The proper use of skin care products can not only play a role in repairing the skin barrier and relieving inflammation, but also reduce symptoms such as dryness, burning and itching of the skin, reduce drug dosage, prevent recurrence of skin diseases, and improve the quality of life. In view of the national situation and cosmetic management policies, in order to better regulate and guide dermatology clinicians in the use of cosmetics, the Working Committee on Cosmetic Dermatology of the Dermatologists Branch of the Chinese Medical Association reached a preliminary consensus on the clinical use of skin care products after a long and thorough brewing and discussion.
I. Concept
1, China’s definition of cosmetics: daily-use chemical industrial products that are applied, sprayed or other similar methods and dispersed on any part of the human surface (skin, hair, nails, mouth and lips, etc.) to cleanse, eliminate bad odors, skin care, beauty and grooming purposes. The new regulations will be toothpaste, mouthwash and other oral cleaning and health care products are also classified as cosmetics.
2, the concept of skin care products: according to the above definition, “skin care products” are cosmetics used for the skin and its appendages, and are the main category of cosmetics. In this article, the following types of cosmetics are collectively referred to as skin care products.
3.Medical skin care products: With the progress of cosmetic science and the development of related technology, the efficacy of cosmetics is both the driving force for the development of the cosmetics industry and the biggest demand for consumers to use the products. Therefore, as early as the early 1970s, the famous American dermatology professor AlbertKligman will have both cosmetic characteristics and certain efficacy of the product, with cosmeceutcal to say, cosmetics “cosmetic” and pharmaceutical ” Pharmaceutical” is a superposition of two words. Domestic scholars translate “cosmeceuticals” as “medicinal cosmetics”, “functional cosmetics”, “active cosmetics “etc. Most dermatologists in China refer to products for clinical use as “medical skin care products”. Although there are some differences in understanding and translation, in the past 20 years, some efficacious skin care products have been widely used in clinical practice and have accumulated rich evidence-based medical data. This consensus is based on numerous clinical applications and emphasizes that skin care products for clinical use should have the following characteristics.
(1) Higher safety: Although cosmetics already have strict safety requirements before they are marketed, skin care products for clinical use place more emphasis on streamlined formulations, strict screening of raw materials, and no or minimal inclusion of substances that can easily damage the skin or cause skin allergies, such as pigments, fragrances, preservatives, and irritating surfactants. Product packaging pay more attention to prevent pollution. As far as possible, clinical safety assessment of raw materials and finished products.
(2) Clear efficacy: Based on the physiological characteristics of different types of skin and the pathogenesis of skin diseases, the product components have a clear mechanism of action and have been tested and confirmed to play a supplementary therapeutic role for some skin diseases.
(3) Clinical validation: The clinical efficacy and safety of the products are verified through human trials before marketing to ensure less irritation and lower incidence of allergic reactions, etc.
Second, the categories of clinically used skin care products
Based on the claimed efficacy of the products, the skin care products used clinically in dermatology can be broadly classified into the following categories.
1.Cleaning category
Clinical cleansing products generally use mild surfactants that are less irritating to the skin. Pay attention to the physical and chemical properties of the product such as pH. Added such as chamomile, amaranth, natural spring water, moisturizing factors, etc., both cleaning and soothing effect, can achieve relief of dry skin, tightness and other effects.
2.Moisturizing, skin barrier repair class
Skin care products play a role in moisturizing and nourishing the skin through the following ways: ① Moisture absorbers, including glycerin, butylene glycol, sodium lactate, urea and other small molecules, can absorb water from the environment, so that the stratum corneum can form a water concentration gradient from the inside out, replenishing the water lost from the stratum corneum. ②sealant raw materials, such as fatty acid, petroleum jelly, aloe vera, avocado oil, etc., can form a thin hydrophobic oil film on the skin surface, which has the effect of reinforcing the skin barrier. ③Add the same or similar “bionic” raw materials with epidermis and dermis to supplement the shortage of natural skin components, enhance their own moisture, and have the effect of repairing the skin barrier, such as natural moisturizing factor; lipid barrier agents, such as cymbopogon oil, ceramide; biological macromolecules, such as hyaluronic acid, collagen, etc.
3.Soothing class
Contains certain anti-inflammatory, anti-irritant, anti-oxidant and other ingredients, such as aloe vera, amaranth, chamomile, licorice extract, alpha-red myrrh alcohol, etc., with better auxiliary anti-inflammatory and anti-allergic effects.
4.Oil control, anti-acne class
Add elemental zinc, vitamin B, evening primrose, tansy ketone, elm hydrangea, heavy floor extract, etc. has the function of inhibiting sebaceous gland, reduce the role of oil secretion; contains low concentrations of salicylic acid, fruit acids, retinoids, etc. has a certain dissolution of keratin, acne effect, etc., so that oily skin is improved.
5.Whitening and anti-spot class
Add arbutin, licorice flavonoids, tranexamic acid, vitamin C, green tea, Dianshan tea extract and other active whitening ingredients, through the inhibition of tyrosinase and other mechanisms to achieve whitening, spot removal, reduce the role of pigmentation.
6.Sunscreen category
Sunscreens such as titanium dioxide and benzophenone 3 are added to delay skin photoaging and prevent the occurrence of photodermatoses by physically covering and scattering light or chemically absorbing UV rays. [16]
7.Promote trauma healing class
Add aloe vera, peptides, amino acids, hyaluronic acid and other ingredients to promote the healing of trauma after laser and minimally invasive surgery.
8. Skin rejuvenation and anti-wrinkle
Add vitamin E, green tea extract and other antioxidants, vitamin A analogues, or ginseng, astragalus, ganoderma lucidum extracts to improve skin metabolism, to rejuvenate skin and delay skin aging. [18-20]
9. Concealer class
Add opaque raw materials such as talc, kaolin and other mineral powders to cover blemishes and beautify skin texture.
10.Other
Adding skin care products that inhibit sweat secretion and antibacterial raw materials can be used to improve hyperhidrosis, armpit odor; add ingredients that activate hair follicle metabolism to achieve the role of promoting hair growth. With the progress of cosmetic science and technology, more skin care products will be applied to clinical use in the future.
Third, skin care products can be used as adjuvant treatment of common diseases
1. Skin diseases with damaged skin barrier
Mainly include: ① dry skin diseases: such as atopic dermatitis, eczema, pruritus, etc.; [i], [ii] ② erythematous scaling diseases: such as psoriasis, hair red fur, erythrodermatitis, etc.; ③ facial dermatitis: seborrheic dermatitis, rosacea (rosacea), perioral dermatitis, chronic exfoliative lipitis, etc.; ④ keratinization abnormal skin diseases: such as ichthyosis, perioral keratosis, exfoliative keratosis, etc.; ⑤ Drug-induced dry skin flaking: such as retinoic acid, benzoyl peroxide, etc.; ⑥ Physiological dry skin: mainly seen in the elderly or seasonal climate change caused by dry skin.
Product selection: soothing cleansers; moisturizing, skin barrier repair skin care products.
2. Sensitive skin
Sensitive skin can be seen in ① sensitive or intolerant subhealthy skin; ② poor quality cosmetics or improper use of cosmetics, skin barrier destruction; ③ medical source: after laser and other minimally invasive surgery, various drug treatment caused by skin intolerance: such as hormone dependent dermatitis.
Product selection: soothing cleansers, soothing skin care products, moisturizing or skin barrier repair skin care.
3. Seborrheic dermatoses
Mainly include: acne, seborrheic dermatitis, rosacea (rosacea) and other skin diseases.
Product selection: oil control cleansers, oil control, anti-acne cosmetics, soothing or skin barrier repair.
4. Pigmented dermatoses
Pigment increase skin diseases, such as melasma, post-inflammatory hyperpigmentation, melanosis, etc. Product selection: skin care products for whitening and spot removal. Combine with moisturizing class and soothing class for basic care, and apply sunscreen externally.
Hypopigmented skin diseases, such as vitiligo, etc. In parallel with drug treatment, concealing skin lesions can be covered with concealing skin care products.
5. Photodermatosis
Including photosensitive dermatitis, polymorphic heliotrope, chronic actinic dermatitis, etc.; lupus erythematosus, dermatomyositis, etc.; skin photoaging.
Product selection: sunscreen. Use moisturizers to improve the symptoms of dry, flaky skin. Skin rejuvenation products for delaying photoaging.
6, laser and other minimally invasive post-operative skin care
Product selection: Soothing cleansers, soothing wet masks, moisturizers or skin barrier protection products for basic care. Skin care products that promote trauma healing to accelerate skin repair, and sunscreen products after the acute phase.
7. Others
For armpit odor and hyperhidrosis can use anti-odor and antiperspirant skin care products. Certain types of hair loss can use hair care products.
Fourth, the application of skin care products precautions
1, dermatologists must understand skin care products, master the basic characteristics of the main efficacy of raw materials, the use of various dosage forms. Familiar with the approval number and the full composition of the product logo. Reject the use of exaggerated efficacy propaganda, or fake and shoddy products with incomplete documentation;
2, according to the classification of the skin, the nature of the skin disease, the patient’s age [32] and other specific circumstances, a reasonable choice of skin care products;
3.Strengthen the science education, do a good job of doctor-patient communication, so that they understand the efficacy and use of skin care products, and improve compliance.
4, to understand the patient’s situation after using the product, if there are adverse reactions, timely discontinue use, and make the corresponding treatment.