SkinMedica At-A-Glance

Strengths: Many of the moisturizers and serums are truly state-of-the-art formulas; every sunscreen provides sufficient UVA protection; good cleansers; andseveral products are fragrance-free.

Weaknesses: Expensive; the acne products are terrible, and do not feature a topical disinfectant; no reliable AHA or BHA exfoliants; the unknowns about daily topical use of human growth factors make theTNS subcategory of products a potentially risky endeavor.

California-based SkinMedica offers a range of dermatologist-developed skin-care products aimed at the symptoms of aging skin, such as wrinkles and skin discolorations. (Is there anyone whose skin isn't aging?) They also offer products to manage acne and for skin discolorations. Regrettably, the products for acne are a giant step in the wrong direction, and the skin-brightening options are paltry (although the latter do contain a potentially effective amount of vitamin C). So, as far as SkinMedica's anti-aging products (a subcategory labeled TNS) go, they are far more senseless than significant.

All of the TNS products contain an ingredient complex the company refers to as "human fibroblast conditioned media." Before we launch into a discussion of the technical aspects, let me point out that "human fibroblast conditioned media" doesn't really tell the consumer anything. Fibroblasts are connective tissue cells that secrete proteins that help generate new tissue (such as collagen). Collagen, as we know, is damaged by sun exposure and is depleted with age; the number of fibroblasts, which produce collagen, also decreases with age (Source: The FASEB Journal, 2000, pages 13251334). In the International Cosmetic Ingredient and Handbook, human fibroblast conditioned media is "the growth of media removed from culture of human fibroblasts and human keratinocytes [skin cells] after several days of growth." The handbook also mentions that the "media" used to begin the process are Dulbecco's Modified Eagle Medium mixed with Hams Nutrient Mixture F-12 and calf serum.

What are these media and mixtures, and what is their relevance for aging skin? Both the Dulbecco and the Ham media, which contain glucose along with varying blends of salt, minerals, and/or the amino acid L-glutamine, are used in laboratories to grow cell cultures and keep them stable so they in turn can be evaluated and/or used in experiments. Neither of these media have relevance for aging skin; they are merely the substrate on which these human fibroblast cells grow in a petri dish. As for the calf serum, we assume that it's a source of various growth factors. We make that assumption based on a comparative study published in the May 2006 issue of Dermatologic Surgery. In this study, the TNS (Tissue Nutrient Solution) mixture used in all of the NouriCel-MD products was detailed as containing "a variety of growth factors, including TGF-beta(1), vascular endothelial growth factor (VEGF), and human growth factor (HGF)."

They didn't specify the origin of the human growth factor in the TNS blend, but it is presumably a component of the lab-grown fibroblast cells. Regardless, the results of this single-blind study involving 31 participants indicated, according to NouriCel-MD, that topical products with growth factors promote better results on aging skin than topical vitamin C. However, they don't mention anything about the effects of other ingredients or of a cocktail of ingredients. All in all, this study is completely meaningless. Even more disappointing is that the improvements were not tremendous, andhere's the kickerthe results were measured based on a physician's assessment of before and after photographs, and on the participant's self-assessment. Who knows if the photographs were doctored, or even if the lighting or the subject's pose was different at the end of the study (a slight tilt of the head or change in lighting can easily make wrinkles more or less prominent). In the end, this isn't a study you should take seriously, and the only other published research on this ingredient complex was authored by Dr. Richard Fitzpatrick, whoSurprise! Surprise!is the dermatologist behind the SkinMedica line (Sources: Dermatologic Therapy, September-October 2007, pages 350359; and Journal of Cosmetic and Laser Therapy, April 2003, pages 2534). That's sort of like a tobacco company writing a report concluding that smoking isn't actually as detrimental to health as common thinking suggests!

Moreover, Dr. Fitzpatrick admits that "More double-blind and controlled studies are needed to confirm the preliminary clinical effects of growth factor products, and more controls on product quality and stability need to be established." Now that's an understatement!

As it turns out, the human fibroblast conditioned media/TNS complex present in all of the NouriCel-MD products is a cocktail of growth factors, none of which have a history of safety when used as part of a daily anti-aging skin-care routine on healthy, intact skin. For detailed information on human growth factor and other growth factors, please refer to the Cosmetic Ingredient Dictionary on the Home page of this Web site. For now, all that can be reasonably concluded is that there are too many unknowns about topical use of growth factors to deem it advisable to look for this group of ingredients when shopping for anti-aging products.

Conceivably, it's a promising field, but your skin doesn't need to be the guinea pig for what may prove to be problematic with ongoing use. The vast majority of research on topical application of growth factors (most notably human growth factor and transforming growth factors) has focused on wounded or diseased skin (think diabetes, ulcers, and skin cancer); essentially, skin that needs to be healed, which is an area where naturally occurring growth factors in the human body work on their own accord. This research is not related to applying growth factors to otherwise healthy (albeit wrinkled or discolored) skin; wrinkles are not wounds, nor does their formation over time have anything to do with how the skin heals itself when cut or ulcerated.

Although SkinMedica tries to establish medical credibility by advertising that its products are available only through dermatologists and dermatology professionals (the latter a term that is open to interpretation, thus allowing non-medical retail sales), the reality is that any consumer can purchase these products from a variety of non-medical sources. As it turns out, despite the concerns described above for the NouriCel-MD products, there are several outstanding options to consider from SkinMedica, so you may indeed want to indulge.

For more information about SkinMedica, call (877) 944-1412 or visit www.SkinMedica.com.

By the way, SkinMedica's pharmaceutical arm produces such prescription products as Vaniqa, NeoBenz Micro (benzoyl peroxide), and EpiQuin Micro (contains 4% hydroquinone). Any physician can prescribe these products if necessary to address your skin-care concerns (or, in the case of Vaniqa, unwanted hair).