Skincare 101 - Active Ingredients That Really Work

A key component of skincare products are the active ingredients, the components that help to restore the skin's optimal wellness and appearance. Active ingredients help to boost your skin's ability to combat and reverse the damages of environmental and internal ravages, and are an important part of your daily care routine.

Which skincare? Consumers are spoilt for choice.

There are literally thousands of skincare brands on the market, with many more being launched every day. Expensive skincare brands are often advertised heavily, with endorsements by beautiful celebrities and models, but do big advertising budgets guarantee great products? Other brands are less well advertised but they appeal to different niche markets, whether it be the close-to-nature, hypo-allergenic or chic-but-cheap sectors. they all have different ingredients and claims that make the right choice very hard to make.

Which products have proven efficacy?

Dermatologist-tested products, or those who have been proven through clinical trials and tests, are your best option for products that actually give you your money's worth.

Anti-wrinkle creams are among those that are the most popular in the market. Everyone dreams of creams that can erase lines and wrinkles overnight, but unfortunately there are few products that actually live up to their exorbitant claims. One active ingredient that is proven is tretinoin, a Vitamin-A derivative which has been shown in trials to improve skin exfoliation and stimulate collagen production. It has also been shown to reduce pigmentation, improve skin tone and texture, and give a 'rosy glow' due to increased blood circulation.

Tretinoin must be applied daily for a minimum of 6 months for noticeable results. It has been tested in many short and long term clinical studies, and has been proven to work even on severely aged and wrinkled skin. Tretinoin can be highly irritating to the skin and can cause acne and skin peeling in the initial stages, so it should be prescribed and administered carefully under a doctor's care. A high SPF sunscreen is a must to prevent the skin from continuing sun damage during the treatment process. Pregnant or lactating women should not use tretinoin, and it should also be avoided if you have rosacea (skin redness). Also commonly prescribed for the treatment of acne, tretinoin is also now available in micronized form to help with some of the side effects such as skin dryness and irritation.

Over-the-counter products with Vitamin A in the form of retinol do not have the same efficacy as prescription products as retinol is not as easily absorbed and used by the skin. Retinol can be more helpful as a preventative measure to help younger skin prevent the signs of aging. Other forms of Vitamin A such as tazarotene and adapalene are also available, but most patients find tazarotene highly irritating, and adapalene too gentle and non-effective.

Products containing hydroquinone are also effective for lightening of pigmentation problems such as freckles, melasma, liver spots and age spots. Hydroquinone works by inhibiting enzyme reactions within the skin, thus preventing pigmentation. Hydroquinone creams are available at 2% strength in OTC products, but your doctor can prescribe a cream up to 4% strength for better results. The use of a sunblock is essential during treatment with hydroquinone creams. Some doctors use a hydroquinone and tretinoin combination for stubborn melasma or hyperpigmentation cases.

Alpha-hydroxy acids such as glycolic acid or lactic acid work by exfoliating dead skin cells to allow for growth of new skin. They also help to unclog pores, improve skin texture and have an added benefit of skin lightening and depigmentation. The pore cleansing action of AHA also means it can be helpful in controlling mild to moderate acne. AHA creams are very commonly available, but the low acid content of most OTC products means they have limited effectiveness; for AHAs to really make any difference, they must have at least a 10% acid content or more, and have a low pH of around 2. 15% glycolic acid lotions are a useful additional treatment for melasma, when used in conjunction with treatment creams such as Tri-Luma.

A doctor-administered glycolic acid peel can be useful to restore the skin by exfoliation to reveal the younger, smoother, lighter skin beneath. Research has also shown that glycolic acid peels used in combination with topical active ingredients such as tretinoin, can increase the effectiveness of the anti-wrinkle or skin lightening process.

Beta-hydroxy acids or salicylic acid, is more suitable for younger, oily skin, as it is soluble in oil. It helps to soften keratin and promotes clearance of blocked pores. BHAs are also useful in promoting skin moisture levels and is an effective anti-inflammatory agent as well. Salicylic acid is also prized for it's ability to improve cell turnover and promote depigmentation, and is therefore a great alternative for those who are sensitive to AHA creams.

Antioxidants are active ingredients that help to fight the free radical activity that damages skin cells, and therefore should be an important ingredient in your daily fight against skin degeneration. The good news is that there are many antioxidants that have been shown to have great efficacy. Green tea  or olive extracts, for example, contain polyphenols, which have been featured in numerous clinical studies that show their ability to retain moisture, fight oxidative stress and prevent formation of skin damage. Alpha -lipoic acid is another potent antioxidant that can inhibit cellular aging, help soothe inflammation and promote detoxification of a variety of chemicals. Vitamin C, CoEnzyme Q-10 and caffeine are also antioxidative substances that show promise in the battle against premature aging.

Perhaps the single most effective skin care product that you can use to prevent premature aging and protect your skin against sun damage is proper sun protection and sunblock. I wrote about the importance of proper sun care in a previous article, Sun Safety: Is Your Sunscreen Doing Its Job?. If your skin is being attacked and damaged by the sun on a daily basis, then it cannot look its best and absorb any of the goodness from your active ingredients, and you are essentially wasting your efforts and your money.

Cosmetic Medicine, MD

Dr. Liow Tiong Sin is an aesthetic practitioner who practices in Kuala Lumpur and Melaka, Malaysia. He has more than 12 years of expertise with non-surgical cosmetic treatments, and  conducts training courses for other doctors from all around Asia. To connect with Dr. Liow, Like Cosmedmd's Facebook page. medical centre website or email.