Summit Event's first anti-ageing skin care conference tackled a wide range of issues related to skin ageing. Richard Summers & Clare Henderson report from the London event (10-11 June)
The first Anti-ageing skin care conference organised by Summit Events attracted over 80 delegates to the world class facility of the Royal College of Physicians. The hope of the organisers, Jack Ferguson (Skinnovation Ltd) and Paul Matts (Procter & Gamble), was to highlight a number of aspects of ageing and examine how as an industry we manage to combat the telltale signs of growing old. Nineteen lectures and four keynote presentations covered a lot of ground, from ageing mechanisms to regulatory conundrums.
Professor of Dermatology at Manchester University, Chris Griffiths got the ball rolling in a keynote address discussing how ageing actually affects the skin, both from a photo ageing and a chronological ageing perspective. Interestingly, from the data presented Griffiths demonstrated that photo damaged skin was significantly different in structure to chronologically damaged skin. Griffiths examined the various mechanisms of ageing and how some cosmetic treatments affected the physiology of the skin. “There is good evidence that the application of sunscreen may allow the skin to repair itself,” said Griffiths. “Whether it’s to a degree clinically discernible is another matter.” He added that he was not wholly convinced about the antioxidant story. The best researched topicals are retinoids, and retinoid deficiency increasingly seems to be the most sensitive marker.
Horst Wenck (Beiersdorf) then took delegates through the mechanisms of ageing in more detail and made a few suggestions on targets for anti-ageing products, sharing data that showed some significant improvements in the skin structures and good visual signs of activity. Some of the actives Wenck talked through included vitamin E – and he agreed with Griffiths that this does not have an effect – and vitamin C. “Antioxidants will add to the efficiency of a UV filter,” he said. He also examined retinol and creatine. Wenck said harsh regenerative processes can work beautifully in the hands of professionals but are perhaps questionable when it comes to consumer use. “Targeted stimulation of biosynthesis in a manifold way is the most prosperous, effective way to go,” he concluded.
Mark Birch-Machin (University of Newcastle) discussed the role of mitochondria in ageing skin and how it can be used to study the effects of photo-protection by antioxidants in human skin, considering the mitochondria as the batteries of the cell that effectively provide a diary of sun exposure. His approach is using mitochondrial DNA as a marker for damage rather than the more common method of using nucleic DNA; there are no reliable markers of sunburnt DNA in skin, said Birch-Machin. Work is ongoing but the model is believed to have the potential to be used to predict whether sunscreens can provide enough protection against photo-oxidative stress.
Sidestepping away from the hard science, consultant psychologist at the Fernleigh consulting centre, Eileen Bradbury provided a fascinating insight into people’s perceptions to ageing and anti-ageing procedures. Looking primarily at the more drastic surgical anti-ageing methods, Bradbury highlighted factors that would encourage people to follow this course of action and at certain situations where this would not be the best choice.
Berhard Fink (University of Göttingham, Germany) demonstrated how we perceive ageing in people and the role skin tone plays in directing our opinions. Fink presented work carried out with P&G looking at the consistency of skin tone and how perceived age alters. The data was produced from flat models with no topological effects so the results were based purely on skin pigment-ation. The conclusion was that we all judge attractiveness and age by the colourations of a person’s skin. Looking ahead Fink plans to investigate: the interaction of skin condition with face shape; cross-cultural ethic skin studies; more detailed examination of the effects of fine lines, wrinkles and microtopography on perception; actual measures of health; and additional measures of skin properties (eg hydration, elasticity).
A second keynote presentation was given by Peter Elsner (Fredrick Schiller University, Germany). Elsner has been looking into the mechanisms that affect skin ageing and how it may be possible to develop in-vitro and in-vivo tests to show that actives are affecting these mechanisms. The older style of approach was to focus on purely visible signs of ageing. But newer research has suggested other factors that are good indicators of damaged skin and it is these that Elsner thinks will be the future to developing anti-ageing products.
PSYCHOLOGY, BIOLOGY, TECHNOLOGY
Paul Matts presented more of the data obtained in conjunction with the University of Göttingham, looking specifically at skin pigmentation and how the density of this differs from younger to older skin. He showed a number of slides showing different chromophore maps ranging from very young skin to old skin, demonstrating how looking at just these chromophores you can guess a person’s age.
“There is an emerging appreciation for the importance of the psychology of perception and we are beginning to correlate perception with biology and develop improved methods and measures of identified endpoints,” said Matts. “Tecnology developed to target endpoints identified in this way appears to punch above its weight.” He predicted that the high performance anti-ageing skin care of the future would be developed increasingly by a marriage of psychology, biology and technology.
Continuing the clinical study discussions Roland Bazin (L’Oréal) looked at the range of tools available to the scientist to help understand how things are working. The most important of these is the Skin Atlas, a process by which a number of photographs of different areas of the face are standardised to provide a representative cross section of ageing effects. This allows a correlation of effect to age during clinical studies. There are different atlases at the moment, and not all are finished, but ultimately Bazin would like one to suit all. A number of specifically designed instruments that make these evaluations easier were also discussed.
Mathias Rohr (Insitute Dr Schrader - hautphysiologie) presented the interestingly titled Photons into the skin, photons out of the skin. Rohr’s work measures topology of the skin using instrumental methods. The differences in skin topology are easily measured using a FOITS (Fast Optical In-vivo Topometry of the Skin) technique. Looking at the frequency distribution of the lines in the skin it is possible to see the shift from small, shallow lines in young skin to longer, more defined lines as skin ages.
The final paper of day one came from Nikiforos Kollias (Johnson & Johnson Consumer Companies). He demonstrated how the face changes as age increases, as we would all expect, but also that these changes are not consistent across the whole population. The variety in ethnicity and culture gives a very wide diversity of ageing signs. These are all measurable and Kollias showed how different areas of the face provide stronger markers to ageing depending on the ethnicity and culture of the face being studied.
CLAIMS & BORDERLINES
Day two kicked off with another keynote address, this time from the Advertising Standards Authority’s (ASA) Guy Parker who discussed products and claims currently on the market and why some of them have been brought to the attention of the ASA. The claims that advertisers are making for products have been getting stronger as the science behind the products becomes ever more cutting edge. “You can’t get round poor claims with a testimonial and a before and after picture,” said Parker.
He discussed developments between the CTPA and the ASA, specifically work on cumulative moisturisation and persistent effect, which the industry has put a lot of effort into supporting. Parker complimented the industry on doing a good job on this and the ASA now accepts ‘proof of concept’. However, he pointed to what he termed the thorny issue of how you define dry skin and said there was still work to do on this.
One problem with product claims is that they can frequently come close to being classed as medicines. The main decision maker here is the Medicines Healthcare products Regulatory Agency (MHRA). “If the MHRA is relaxed on something we’re unlikely to go against it; medicinal law trumps cosmetics law,” said Parker. “But the borderline is becoming a hotter issue as companies are wanting to move into this area. You can’t have it both ways. You don’t have a right to sell a cosmetic on a medicinal claim because you want to.” From discussions, it does seem increasingly likely that we’re going to see cosmetic products with a physiological effect... it just depends how that effect is achieved.
The MHRA has a borderline section that looks after the grey area between an out an out cosmetic and a medicinal product and the MHRA’s Jane Cole drew delegates further into borderline issues. “A product must be a medicine OR something else. It can’t be a medicine AND something else,” she said. The things that affect a product’s classification are the claims and the pharmacological effect of the product. Again, as the products become more active the borderline becomes harder to control. The connection is likely to be the ingredients so be careful which raw materials you’re using. “We do consider what ingredients are in a product and what effect they could have, particularly in the area of herbals and botanicals,” said Cole. She also pointed out that the much used term ‘cosmeceuticals’ has no legal meaning in the UK. “It’s a US expression used to describe a cosmetic with a therapeutic effect. We don’t recognise this term.”
With the regulatory agencies having outlined how products can be judged, Debra Redbourn (dR cosmetic regulations) then provided a number of examples of products that have had claims upheld, both in the UK and the US. Her examples all showed that claims advertisers make for their products have to be substantiated and not fall within the realms of the MHRA borderline section.
Standing in for Raniero De Stasio (L’Oréal), Julie McManus demonstrated, using the case study of the recently introduced Derma-Genesis product range, how a raw material is incorporated into the marketing of a product and how this differs from country to country. While McManus’s role is scientific advisor at L’Oréal, she said her time was actually dominated by the creativity of the marketeers in her company. The key ingredient of Derma-Genesis is Pro-Xylane, a breakthrough that L’Oréal has put into a lot of brands. “There has been a lot of research and investment so it’s a bit soul destroying if we can’t claim much for it,” said McManus. In fact, quite different claims are allowed in different countries. For example, while the science is the same, in France you can say ‘skin is firmer’ while in the UK you have to settle for ‘skin looks firmer’.
Farah Ahmed (Personal Care Products Council, formerly the CTFA) provided further detail on how anti-ageing products are regulated in the US. Ahmed used a few examples showing how some products will still fall into the OTC medicine category but that, as with the ASA in the UK, there are ways of wording materials and providing back-up data that keep anti-ageing products within the cosmetics market. Returning to cosmeceuticals, she said these are not recognised by the FDA.
The way all of these various global differences are implemented was demonstrated by Claire Byrne (Oriflame). In addition to general regulatory differences, globalisation has to investigate markets to find data on such aspects as how developed markets are and the level of sophistication consumers expect. This involves all departments within the company and proves that ‘one size fits all’ is not always the best method. “Consider whether there is a more generic claim that can be interpreted in each market,” said Byrne.
TECHNIQUES IN PRACTICE
Jonathan Hadgraft (University of London) examined the bioavailability of actives and the ability to measure this. Initially using techniques such as infra red, it is possible to plot the expected transport of actives through the skin. Understanding this transport also allows the calculation of dosages based on expected absorption. He pointed out just how hard it is to actually get things through the skin; on the popularised notion that 65% is absorbed... “from a pharmaceutical point of view, if only,” he said. Hadgraft has also looked at using tape stripping to establish levels of actives left on the surface of the skin. All of this precedes work using mass spectroscopy techniques currently being pioneered to do more in depth analysis.
Deborah Finlay (Procter & Gamble) stood in for Rosmarie Osborne on the subject of in-vitro skin models. This method for testing products has increased in popularity and the problem with finding reliable models is well known. The method presented here showed how research has improved and now provides a more accurate model than ever before. She commented that you can always make comments or statements based on in-vitro results but that you always need a clinical trial.
The conference drew to a with a final keynote address, an energetic presentation from Aubrey de Grey (Methuselah Foundation). De Grey’s work focuses on preventative treatments rather than fixing things that have happened. The premise of a constant maintenance system to prevent ageing using damage treatment rather than trying to affect the metabolic pathways is to target small changes rather than try to affect the whole once it has occurred. A lot of work is currently being done on isolating organisms and pathways that can stop or reduce harmful activities, such as the formation of cholesterol.
Organisers Ferguson and Matts put together a very worthwhile two days. Hopefully the event will be back in two years’ time, when as well as having skin that’s two years older we’ll discover how far our understanding of skin ageing and our approach to it has moved on.