Vol. 30. No. 3


The term cosmeceutical was coined by Dr Albert Kligman in 1984 to describe topical products that afford both cosmetic and therapeutic benefits.1 These products exist on the spectrum between cosmetics, which solely adorn the skin, and medications, which must undergo testing to prove a functional benefit. Cosmeceuticals promote skin health but are not subject to safety or efficacy regulation by the U.S. Food and Drug Administration (FDA). The FDA does not recognize the designation “cosmeceutical,” and instead considers these products cosmetics. Modern society’s youth fixation and its insatiable appetite for methods of turning back the clock have fueled an explosion in the cosmeceutical industry. Irrespective of one’s opinion regarding cosmeceuticals vis-à-vis prescription medications, it is impossible to ignore them. Like Spanish explorer Juan Ponce de León on his mythical journey to find the fountain of youth (Fig. 1), consumers inundated by mass media advertisements navigate aisles of products purporting to restore skin radiance. In fact, analysts forecast that U.S. cosmeceutical sales will reach US$21 billion by 2012.2 In selecting contributors to this issue of Seminars in Cutaneous Medicine and Surgery, the editors sought out recognized experts in the field to distill the innumerable products and ingredients available to those most clinically relevant. To maximize the practical benefit of these manuscripts, when possible our authors have included pearls regarding cosmeceutical use in their daily practice. To set the stage, Dr Brandt’s group draws upon decades of experience in the cosmeceutical industry to provide a snapshot of its scope and to forecast future trends. Although not cosmeceuticals, home-use laser and light skin devices also represent direct-to-consumer marketed skin health products that are garnering increased public attention. The editors provide an update on these products and review available evidence for their efficacy. In the next manuscript Drs Emer, Waldorf, and Berson review cosmeceuticals for rosacea that can prove useful adjuncts in its management. In the subsequent article, Drs Jacob and Lupo discuss the use of cosmeceuticals to optimize outcomes of laser therapy. Dr Farris follows with a description of promising new antioxidant ingredients. At the forefront of research on the pathophysiology and treatment of cellulite, Dr Hexsel and her group weigh in on the role cosmeceuticals may play in its management. Next, Dr Woolery-Lloyd shares her experience with cosmeceuticals for hyperpigmentation. Finally, Dr Golubovic and colleagues gaze into the future of cosmeceuticals as they describe novel nanotechnology delivery systems. A comprehensive review of all cosmeceuticals is beyond the scope of this issue. Further limiting a scientifically rigorous discussion of these over-the-counter products is the paucity of published data evaluating their efficacy. However, it is the hope of the editors that the knowledge shared in the pages herein will emphasize the relevance of cosmeceuticals to dermatologists as well as highlight salient manners of incorporating them into daily practice. The editors wish to express our sincere gratitude to Dr Kenneth Arndt, whose exemplary intellectual curiosity and compassion guides us.

Cosmeceuticals for Cellulite

Doris Hexsel, MD
Cellulite is characterized by alterations to the skin surface, presenting as dimpled or puckered skin of the buttocks and posterior and lateral thighs. It mainly affects women. Cellulite occurrence is believed to be due to structural, inflammatory, morphological and biochemical alterations of the subcutaneous tissue. However, its pathogenesis is not completely understood. Topical treatments for cellulite include many agents, such those that increase the microcirculation flow, agents that reduce lipogenesis and promote lipolysis, agents that restore the normal structure of dermis and subcutaneous tissue, and agents that scavenge free radicals or prevent their formation. There are many cosmetic and medical treatments for cellulite. However, there is little clinical evidence of an improvement in cellulite, and none have been shown to lead to its resolution. The successful treatment of cellulite will ultimately depend upon our understanding of the physiopathology of cellulite adipose tissue. Semin Cutan Med Surg 30:167-170 © 2011 Elsevier Inc. All rights reserved.

Treatment of Hyperpigmentation

Heather Woolery-Lloyd, MD
Hyperpigmentation is a common dermatologic condition that is seen in all skin types but is most prominent in skin of color. In skin of color, any inflammation or injury to skin can almost immediately be accompanied by alterations in pigmentation, either hyperpigmentation or hypopigmentation. Post-inflammatory hyperpigmentation can be observed in many skin conditions including acne, eczema, and contact dermatitis and treatment can be challenging. The goal is to reduce the hyperpigmentation without causing undesirable hypopigmentation or irritation in the surrounding area. This review will discuss current research on treatments for hyperpigmentation and approaches to treating this condition. Semin Cutan Med Surg 30:171-175 © 2011 Elsevier Inc. All rights reserved.

Nanotechnology Use with Cosmeceuticals

Bhavdeep Shah, PhD | Nevenka Golubovic-Liakopoulos, PhD
The skin is a complex organ and its aging is a complex process. Cutaneous aging is influenced by factors such as sun exposure, genetics, stress and the environment. While skin laxity, rhytides, and dyschromia appear on the surface, these processes originate in deeper layers including the dermis and subcutaneous tissues. Until recently, most topical skin treatments were applied to, and consequently only affected the skin surface. Skin care has evolved to be scientifically based, and as knowledge increases about the physiology of the skin, novel methods of maintaining its health and appearance are developed. New generation skin care products are targeting multiple aging mechanisms by utilizing functional active ingredients in combination with innovative delivery systems. Semin Cutan Med Surg 30:176-180 © 2011 Elsevier Inc. All rights reserved.


SCMS: Seminars in Cutaneous Medicine and Surgery
In the June 2011 article “Approach to Pruritus in the Adult HIV-Positive Patient” (vol 30, no 2, pages 101-106), the first author’s name was listed incorrectly. It should be listed as follows: Ser Ling Chua.