Can massage boost skin care efficacy?

Published: 18-Oct-2016

Exploring the ways in which self-massage can enhance the performance of topical skin care products

This article was first published in SPC Magazine, the leading international magazine for the cosmetics, toiletries and fragrance industries. More information and how to subscribe.

The revenue forecast for the anti-ageing skin care category is on the rise with an overwhelming number of competitive launches. The skin care industry must give consumers what they need[1], which is based on the biology of the human body. Regardless of the skin cellular target, advancement in technology (delivery, efficacy or combination of actives) and consumer compliance, a jar of a cream on the shelf can only achieve so much in terms of anti-ageing. This article provides an overview of the benefits of self-administered facial massage as an adjunct to enhancing skin care product efficacy.

Professional facial massage is one of the most pleasurable and intimate topical facial treatments. However, it delivers more than just a feel-good factor. Identifying the best ways to use facial massage in different therapeutic protocols, targeting skin tissues that benefit from different massage techniques and implementing short, results-focused self-massage into at-home maintenance programmes can increase revenue and repeat client visits in a professional skin care setting.

The use of specific massage techniques on different parts of the face – such as effleurage or friction – is effective in the salon[2]. However, a shorter, light manipulation designed to increase blood flow and oxygenation allows for an easy-to-use and consistent self-massage routine. Simply gently stroking the face results in increased circulation, stimulating skin turnover and providing a healthy glow to any complexion, although product type should be selected based upon the individual skin type and condition. Some Japanese, French and British skin care brands already include simple massage charts in their product information. Some have enlisted the help of a celebrity therapist. But, nowadays, it is essential to ensure that these massage routines are evidence-based.

An evidence-based approach

Evidence underpinning the clinical outcomes of skin massage is slowly emerging. However, the empirical experience of massage benefits acquired by beauty therapists over time serves the majority of skin care consumers who do not visit professional salons.

For a therapist, massage is expected to deliver certain physiological benefits. On the epidermal level, light massage may encourage corneocyte shedding, increase epidermal proliferation and potentially increase skin thickness. Dermal tissue is also expected to benefit from increased blood flow and tensional forces in the dermis (induced by deeper mechanical stimulation), where dermal fibroblasts change phenotype and produce more collagen. Superficial massage, on the other hand, allows for the removal of interstitial fluid or lymphatic drainage. Benefits to consumer psychological wellbeing include relaxation and even temporary changes to the brainwave patterns. It has been proposed that repeated massage might have a cumulative effect with time[3].

Increased penetration

The existing clinical evidence behind the physical benefits to the human body likely includes the increased penetration of active ingredients and even the alleviation of skin sagging. Dermatologists have often recommended rubbing when applying topical treatments. However, quantitative studies to support its efficacy remain scarce. Nor is there data on the effect of rubbing on skin care formulations. The available research suggests that rubbing can significantly affect absorption rates and the first review[4] of this research calls for more in-depth investigations to specify the mechanisms of massage in boosting the efficacy of skin care ingredients.

Studies measuring permeation rates reported that rubbing increased the flux of actives, reduced skin impedance and increased active ingredient retention."

Massaging the skin may influence the penetration of active ingredients and although early animal studies did not show any effect, later studies measuring permeation rates (through human skin ex vivo) reported that rubbing increased the flux of actives, reduced skin impedance and increased active ingredient retention. There is preliminary evidence suggesting that massage can be an important factor in skin care, and its impact may be defined by a) the properties of the active b) duration c) pressure d) technique specifics and e) quantity of product applied.

The concentration of the active ingredients in the product needs to be high enough to notice any effect from rubbing. Pressure on the skin also seems to increase the stratum corneum (SC) filling rate or increase follicular penetration, as seen for liposomal drug delivery systems. It has been reported that rubbing an active ingredient itself into the skin effectively enhances penetration, as opposed to simply rubbing the skin before the application.

Rubbing has been shown to impact directly on the barrier function of the skin, thereby facilitating penetration, possibly by affecting the skin’s lipid structure. Depending on the specific rubbing experiment, there was a two- to three-fold increase in the active ingredient retained in the skin. Therefore, there is an indication that rubbing promotes faster and deeper penetration into the skin’s layers. Finally, the effect of massage differs for hydrophilic and lipophilic substances. Further investigation into the effect of massage in altering the different skin layers is needed.

The psychological effect

Skin care is ultimately a tool to maintain skin health and wellbeing, allowing consumers to relax and feel comfortable. Stress, social isolation and negativity contribute to physical damage that can be repaired through restorative processes and behavioural interventions, ie sleep, diet, exercise, positive emotions and social interactions.

The skin envelops the entire body and it has been suggested that an impaired skin barrier can alter mental health, or vice versa. There is a strong relationship between the skin and the brain; they have the same ectodermal origin and are affected by the same hormones and neurotransmitters.

Professional facial massage leads to relaxation, in turn reducing anxiety and insomnia. In a pilot project for the development of a new skin care application approach using facial massage as a tool to aid relaxation, electroencephalography (EEG) has been used to measure brainwave activity. The study focused on alpha brainwave activity, associated with relaxed mental states, and showed an increase in relaxation through a cumulative self-massage application[5].

The skin is also linked to the brain by its primary function in tactile receptivity. Touch is often referred to as the “mother of all senses” or the first of our senses to come ‘on-line’ as the tactile system is the first sensory system to develop in the embryo. Touch is vital for our emotional and physical health. Touching the skin can be a powerful means of modulating human emotion. An emotional response to tactile stimulation can play an all-important role in human grooming and nurturing behaviors, as well as social communication. Pleasant touch can increase quality of life and social wellbeing; pleasant touch decreases stress in pre-operative situations and nursing home staff have found increases in eating behaviour associated with increased tactile contact. Tactile stimulation regulates blood lactate levels, while transduction of sensory signals by skin impacts on energy in the brain. Hence, it seems to play a role in cognitive and social development, and has been proven to benefit newborns.

Skin care application with gentle massage uses the fingertips. Research into the skin’s sense of touch has focused mainly on the fingertips – and specifically on specialised, discriminative receptors and their sensitivity, which enables us to detect the microscopic surface properties of objects (such as roughness, smoothness or softness), as well as temperature. However, touch has other dimensions, beyond the purely discriminative: an affective function manifested as itch or pain when the skin is damaged and the familiar affective (pleasant) touch.

It is now known that some skin nerves send ‘feel good’ signals to the brain when activated by gentle stroking touch[6]. Recent research has identified a third class of fibres that are sensitive to low force/velocity dynamic stroking touch. Although there is evidence for the benefits of pleasant touch on mood, health and wellbeing, it might also be the case that when mediating affective touch, the fibres that respond optimally to gentle stroking touch may well interact with the more well-known functional properties of itch and pain nerves.

Application of facial massage that targets pleasant touch could provide a complementary, non-pharmacological means of treating both the physical and psychological aspects of chronic skin conditions, such as itch and eczema[7].

Instructions for self-massage

The creation of the ideal ‘skin feel’ is popular among ingredient manufacturers. Developing this concept further, Switzerland’s DSM has focused on ‘comfort science’. It applied a holistic approach to epidermal skin sensation, connecting a youthful appearance to a healthy, functioning epidermis. This approach brings a different dimension to the SC – the upper layer of epidermis – by recognising it as an interface for imparting visual and tactile sensory signal processing. The SC is no longer considered a passive, inert, metabolically lifeless membrane; it is understood to be very much alive, and the focus of the intervention is on enhancing epidermal sensation by building a strong barrier function.

This focus on epidermal sensation is a step in the right direction. However, an effective facial self-massage technique, working on multiple facial structures, supersedes the pure effect of ingredients. Short self-massage protocol, as a part of a daily skin care application, has to consider not only the SC but also other facial structures: muscles and muscle insertions, sub-dermal fat deposits and dermal volume, as well as epidermal characteristics (eg varied skin barrier integrity, sebum production and sensitivity in the distinct facial areas)[8]. As explained above, the technique and intensity of the massage movement, as well as the length of the massage intervention have to be taken into consideration when designing new self-massage protocols to benefit skin care product application.

Enhancement of efficacy

Taking care of one’s appearance is a part of being human, and it strengthens positive emotions... touching one’s own face with a short self-massage should become a pleasant part of daily life and one of the living-well resources."

Anti-ageing interventions based on ‘hormetins’ are at the forefront of research and hold much promise. Hormetins are defined “as elements inducing the life-supporting beneficial effects that result from the cellular responses to single or multiple rounds of mild stress to stimulate various defense pathways”. Facial massage represents just that; a physical type of a hormetin, introducing single or multiple stresses to the different types of skin tissue. However, the massage parameters, timing, frequency and specificity of various stresses are yet to be investigated in detail. Evidence-based massage protocols and tutorials should become a part of product application instructions, tailored to the target consumer group and clinical benefits related to a specific outcome (ie anti-wrinkle, anti-sagging, sebum reduction or enhanced moisturisation) and application techniques for the face.

Taking care of one’s appearance is a part of being human, and it strengthens positive emotions. These emotions influence the neurological pathways of all our cognition too. Psychological research suggests that “momentary positive emotions” are important; people become more satisfied not simply because they feel better but because they develop resources for living well. Touching one’s own face with a short self-massage should become a pleasant part of daily life and one of the living-well resources.

Consumers’ approach to skin care differs; the techniques must fit into the narrative of their lives and their motivation. Motivation to look youthful is powerful across the Western demographics. I have argued in the past that skin care should go beyond the science and put on the shelf a marriage of skin care technology with the comfort and care of traditional practices for the consumer. A self-massage can be just that.

This approach will receive acceptance through evidence-based means only in its own time; at present, an availability of early evidence and empirical insights of specialists who practice facial massage with their clients on a daily basis is what we have to work with. The imperative is for the skin care industry to carry out randomised, controlled clinical trials and demonstrate that the combination of a skin care product and self-massage application targeting a skin concern or a condition can provide evidence to substantiate new and stronger claims.

Dr Katerina Steventon


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