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They've been around since the pyramids, but modern medicine killed them off in a wave of pharmaceutical-inspired paranoia. Now, according to L Denzil Phillips, cosmeceuticals are making a comeback as research supports their clinical efficacy.

There is no dictionary definition for the term cosmeceutical—it's a little too peripheral to have made it into mainstream language just yet. In Europe, many still refuse to accept the existence of cosmeceuticals at all, claiming the term to be little more than a US marketing gimmick. Be that as it may, for the purposes of this article, we'll define cosmeceuticals as "a category of cosmetic products that produce or claim to produce therapeutic benefits." These may be physiological or even psychological. And, yes, they certainly can be useful for marketing purposes.

Every day there seem to be more and more terms describing what we are referring to as cosmeceuticals. These include:

• Beauty supplements
  
  
• Active cosmetics
  
  
• Bio-active cosmetics
  
  
• Performance cosmetics
  
  
• Phytocosmetics
  
  
• Functional cosmetics
  
  
• Dermaceuticals
  
  
• Skinceuticals
  
  
• Cosmetic drugs
  
  
• Therapeutic cosmetics

These terms are, of course, not all identical. In some cases, the users are trying to make some valid distinctions between product categories, in others they may be simply trying to "put new wine into old bottles."

Beauty supplements are basically a nutraceutical sub-category featuring products intended or claimed to produce beauty from within. Like dietary supplements, they are generally consumed as capsules, or less frequently as tisanes or even tinctures.

Active cosmetics include 'active' ingredients that may or may not produce desirable health benefits, while terms like performance or functional imply they perform some useful task or function beyond the cosmetic.

Terms like dermaceuticals and skinceuticals simply refer to a narrow group of cosmeceuticals, whereas cosmetic drugs are products that the US Food and Drug Administration defines as combinations of cosmetics and drugs. Such products include fluoride toothpaste and anti-dandruff shampoos, and they must comply with both health and cosmetic health and safety regulations. The term therapeutic cosmetics may be the best one to describe the role and purpose of cosmeceuticals without raising unnecessary legal debate.

Cosmeceutical History
Although the term cosmeceutical was first coined by American dermatologist Albert Kligman, MD, PhD, in the late 1970s, the Egyptians were the first to recognise the health-giving properties of cosmetics. Archaeologists have unearthed several cosmetic jars whose hieroglyphics say "good for sight" and "stops bleeding." The "Ebers," a medical papyrus written in 1600 BC, makes frequent reference to a number of cosmeceutical-type products. A favourite was a formulation using honey and milk that claimed to help cure skin diseases, while another product mentioned in the Ebers, claiming to "expel wrinkles from the face," was made from frankincense, balantine oil, rush oil and wax, in equal proportions.

To many medieval Arab physicians and their European counterparts, there were no distinctions between cosmetics, fragrances and herbal medicines. Their research and development work covered all these disciplines simultaneously. The separation of the cosmetic and toiletries industry from medicine and pharmacy was a 19^th century phenomenon that occurred when the modern pharmaceutical industry was first developed and when the first government statutes regulating the sale of drugs were drafted.

During the next 50 or so years, both doctors and the public were, somewhat ironically, preoccupied with the allergic reactions caused by cosmetics. The role of cosmetics as a positive healing aid was ignored until its revival in the late 1970s and early '80s.

Kligman rekindled interest by developing formulations to improve the appearance of UV-damaged and wrinkled skin, using retinoic acid as the active ingredient. Retinoic acid has proven ability to diminish small wrinkles, reduce senile keratosis and support collagen formation.

Kligman said novel cosmetic technology "makes it possible to incorporate in skin care products an unlimited number of active substances from natural sources—from plants, sea, earth and next, the universe. The list of beckoning substances including those synthesised by chemists is staggering. It includes vitamins and antioxidants, anti-inflammatories, mood-influencing fragrances, placenta, amniotic fluid serum and numerous hormones. The choices range from the preposterous to the persuasive."

A Cosmeceutical Fit
The European cosmetics industry is frequently divided into the following sub-sectors:

• Skin Care, including sun care and other skin-care products
  
  
• Hair Care, including shampoos, conditioners and scalp-health products
  
  
• Body Care, including deodorants and a wide range of toiletries
  
  
• Decorative, including nail care, eye care and colour cosmetics

The majority of cosmeceuticals has been for skin care, with special emphasis on the sub-category of sun care. The next biggest category is hair care. Cosmeceutical body care formulations have been limited, and cosmeceuticals are, almost by definition, not found in the decorative cosmetics segment.

Sun care is the fastest-growing component of the cosmetics industry. The EU market is estimated at approximately $1.1 billion, and manufacturers continue developing UV absorbers with broad-spectrum protection. Given that almost all cosmeceutical formulations are focused in the skin and hair care segment of the market (perhaps 15 per cent of the former and five per cent of the latter), we can safely estimate the EU market for cosmeceuticals at approximately $1.5-$1.75 billion.

A recent report on the world cosmeceutical market prepared by the US research company Technology Catalysts suggests there are more than 120 key companies undertaking cosmeceutical research. These include nutraceutical companies such as Nu-skin, Indena and Weleda, the chemical firms Croda and BASF, and cosmetic giants Estée Lauder, Beiersdorf, Sheisedo and L'Oreal.

The drive to develop cosmeceuticals is often strongest among companies that operate simultaneously in both the cosmetics and pharmaceutical field for whom research, development and marketing crossovers can be most effectively harnessed. Companies like Japan's Kanebo, Aventis of France and Germany's Henkel have major interests in both sectors, and they are perceived as leaders in this sector. These companies are developing new products and carrier systems that will transform our understanding of the word "cosmetic." Some technologies being considered include:

• Patchless transdermal delivery systems
  
  
• Lipomelanins as UV absorbers
  
  
• Phase Inversion Technology
  
  
• Transdermically delivered peptide skin moisturisers
  
  
• EDT/Microsponge
  
  
• Softgel cosmetic supplements

EDT/Microsponge technology enables active ingredients such as retinol and salicyclic acid to be trapped in a patented polymeric material to give controlled release from a formulation into the skin. By using a controlled, pulsed delivery system, high levels of actives can be delivered without the dangers of skin irritation and other side effects. Also, the use of softgels in the therapeutic cosmetic field is ideal for somewhat unstable active ingredients, which formerly could not have been used in skin care.

Gender-specific Cosmeceuticals
Amongst men, the key areas of potential cosmeceuticals use are:

• Hair regrowth, anti-ageing, anti-dandruff, anti-perspirant, for dermatitis, tooth decay, athlete's foot and as an astringent.
  
  In females, cosmeceuticals are most used for:
  
  
• Anti-wrinkle, breast firming and enlargement, anti-cellulite, hair removal, oral hygiene, tanning, skin whitening, cell recovery, preventing free radicals, varicose- vein treatment.

For women, anti-ageing creams and skin-toning products comprise an ever-growing market in all societies where ageing populations associate youth with beauty. Some of the most popular and controversial cosmeceuticals in recent times have been the fruit acids alpha-hydroxy acid (AHA) and beta-hydroxy acid (BHA), both highly popular "anti-ageing substances."

Varicose veins is another problem area where bio-cosmetics and phyto-cosmetics are becoming increasingly popular. A number of botanicals, especially vine leaf extract products, have been successfully launched, while topical creams to alleviate the problem also are increasingly finding their way onto the market.

Unnatural Cosmeceuticals
Not all cosmeceuticals are natural, and indeed, not all natural cosmetics are cosmeceuticals, so the crossover with the botanical industry is not always straightforward. Some of the most successful cosmeceutical products are synthetic derivatives of by-products of drug discoveries in quite different fields. For example, Minodoxil was developed as a blood thinner and its once "undesirable" side effect—hair regrowth—has been exploited in hair care products.

Essential Herbals
Herbals are gaining increasing popularity in the cosmeceuticals industry. The following are making waves right now:

Cassia Angustifolia: The sub-tropical plant grown in India and Egypt has been widely used in both traditional and allopathic herbal medicine for many years. Sennasoides are extracted from the plant and used as a laxative by leading European and US companies. More recently, the polysaccharides of cassia seed have been extracted and purified and sold in Europe under the name of Galactomannan. The extract includes 64 per cent mannose, 27 per cent galactose, two per cent glucose, one per cent xylose and one per cent arabinose. The cosmetic properties of this extract perform the following functions:

• Repair rough, dry skin
  
  
• Exhibit biosubstantivity to skin and hair
  
  
• Have film-forming capability
  
  
• Provide sustained moisturising
  
  
• Improve capacity of stratum corneum to hold water

In vitro tests on Galactomannan found benefits compared to placebo in skin moisturising and suppleness, skin barrier strengthening, cutaneous microrelief and hair conditioning.

Buckton Scott Group: www.buckton.com Aventis: www.aventis.com BASF: www.basf.com Beiersdorf: www.beiersdorf.com Croda: www.croda.com Estee-Lauder: www.esteelauder.com Henkel: www.henkel.com Kanebo: www.kanebo.co.jp L'Oreal: www.loreal.com Roche Nicholas: www.rochenicholas.com Sheisedo: www.sheisedo.co.jp

Centella Asiatica: This native of Indian swamps has been widely used in Ayurvedic medicine, but is a new entrant to the cosmetics market. The asiaticosides and triterpenes extracted from the plant have modulating properties on the development and metabolism of connective tissue. Consequently, centella improves wound repair with a better re-epithialisation and a normalisation of perivascular connective tissue, thus allowing an improvement of the venous wall tone and elasticity. Roche Nicholas in France produces more than three tonnes of a patented titrated extract of centella (TECA). It found that in poor connective tissue conditions, the triterpenes are able to renew the collagen, in quantity and quality, and restore tissue firmness and skin elasticity, improving skin appearance and comfort. Centella extract (40 per cent standardised asiaticoside) is taken either in the form of 10mg capsules—three to nine times a day—or as a topical application with cream at two to four per cent.

Echium Oil: Echium is a member of the borage family, which grows widely in the UK. It has been used in traditional herbal medicine since medieval times. The oil contains significant amounts of gamma-linolenic acid, ranging from 1.77 per cent to 5.02 per cent of total seed weight depending on variety. It also contains two to 12 per cent stearidonic acid.

Echium oil has recently been considered an interesting therapeutic cosmetic raw material in sun and anti-wrinkle products. The anti-inflammatory properties of echium lipids have been shown to be effective as an after-care product following exposure to the sun. When applied topically to a skin model, echium oil inhibited the release of prostaglandin E2 by nearly two-thirds compared with untreated tissue. This is considerably superior to other similar products such as black currant seed oil and is probably due to the high level of stearidonic acid in the product. Studies on the anti-wrinkle properties of the product by Croda Chemicals indicate echium oil to be effective in reducing skin roughness.

Tamarind: The paste extracted from the fruits of the sub-tropical leguminous tree Tamarindus indica for centuries has been widely used in herbal medicine and as a foodstuff. Tamarind paste made from the fruit pods is a traditional natural thickening agent in food as well as an ingredient in the textile, paper and pulp industry. More recently the polysaccharides of tamarind have been extracted for use in cosmetic products. They are recommended for the stimulation of skin repair, for environmental skin protection and for premature ageing.

A tri-dimensional polysaccharide from tamarind, known as Xyloglucan, includes 49 per cent glucose, 31 per cent xylose and 18 per cent galactose. The product has been shown to have both immunostimulating effect and anti-free radical activity. Using both human monocyte and human polymorphonuclear neutriphiles activation tests, French manufacturer Laboratoires Seriobiologiques has shown that Xyloglucan has inhibited the number of ingested yeast by 85 per cent (competitive inhibition) when added simultaneously with the killed yeasts and increased the number of phagocytosed yeasts by 58 per cent (deferred stimulation). The immuno-stimulating effect of another product containing tamarind was found to be far higher than for any other similar polysaccharide.

Tea: The growth in green tea consumption as a dietary supplement and functional beverage has been enormous in both Europe and the US. Green tea extracts are now amongst of the fastest-growing herbal products. The use of tea extracts in cosmetics has been a more recent phenomenon, although the high level of complex polyphenolic compounds in tea provides the same protective effect for the skin as for internal organs. Further study is being undertaken by Dragoco in Germany to assess the benefit of green tea extract to treat or prevent body odour or acne produced by skin bacteria. More than 19 per cent of the content of green tea extract is catechins, which are known to have effective free radical-scavenging properties.

Possibly more interesting than the application of green tea to cosmetics has been the application of the very rare white tea. White teas are claimed to possess far higher levels of polyphenols than green tea, mainly because only the tiny young buds at the very tip of the plant are picked. The product has been used by Estée Lauder's Origins company in its top-selling skin care product, A Perfect World.

In sum, cosmeceuticals are on the shelves, and many more are on the way. Cosmeceuticals may not be on everyone's lips, but whatever you call these nutritive natural ingredients, they are in fact increasingly in the products that get put on everyone's lips.

L. Denzil Phillips is director of Denzil Phillips International, Surrey, UK. info@denzil.com, Tel: +44 208 940 4100 www.denzil.com