Wiener klinische Wochenschrift

, Volume 121, Issue 13–14, pp 431–439

Evidenz-basierte Kosmetika: Konzept und Anwendung bei den Zielstellungen Licht-geschädigte Altershaut und Xerosis

  • Tatjana Pavicic
  • Stephanie Steckmeier
  • Martina Kerscher
  • Hans Christian Korting
Übersicht

Zusammenfassung

Wie bei Dermatika erscheinen auch bei Kosmetika Studien zur Überprüfung der Wirksamkeit erforderlich, die den Ansprüchen der Evidenz-basierten Medizin (EBM) genügen. Obwohl das Konzept einer Evidenz-basierten Kosmetik bislang nur in Ansätzen entfaltet worden ist, gibt es doch bereits Präparate, die als Evidenz-basiert gelten können. Daten aus verschiedenen Studien werden dargestellt, welche den Anspruch erheben, die Wirksamkeit kosmetischer Zubereitungen zur Behandlung einiger ausgewählter Hautprobleme wie Lichtschädigung und Altershaut sowie solare Lentigo und Melasma nach EBM-Kriterien zu dokumentieren. Weitere wissenschaftlich fundierte Studien sind notwendig, um alle wichtigen Einsatzgebiete von Wirkkosmetika abzudecken. Als Evidenz-basierte Substanzen zur Minderung der Hautalterungszeichen können Retinol und Antioxidantien wie Vitamine oder Coenzyme, die über verschiedene Mechanismen einen positiven Effekt auf den Kollagenstoffwechsel ausüben, bezeichnet werden. Entsprechend den gleichen Kriterien wurde auch die präventive Wirkung eines regelmäßigen Gebrauchs von dermokosmetischen Sonnenschutzmitteln auf die Entwicklung aktinischer Keratosen gezeigt. Ein beträchtlicher Bleich-Effekt, größenordnungsmäßig 0,1%igem Tretinoin entsprechend, kann mit einem 10%igen All-trans-Retinol-Gel erzielt werden. Dermokosmetische Sonnenschutzmittel sollen durch eine geeignete Kombination von organischen und/oder mineralischen Filtern eine ausreichende Schutzwirkung im UV-B- und im UV-A-Bereich und eine gute Hautverträglichkeit aufweisen. Außerdem können sie ergänzende Wirkstoffe wie Antioxidantien, DNA-Reparaturenzyme oder hautberuhigende Substanzen wie Dexpanthenol, Glycerin oder Hamamelis-Destilat enthalten. Als besonders gut charakterisierte und als wirksam belegte Substanzen zur Behandlung der trockenen Haut gelten entsprechend dem gewünschten Effekt unterschiedlich hoch konzen trierter Harnstoff, Ammoniumlaktat sowie Glycerin. Nach wie vor stellt der Wirksamkeitsnachweis eines dermokosmetischen Produkts auf Grund von Mangel an kontrollierten Studien, die die Überlegenheit der Applikation eines Wirkstoff-haltigen Mittels gegenüber der einer korrespondierenden Grundlage ein Problem dar. Umso mehr gilt es in der Zukunft, die Wirksamkeit weiterer Wirkstoffe nach EBM-Prinzipien zu erfassen und weitergehende Fragen zu beantworten wie die nach der Nachhaltigkeit erzielter Wirkungen sowie anerkannte Richtlinien zur Wirksamkeits- und Sicherheitsprüfung von Dermatokosmetika zu etablieren.

Schlüsselwörter

Lichtschädigung Altershaut Solare Lentigo Melasma 

Evidence-based cosmetics: concepts and applications in photoaging of the skin and xerosis

Summary

As well as for topically used dermatological agents, studies performed according to the rules of evidence-based medicine (EBM) are also needed for cosmetics. Although the concept of evidence-based cosmetics has been only partly developed so far, there are some agents and preparations available that can be considered as evidence-based. In this paper we present data from several studies that claim to have examined and demonstrated the efficacy of cosmetic preparations for the management of solar damage and aging skin as well as lentigo and melanosis according to EBM criteria. Certainly, further controlled studies are needed to cover the main application areas of dermocosmetics. Retinol and antioxidant agents such as vitamin C and coenzymes that positively act via several mechanisms on collagen biosynthesis can be considered evidence-based substances for the management of aging skin. According to the same criteria, the preventive effect of regularly applied dermocosmetic sun screens on the development of actinic keratosis could also be shown. Dermocosmetic sun screens should offer adequate protection against UV-B and UV-A light by combining compatible organic and/or non-organic UV-filters and at the same time be well tolerated. Furthermore, they may contain some additional agents such as antioxidants, DNA repair enzymes, dexpanthenol, glycerin or hamamelis distillate. In the treatment of melanosis, a substantial bleaching effect corresponding to that of 0.1% topical tretinoin can be achieved with 10% all-trans-retinol gel. Preparations containing urea, ammonium lactate or glycerol in different concentrations are considered the best characterized and most effective substances for the care of dry skin. However, the lack of controlled studies confirming the efficacy of dermocosmetic products as well as the superiority of the preparation incorporating the active agent over the corresponding base is a problem yet to be solved. Undoubtedly, the efficacy and the sustainability of the achieved effects have to be examined and proven accordingly to EBM criteria in further active cosmetic agents. Moreover, generally accepted guidelines for the examination of efficacy and tolerability of dermocosmetics have to be developed.

Keywords

Photo damage Ageing skin Solar lentigo Melanosis 

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Tatjana Pavicic
    • 1
  • Stephanie Steckmeier
    • 1
  • Martina Kerscher
    • 2
  • Hans Christian Korting
    • 1
  1. 1.Klinik und Poliklinik für Dermatologie und AllergologieKlinikum der Universität MünchenGermany
  2. 2.Studiengang KosmetikUniversität HamburgGermany

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