Dr. Leslie Baumann discusses antiaging cosmeceuticals and supplements, including tried-and-true ingredients as well as what’s new, what works, and why.
Leslie Baumann, MD, Cosmetic Dermatologist, Baumann Cosmetic & Research Institute, Miami, Florida
“I’m a big lover of skincare and cosmeceutical ingredients. I’ve launched a YouTube channel* where I’m interviewing cosmetic scientists about this topic. I wanted to get those scientists in the room and ask them pointed questions about the science and the studies,” said Leslie Baumann, MD, who presented “Antiaging Cosmeceuticals and Supplements” at the 2023 Alabama Dermatology Society (ADS) Summer Symposium.
According to Dr. Baumann, these interviews have generated several conversations on product ingredients.
“The spoiler alert is that retinoids are still the best for antiaging. We’ve known this since the 1980s, and more and more studies keep coming out about how good retinoids are.”
One study performed decades ago showed that topical tretinoin applied once daily for 48 weeks improved photodamage,1 said Dr. Baumann.
After the 48 weeks, “The authors divided people into three groups. One group didn’t use tretinoin at all. One group used it three times a week. And the third group used it once a week. What they found is, if you didn’t use it at all you went back to baseline. If you used it once a week you got worse but maintained some significant results compared to baseline. At three times a week, you maintained your results. So, the moral of the story is if we can get our patients on retinoids every night for 48 weeks, then if they just use them three times a week, they’ll continue getting the benefit.”
But even the lesser regimen is not so easy, said Dr. Baumann.
“It’s really hard to get our patients to use retinoids because they get retinoid dermatitis and they peel. It’s not that sexy an ingredient with all the new things coming out, but it’s still the best.”
Exosomes, peptides, and growth factors are today’s trendy skincare ingredients, said Dr. Baumann.
“The big one now is exosomes. But before I talk about exosomes, I want to talk about some antiaging science that you need to understand. It’s all about cellular senescence.”
Cellular senescence is when cells have gotten old but haven’t yet died, said Dr. Baumann.
“Cells start out as stem cells, then they proliferate, then they differentiate, then they become senescent, then they become apoptotic and die.”
Before they die, senescent cells give off inflammatory factors, damage surrounding cells, and cause inflammation. Today’s antiaging research is focused on getting rid of senescent cells to make room for younger cells. One of the ways to do this is with a process called autophagy—when the cells, in essence, eat themselves, said Dr. Baumann.
“There are ingredients geared to upregulate autophagy, whether it’s autophagy of the mitochondria or autophagy of the whole cell. Many different products and ingredients claim to do that, but the ones that have the best data behind them (in my opinion) are the exosomes.”
While stem cells were touted as the “it” ingredient in skincare, stem cells have yet to pan out in topicals, said Dr. Baumann.
“I’ve never been a fan of stem cells in cosmetic products because they don’t penetrate well under the skin. The stem cells in skincare products are from apples and other plants and those are not the same as what we need, so those are useless. And they usually die in the product anyway.”
Stem cells, however, release these tiny spheres called exosomes, said Dr. Baumann.
“Inside those spheres are all kinds of things—they have growth factors and cytokines. But they also have RNA and mRNA. And that RNA can go to another cell and get in that cell and change the DNA of another cell.”
Exosomes are powerful at sending cell signals between cells, but scientists only recently realized that power because exosomes are so small and easily break down. They just weren’t showing up in different older assays, said Dr. Baumann.
“But now that they’ve been discovered the trend is more toward exosomes than stem cells…. And exosomes are a little more exciting than growth factors because they have growth factors as well as all these other things.”
Exosome Product Differentiators
The first question to ask about a skincare product is, are the exosomes coming from platelets, the umbilical cord, blood, fat? This determines the kinds of signals they carry and how they work, said Dr. Baumann.
“Of course, they should be human-derived exosomes.”
According to Dr. Baumann, “The most popular product with exosomes right now comes from platelets. It comes from donated blood where they take the platelets out and spin it down and take these platelet factors. It’s like [platelet-rich plasma] PRP in a serum.”
But there are all kinds of other exosome products on the market, she said.
“I haven’t had the chance to research them all, but it is a fascinating field. I think we need to make the companies diligent about the data because we don’t want our patients to waste money. There’s one brand that’s $1000 a jar that I don’t want to mention [by name], but it’s probably useless. Exosomes will work if you get the right products.”
The second question, according to Dr. Baumann, is how are those exosomes centrifuged?
“If you do PRP in your practice, you know that you take the blood, spin it down, and get the platelets. The type of centrifuge you use and how fast the centrifuge spins make a big difference because the products you’re using from those platelets break down if the centrifuge is too fast or isn’t right. It’s the same with exosomes. You have to extract the exosomes with the right kind of centrifuge, so these spheres do not break open.”
Supplements for Cellular Senescence
Much like with topicals, the purpose of antiaging supplements is to try to prevent cells from becoming senescent, said Dr. Baumann.
“All kinds of research is going into that.”
Diet, including calorie restriction, is among the topics of the research. And calorie restriction has been shown to prevent cellular senescence, she said.
“Eating broccoli, cauliflower, and cruciferous vegetables also can help. Melatonin supplements may play a role. Resveratrol is probably the most exciting but the dose you get right now just isn’t high enough.”
Dr. Baumann said she loves incorporating vitamin C.
“Whether you’re making the fibroblasts make collagen, using growth factors or exosomes or retinoids, you have to have vitamin C to make collagen. I like vitamin C orally and topically.”
Antiaging skincare today still relies on the basics of sunscreen, retinoids, and vitamin C, with the newer exosome twist, said Dr. Baumann.
The regimen, or order of application, also matters, said Dr. Baumann, who has developed software to help dermatologists best guide patients on how to layer products.
“You don’t want to put some expensive, wonderful exosome product on and then put something on top of it that will inactivate it.”
*Skin Type Solutions; playlist name is Product Talks.
Reference:
- Olsen EA, Katz HI, Levine N, et al. Sustained improvement in photodamaged skin with reduced tretinoin emollient cream treatment regimen: effect of once-weekly and three-times-weekly applications. J Am Acad Dermatol. 1997;37(2 Pt 1):227-230. doi:10.1016/s0190-9622(97)80129-6.
Disclosure: Dr. Baumann is CEO of Skin Type Solutions that licenses the regimen software.