External means in cosmetology

Essential dosage forms and products in dermatocosmetology

The external preparations used in cosmetology meet the same goals as in dermatology:

1. Elimination of the cause of the disease (etiological therapy).
2. Elimination of pathological changes in the skin (pathogenetic therapy).
3. Elimination of subjective sensations (symptomatic therapy).
4. Skin protection.

At the same time, the need to solve aesthetic problems somewhat broadens the indications for the appointment and introduces some additions to the indicated points. Widely used external etiologic therapy, for example, antimicrobial - with pyoderma, papulopustular acne, pustular form of rosacea, fungicidal - with dermatophytias and seborrheic dermatitis, antiparasitic - with scabies and lice. The agents affecting the links of pathogenesis are used for acne, cancer, allergic, perioral, atopic dermatitis, psoriasis and other dermatoses.

However, more often external therapy is symptomatic and is aimed at eliminating and resolving the pathological changes that arise in the skin and accompanying subjective sensations. If in dermatology the specialist chooses therapy with a primary effect on such subjective symptoms as itching, burning, paresthesia, then in cosmetology, other complaints are taken into account: the feeling of "tightness" of the skin, greasy shine, pale skin color, sensations of "hot flashes" to the skin surface and etc. In some cases, external therapy is prescribed to protect the affected skin stems from the effects of external irritant factors. Thus, in dermatology, a paste is used to protect the skin around a peptic ulcer or around a site where funds with a high concentration of keratolytic agents and other destructive ingredients are applied. In cosmetology, photoprotective agents are widely used to protect the skin, as well as anti-radical agents. The use of aniline dye and traditional tar in tar in dermatology, ASD is significantly limited in cosmetology due to the persistent coloration of the first and specific smell of the latter.

These objectives are achieved by the use of pharmacological agents of external therapy in various forms. Cosmetology uses both classical pharmacological agents of external therapy, as well as some vegetable and synthetic ingredients designed to solve a number of aesthetic problems (cosmetic products that are part of cosmetology products). Pharmacological agents are divided into indifferent and possess a certain pharmacological action. Indifferent agents that exert their action only at the expense of their physical properties include water, chemically neutral powdery substances, oils, fats, fat-like substances, gels, collodions. They usually form the basis of various forms.

In traditional dermatology the following dosage forms are most often used: solution, powder (powder), agitated gel suspension, paste, aerosol, cream, ointment, lacquer, plaster.

The solution is a liquid dosage form, which is obtained by dissolving solid or liquid medicinal substances in a solvent. Distilled water or ethyl alcohol is usually used as the solvent. The solution is used in the form of lubrication, wiping, lotions, wet-drying dressings and warming compresses. For lubrication and wiping apply aqueous and alcohol solutions of disinfecting and antipruritic drugs. In cosmetology widely using solutions for skin cleansing and toning. In such cases, synthetic detergents, acids, disinfectants, moisturizers and other substances are added. In recent years, preference has been given to the means for cleansing and toning the skin that do not contain alcohols. Cosmetology of the body uses solutions for wiping large areas of the skin. The addition of moisturizers, preparations that stimulate blood supply and lipolysis, allows the use of such solutions in the complex correction of manifestations of gynoid lipodystrophy (cellulite) and obesity.

Powder - chemically neutral fine powders of mineral (zinc oxide, talc, kalamin - a mixture of zinc oxide and iron oxide) and vegetable origin (various starches - wheat, potato, rice, etc.). Powder has a large hygroscopicity, absorbs sweat and sebum, drying and degreasing the surface of the skin. As a result, evaporation increases and skin cooling takes place. This causes a narrowing of the vessels and a reduction in inflammation and itching. The action of powder is superficial, therefore they are prescribed for superficial inflammatory processes without mocclusion, increased fat and perspiration, a feeling of itching and burning, localization of lesions in folds (intertrigo). In cosmetology, the most commonly used powders for the purpose of degreasing and drying the skin for hypersecretion of sebum, as well as for fixing make-up (loose and compact powders). Powdered industrial powders are distinguished by their fine fineness. Since the powder easily falls off the surface of the skin, it needs to be applied several times a day. In cosmetology, the powder form is also used as a drying mask, for example, in seborrhea and acne. It should be remembered that powders overdry the skin, they are contraindicated in inflammatory processes accompanied by wetting, as when mixed with exudate formed crusts and lumps.

Shaking suspensions are a suspension of indifferent powders in water or oil. Are indicated in acute and subacute inflammatory processes, not accompanied by wetting. The main components of the aqueous suspension ("talkers") are indifferent powders (30%) suspended in water with the addition of glycerol 10-20%. The oily slurry ("zinc oil") is a suspension of zinc oxide (35-40%) in vegetable oil. In cosmetology use shaken suspensions as masks. In this case, aqueous suspensions are prescribed for oily skin, oil - for dry. Depending on the tasks of the manufacturer, such masks can be ready for use or produced in the form of two substances (powder and liquid), they are prepared ex tempore. For the treatment of seborrhea and acne, water-alcohol stirring suspensions are also used, which include glycerol (5-10%), ethyl alcohol (40-50%), distilled water (40-50%) as base, precipitated sulfur, keratolytic agents, disinfectants.

Gel (jelly). In dermatology, hydrogels, which are a colloidal dosage form, are more often used. The gel has a gelatinous consistency, capable of retaining its shape and possessing elasticity and plasticity. According to the mechanism of action, hydrogels approach the beetle, and in consistence to the ointment, free from fats. For the production of gels, hydrophilic substances (gelatin, agar-agar, gum arabic, etc.), swelling in water with the formation of a colloidal system, are used. In recent decades, the gel base, manufactured by industry, includes acrylates, silicone derivatives, B gels include various pharmacological agents (glucocorticoid, fungicidal, antibacterial, etc.) that rapidly penetrate the skin. In cosmetology, gels are used for daily basic care for oily and combination skin. Gels with the addition of cyanoacrylates have the ability to penetrate deep into the mouth of the sebaceous-hairy apparatus and thicken with exposure. It is on the basis of such gels that facial masks are made with oily, large pores skin with the presence of comedones

Pasta is a dosage form of a dough-like consistency, containing 50% of indifferent powders and dense fat-like substances or fat (petrolatum, lanolin, lard). It has a drying and anti-inflammatory effect due to the powders included in its composition. Softens the stratum corneum, increasing its permeability for medicinal substances introduced into the paste, softens scales and crusts, facilitating their removal, and mechanically protects the skin from external irritating effects due to the fats entering into its composition. Apply paste with subacute inflammatory processes, not accompanied by wetting. Pasta should not be used on areas with thick hair. In cosmetology, both face and body, the form of the paste is used for masks. As well as agitated suspensions, they can be produced already ready-made, and can consist of two separate substances, which must be mixed immediately before applying the mask. The convenience of this method of mixing is that the cosmetologist can adjust the density of the applied shape depending on the skin type of the patient. Traditionally, the skin surface is cleaned from the paste with any vegetable oil, and in cosmetology - with the help of a cleaning emulsion or solution.

Aerosol is a dispersion system consisting of a gaseous medium and liquid or solid particles in a suspended state. The aerosol is pressurized in a hermetically sealed container with a valve and a nebulizer. The mechanism of action is determined by the properties of the pharmacological agent in the solvent. After spraying the solvent, it facilitates the rapid penetration of the pharmacological agent into the upper layers of the skin and evaporates. Therefore, the surface effect of the aerosol is largely dependent on the medicinal substances contained in it, which have anti-inflammatory, antimicrobial, analgesic and epithelial effects. Aerosols can be applied in creases, as well as on wet, erosive lesions. In cosmetology, the form of aerosol is used in the manufacture of post-shaving and postdepilation care products, including the "bikini" zone I

Cream (emulsion ointment) - a dense or liquid emulsion drug form, consisting of fat or fat-like substance, mixed with water in a ratio of 2: 1 or less. Liquid emulsions of the oil-in-water type (where the droplets of fat are distributed in the liquid) and fatty creams or water-in-oil emulsions that are formed as a result of the dispersion of water in the fat medium are used. The water entering the cream, evaporating, cooling the skin, causes the narrowing of the blood vessels and causes an anti-inflammatory effect. Lanolin, which is part of the cream, has great hygroscopicity and absorbs water, providing the skin with a cooling and softening effect. Creams are used for subacute and chronic inflammatory processes, as well as for dry skin or decreased elasticity. This dosage form resembles the hydrolipid mantle of the surface, it does not interfere with skin breathing and is well tolerated. That's why creams are used for daily "basic" skin care. Emulsions such as "oil in water" are used to cleanse dry and sensitive skin (so-called cosmetic "milk" or cosmetic "cream"). They are part of the classical multi-stage skin cleansing system used in the cosmetic salon. In cosmetology, depending on the ingredients that make up the cream, purifying, moisturizing, protective, nourishing creams are isolated. When you add various acids (eg hydroxy acids) to the cream residues, peeling creams for home peeling or pre-peel preparation are produced, and when solid-phase filler is added (fine silicone particles, crushed fruit bones, etc.). Creams-scrubs for mechanical peeling (gommage).

Ointment is a dosage form based on fats or fat-like substances: petroleum jelly, lanolin, animal fats, vegetable and mineral oils, hydrogenated oils, etc. Fatty indifferent bases fatten and soften dry, flaky skin, improve its elasticity, soften crusts and scales, prevent evaporation of moisture. Therefore, they increase inflammation, contribute to the resolution of skin infiltration and penetration of the underlying pharmacological substances into the skin. In recent years, they have been successfully replaced by synthetic ointment bases: polyethylene glycols, cellulose derivatives, phospholipids, etc. They are well tolerated by the skin, easily penetrate into it and removed from the surface, do not oxidize and do not decompose. They do not obeshiruyut the skin, slightly inhibit the evaporation of moisture and are well emulsified. Traditional fatty ointment bases have a more pronounced occlusive effect than synthetic water-soluble ones. The effect of the dosage form on the skin is deeper, the more it stops the evaporation of moisture from its surface, so ointments are used in those cases when it is necessary to achieve a deep and long-lasting effect of the drug substance on the affected area of the skin. The use of ointments is indicated for chronic inflammation of the skin, accompanied by congestive flushing, desquamation, infiltration and lichenification; for softening and removing crusts and thickened stratum corneum; in the treatment of superficial infectious and parasitic skin diseases. The form of the ointment is used in cosmetology for masks intended for dry and dehydrated skin.

Varnish is a viscous liquid that is a solution of film-forming substances in organic solvents (ethyl alcohol, acetone, ether, chloroform, dimethyl sulfoxide). It dries quickly and leaves a thin, transparent film, which has a pronounced adhesive property, which ensures a long-term contact with the skin of the lacquer. Pharmacological agent, the physical action of the lacquer is similar to that of the ointment, so it is used for the purpose of deep exposure to potent pharmacological agents strictly on a limited area of the skin (with hyperkeratosis, vulgar warts, etc.). Due to the sealing and the pressure exerted on the underlying skin, the lacquer provides a deep effect, facilitating the absorption of the infiltrate, accelerates the penetration of the pharmacological agents contained in it. The composition of the varnish includes a variety of drugs: keratolytic, fungicidal, disinfectant, resolving, etc. Also varnishes are often used in cosmetology of feet.

The plaster is a thick, viscous mass obtained by melting wax, rosin, resins, lanolin and other substances in different ratios. The composition includes a drug substance, whose name is determined by the name of the patch (salicylic, urea). The patch acts analogy but lacquer, but much deeper. It is prescribed when it is necessary to soften or loosen the thickened stratum corneum. The patch has irritating effects, so it is applied to small areas of the skin with the desiccation of inflammatory phenomena. Just like the varnish, they use stop in cosmetology. In dermatologic surgery, patches are used with local anesthetics (eg Emla),

Currently, dermatocosmetology often uses ready-made external preparations. They can be medical and cosmetic. The principle composition of any manufactured external product manufactured by the industrial company is represented by the following components:

• the active ingredient, or agent;
• foundation, or form;
• additional substances.

Active ingredients (agents) are introduced into external medicinal cosmetic forms in order to impart to them new properties and enhancing their physical action on the skin. It is customary to allocate pharmacological and cosmetic means, although such division is conventional on time. According to the primary effect on the skin of pharmacological agents, the following groups are distinguished: anti-inflammatory, antipruritic, resolving, keratolytic, antimicrobial and antiseptic, fungicidal, antiviral, antiparasitic cauterizing (destroying). It should be remembered that the same means in different concentrations affects the skin different, sometimes anti-climactic action (for example, ichthyol, various acids).

Anti-inflammatory drugs include astringents, ichthyol and naphthalan in low concentrations, pimecrolimus, glucocorticosteroids. Binding agents are used in the form of lotions and moist-drying dressings for acute inflammation with mocclusion (1-2% solutions of tannin and rush zorcin, 0.25% solution silver nitrate, 0.1% copper or zinc sulfate, aluminum acetate, etc.).

Ichthyol and naphthalan in a concentration of up to 5% have a weak anti-inflammatory effect. They are used in the form of a solution (for example, 2% Ichthyol) for the treatment of acute inflammatory processes and paste (2-5% ichthyol or naphthalane) for the treatment of subacute inflammatory processes.

Pimecrolimus is a natural macrolide, one of the representatives of the class of ascomycin macrolactams, belonging to the non-steroidal selective anti-inflammatory drugs. The drug is available in the form of 1% cream (Elidel, Novartis). It suppresses the function of T-lymphocytes, the synthesis of interleukins and simultaneously has no effect on local and systemic immunological reactions, does not inhibit the growth of keratinocytes, fibroblasts and endothelial cells. In some cases it can be considered as a substitute for topical steroids (for example, with atopic dermatitis, steroid dermatitis)

Glucocorticosteroids. Topical glucocorticosteroids have anti-inflammatory, antiallergic, epidermostatic, symptomatic (antipruritic, etc.) action, and also inhibit the synthesis of collagen and slow the synthesis of melanin in melanosomes. They are used in the forms of cream, ointment, aerosol, solution.

By activity, glucocorticosteroids are divided into 4 groups:

• very strongly acting - clobetasol propionate (Dermoveit), etc .;
• Betamethasone, Betamethasone valerate (Betnoveit, Celestoderm B, Valoderm), Betamethasone dipropionate (Beloderm), Budesonide (Apulein), Halomethasone Monohydrate (Sicorten), Hydrocortisone Butyrate (Maticort, Mocoid), Methylprednisolone Aceponate (Advantai), mometasone furoate (Elokom), triamsinolone acetonide (Kenalog, Triacort, Cinacort, etc.), fluocinolone acetonide (Sinaflanc, Ezocinop, Synoderm, Sinalar), fluticasone propionate (Cutivate), etc .;
• intermediate-active - predkarbart (Dermatop), flumethasone pivalate (Lokakorten, Lorindei, Fluvet), fluocortolone (Ultralan);
• weakly acting - hydrocortisone acetate (hydrocortisone ointment), mazipredon hydrochloride {deperzolone), prednisolone (prednisolone, prednisolone ointment), etc.

Steroids should be used strictly according to the indications. Indications for the appointment of topical steroids are direct, or absolute, and indirect, or relative. Direct indications include simple and allergic dermatitis, to indirect - chronic inflammatory dermatosis in the stage of exacerbation (atopic dermatitis, psoriasis, etc.). In cosmetology, in addition, steroids are used in the treatment of hypertrophic and keloid scars, less often as a bleaching agent, necessarily in combination with topical retinoids, hydroquinone and other drugs.

Contraindications for the appointment of topical steroids are infectious (in the first place - viral dermatoses, tuberculosis, syphilis, etc.) and parasitic (scabies, lice) dermatoses. If necessary, suppress inflammation with signs of pyococcal or mycotic infection for the shortest possible time can be prescribed combined drugs (Triderm, Pimafukort, Mikozolon, Dermozolone, etc.).

It should be remembered that with prolonged and uncontrolled use of corticosteroids, especially those containing fluoride, a number of side effects develop: skin atrophy, telangiectasia, activation of infection (bacterial, fungal, viral), perioral (steroid) dermatitis, less often striae, hypertrichosis. Recommend the following rules:

• to exterminate topical corticosteroids with minimal frequency; Do not prescribe the drug at doses exceeding 30 g per week for very strong and strong steroids, 50 g for medium-heavy ones and 200 g for weak-action ones, with a total treatment duration of more than 1 month;
• if possible, avoid applying topical kortakosteroidov to the skin of the face, genitals, palms and soles;
• alternate sites of exposure when using highly active drugs.

Antipruritics include menthol (1% alcohol solution, ointment, boltushka), diphenhydramine (2-5% solution, mash, ointment), dimethindene (2% gel - Fenistil), dicaine and lidocaine (3% alcohol solution, ointment), anesthesin (10% solution of alcohol, paste, ointment), salicylic acid (2% solution of alcohol, ointment), phenol (0.5-3% alcohol solution, mallet, ointment), vinegar (2-3% alcohol solution, blubber) , ethyl alcohol (10, 40, 70% aqueous solution).

The permissives include ichthyol (> 5% ointment, cream, paste, per se), tar (3-20% ointment, cream, paste, perse), sulfur (5-20% ointment, cream), ASD-3 fraction 3-10% ointment, cream, paste), anthralin (0.25, 1, 3% ointment - Dithranol).

Keratolytic agents include salicylic acid (5-15%) lactic acid (5-15%), resorcinol (5-15%), urea (> 10%), hydroxy acids (25-70%) In cosmetology they are used for chemical pilling .

The group of antimicrobial and antiseptic agents included chlorhexidine bigluconate (0.05% aqueous solution), miramistine (0.01% aqueous solution), dioxidine (0.5-1% aqueous solution, 5% ointment), various dyes (furacilin, ethacridine lactate, brilliant green, iodine and dr.), fusidic acid (Fucidin), antibiotics, sulfonamide preparations (streptocid 5-10% powder, ointment, sulfadiazine silver - 1% ointment, cream Dermazin, mafenide - 10% ointment), salts bismuth (dermatol, xeroform - 3-10% powder, paste), mercury salts (aminochloride and dichloride of the mouth are used seicha rare). In dermatology, the following antibacterial drugs are most often used: bacitricin, heliomycin (Bapeocin), gentamicin (Garamycin), clindamycin (Dalocin 7), mupirocin (Bactroban), erythromycin (Zipnerite).

Fungicidal agents are represented by azoles (bifoazole - Mycospot isoconazole - Travogen, ketoconazole - Nizoral, clotrimazole - Clotrimazole, Kanesten, Candide, etonazol - Ecolin, etc.), terbinafines (naphthyfine - Exoderyl, terbinafine - Lamisil, Terbizil, etc.) , cyclopyrox derivatives (cyclopyroxolamine-Batrafen), amorolfine (Loceril). Antifungal effect is also possessed by iodine, sulfur, tar, undecylenic acid (Mikoseptin). Antikandil drugs include polyene antibiotics (for example, natamycin - Pimafucin).

Antiviral agents include acyclovir (Zovirax, Acyclovir, tromantadine (Viru-Merz), epervudine (Gevison), glycyrrhizic acid (Epigen)

Antiparasitic agents include benzyl benzoate (10-20% ointment, suspension), sulfur (10-20% ointment, bolt), lidan (1% lotion, cream, ointment), crotamiton (10% lotion, cream, ointment), permethrin 0.5-1% cream, alcohol solution), tar (5-20% ointment, alcohol solution).

Cauterizing (disrupting) agents: 10-50% silver nitrate (lapis), 30% resorcinol, undiluted phenol, undiluted trichloroacetic acid 10-20% podophyllin, 0.5% podophyllotoxin.

Additional substances included in external pharmacological and cosmetic preparations include: aromatic fragrances, dyes, preservatives. The current trend in the manufacture of external drugs is to reduce the number of additional substances, especially those that can act as allergens (haptens). It is believed that hypoallergenic drugs and cosmetics contain a minimum of additional substances. Many companies in recent years include tested compounds of plant origin as additional substances, replacing them with synthetic ones.

Any cosmetic or medical preparation can contain a variety of microorganisms (bacteria, fungi) that enter it from raw materials or in the manufacturing process and packaging. In many European countries and in America, there are standards regulating the number of certain microorganisms in the preparation. In order to solve this problem, manufacturers carefully process raw materials, maximize the production process and include preservatives in the formulation of preparations. Unfortunately, the latter is a "necessary evil": it is much better to add a preservative and to achieve compliance with established standards of safety and quality than to produce contaminated products. It is also very important to store the product correctly after its release (avoid direct sunlight, high ambient temperature). It is known that bacteria and fungi tend to multiply in the aqueous phase of cosmetic preparations, therefore, those with a high water content pose the greatest risk for contamination by microorganisms. The most commonly used are the following preservatives: benzoic acid, benzyl alcohol, formaldehyde, various parabens (melhylparaben), urea derivatives (irnidazolidmyl urea), Quatemium 15.

[1], [2], [3], [4], [5], [6]

General information on skin permeability

From the point of view of permeability, the skin is a cover organ consisting of three anatomically distinct layers: stratum corneum (thickness about 10 microns), epidermis (thickness about 100 microns), papillary dermis (thickness about 100-200 microns). Each of these layers has different diffusion parameters. Even the skin of a perfectly healthy individual allows to penetrate almost any substance, and the intensity of penetration of various agents can vary significantly. In particular, the human skin is weakly resistant to water, and at the same time it is practically impermeable to sodium, potassium and other ions in aqueous solution. Most of these covalent substances, such as glucose, urea, macromolecules, have low permeation constants. On the contrary, a number of aliphatic alcohols, as well as various substances dissolved in organic solvents (for example, alcohol, ether, etc.), have high permeation parameters.

The severity of percutaneous absorption also depends on anatomical localization. So, the permeability of the skin in the face, especially the forehead, the rear of the hands, the scrotum is much higher than the skin of the trunk, upper and lower extremities. It is also known that the palms and soles are impenetrable for almost all molecules, except for the water molecule. An important role is played also by age: in the childhood and the elderly, skin permeability is significantly higher than in the youth and the average.