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A Dermatologist’s Perspective on Clean Beauty

Ep 15: A Dermatologist’s Perspective on Clean Beauty

Dr. TWL: Hi guys, this is Dr. Teo Wan Lin and welcome to my podcast Dermatologist Talks: Science of Beauty. Today we’re going to talk about the buzzword clean beauty and what it really should mean.

Chelsea: Many skincare products and other cosmetics claim to be natural, organic, green, or some combination of the three. ‘Clean Beauty’ has been the recent buzzword in the skincare and beauty industry. Since there’s no legal or official definition, many brands have taken it upon themselves to define the term ‘clean beauty’. Nowadays, we often see marketing of ‘clean’ products as “preservative free”,  “all natural”, and free of synthetic ingredients such as parabens. But, many brands don’t often agree about which ingredients are problematic. Many say there’s a disconnect between the information widely circulated by clean beauty enthusiasts and scientific facts.

Is clean beauty really a sound movement, or is it just a marketing ploy? 

Dr. TWL: Since the introduction of the term ‘clean beauty’, there has certainly been quite a lot of controversy surrounding it. And rightly so. As a dermatologist, I have to emphasize that the definitions of clean beauty that many cosmetics brands use aren’t scientifically accurate. Neither does it serve any true purpose beyond its obvious marketing value. Certainly, it is beneficial for all of us and brands in their advertising and marketing, to take into consideration the issues about sustainability, cruelty-free products. But to formulate a product and to say that it is free of chemicals or synthetics – I think that is a little bit exaggerated, because it’s not possible.

Free of preservatives?

First of all, a product cannot be completely free of a preservative, as it has to remain stable enough to be sold on the shelf, and has to have a certain expiry date which is mandated by all cosmetic regulatory bodies internationally. However, there are other considerations. For example, if you have a solid-state formula, for example, when we formulated the LipSerum stick for the Lip Lab. By virtue of the fact that it is a microcrystalline solid-state formula, we minimize the amount of growth in bacteria and other microorganisms. This is compared to say, if it were a liquid or a gloss.

In the choice of a preservative, we are able to use a natural antioxidant – vitamin E. The purpose of this formula was to ensure that it was a 100% edible lipstick formula. To apply the concept to a liquid foundation or to a moisturizer is not very sound. Because, liquid formulas are a great culture media for most microorganisms. So, it’s not feasible to safely formulate a product without a preservative. Most of the time, it’s going to be a synthetic preservative. 

Parabens

Of course, there is emerging research about possible effects of these preservatives. For example, parabens etc on the endocrine system in the long term. But all of that remains a topic that has to be further borne out by research. As it is, almost all our skincare medications are preserved by parabens. Our topical steroids all have parabens, and a lot of dermatologist-recommended clinical care moisturizers as well. We currently omit the use of parabens in the moisturizer we formulate under the pharmacy, and in the cosmeceutical products. But, there usually is another substitute that would prevent it from deteriorating in storage. 

So what does clean beauty really mean? 

Moving on to what clean beauty should mean, I’m speaking of course on my own accord. But my training as a dermatologist I believe, allows me to arrive at this conclusion. I really would like the public to reflect on this concept of skin tolerability. Which to a dermatologist, reflects how well tolerated a product or an active ingredient is, by someone with sensitive skin or diseased skin. In particular, someone with a condition like rosacea, perioral dermatitis, or eczema. It is something that an individual with combination skin, or acne-prone, seborrheic type skin would be able to tolerate equally. It should be a formula that someone in their 20s, as well as their 60s is able to tolerate.

Tolerability of skincare

The tolerability of cosmeceuticals directly influences its effects on skin. You may have heard of synthetic cosmeceuticals. We have plenty of experience with the use of these because they are prescription items. For the last decade, these have been the mainstay of anti-aging formulas in clinical practice. For example, these would be retinoids or hydroquinone for skin lightening for pigmentation, melasma, solar lentigo, or ephelides.

You may see certain scientists or pharmacists on social media extolling the benefits of these synthetic chemicals and saying that while these are not clean active ingredients, they are widely prescribed and are very effective. Well all that is true, except that they do not see the side effects of these medications that we as dermatologists see. In particular, in this part of the world, its effects on Asian skin. Which I believe, are more pronounced than in Western counterparts. Because of the nature of Asian skin being more pigmented, and prone to developing post-inflammatory hyperpigmentation from use of these synthetic cosmeceuticals.

Retinoid dermatitis

I speak from personal experience. I was using a retinoid for over a decade. This was in my 20s, up to my early 30s, and I was able to tolerate the highest dose of retinoid at 0.05%. But once I hit my 30s, I found that I started to develop retinoid dermatitis. A lot of individuals will develop retinoid dermatitis even if they do not have sensitive skin. This is because of a cumulative effect of retinoids. It is a well established adverse reaction. I would say that perhaps, because pharmacists and scientists are not at the treatment end, where they are clinically reviewing and treating patients – it’s something that they don’t see. I feel that this is where our input as a dermatologist becomes valuable.

Is it wise to follow certain advice to wait out the irritation side effects, and “harden” your skin until you are able to tolerate it? I’ve read that somewhere by a non-dermatologist, and I believe it was a doctor who said that. On a personal level, and also based on my clinical experience as a skin specialist, that is not necessarily the best thing to do. What I have been doing in the last 3-5 years, is if a patient develops retinoid dermatitis, we simply would stop the retinoid and we won’t go back on that.

Alternatives to retinoids

The reason is because there are alternatives that produce retinoid-like effects but without irritation. Oligopeptides, for example, are involved in cell signalling. This can stimulate collagen the way a retinoid does, and it is very tolerable. I have never had a patient with an adverse reaction to an oligopeptide formula. Frankly, that’s the mainstay of my regimen- I have not used retinoids in the last 4-5 years. 

The other thing is of course, is that we now understand a lot more about botanical actives, mainly from the Korean biotechnology industry. Traditionally, the eastern world of beauty has focused on herbal remedies in skincare and healthcare. Western medicine is gradually realizing that certain TCM extracts, for example, Berberine does exert potent anti-inflammatory, anti-sebum effects that are effective for the treatment of acne. These have been borne out in cell studies as well as in a few case series. 

So what are the benefits that the clean beauty movement is bringing to the skincare and beauty industry? 

I feel that clean beauty itself is a good concept because it encourages people to reflect on their lifestyle practices. I’m all for sustainability and think that cruelty to animals is utterly unnecessary in the context of testing. I think it is well established now in the cosmetic industry that animal testing is not necessary. With the COVID-19 pandemic and the ultra-rapid development of a vaccine, I think it’s been clearly borne out that we actually don’t need to have all these animal testing protocols, before we go on to human trials.

This is not to say that our results are always going to be full-proof. But there is a certain logic in testing in the human population as there are what will be used in the human population. I think that is a point that the entire pharmaceutical industry should reflect on collectively. The aspect about beauty being free of cruelty is probably the most beautiful thing that has come out of this clean beauty movement.

The danger of DIY home remedies for skin

But there is another aspect which is the science-based aspect, and not to spread misleading information. If somebody thinks that they’re going to be able to come up with a clean formula by DIY-ing their own chemical peel with fruits or citrus in their kitchen – now that’s very dangerous. Or if they think that they can concoct their own DIY home skin remedies with apple cider vinegar etc to apply on their skin, we know that it can lead to irritation on the skin. I myself have seen quite a number of patients who have suffered irritant contact dermatitis from these home remedies.

You mentioned that one of the main features of a good skincare product would be about skin tolerability. Can you elaborate on that?

Back to this issue about skin tolerability, there are a few components which determine how well tolerated a product is. It has to do with the composition of the formula. So whatever you are trying to deliver to your skin, be it in the form of a peptide, an ingredient like an antioxidant vitamin C, ferulic acid, you have to bear in mind a few things.

What is the irritation potential of the active ingredient, and does your formula base reflect the ability for the cream or lotion to repair the skin barrier? You may want to deliver the active ingredient, but you mustn’t forget that it needs a vehicle. That’s why certain active ingredients are best delivered in the form of a serum, and others in the form of a lotion.

In our case, we use an emulsion formula, which is much more appropriate for our humid, tropical climate. Given that combination skin is the most common skin type, at least in this part of the world. It has the benefits of having significant oil levels in order to increase the penetration of the active ingredients. At the same time, it remains lighter than a cream formula. This allows rapid absorption, which is very important point for the sensorial aspect of cosmetic application, which a lot of men and women do care about. 

Closing thoughts

We have covered a few concepts in the podcast today, namely: 

1. Clean beauty isn’t a scientifically accurate definition of skincare or makeup formulations.

2. Dermatologists should be clear on their stand on the risk of skin irritation with synthetic cosmeceuticals like retinoids and hydroquinone- especially in skin of colour.

3. Considering the environmental impact of our beauty practices, from brand packaging to saying no to animal testing- should be focus of this movement.

4. I prefer to use the term conscious beauty, also because beauty truly, starts from the inside.

Well I hope the ending of this podcast has put a smile on your face just like it’s put a smile on mine. Till the next episode and remember to follow us on Spotify, Apple, or wherever you get your podcasts for the latest updates.

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