Keeping up with cosmeceuticals can feel like a full time job as the field has grown to include everything from botanicals to exosomes. To make things more challenging, our patients increasingly desire clarification on postulates consumed on social media regarding myriad products and techniques. Emmy Graber, MD walked us through the data to ensure we have all the information to answer our patients’ questions and contextualize the newest skincare trends. The current on-trend ingredient list she covered includes niacinamide, snail mucin, alternative retinoids, which differ from their prescribed counterparts as they do not bind directly to nuclear retinoid receptors, and mushrooms. 

Niacinamide has shown substantial growth in the past few years for its seemingly innumerable benefits by inhibiting sebum production and inflammatory cytokines, increasing production of collagen and skin barrier lipids thereby reducing transepidermal water loss, and decreasing melanosome transfer to keratinocytes. One placebo-controlled split-face trial (n=50) showed decreased fine lines, hyperpigmentation spots, and redness with the use of niacinamide 5% in middle-aged women in 12 weeks. Another split-face trial (n=50) in patients with rosacea also demonstrated improvement in a variety of features including inflammatory lesions and erythema by week 4. 

Snail mucin, another hot topic in the cosmeceutical industry, contains secretions from cryptomphalus aspersa which, in a 14 week split-face RCT, demonstrated significant improvement in periocular rhytides that persisted 2 weeks after discontinuation of this anti-photoaging product. Alternative retinols, or “bio-retinols”, such as bakuchiol have been touted to be less irritating, and this was supported by a RCT in which patients applied either bakuchiol 0.5% cream twice daily or retinol 0.5% cream daily. Bakuchiol users did report less skin scaling and stinging without significant impact to grading of rhytides. The last popular ingredient Dr. Graber discussed was mushrooms, which may be referred to as “adaptogens”. One study on veratric acid, which can be derived from medicinal mushrooms, reported significant impact on rhytides by modulating matrix metalloproteinases and epidermal layer integrity. More studies are required to ascertain efficacy against alternative options. She concluded by addressing an emerging concern of visible light in photoaging by inducing reactive oxygen species. An adequate method to mitigate this is opting for a sunscreen product with antioxidants.