The right care for men's skin

EN

Male skin is decidedly different from that of females and therefore requires specially tailored skincare. What is the difference between male and female skin? The major differences lay in the thickness of the skin, as well as the size and activity of the sebaceous glands of the face.

Features of male skin

Hormones

The actions of male hormones also influence the composition of the skin’s surface, working to stimulate the production of sebum (1).  Sebum, consisting mainly of triglycerides and fatty acids, creates a protective film on the skin’s surface, preventing excessive water loss from the upper cell layers. As a result, the skin remains supple and doesn’t dry out.

Refrain from fatty care products

The elevated amount of sebum, however, creates an environment conducive to the proliferation of higher concentrations of bacteria. In addition, pores can become clogged and subsequently inflamed. One can therefore conclude that men’s skincare should not contain products that are fatty, also termed comedogenic.

Moisture content of the skin

Male skin contains more collagen and therefore has increased viscoelasticity and tension. In addition, the collagen fibers are arranged perpendicularly, whereas the fibers are arranged parallel to each other in women.

In one study, the University of Hamburg was able to demonstrate that women up to 50 years of age lost more moisture through their skin when compared to men (2). As a result, male skin ages somewhat more slowly. Nevertheless, men should still practice routine skincare.

The care after shaving

An important point in the context of male skincare is the practice of shaving. A man’s beard zone can contain between 5,000 and 30,000 individual hairs. Shaving can irritate the skin and cause microinjuries which can become inflamed. If the horny layer is especially thick, hairs can become ingrown. Routine use of peeling can help prevent this occurrence.

Influence of age

Age is another important factor in the physiology of the skin of both sexes. A 2014 study demonstrated that both the pH of the skin as well as the moisture content of the stratum corneum, the uppermost cell layer, changes with age. The production of sebum by sebaceous glands, however, remains constant (3).

Conclusion

no matter if young or old, man or woman, oily skin type or not – all of us need skincare tailored to our individual needs.

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Bibliography

1. Zouboulis CC. The human skin as a hormone target and an endocrine gland. Hormones. 2004;3:9–26.

2. Luebberding S, Krueger N, Kerscher M.: Skin physiology in men and women: in vivo evaluation of 300 people including TEWL, SC hydration, sebum content and skin surface pH. Int J Socmet Sci 2013 Oct;35

3. Luebberding S, Krueger N, Kerscher M. Age-related changes in male skin: quantitative evaluation of one hundred and fifty male subjects. Skin Pharmacol Physiol. 2014;27(1):9-17

Higher dosages of botulinum toxin A for the treatment of glabellar wrinkles

EN

Botulinum toxin A is used in aesthetic medicine for the treatment of wrinkles. It is a neurotoxin whose mechanism of action is based on inhibiting the transmission of excitation from nerve cells to other cells, especially muscle cells.

Mechanism of action of botulinum toxin

By destroying protein complexes, the release of the neurotransmitter acetylcholine is blocked depending on the target tissue, because of which the contraction of the muscle becomes weaker or fails completely, causing paralysis of the muscle. The duration of action of the substance usually lasts up to 12 weeks. 

Dosage of the preparation

Low-dose botulinum toxin A is particularly suitable for the treatment of dynamic facial wrinkles in the upper third of the face and neck, which are caused by activity of the mimic muscles. Dosages of up to 100 units of Botox and 230 units of Dysport per session are used to correct wrinkles.

On average, the dosage of Botox is 20 to 40 units and of Dysport 100 units, so if performed correctly, there are usually no serious side effects. The lethal dose of botulinum toxin A for a 70kg person is 3000 units. 

Evidence-based medicine

In one study, J. Kaufman-Janette et al (2021) looked at higher doses of botulinum toxin A for injections into the glabellar folds. This involved 5 studies that were randomized, double-blinded, and with varying population sizes.

Botulinum toxin formulations approved for the treatment of glabellar wrinkles in the USA or in Europe (Abotulinumtoxin A, Incobotulinumtoxin A, Onabotulinumtoxin A) were used. A high dosage was defined as a dosage that was higher than the dosage indicated in the technical information of the respective formulations.

Higher dosage of the botulinum toxin A preparation

The result of the study illustrates that an injection with a higher dosage of the botulinum toxin A drug is applicable and increases the duration of action of the drug without increasing potential risks.

An approximately 9-month increase in duration of action was obtained with a 2-2.5-fold increase in the on-label dose of Abotulinumtoxin A or a 5-fold increase in Incobotulinumtoxin A. A median duration of action of approximately 6 months was achieved with a 2-4-fold increase in the on-label dose of Onabotulinumtoxin A. 

Conclusion

The goal of treatment with increased botulinum toxin A dosage is to ensure patient satisfaction and to achieve a natural appearance. Although more data need to be collected, the findings of this study may contribute to more effective treatment and an individualized treatment plan to meet patient expectations.

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Atopic Dermatitis

Atopic dermatitis, also known as atopic eczema, is one of the most common chronic skin conditions. It presents predominantly in childhood and tends to...

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Bibliography

  1. Kaufman-Janette et al.: Botulinum Toxin Type A for Glabellar Frown Lines: What Impact of Higher Doses on Outcomes? Toxins2021, 13(7), 494
  2. Kerscher, Martina et al.: Botulinumtoxin A in der Faltenbehandlung: Übersicht und Abgrenzung zu alternativen Verfahren Dtsch Arztebl 2001; 98(26): A-1758 / B-1508 / C-1400

  3. J. Schantz, E. A. Johnson: Properties and use of botulinum toxin and other microbial neurotoxins in medicine. In: Microbiol Rev.1992;56, S. 80–99.

What does the right lip care include?

EN

The lips are a central feature of the face and require specialized care due to their unique skin structure. What is the best care for lips?

Features of the skin structure of the lips

How does the skin of the lips differ from the skin covering the rest of our bodies?

Anatomy

Anatomically, we differentiate between an upper and lower lip. The darker, pigmented portion is the red aspect of the lip, also known as the vermillion. The surrounding skin is the white aspect of the lip.

Due to the lack of a protective keratinized layer, the skin of the lips is exquisitely sensitive. It is made up of a minimally keratinized squamous epithelium which seamlessly transitions into the mucosa of the oral cavity.

Lack of moisture content

Since there are neither hair follicles nor sweat or sebaceous glands, the lips are unable to produce a protective hydrolipid film. As a result, the skin of the lips dries out quickly and is more sensitive to changes in temperature. Especially temperature extremes, such as the cold of winter or the heat of summer, take a toll on the lips.

Protection from UV radiation

The lips also possess very few melanocytes. Melanocytes are cells that are found in the skin and produce melanin, a substance that gives the skin its color and protects it from UV rays. As a consequence, the lips are also more susceptible to sunburn, even during winter activities such as skiing.

Why is the care of the lips important?

Since the lips lack the intrinsic protection offered by skin in other areas of the body, proper lip care should try to emulate the missing hydrolipid film. Our lips are in constant action, whether it’s during speaking, eating, or facial expression.

And although the tongue periodically naturally moisturizes the lips, saliva dries out rapidly and thereby provides only temporary relief to dry lips.

Inflammation prevention

Taken to an extreme, dry lips can progress to profound inflammation of both the red and white aspects of the lip, a condition known in dermatology as “cheilitis sicca.” This condition is characterized by dry, painful lips, with redness, flaking, and cracking of the skin.

Conditions such as atopic dermatitis, diseases of the thyroid gland, cold sores, or nutritional insufficiency such as zinc deficiency can also cause dry lips.

What does optimal lip care look like?

First and foremost, lips need special care, which means that regular facial creams should not be applied to the lips. Since products applied to the lips can easily enter the oral cavity and be systematically absorbed, lip care products should be composed of natural ingredients.

Examples of such include natural oils and fat-soluble vitamins. Especially in summer, when the amount of UV radiation is at its highest, lip care products should include a sun protection factor (SPF).

Fatty natural products

Good lip care contains plenty of fats. Suitable substances include natural products like shea butter (1). Another excellent natural product is cocoa butter, as it too contains many valuable fats which mimic natural those produced by our bodies and therefore keep the lips smooth and supple (2).

Coconut oil

Several studies show that the topical application of virgin coconut oil has anti-inflammatory activity by inhibiting the various levels of cytokines (small proteins that are important in cell signaling) including TNF-α, IFNγ, IL-6, IL-5, and IL-8, thus improving skin barrier function as well as protecting against ultraviolet-B radiation (3).

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Bibliography

  1. Thioune O, Khouma B, Diarra M, Diop AB, Lô I. The excipient properties of shea butter compared with vaseline and lanolin. J Pharm Belg. 2003;58(3):81-4.
  2. Lin TK, Zhong L, Santiago JL. Anti-Inflammatory and Skin Barrier Repair Effects of Topical Application of Some Plant Oils. Int J Mol Sci. 2018 Jan; 19(1): 70.
  3. Sandeep R. Varma, Thiyagarajan O. Sivaprakasam, Ilavarasu Arumugam, N. Dilip, M. Raghuraman, K.B. Pavan, Mohammed Rafiq, Rangesh Paramesh. In vitro anti-inflammatory and skin protective properties of Virgin coconut oil. J Tradit Complement Med. 2019 Jan; 9(1): 5–14.

How does collagen work? - Beneficial for joints and skin

EN

The word ‘collagen’ is on everyone’s lips, and for good reason. Collagen, after all, accounts for more than 30% of human proteins and is an important building block in our connective tissue. Forms of connective tissue includes bones, cartilage, tendons, and skin.  

What is collagen?

Collagen production is a complex process which takes certain amino acids – the building blocks of proteins – and links them together over several steps in a biochemical pathway.

There are over 25 different types of collagen. The collagen contained within the skin has a unique biochemical composition and serves to maintain the integrity and elasticity of the skin.

The effect of collagen

Against optical skin aging

As proven in scientific studies, collagen fibers lose thickness and strength as we age. This process has been shown to be associated with skin aging (1).

There are, however, various methods to replenish the body with collagen. In addition to food supplements, which promote regeneration of bone and cartilage, collagen can also be introduced into the body in the form of creams (2).

Moisture content of the skin

A further study demonstrated that the intake of collagen peptides over an 8-week period led to a measurable increase in the moisture content of the skin. In addition, the study showed an increase in collagen density that lasted up to 12 weeks after supplementation ended (3).

Treatment of sun-exposed skin

In a 2020 study using a population of 36 postmenopausal women, a 4-week trial of marine collagen led to a significant improvement in the elasticity of the skin in sun-exposed areas. This improvement persisted for a further 4 weeks after the trial ended (4).

Can topical products stimulate collagen production?

There are indeed products that, when applied to the skin, can lead to an improvement in collagen production. Since the body can only produce collagen with the help of vitamin C, it’s recommended to use products containing this vitamin. Even at concentrations below 5%, vitamin C promotes the desired effect (5).

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Atopic Dermatitis

Atopic dermatitis, also known as atopic eczema, is one of the most common chronic skin conditions. It presents predominantly in childhood and tends to...

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Bibliography

  1. Rodríguez, María & Rodriguez Barroso, Laura & Sánchez, Mirna. (2017). Collagen: A review on its sources and potential cosmetic applications. Journal of Cosmetic Dermatology. 17. 10.1111/jocd.12450.
  2. Avila Rodríguez MI1, Rodríguez Barroso LG1, Sánchez ML2. Collagen: A review on its sources and potential cosmetic applications. J Cosmet Dermatol. 2018 Feb;17(1):20-26. doi: 10.1111/jocd.12450. Epub 2017 Nov 16.
  3. Asserin J1, Lati E2, Shioya T3, Prawitt J4. The effect of oral collagen peptide supplementation on skin moisture and the dermal collagen network: evidence from an ex vivo model and randomized, placebo-controlled clinical trials. J Cosmet Dermatol. 2015 Dec;14(4):291-301. doi: 10.1111/jocd.12174. Epub 2015 Sep 12.
  4. Sangsuwan W, Asawanonda P. Four-Weeks Daily Intake of Oral Collagen Hydrolysate Results in Improved Skin Elasticity, Especially in Sun-Exposed Areas: A randomized, double-blind, placebo-controlled trial. J Dermatolog Treat. 2020 Feb 1:1-19
  5. Gallarate M, Charlotti ME, Trotta M, Bovo S. On the stability of ascorbic acid in emulsified systems for topical and cosmetic use. Int J Pharm 1998; 188:233–241

Hydration – the groundwork of healthy skin

EN

Skin hydration, also referred to as skin moisture, is a widely used term. But exactly what is behind it and why is it such a crucial component of the skin’s wellbeing?

Moisture content of the skin

A major function of skin is the prevention of excess water loss by means of an epidermal barrier. The skin’s moisture level influences not only the microscopic parameters, such as protein activity and intercellular signaling, but also macroscopic, or visible, aspects such as the elasticity and suppleness of the skin (1).

Hydration function

Chemically speaking, hydration denotes the arrangement of water molecules to create a protective hydration shell through the formation of hydrogen bonds. This envelope offers protection from factors such as environmental stressors and noxious agents, among others, that could damage the skin.

Moisture can leave the skin by evaporating off the skin’s surface through perspiration, but this process is limited. The skin possesses a multitude of regulatory mechanisms to keep the upper layer, known as the stratum corneum, adequately supplied with moisture.

The right skin care

Furthermore, good skin care can significantly reduce the amount of water lost and thus increase the moisture content of the skin. The skin-lipid barrier plays a vital role in the hydration process. Intercellular lipids (lipids located between cells) store moisture by using their water repelling properties to reduce the amount of water lost to evaporation.

Which skincare products promote hydration?

Almond oil

There are various active ingredients capable of improving the skin’s moisture by specifically strengthening the skin-lipid barrier. One example is almond oil, a product used in ancient Chinese, Ayurvedic, and Greek medicine (2). In one randomized, double-blind study, the application of lactic acid and refined almond oil, both with and without polidocanol (an antipruritic agent), led to a significant reduction in itchiness and an increase in the skin’s lipid content (3).

Aloe vera extract

Another class of ingredients shown to improve skin moisture and elasticity are aloe vera extracts. One particular study showed that a moisturizing cream containing aloe vera extracts, as well as wheat germ oil and other herbal ingredients, provided a measurable hydrating effect when participants applied the cream twice daily for three weeks (4).

How does one attain good long-term effects?

There exist various topical preparations with various active ingredients. For long-lasting hydration, note the following important points:

  1. Regular application of the product
  2. Consume adequate fluids (2-3 Liters per day)
  3. Protect the skin from drying out (for example, avoiding air conditioning, excessive washing, and sun exposure)

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Bibliography

  1. Duplan H, Nocera T, Skin hydration and hydrating products. Ann Dermatol Venereol. 2018 May;145(5):376-384.
  2. Ahmad Z., The uses and properties of almond oil. Complement Ther Clin Pract. 2010 Feb;16(1):10-2.
  3. Simon D, Nobbe S, Nägeli M, Barysch M, Kunz M, Borelli S, Hasan-Ali O4, Wildi E, Gasser UE. Short- and long-term effects of two emollients on itching and skin restoration in xerotic eczema. Dermatol Ther. 2018 Nov;31(6):e12692.
  4. Saraf S, Sahu S, Kaur CD, Saraf S. Comparative measurement of hydration effects of herbal moisturizers. Pharmacognosy Res. 2010 May;2(3):146-51.

Public health insurers' coverage of botulinum toxin treatment costs

EN

Treatments with the neurotoxin botulinum toxin can be covered by public health insurance under certain circumstances. However, this does not usually include aesthetic indications such as anti-wrinkle injections. If, on the other hand, there are medical indications, the treatment can in many cases be covered by the public health insurance. 

Working principle

Botulinum toxin is a neurotoxin that is produced by anaerobic bacteria of the genus Clostridium botulinum in seven different serotypes from A to G. Subtype A is particularly used for numerous therapeutic purposes.  

This toxin acts by inhibiting the transmission of excitation from nerve cells to other cells, especially muscle cells. Through the breakdown of protein complexes, the release of the neurotransmitter acetylcholine is blocked. As a result, the contraction of the muscle becomes weaker or fails completely, causing paralysis of the muscle. The duration of action of the drug is usually about 12 weeks. 

Indications

The indications that are usually covered by public health insurance include the following: 

Neurological diseases

  • Focal spasticity of arms and legs (after stroke)
  • Blepharospasm (eyelid spasm)
  • Spasmus hemifacialis (unilateral spasm of the facial muscles)
  • Cervical dystonia (torticollis)
  • Pointed foot due to infantile cerebral palsy
  • Tension headaches & chronic migraines (more than 15 days per month)

Bladder dysfunction

  • Overactive bladder
  • Urinary incontinence following unsuccessful treatment with anticholinergics
  • Detrusor-sphincter dyssynergia

Skin related disorders

  • Severe primary hyperhidrosis axillaris

Gastrointestinal disorders

  • Achalasia & esophageal spasms
  • Hirschsprung's disease
  • Anal fissures

Ocular disorders

  • Strabismus

Conclusion

If the compound is used for a purpose not listed in the compound's technical information, it is necessary to consult with the health insurance provider prior to treatment, as the reimbursement of costs is often individually assessed.

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Atopic Dermatitis

Atopic dermatitis, also known as atopic eczema, is one of the most common chronic skin conditions. It presents predominantly in childhood and tends to...

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Bibliography

  1. J. Schantz, E. A. Johnson: Properties and use of botulinum toxin and other microbial neurotoxins in medicine. In: Microbiol Rev.1992;56, S. 80–99.
  2. Deutsche Gesellschaft für Neurologie: Migräne: Bakteriengift hilft chronisch Kranken.Deutsche Gesellschaft für Neurologie, Pressemitteilung September 2009
  3. Kassenärztliche Bundesvereinigung Neue Leistung ab 2018: Botoxbehandlung bei Blasenfunktionsstörung.
  4. Cornelia Neth: Was ist bei der Abgabe von Botox zu beachten? newsletter. deutsche-apotheker-zeitung 2021
  5. Botulinumtoxin-Therapie Universität Würzburg Prof. med. Dr. Jens Volkmann

What is hyaluronic acid

EN

Hyaluronic acid is a sugar-based molecule distributed widely throughout our body. It is important for binding water, cell growth, as well as membrane receptor function and adhesion. It is a very genetically conserved substance.

Definition

In the skin, hyaluronic acid is preferentially localized in the deep layer, called the dermis, where the cells are not as tightly packed. In this layer, we can also find collagen and elastin fibers, which provide the skin with its elasticity. As part of the aging process, there is a physiological decrease in hyaluronic acid content.  This process can be accelerated, for example by chronic sun exposure.

Molecular composition

Hyaluronic acid is one of the main components of the extracellular matrix: a three-dimensional network of extracellular macromolecules like collagen, enzymes (proteins), and other important proteins that provide structural and biochemical support for surrounding cells. Therefore, it is indispensable for the cell’s skeletal structure.

Mechanism of action

Hyaluronic acid is also able to increase cell motility by activating various cell receptors to promote cell migration during wound healing. This property makes it particularly suitable as a moisturizing substance in aged skin, whether due to a genetic predisposition or due to external factors (1-4).

The positive effects of topically applied hyaluronic acid on dermal connective tissue metabolism and the antioxidant capacity of hyaluronic acid have made the popularity of this substance grow, leading to its increased use in the field of cosmetics.

Evidence-based medicine

Recent studies on the daily use of hyaluronic acid creams over the course of three months showed that the depth of perioral and periorbital wrinkles demonstrated a significant decrease of about 10-20% in all groups tested, whereas skin tightness increased significantly in all groups by about 13-30%.

The depth of wrinkles was measured with a computer-assisted surface measurement technique based on optical 3D measuring methods. Skin firmness and elasticity were measured with a cutometer, an instrument that measures physical properties of the skin, such as elasticity (5).

How should we apply hyaluronic acid?

As previously stated, it is important that hyaluronic acid passes the skin barrier to reach the dermis. This is why it has to be formulated in a fragmented form. After fractionation, the low molecular weight allows for easier penetration into the skin. Once it has reached the depth where the collagen and elastin fibers are located, it can bind water, improve skin elasticity, and attenuate skin lines.

Serum

As a booster, it can be used as a serum if it is highly concentrated. As part of a daily routine, the serum is appropriate for every skin type. Furthermore, a study showed that the daily topical application of hyaluronic acid may improve seborrheic dermatitis (6), a chronic skin disorder characterized by red, scaly, greasy, itchy, and inflamed skin.

Cream

For a more moisturizing effect, such as in the case of skin with a tendency to dry out, a facial cream can be applied. Facial creams are also "moisturizers" because they contain two groups of active ingredients that increase hydration of the most superficial layer of the skin.

These occlusive and moisturizing substances form an evaporation barrier on helping the skin to bind water. In addition, facial creams contain cosmetic preparations called emollients that smooth rough skin surfaces.

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Atopic Dermatitis

Atopic dermatitis, also known as atopic eczema, is one of the most common chronic skin conditions. It presents predominantly in childhood and tends to...

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Bibliography

  1. Kerscher M, Bayrhammer J, Reuther T. RejuvenatingInfluenceof a StabilizedHyaluro- nicAcid-Based Gel ofNonanimal Origin on Facial Skin Aging. DermatolSurg. 2008; 34:1–7
  2. Trommer H, Neubert RH. Screening fornewantioxidativecompoundsfortopical ad- ministrationusingskinlipidmodelsystems. J PharmPharmSci. 2005; 8(3):494–506
  3. Weindl G, Schaller M, Schäfer-Korting M, Korting HC.Hyaluronicacid in thetreatmentandpreventionofskindiseases: mo- lecularbiological, pharmaceuticalandclinicalaspects. Skin PharmacolPhysiol. 2004; 17(5):207–213
  4. Wiest L, Kerscher M. Native hyaluronicacid in dermatology – resultsof an expert meeting. J DtschDermatol Ges.2008; 6(3):176–180
  5. Poetschke J, Schwaiger H, Steckmeier S, Ruzicka T, Gauglitz GG. Anti-wrinklecreamswithhyaluronicacid: howeffectivearethey? MMW Fortschr Med. 2016 May 25;158 Suppl 4:1-6.
  6. Schlesinger T, Rowland Powell C. EfficacyandSafetyof a Low MolecularWeightHyaluronicAcidTopical Gel in the Treatment of Facial Seborrheic Dermatitis Final Report. J ClinAesthetDermatol. 2014 May; 7(5): 15–18.

Beneficial effects of the horse chestnut

Rosskastanie

EN

Horse chestnut, also called aesculus hippocastanum, is a plant. Its seed, bark, flowers, and leaves have medicinal properties. Horse chestnut seeds can be processed so that the active chemicals are extracted and concentrated.

Ingredients of horse chestnut

The result is called aescin, an extract that is a powerful anti-aging compound and has potent cell-protective effects through its antioxidative properties (1).

Furthermore, it is also rich in a number of flavonoids. The word flavonoid (or bioflavonoid) comes from the Latin word flavus meaning yellow, their natural color. It is a class of secondary plant and fungus metabolites. Flavonoids are powerful antioxidants with anti-inflammatory and immune system benefits.

Historically, they had been used in Chinese and Ayurvedic medicine, as they have been associated with protection of the skin, brain, and prevention of diabetes. Moreover, flavonoids are also known for their positive effects regarding blood pressure regulation.

Evidence based medicine

A study published in a prestigious journal such as Lancet reported about the protective effects of horse chestnut on blood vessels. Specifically, this study in patients with chronic venous insufficiency showed that chestnut, taken orally, stimulates the microcirculation and strengthens the blood vessels (2).

Efficacy of horse chestnut extract

The efficacy of horse chestnut extract works by reducing edema (which means swelling due to water storage in the tissue outside the blood vessels).  This has been reported in several clinical trials in patients with chronic venous insufficiency (3,4). 

A possible mechanism suggested by some authors is that horse chestnut seed extract has an inhibitory action on capillary protein permeability, meaning that important proteins don’t get lost from the vessels, thus avoiding the development of edema (5).

Trace elements

Furthermore, the leaves of the horse chestnut plant contain zinc, among other trace elements. This chemical element is a nutritionally fundamental compound that modulates immune response and has antioxidant and anti-inflammatory properties.

It also retards oxidative processes responsible for aging (6, 7). This leads to the conclusion that horse chestnut may have positive effects on our organism.

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Atopic Dermatitis

Atopic dermatitis, also known as atopic eczema, is one of the most common chronic skin conditions. It presents predominantly in childhood and tends to...

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Bibliography

  1. Tsutsumi S, Ishizuka S. Anti-inflammatory effects of the extract of Aesculus hippocastanum L. (horse chestnut) seed. Shikwa Gakuho. 1967 Nov;67(11):1324-8.

  2. Diehm C, Trampisch HJ, Lange S, Schmidt C. Comparison of leg compression stocking and oral horse-chestnut seed extract therapy in patients with chronic venous insufficiency. Lancet. 1996 Feb 3;347(8997):292-4.

  3. Rudofsky G, Neiss A, Otto K, Seibel K. Ödemprotektive Wirkung und klinische Wirksamkeit von Venostasin retard im Doppelblindversuch. Phlebol Proktol 1986; 15: 47-54.
  4. Steiner M,Hillemanns HG..Untersuchung zur ödemprotektiven Wirkung eines Venetherapeutikums. MünchMedWochenschr 1986;31: 551-52.

  5. Kreysel HW, Nissen HP, Enghofer E. A possible role of lysosomal enzymes in the pathogenesis of varicosis and the reduction in their serum activity by Venostasin. Vasa 1983; 12: 377-82.

  6. Kim ND, Fergusson JE. Seasonal variations in the concentrations of cadmium, copper, lead and zinc in leaves of the horse chestnut (Aesculus hippocastanum L.). Environ Pollut. 1994;86(1):89-97.

  7. Jarosz M, Olbert M, Wyszogrodzka G, Młyniec K, Librowski T. Antioxidant and anti-inflammatory effects of zinc. Zinc-dependent NF-κB signaling. Inflammopharmacolog. 2017 Feb;25(1):11-24.

Cleansing rituals for each skin type

Hautreinigung

EN

The key to gentle cleansing is to start with a mild product and avoid too frequent washing. The chemical structure, pH and cleansing ability are crucial for a good cleansing product, which should be individually tailored to your skin type.

History of cleansing

The first evidence of soap production can be found in the ancient civilization of the Sumerians, who lived in the area of Sumer in southern Mesopotamia in the 3rd millennium BC. It is believed that they overlooked the purifying effect of the alkaline mixture and used it as a cure for injury. Egyptians and Greeks took over the instructions for the chemical formulation, but the purifying effect of soap was first established by the Romans(1).

In the 17th century, the French King Louis XIV helped soap reach a new heyday by bringing the best soap makers to Versailles. Four centuries later, traditional olive oil soap production continues to thrive in Marseille, as well as in many Mediterranean countries.

Chemical function of soaps and syndets

Soaps

Soap molecules attribute their properties to the fact that they consist of a water-repellent (hydrophobic) and a water-attracting (hydrophilic) part. This is why they do not completely dissolve in water, but rather form micelles and act as surfactants.

Surfactants are substances that reduce the surface tension of a liquid or the interfacial tension between two phases and allow or support the formation of dispersions or act as a solubilizer.

Syndets

However, soaps not only remove dirt, but also remove part of the natural oil film of the skin. This can lead to chapped, rough skin, especially if washed too frequently. Protection against this condition is offered by soap with a high glycerine content(2).

These so-called syndets („syn“ from synthetic and „det“ from detergents) act as a soap, but are often more skin-friendly, as their pH level has been adjusted to better suit skin.

What kind of products are recommended for cleansing?

There are a lot of factors, including chemical structure, pH, and cleansing ability that are crucial for a good cleansing product (3). The key to gentle cleansing is starting with a mild product and avoiding too frequent washing. Some products add moisturizing agents such as aloe vera, provitamin B5, and purslane, which also possess anti-inflammatory properties. (Check out the citations in our article on panthenol.)

What are the differences between oil/balm and foam cleansers?

One of the most important cosmetic preparations is the oil-in-water (O / W) emulsion, in which a lipid phase is dispersed in a water phase. Most of the creams for normal to mixed skin usually consist of this type of emulsion. Characterized by a pleasant application, they are non-greasy on the skin and are absorbed quickly.

Regarding foam cleansers, these are also formulated as oil-in-water emulsions. Nevertheless, this formula is not always suitable for dry skin as there is inadequate moisturization of the skin. In these cases, a water-in-oil (W / O) formulated oil or balm cleanser is recommended, which contains lipids in which water droplets are distributed. 

What about different skin types?

An important pillar of the cosmetic treatment of seborrheic skin is the thorough, but gentle cleansing of the skin, as too aggressive cleansing measures can cause a worsening of seborrhoea.

A well-suited formulation for the care of seborrheic skin is usually the O / W emulsion. W / O emulsions and ointments should be avoided in order to prevent cosmetic-induced acne, also known as acne cosmetica (4).

Conclusion

Independent of the skin type, double cleansing may lead to skin barrier dysfunction due to a reduction of natural moisturizing factors. A good alternative is offered by the combination of a specific eyelid cleanser, such as a dual-phase cleanser containing a water-based and oil-based mixture (5), and a gentle foam cleanser for the rest of the face, neck, and body. The addition of natural moisturizing factors in a cleansing product is essential in order to preserve the integrity of the skin barrier. 

Table of Contents

Atopic Dermatitis

Atopic dermatitis, also known as atopic eczema, is one of the most common chronic skin conditions. It presents predominantly in childhood and tends to...

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Bibliography

  1. Günter Wagner: Waschmittel: Chemie, Umwelt, Nachhaltigkeit. Wiley-VCH, Weinheim 2011, ISBN 978-3-527-64366-0, S. 163
  2. Prieto Vidal N, Adeseun Adigun O, Pham TH, Mumtaz A, Manful C, Callahan G, Stewart P, Keough D, Thomas RH. The Effects of Cold Saponification on the Unsaponified Fatty Acid Composition and Sensory Perception of Commercial Natural Herbal Soaps. Molecules. 2018 Sep 14;23(9).
  3. Strube DD, Nicoll G. The irritancy of soaps and syndets. Cutis. 1987 Jun;39(6):544-5.
  4. Jean L. Bolognia , Julie V. Schaffer , Lorenzo Cerronia. Dermatology. 4th Edition. Elsevier.
  5. Sung J, Wang MTM, Lee SH, Cheung IMY, Ismail S, Sherwin T, Craig JP. Randomized double-masked trial of eyelid cleansing treatments for blepharitis. Ocul Surf. 2018 Jan;16(1):77-83.

Can sheep's wool heal?

Wirkung der Heilwolle

EN

Healing wool is untreated, natural sheep's wool. This contains wool wax, which is also called lanolin. It has anti-inflammatory properties and can absorb many times its volume of water thanks to the wool wax alcohols it contains.

History

Healing wool has long been known for its beneficial and healing effects. Ancient people already knew about these properties and made use of them. This is what the Greek physician Dioscorides referred to in his writings as ‘Oesypus’, known to us as lanolin or wool wax.

He praised the medicinal properties of this substance. However, in the centuries that followed, knowledge of the healing power of this natural product was largely forgotten. In 1885, the German pharmacologist Oskar Liebreich rediscovered the special uses of wool for healing purposes.

Evidence based medicine

Although there is limited evidence, wool clothing has traditionally been considered an irritant for individuals with atopic dermatitis and was therefore historically not recommended in patients with this condition.

However, wool fibers actually have beneficial thermodynamic and moisture transporting properties (1).

Application of the healing wool for newborns

Sheep’s wool has been used for centuries for diaper dermatitis. It facilitates a microcirculation of air in the diaper by putting layers of wool between the skin and the diaper. The wool prevents direct contact of urine and stool with the skin. As a result, the skin is not permanently moist and there is less irritation from urine and stool (2).

Furthermore, sheep’s wool contains lanolin, a substance that has a positive effect on the recovery of the skin.

What healing properties does lanolin have?

Lanolin is a yellow fat obtained from sheep's wool (3). Over the years, it has been used topically to treat sore nipples due to breastfeeding. Lanolin can be purified by removing pesticide and detergent residues. This leads to an improvement in safety and reduces the allergenic potential (4).

This yellow fat mainly consists of fatty acids and fatty alcohols. It has anti-inflammatory properties as well as the ability to absorb many times its own volume in water, thanks to the wool wax alcohols it contains. Wool wax has skin-caring, softening, emulsifying, lipid-replenishing, water-repelling, and skin-protecting properties, thus promoting skin repair. For these reasons, it is an excellent substance for the care of sore nipples and lips.

Table of Contents

Atopic Dermatitis

Atopic dermatitis, also known as atopic eczema, is one of the most common chronic skin conditions. It presents predominantly in childhood and tends to...

Weiterlesen »

Bibliography

  1. Su JC, Dailey R, Zallmann M, Leins E, Taresch L, Donath S, Heah SS, Lowe AJ. Determining Effects of Superfine Sheep wool in INfantile Eczema (DESSINE): a randomized paediatric crossover study. Br J Dermatol. 2017 Jul;177(1):125-133
  2. http://www.babypedia.nl/index.php/Healing_wool
  3. Drugs and Lactation Database (LactMed) 2018
  4. Mohammadzadeh A, Farhat A, Esmaeily H. The effect of breast milk and lanolin on sore nipples. Saudi Med J. 2005;26:1231-4