects in the skin, the most important being antioxidant action. Unlike Ascorbyl Palmitate, Ascorbyl-Phosphate protects skin cells in sunlight.
Studies from the prestigious Department of Carcinogenesis of the M.D. Anderson Cancer Center proves that when Ascorbyl Palmitate is applied to the skin before a known carcinogen (cancer-causing agent) and without sunlight, it will inhibit its cancer-causing effect (decreased the cancer inducing enzyme Epidermal Ornithine Decarboxylase activity) to 59%. But they demonstrated that topical Alpha Tocopherol (Vitamin E) also inhibits that cancer-causing enzyme, and does so to 70% inhibition. Plus, Alpha-Tocopherol in its topical therapeutic concentration does not cause skin cells to become injured. Furthermore, Alpha-Tocopherol was more effective than Ascorbyl Palmitate in preventing the growth and number of skin tumors (papillomas).
Therefore, based on all the credible and reliable science, there is no reason to use Ascorbyl Palmitate in any topical preparation. Unfortunately, many cosmetic products still use the outmoded "technology", some of which cost up to $570.00 for a 2-ounce bottle and also includes Neuropeptides, Tocopherol Acetate, (form of Vitamin E), Propyl-Paraben, Isopropyl-Paraben, and Methyl-Paraben, of which we do not recommend for all the specific reasons.
In oral therapy, Ascorbyl Palmitate is a safe and effective (but unnecessarily expensive) source of Vitamin C because sunlight cannot reach your internal organs, and it is hydrolyzed (split apart in water) into Ascorbic Acid (Vitamin C) and Palmitic Acid, a fatty acid that your body can "burn" for energy. Plus, in a dry capsule or tablet, it has a long shelf life. Just do not use it in a topical lotion or cosmetic product unless you limit its use only after sundown.
Are Peptides And Neuropeptides Safe?Do you know where all the Peptides and Neuropeptides in cosmetics come from?
How safe are they? In 2005, a Medical School Dermatology professor published a very scholarly article: "Cosmeceutical Peptides" that had the shocking conclusion, which in essence noted that you could very well become an unwitting and unpaid volunteer of cosmetic manufacturers by testing (buying and using) cosmetics containing Peptides, in order for most companies to avoid the cost of obtaining FDA approval.
Here are her exact words:
"The question then, finally, may be asked that if such a product (referring to biologically active Peptides) is available, is it truly a cosmeceutical or is it a pharmacologic agent (drug) because it is altering physiologic (active biological) processes in the skin? It seems that effective cosmeceuticals lie in a gray area between cosmetics and drugs. Even the with products clearly beneficial to the skin, it most cases, manufacturers make a calculated decision not to make claims that will result in scrutiny by the US Food and Drug Administration (FDA) of the product as a drug. Clinical testing (done as an official company sponsored a research study) could also draw the attention of the FDA, so some manufacturers opt instead to allow the consumer arena (unwitting guinea pig customers: you) to become the test market. If improvement of the skin is seen, the product would be a commercial success without the cost of FDA approval. However, if true physiologic changes are occurring with these products as it seems for some, it is only a matter of time before FDA scrutiny occurs to evaluate the effectiveness, safety, and potential toxicity (poisonous and dangerous biological activity) of these new ingredients.
Do NOT become a Guinea pig testing any Peptides. You will learn of some of the many concerns and dangers we have based on the little that is medically and scientifically known about "natural" and synthetic Peptides, which are amino acids attached together, like links in a chain. Some of these Peptides have their amino acid contents and order of linkage fully identified, while some do not. Neither makes them safe and not toxic to your skin, and to your entire body, if they are absorbed. These are biologically active compounds.
Peptides are fragments of larger proteins in nature. Most often they come from meat. Which meat? From what country of origin? Have they been thoroughly tested for Mad Cow Disease prions (the infective agent that causes Mad Cow Disease, which cannot be destroyed by heating or other forms of sterilization in common use)? Have they been thoroughly tested for such viruses as Bird Flu and bacteria such as Tuberculosis Bacillus? Have they been sterilized for these germs? We have been unable to find any medical or scientific published studies to answer our questions. We do not recommend their use until their safety is proven 100%.
Synthetic Neuropeptides also have biological actions that have not passed the scrutiny of the FDA. One hexapeptide (a Peptide containing six amino acids) can penetrate the skin and cause muscle paralysis. Somewhat like the effects of the injectable drug Botox. But a paralyzed muscle loses its thickness (muscle mass) and thereby atrophies (shrivels up). This is exactly the opposite of what a youthful and plump muscle appearance has to offer you. Concave (inward collapsing) is the appearance of "old age". Youthful faces have convex (outward bulging) contours from active healthy facial muscles. In addition, we have been unable to find any studies of the internal effects on the body, including the heart (which is a muscle) from this muscle paralyzing hexapeptide. What amount of this drug is actually absorbed? And how will its cumulative absorption, if any, effect your body?
Likewise, where do the Neuropeptides found in some cosmetics come from? Brains and spinal cords have the highest concentration of Neuropeptides in your body and that of all animals, including cows, where the Mad Cow Disease prions are in highest concentrations. If any Neuropeptides come from bovine (cow) sources, that poses a serious problem. In 2004 the FDA warned against the use of topical Collagen because of the potential danger of catching Mad Cow Disease. But Neuropeptides from cow brains and spinal cords pose a much greater danger. Furthermore, what country do they come from? England has the highest Mad Cow Disease rate and deaths from this neuro-degenerative disease in the world. They had routinely fed their cows the renderings (left over body parts, including brains and spinal cords) in their animal feed. And by its nature, this prion caused Mad Cow Disease takes years to develop.
Many Peptides in your body have active biological properties, including hormone-like effects. In our opinion your safety is paramount. Anti-aging and wrinkle prevention and reversal is so effectively treated by safe and beneficial alternatives, such as Glucosamine Sulfate and Magnesium-L-Ascorbyl-Phosphate, we cannot recommend the topical use of any Peptides and Neuropeptides.
500 Peptides also come from a yeast (fungus) Saccharomyces crevisiae. These include Superoxide Dismutase, which is very safe and effective when applied topically to your skin. Three others include Heat-Shock Protein 12, Ubiquitin and Acyl-CoA. These four have been studied together and have been able to accelerate wound healing in diabetic mice. These compounds are known as "Stress Proteins" because they are "induced in response to several agents that cause cellular injury such as heat, free radicals, heavy metals, ischemia (impaired oxygenated blood flow), and toxins (poisons)."
Although the original yeast extract that was first discovered in 1901 was responsible for the rapid growth of yeast, and that it was found helpful in treating hemorrhoids in the 1930s, we have been unable to document its use on skin to treat wrinkles and the effects of aging, except for Superoxide Dismutase.
Furthermore, these isolated Peptides from the original yeast brew are hundreds of times more potent. We have not seen any studies on all the safety issues such concentrated extracts raise in our minds. In fact the author of a 2004 published medical article raises the same point that we just made: "Further clinical studies will provide data currently lacking for peptide technology." "Peptides are being studied that act as growth factors via activation of Protein Kinase C (PKC), a key enzyme for cell growth and migration."
However, our research has documented that Protein Kinase C (PKC) is a key enzyme for the growth of cancer cells and the spread ("migration") of cancer cells. Being a Guinea pig for these Peptides, with a let's see if they work, and avoid all the safety tests, because they cost money, to us is immoral and very dangerous to your skin.
The Neuropeptide Gastrin-Releasing Peptide (the stomach hormone that causes the stomach to make lots of acid for digestion) was experimentally shown to stimulate human skin epidermal cell (keratinocytes) in vitro (laboratory test tubes), and some have recommended that it should be rubbed onto your skin. Just the thought gives us a "stomach ache". Do you know what else it could do on and in your skin? And what it could do if it were to be absorbed into your bloodstream?
In one study, a hexapeptide (which only means that it contains six amino acids), this one containing the amino acids Valine-Glycine-Valine-Alanine-Proline-Glycine (VGVAPG) was found to stimulate the human dermal (deep skin layer) fibroblasts while down-regulating (decreasing; inhibiting) Elastin production. But Elastin is an essential elastic fiber component of your skin, which is responsible for its youthful elasticity. And another study of this same VGVAPG Peptide stimulated skin biological processes (triggered cell signal pathways) that resulted in the up-regulation (increased production) of Matrix MetalloProteinases 1 and 3 (MMP-1 and MMP-3), which resulted in the protein in skin being digested (proteolytic and inflammatory damage). With cosmetic Peptides like these, why ever worry about "flesh eating disease" (Streptococcal bacterial spreading fasciitis).
Another Peptide (Lysine-Therine-Lysine-Serine) has been implicated in regulating Collagen synthesis by increasing production of the extracellular matrix proteins (such as: Collagen, Hyaluronic Acid, and Elastic Fibers). However, this same Peptide containing these amino acids has been link to Palmitic Acid, a fatty acid, in order to improve its ability to penetrate into the skin. It is being sold now in cosmeceutical products. Unfortunately, Palmitic Acid, when exposed to sunlight (ultraviolet irradiation: UVA and UVB) kills skin cells, (it is toxic to keratinocytes) as determined by the prestigious Mayo Clinic in 2002, in their study of Ascorbyl Palmitate. These experts in the skin science documented the fact that sunlight causes the Palmitic Acid to become very toxic to these skin cells even at very low concentrations of Palmitic Acid, at (doses that were more than 10,000% less than in commercial use.
These are a few examples of "synthetic" functioning untested for total safety, even when some of their dangers could be anticipated, as we have described.
Finally, if Peptides stimulate the enzyme Telomerase, it can significantly increase your risk for developing cancer. The frayed ends of every chromosome limit the number of cell divisions. Cancer cells possess the enzyme Telomerase which repair the frayed ends of chromosomes, thereby allowing these cells to duplicate themselves, forever. We have been unable to find any research on the effects of Peptides and Neuropeptides on the enzyme Telomerase and cancer cell division.
The Hippocratic Oath of doing no harm that Medical Doctors take goes beyond harm to your wallet. We will not recommend any topical nutrient until it has been studied sufficiently (by independent researchers) to prove to us that it is safe and effective. When that occurs we will update our formulations for your optimum skin care.
Alpha Hydroxy Acids and Glycolic AcidThe most commonly used cosmetic Alpha Hydroxy Acid is Glycolic Acid. The others are Citric Acid, and Lactic Acid. Malic Acid and Tartaric Acid also are Alpha Hydroxy Acids but are not used in cosmetic preparations.
Although Glycolic Acid comes from cane sugar, it is also synthesized. In addition to cosmetics, its main use is in industry where it is commonly used:
In the leather industry and fur dressing because of its ability to dissolve calcium salts, and because of its metal chelation properties in alum and chrome baths;
As an acid cleaner for removing scale and milkstone in dairies;
Cleaning heat exchangers and boiler scale;
Polishing copper;
Etching lithographic plates;
Electropolishing baths for stainless steel;
Electroplating;
Metal pickling; and
Textile dyeing.
How Alpha Hydroxy Acids and Glycolic Acid workThe healthy "glue" that holds your epidermis together is eroded by these acids, loosening these protective cells. That leagues to "exfoliation" (the loss of your superficial epidermal cells). It also removes your natural oils.
What about the claims that Alpha Hydroxy Acids increase the skin's production of Collagen? Some do, but at concentrations in which they also cause damages. Concerning the research on the Collagen stimulation production; after a detailed search of all the world's literature we have discovered the following:
One article described the use of 20% Glycolic Acid on the forearm of volunteers twice a day for three months. This was not done on the more sensitive facial skin. These researchers made the following guess: "Longer treatment intervals MAY result in Collagen deposition."
The next study used 25% Glycolic, Lactic, or Citric Acid for 6 months, and again to the forearm and not the face. Some increase in skin thickness was noted along with a greater density of Collagen. These patients were under the direct supervision of doctors.
The third and final study involved the use of 15% Glycolic Acid for 10 weeks on the skin of mice. Citric Acid is not a true exfoliator. It is an antioxidant and weak bleach of discolored skin.
How Glycolic and Hydroxy Acids reduce the appearance of wrinklesRemember when you injured yourself, such as a sprained ankle or wrist? It swelled up because of that trauma (injury to your flesh). That swelling (edema) is composed of salt water, of which your body holds 4 quarts in your blood stream, and 15 quarts in the fluid between all your cells (interstitial fluid). The medical term for the abnormal fluid accumulation in your skin is called "edema", and also commonly seen in heart failure, kidney failure, and some circulation problems.
These acids cause a chemical burn to your skin, which causes this edema to accumulate. This temporary swelling of your skin stretches it from within, eliminating the appearance of wrinkles. But does not affect the permanent cross-linking of your Collagen (fibrous flesh) in your dermis and epidermis unless used daily or twice a day, and at very high (and more dangerous) concentrations. And now with the outer layer of your epidermis gone, you are much more susceptible to accelerated damage from the millions of free radicals generated by the unobstructed sunlight, and the lack of protective oils. That's why all those products warn you to avoid the sun, use at least 25 SPF ("Sun Protective Factor") or greater, use a "moisturizing cream", and that you may even have to avoid all your cosmetics and cleansing soaps. F.Y.I. SPF only refers to blocking the UVB sunlight rays, not the dangerous UVA ultraviolet sunlight irradiation.
Your natural body armor has been destroyedSome products claim to have "buffered" the acid (chemically treated to reduce their acid content with a chemical "base" such as lye), to reduce its caustic (burning and corrosive) side effects "without effecting its efficacy". That is false, since it works through it acidic properties.
There are no long-term studies over 10 to 20 years to look for the serious damage that can result, including increasing the risk of developing skin cancer, as well as the very deadly Malignant Melanoma cancer, plus shortening the limited lifespan of your only skin.
One safer way to eliminate wrinkles is to cause trauma by repetitive slapping, but that is not an acceptable form of "Treatment", plus there are no studies for that unconventional form of wrinkle treatment, which we do not recommend. Just like we cannot support the use of any skin burning (peeling) method.
Retinol, Retinaldehyde, and Retinyl-Esters Versus Retinoic Acid sold as Retin-A (Tretinoin)There is an almost universal confusion concerning about what is Vitamin A. Retinoic Acid (Tretinoin) is Vitamin A but you should never put it on your skin, unless you are a masochist. It is very irritating. However, the good news is that it has non-irritating precursors - biological compounds that your skin can easily and safely convert into Vitamin A once they are inside your skin where they are needed. And these precursors are not irritating. Retinol and Retinaldehyde are safe and effective biological precursors of Vitamin A. In extensive testing they have been determined to be non-irritating.
Vitamin A, Retinol and Retinaldehyde are stored in your skin as Retinyl-Esters. And as more Vitamin A is needed, these Retinyl-Esters convert back to Retinol and Retinaldehyde, where your body uses these precursors of Vitamin A to make that essential skin protective vitamin for you.
How Botulinum Toxin worksThe junction where one nerve stimulates a muscle is called a synapse. This is the cholinergic neuro-muscular junction. The Botulinum toxin (poison) saturates this pre-synaptic terminal (end of the nerve). After it binds to this nerve terminal ending, it is repetitively recycled back into that nerve's ending, resulting in a long-standing paralysis of the muscle from lack of energetic stimulation.
Technically, it attaches to the nerve ending's acetylcholine containing storage vesicles (microscopic intra-cellular chemical containers). There the Botulinum toxin blocks the exit of this muscle stimulating acetylcholine. It does not affect the storage of acetylcholine, or the propagation of nerve impulses.
Consider the following analogy: Your brain sends a signal, which eventually travels along this peripheral nerve (located outside of the brain and spinal cord). Although the signal passes rapidly along the nerve there is the equivalent of an insulating material between the end of the nerve and one of your facial muscles that blocks that conduction. The connection is disrupted.
This paralysis is reversible by time. The amount of paralysis depends on the dose injected into each muscle. The usual peak of the paralysis occurs within five to seven days after it is injected into each muscle. Examining a biopsy of your facial muscle at that time would reveal muscle atrophy (degeneration appearing as loss of muscles substance), and demyelenation (loss of the outer insulation sheath) of that peripheral nerve's terminal ending. A slow recovery then occurs, with the nerve ending sprouting at its neuromuscular junction, which has an appearance like an onion bulb. Although the maximal recovery is usually seen after six to nine months after the injection of the Botulinim toxin, the muscle strength (function) may not return to normal. And progressive weakening of the muscle may develop with additional injections.
As you may already know from your own exercise routines, the failure to continue vigorous exercise resulted in a fairly significant loss of your strength. However, those muscles still were used during your activities of daily living. Therefore, their atrophy was only back to their pre-workout level. However, with paralysis, the muscle atrophy (shriveling up) would be much more profound. Some of the muscle fibers would actually be replaced by scar tissue (fibrosis) of their substance and/or the flesh surrounding them.
When patients are paralyzed from injury, it is essential to work their joints passively to maintain a normal range of motion. The failure to do that basic physical therapy results in joint contractures (stuck in a progressively flexed position) because of those paralyzed muscles becoming replaced by scar tissue, which has a natural tendency to contract. In addition to range of motion physical therapy, electrical muscle stimulation is often used on a daily basis to keep each muscle fiber alive, with the hope that eventually the damaged nerve (like a cut wire) will somehow heal, bringing their body's natural "electricity" (release of acetylcholine at each neuromuscular junction), causing the muscle to contract before excessive and irreversible fibrosis (scarring) develops.
We are not aware of any ongoing medical practice to have each patient who has their facial muscles paralyzed by the use of Botulinum Toxin be aided by electrical stimulation done on a daily basis in the privacy of their own home, to prevent long-term permanent weakness, progressive sagging skin, and an aged appearance.
A paralyzed muscle also loses its bulk, and therefore goes from the youthful convex (outward bulging) shape, to the atrophic convexity (inward collapsing) shape of advanced aging.
Additional injection risksThere is a small risk of infection. One of the most severe infections is Necrotizing Fasciitis ("flesh eating disease"). Bleeding and subsequent scarring is always possible, since the needle is inserted "blindly" into the flesh, and there are innumerable at risk blood vessels coursing within. Anticoagulants (blood thinners), including Coumadin (warfarin), and even one aspirin taken within one week of any injection increases the risk of internal flesh hemorrhage. Furthermore, since bovine (cow) serum (blood plasma fluid derivative) albumin is used as the fluid carrier protein in Botox, there is a theoretical risk of catching "Mad Cow Disease" from the transmission of those prions (infective-like proteins), which are not denatured (sterilized) by heat. This has not "yet" been reported, but it takes many years for that brain wasting disease to develop.
Injectable Collagen causes severe inflammationIn a study, Collagen was taken from three sources and compositions including: "a sponge formulation and a thin film composed of Type I Collagen from bovine (cow) Achille's tendon (at the rear of the ankle), and a membrane prepared from bovine derma (skin)," were injected. All caused a significant inflammatory response and cell membrane breakdown. This was confirmed by measuring the inflammatory agent produced by the body: PGE-2 (Prostaglandin E-2). These scientists noted that "hydrolysis (breakdown) of exogenous Collagen (from an external source) starts shortly after it is kept in contact with tissues and evokes a local inflammatory response."
Collagen is a deadly poison Collagen from different animal sources were tested and all had the same final result: death. As these doctors stated in their published a study, "Different preparations of soluble Collagen, from rabbit skin, rat skin, rat tail tendon, and guinea pig skin, produced respiratory distress, agitation, convulsions, and finally death when infused intravenously in lethal doses." Blood tests noted that "damage to the liver occurred as a result of Collagen infusion." And when they looked at the organs under the microscope (histopathological examination) "confirmed that damage has occurred to the lungs and livers of these animals. The source of Collagen did not appear to influence its toxicity (poisonous effect) at the tissue level".
Obviously a doctor will not knowingly inject any Collagen into a vein, but with the multiple sticks and hundreds of small to large veins in the skin and just below its deeper layer (dermis), accidents can happen. Furthermore, all Collagen from exogenous sources (not made by you inside your skin) will be absorbed over weeks to months, and has the potential to cause some degree of liver and lung injury.
Why would anyone subject themselves to this procedure that has risks (scarring, bleeding, infection, and now even more potential risks) when there are safer (topical) ways to stimulate your own body to produce a more of its own Collagen (Magnesium Ascorbyl Phosphate and Ursolic Acid, plus Glucosamine Sulfate to significantly increase the amount of Hyaluronic Acid in your own skin) safely.
Information about "Static" Wrinkle InjectionsThe source of the Dermal (Skin) Fillers "material": Autogenic (from you), Allogenic (from other humans), Xenogenic (from animals), and Synthetic (laboratory made):
Autogenic Skin Fillers: Fats, Plasma, and Cell Culture Grown Fibroblasts (Your Skin's Cells That Produce Collagen):
Fat: Body fat is removed during liposuction, or a mini-liposuction procedure. It is then injected under the skin to replace the lost volume to correct static wrinkles. There can be problems at the donor site including pain, infection, bruising, bleeding, and scarring. At the injected sites your body's fat, now separated from its natural blood supply (its small arteries, and veins) will usually become gangrenous (necrotic) or undergo a fatty-scar tissue (lipogranulomatous) degeneration. This results in a lumpiness feeling to your skin.
Autologous Plasma: Your blood is removed using a needle and syringe (phlebotomy). Using an F.D.A. approved kit (PlasmaGel and Fibrel), your plasma (the clear fluid part of your of your blood) is separated from the red and white blood cells, and used for injection into the static wrinkles. However, the problem is that its effects are very short lived.
Cell Fibroblast Culture: A punch biopsy (small pinch of skin) is removed, and your skin fibroblasts (the cells that produce and secrete Collagen, one of the main components {matrix} of skin) are grown in a laboratory in sterile bottles (cell culture). This is not cloning. Then they are collected using a product and technique called Isolagen. Your own fibroblasts are injected into your wrinkles. Only one biopsy is needed for an unlimited future supply of your own fibroblasts, if they do not become contaminated. However, this process is expensive, and time-consuming.
Allogenic Skin Fillers: This source of human Collagen comes from the skin of cadavers. Their skin is processed into a product without cells, but with the same components including Collagen, Elastin, and Proteoglycans (mostly Hyaluronic Acid). This is marketed under the brand name Alloderm. Its micronized (chopped into finer particles) product is Cymetra. In addition, another product, Dermalogen, comes from human skin, while Fascian is derived from human fascia (the fibrous gristle surrounding muscles).
Unfortunately it is absorbed over months. Since it comes from humans, it does not cause an allergic reaction like that Collagen from animals (xenografts). There is a concern that with any flesh that is not your own, infections with viruses (if there is any failure of the sterilization), and even prions (the proteins that cause Mad Cow Disease which cannot be destroyed by sterilization) can be transmitted to the recipient.
F.D.A. approved human Collagen products are Cosmoderm, and Cosmoplast, which has the Collagen molecules cross-linked (attached) with the chemical glutaraldehyde. That cross-linking increases its strength and possible longevity in your skin. Since it is of human origin, no prior skin test is needed to check for any allergic reaction. These products are injected into your wrinkles through multiple punctures ("serial-puncture technique"). It is immediately massaged to help spread it evenly, and to try to avoid lumps and bumps.
Then there is a the question that if one were to receive live transplanted cells from another human, would they survive long enough to function? This survivability of allo-transplanted (same species) live cells was studied by using prepared porcine (pig) cells, and injecting them into another pig. At three days some cells were detected. But none were found intact after just seven days using the most sensitive DNA testing (polymerase chain reaction analysis). But unlike the use of injected live cells, injected Hyaluronic Acid has been found to attract the recipient's own cells (chemotactic to mesenchymal cells) and profoundly promotes new blood vessel growth (pro-angiogenic). See this book's chapter on Glucosamine Sulfate for the best alternative, so that with its optimal concentration applied topically (on your skin's surface), it is well absorbed so that you can produce your own Hyaluronic Acid, at the maximum amounts, just as you did many years ago.
Xenographic (Animal Source) Skin Fillers: These non-human sources of Collagen and Hyaluronic Acid have been available from cows, pigs, and roosters for years, and Hyaluronic Acid is also bioengineered through the use of specialized bacteria.
Although the Collagen from animal sources is similar to your Collagen, it is not identical. Therefore there is a real risk of an immediate as well as a delayed allergic (hypersensitivity) reaction. Skin testing for immediate and delayed hypersensitivity reactions is mandatory. Therefore, treatment must be delayed for weeks. In 3% of patients the skin test is positive, but 1.2% of patients who tested negative may eventually develop an allergic (immune) reaction.
Bovine Collagen is absorbed over months and found in the following products: Restoplast, DermaDeep (this creative name reminds us of the movie Jaws), Duraplast, Zyderm, and Endoplast-50. Bovine (cow) Collagen is used as a "carrier" molecule for some synthetic materials, which you will soon read all about, below. We have a safety concern about any cow derived Collagen source.
Endoplast-50 mentioned above is Elastin suspended in bovine Collagen. This lasts about one year, and is "believed" to also work by stimulating your fibroblasts (the cells that make and secrete Collagen).
Fibrel is a product containing porcine (pig) Collagen combined with aminocaproic acid and your plasma. It is "believed" to work by the Collagen creating an immediate sort of scaffold or structure in which your plasma forms a clot. The aminocaproic acid (correctly called varepsilon-aminocaproic acid) inhibits your body from dissolving the newly formed clot. Then your fibroblast cells migrate into this Collagen-clot substance (matrix {not the movie, but it is futuristic}), and produces Collagen. 67% of the correction remains after five years. Unfortunately, the longer a substance remains, the longer any negative reactions (complications) will also tend to last.
DermiCol is a product under testing. It cross-links (attaches) Collagen molecules together creating a larger (but stiffer) molecule, which decreases its degradation and absorption. Its half-life (the point at which one-half is gone) is about two years.
Hyaluronic Acid skin fillers: Hylaform, Restylane, PerlaneHyaluronic Acid does not require any skin testing for its molecular allergenicity because whether it comes from rooster combs (cartilage) (Hylaform) or performed by a bacterial fermentation process, it is the same as in our skin. But if you are allergic to chickens, caution is needed with Hylaform because there may be some other chicken natural molecules mixed in with the Hyaluronic Acid. After injection, it has been shown to cause abscesses.
Hylaform comes in three densities: Hylaform Fineline whose particles measure 300 um (micro-meter = millionths of a meter: yard), Hyaline Regular at 500 um, and Hylaform Plus measuring 700 um. The finer particles are used for finer lines, but for the wrinkles, which are deeper, the larger particle size is used. However, if the thicker viscosity (larger size particles) are used for fine wrinkle lines, they will appear more lumpy.
Restylane, the bacterial fermented Hyaluronic Acid comes as Fine Line with its particle size of 150 um, and Restylane at 250 um. One milliliter (one-thousandth of a liter/quart) contains 100,000 particles.
Recent severe reactions to the Restylane Hyaluronic Acid product have been reported: Sarcoidosis is an auto-immune disease in which the body reacts against components of its own flesh. In one published medical study in 2005 in the International Journal of Dermatology, a patient developed biopsy proven Sarcoidosis four months after her facial injections of Restylane. In another 2005 study published in the Journal of Ophthalmological Plastic Reconstructive Surgery it stated: "A 62 year old woman received injections of Restylane, cross-linked Hyaluronic Acid, for the cosmetic filling of facial rhytids (wrinkles) and developed a severe dermal (deep skin) inflammatory reaction."
Perlane is made by the same bacterial fermentation process, but has larger particles measuring 1,000 um, and one milliliter contains 10,000 particles. This is a more highly concentrated form of Hyaluronic Acid, and swells more by its attraction of more water. The manufacturer warns that the patient should not expose the injected area to intense heat or cold for a few days in order to reduce the degree of inflammation.
In case you wanted to know how it is injected into your flesh, the needle's full-length is inserted into your skin the entire length under the wrinkle, and these products are injected as the needle is slowly pulled backward.
Permanent Injectable Skin Filler: ArtecollArtecoll is an injectable wrinkle filler that is made from highly purified polymethyl methacrylate (PMMA) particles which are suspended in bovine Collagen. To this is added to a local anesthetic (numbing agent like your dentist uses). Each particle is a microsphere measuring 30 to 40 um, and has a smooth residue free surface. They are too large to be eaten by your body's scavenging cells (macrophages), but small enough to be an injected through a 27-gauge needle (whose opening is about a width of a hair).
The body's reaction and the cosmetic changes are unique to this product. In the first few weeks the Collagen is eaten by your body's macrophages, and the PMMA particles form clusters. After four weeks the wrinkles will reappear, and the injected lips will return to their pre-injected (normal) state. After the fibroblastic (scar tissue causing) activity reaches its peak, the wrinkle lines will gradually begin to fill in. This process becomes complete at 3 months. Final correction may require two or even three injections, each going through this same process. The final result may take up to 1 to 2 years to complete.
Because the product must be delivered with bovine Collagen as the carrier, a skin allergy test is required. The same theoretical Mad Cow Disease potential exists. There is also the risk for a delayed hypersensitivity allergic reaction, even with a negative skin test.
The technique of how it is injected into your flesh is even more critical with this filler than others, because of the permanent nature of the PMMA particles. Here the product is injected into the deep layer of your skin, with the needle kept in constant motion, in a scaffolding pattern. Because of this constant needle (think very sharp) wide penetration, bruising is an increased risk. And there is a tendency for the Artecoll or skin to plug the needle requiring its removal, and reinsertion. If the doctor just pushes harder on the plunger of the syringe to clear the needle's block, too much can shoot into a localized area.
No matter what the cause, if too much of the Artecoll product is injected into one area, you initially can't feel that material as a bump, but it can develop into a permanent nodule. That nodule can become deformed over time, and easily felt in your lips, as well as sometimes even becoming visible. Six to twelve months after the injection, an inflamed lump of this material in scar tissue (granuloma) can result. This can occur at all implant sites simultaneously. These can grow to the size of a bean. An injectable steroid such as Kenalog can be used to try to soften the resulting scar tissue, but it can cause atrophy (thinning) of the overlying skin. Surgery may be required to remove these granulomas and nodules that do not respond to the injection of steroids.
One physician tested 10 injectable fillers in the skin on your forearm, and then had a biopsy at each of these 10 sites done at 1,3,6, and 9 months (40 biopsies): the results of this study:
Collagen (Zyplast) was gone in 6 months;Hyaluronic Acid (Restylane) gone at 9 months; Artecoll (PMMA microspheres) was completely enclosed by scar tissue and macrophages (the body's scavenger cells), as well as giant cells (which are seen in chronic foreign body inflammatory reactions);Silicone Oil was not felt inside the skin clinically, but this never to be used and banned substance caused a chronic foreign body reaction;New-Fill (polylactic acid microspheres) caused a mild inflammatory response; it disappeared clinically (not felt any longer) at 4 months;Reviderm Intra (dextran microspheres) caused a pronounced foreign body reaction (inflammation), and was gone at 6 months;Dermalive (polymethylacrylate particles) caused the lowest cellular reaction, but had disappeared at 6 months;Aquamid (polyacrylamide) was well tolerated it his arm, and was still able to be felt, although to a lessening degree, the entire 9 months. By microscopic examination, it was removed by the body slowly, but was held in place through fine scar tissue covering it;Evolution (polyvinylhydroxide microspheres suspended in acrylamide) was well tolerated, and slowly diminished over the 9 months;Radiance RN (calcium hydroxylapatite microspheres) caused almost no foreign body reaction, but the skin absorbed it at 12 months.
Stated in October 2003: "Since the mechanism of late inflammation or granuloma formation is still unknown, early histological (biopsies examined under the microscope) are not useful in predicting possible late reactions to filler substances".
Skin Peels, Laser Resurfacing, and DermabrasionThey burn and remove your epidermis, and some cause deeper (dermis) damage than others.
Basic information about skin burns:A First Degree Burn is causing redness to the skin, without blisters. The most common cause is excessive sunlight. Chemicals and heat are frequent other causes.A Second Degree Burn causes blisters to form. The epidermis (top layer) is so severely damaged that it dies, and your body's blood serum weeps into the dead space formed beneath what was your epidermis and above your live dermis.A Third Degree Burn results from the death of both the epidermis and the dermis, the deep area of your skin, between the epidermis and the fat and muscles below. This dead dermis is replaced with permanent scar tissue, not new skin.
If a second degree burn becomes infected, the dermis can also begin to die. That means the risk of intentionally creating a second degree burn is that it can become infected and cause a third degree burn. Also, if the depth of the skin injury is not correctly calculated because of doctor error or inexperience, or because of the thinness or sensitivity of your skin or impaired blood supply, and it becomes infected or traumatized too soon (exposure to sunlight, harsh chemicals, or irritating cosmetics), it can be transformed into a third degree burn.
The goal of the skin peel, whether by chemical burning or laser burning (vaporization), is to remove the epidermis with its imperfections and hopefully allow the dermis to regenerate a new and healthier, smoother, and younger epidermis.
The deeper the epidermis is destroyed, the greater the risk for scarring, infection, uneven coloration, and longer time for recovery. Very superficial peeling and laser ablations (skin destruction) take several days to two weeks to recover. But deep peels and deep laser "resurfacing" procedures take weeks to months for complete recovery, during which time very careful attention must be paid to your deep facial blisters. One slip-up can cause irreversible scarring. Your self-care is a major commitment, and often work must be put on hold.
The deeper the peel, the longer it will last. Superficial peels have to be repeated every few months. Medium peels can last up to a year. And the deepest - and most painful and dangerous - peels can last a lifetime, as do their bad results.
The deeper peels also have a risk of activating herpes skin ("cold sore") infections. If these spread to your eyes, blindness can result.
Superficial peels require no anesthesia. Medium peels are painful and require oral sedatives. But the deepest peels are the most painful ever and often require intravenous (by vein) sedatives or even general anesthesia.
Chemical peels
SuperficialThese are 10% strength (concentration of 10 grams per 100 milliliters [3.3 ounces]) of non-prescription Alpha Hydroxy Acids (Glycolic) or Beta Hydroxy Acid (Salicylic Acid). These are sometimes referred to as "luncheon peels," and are commonly done in salons. But as we noted earlier in this Chapter, the published studies on humans used 15% or 25% Glycolic Acid daily or twice a day for three to six months.
Strong SuperficialThese are only prescription strength and applied by Dermatologists and some Plastic Surgeons. They use 30% to 70% Alpha Hydroxy (Glycolic) Acid, 20% to 30% Salicylic Acid, or 10% TriChloroAcetic Acid (TCA).
MediumThese use 20% to 40% TCA or the highest (70%) Glycolic Acids.
StrongPhenol (Carbolic Acid) is the strongest skin burning chemical used to achieve the deepest peeling. Intravenous fluids are used as well as a heart monitor. Immediately afterward, petroleum jelly must be applied and reapplied for 48 hours. Severe redness, peeling, and scabbing are to be expected for each session. Yes, each session. And each session lasts 60 to 90 minutes.
LasersThere are different types of lasers (Light Amplification by Simulated Emission of Radiation), depending on the depth and coloration to be destroyed.
Originally there was only the CO2 laser, and it was very harsh on the skin. It burned deep, and the depth was hard to control.
More recently, the Erb:Yag (Erbium: Yttrium-Aluminum-Garnet) laser was developed, along with the Nd:Yag (Neodymium:Yag) laser. The Nd:Yag laser's single wavelength targets just the brown and black discolored areas in the skin. The Erb:Yag laser's wavelength targets fine lines and wrinkles.
The Alexandrite Laser removes tattoos and unwanted hair, while the Ruby Laser eradicates the fine "spider" veins. Diode Lasers are the latest devices. These are smaller and being used to remove hair and spider veins.
A newer version of the CO2 laser, the "superpulsed" CO2 laser, is used for deeper burning into the epidermis.
Just like chemical skin peels, the deeper the burn, the greater the risks, the greater the pain, the longer the recovery period, and the longer the results last - both good and bad.
DermabrasionThese are electric sanders used to remove the epidermis. Unfortunately, the control of the depth has been imperfect in too many hands, resulting in too much depth of skin removed. The bleeding skin can interfere with the precision necessary for an even depth of epidermal skin removal. Unlike dermabrasion skin sanders, lasers usually seal blood vessels exposed by their powerful vaporizing effect.
"Power Peeling" is a misnomer. It is rather gentle and only removes the very top dead layer (stratum corneum) of the epidermis. It uses very fine Aluminum Oxide crystals for its abrasion but that increases the risk of injury from the sunlight, cosmetics, and skin dehydration.
The Facts about SunscreenSome sunscreens increase the growth of Breast Cancer and can cause Uterine Enlargement Doctors at the Institute of Pharmacology and Toxicology at the University of Zurich "examined frequently used UVA and UVB screens for estrogenicity (female hormone activity) in vitro (laboratory test tubes) and in vivo (live animals)." Five sunscreens "increased breast cancer cell proliferation (multiplication), with median effective concentration values between 1.56 and 3.75 microMolar (one millionth its molecular weight per liter of volume)." These sunscreens were: benzophenone-3 (Bp-3), homosalate (HMS), 4-methyl-benzylidine camphor (4-MBC), octyl-methoxycinnamate (OMC), and octyl-dimethyl-PABA (OD-PABA). In live female immature mice "uterine (womb) weight was dose-dependently (more had a greater effect) increased by 4-MBC, OMC, and weakly by Bp-3. Dermal (topical) application of 4-MBC to immature hairless rats also increased uterine weight. There is possible long-term effects in humans."
Unlike these absorbed chemicals into your body, Titanium Dioxide, which is an excellent sunscreen and sun block against UVA and UVB, is not absorbed. It is non-toxic, and our choice for your benefit. Avobenzone (Parsol 1789) used for UVA protection has problems.
The UVA protection you expect from Avobenzone (Parsol 1789) does not last. In fact, a study in 2005 documented that "after two hours of sunlight, the preparation containing the Avobenzone (Parsol 1789); 4-tert-butyl-4'-methoxy-dibenzoyl-methane {BM-DBM}) lost 85% of its UVA absorbance."
Another 2005 research study of Avobenzone showed that instead of preventing free radical (oxidant) generation after UVA irradiation, these researchers discovered that "this product produced free radicals detected by Electron Spin Resonance (ESR) spectroscopy that persisted even after the exposure had ended."
That's not "fun in the Sun" with loss of protection, and which generates persisting free radicals, even after you go indoors.
Avobenzone (Parsol 1789) did not prevent biochemical damage. Without any protection: "UVA exposure induces significant cell mortality, decrease in protein concentration, release of LDH (an enzyme inside cells that is only released on cell injury or death), increase in apoptos
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