In this article you'll learn:
1. Why aloe is the first ingredient in our morning cream.
2. Drinking bone broth will not help your skin produce more collagen.
3. How synthetic ingredients mimic natural ingredients.
4. The real deal in the retinol vs. bakuchiol acne debate.
5. What dermatologists learn in school about natural ingredients.
6. The truth about honey masks and oatmeal moisturizers.
When it comes to natural ingredients for skin care products, many brands make grand claims about the rejuvenating properties of olive oil, honey masks, tea baths, and many other ingredients.
So we asked Dr. Steve, our founding dermatologist, to give us some truth serum.
One of the more popular natural ingredients people use for skincare is aloe vera. We use it in our morning cream. Would you say that of all the natural ingredients, aloe has the most potency or the highest efficacy?
Dr. Steve: Aloe is cooling, it's got a moisturization effect, and is used for burns. It has some data around it. When it comes to efficacy, using aloe vera for burns, to me it is fine. But do I think aloe vera is superior to Vaseline? I would say probably not, unless there's a really good trial that I'm not aware of that looked at it.
So, to me, aloe vera is one of those things that has a long history and has been shown in some studies to be helpful. I don't have a concern about it because people aren't using aloe vera necessarily as some kind of cure-all for wrinkles or to reverse aging. I feel differently about Korean Red sea kelp extract or other kinds of things where there's really not any evidence that it works.
Can drinking bone broth boost your skin's collagen?
Not at all. There are foods that are rich in collagen, but remember it hits your stomach with an acid pH of two or three, and all that collagen is getting broken down into amino acids, getting absorbed by your liver or getting into your bloodstream, and then it’s going to get resynthesized into collagen. There's nothing really special about collagen versus any other regular protein, it all gets broken down to its amino acid. It's just sort of like you're drinking a protein, like a high protein soup. Nothing really specific where that collagen broken down in your stomach pH actually magically reaches all of your skin cells. It biologically doesn't make that much sense.
Some ingredients that Geologie uses are produced naturally, either in the body or in nature – hyaluronic acid, the main moisturizing ingredient in the morning cream, is produced by the body, and we know that production slows down as we age. Does synthetic hyaluronic acid replace the loss of natural hyaluronic acid as we get older?
Yeah, you can definitely say that. Hyaluronic acid is a glycosaminoglycans, a sugar-protein building block, part of the extracellular matrix that's produced by our skin cells. Its unique feature is that it can absorb a ton of water and maintain it, which is what you want for a skin barrier.
But as you get older, your skin cells are less efficient at making this natural moisturizing factor — and there are biological reasons for that — which is why moisturization is more and more important as you get older.
Does the hyaluronic acid penetrate deeply enough to mimic what the natural hyaluronic acid was doing?
Hyaluronic acid and moisturizers operate at the epidermis level, 10 to 30 microns. So I think they do penetrate deep enough for what they want to do. If you think the hyaluronic acid is getting into your fat cells or your bloodstream, that's definitely not happening. But I don't know if that's really necessary. It's doing what it's doing and it goes as deep as it needs to go.
There’s an herb called bakuchiol that we hear might be a natural alternative to retinol.
Dr. Steve: From my understanding, bakuchiol is completely different, chemically, than retinol. It’s not even like a derivative of retinol.
I’ve seen a research paper about topical bakuchiol versus retinol in facial photo aging. It was a randomized double blind assessment, done for 12 weeks and it studied 44 patients. It's pretty well done and it was published in the British Journal of Dermatology, a legit journal. They showed that it was comparable with retinol, but more tolerated.
But when you track the scientific evidence, which is something you always want to do, a ton of papers followed that one, and they all cited that first paper. Some papers talk about bakuchiol as an allergen. There are some that talk about testing it as part of a single arm study.
So, maybe bakuchiol is an effective natural alternative to retinol, but there's only one well designed clinical trial on it, and the rest look more or less like thought pieces — very different from the hundreds, if not thousands of papers on retinol.
So I would take with a grain of salt any claims that bakuchiol is a natural alternative to retinol. One well-designed paper is not a body of work that moves me to say that it’s way better.
That leads us to a larger question about pharmaceuticals versus botanicals. There are so many studies about synthetics because those studies are driven by industry, and there's less about botanicals because it's not nearly as profitable. Is that a fair statement?
Dr. Steve: Clinical trials are expensive, right? To get a topical drug approved probably takes $50 million to $100 million, in terms of FDA phase one, phase two, phase three trials. And if you're a botanical company, a mom and pop, you're just not going to do that. It’s too expensive and complicated. It doesn't mean the products are not good or don't work. We just won't really know until those studies actually get done.
And unfortunately, it's relatively easy to do bad clinical studies. Like you take 10 people and you don't control for anything and you ask them, do they look better? You have one or two perfect before and after pictures with a slight change in lighting, that kind of stuff. I could do those types of studies every day. And you know, it's relatively easy to make a product look good. Because if the product doesn't look good, then you'll never see the study either. There's a success bias in publishing. If your product sank and failed, why would you publish it? So all these are systemic problems.
In dermatology school, do natural remedies and ingredients take a backseat in clinical dermatology?
Dr. Steve: Yeah, they do take a backseat. From our perspective, they’re not that reliable in terms of what evidence there is that they work or don't work. They're not really backed by well constructed clinical trials and studies. So for a lot of dermatologists, it's sort of like, maybe they work, I'm not sure, you know? We'd rather push drugs and topicals that have been proven. It’s very similar to how regular doctors feel about supplements and vitamins.
So, do botanicals and herbs play any role in the curriculum when you were actually going through it?
Dr. Steve: They play a role in that we know that certain botanicals can cause skin allergies. And so it's sort of like a negative in terms of botanicals and natural ingredients. We do talk about it, but it's very, very small. Like, tea tree oil, we learn a little bit about some of its mechanisms. You know, a lot of these natural moisturizers are really just moisturizers. So we talk about coconut oil as a moisturizer for eczema, and there's some evidence that works. So I would say it's really underemphasized but we do talk about some of the ones that float to the top.
We hear people singing praises about honey masks. It's got antibacterial and antiseptic properties to help clear acne and control oil production. Is this legitimate?
Dr. Steve: Honey is medicine — we use it as an antibacterial, it's embedded in bandaids. Like tea tree oil, honey can do everything, but it's not very well proven. The honey mask is really more of a fad. It's unlikely to really hurt you.
But, dermatologists don't ever prescribe honey for acne. It's also kind of messy and sticky, things that make it completely unfeasible to use on a daily basis. It also has wildly different characteristics, it’s a very complex and viscous fluid.
I think my opinion is that when it comes to efficacy for acne, go with salicylic acid and retinoids. These kinds of things have way better evidence and performance and the outputs that you want than honey. Also ask yourself: what are you going to use consistently, effectively, daily that doesn't affect your routine
When it comes to moisturizer, some brands say to look specifically for moisturizers that contain an oil absorbing ingredient like oatmeal. Does that sound legitimate to you?
Dr. Steve: Oatmeal is a big part of Aveeno moisturizers, which is famous for using colloidal oatmeal, a kind of mashup of oatmeal into a paste. Oatmeal itself has lipids and fats and moisturizing elements, so it really isn't actually an “oil absorbing” ingredient.
Like, can you really absorb in a lotion?
Dr. Steve: When I think about oil absorbing cosmetic products, I think about wipes. I think about things that are not leave-on, because that's what really is gonna work to reduce oil on the skin — aside from retinol, which will mitigate oil production on the DNA level. But when you have something like a lotion applied on there, it really just stays there. So whatever you've absorbed, it's still on your skin.
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