Better than Botox Report-revise
Is Any
Cosmetic
Better than B OTOX ® ? A Special Report by Paula Begoun T he number of letters and emails I receive asking about the many topical products claiming to work like or mimic the effects of Botox is astounding. Results from Botox injections are so instantaneously impressive, it's no wonder it has become the most commonly performed cosmetic corrective procedure in the US and such a recognizable name. In 2003, there were 2,272,080 Botox treatments administered, making it the number-one nonsurgi- cal cosmetic corrective procedure, up from 1.5 million treatments in 2002 (Source:http://surgery.org/ press/procedurefacts-asqf.php). Alas, it is also expensive and the thought of being injected with the botulism toxin (that's what Botox is) leaves some people fearfully furrowing their brows which explains why so many cosmetics companies are launching non-invasive, topical products claiming to be "better than Botox." As a reminder, Botox injections introduce a minute amount of the synthetic botulinum type-A toxin into the muscles of the forehead (or other areas where it is injected). This prevents the use of facial muscles (you can't frown or lift your eyebrows after being injected until the effect wears off, typically four months later). Within 24 to 48 hours of receiving Botox, forehead wrinkles are gone. Botox poses little to no risk. It has been used for decades to treat eye spasms, dystonia, cerebral palsy, and more recently, wrinkles. Recent studies have even found it to be helpful for migraine relief. So is there any cosmetic lotion or cream that can work better than Botox, or in any way shape or form, similar to Botox? The short answer is a resounding no! According to Dr. Alistaire Carruthers, Clinical Professor of Dermatology at the University of British Columbia who has also published many studies about Botox, you can't affect muscle movement topically. And besides, to have that effect on muscles would be problematic for the body, not to mention it would affect muscles you do not want "relaxed," such as those in your hands or near your mouth. But of course none of that ever stops the cosmetics industry from trying to convince women otherwise. In reality, there are no ingredients that can come remotely close to creating the improvement in wrinkles that Botox does. As nice as it would be to get Botox-like results "without painful injections" it just isn't possible. (By the way, about those painful injections, I'm not going to pretend Botox injections don't hurt, but from my experience and that of others I have spoken to, it is more of a mild discomfort than a painful experience.) That said, here are my reviews of some of the many "better than Botox" products on the market. Is Any Cosmetic
Better than B OTOX ® ? Klein-Becker StriVectin-SD ($135 for 6 ounces) is the prod- uct that started the whole "better than Botox" craze. It went from email spam and ads in Parade maga- zine to prominent shelf space in Nordstrom and Sephora. Interestingly enough, StriVectin didn't start as an anti-wrinkle product. Rather, its original claim to fame was for eliminating stretch marks. However, the only studies proving StriVectin’s benefits (via pep- tide technology) were paid for by the manufacturer, and they have never been published. There have been papers presented on this topic at dermatology con- ferences, but such presentations are not held to the same standard as peer-reviewed, publishable stud- ies. That's about as reliable as a Marlboro coming out with a study that says cigarettes are safe. Though there is no way to be sure, it seems Klein-Becker simply decided that the market for a stretch mark product wasn't as lucrative as one for an anti-wrinkle product. So the company modified their ads, stating they were surprised to find that not only was StriVectin-SD getting rid of women's stretch marks, but it also got rid of their facial wrinkles, and we now have the astounding “anti-wrinkle break- through of the decade.” Regrettably, they do not have to back up this claim with supportive research to sell this kind of hyperbole. All any company has to do is claim their product will get rid of wrinkles and women will buy it in droves, as evidenced by the fact that StriVectin-SD has been the best-selling product in department stores since November 2003, with sales topping $30 million between January and June 2004 (Source: The Rose Sheet, June 7, 2004, page 3)! The con is on, and many consumers are buying it (literally and figuratively). Perhaps the most enticing part of StriVectin's ads are the portions that read, “The active formula in StriVectin-SD has recently been shown in clinical tri- als to significantly reduce that category of fine lines and facial wrinkles that can add 10-15 years to your appearanceˇand even reduce the dark circles under your eyes ...without irritation, painful injections, or surgery.” Another statement reads “in fact, [StriVectin-SD] is the only topical formulation clinically proven to effectively confront every aspect of wrinkle reduction.” It is easy to debunk all of this overblown nonsense by pointing out the product's lack of sunscreen; perhaps StriVectin overlooked the voluminous research about sun exposure's deleterious, wrinkling, and discoloring effects on skin. That omission alone puts their claims in the category of overstatement and nothing more. The two studies quoted in StriVectin’s ads were presented at the 20th World Congress of Dermatology, held in July 2002. These papers examined the effects of the ingredient palmitoyl pentapeptide-3 (one of the ingredients in Strivectin, though they advertise this ingredient with the name Pal-KTTKS) and compared it to vitamin C and retinol. Of course, according to them, palmitoyl pentapeptide-3 won. However, there is no published research substantiating the results, the stud- ies were from the ingredient manufacturer, and StriVectin declined to send us any documentation. Further, presenting a paper at a dermatology meeting is not the same as having your information published in a medical journal with strict protocol standards. With lack of substantiated research but a strong desire to capture baby boomers' dollars, Klein-Becker has taken these claims and almost single-handedly created a market for "works like Botox" products. StriVectin-SD is supposedly preferable because of its long-term results versus the short-term results (and repeated treatments) of Botox. A Dr. Nathalie Chevreau is quoted in the ad, saying “the cumulative effects of using a product like StriVectin become more noticeable every day, and ultimately lasts longer than Botox.” Chevreau is hardly an impartial source—she works for Klein-Becker! Further, Dr. Chevreau is a licensed dietician in Utah, a fact that is conveniently left out of StriVectin’s ad because it would conflict with her credibility as a medical doctor speaking about the legitimate benefits of an antiwrinkle cream. If you are still wondering if there is any way possible that StriVectin-SD might somehow be better than Botox, the short answer is no—and that means no way, and no how. It certainly isn't better than the daily use of an effective sunscreen! StriVectin is merely a moisturizer with some very good emollients, water-binding agents, antioxidants, and peptides. Unfortunately, this product also contains peppermint oil, a problematic skin irritant. I suspect this was included to make the skin tingle (a sensitizing reaction) to create the impression that the product is “doing something” to the skin. StriVectin-SD won't alter the wrinkling on any part of your face, in the long term or in the short term. Riding on the success of StriVectin-SD, several cosmetic companies have created their own products claiming to be better than Botox or better than cosmetic corrective surgery. The list below covers the most widely advertised, readily available products. Avon Anew Clinical Deep Crease Concentrate with Bo-Hylurox ($32 for 1 ounce) has a name not only reminiscent of Botox, but is advertised to make you wonder why anyone would subject themselves to an injection when they can achieve the same (or at least similar) results with this water-based serum. Sold with the scare-tactic tag line "Look stunning, not stunned," Avon's alter- native to Botox claims to "reduce the overall length, depth and number of deep expression lines around your eyes, mouth and forehead, the areas that are in motion whenever you show emotion." Well, when done correctly, Botox injections absolutely do not make a person look stunned—the list of Hollywood celebrities who have had Botox injections is what's really stunning, and they don't look "stunned!" As one Hollywood plastic surgeon told me, if Botox was a problem half the town would be sick. Unlike genuine Botox injections, this Avon product absolutely cannot get rid of wrinkles. Anew Clinical Deep Crease Concentrate contains two ingredients that are supposedly re- sponsible for the crease-filling and wrinkle-smoothing. The first is Portulaca oleracea, a plant ex- tract. Avon maintains it "helps you lose those hard-to-treat creases while keeping your facial ex- pressions, naturally." However, there is no substantiated or published research showing Portulaca oleracea has that (or any) anti-wrinkle effect. Research has shown that it may have anti-inflamma- tory or analgesic properties, and it is also believed to be effective topically for wound healing (Sources: Journal of Ethopharmacology, October 2003, pages 131-136, and December 2000, pages 445-451). But none of that is related to treating expression lines in any way, shape, or form or duplicating Botox's effect on wrinkles. One study did examine Portulaca's effect on brain activity and resulting muscle relaxation, but the substance was used in a 10% concentration and injected into pigs' stomachs, quite different from applying lesser amounts of this ingredient to skin (Source: Journal of Ethnopharmacology, July 2001, pages 171-176). The second hyped ingredient is acetyl hexapeptide-3 (trade name: argireline), which is de- scribed in detail in the DDF Wrinkle Relax review below. BlissLabs No-Motion Lotion ($35 for 1 ounce) is another "works-like-Botox" product, and, like all the others, is completely ineffective at preventing muscle contractions to "address the mechanical causes of skin aging." What a joke! This lotion contains sodium polystyrene sulfonate, a resin- based film-forming agent that is considered a skin irritant (Source: Handbook of Cosmetic and Personal Care Additives, Second Edition, volume 2, 2002, page 1513). It also contains a starch
derivative that creates a (temporary) tightening effect on skin. Peppermint oil and menthol are here, too, probably so you'll think this do-nothing-positive product is doing something. But all it ends up doing is irritating skin and that is a problem if you want healthy skin. This is a poorly formulated product and it's not even worth going through the motions of ordering it. DDF Wrinkle Relax (previously known as Faux-Tox) ($75 for 0.5 ounce) is another Botox wannabe. This pricey product, which over a year's time wouldn't cost that much less than an actual Botox treatment, claims to contain a non-toxic, anti-aging peptide, chemically combined from natu- rally derived amino acids, [that] helps prevent fine lines induced by repeated facial movements without the loss of facial expression." And the results are supposed to be visible within two weeks. The miracle ingredient in this lightweight lotion is Argireline, which is the trade name for the syn- thetically derived peptide called acetyl hexapeptide-3. The company selling acetyl hexapeptide-3 is Centerchem (www.centerchem.com), an ingredient manufacuter based in Spain and, according to their Web site, "Argireline works through a unique mechanism which relaxes facial tension lead- ing to a reduction in superficial facial lines and wrinkles with regular use. Argireline has been shown to moderate excessive catecholamines release." Other than Centerchem's assertions, there isn't a shred of research substantiating any part of it. However, even if it were vaguely true, these effects would not be good news for your body because you wouldn't want any cosmetic without any safety data, efficacy documentation, or inde- pendent research messing around with your catecholamines. Catecholamines are compounds in the body that serve as neurotransmitters such as epinephrine, adrenaline, and dopamine. Epi- nephrine is a substance that prepares the body to handle emergencies such as cold, fatigue, and shock. A deficiency of dopamine in the brain is responsible for the symptoms of the Parkinson's. None of that sounds like something you want a cosmetic to inhibit or reduce. What if you acciden- tally overuse the product or apply too much? What is excessive for your body? The entire notion is more worrisome than almost anything I've encountered in my research thus far. However, the good news is that the physicians I've interviewed say this ingredient can't perform as DDF suggests. Also available is DDF’s Anti-Wrinkle Eye Renewal Treatment ($48 for kit). The kit includes four products, with the main attraction being the Anti-Wrinkle Dermal Gel, a water-based serum that contains the same "active" ingredient the company uses in their Wrinkle Relax product above, with equally suspect claims. In addition, there are clinical studies for Argireline revealing that this ingredient was not as effective as Botox (Source: www.cremedevie.com/clinical_details.htm). Again, this is not an ingredient to consider because there are too many unknowns about its effect on biological processes, not to mention its dubious anti-wrinkle claims. Dr. Brandt Crease Release ($150 for 1 ounce). According to Dr. Fredric Brandt's book, Age-Less The Definitive Guide to Botox, Collagen, Lasers, Peels, and Other Solutions for Flawless Skin, he was one of the physicians involved in the drug trials leading to the FDA's approval of Botox. Ironically, and potentially unethically, he hypes his Crease Release as being similar (and a viable alternative) to Botox. Suffice it to say, it isn't! Crease Release contains gamma aminobutyric acid (GABA), an amino acid that acts as a neurotransmitter inhibitor and is associated with reducing seizures and depression (Sources: Ad- vances in Experimental Medicine and Biology, 2004, volume 548, pages 92-103; and Archives of
General Psychiatry, July 2004, pages 705-713). GABA's relationship to reducing how often nerves fire is what Brandt wants the consumer to associate with its topical application. If GABA can stop nerves from firing in the brain, it should be able to stop facial muscles from being triggered when applied topically and voila! you have a product that is better than Botox! However, aside from the fact that there is absolutely no research showing that to be the case, GABA does not work alone in the body. It requires many other components in order to function as a substance blocking nerves from being triggered (Sources: www.emedicine.com, www.emedicine.com/neuro/ topic692.htm#section~gaba_reuptake_inhibitors). Even if Crease Release did work, there would be serious problems for those who decided to apply it all over their face because while muscle movement causes lines on the forehead, the muscles of the jaw, chin, and neck support skin in that area. You could get more sagging if those muscles became relaxed. And what about your hands or other areas that came in contact with this cream? If it worked the way Brandt describes you could easily have unwanted side effects. What all of this adds up to is a lot of scientific confusion that a consumer will assume is true because it is being sold with a well-known doctor's blessing. Even more disturbing is the price, which is a complete burn considering this not-even-close- to-Botox product costs one-third of the actual treatment which will produce impressive results. Estee Lauder Perfectionist [CP+] with Poly-Collagen Peptides Correcting Serum for Lines/Wrinkles/ Age Spots ($55 for 1 ounce). I was wondering when Lauder was going to jump on the “works like Botox” product bandwagon, and here it is, launched with the same absurd claim as everyone else is using: “Now, triumph over wrinkles without toxins, lasers or injections. Estee Lauder Research boldly advances the fight against wrinkles—and now age spots—with our most comprehensive treatment ever,” is it any wonder why there’s been such intense curiosity about this product? But before I discuss the formula, I want to mention that this product is not a substitute in any way, shape, or form for Botox, lasers, or any type of dermal filler. No topical cosmetic product is capable of attaining anywhere near the results obtainable from those medical corrective procedures. Clearly, the desire for such a product is strong, or companies such as Lauder, L’Oreal, Lancome, Revlon, and a host of others wouldn’t keep consumers’ hopes alive with such claims as “it virtually immobi- lizes lines and wrinkles without affecting your natural facial expressions” or that their product can intercept “the cycle of irritation that can increase the depth and length of a wrinkle.” From my perspective, these suggestions (which is what advertising of this nature always is: impression, not fact) are just that, and nothing more. If your lines were immobilized, your facial expressions would definitely be affected. Furthermore, deep wrinkles are not inherently caused by simple irritation, but rather by deep inflammation from cumulative unprotected sun exposure and myriad other factors. So what’s in this product that allegedly can smooth wrinkles without (eek!) resorting to needles or other medical procedures? The “CP” in the product’s name stands for collagen peptides. Accord- ing to information from Lauder on www.gloss.com, patent-pending “triple enzyme technology rushes” this collagen peptide complex to “even the most prominent wrinkles.” While there is much hope that peptides may help skin, they are easily broken down by enzymes, and that doesn’t help get them to the cells in the lower layers of skin, where wrinkles begin. It all adds up to another dubious “treatment” product that isn’t any more perfecting than those in Lauder’s previous Perfectionist incarnation. Aside from the correcting claims, Lauder does know how to make moisturizers. This silky formulation has numerous water-binding agents and, further down the lengthy ingredient list, anti- oxidants that will help improve the way it looks and feels (though these would have been more useful if they were present in larger amounts). If you were hoping Lauder’s showcased CP+ peptide solution was the answer, you should know that the amount of peptides in this product is not unique, nor superior to other peptide- containing products from Olay’s Regenerist, Neutrogena’s Active Copper, or even, dare I say, StriVectin-SD. Perfectionist [CP+] contains acetyl hexapeptide-3, an ingredient that is common in many products claiming to “work like Botox.” As I mentioned earlier in this issue, there is no sub- stantiated research proving that this peptide is capable of affecting muscle contractions to the point of smoothing a wrinkle, and if it could work topically (as claimed), why wouldn’t it affect other areas it contacts, such as your fingers? Freeman Botopical Instant Wrinkle Eraser Eye Repair ($13.39 for 0.5 ounce) is yet another product that claims to reduce wrinkles in lieu of Botox injections. You should know it contains absolutely nothing that can leave skin (around the eyes or elsewhere) wrinkle-free, either instantly or after several hours (or days, months, or years) of use. It is nothing more than water, thickener, film- forming agent, emollient, alkaline resin, slip agent, plant extracts, glycerin, preservatives, several more film-forming agents, and fragrance. The large amount of film-forming agents can constrict skin and cause irritation. Although that can make skin temporarily look tighter and smoother, con- sistent use will likely lead to problems that will end up making wrinkles look worse. Other than that, this is also poorly formulated lacking any state-of-the-art ingredients for skin. It is actually more problematic than helpful for skin. Freeze 24/7 This New York-based company sells a small line of "works like Botox" products, all accompa- nied by the droll slogan "nature, not needles." Their products supposedly are formulated with TMRs (Topical Muscle Relaxers) that they claim can exert Botox-like effects every time you apply them. If their claims were true, this collection of products would render all of us completely wrinkle- free, and Allergan, the company that makes Botox Cosmetic®, would go out of business. Besides, the ingredients in these products simply can't replace Botox or any other medical cosmetic correc- tive procedure. The main "active" ingredient touted by Freeze 24/7 is gamma aminobutyric acid (GABA). As I mentioned in the review above for Dr. Brandt's Crease Release, GABA is an amino acid that acts as a neurotransmitter inhibitor and is associated with reducing seizures and depres- sion (Sources: Advances in Experimental Medicine and Biology, 2004, volume 548, pages 92-103; and Archives of General Psychiatry, July 2004, pages 705-713). GABA's use in reducing the speed with which nerves fire (in the brain) is what companies such as Freeze 24/7 use to convince consumers they are buying the equivalent of topical Botox, with the logic being that topical GABA can influence the nerves that control muscles, selectively preventing muscle contractions. If GABA can stop nerves from firing in the brain, maybe it isn't a stretch to assume it could do that for the nerves that cause muscle movement, thus diminishing expression lines without (and this is almost becoming a cliché "painful injections." However, aside from the fact that there is absolutely no research showing that to be the case, even when taken orally GABA does not work alone to prevent seizures or lessen depression. Many other compo- nents found in the body are required for it to function (Source: www.emedicine.com, www.emedicine.com/neuro/topic692.htm#section~gaba_reuptake_inhibitors). You simply can't get GABA to act like that when it's applied topically. Just supposing you could, what would prevent GABA from causing the muscles in your hand not to move? After all, you are applying the stuff with your fingers. Now that would be a problem! The Freeze 24/7 range consists of EyeCicles ($95 for 0.5 ounce), Freeze 24/7 ($95 for 1 ounce), and IceCream ($80 for 1.7 ounces; this product also contains the questionable ingredi- ent acetyl hexapeptide-3 reviewed above). None of these overpriced products are recommended. Hydroderm Fast Acting Wrinkle Reducer ($79.95 for 1 ounce) and Anti-Aging Eye Complex ($27.95 for 0.25 ounce). Hydroderm is very busy trying to be a StriVectin-SD wannabe, but unlike Strivectin which, except for the peppermint oil, is actually a well formulated moisturizer, Hydroderm only has hype going for it. Hydroderm lacks any state-of-the-art ingredients for fighting wrinkles, and is actually pretty sneaky about what ingredients their product does contain. The company claims that "Because of the Hollywood hype of Botox, consumers are failing to realize the adverse effects of Botox. Bleeding, bruising and infection are just a few risks of injected Botox treatments. With Hydroderm, you apply the liquid with your fingertips and see the results—younger-looking, smoother skin with less fine lines and wrinkles." There are definitely risks with Botox, but the injections have no higher risk of causing bleeding, bruising, or infection than a shot of B vitamins does. Further, a shot of Botox doesn't just "reduce fine lines and wrinkles," it erases them completely (although the effect is not permanent, lasting about four months in most cases). The exaggerated risk assess- ment by Hydroderm is mere histrionics. The two Hydroderm products above have formulations so mundane they are almost laugh- able. Perhaps because Hydroderm is concerned about their ingredients, they disguise their con- tent on the ingredient label with names that are not allowed by the FDA. Cephene is amniotic fluid (Source: International Cosmetic Ingredient Dictionary and Handbook, 10th Edition, 2004); Synasol is ethyl alcohol (Source: www.chemfinder.com); and PRE Complex is placental protein (Source: International Cosmetic Ingredient Dictionary and Handbook, 10th Edition, 2004). In essence, these products mostly contain collagen, water, preservatives, protein, amniotic fluid, and vitamin C. Hydroderm's customer service department told me the amniotic fluid (the liquid surrounding a developing fetus inside the womb) comes from a plant source! I almost dropped the phone.
However, the amount of this ingredient is so minute it is insignificant for skin, and there isn't any
research showing it to be of benefit for getting rid of wrinkles anyway. Collagen is the showcase
ingredient in this product. I thought the collagen fad was truly a thing of the past because it never
worked for combating wrinkles and there is no research showing it ever did. Almost every anti-
aging skin-care product sold in the late 1980s and 1990s contained collagen, and wrinkles did not
go away or slow down then either. Applying collagen on top of the skin cannot affect the collagen
in the skin, and the same is true for this product's protein content: it doesn't add to the protein in
your skin. Collagen and protein are both good water-binding agents, but that's about it. Hydroderm also contains the acid form of vitamin C, but it is present in such a low amount that it is barely detectable and, therefore, unable to help skin (Sources: Experimental Dermatology, June 2003, pages 237-244; and Dermatologic Surgery, March 2002, pages 231-236). The Anti- Aging Eye Complex adds vitamin E to the mix, but that is hardly exciting or unique; thousands of
products contain vitamin E. If there is any research supporting Hydroderm's claims, the company is not willing to reveal it. One other interesting point: The Hydroderm Web site quotes a Dr. Judy Lavrich, a "board certified"
physician, as being "a supporter" of these products. Yet there is no information anywhere about
what medical board certified her, or where her office, if any, is located. A search of several medical databases indicates she has never published a paper or been part of a medical research team. L’Oreal Dermo-Expertise Wrinkle De-Crease Eye Wrinkle Corrector and Dermo Smoother ($19.99 for 0.5 ounce), Dermo-Expertise Wrinkle De-Crease Daily Smoothing Serum with Boswelox
($19.99 for 1 ounce), Dermo-Expertise Wrinkle De-Crease Advanced Wrinkle Corrector and
Dermo-Smoother Night Cream ($18.99 for 1.7 ounces), and Dermo-Expertise Wrinkle De- Crease Wrinkle Corrector and Dermo-Smoother Cream ($18.99 for 1.7 ounces). Interestingly enough, L'Oreal, Lancome's parent company, has its own version of Lancome's Resolution D-
Contraxol products (reviewed below) called Dermo-Expertise. In addition to the manganese glu-
conate Lancome uses, L'Oreal included what they refer to as a "breakthrough phyto-complex,
combining a powerful dose of boswellia extract and manganese," all of which are said to reduce
the appearance of lines around the eye resulting from "facial micro-contractions." Boswellia extract
is also known as Indian frankincense. The active part of this plant is the resin, which contains the
anti-inflammatory agents boswellic acid and alpha-boswellic acid. However, the research pointing
to boswellia extract's anti-inflammatory properties dealt with oral consumption. There is insufficient
evidence to support its use topically, and it definitely has no effect on muscle contraction or wrinkles
(Source: Natural Medicines Comprehensive Database, 4th Edition, 2002, page 713). Moreover, if boswellia extract is so special, why did it get left out of Lancome's Resolution D- Contraxol products? You would think if L'Oreal knew something was so great for skin they would be nice enough to share it with another product line they own. Lancome Resolution D-Contraxol Intensive Anti-Wrinkle Treatment Dermo-Crease Reducer for Nor- mal to Dry Skin ($68 for 1.7 ounces), Resolution D-Contraxol Intensive Anti-Wrinkle Treatment Dermo-Crease Reducer for Normal to Combination Skin ($68 for 1.7 ounces), Resolution Eye D-Contraxol Intensive Anti-Wrinkle Eye Treatment ($49 for 0.5 ounce), and Resolution Wrinkle Concentrate Advanced Anti-Wrinkle Serum Dermo-Crease Reducer ($68 for 1 ounce) are Lancome's answer to Botox treatments. According to an article in the February 2003 issue of Vogue magazine, Lancome has spent ten years of research and millions of dollars to develop these prod- ucts. The article pointed out that Lancome scientists are not calling their Resolution D-Contraxol lineup "Botox in a jar," but did indicate that it's close. It was also noted that while Botox is classified (and regulated as) a drug, Resolution D-Contraxol is strictly a cosmetic (what a shock!). Above all else, that means one thing for the consumer: Lancome can make wrinkle-reducing claims without providing any proof or substantiation that the product can actually have that effect because the D- Contraxol products are cosmetics and thus not regulated with anything approaching the same scru- tiny as would occur for a drug (such as Botox). If you're curious about what is in Lancome's D-Contraxol products that they claim can behave like Botox, it turns out the key ingredient is manganese gluconate. According to Alan Meyers, vice president of central research for L'Oreal USA (Lancome's parent company), "Manganese has a relaxing effect on cells. When your face is flexing, it prevents the fibroblasts [cells that create collagen] from staying contracted. Skin tends to go back to its original shape, even if there are already deep lines present" (Source: Vogue, February 2003, page 282). Fibroblasts don't contract; they are cells that create collagen. They do not function as skin tissue because they create col- lagen, not skin, and they cannot provide sole support to skin (other elements, like elastin, are required). More to the point, after supposedly ten years of research there are no published, peer- reviewed studies supporting Meyers's statements. If you're wondering about manganese gluconate, it is a mineral salt that's found in trace amounts in the tissues of the body. It plays a vital role in the processes of many body systems, but there is no evidence that it serves any purpose when applied to the skin, though theoretically it can be an antioxidant. And what about the fact that the entire premise behind Botox is the temporary paralysis of facial muscles to prevent expression lines from appearing? Assuming Meyers's state- ment about manganese and its effect on fibroblasts is correct, what good would that ingredient be for relaxing expression lines when it is the repetitive contraction of facial muscles that, over many years, leads to expression lines such as the furrow between your brow or laugh lines around the mouth? Botox is so successful because it immobilizes specific muscles involved in the types of facial expressions that can leave telltale marks on skin. Without the muscles pulling the skin, the expression lines don't appear. Manganese can't do anything remotely similar to that, though all of the Resolution D-Contraxol products have merit as moisturizers. Paula’s Choice, Inc.
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policy.asp?TYPE=TERMS. Revlon Revlon's Age Defying Makeup line, a collection of products aimed at baby boomers con- cerned with wrinkles and other visible signs of aging, is the first mass-market makeup line sold with Botox-like claims. In order to keep pace with the latest hyped ingredients (and because they don't offer much in the way of skin care), the Age Defying products are said to minimize the ap- pearance of lines and wrinkles with something called Botafirm. Botox, Botafirm, get the connec- tion? Botafirm complex contains acetyl hexapeptide-3, trade name Argireline. Despite claims from the ingredient manufacturer that Argireline works in a unique way to topically relax facial muscles and tension, thus reducing the appearance of expression lines, there is no independent substan- tiated evidence to support this idea. Everyone using this ingredient is banking on unproven claims. As mentioned in the reviews above, the flip side is that if the claims are valid, acetyl hexapeptide- 3's mechanism of action could cause problems with the release of catecholamines, which include various chemicals in the body, such as epinephrine, that monitor our responses to external stimuli. That is not something you'd want to disrupt with a topical application of cosmetics! Thankfully, that does not appear to be possible, so you can use Revlon's latest makeup options without concern (either positive or negative) for acetyl hexapeptide-3. Just keep in mind that Revlon's Botafirm will not help your skin "bounce back from smiles, squints, and frowns." Better Than Botox? Bogus! I know many of you are hoping that the next works-like-Botox product really will fulfill that promise, but as evidenced from the information above, the lack of substantiated studies, and the ever-growing popularity of genuine Botox injections, along with other cosmetic corrective proce- dures performed by dermatologists and plastic surgeons, that isn't likely to happen anytime soon. In the meantime, remain skeptical and think twice before handing over your credit card at the cosmetics counter or drugstore. Anything claiming to work like Botox that is being sold without a prescription is far removed from the real deal, and all claims to the contrary should be considered completely bogus.
Cosmetic
Better than B OTOX ® ? A Special Report by Paula Begoun T he number of letters and emails I receive asking about the many topical products claiming to work like or mimic the effects of Botox is astounding. Results from Botox injections are so instantaneously impressive, it's no wonder it has become the most commonly performed cosmetic corrective procedure in the US and such a recognizable name. In 2003, there were 2,272,080 Botox treatments administered, making it the number-one nonsurgi- cal cosmetic corrective procedure, up from 1.5 million treatments in 2002 (Source:http://surgery.org/ press/procedurefacts-asqf.php). Alas, it is also expensive and the thought of being injected with the botulism toxin (that's what Botox is) leaves some people fearfully furrowing their brows which explains why so many cosmetics companies are launching non-invasive, topical products claiming to be "better than Botox." As a reminder, Botox injections introduce a minute amount of the synthetic botulinum type-A toxin into the muscles of the forehead (or other areas where it is injected). This prevents the use of facial muscles (you can't frown or lift your eyebrows after being injected until the effect wears off, typically four months later). Within 24 to 48 hours of receiving Botox, forehead wrinkles are gone. Botox poses little to no risk. It has been used for decades to treat eye spasms, dystonia, cerebral palsy, and more recently, wrinkles. Recent studies have even found it to be helpful for migraine relief. So is there any cosmetic lotion or cream that can work better than Botox, or in any way shape or form, similar to Botox? The short answer is a resounding no! According to Dr. Alistaire Carruthers, Clinical Professor of Dermatology at the University of British Columbia who has also published many studies about Botox, you can't affect muscle movement topically. And besides, to have that effect on muscles would be problematic for the body, not to mention it would affect muscles you do not want "relaxed," such as those in your hands or near your mouth. But of course none of that ever stops the cosmetics industry from trying to convince women otherwise. In reality, there are no ingredients that can come remotely close to creating the improvement in wrinkles that Botox does. As nice as it would be to get Botox-like results "without painful injections" it just isn't possible. (By the way, about those painful injections, I'm not going to pretend Botox injections don't hurt, but from my experience and that of others I have spoken to, it is more of a mild discomfort than a painful experience.) That said, here are my reviews of some of the many "better than Botox" products on the market. Is Any Cosmetic
Better than B OTOX ® ? Klein-Becker StriVectin-SD ($135 for 6 ounces) is the prod- uct that started the whole "better than Botox" craze. It went from email spam and ads in Parade maga- zine to prominent shelf space in Nordstrom and Sephora. Interestingly enough, StriVectin didn't start as an anti-wrinkle product. Rather, its original claim to fame was for eliminating stretch marks. However, the only studies proving StriVectin’s benefits (via pep- tide technology) were paid for by the manufacturer, and they have never been published. There have been papers presented on this topic at dermatology con- ferences, but such presentations are not held to the same standard as peer-reviewed, publishable stud- ies. That's about as reliable as a Marlboro coming out with a study that says cigarettes are safe. Though there is no way to be sure, it seems Klein-Becker simply decided that the market for a stretch mark product wasn't as lucrative as one for an anti-wrinkle product. So the company modified their ads, stating they were surprised to find that not only was StriVectin-SD getting rid of women's stretch marks, but it also got rid of their facial wrinkles, and we now have the astounding “anti-wrinkle break- through of the decade.” Regrettably, they do not have to back up this claim with supportive research to sell this kind of hyperbole. All any company has to do is claim their product will get rid of wrinkles and women will buy it in droves, as evidenced by the fact that StriVectin-SD has been the best-selling product in department stores since November 2003, with sales topping $30 million between January and June 2004 (Source: The Rose Sheet, June 7, 2004, page 3)! The con is on, and many consumers are buying it (literally and figuratively). Perhaps the most enticing part of StriVectin's ads are the portions that read, “The active formula in StriVectin-SD has recently been shown in clinical tri- als to significantly reduce that category of fine lines and facial wrinkles that can add 10-15 years to your appearanceˇand even reduce the dark circles under your eyes ...without irritation, painful injections, or surgery.” Another statement reads “in fact, [StriVectin-SD] is the only topical formulation clinically proven to effectively confront every aspect of wrinkle reduction.” It is easy to debunk all of this overblown nonsense by pointing out the product's lack of sunscreen; perhaps StriVectin overlooked the voluminous research about sun exposure's deleterious, wrinkling, and discoloring effects on skin. That omission alone puts their claims in the category of overstatement and nothing more. The two studies quoted in StriVectin’s ads were presented at the 20th World Congress of Dermatology, held in July 2002. These papers examined the effects of the ingredient palmitoyl pentapeptide-3 (one of the ingredients in Strivectin, though they advertise this ingredient with the name Pal-KTTKS) and compared it to vitamin C and retinol. Of course, according to them, palmitoyl pentapeptide-3 won. However, there is no published research substantiating the results, the stud- ies were from the ingredient manufacturer, and StriVectin declined to send us any documentation. Further, presenting a paper at a dermatology meeting is not the same as having your information published in a medical journal with strict protocol standards. With lack of substantiated research but a strong desire to capture baby boomers' dollars, Klein-Becker has taken these claims and almost single-handedly created a market for "works like Botox" products. StriVectin-SD is supposedly preferable because of its long-term results versus the short-term results (and repeated treatments) of Botox. A Dr. Nathalie Chevreau is quoted in the ad, saying “the cumulative effects of using a product like StriVectin become more noticeable every day, and ultimately lasts longer than Botox.” Chevreau is hardly an impartial source—she works for Klein-Becker! Further, Dr. Chevreau is a licensed dietician in Utah, a fact that is conveniently left out of StriVectin’s ad because it would conflict with her credibility as a medical doctor speaking about the legitimate benefits of an antiwrinkle cream. If you are still wondering if there is any way possible that StriVectin-SD might somehow be better than Botox, the short answer is no—and that means no way, and no how. It certainly isn't better than the daily use of an effective sunscreen! StriVectin is merely a moisturizer with some very good emollients, water-binding agents, antioxidants, and peptides. Unfortunately, this product also contains peppermint oil, a problematic skin irritant. I suspect this was included to make the skin tingle (a sensitizing reaction) to create the impression that the product is “doing something” to the skin. StriVectin-SD won't alter the wrinkling on any part of your face, in the long term or in the short term. Riding on the success of StriVectin-SD, several cosmetic companies have created their own products claiming to be better than Botox or better than cosmetic corrective surgery. The list below covers the most widely advertised, readily available products. Avon Anew Clinical Deep Crease Concentrate with Bo-Hylurox ($32 for 1 ounce) has a name not only reminiscent of Botox, but is advertised to make you wonder why anyone would subject themselves to an injection when they can achieve the same (or at least similar) results with this water-based serum. Sold with the scare-tactic tag line "Look stunning, not stunned," Avon's alter- native to Botox claims to "reduce the overall length, depth and number of deep expression lines around your eyes, mouth and forehead, the areas that are in motion whenever you show emotion." Well, when done correctly, Botox injections absolutely do not make a person look stunned—the list of Hollywood celebrities who have had Botox injections is what's really stunning, and they don't look "stunned!" As one Hollywood plastic surgeon told me, if Botox was a problem half the town would be sick. Unlike genuine Botox injections, this Avon product absolutely cannot get rid of wrinkles. Anew Clinical Deep Crease Concentrate contains two ingredients that are supposedly re- sponsible for the crease-filling and wrinkle-smoothing. The first is Portulaca oleracea, a plant ex- tract. Avon maintains it "helps you lose those hard-to-treat creases while keeping your facial ex- pressions, naturally." However, there is no substantiated or published research showing Portulaca oleracea has that (or any) anti-wrinkle effect. Research has shown that it may have anti-inflamma- tory or analgesic properties, and it is also believed to be effective topically for wound healing (Sources: Journal of Ethopharmacology, October 2003, pages 131-136, and December 2000, pages 445-451). But none of that is related to treating expression lines in any way, shape, or form or duplicating Botox's effect on wrinkles. One study did examine Portulaca's effect on brain activity and resulting muscle relaxation, but the substance was used in a 10% concentration and injected into pigs' stomachs, quite different from applying lesser amounts of this ingredient to skin (Source: Journal of Ethnopharmacology, July 2001, pages 171-176). The second hyped ingredient is acetyl hexapeptide-3 (trade name: argireline), which is de- scribed in detail in the DDF Wrinkle Relax review below. BlissLabs No-Motion Lotion ($35 for 1 ounce) is another "works-like-Botox" product, and, like all the others, is completely ineffective at preventing muscle contractions to "address the mechanical causes of skin aging." What a joke! This lotion contains sodium polystyrene sulfonate, a resin- based film-forming agent that is considered a skin irritant (Source: Handbook of Cosmetic and Personal Care Additives, Second Edition, volume 2, 2002, page 1513). It also contains a starch
derivative that creates a (temporary) tightening effect on skin. Peppermint oil and menthol are here, too, probably so you'll think this do-nothing-positive product is doing something. But all it ends up doing is irritating skin and that is a problem if you want healthy skin. This is a poorly formulated product and it's not even worth going through the motions of ordering it. DDF Wrinkle Relax (previously known as Faux-Tox) ($75 for 0.5 ounce) is another Botox wannabe. This pricey product, which over a year's time wouldn't cost that much less than an actual Botox treatment, claims to contain a non-toxic, anti-aging peptide, chemically combined from natu- rally derived amino acids, [that] helps prevent fine lines induced by repeated facial movements without the loss of facial expression." And the results are supposed to be visible within two weeks. The miracle ingredient in this lightweight lotion is Argireline, which is the trade name for the syn- thetically derived peptide called acetyl hexapeptide-3. The company selling acetyl hexapeptide-3 is Centerchem (www.centerchem.com), an ingredient manufacuter based in Spain and, according to their Web site, "Argireline works through a unique mechanism which relaxes facial tension lead- ing to a reduction in superficial facial lines and wrinkles with regular use. Argireline has been shown to moderate excessive catecholamines release." Other than Centerchem's assertions, there isn't a shred of research substantiating any part of it. However, even if it were vaguely true, these effects would not be good news for your body because you wouldn't want any cosmetic without any safety data, efficacy documentation, or inde- pendent research messing around with your catecholamines. Catecholamines are compounds in the body that serve as neurotransmitters such as epinephrine, adrenaline, and dopamine. Epi- nephrine is a substance that prepares the body to handle emergencies such as cold, fatigue, and shock. A deficiency of dopamine in the brain is responsible for the symptoms of the Parkinson's. None of that sounds like something you want a cosmetic to inhibit or reduce. What if you acciden- tally overuse the product or apply too much? What is excessive for your body? The entire notion is more worrisome than almost anything I've encountered in my research thus far. However, the good news is that the physicians I've interviewed say this ingredient can't perform as DDF suggests. Also available is DDF’s Anti-Wrinkle Eye Renewal Treatment ($48 for kit). The kit includes four products, with the main attraction being the Anti-Wrinkle Dermal Gel, a water-based serum that contains the same "active" ingredient the company uses in their Wrinkle Relax product above, with equally suspect claims. In addition, there are clinical studies for Argireline revealing that this ingredient was not as effective as Botox (Source: www.cremedevie.com/clinical_details.htm). Again, this is not an ingredient to consider because there are too many unknowns about its effect on biological processes, not to mention its dubious anti-wrinkle claims. Dr. Brandt Crease Release ($150 for 1 ounce). According to Dr. Fredric Brandt's book, Age-Less The Definitive Guide to Botox, Collagen, Lasers, Peels, and Other Solutions for Flawless Skin, he was one of the physicians involved in the drug trials leading to the FDA's approval of Botox. Ironically, and potentially unethically, he hypes his Crease Release as being similar (and a viable alternative) to Botox. Suffice it to say, it isn't! Crease Release contains gamma aminobutyric acid (GABA), an amino acid that acts as a neurotransmitter inhibitor and is associated with reducing seizures and depression (Sources: Ad- vances in Experimental Medicine and Biology, 2004, volume 548, pages 92-103; and Archives of
General Psychiatry, July 2004, pages 705-713). GABA's relationship to reducing how often nerves fire is what Brandt wants the consumer to associate with its topical application. If GABA can stop nerves from firing in the brain, it should be able to stop facial muscles from being triggered when applied topically and voila! you have a product that is better than Botox! However, aside from the fact that there is absolutely no research showing that to be the case, GABA does not work alone in the body. It requires many other components in order to function as a substance blocking nerves from being triggered (Sources: www.emedicine.com, www.emedicine.com/neuro/ topic692.htm#section~gaba_reuptake_inhibitors). Even if Crease Release did work, there would be serious problems for those who decided to apply it all over their face because while muscle movement causes lines on the forehead, the muscles of the jaw, chin, and neck support skin in that area. You could get more sagging if those muscles became relaxed. And what about your hands or other areas that came in contact with this cream? If it worked the way Brandt describes you could easily have unwanted side effects. What all of this adds up to is a lot of scientific confusion that a consumer will assume is true because it is being sold with a well-known doctor's blessing. Even more disturbing is the price, which is a complete burn considering this not-even-close- to-Botox product costs one-third of the actual treatment which will produce impressive results. Estee Lauder Perfectionist [CP+] with Poly-Collagen Peptides Correcting Serum for Lines/Wrinkles/ Age Spots ($55 for 1 ounce). I was wondering when Lauder was going to jump on the “works like Botox” product bandwagon, and here it is, launched with the same absurd claim as everyone else is using: “Now, triumph over wrinkles without toxins, lasers or injections. Estee Lauder Research boldly advances the fight against wrinkles—and now age spots—with our most comprehensive treatment ever,” is it any wonder why there’s been such intense curiosity about this product? But before I discuss the formula, I want to mention that this product is not a substitute in any way, shape, or form for Botox, lasers, or any type of dermal filler. No topical cosmetic product is capable of attaining anywhere near the results obtainable from those medical corrective procedures. Clearly, the desire for such a product is strong, or companies such as Lauder, L’Oreal, Lancome, Revlon, and a host of others wouldn’t keep consumers’ hopes alive with such claims as “it virtually immobi- lizes lines and wrinkles without affecting your natural facial expressions” or that their product can intercept “the cycle of irritation that can increase the depth and length of a wrinkle.” From my perspective, these suggestions (which is what advertising of this nature always is: impression, not fact) are just that, and nothing more. If your lines were immobilized, your facial expressions would definitely be affected. Furthermore, deep wrinkles are not inherently caused by simple irritation, but rather by deep inflammation from cumulative unprotected sun exposure and myriad other factors. So what’s in this product that allegedly can smooth wrinkles without (eek!) resorting to needles or other medical procedures? The “CP” in the product’s name stands for collagen peptides. Accord- ing to information from Lauder on www.gloss.com, patent-pending “triple enzyme technology rushes” this collagen peptide complex to “even the most prominent wrinkles.” While there is much hope that peptides may help skin, they are easily broken down by enzymes, and that doesn’t help get them to the cells in the lower layers of skin, where wrinkles begin. It all adds up to another dubious “treatment” product that isn’t any more perfecting than those in Lauder’s previous Perfectionist incarnation. Aside from the correcting claims, Lauder does know how to make moisturizers. This silky formulation has numerous water-binding agents and, further down the lengthy ingredient list, anti- oxidants that will help improve the way it looks and feels (though these would have been more useful if they were present in larger amounts). If you were hoping Lauder’s showcased CP+ peptide solution was the answer, you should know that the amount of peptides in this product is not unique, nor superior to other peptide- containing products from Olay’s Regenerist, Neutrogena’s Active Copper, or even, dare I say, StriVectin-SD. Perfectionist [CP+] contains acetyl hexapeptide-3, an ingredient that is common in many products claiming to “work like Botox.” As I mentioned earlier in this issue, there is no sub- stantiated research proving that this peptide is capable of affecting muscle contractions to the point of smoothing a wrinkle, and if it could work topically (as claimed), why wouldn’t it affect other areas it contacts, such as your fingers? Freeman Botopical Instant Wrinkle Eraser Eye Repair ($13.39 for 0.5 ounce) is yet another product that claims to reduce wrinkles in lieu of Botox injections. You should know it contains absolutely nothing that can leave skin (around the eyes or elsewhere) wrinkle-free, either instantly or after several hours (or days, months, or years) of use. It is nothing more than water, thickener, film- forming agent, emollient, alkaline resin, slip agent, plant extracts, glycerin, preservatives, several more film-forming agents, and fragrance. The large amount of film-forming agents can constrict skin and cause irritation. Although that can make skin temporarily look tighter and smoother, con- sistent use will likely lead to problems that will end up making wrinkles look worse. Other than that, this is also poorly formulated lacking any state-of-the-art ingredients for skin. It is actually more problematic than helpful for skin. Freeze 24/7 This New York-based company sells a small line of "works like Botox" products, all accompa- nied by the droll slogan "nature, not needles." Their products supposedly are formulated with TMRs (Topical Muscle Relaxers) that they claim can exert Botox-like effects every time you apply them. If their claims were true, this collection of products would render all of us completely wrinkle- free, and Allergan, the company that makes Botox Cosmetic®, would go out of business. Besides, the ingredients in these products simply can't replace Botox or any other medical cosmetic correc- tive procedure. The main "active" ingredient touted by Freeze 24/7 is gamma aminobutyric acid (GABA). As I mentioned in the review above for Dr. Brandt's Crease Release, GABA is an amino acid that acts as a neurotransmitter inhibitor and is associated with reducing seizures and depres- sion (Sources: Advances in Experimental Medicine and Biology, 2004, volume 548, pages 92-103; and Archives of General Psychiatry, July 2004, pages 705-713). GABA's use in reducing the speed with which nerves fire (in the brain) is what companies such as Freeze 24/7 use to convince consumers they are buying the equivalent of topical Botox, with the logic being that topical GABA can influence the nerves that control muscles, selectively preventing muscle contractions. If GABA can stop nerves from firing in the brain, maybe it isn't a stretch to assume it could do that for the nerves that cause muscle movement, thus diminishing expression lines without (and this is almost becoming a cliché "painful injections." However, aside from the fact that there is absolutely no research showing that to be the case, even when taken orally GABA does not work alone to prevent seizures or lessen depression. Many other compo- nents found in the body are required for it to function (Source: www.emedicine.com, www.emedicine.com/neuro/topic692.htm#section~gaba_reuptake_inhibitors). You simply can't get GABA to act like that when it's applied topically. Just supposing you could, what would prevent GABA from causing the muscles in your hand not to move? After all, you are applying the stuff with your fingers. Now that would be a problem! The Freeze 24/7 range consists of EyeCicles ($95 for 0.5 ounce), Freeze 24/7 ($95 for 1 ounce), and IceCream ($80 for 1.7 ounces; this product also contains the questionable ingredi- ent acetyl hexapeptide-3 reviewed above). None of these overpriced products are recommended. Hydroderm Fast Acting Wrinkle Reducer ($79.95 for 1 ounce) and Anti-Aging Eye Complex ($27.95 for 0.25 ounce). Hydroderm is very busy trying to be a StriVectin-SD wannabe, but unlike Strivectin which, except for the peppermint oil, is actually a well formulated moisturizer, Hydroderm only has hype going for it. Hydroderm lacks any state-of-the-art ingredients for fighting wrinkles, and is actually pretty sneaky about what ingredients their product does contain. The company claims that "Because of the Hollywood hype of Botox, consumers are failing to realize the adverse effects of Botox. Bleeding, bruising and infection are just a few risks of injected Botox treatments. With Hydroderm, you apply the liquid with your fingertips and see the results—younger-looking, smoother skin with less fine lines and wrinkles." There are definitely risks with Botox, but the injections have no higher risk of causing bleeding, bruising, or infection than a shot of B vitamins does. Further, a shot of Botox doesn't just "reduce fine lines and wrinkles," it erases them completely (although the effect is not permanent, lasting about four months in most cases). The exaggerated risk assess- ment by Hydroderm is mere histrionics. The two Hydroderm products above have formulations so mundane they are almost laugh- able. Perhaps because Hydroderm is concerned about their ingredients, they disguise their con- tent on the ingredient label with names that are not allowed by the FDA. Cephene is amniotic fluid (Source: International Cosmetic Ingredient Dictionary and Handbook, 10th Edition, 2004); Synasol is ethyl alcohol (Source: www.chemfinder.com); and PRE Complex is placental protein (Source: International Cosmetic Ingredient Dictionary and Handbook, 10th Edition, 2004). In essence, these products mostly contain collagen, water, preservatives, protein, amniotic fluid, and vitamin C. Hydroderm's customer service department told me the amniotic fluid (the liquid surrounding a developing fetus inside the womb) comes from a plant source! I almost dropped the phone.
However, the amount of this ingredient is so minute it is insignificant for skin, and there isn't any
research showing it to be of benefit for getting rid of wrinkles anyway. Collagen is the showcase
ingredient in this product. I thought the collagen fad was truly a thing of the past because it never
worked for combating wrinkles and there is no research showing it ever did. Almost every anti-
aging skin-care product sold in the late 1980s and 1990s contained collagen, and wrinkles did not
go away or slow down then either. Applying collagen on top of the skin cannot affect the collagen
in the skin, and the same is true for this product's protein content: it doesn't add to the protein in
your skin. Collagen and protein are both good water-binding agents, but that's about it. Hydroderm also contains the acid form of vitamin C, but it is present in such a low amount that it is barely detectable and, therefore, unable to help skin (Sources: Experimental Dermatology, June 2003, pages 237-244; and Dermatologic Surgery, March 2002, pages 231-236). The Anti- Aging Eye Complex adds vitamin E to the mix, but that is hardly exciting or unique; thousands of
products contain vitamin E. If there is any research supporting Hydroderm's claims, the company is not willing to reveal it. One other interesting point: The Hydroderm Web site quotes a Dr. Judy Lavrich, a "board certified"
physician, as being "a supporter" of these products. Yet there is no information anywhere about
what medical board certified her, or where her office, if any, is located. A search of several medical databases indicates she has never published a paper or been part of a medical research team. L’Oreal Dermo-Expertise Wrinkle De-Crease Eye Wrinkle Corrector and Dermo Smoother ($19.99 for 0.5 ounce), Dermo-Expertise Wrinkle De-Crease Daily Smoothing Serum with Boswelox
($19.99 for 1 ounce), Dermo-Expertise Wrinkle De-Crease Advanced Wrinkle Corrector and
Dermo-Smoother Night Cream ($18.99 for 1.7 ounces), and Dermo-Expertise Wrinkle De- Crease Wrinkle Corrector and Dermo-Smoother Cream ($18.99 for 1.7 ounces). Interestingly enough, L'Oreal, Lancome's parent company, has its own version of Lancome's Resolution D-
Contraxol products (reviewed below) called Dermo-Expertise. In addition to the manganese glu-
conate Lancome uses, L'Oreal included what they refer to as a "breakthrough phyto-complex,
combining a powerful dose of boswellia extract and manganese," all of which are said to reduce
the appearance of lines around the eye resulting from "facial micro-contractions." Boswellia extract
is also known as Indian frankincense. The active part of this plant is the resin, which contains the
anti-inflammatory agents boswellic acid and alpha-boswellic acid. However, the research pointing
to boswellia extract's anti-inflammatory properties dealt with oral consumption. There is insufficient
evidence to support its use topically, and it definitely has no effect on muscle contraction or wrinkles
(Source: Natural Medicines Comprehensive Database, 4th Edition, 2002, page 713). Moreover, if boswellia extract is so special, why did it get left out of Lancome's Resolution D- Contraxol products? You would think if L'Oreal knew something was so great for skin they would be nice enough to share it with another product line they own. Lancome Resolution D-Contraxol Intensive Anti-Wrinkle Treatment Dermo-Crease Reducer for Nor- mal to Dry Skin ($68 for 1.7 ounces), Resolution D-Contraxol Intensive Anti-Wrinkle Treatment Dermo-Crease Reducer for Normal to Combination Skin ($68 for 1.7 ounces), Resolution Eye D-Contraxol Intensive Anti-Wrinkle Eye Treatment ($49 for 0.5 ounce), and Resolution Wrinkle Concentrate Advanced Anti-Wrinkle Serum Dermo-Crease Reducer ($68 for 1 ounce) are Lancome's answer to Botox treatments. According to an article in the February 2003 issue of Vogue magazine, Lancome has spent ten years of research and millions of dollars to develop these prod- ucts. The article pointed out that Lancome scientists are not calling their Resolution D-Contraxol lineup "Botox in a jar," but did indicate that it's close. It was also noted that while Botox is classified (and regulated as) a drug, Resolution D-Contraxol is strictly a cosmetic (what a shock!). Above all else, that means one thing for the consumer: Lancome can make wrinkle-reducing claims without providing any proof or substantiation that the product can actually have that effect because the D- Contraxol products are cosmetics and thus not regulated with anything approaching the same scru- tiny as would occur for a drug (such as Botox). If you're curious about what is in Lancome's D-Contraxol products that they claim can behave like Botox, it turns out the key ingredient is manganese gluconate. According to Alan Meyers, vice president of central research for L'Oreal USA (Lancome's parent company), "Manganese has a relaxing effect on cells. When your face is flexing, it prevents the fibroblasts [cells that create collagen] from staying contracted. Skin tends to go back to its original shape, even if there are already deep lines present" (Source: Vogue, February 2003, page 282). Fibroblasts don't contract; they are cells that create collagen. They do not function as skin tissue because they create col- lagen, not skin, and they cannot provide sole support to skin (other elements, like elastin, are required). More to the point, after supposedly ten years of research there are no published, peer- reviewed studies supporting Meyers's statements. If you're wondering about manganese gluconate, it is a mineral salt that's found in trace amounts in the tissues of the body. It plays a vital role in the processes of many body systems, but there is no evidence that it serves any purpose when applied to the skin, though theoretically it can be an antioxidant. And what about the fact that the entire premise behind Botox is the temporary paralysis of facial muscles to prevent expression lines from appearing? Assuming Meyers's state- ment about manganese and its effect on fibroblasts is correct, what good would that ingredient be for relaxing expression lines when it is the repetitive contraction of facial muscles that, over many years, leads to expression lines such as the furrow between your brow or laugh lines around the mouth? Botox is so successful because it immobilizes specific muscles involved in the types of facial expressions that can leave telltale marks on skin. Without the muscles pulling the skin, the expression lines don't appear. Manganese can't do anything remotely similar to that, though all of the Resolution D-Contraxol products have merit as moisturizers. Paula’s Choice, Inc.
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policy.asp?TYPE=TERMS. Revlon Revlon's Age Defying Makeup line, a collection of products aimed at baby boomers con- cerned with wrinkles and other visible signs of aging, is the first mass-market makeup line sold with Botox-like claims. In order to keep pace with the latest hyped ingredients (and because they don't offer much in the way of skin care), the Age Defying products are said to minimize the ap- pearance of lines and wrinkles with something called Botafirm. Botox, Botafirm, get the connec- tion? Botafirm complex contains acetyl hexapeptide-3, trade name Argireline. Despite claims from the ingredient manufacturer that Argireline works in a unique way to topically relax facial muscles and tension, thus reducing the appearance of expression lines, there is no independent substan- tiated evidence to support this idea. Everyone using this ingredient is banking on unproven claims. As mentioned in the reviews above, the flip side is that if the claims are valid, acetyl hexapeptide- 3's mechanism of action could cause problems with the release of catecholamines, which include various chemicals in the body, such as epinephrine, that monitor our responses to external stimuli. That is not something you'd want to disrupt with a topical application of cosmetics! Thankfully, that does not appear to be possible, so you can use Revlon's latest makeup options without concern (either positive or negative) for acetyl hexapeptide-3. Just keep in mind that Revlon's Botafirm will not help your skin "bounce back from smiles, squints, and frowns." Better Than Botox? Bogus! I know many of you are hoping that the next works-like-Botox product really will fulfill that promise, but as evidenced from the information above, the lack of substantiated studies, and the ever-growing popularity of genuine Botox injections, along with other cosmetic corrective proce- dures performed by dermatologists and plastic surgeons, that isn't likely to happen anytime soon. In the meantime, remain skeptical and think twice before handing over your credit card at the cosmetics counter or drugstore. Anything claiming to work like Botox that is being sold without a prescription is far removed from the real deal, and all claims to the contrary should be considered completely bogus.
Download Better than Botox Report-revise.pdf
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