Ask Dr. Loretta
September: Do the ingredient no-no's for pregnancy also apply to women who are breastfeeding?
Dr. Loretta's answer: Yes, most often they do, and we do place warnings for both on our labels. However, for any product or ingredient in our products where there may be a concern, women who are breastfeeding should always ask their pediatrician first if it is safe to use those products while they are lactating especially the ones that were not recommended during pregnancy.
August: Sometimes customers watch TV shows like Dr. Oz and they want to know if we are adding the ingredients being featured on the show to our line and if not, why not?
Dr. Loretta's answer: Our CosMedical line of medical grade skincare is based on developing regimens to address specific problems and to give clinically significant improvement. We recognize that there are many beneficial ingredients in the marketplace and we do investigate many ingredients to see their clinical validity, bringing to market only a small number of these products which we are sure met the criteria of giving clinical improvement in short periods of time and are proven safe for use.
Remember too that our products also have a benefit to the skin because of what isn’t in them. We go to great lengths to research and avoid using ingredients that although they have been determined safe for use in cosmetics are known as possible links to cancer, promote nitrogen radicals in skin, are comedogenic or irritating.
July: With summer around the corner, you may want to know what the difference is between sunscreen and sunblock? Why does CosMedical distinguish between chemical-free sunscreen and regular sunscreen (only Daily Replenishing is chemical-free)?
Dr. Loretta's answer: There is currently no true distinction between the terms sunscreen and sunblock. Instead, when a formula does not have any chemical UV-absorbers, it is called “chemical free”.
The distinction between sunscreen and sunblock is pretty much outdated in favor of the newer classification but about a decade ago, it was proposed that sunblock refer to physical UV agents and sunscreen refers to chemical UV absorbers, but this distinction has not gone into practice.
Sun protection active ingredients can be classified into two major types: chemical and physical UV blockers. Chemical sunscreens contain special ingredients that act as filters to absorb UV and reduce ultraviolet radiation penetration to the skin. These sunscreens often are colorless and maintain a thin visible film on the skin. These sunscreens usually contain UVB and UVA- absorbing chemicals.
The physical, sun-blocking ingredients are only two: titanium dioxide and zinc oxide which physically block ultraviolet radiation (UVR). A chemical free formulation will have one or both of these as the active ingredient(s).
June: Why has Dr. Loretta decided to start taking the parabens out of her formulas?
Dr. Loretta's answer: A 2004 study showed that parabens were in 18/20 positive breast cancer biopsies and none of the negative, benign biopsies. That made Dr. Loretta work to get the parabens out. Here is one of hundreds of quotes from well-known surgeons on this subject...
According to the National Cancer Institute, some scientists believe parabens in antiperspirants and deodorants may be associated with breast cancer because they are applied frequently to an area next to the breast. Timothy Moynihan, M.D., a cancer specialist at Mayo Clinic in Rochester, Minnesota, explains that a 2004 study found parabens in 18 of 20 tissue samples from breast tumors. “Parabens, which act like estrogen in the body, are preservatives used in antiperspirants and deodorants,” says Dr. Moynihan. The study, however, did not prove that parabens caused breast cancer, nor did it identify the source of the parabens. It was concluded that more research is needed to determine whether or not parabens are linked to breast cancer through antiperspirants and deodorants.
Since deodorants are really considered the culprits, Dr. Loretta is not worried about the fact that we have used them in our skincare, but wants to take them out of her formulations for now, pending further investigation.
May: Which of our Glycolic products are buffered?
Dr. Loretta's answer: All of our glycolic products, except for our 35% Professional Glycolic are partially buffered. The FDA requires that glycolic products that are for at-home use must be buffered/"neutralized" to a pH of 3.5 or higher, and all of our at-home glycolic products are at a pH of ~3.5. The pH of 3.5 means that they are as acidic as allowed by law and this helps to define them as a medical grade product. The low pH results in a greatly increased cell renewal rate and therefore more exfoliation and faster clinical response. The products in this category are:
At Home Products:
1. Glycolic Gel, 10%
2. AHA Clarifier, 12% Glycolic Acid
3. Dual Action Toner, 5% Glycolic
4. AHA Marine Moisture Crème, 15% Glycolic Acid
5. AHA Marine Fade Lotion, 15% Glycolic Acid
6. Ultra Firming Marine, 15% Glycolic Acid
Professional:
70% Glycolic Gel has a pH of about 2, because it is partially buffered.
April: What is Exfoliation?
Dr. Loretta’s Answer….Here you go!
March: A customer's question
"Dr. Loretta, one big challenge for me is treating people with hyperpigmentation. Some people come in after seeing many doctors and after years on protocols like Obagi or TCA peels, without ever clearing. Have you got advice on how to give confidence to clients that I can really help them?"
JD, Miami, FL
Dr. Loretta’s Answer….Here you go!
Tips for Hyperpigmentation Management
1. FIND OUT WHY:
Get a good history of ethnic background and any new products, medications, or procedures that the person uses or had been using during the onset of the hyperpigmentation or for the six months prior to onset.
2. BRING IN “THE BAG”:
Many times these patients have used many things that could be a problem and they don’t realize it. Ask them to bring in a bag filled with all the products they use on their face and neck…this should include depilatories, fragrance they may spray on their necks, hair spray. Look for certain fragrances, like musk, which is notorious for staining skin; sodium lauryl sulfate, which can inflame skin and then cause pigmentation; and other possible irritants which could cause inflammation and/or photosensitivity.
3. EXAMINE THE SKIN:
Along with the history, a good skin exam can help to finally resolve even longstanding hyperpigmentation. For instance, many people diagnosed with melasma really have post-inflammatory hyperpigmentation (PIH) instead. If the correct diagnosis is really PIH, you have to clear the inflammation before you can get rid of the hyperpigmentation. Examples would be people who are experiencing lingering stains after acne breakouts or laser hair removal that leaves hyperpigmentation on the face. If the diagnosis is really staining after acne, you have to give the client a good at-home acne management regimen before you can resolve the hyperpigmentation problem. If you have difficulty identifying the cause(s) of the problem you can take a photo and email it to us at info@cosmedicaltechnologies.com and we will help you!!
4. DAILY REPLENISHING SPF 36 IS A MUST:
Daly Replenishing Sunblock SPF 36 (even if the person comes to you, as they often do, using SPF 80 or more!)…the Zinc in the formula will calm the skin which helps with management of hyperpigmentation. This is a product that all people with hyperpigmentations should use.
5. MANAGE MELANOGENESIS:
The process that creates melanin (or pigment) in the skin can be triggered by both inflammation and hormones. There are numerous substances that help to reduce pigmentation in the whole process. Some of these tyrosinase-inhibiting ingredients include antioxidants such as Vitamin C (Ascorbic Acid) and Resorcinol (found in J-Peel). Our Ultra Benefits Moisturizer has broad-spectrum protection. Other ingredients that prove beneficial are retinol and 2% hydroquinone.
Case presentation
This woman had a two year history of hyperpigmentation that was diagnosed as melasma. She also complained of clogged pores and breakouts. She hadn’t responded to traditional regimens. Her before and after photos were taken 12 weeks apart.
Here’s how she improved with CosMedical Technology products and peels:
She was placed on the following at-home regimen:
1. Salicylic Face and Body Wash: (2% Salicylic Cleanser): since excess pigment gets stored for weeks in the dead cells of the stratum corneum, this helps to lessen hyperpigmentation - and you’ll note it helped her pore appearance as well (am/pm)
2. Dual Action Toner: to micro-exfoliate (am/pm)
3. Vita-Soothe: this anti-oxidant hydrating serum brightens skin as it moisturizes. Vita-Soothe recreates skin’s protective barrier function to protect against environmental insults and therefore aids in preventing new hyperpigmentation (am/pm)
4. Ultra Benefits: This twice-daily moisturizer with our proprietary ABF™ complex provides the only broad spectrum anti-oxidant coverage on the market, soy for skin lightening and three skin firming peptides (am/pm)
5. Daily Replenishing SPF 30+: This physical sunblock contains 7.5% Zinc Oxide and 2.4% Titanium Dioxide to not only effectively block pigment-producing UVA but also to calm skin (am only)
In-Office Peels:
She had a series of 70% CosMedical Glycolic Washes weekly or biweekly, depending on scheduling issues, for a total of six CosMedical peels.
Other Important Information:
She stopped her laser hair removal treatments since we determined that her real diagnosis was not melisma but PIH after laser hair removal; her hyperpigmentation coincided with the areas of laser hair removal which had been performed approximately three months prior to the onset of the hyperpigmentation. She continues to do well after the peels and is scheduled to have a maintenance peel every three months.