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frequently asked questions: PCA SKIN products, ingredients & philosophy Jennifer Linder, M.D. Dermatologist and Mohs Skin Cancer Surgeon Private Practice, Scottsdale, Arizona Clinical Instructor, University of California, San Francisco Chief Scientific Officer, PCA SKIN® All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Could the epidermal growth factor in rejuvenating serum encourage proliferation of cancerous cells? the amount of EGF utilized is designed to promote healthy cell proliferation this ingredient is designed to help new cell turnover but should not promote rapid cell development I feel comfortable recommending rejuvenating serum to my patients that have had skin cancers in the past to be safe, the use of any product capable of promoting new cell growth should be avoided on those with active cancerous lesions All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs What is the difference between natural and synthetic ingredients in skincare products? many of the most effective ingredients in dermatology are synthetic and cannot be found naturally (e.g. retinol, benzoyl peroxide) in many cases, synthetically reproduced ingredients offer a consistently available alternative to the naturally derived option • these are molecularly identical to the natural form using synthetic ingredient options often reduce the chance of toxins and depletion of natural resources All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Do natural and synthetic ingredients react differently within the skin? synthetic and naturally derived molecules are identical their bioavailabilty and bioactivity are the same Vitamin C All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Why does the color of certain PCA products change from batch to batch? there is no true color in nature PCA utilizes a combination of natural and synthetic ingredients for the most efficacious products possible natural ingredients may vary in color depending on the time of year the ingredient is harvested by the raw material supplier PCA does not utilize any artificial dyes or fragrance, as both are topical allergens All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Can the use of AHA, TCA and/or chemical peels thin the skin to the point that they can be detrimental to skin health? the concern surrounds the Hayflick limit the Hayflick limit is the number of times a cell can divide before it loses its ability to replicate we have stem cells in our skin and it is their job to produce the new cells unlike other kinds of cells, stem cells do not have a Hayflick limit because stem cells replace senescence cells; it is not possible to thin the skin with chemical peels or to do too many exfoliations All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs What is the function of retinoic acid (tretinoin) on the skin? How does it compare to retinol, retinyl palmitate and other derivatives? retinoic acid offers multiple topical benefits • increases water content in the epidermis • increases hyaluronic acid production • fights free radical damage • encourages cellular proliferation • reduces the amount of desmosomes • reduces the amount of melanosomes, inhibits tyrosinase and reduces pigment transfer from melanocyte to keratinocyte • increases collagen, elastin and fibronectin and acts as an MMPi • reduces keratinization within the follicle All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs What is the function of retinoic acid (tretinoin) on the skin? How does it compare to retinol, retinyl palmitate and other derivatives? straight retinoic acid can be irritating retinol and other derivatives are converted to retinoic acid in the skin and are typically non-irritating • 1% retinol is converted to 0.05% retinoic acid • retinyl esters (e.g. retinyl palmitate, retinyl linoleate) are more stable than retinol and pure retinoic acid however they must be converted to retinol, then to retinoic acid • retinyl esters are often utilized at lower percentages and only offer antioxidant benefits All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Are certain ethnicities more prone to certain skin conditions? most skin conditions can be found in any skin tone or hereditary background however, different ethnicities may be more prone to certain skin conditions All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Are certain ethnicities more prone to certain skin conditions? The most common skin conditions in African-American skin: • acne • hyperpigmentation • atopic dermatitis (eczema) • seborrheic dermatitis Source: Halder R, Nootheti P (2003) Journal of American Academy of Dermatology;48:6,S143-S148 All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Are certain ethnicities more prone to certain skin conditions? The most common skin conditions in Caucasian skin: • skin cancer • hypopigmentation • photoaging • rosacea All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Are certain ethnicities more prone to certain skin conditions? The most common skin conditions in Asian skin: • xerosis (dry skin) • atopic dermatitis (eczema) • melasma • photodermatoses Source: Halder R, Nootheti P (2003) Journal of American Academy of Dermatology;48:6,S143-S148 All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Are certain ethnicities more prone to certain skin conditions? The most common skin conditions in Hispanic skin: • acne • atopic dermatitis (eczema) • photoaging • hyperpigmentation Source: Halder R, Nootheti P (2003) Journal of American Academy of Dermatology;48:6,S143-S148 All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs How do melanogenesis inhibitors behave in the skin? depending on the type, different melanogenesis inhibitors behave differently within the skin a combination of melanogenesis inhibitors is the most effective method of treatment Illustrations © 2008 Physicians Care Alliance, LLC All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs How do melanogenesis inhibitors behave in the skin? arbutin • found naturally in cranberry, blueberry and bearberry leaves, and wheat and pears • less cytotoxic to cultured melanocytes than HQ • mechanism of action a natural derivative of HQ that allows controlled release of HQ inhibits tyrosinase activity inhibits melanosome maturation a potent antioxidant agent Sensi Peel®, Esthetique Peel, Smoothing Body Peel, A&C synergy serum, brightening therapy with TrueTone All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs How do melanogenesis inhibitors behave in the skin? kojic acid • derived from rice, soy and mushrooms • may induce irritation in certain skin types • mechanism of action chelates the copper bound to the tyrosinase decreases the number of melanosomes and melanocytic dendrites Ultra Peel® I, Ultra Peel® Forte, Sensi Peel®, Esthetique Peel, all PCA Peels®, Smoothing Body Peel, pigment bar, both pigment gels®, A&C synergy serum, perfecting face & body hydrator SPF 30 All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs How do melanogenesis inhibitors behave in the skin? retinol • synthetically produced retinoid • stimulates collagen, elastin, and glycosaminoglycan production • mechanism of action inhibits tyrosinase activity decreases the number of melanosomes inhibits the transfer of melanin from melanocyte to keratinocytes enhances the penetration of actives through stratum corneum increases cell turnover, accelerating the lifting process Ultra Peel® II, Esthetique Peel, AO2, A&C synergy serum, retinol renewal with restorAtive complex, hydrator plus SPF 25, protecting hydrator SPF 25, purifying mask, C-Strength 15% and 20%, clearskin, perfecting face & body hydrator SPF 30, acne cream All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs How do melanogenesis inhibitors behave in the skin? ascorbic acid • derived from many botanical sources such as citrus fruit and corn • may induce irritation in certain skin types • mechanism of action chelates the copper bound to the tyrosinase decreases the number of melanosomes and melanocytic dendrites Ultra Peel® Forte, Ultra Peel® I, Sensi Peel®, Esthetique Peel, Ultra Peel® II, collagen hydrator, C-Quench® antioxidant serum, C-Strength 15% and 20 %, A&C synergy serum, ExLinea® peptide smoothing serum, acne cream All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs How do melanogenesis inhibitors behave in the skin? lactic acid • derived from sour milk and sugars • effective humectant and antimicrobial agent • mechanism of action suppresses the formation of tyrosinase increases exfoliation of melanin-filled keratinocytes Detox Gel, Ultra Peel® Forte, Ultra Peel® I, Sensi Peel®, all PCA Peels®, Esthetique Peel, AO2, Smoothing Body Peel, facial wash normal and oily/problem, smoothing toner, nutrient toner, hydrator plus SPF 25, both pigment gels®, ReBalance, A&C synergy serum, perfecting face & body hydrator SPF 30, acne cream, total wash face & body cleanser All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs How do melanogenesis inhibitors behave in the skin? azelaic acid • naturally sourced from grain products, castor beans, or by the oxygenation of oleic acid, found in milk • antimicrobial, anti-inflammatory and helps to normalize keratinization in the skin • mechanism of action inhibits tyrosinase activity shuts down malfunctioning melanocytes inhibits abnormal proliferation of melanocytes Ultra Peel® Forte, Ultra Peel® I, Sensi Peel®, pigment bar, both pigment gels®, acne gel All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs How do melanogenesis inhibitors behave in the skin? licorice root extract • naturally derived or synthetically produced • mechanism of action inhibits tyrosinase activity anti-inflammatory A&C synergy serum, eyeXcellence, perfecting face & body hydrator SPF 30, acne gel All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs How do melanogenesis inhibitors behave in the skin? morus bombycis root extract (mulberry) • naturally derived • mechanism of action inhibits the conversion of L-DOPA to dopaquinone potent antioxidant and anti-inflammatory agent perfecting face & body hydrator SPF 30 All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs How do melanogenesis inhibitors behave in the skin? rumex extract • derived from different herbs western dock yellow dock golden dock • no topical irritation • mechanism of action inhibits tyrosinase Esthetique Peel All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs How do melanogenesis inhibitors behave in the skin? phenylethyl resorcinol • synthetically produced resorcinol derivative • results comparable to kojic acid and HQ without any potential for topical irritation • mechanism of action inhibits the conversion of tyrosinase to L-DOPA potent antioxidant brightening therapy with TrueTone All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs How do melanogenesis inhibitors behave in the skin? undecylenoyl phenylalanine • synthetically produced • mechanism of action prevents the synthesis of the melanocyte-stimulating hormone (MSH) brightening therapy with TrueTone All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Does brightening therapy with TrueTone replace any of your other pigment control products? brightening therapy with TrueTone can be used on all Fitzpatrick skin types and sensitivity levels it effectively increases overall luminosity and evens the complexion to bring out the patient’s own true tone brightening therapy with TrueTone is designed to work in conjunction with pigment gel® and A&C synergy serum using these products together leads to faster, more dramatic pigment reduction results All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. pigment control solution mechanism of action inflammation/hormonal stimuli pigment gel® (with or without HQ) brightening therapy with TrueTone melanocytestimulating hormone A&C synergy serum perfecting face & body hydrator SPF 30 tyrosinase + Copper tyrosine L-DOPA dopaquinone melanosome formation melanosome distribution All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs If I see a significant improvement in the appearance of my pigmentation, can it come back? yes, all types of hyperpigmentation may reoccur or worsen if exposed to UV radiation one day of unprotected or prolonged sun exposure may cause pigment to re-surface broad-spectrum UV protection is crucial to the achieving and maintaining pigment control results once one has hyperpigmentation, they are prone to the condition • the daily use of melanogenesis inhibitors should be continued to prevent the future occurrence of discolorations All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs What are the unique benefits of PCA SKIN C-Strength 15% and 20% with 5% vitamin E? ascorbic acid is inherently unstable and oxidizes easily C-Strength is a non-aqueous base, promoting stability silicone wraps encase the ascorbic acid, ensuring no water, air or light are able to come in contact with the active ingredient All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Why is it beneficial to utilize vitamins C and E in conjunction? studies show that combinations of vitamins C and E provide superior antioxidant benefits to either used alone vitamin C is hydrophilic and vitamin E is lipophilic – each protects different environments within the skin the two vitamins also keep one another stable and active All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs If ascorbic acid is so unstable, why not use ascorbyl palmitate or other esters instead? ascorbyl palmitate and other esters are more stable, however they do not behave the same way as ascorbic acid does in the skin ascorbic acid is the only bioavailable form of vitamin C the skin is not able to breakdown these esters to the active form additionally, studies show ascorbyl palmitate promotes lipid peroxidation and cytotoxicity in keratinocytes when exposed to UV rays All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs How is the C-Quench® antioxidant serum stabilized? ascorbyl All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Are parabens carcinogenic? no, parabens have a long history of use in cosmetic products and their safety is well documented and continually evaluated ONE study stirred up media attention by suggesting a link between breast cancer and the use of parabens in antiperspirants and deodorants • this study has been widely discredited and was deemed inconclusive some parabens have shown estrogenic effect in screening tests • these estrogenic effects are many thousands of times less potent than the natural estrogens in the body, and even less potent than the estrogenic compounds in foods such as apples, carrots, beans, dairy foods, garlic, papaya, potatoes, rice, soybeans, wheat, and yams that are eaten everyday. All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Are sunscreens carcinogenic? no, sunscreens have been proven to help prevent certain cancers when sunscreens absorb UV radiation it is possible for them to release free radicals this reaction only occurred in studies once the sunscreen product had absorbed into the skin • if sunscreen products are re-applied appropriately, this free radical production does not occur formulating sunscreen products with antioxidant ingredients prevents this reaction • applying antioxidant products in conjunction with sunscreens also prevents this reaction All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Why should I buy your sunscreen when I have an SPF 40-60 that I bought at the local drugstore? the amount of protection a product offers does not increase proportionately with the SPF number a SPF 15 sunscreen protects the skin from 93% of UVB radiation, a SPF 30 sunscreen provides 97% protection, and a SPF 65 provides approximately 98% protection All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Why should I buy your sunscreen when I have an SPF 40-60 that I bought at the local drugstore? PCA SKIN sunscreen products are much more than broadspectrum UV protection • non-comedogenic • improve skin barrier function • melanogenesis inhibition • antioxidant • cosmetically elegant All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Why doesn’t PCA make a physical sunblock? titanium and zinc products tend to be very thick and are often uncomfortable for daily use PCA strives to formulate cosmetically elegant sun protection products that are effective and also have a smooth, light feel when applied to the skin chemical sunscreen ingredients have a much more comfortable feel on the skin than physical blocks our products are formulated with every skin type, condition and tone in mind • darker-skinned individuals often find physical blocks leave them with a chalky or ashy appearance, as the ingredients sit on the surface of the skin rather than being absorbed All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Can PCA SKIN products be used during pregnancy/lactation? yes, many are appropriate for use during pregnancy the list of appropriate ingredients for use during pregnancy and lactation differs from physician to physician it is wise to advise patients to check with their caring OB/GYN prior to the use of any topical products the following cosmeceutical ingredients are typically avoided: • retinol • hydroquinone • resorcinol • higher percentages of AHA All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Does PCA SKIN test on animals? no, PCA SKIN does not perform or condone animal testing all finished products are tested in case studies with patients of our medical practice All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Why is it important that a client preps the skin with PCA daily care products before receiving a PCA professional treatment? prepping the skin ensures proper skin function • enhances treatment outcome • shortens healing time • reduces the chance of complications and patient reactions • promotes even penetration of active ingredients All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs Why don’t you offer single use samples? using any product once does not adequately show the patient the product’s benefits our trial size products offer two to three weeks worth of product this amount ensures the patient will see the effects of the product prior to purchasing the full size these products have value and are not just a give-away All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only. PCA SKIN® FAQs What is the benefit of starting a patient on one of the trial-size daily care solutions? these sets are meant for the patient to try and test the product line before purchasing full size once they try these products and come back with their feedback that it then makes the customization process easier and more meaningful All content copyright 2009 PCA SKIN and Physicians Care Alliance LLC. Images are for internal use only.