FAQs

Every skin type, with or without “problems” can benefit from using dermaviduals.

dermaviduals is an excellent choice for both maintenance of healthy skin & prevention of skin barrier disorders as well as problematic & more demanding skin conditions.

Dermatological skin care is the term used to describe products free of non-physiological emulsifiers, preservatives, mineral oils, perfumes, dyes and additives.  These products have been proven to support the composition of the skins barrier layers by having a physical structure identical to that of the skins natural membrane.

Or, it is a range of skin care products, one step above cosmeceuticals,  that are targeted and specific to a range of skin types and conditions which allows the user to work further into skin correction than simply providing a cosmeceutical benefit.

Using a combination of different skin care lines is always discouraged as they use different ingredients that have not been tested and may prove to be incompatible.

As dermaviduals contain active ingredients able to be transported directly into the skin it is strongly advised that your regime consist only of dermaviduals to avoid any potential skin irregularities.

When changing from traditional products containing ingredients not compatible with the bilayers of the skin such as fragrances, mineral oils and preservatives,  it will sometimes take a few weeks to for your skin to adjust. Your Skin Treatment Therapist is the best person to guide you through this transition.

dermaviduals’ unique manufacturing processing allows for a shelf life of up to 24 months, with most of our products, once the product has been opened.  Unopened, most remain viable for 36 months.

However, there are certain “actives” contained in some of our products that need to be used within 3 months of opening. These are rose hip oil and linseed oil.

Prof. A. M. Kligman (a renowned American professor of dermatology and who first discovered Retin A) coined the term corneotherapy.

Corneotherapy is aimed at the recovery of the stratum corneum.  It improves the skins barrier function and overall homeostasis of the skin.

Kligman showed that  persistent corneotherapeutic treatment of disturbed homeostasis as the characteristic feature of atopic dermatitis (using appropriate skin care substances) may achieve substantial clinical effects.

For the purposes of preventive corneotherapy, it is essential to avoid skin care products with harmful substances such as irritants and allergens and to select the appropriate skin care substances to individually adapt the skin care products to the specific skin problems. 

Liposomes are microscopic spherical bodies similar to biological cells. They are used as a vehicle for the transportation of “actives” contained within dermaviduals products. Like natural plant and animal cells, liposomes consist of a “bilayer” which is encased in phosphatidylcholine.

As phosphatidylcholine is naturally found in human skin bilayers (or the “acid mantle” of skin), liposome’s mimic & easily merge with the skins natural barrier layers, allowing for heightened penetration of the cosmetic and dermatological ingredients.

Nanoparticles are spherical bodies that are covered with a monolayer of phosphatidylcholine (phosphatidylcholine forms a part of the natural composition of our skin). They are used to transport lipid-based actives compatible with the skin. The nanoparticles contained within dermaviduals products are dispersed in a milk-like fluid which protects the active ingredient to stay in its pure form for the most effective delivery to your skin.

Nanoparticles are only visible under an electron microscope. Like liposomes, nanoparticles transport active agents into the stratum corneum. dermaviduals use only fluid, bio-degradable nanodispersions. This is explained below.

Nanoparticle (noun)

(Chemistry) – a particle of something such as a metal, polymer, or oxide, with dimensions in the nanometre range.

To answer this question, we must also consider the different kinds of nanoparticles.

Nanoparticles have a longer history than many would suppose. Since human beings have inhabited the earth they have been exposed to small particles from a variety of sources. Aerosols (small airbound particles) have always been with us. Some examples include smoke and soot developed from fires, dust from deserts (which can travel over hundreds of kilometres), microscopic seeds, grains and pollens - are also always in the air in some form. Soil blown by wind from the fields contains mineral particles. Volcanic ash is capable (as was evidenced by the recent eruption of Eyjafjallajökull Volcano in Iceland) of soaring and floating high into the atmosphere’s upper air layers of the planet, staying there for months. They are all nanoparticles

Any friction of natural or synthetic solid bodies generates tiny visible bodies but also miniature particles that cannot be detected by the human eye. Therefore, among aerosols and dusts, nanoparticles are omnipresent.

Some can certainly have adverse effects on the human body. Examples include: diesel dust (lungs), hard coal dust (lungs), asbestos particles (lungs), anti-cancer nanoparticles - injected medical iron particles (liver) and other insoluble powder-like technical nanoparticles (lungs). All the components of these nanoparticles are non-biodegradable. They behave in the body like foreign matter.

Others have been shown to be harmless to the human body.

In the skin care industry two kinds of nanoparticles are used. They are; non-biodegradable and biodegradable.

Biodegradable means the components of the nanoparticles are metabolized in the same way as other compounds contained in creams, lotions etc. But how is the biodegradability of the components recognised by the skin? In principle that's very easy to understand if you are familiar with the INCI declaration. However to the layperson, it's difficult to conceptualise so here are some examples:

Biodegradable components include:

• Phosphatidylcholine (PC; INCI: Lecithin) forms membranes around mostly vegetable oil bodies. With reference to liposomes these "fluid" or "liquid" nanoparticles are sometimes called nanosomes or nanodispersions. Other components can include physiological ceramides, phytosterols, fatty acids and vitamins.
• Liposomes differ from fluid nanoparticles by encapsulating water soluble active agents like vitamin C; their structure is derived from natural cells. (see Liposome definition below)

The advantage of these systems is the fact they don't need rely on emulsifiers to be delivered. Emulsifiers and Tensides are not tolerated by many consumers particularly with problem skin because of irritation potential and their known wash-out-effect of skin components when cleansing.

• Non-biodegradable components include:
• Metal oxides like titanium dioxide (INCI) which are used for mineral sun protection. Titanium dioxide is a component of solid nanoparticles.
• Solid lipid nanoparticles (SLN) contain high melting hydrocarbons and waxes. They combine on the skin into a surface film from which the active agents are released - similar to an occlusive mineral wax containing W/O-system. Currently there are no conclusions that they are able to cause any harm.

To the present day there are no empirical findings that cosmetic non-biodegradable nanoparticles like titanium dioxide embedded in the matrix of many sun protection creams can penetrate into the skin. This also applies to diseased skin, e.g. psoriasis. Nanoparticles based on solid hydrocarbons, waxes (SLN) are also blocked off by the horny layer. They aggregate to form superficial films and then release their active agents into the skin.

From time to time you read other information on nanoparticles. Much of this is poorly researched and can create confusion in the industry and with members of the general public. Some health and beauty journalists tend to disingenuously or mischievously mix the facts of potentially harmful nanoparticles with the non-harmful nanoparticles that can be used in the cosmetics industry. They do not consider or explain the chemical composition and the biodegradability but instead focus only the word "nano".

This is why we emphasise again that solid nanoparticles in the pharmaceutical field can have undesired effects. Whereas fluid nanoparticles cannot penetrate through the skin. They harmlessly dissolve upon contact with the barrier layers of the stratum corneum from where they release the active agents selectively in molecular form.

For further details please refer to Dr Hans Lautenschläger’s publication "Precious load - transport of active agents"

Quite different are fluid nanoparticles and their hydrophilic relatives, the liposomes. They penetrate into the barrier layers of the horny layer where they dissolve immediately due to their specific composition. During this process a fluidization of the skin barrier layers takes place and the encapsulated active agents are released and can pass through the skin barrier.  A specific advantage of fluid nanoparticles is that besides lipophilic active agents, natural oils can be forced into a sensorial agreeable aqueous dispersion without adding synthetic or barrier disturbing emulsifiers (which easily penetrate into the skin and can cause irritation).

With all the commotion about small particles it should always be kept in mind that the skin is continuously exposed to substances the size of molecules. Depending on their size and polarity they more or less pass through the skin barrier or are completely retained. Small molecules occur in sizes less than 1nm (nanometre). Atoms and ions, about 0.1 nm are even smaller.

For example, table or sea salt, dissolved in water, is about in the same order of nanometres.  Nobody would argue that skin contact with saline is really dangerous - in fact saline is widely recognised in medical fields as a perfect rinsing solution.

We recommend looking only at the composition (INCI) of cosmetics to be sure about the tolerability. The skin (...and the body) is unconcerned whether cosmetic formulas consist of emulsions, nanodispersions, micro emulsions or solutions. The skin (... and the body) reacts only on the quality and quantity of the ingredients that are listed as components in the INCI.

dermaviduals strives to provide the highest quality of ingredients (INCI) from around the world to bring you safe, effective skin care.

Furthermore all dermaviduals’ nanoparticles and liposomes are fluid and fuse with the top layer of the skin allowing penetration of actives to the stratum spinosum. The actual liposome or nanoparticles do NOT travel to the spinosum; just the actives that were once encapsulated within nanoparticles or liposomes prior to the infusion of the active ingredients.

Cosmetic liposomes always consist of a mixture of unilamellar and multilamellar liposomes as the manufacturing process for pure unilamellar liposomes is much more elaborate and hence more expensive. In contrast to what can be seen in the advertising and media fields, the number of shells has no influence on the encapsulation, penetration and efficacy of active agents. The concentration of phosphatidylcholine (PC) is the crucial factor in the efficacy of liposomes. Unfortunately, PC has no specific denomination in the INCI but is listed as lecithin. The penetrating mechanism is described in the publication "Applied corneotherapy and skin care - guidelines for the anti-aging treatment" by Dr Hans Lautenschläger

Emulsifiers are widely and very commonly used to bind water-based ingredients with oil-based ingredients to form a stabilised, creamy suspension. As technology has advanced, cleansing the skin “reactivates” the build up of these emulsifiers, causing them to dissolve our natural lipids. Over time this can create sensitive skin.  It also causes our skin care regime to have a “wash-out effect”.  This can cause water loss and barrier disturbance.

Perfumes have been found to be the No. 1 sensitiser to skin and its condition.  They may cause issues with skin barrier function.  Already compromised skins can suffer greatly when low-grade fragrances are included in cosmetic creams.

dermaviduals is a prescriptive skin care line that is custom-blended and individually tailored for each skin type and condition.  At Derma Aesthetics we believe that to obtain the best results you should be professionally diagnosed by a qualified Clinician to yield unparalleled results.

Rosacea can present with only a few or a combination of symptoms.

Not all people will develop all of the skin changes associated with Rosacea,  however experiencing more than one symptom at the same time is typical.

They include: redness of the face, flushing, the presence of small blood vessels, acne, surface irregularities of the nose, skin sensitivity and enlarged sweat glands.

Rosacea symptoms can be diminished by; controlling oil production, reducing inflammation, reducing cellular build-up and minimising naturally occurring bacteria on the skin. More recent research indicates that water content in topical solutions to the skin should also be minimized.

Rosacea often begins with easy blushing of the facial skin. These symptoms may come and go at first. Eventually, redness persists around the nose, extending to the rest of the face. As rosacea progresses, additional facial symptoms such as burning, stinging, pimples, swelling, dry skin, enlarged blood vessels, and eye involvement may occur. These symptoms fall into the following four subtypes:

• Grade 1: Facial Redness (Erythematotelangietatic rosacea). Flushing and/or continuous facial redness occurs. Blood vessels are visible, especially around the nose.

• Grade 2: Bumps and pimples (Papulopustular rosacea). Pimples occur, and pus-like lesions may be present, along with the facial redness. You may feel burning and stinging, and blood vessels on your face may be enlarged. This stage of rosacea may also be known as acne rosacea.

• Grade 3: Enlargement of the nose (Phymatous rosacea). Your skin begins to thicken and develops an irregular texture. This thickening is most evident on the nose and can also occur on the ears, chin, cheeks, and forehead. You may have enlarged skin pores in addition to the large blood vessels.

• Grade 4: Eye irritation (Ocular rosacea). One or both eyes are affected in this category. They may be bloodshot, teary, itchy, dry, burning, or stinging, and you may have blurred or decreased vision. It's common to feel as though you have a foreign body in the eye. This is a serious eye condition; you should see an ophthalmologist. 

In treating Rosacea, it is very important to follow a regimented skin care routine prescribed by a qualified dermaviduals clinician. The founder of dermaviduals, Dr Lautenschläger, has focussed a major part of his studies on inflammatory skin disorders and diseases thus ensuring that dermaviduals is world-renowned for its research into, and treatment of Rosacea and other skin disorders.

Homeostasis is the term given to our body’s natural state of health or balance.
A healthy skin can only be achieved by ensuring the skin’s stability in response to fluctuating external factors. At dermaviduals, we are able to achieve this by first assessing the skin’s specific requirements and then by prescribing use of certain actives in conjunction with a basic dermatological skin care regime.
The following are components of healthy skin.

Smooth Texture

If you look closely at healthy skin, its surface is "regularly irregular." This means that the skin is not smooth like glass but has tiny peaks around hair follicles and pores, and tiny valleys in between the peaks. These peaks and valleys are consistent throughout the skin giving it a uniform appearance. On the other hand, unhealthy skin does not have a uniform texture.

Hydration

Healthy skin is well hydrated. It is natural and normal for the skin to regularly slough off its cells.  In hydrated skin, this sloughing is not noticeable. In poorly hydrated skin, to many skin cells slough at the same time creating problems such as:

• Flaking skin
• Scaly skin

Normal Sensations

If your skin is healthy, you shouldn't notice or feel it. Healthy skin doesn't have any unusual sensations. Signs of unhealthy skin sensations include:

• Itching
• Burning
• Stinging
• Pulling

The skin is made up of 3 layers - the epidermis, dermis, and subcutaneous tissue.
The epidermis is the outer layer and functions as a barrier to the external environment, protecting our cells and systems. The cells of the epidermis; keratinocytes, move from the bottom layer of the epidermis to the top layer, building up a large amount of keratin and developing a tough outer shell. Once these cells reach the top layer, they flake off. If this process becomes abnormal the skin can look scaly.

There are four major layers of keratinocytes (the structural cells) in the epidermis and one layer that is present only in certain parts of the body. The bottom layer, the stratum basale, has cells that are shaped like columns. In this layer the cells divide and push already formed cells into higher layers. As cells move into the higher layers, they flatten and eventually die.

The cells in the Stratum Corneum layer are known as corneocytes. The cells have flattened out and are composed mainly of keratin protein, which provides strength to the layer but also allows the absorption of water.

The Stratum Lucidum layer is only present in thick skin where it helps reduce friction and shearing forces between the Stratum Corneum and Stratum Granulosum.

The cells in the Stratum Granulosum, or granular layer, have lost their nuclei and are characterised by dark clumps of cytoplasmic material. There is a lot of activity in this layer as keratin proteins and water-proofing lipids are being manufactured and organised.

Cells that move into the Spinosum Layer change from being columnar to polygonal. In this layer the cells start to synthesize keratin.  Importantly, this is the area where the actives of dermaviduals are transported.  Feeding the Spinosum with the correct active ingredients results in a healthier Stratum Corneum and improves the structural integrity of the skin. 

The Stratum Basale is the bottom layer of keratinocytes in the epidermis and is responsible for constantly renewing epidermal cells. The dermis is the second layer of skin, which contains the structural elements of the skin such as connective tissue. There are various types of connective tissue with different functions. For example, collagen gives the skin its strength, proteins called glycosaminoglycans give both collagen and elastin the support and maintenance it requires, and elastin fibres give the skin its elasticity.
Glycosaminoglycans (GAGs or interstitial fluid).  The main function of glycosaminoglycans is the maintenance and support of Collagen and Elastin. It also promotes the ability of the collagen and elastin fibres to retain moisture.

The interstitial fluids are essential to the epidermal & dermal cells’ metabolism and maintaining the connective tissues (collagen and elastin) in good condition. They seep from the capillaries by micro-circulation and are dependent on efficient respiration transpiration and hydration. They are also linked to the lymphatic system.

The two layers of the dermis are the papillary and reticular layers. The upper, papillary layer contains a thin arrangement of collagen fibres. The lower, reticular layer is thicker and made of thick collagen fibres that are arranged parallel to the surface of the skin.
The dermis contains many specialised cells and structures, including hair follicles. Sebaceous (oil) glands and apocrine (scent) glands are associated with hair follicles. This layer also contains eccrine (sweat) glands. Blood vessels and nerves network through this layer.
Dermal-Epidermal Junction. The junction between the dermis and the epidermis is an important structure. The dermal-epidermal junction interlocks, forming finger-like projections called rete pegs. The cells of the epidermis receive their nutrients from the blood vessels in the dermis. The rete pegs increase the surface area of the epidermis so it is more readily exposed to its required nutrients.
Subcutaneous Tissue.  The bottom layer of skin is the subcutaneous tissue containing fat cells. These fat cells provide insulation to the body and make the skin look plump. This layer is important as it regulates the temperature of the skin and body. The size of this layer varies throughout the body and from person to person.

Sunlight has a profound effect on the skin. It can cause premature skin ageing, skin cancer, and a host of other skin changes. Exposure to ultraviolet light, be it UVA or UVB, from sunlight accounts for 90% of the symptoms of premature skin ageing.

Many skin changes that were commonly believed to be due to ageing, such as easy bruising, are actually a result of prolonged exposure to UV radiation.

Dark spots on the skin, also called hyperpigmentation, are a common skin problem. There are a variety of conditions and agents that can cause them to develop. One of the most under-recognised causes of dark spots is post-inflammatory hyperpigmentation. This occurs after some type of trauma to the skin - especially infections like acne. This and other skin diseases are listed here:

• Melasma
• Riehl's melanosis
• Poikiloderma of Civatte
• Erythromelanosis follicularis
• Linea Fusca
• Post inflammatory hyperpigmentation

Certain medications can also sensitise the skin to the sun and other medications can cause dark spots without sun exposure. The most common offending medications are:

• Estrogens
• Tetracyclines
• Amiodarone
• Phenytoin
• Phenothiazines
• Sulfonamides

UV light is a major cause of not only dark spots, but other types of skin damage. The various types of dark spots caused by UV light are:

• Melasma
• Solar lentigines - freckles
• Ephelides

Other conditions or diseases that can cause dark spots:

• Pregnancy
• Liver disease
• Addison's disease
• Hemachromatosis
• Pituitary tumors

Free radicals are unstable oxygen molecules that have only one electron instead of two. Because electrons are found in pairs, the molecule must scavenge other molecules for another electron. When the second molecule loses its electron to the first molecule, it must then find another electron, thus repeating the process. This process can damage cell function and alter genetic material. Free radical damage causes wrinkles by activating the metalloproteinases that break down collagen. They can cause cancer by changing the genetic material, RNA and DNA, of the cell.

Free Radicals UV radiation is one of the major creators of free radicals.

Chronological Ageing and Wrinkles

As people age, their epidermal cells become thinner and less sticky. The thinner cells make the skin look noticeably thinner. The decreased stickiness of the cells decreases the effectiveness of the barrier function allowing moisture to be released instead of being kept in the skin. This causes dryness. The number of epidermal cells decreases by 10% per decade and they divide more slowly as we age, making the skin less able to repair itself.

The effects of ageing on the dermal layer are significant. Not only does the dermal layer become thinner, but less collagen is produced, and the elastin fibres that provide elasticity wear out. These changes in the structure of the skin causes it to wrinkle and sag.

Sebaceous glands start to get bigger but produce less sebum, and the number of sweat glands decreases. Both of these changes lead to skin dryness.

The rete pegs of the dermal-epidermal junction flatten out, making the skin more fragile. This process also decreases the amount of nutrients available to the epidermis by limiting the surface area in contact with the dermis, which interferes with the skins normal repair process.

In the subcutaneous layer the fat cells get smaller with age. This leads to more noticeable wrinkles and sagging, as the fat cells can no longer "fill in" the damage from the other layers.

All acne is a disorder of the pilosebaceous unit, which is made up of a hair follicle, a sebaceous gland and a hair. These units are found everywhere on the body except on the palms, soles of feet and the lower lip. Pilosebaceous units are in greatest numbers on the face, upper neck, and chest.

Sebaceous glands produce a substance called Sebum, which is responsible for keeping the skin and hair moisturised. During adolescence, sebaceous glands enlarge and produce more sebum (under the influence of rapid hormonal changes), also called androgens. After about age 20, sebum production begins to decrease.
Acne & Bacteria - a bacteria, known as Propionibacterium acnes (p-acne), is a normal inhabitant of the skin. It uses sebum as a nutrient for growth, therefore increases in follicles during puberty. People with acne have more Propionibacterium acnes in their follicles than people without acne. The presence of bacteria attracts white blood cells to the follicle. These white blood cells produce an enzyme that damages the wall of the follicle, allowing the contents of the follicle to enter the dermis. This process causes an inflammatory response seen as papules (red bumps), pustules, and nodules. The bacteria also causes the formation of free fatty acids, which are irritants, increasing the inflammatory process in the follicle.

Normal Follicles - sebum produced by the sebaceous gland combines with cells being sloughed off within the hair follicle which "fills up" that follicle. When the follicle is "full", the sebum spreads over the skin surface giving the skin an oily appearance. When this process works correctly, the skin is moisturised and remains healthy.
Obstructed Follicles - problems arise when the sebum is trapped in the hair follicle.  The sebum is produced, but gets trapped on the way out, and the cells that are normally sloughed off become "sticky" and plug up the follicle.  The process of obstructing follicles is called comedogenesis. It causes some follicles to form comedones, more commonly known as blackheads or whiteheads.

IMG HERE

Figure showing stages of acne. (A) Normal follicle; (B) open comedone (blackhead); (C) closed comedone (whitehead); (D) papule; (E) pustule.

Dermatologically tested - what does it mean?

Dermatologically tested means that a dermatologist has overseen product tolerance tests, which are carried out during product trialling, generally using human volunteers.

However, many products will claim to be dermatologically tested without providing any further information on the tests themselves.  They may not provide information on the product contents, method of testing, control studies (if any), application of the product, where it has been applied, how often and on which body parts. Other hard data may not be supplied such as tolerance levels, efficacy and efficiency. 

Without appropriate detail, the term ‘dermatologically tested’ has no practical value.  It should always be possible to ask the manufacturer for details on the test design and the results.

Interestingly, every product on the Australian market is dermatologically tested with or without this statement printed on the container or within its label.

According to the Cosmetic Decree in Germany (KVO) tolerance tests are a significant basis for the safety assessment of cosmetic products besides the declaration of the toxicological data of the ingredients.

The phenomenon of dry skin is occurring more and more frequently. Experts agree that today's skin care habits play a significant role. As such, particular care should be taken to select products that have a specific focus on the composition of the products used in treating dry skin. Those to be avoided include:

• Mineral oils (the most frequent components besides water), vaseline and mineral waxes may well leave a pleasant and smooth feeling on the skin.  However, their long-term use will slow down the natural recovery functions of the skin.
• Emulsifiers are additives with the very useful characteristics of combining lipid substances and water into a cream and transporting them into the skin. On the other hand they have also been shown to leach the cream components and natural protective substances out of the skin.  Consequently, frequent cleansing with products containing emulsifiers will lead to dry skin.

dermaviduals DMS dermal membrane structure creams can significantly alleviate dry skin.  DMS will realign the  lipid bilayers of the skin and the pure concentration of active ingredients can deliver a powerful range of targeted products to your skin without sensitising it as DMS is FREE of preservatives (including parabens), mineral oils, colours, fragrances, silicones and amines.

dermaviduals, why you ask will this be different to everything else I have tried?  As dermaviduals are formulated FREE from perfumes, preservatives,including parabens, colours, mineral oils, amines and  silicones,  you will not experience any of these issues.  If you happen to have a problematic skin due to the common water phase found in skin care we even have the answer for your skin.  Of course seek professional advice from a dermaviduals aesthetician.

Sensitisation and allergies

Generally speaking, there are three different problem groups. There are individuals who show allergic reactions to certain substances. The most harmless reactions in this context are skin redness, blisters or welts which can escalate via breathing troubles and asthma attacks during inhalations to severe reactions like anaphylactic shock that can also occur for example after insect bites. We are dealing here with a sensitisation or allergic reaction that is triggered by an exaggerated immune response of the human body. The immune response can be clinically verified. However it often takes a good deal of detective work to identify the substances responsible for this reaction and to eliminate them. Examples here are widely used preservatives and certain groups of perfumes but also food like hazelnuts or soybean and milk proteins. In most cases the dermatologist or skin treatment therapist uses a simple patch test to find out which substances will lead to these unwelcome reactions.

Irritations

These are reactions that cannot be traced to certain substances but are triggered by the concentration or pH level of a substance.. Examples here are burning eyes after contact with salt or onion fumes, burning in cases of cracked skin after contact with urea (often found in dermatological creams), acids or brine. In extreme cases it will lead to skin detachments (keratolysis) or chemical burns which may also happen after AHA acid treatments. Irritations are reversible processes and are quite different from allergic reactions.

Sensitive and diseased skin

Individuals with an inherently specific skin condition due to heredity, metabolism disorders, enzyme defects, organic or mental disease belong to this problem group. Their skin is extremely sensitive and will not tolerate every substance. They belong to the estimated 5 to 10 percent of the population who have substantial difficulties with widely used but rather harmless substances.
Frequent use of inadequate skin care and above all excessive skin cleansing causes problems for these individuals. Thus the water-based skin cleansing will involve a ‘washing out’ effect of the natural protective substances of the skin because of the effects of the tensides contained in cleansing products. It is still largely unknown that unconventional non-foaming cleansing products without re-fattening substances are more gentle to the skin than foaming and re-fattening substances. So the first priority for skin that is sensitive or prone to irritation should be analysing the cleansing process to ensure the pH is not disturbed and the skin is not suffering from being overcleansed. Also the emulsifiers contained in skin care products which are related to the cleansing tensides support the washing out of natural protective substances. Hence many people suffering from neurodermatitis could be helped by providing emulsifier free skin care creams and by reducing the length and frequency of cleansing. In the same way that emulsifiers transport lipid substances into the skin they also wash out lipids and skin protective substances out of the skin. The skin barrier of neurodermitis is rather susceptible for this process.

Individuals with sensitive skin should basically avoid all the additives in skin care products like perfumes, preservatives, mineral oils and silicones. Both the latter mentioned substance groups reduce the natural recovering ability of the skin. In summary,many of the current skin problems and skin disorders of pre-disposed individuals are triggered or developed by inadequate skin care and hygienic procedures. Skin analysis, individual consultation and treatment by experienced professionals can perform miracles in this area and frequently stop the counterproductive dependence on cortisone creams.

Multiple chemical sensitivity

Far more complicated are circumstances for individuals with multiple chemical sensitivity (MCS). These individuals show reactions like nausea, concentration loss, exhaustion, depression, breathing troubles, skin reactions, flushing, running eyes and sleeping disorders specifically to scents and fumes of solvents, dyes and perfumes. The reactions can last from several hours up to several days. Things that just result in a tickling nose for most people or even a pleasant feeling (perfumes) may considerably affect their daily life and even lead to organ damages or chronic diseases in an advanced stage. Different from allergic reactions, this kind of sensitivity which frequently is not specific to certain substances cannot be clinically verified as an immune reaction. In most cases the persons concerned try to protect themselves by avoiding the triggering substances they know insofar as they keep away from public events. The intolerance to certain chemicals may extend to the food sector and also to pharmaceutical drugs. There are many reasons for MCS and there is still much research to be conducted.

Phobias do not belong to MCS disorders. People suffering from phobias translate certain sensory inputs like scents, flavours, body contact and feelings which seem absolutely normal to most people, into alarm signals. The consequences are irrational body or skin reactions.

It is assumed that the nerve system of people affected by MCS has been directly damaged by chemicals. MCS frequently shows low dose effects of unspecific chemicals that will not activate the immune system or cannot stimulate a pre-damaged immune system but may have neurotoxic effects. The chemicals come into contact with a hypersensitive or pre-damaged nerve system with a strong feedback effect that transmits a previously specific stimulus to similar sensory substances, and thus will become more and more sensitive.
Several nerve toxins are able to invert olfactory sensations which means that the substances present only are perceived during an initial phase however after being removed the sensation again is noticed as it would still be there. Nerve toxins among others are chemicals belonging to the following substance groups: esters, ethers, halogenized, aliphatic and aromatic hydrocarbons, alkaloids and kresyl phosphates.

The only way to provide cosmetic or dermatological help for this group of people is to apply products free of perfumes, preservatives and other potential trigger substances. As requirements for an individual cream composition may substantially differ, modular systems have proved successful as they allow to prepare individual formulations that are perfectly adapted to the specific skin condition and remain well tolerated by the skin.

In this context, a comprehensive skin analysis is critical.

Scleroderma - simply put - is a progressive hardening of the connective tissue. The causes have not yet been identified. The collagen fibres, among other things, are involved in the changes of the cutaneous connective tissue. The care for this type of problem skin focuses on:

• supporting the skin recovery with vitamin A
• preventing inflammatory processes with boswellia acids, gamma linolenic acid (evening primrose oil), alpha linolenic acid (omega 3 fatty acids, linseed oil)
• supporting the micro circulation with caffeine (green tea extract) and
• nurturing oedematous skin with echinacea extract & butcher's broom extract.

Information provided in this context is based on empirical values and does not claim to apply for all scleroderma cases. Hence it is recommended to adjust the skin care to the specific therapy of the dermatologist or skin treatment therapist.

According to a hit list of allergens compiled by the German Surveillance System of Dermatological Hospitals (Interessenverbund der dermatologischen Kliniken - IVDK) the following substances are the most frequent triggers of allergies (conducted by an evaluation of 9676 tests in the year 2000):

Nickel sulfate

15.5%

Duftstoff-Mix (fragrance mix)

10.5%

Balsam of Peru

8.8%

Thiomersal

7.4%

Cobalt chloride

5.4%

Woolwax alcohols

4.2%

Colophony

4.2%

MDBGN(Dibromodicyanobutane)*

4.2%

p-Phenylendiamine

4.1%

Potassium dichromate

3.5%

Thiuram-Mix

2.5%

(Chlor-)Methylisothiazolinone*

2.3%

Neomycine sulfate

2.3%

Mercury(II) amide chloride

2.2%

Terpentine (tee tree oil)

2.1%

Formaldehyde*

1.8%

Propolis

1.,8%

Bufexamac

1.4%

Benzocaine

1.4%

Epoxy resin

1.2%

Cetearylalcohol

1.2%

Paraben-mix*

1.2%

*) preservatives in cosmetics, among others

Source: Ärztliche Praxis - Dermatologie (5), Sept.-Oct. 2001, p. 30

Oily skin can generally be treated with low fat skin care products with liposomes that are rich in linoleic acids. As liposomes increase the permeability of the skin to receive the active ingredients, it makes sense that these, products are free of preservatives and perfumes in order to avoid sensitisations. Emulsifiers are widely used in cosmetics and can cause bad skin or acne particularly after sun exposure due to the wash out effect explained above.

Tacrolimus belongs to the so-called macrolides. It is a substance that can reduce negative immune reactions of the body. For example, it is used to treat individuals who have received organ transplants.

In the treatment of neurodermitis, tacrolimus also reduces the immune response in acute phases of the disease which can lead to an improvement of symptoms. Despite this, the basic cause of neurodermitis cannot be treated. Yet, the sensitivity of the skin to infections is increased similar to the cortisone treatment. In contrast to cortisone however tacrolimus will not cause atrophic skin.

Alcohol is used in many cosmetic products. It acts as a solvent and along with propylene glycol, it is the most frequently used extracting-agent for natural compounds such as flavonoids, vitamins and provitamins.

Alcohol, in certain concentrations has antimicrobial characteristics, which means that it can replace the need to use harmful preservatives in products. Contrary to some opinions it does not dehydrate the skin when used in small concentrations. Dehydrating effects only appear with high concentrations (typically more than 20%) such as those used in some shaving lotions and most perfumes. dermaviduals uses food grade alcohol in concentrations of less than 5- 10% which does not have any negative effects on the skin.

In cosmetic formulations, PEG (polyethylene glycols) and specifically their derivatives, ethoxilized alcohols, are frequently used as surface-active agents. They act as solvents, emulsifiers, tensides and re-fattening agents in skin care as well as in cleansing products.

Their disadvantage is that they are not physiological which means that they are not bio degradeable in the skin and, depending on their structure they consequently lead to a more or less intense washing out effect of the natural protective substances of the skin during skin cleansing. A further disadvantage is that they are quite sensitive to the joint attack of atmospheric oxygen and UV radiation. During this process highly reactive peroxides are formed which can trigger acne in sensitive individuals. In order to prevent this effect, antioxidants are added to the formulations.

In recent years a steady increase of skin conditions such as disorders of the connective tissue and rosacea are afflicting a growing proportion of our community. It appears that frequent fruit acid (AHA) and chemical peelings have significantly contributed to this problem.

People who have had such treatments reported a temporary itching after applying Oil in Water (O/W) emulsions. In most cases the skin feels dry (barrier disorder) with a tendency to itch, dilated blood vessels and displays weak connective tissue. The effects can be compared with the feeling when "rubbing salt into sore wounds" (slang expression) or in more technical terms, water-soluble substances penetrating below the horny layers of the skin and beginning to irritate the skin.

DMS® based products (Derma Membrane Structure) are beneficial in this case provided that they are used moderately. Frequent or even excessive application may increase the local concentration of water-soluble substances - particularly in winter with cooler outside temperatures and heated rooms. In these cases it is recommended to (a) reduce the application of water-containing products, (b) apply base cream High Classic Plus + NMF concentrate + hyaluronic acid and (c) use Oleogel Plus (water-free).

Strongly disturbed skin is susceptible to infections caused by micro-organisms. Typical symptoms are itching and feelings of tension followed by inflammations which will not only affect the cheeks and nose but also spread to the brims of the eyelids and to the perioral area between upper lip and nose and around the chin. Even Oleogel Plus will be no relief for the acutely inflamed skin as the fatty substances provide excellent living conditions for anaerobic bacterial strains like propionibacterium acnes or in other words, bacterial strains that can live without atmospheric oxygen. The dermatologist will prescribe azelaic acid products (liposome concentrate plus) which are effective against anaerobic bacterial strains and unicellular organisms, or alternatively, antibiotics like erythromycin and metronidazole. Metronidazole also stabilizes the blood vessels in skin-neighbouring areas.

Weak connective tissue is predominantly a hereditary condition and can also be impaired by external circumstances such as excessive peelings and environmental damage from our harsh climate. Rosacea skin cannot tolerate peeling procedures. The first rosacea symptoms become visible around age thirty and for women, increasingly in the late forties with hormonal changes and the onset of menopause. Recommended particularly for the preventive care of the rosacea-prone skin is base cream High Classic, liposome concentrate plus (contains 1% azelaic acid), echinacea extract and butcher's broom serum. Both the latter mentioned active agent concentrates have vessel and tissue stabilising effects.