Do you often get asked, “What skin care regimen should I use?” “Is this a good product?” “What ingredients are best for anti-aging?” With so many trending ingredients and treatments on the market it can be hard to sift through all the options. If only there was a magic pill for fine lines, pigmentation, and loss of elasticity. In this episode of the Rogue Pharmacist with Benjamin Knight Fuchs, we go back to basics and discuss Ben’s favorite three ingredients for younger, healthy skin.
Associated Skin Care Professionals (ASCP) presents The Rogue Pharmacist with Benjamin Knight Fuchs, RPh. This podcast takes an enlightening approach to supporting licensed estheticians in their pursuit to achieve results-driven skin care treatments for their clients. You can always count on us to share professional skin care education, innovative techniques, and the latest in skin science.
About Benjamin Knight Fuchs, RPh:
Benjamin Knight Fuchs is a registered pharmacist, nutritionist, and skin care chemist with 35 years of experience developing pharmacy-potent skin health products for estheticians, dermatologists, and plastic surgeons. Ben’s expert advice gives licensed estheticians the education and skin science to better support the skin care services performed in the treatment room while sharing insights to enhance clients’ at-home skin care routines.
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0:00:55.2 Maggie Staszcuk: Hello and welcome to ASCP and the Rogue Pharmacist with Benjamin Knight Fuchs. In each episode, we will explore how internal and external factors can impact the skin. I'm Maggie Staszcuk, ASCP's cosmetology education manager, and joining me is Ben Fuchs. Hi Ben.
0:01:11.8 Ben Fuchs: Hi Maggie. Good to see you.
0:01:13.7 MS: Good to see you. Ben, I'm curious. If you could pick three ingredients to younger, healthy skin, what would they be?
0:01:20.2 BF: That's a really good question because there's so many ingredients out there. Every year, I go to ingredient shows. There's two really big shows. They do one every other year, and one, every year annually. And it takes me hours to walk the floor to see all the different ingredient of vendors, and each vendor has 20, 30, 100, sometimes 200 different ingredients. There's so many different ingredients out there. It's really confusing. Right? So what do you do? Well, the way I look at the skin as a pharmacist, and I know we've talked about this before, is the skin that we see is not really where the skin starts. We see the end of it. The surface of the skin is the end result of what's happening in the cells. So if you want really beautiful skin, from a topical perspective, if you wanna make the skin really beautiful, you don't wanna take care of the skin, you don't wanna address the skin. You don't take care of your skin by addressing the skin. You take care of the skin by addressing the skin cell.
0:02:13.5 MS: Okay, interesting.
0:02:14.4 BF: It's all about the cell. This is the big mistake people make and companies make, and we all make, collectively, when we try to treat our skin. We try to treat the surface. The surface is essentially dead. It's made up of dead cells. There's some chemistry going on there, but it's essentially made up of dead cells. You get your fancy schmancy moisturizing cream or whatever it is, $200 an ounce, you rub it on your skin and you get soft dead skin. Congratulations. That's what you get for your $200 an ounce product. It's ridiculous really when you think about it. The real art and science to changing the skin via skincare products, via topical products, is get to the cell. And that means being able to, number one, get through the skin to where the cell is, in the basal layer, the bottom of the skin, and number two, once you're there having an ingredient that the cell will respond to.
0:03:00.6 BF: When you use those two criteria, that eliminates 99.99% of the all those ingredients that are in skincare, 'cause there's not a lot of ingredients that, number one, can penetrate, and number two, can actually activate or initiate behavior at the cell level once those ingredients are there. So my favorite ingredients are ingredients that have a penetrating power, and have an ability to activate cells to initiate actions at the cell level. And so when I think of ingredients, the first class of ingredients, the first type of ingredients I think of are hydroxy acids. Now, there's two... Technically, there's only one group of hydroxy acids that affect the skin called alpha hydroxy acids, but there's also what they call beta hydroxy acids, which aren't really in the same type of molecules in alpha hydroxy acids.
0:03:50.9 BF: Nonetheless, we'll group them all together; beta hydroxy acids, salicylic acid, and then there's a bunch of alpha hydroxy acids. Alpha hydroxy acids, first of all have a surface effect. They'll exfoliate the cells off of the surface and they'll give you a smoother, softer texture to the surface of the skin. They'll also help eliminate pigment from the surface of the skin. So you get immediate surface superficial effects. But alpha hydroxy acids also can penetrate and they can especially penetrate electronically. Acids, it's kind of interesting when I say that. Acids are actually an electronic... When something's acidic, it's an electronic phenomenon. And by that I mean little pieces of electricity called protons can actually migrate through the surface of the skin and initiate activity at the cell level. Protons are absorbed into the skin cell, not really absorbed, but there's mechanisms that will deliver the proton to the skin cell, intracellularly in the skin cell to turn on activity.
0:04:47.9 BF: Protons tell the cell to work. So alpha hydroxy acids will give you a surface benefit via exfoliation, but they'll also give you an activating benefit at the level of the skin cell. That activating benefit, number one, initiates growth. Number two, at the level of fibroblast, it initiates the production of collagen and elastin and high anaerobic acid, so you get benefits for a stronger, healthier stratum, corneum and epidermis in general, and you get a stronger, healthier dermis, meaning less wrinkles, less fine lines, thicker stronger skin, a healthier skin barrier, all of which will improve skin health in a non-toxic fashion, in the sense that alpha hydroxy acids are part of the natural milieu of the body. All cells get their energy from alpha hydroxy acids; your heart, your liver, your bone. All the 200 different cells in the body are energized by the actions of alpha hydroxy acids, specifically, citric acid, something called the Krebs cycle. Maybe you've heard of that.
0:05:43.5 MS: I have heard about that, specific to microcurrent, and that's stimulating ATP, right?
0:05:49.0 BF: Encouraging the production of ATP. Exactly, the Krebs cycle is how ATP is produced. The Krebs cycle is named after Dr. Eugene Krebs who discovered it. The Krebs cycle is called a cycle because it's a biochemical pathway that goes in a circle. Usually biochemical pathways, which I think we've talked about, is where A goes to B goes to C, goes to D, goes to E and that's how everything gets made in the body. A cycle is where A goes to B goes to C, goes to D, goes back to A, goes to B, to C, D, E and then back A, it goes in a cycle. And the energy in the cells are all produced via this biochemical pathway, this biochemical cyclical pathway called the Krebs cycle, which is also called the citric acid cycle, because it begins with citric acid, which is an alpha hydroxy acid. There's also an alpha hydroxy acid that we all know about from working out, from exercising. I know you do yoga and you do working out. Do you ever get to the point where you feel the burn?
0:06:40.0 MS: Right. Yeah.
0:06:40.6 BF: What's the burn?
0:06:41.3 MS: Lactic acid.
0:06:42.2 BF: Right. Yeah, alpha hydroxy acid. And what does the burn do? Why do you wanna feel the burn? Because it initiates growth, muscle growth. It turns out that these acids via this protonic effect, via this drop in pH, is really what's happening, stimulate growth. So alpha hydroxy acids give you a superficial effect, wonderful superficial effect, they give you an epidermal effect, and they give you a dermal effect. Less wrinkles, thicker skin, better barrier, antibacterial properties, lighter skin, more moisture factors for folks who have dry skin. There's so many benefits that you get from this wonderful non-toxic ingredient. To me, no skincare program is complete without alpha hydroxy acids. However, you've gotta know how to use them. That is, number one, you want the pH to be at the acid level, to be stimulating enough, but not too stimulating. So you want somewhere less than skin pH. Skin pH is around, say, 4.5 at the low end. You wanna be below 4.5 to really get activity from your alpha hydroxy acid. Otherwise, the skin's like bored. It doesn't even notice it. So somewhere around two or three. Two is a little low. Three-ish, somewhere in there, 3.5, something like that.
0:07:52.2 BF: And then you have to know how to take days off because you can... Stimulation's good, but you don't wanna over stimulate. So you wanna make sure that your alpha hydroxy acid program utilizes or leverages time off. And that's the most common question people will ask when they start an alpha hydroxy acid program, is how often do I use my alpha hydroxy acids? And there's no real answer to that. You wanna stimulate as much as possible without overstimulating, and you wanna be able to leverage and maximize the rest period, because that's really when the recovery and the tissue grows. So it's kind of a balance. For most people, a good alpha hydroxy acid program is three times a week, four times a week kind of thing. And then once or twice a month at an esthetician who can give you an intense workout.
0:08:31.3 MS: Different alpha hydroxy acids have different sized molecules, right?
0:08:36.1 BF: That's kind of a minutia. It's true that you're gonna get a little bit more surface effects with lactic acid than you will with glycolic acid. Mandelic acid, which I absolutely love, has a water soluble and fat soluble nature, so that makes it kind of unique. But for the most part, glycolic, lactic and mandelic are the most important ones. There's also malic, and there's tartaric, and there's adipic, and they'll give you slightly different qualities. But basically speaking, the smallest alpha hydroxy acid molecule is glycolic, and that's the one that most of the studies are done on, and that'll give you a penetrating effect. And if you don't want as much penetration, but you want more surface effects, more high gross scopicity or water trapping ability, you go lactic. And if you wanna have a kind of the advantages of water solubility, which is penetration and fat solubility, which is dissolving oil and disrupting the stratum corneum barrier, you go mandelic.
0:09:29.9 BF: If you really wanna be fat soluble or lipophilic, salicylic acid is the way to go, and that's the beta hydroxy acid. And that's more appropriate for acne patients, oily skin patients, thick skin patients. You want a more fat soluble or a fatty hydroxy acid like mandelic or like salicylic for thicker skin types, oily skin types, or acne prone skin. Another benefit, by the way, I should say, of both alpha and beta hydroxy acids is antibacterial effects. So you kill bacteria in a nonresistant form. Like there's things like benzoyl peroxide and there's triclosan, both having antibacterial properties, but glycolic acid or alpha hydroxy acids give you antibacterial effects without toxicity. Benzoyl peroxide has toxicity, and triclosan, which is another, you've probably heard of that, that's another antibacterial ingredient in products that has toxicity too. And in fact, there's issues with triclosan in the water supply and triclosan in the environment from products.
0:10:28.4 BF: So these antibacterial drug ingredients, they'll kill bacteria for folks who have acne or if they want to kill bacteria for whatever reason, but you have toxicity and you have environmental issues. You don't have any of that with alpha hydroxy acids. You get the same antibacterial properties, but you get stimulating effects and anti-aging effects and general health effects. So for all those reasons, number one on my list will be alpha or beta hydroxy acids. Then there's two other ingredients which are must haves. So getting back to this idea of the cell and activating the cell, yes, it's true, there's a lot of ingredients that can penetrate through the skin surface. Pretty much all fatty ingredients will have some degree of penetration. But once you're there, you gotta be able to activate the cell. And there's a few ingredients that can activate the cell, but there's two ingredients that will actually work intracellularly.
0:11:18.8 BF: They'll actually go inside a skin cell, fibroblast or keratinocytes, from topical application. That's incredible. In other words, you can actually feed your skin cells by putting these ingredients on the surface of the skin and having them migrate, basically taking a spoon and like feeding the cell. And that makes these two ingredients really important. And that's number one, vitamin C, which works on numerous levels. But in terms of getting into a skin cell, it has a very powerful collagen building factor. In fact, it is the most important ingredient in the building of collagen and connective tissue at the level of the fibroblast. So that means you put vitamin C on the skin and actually get a fibroblastic effect, an intracellular fibroblastic effect way deep in the dermis. That's number one. But there's other benefits too. Vitamin C has a protective effect on the skin.
0:12:09.4 BF: So vitamin C protects the skin from the environment, but it also protects fats inside the skin cell or inside the skin from degrading or breaking down. It's an antioxidant for fats. Vitamin C is also a skin liner. It's a tyrosinase inhibitor at the level of the melanocyte. And on top of all that is, if that weren't enough benefits, Vitamin C has an ability to keep skin cells healthy as they're rising from the bottom to the top. It supports the movement of cells, keratinocytes, as they're rising from the basal layer to the surface. We call that differentiation, and it's a pro-differentiation vitamin. So vitamin C is the second, and I don't wanna say second in terms of second. It's not like the second most important, but it's the second of the three most important. They're all equally important.
0:13:00.0 BF: And then the third is vitamin A. And vitamin A, it may be the skin's most important nutrient for a lot of reasons. First of all, vitamin A is the only FDA approved topical ingredient that has been shown and approved by the FDA and indicated to reverse photo damage. The reason I say vitamin A and not retinol is because, collectively, all the different forms of vitamin A, they're called retinoids, will have retinoid effects on supporting the health of the skin and skin cells. So you can put vitamin A on the top of the skin, and like vitamin C, it will migrate down to the bottom and it will literally go inside a cell, inside a skin cell, fibroblast or a keratinocyte. But even better than that, vitamin A works in the nucleus of a cell.
0:13:44.5 BF: So you can actually put vitamin A on the surface of your skin, I'll tell you all the different types in second, and it will go down to the bottom. It will get... It meets the first criteria of an important ingredient, that is getting there, and then secondly, it will actually enter into the cell and get escorted. It has its own escort service. It will bind to a molecule inside the cell and get escorted into the nucleus where it will manipulate the genetics.
0:14:11.6 MS: Interesting.
0:14:12.6 BF: So you get genetic effects with vitamin A. You actually will upregulate genetics. It's called epigenetic factor, meaning that it turns on genes. That's incredible. You can actually change your genetics or the genetics of your skin cells by putting an ingredient on the surface of the skin. That makes it valuable for a whole range of health challenges, ranging from psoriasis, and acne, and eczema, to skin cancer and actinic keratosis, not to mention anti-aging and reversing photo damage. And this is all via topical application, and that's why it's the only FDA approved ingredient for anti-aging skin, essentially for reversing photo damage. So you raise an interesting point.
0:14:55.3 BF: Vitamin A is a member of a family called the retinoids, and retinoids are found throughout nature. There are phyto retinoids, there's pharmaceutical retinoids, and there's the three main retinoids which are used in skincare, and those are retinyl palmitate, retinoic acid, and retinol. They all have different types of activity. Retinyl palmitate is somewhat weak. Retinyl palmitate is broken off. There are enzymes in the skin that break retinyl palmitate and release the vitamin A part, the retinol part of it, or the retinol part of it essentially. Retinoic acid is a prescription. Super powerful. It is the active form of vitamin A. It's retinoic acid that does the work. So retinyl palmitate has to be converted into retinoic acid for it to do the work.
0:15:45.0 BF: It is my favorite form of vitamin A, and the reason I say it's my favorite form is because retinoic acid is active vitamin A, but you need a prescription for it. And that requires going to the doctor, and waiting in a line at the pharmacy, and dealing with insurance companies and all the things you have to do when you get a prescription. Retinol's much weaker than retinoic acid. It's converted to retinoic acid, but you don't need a prescription for it. And so that makes it, the way I look at it as a formulator, that makes it a advantageous. Retinoic acid is really doing the work and the retinol has to get turned into retinoic acid, but in order to get a retinoic acid containing product, you gotta jump through a lot of pharmacy and medical hoops. You don't have to do that with retinol. However, retinol is much weaker than retinoic acid.
0:16:28.0 BF: So you need a strength of retinol that is gonna be aqua potent or have the same potency as a retinoic acid product if you wanna really get the good benefits of retinol, and that gets us to the downside of retinol and retinoic acid. And that is, they can be inflaming and they can be irritating, particularly if the skin surface is not healthy. If the stratum corneum is not healthy, the skin will respond to retinol and retinoic acid with inflammation and sometimes severe inflammation that can make retinol and retinoic acid a problematic ingredient. If that happens, the solution is, ironically, to use retinol and to use retinoic acid because they strengthen the stratum corneum barrier eventually. So it's kind of a catch 22 in a way. Retinol and retinoic acid strengthen the stratum corneum barrier, but if the stratum corneum barrier is weak, you can't use retinol and retinoic acid.
0:17:23.3 BF: So what do you do? Well, first of all, you can start off slow and start off with low dose. So if you have sensitive skin or your skin is prone towards irritation and you wanna build a stratum corneum up with retinol or retinoic acid, start off with a 0.5% strength, 0.3% strength, 0.1% strength of retinol, and then build yourself up slowly. So you start off with a low dose of retinol or a low dose of retinoic acid, and start off maybe once every two weeks, and then gradually build yourself up into once a week and then into twice a week, maybe even three times a week, and increase your dose or your concentration slowly. You can also use nutritional supplementation that will help strengthen the stratum corneum barrier and will allow you to use retinol and retinoic acid. And two of the most important are essential fatty acids, which are always important for skin health, and niacin, vitamin B3, which has a specific role on building the stratum corneum barrier and supporting the stratum corneum barrier.
0:18:20.9 BF: So, for folks who can't use retinol or retinoic acid but want to, make sure you're dosing yourself with EFAs, maybe even start off with essential fatty acid supplementation program for a month before you start your retinol or retinoic acid program. And throw in some niacin, time release niacin, I like maybe 100 or 200mg a day. And then after three weeks to four weeks or a month or so whatever, start to include retinol or retinoic acid low dose and increasing the frequency gradually over time. Those to me those are the three most important ingredients. Retinol, retinoic acid, glycolic acid, or alpha hydroxy acids. And also, I should tell you, I forgot to even mention this, vitamin C is a very unstable molecule. It reacts with oxygen and reacts with water and it breaks down. Try to use a protected form of vitamin C. I like fatty vitamin C THDA, we've talked about that in the past. Not only is THDA protected, it doesn't oxidize, but it has better penetrating power than just plain ascorbic acid.
0:19:20.4 MS: That wraps our show for today, and we thank you for listening. But if you just can't get enough of Ben Fuchs, the Rogue Pharmacist, you can listen for his syndicated radio program at brightsideben.com. For more information on this episode or for ways to connect with Ben Fuchs or to learn more about ASCP, check out the show notes.