The Science of Acne Care

…Roger L. McMullen

Acne vulgaris is a common cutaneous multifactorial disord h ffli large portion of society at some point in their life, espec the adolescence years as well as during pregnan menopause. It affects approximately 85% of individuals aged 1 years and 50% of individuals aged 20-29 years 1 It develops on face or trunk of the body and can cause permanent scarring, whic can be psychologically devastating to the individual

Development of Acne

Acne is caused when the pilosebaceous unit becomes obstructed with sebum and differentiated keratinocytes, due to hyperkeratinization and excessive oil production, resulting in the for mation of comedones (obstruction of the pores that appear as small bumps on the surface of the skin). Comedones can be open (black heads) or closed (white heads), which are both non-inflammatory for ms of acne On the other hand, if the comedones become infected by bacteria, they can develop inflammatory lesions such as papules, pustules, nodules, and cyst

Hypercolonization of the pilosebaceous duct by the bacteri Cutibacterium acnes (formerly Propionibacterium acnes) has traditio been considered as mostly responsible for the ensuing b infection Excessive sebaceous gland activity has been associat onset of puberty and is believed to be the result of the activity o g A comprehensive review of the literature demonstrated that serum levels of testosterone, progesterone, glucocorticoids, insulin, and insulin-like growth factors are elevated in patients with acne while serum estrogen levels are low.2

Topical Treatment of Acne

Mild to moderate acne can be treated with topical ingredients such as retinoids, benzoyl peroxide, antibiotics, and other chemistries (e g , azelaic acid, salicylic acid, sulfur-containing compounds, etc )

Retinoids are known for their ability to increase proliferation of keratinocytes, decrease enzyme activity in lipogenesis, and impede sebocyte reproductive activity all factors important for acne-effected skin 3 Retinoids approved by the Food and Drug Adminstration (FDA) in the United States for the treatment of acne are adapalene, tazarotene, tretinonin, and trifarotene

Benzoyl peroxide functions as a reactive oxygen species (ROS), which for ms free radicals that destroy the bacterial cell wall of Cutibacterium acnes Unlike antibiotics, benzoyl peroxide provides the advantage that bacteria do not develop resistance to it

Treatment of skin with topical antibiotics is another strategy to combat the manifestations of acne vulgaris. There are three topically approved antiobiotics for acne treatment in the United States, which consist of clindamycin, erythromycin, and minocycline

Azelaic acid, salicylic acid, and sulfur-containing compounds are also important topical modalities to treat acne. Azelaic acid is a diacid that is found in wheat, barley, and rye It is known for its ability to ameliorate acne through its keratolytic and antimicrobial activity

It also is a tyrosinase inhibitor and therefore reduces melanin synthesis Salicylic acid is a beta-hydroxyacid, which has comedolytic (inhibits the for mation of comedones) and desmolytic properties, which promotes the exfoliation of stratum (continued on Page 7)

2023 NYSCC EXECUTIVE BOARD & COMMITTEE

Chair Stacey House chair@nyscc org

Chair-Elect

Amber Evans chair-elect@nyscc.org

Treasurer

Alex Blakeman treasurer@nyscc.org

Secretary Luciana Coutinho secretary@nyscc.org

Advisor Giorgio Dell’Acqua advisor@nyscc org

Program

Cathy Piterski program@nyscc org

At Home Live Series

Susanna Fer ndandes Susanna Fer nandes@tri-k com

By-Laws

Amy Marshall amy marshall@altana com

Communications

Maria Sousa socialmedia@nyscc.org

Special Events

Johanna Gigliotti johanna.e.gigliotti@gmail.com

Cosmetiscope Editor

Roger Mcmullen roger mcmullen@fdu edu

Cosmetiscope Advertising

Bret Clark rbclark@ashland com

Social Media

Maria Sousa socialmedia@nyscc org

Letter from the Chair …Stacey House

Well, I am officially halfway through my ter m as Chair of the NYSCC W ithout a doubt, time flies when you are enjoying what you do and that was quite evident at Suppliers’ Day in May!

The 44th Annual Suppliers’ Day Week of Beauty was the biggest Suppliers’ Day in our long history Not only did we have the largest show floor, with 550+ exhibitors from all over the world, but we also had a record number of attendees with over 10,000 registered participants, and almost 500 conference delegates The event featured over 100 hours of educational programming with an expanded number of industry partnerships, while the Future Chemists Workshop attracted a record number of participating students!

We created an incredible immersive experience of “Reimagining Renewal and Wellness,” that was amplified at our Annual Awards Night Program featuring the eight finalists of the CEW Supplier’s Beauty Creators Awards for ingredients and for mulations

Another first for Suppliers’ Day was engagement with SCI COMM Influencers to spread our message and engage the next generation of cosmetic chemists! We hosted an Influencers Chemist Panel on Truth in Beauty with IBA. We also had an Influencers Lounge on the show floor where attendees and exhibitors could meet with some leading voices in the social media space who are recognized experts on the science of beauty.

Our programming was highlighted by a Fireside Chat with Mohamed Kanji, Chief Open Innovation and Operational Excellence Officer, North America at L’Oréal, that featured a conversation to a standing-room only audience on how L’Oréal achieves their green science and sustainability goals

Again, we thank all our exhibitors (who are truly business partners of the event) as well as our members, colleagues, and the tireless volunteers that brought so many programs to life!

The NYSCC continued its outreach after Suppliers’ Day with our first partnership with Women’s Wear Daily (WWD) as official sponsors of the CEO Beauty Summit in New York More than 300 top level executives in Beauty and Personal Care attended, and there is no doubt that ingredients and science were leading the discussion of innovative product development Our plan is to use this partnership to ensure we continue to reach the C-level decisionmakers and engage them at Suppliers’ Day as well as at our programming functions year-round

We are not resting There are still six months to go! What should be next on your calendar? The NYSCC Acne Care Symposium will take place at Fairleigh Dickinson Campus (FDU) Florham campus in Madison, New Jersey on Wednesday, June 14th This full-day program will feature inter national experts on acne care as well as a technology showcase for attendees to lear n and discuss the latest research in the field

Don’t miss our fun outdoor social events this summer including the NYSCC Annual Golf Outing on July 24th at Crystal Springs Resort in Hamburg, New Jersey and the NYSCC Fishing Trip on August 12th departing from Atlantic Highlands, New Jersey.

2023 NYSCC Suppliers’ Day Records Its Biggest Ingredients and Formulation Event

10,362 Attendees and 546 Global Exhibitors from 73 Countries Highlighted the Beauty and Personal Care Event that Reimagined Renewal and Wellness

The 44th Annual Suppliers’ Day broke attendance records on May 2-3, 2023, at the Jacob K Javits Convention Center in New York The event attracted 10,362 registrants (representing 73 countries) coming from R&D and Product Development at large brand manufacturers and emerging independents in beauty and personal care Suppliers’ Day 2023 enjoyed its best professional attendance to date

“Attendees and exhibitors were energized by the look, feel, and size of the show and being back t o g e t h e r t o e x p l o re , d i s c o v e r, a n d d i s c u s s t h e science behind ingredients and formulations,” said Stacey House, Chair, NYSCC “Every inch of the show floor embraced our theme of Reimagining Renewal and Wellness and helped spark attendee’s product development plans ”

In addition to an exhibit floor that featured 546 exhibiting companies including 174 new exhibitors, Suppliers’ Day also boasted 100+ hours of education as well as its largest participation in conference delegates with almost 500 registrants Well attended programs covered microbiome, hair care and wellness, biotechnologies, fragrance, moder nizing cosmetic regulations, natural ingredients, Chinese beauty market, innovations from exhibitors, hot topics, and Sci-Comm Influencers Panel Suppliers’ Day core programs, “Digital Age of Beauty,” “Discover Sustainability,”

“World of Chemistry,” and “INDIE 360°” provided fresh content and actionable insight that continues to resonate with attendees.

The Fireside Chat with Mohamed Kanji, Chief Open Innovation and Operational Excellence Officer, North America at L’Oréal took place on the second day of the event and was moderated by Lan Vu, Founder/CEO of BeautyStreams Mohamed discussed how L’Oréal achieves their green science and sustainability goals to a standing room only crowd

The Future Chemists Workshop also broke records this year with more than 100 students from 22 colleges and universities across the county participating in a mini-challenge for the best upcycled leavein hair and scalp spray. The NYSCC Mentorship Mixer and Career Development Program connected members with mentees looking to enhance their professional development and career in cosmetic chemistry

The NYSCC Awards Night event took place on Tuesday, May 2nd at Second Floor NYC and announced the eight finalists of the 2023 CEW Supplier’s Beauty Creators Awards for Ingredients and Formulation. The finalists were: Activen for XEP-716 MiniProtein; BASF for ProBiolift; Cambrium for NovaColl; Croda Inc. for Mel[o]stem; Givaudan Active Beauty for Gravityl; Givaudan Active Beauty for PrimalHyal; Hydra[+], P2 Science, Inc for CitroSperse; and Vantage Specialty Ingredients Inc for Concentrated Conditioner Drops The winner will be announced at the CEW Beauty Creators Awards Luncheon on November 7, 2023

The INDIE 360° Pavilion featured 14 curated brands that are new to market and have novel ingredients, for mulations, and unique concepts The People’s Choice Award went to INA Labs for their clean, clinically tested skincare for a woman ’ s most intimate skin from effective plant-based hygiene routines to OB/GYN-developed solutions for common concer ns

Plans are already underway for next year ’ s NYSCC Suppliers’ Day, which takes place on May 1-2, 2024 Roughly 80% of the 2023 exhibitors have registered and re-signed for the 2024 event. For exhibitor and sponsorship information about 2024 Suppliers’ Day, please send e-mail inquiries to: suppliersday@nyscc org cor neum cells Salicylic acid is available in overthe-counter (OTC) products at a concentration of 0.5% to 2.0% (w/w). There are also products based on sulfur that are efficacious for acne treatment; however, these can often be aesthetically nonpleasing due to odors from sulfur

Typically, OTC products come in various for ms such as creams, lotions, washes, scrubs, and other product for mats 4 In some individuals, active ingredients in these products can cause dry skin, erythema, inflammation, and allergic contact der matitis. Ingredients can be used alone or in combination with one another, or they can be administered alongside oral antibiotics 1

Systemic Agents for Acne Treatment

The most common line of defense for more severe cases of acne vulgaris are oral retinoids (isotretinoin, which is used by itself) or oral antibiotics in combination with topical benzoyl peroxide or retinoids Isotretinoin is a common oral retinoid used for acne treatment It is highly efficacious in all aspects of acne treatment (e g , comedolytic profile, reduction of Cutibacterium acnes, decrease in sebum production, etc ) There are a host of possible side effects associated with isotretinoin treatment, although severe side effects are not common Mild side effects can be managed with dose adjustments and topical medications.5

The tetracyclines are the most common class of oral antibiotics employed for acne treatment and consist of tetracycline, doxycycline, minocycline, and sarecycline.6 They significantly reduce the Cutibacterium acnes bacteria count and ameliorate inflammation The American Academy of Der matology advises der matologists to prescribe oral antibiotics for no more than three to four months due to the risk of increased bacterial resistance.7 In addition, it is advised to administer oral antibiotics in combination with topical treatment

Hormonal therapy is another option for acne treatment, especially for adolescent females and women over the age of 25 where acne vulgaris has relapsed 5 The most common treatments are anti-androgens, contraceptive agents, and spironolactone As an example, contraceptive agents consist of an estrogen and progestin constituent and are often referred to as combination oral contraceptive pills (COCs). They function by modulating hor monal activity, controlling ovulation through a decrease in the levels of androgens, ultimately preventing pregnancy and controlling the symptoms of acne.

Prospects of Herbal Medicine in the Treatment of Acne

Alter native treatments, such as herbal medicine, are often sought after to treat ailments of the skin. There have been a number of studies investigating the effects of botanical ingredients on acne afflicted skin, which is nicely summarized in a recent review by Proença and coworkers.8 The most common botanicals which have been included in clinical trials consist of Aloe vera, Berberis vulgaris (barberry), Camellia sinensis (tea), and Melaleuca alter nifolia (tea tree)

Aloe vera is the gel obtained from the leaves of the plant, Aloe barbadensis miller, which is native to the Arabian Peninsula It has many medicinal properties and historically has been used to treat ailments of the skin such as psoriasis and acne as well as minor bur ns. Some of the principal components of the Aloe vera gel are amino acids, anthraquinones/anthrones, carbohydrates, chromones (phenolic compounds), enzymes, proteins, saccharides, and vitamins.9

Barberries are the red berries of the evergreen plant Berberis vulgaris Various biologically active compounds are found in barberry The most predominant consist of alkaloids, ascorbic acid, phenolic compounds, triterpenoids, and vitamin K.10 One of the most important alkaloids in barberries is berberine, which is considered one of the chief ingredients that offers acne protection In addition to its antibacterial and anti-inflammatory properties, treatment with barberry produces an antilipogenic effect, which could contribute to its potential as an anti-acne agent 11

The therapeutic and health benefits of tea on the skin have been known for some time Camellia sinensis is an evergreen shrub known as the tea plant Its leaves are used to

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The Science of Acne Care (continued from Page 7) make black, green, and oolong tea, which are produced by different manufacturing processes Black tea is the most oxidized while green tea undergoes the mildest preparation process. One of the hallmarks of green tea is its catechin composition, which is a class of antioxidants There are four principal catechins in green tea, which consist of epicatechin, epigallocatechin, epicatechin-3-gallate, and epigallocatechin3-gallate. Black tea, on the other hand, predominantly contains the theaflavin and thearubigin antioxidants. Numerous studies have been carried out to determine the skin health benefits of green tea demonstrating its protection against erythema, UV-induced oxidation of lipids, photoimmunosuppression, and photocarcinogenesis 12 The anti-inflammatory and antioxidant properties of green tea extract have led to its evaluation for acne treatment Overall, topical treatment with green tea extract decreases the inflammatory and noninflammatory lesions in patients who suffer from acne vulgaris 13

Tea tree oil is an essential oil distilled from the Australian tea tree plant (Melaleuca alter nifolia) It contains monoterprenes, such as terpinene-4-ol, 1,8-cineole, limonene, p-cymene, and α-terpinene, which have notable antimicrobial and anti-inflammatory properties In general, tea tree oil has been used to treat bacterial, viral, fungal, and protozoal infections of the skin.14 Its potential for the treatment of acne vulgaris has been well documented in the literature 15

Effects of Nutrition on the Development of Acne

The effect of diet on acne vulgaris is a controversial topic that has been the subject of debate in several reported accounts in the literature Prior to the 1960s, certain foods were associated with the development of acne However, during a period of almost fifty years links between acne and nutrition were dismissed. In recent years, scientists have reexamined associations between acne and food type in the diet. High glycemic load has been well established to aggravate acne vulgaris 16 Consumption of foods with a high glycemic index leads to an increase in the level of insulin, which concomitantly results in elevated amounts of insulin-like growth factor 1, which promotes lipogenesis, proliferation of keratinocytes and sebocytes, and androgen synthesis 1 These factors could play an integral role in the development or exacerbation of acne vulgaris.

The relationship between the intake of dairy products (especially skim milk), fat, and chocolate on the clinical state of acne vulgaris has also been investigated Overall, studies published in the literature suggest that there might be a link between these food types and acne 17 Possibly, these foods contain hor mones or can elicit hor monal effects that ultimately affect biochemical pathways associated with acne.

Blue Light Therapy for the Treatment of Acne Vulgaris

The biosynthesis of porphyrins by Cutibacterium acnes offers scientists a way to target acne with visible blue light. Porphyrins absorb light in the UV and blue light region of the electromagnetic spectrum. Ideally, subjecting acneic skin to phototherapy (also known as photobiomodulation) using laser light or LEDs (light emitting diodes) which emit blue light should decrease the number of Cutibacterium acnes colonies on the skin’s surface. While there appears to be some promise in the utilization of blue light therapy for acne, researchers of two comprehensive studies came to the conclusion that further work needs to be completed due to limitations in the methodologies that were used to grade acne in the existing literature 18,19

Role of the Skin Microbiome in the Etiology of Acne Vulgaris

The skin microbiota consists of beneficial bacteria, fungi, and viruses that work in conjunction with our innate and adaptive immune system to ward off foreign pathogens 20 W ithin the der matological community, it is often thought that Cutibacterium acnes is solely responsible from a microbiological standpoint for the development of acne vulgaris In fact, within each species of microbe there are various strains some are beneficial to the host while others are not. For example, Cutibacterium acnes, which is the most abundant microbial species on the skin, is found in both healthy and acneic skin There are different strains of Cutibacterium acnes, which can be categorized into various phylogenetic groupings in accordance with their pathogenic or protective effect. Therefore, in addition to noting the strains of Cutibacterium acnes that are on the skin’s surface, it is equally important to know what other types of microbes are present. Likewise, the immune system’s response to the microbiota and their metabolic products probably also plays an integral role in acneic skin 21 Not surprisingly, dysbiosis (the imbalance of the skin microbiota) is believed to be responsible for several skin disorders including acne 22 In addition to genetic factors, the health state of the skin depends on interactions between resident cells and the delicate balance of various strains of microbes that constitute the microbiota

References

1 D Z Eichenfield, J Sprague, and LF Eichenfield, Management of acne vulgaris: a review, JAMA, 326(20): 2055-2067 (2021).

2. M.K. Arora, A. Yadav, and V. Saini, Role of hor mones in acne vulgaris, Clin. Biochem., 44: 10351040 (2011)

3. M. Zasada and E. Budzisz, Retinoids: active molecules influencing skin structure for mation in cosmetic and der matological treatments, Adv Der matol Allergol , 36(4): 392-397 (2019)

4. A. Decker and E.M. Graber, Over-the-counter acne treatments: a review, J. Clin. Aesthet. Der matol , 5(5): 32–40 (2012)

5. A. Tobiasz, D. Nowicka, J.C. Szepietowski, Acne vulgaris novel treatment options and factors affecting therapy adherence: a narrative review, J Clin Med , 11: 7535 (2022)

6 E M Graber, Treating acne with the tetracycline class of antibiotics: a review, Der matol Rev , 2(6), 321-330 (2021)

7 A L Zaenglein et al , Guidelines of care for the management of acne vulgaris, J Am Acad Der matol , 74, 945-973 (2016)

8 A C Proença, A Luís, and A P Duarte, The role of herbal medicine in the treatment of acne vulgaris: a systematic review of clinical trials, Evid. Based Complementary Alter n. Med., 2011945 (2022).

9 J H Hamman, Composition and applications of Aloe vera leaf gel, Molecules, 13(8), 1599-1616 (2008).

10 M Rahimi-Madiseh, Z Lorigoini, H Zamani-gharaghoshi, and M Rafieian-kopaei, Berberis vulgaris: specifications and traditional uses, Iran J. Basic Med. Sci., 20(5), 569-587 (2017).

11 M Imenshahidi and H Hosseinzadeh, Berberine and barberry (Berberis vulgaris): a clinical review, Phytother. Res., 33(3), 504-523 (2019).

12. R. McMullen, Antioxidants and the Skin, CRC Press: Boca Raton, FL, 2019.

13 S Kim, T H Park, W I Kim, S Park, J H Kim, and M K Cho, The effects of green tea on acne vulgaris: a systematic review and meta-analysis of randomized clinical trials, Phytother. Res., 35(1), 374-383 (2021)

14. N. Pazyar, R. Yaghoobi, N. Bagherani, and A. Kazerouni, A review of applications of tea tree oil in der matology, Int J Der matol , 52(7), 784-790 (2013)

15. K.A. Hammer, Treatment of acne with tea tree oil (melaleuca) products: a review of efficacy, tolerability, and potential modes of action, Int J Antimicrob Agents, 45(2), 106-110 (2015)

16 W P Bowe, S S Joshi, and A R Shalita, Diet and acne, J Am Acad Der matol , 63(1), 124-141 (2010)

17 E H Spencer, H R Ferdowsian, and N D Bar nard, Diet and acne: a review of the evidence, Int J Der matol , 48, 339-347 (2009)

18 A M Scott et al , Blue-light therapy for acne vulgaris: a systematic review and meta-analysis, Ann. Fam. Med., 17(6), 545-553 (2019).

19 M L Gonçalves Diogo, Effect of blue light on acne vulgaris: a systematic review, Sensors, 21(20), 6943 (2021). DOI: 10.3390/s21206943.

20 A L Byrd, Y Belkaid, and J A Segre, The human skin microbiome, Nat Rev Microbiol , 16, 143155 (2018).

21 T Hitchcock, Rebooting the C acnes narrative, Pract Der matol , December 2021, pp 12-13

22 R Sfriso, M Egert, M Gempeler, R Voegeli, and R Campiche, Revealing the secret life of skin –with the microbiome you never walk alone, Int. J. Cosmet. Sci., 42(2), 116-126 (2020).

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