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December 20, 2011 - 1 ADVANCE IN DERMATO - COSMETOLOGY

All life depends upon the sun. Unfortunately, some people have a terrible price to

pay…


Skin pigmentation

Melanocyte with melanosomes

Keratinocyte with melanin granules over the nucleus

Dendrites


Process of hyperpigmentation

Sun Sun Ingestion or exposure

Coffee with milk macule, melasma,

postinflammatory hyperpigmentation

Ephelides Lentigines Phototoxic/ photoallergic reactions

Increased melanin Increased melanocytes

Hyperpigmentation Iron deposition


Mechanism of hyperpigmentation Tyrosine

DOPA

Dopaquinone

DOPAchrome

DHICA

Eumelanin Phaeomelanin

Tyrosinase


Classification of depigmenting agents

mature melanosome

Tyr

M

endoplasmic reticulum

Golgi complex

transcription inhibitors

glycosylation inhibition

BEFORE melanin synthesis

DURING melanin synthesis

AFTER melanin synthesis


•  Before melanin synthesis :

q  tyrosinase transcription : Tretinoin q  Octadecene dioic acid q  tyrosinase glycosylation

•  During melanin synthesis :

q  tyrosinase inhibition : Hydroquinone and derivatives, Kojic Acid, Azelaic Acid, Arbutin, Vitamin C

q  peroxidase inhibition : Vitamin C q  product reduction : Vitamin C q  ROS scavengers : Vitamin C

•  After melanin synthesis : q  tyrosinase degradation q  inhibition of melanosome transfer q  skin turnover acceleration : Vitamin C


Commonly used bleaching agents

They interfere at only 1 step DURING melanin synthesis :

tyrosinase inhibition

lack of efficacy


Hydroquinone : the golden standard ... ... of the past !

1. high concentrations ( 4 % ) to show effectiveness

2. severe side effects reported for concentrations of 2 % : exogeneous ochronosis ( degeneration of collagen fibers ) ( 1 )

3. improvement appearing to plateau at about 4 months

( 1 ) Levin CY, Maibach H. Exogenous ochronosis. An update on clinical features, causative agents and treatment options. Am J Clin Dermatol 2(4):213-7 (2001).


Melaclear Intense Depigmenting Care


DURING melanin synthesis

It interferes at 4 different steps DURING melanin synthesis :

1. tyrosinase inhibition 2. peroxidase inhibition 3. product reduction

4. ROS scavengers


The four stages of action Tyrosine

DOPA

Dopaquinone

DOPAchrome

DHICA

Eumelanin Phaeomelanin

1

2

3

4

Tyrosinase


Intense Depigmenting Care in Four Stages

+

Phytic Acid 2 % L−Ascorbic Acid 10 %

Specific ROS Modulator System


Oxidation mechanism of melanogenesis


Phytic Acid 2 %

Studies on iron chelation by phytate and the influence of other mineral ions on it. Subba Rao, K.; Narasinga Rao, B.S. Citation:Nutr-Rep-Int. Los Altos, Calif. : Geron-X, Inc. Oct 1983. v. 28 (4) p. 771-782. ill., charts.:Extract: Phytate when present at equimolar or higher proportions forms soluble complexes with iron at pH 7.5 in vitro'. At an iron:phytate molar ratio of 1:3 more than 90% of iron was found to be present in soluble form. The presence of Ca++ or Mg++ ions was found to decrease the iron solubilising ability of phytate. Ca++ is more effective in this respect than Mg++ because of its relatively high affinity for phytate. Ca++ and Mg++ presumably bind to soluble iron-phytate complex, forming insoluble complexes. Ca++ and Mg++ exhibit a synergistic action on the precipitation of iron-phytate complexes as reported in the case of Zn.

Phytate


Système ROS®

•  Powerful antioxidant •  ROS Scavenger •  Block of peroxidases •  Block of U.V activation •  Decrease of melanin •  Block of DOPA-Dopaquinone oxidation


ROS system Quercetine is the reference


Vitamine C 10%

•  Action on dendricyte •  ROS scavenger •  Elimination of reduction products •  Inhibition of Cu ions •  Block of DHICA


Melaclear action : summary Ep

ider

mis

C

orne

al la

yer

Keratynocyte

Corneocyte

Melanocyte

Melanin

Vitamin C Phytic Acid

Specific ROS System

Vitamin C Specific ROS System

UV,physical,hormonal, chemical factors

Free radicals

DHICA

DOPA

Tyrosine Tyrosinase

24

3

1

December 20, 2011 - 22 ADVANCE IN DERMATO - COSMETOLOGY 23 octobre 2008 - 22 ADVANCE IN DERMATO - COSMETOLOGY

MelaClear® International Clinical Pogram

>350 cases

Belgium: Dr Karavani

France: Dr David

Tunisia: CHU La Rabat

Bulgaria: Dr Nikolova

Morocco: Dr Bourra

Japan: Dr Tosa

Brazil: Dr Luciana Lourenço

USA: Dr Beaver

France: Pr. JP Orton (finished)



Dr. Nikolova et Kazandjieva Medical University , Sofia, 2007

•  20 Patients with melasma, lentigo, ephelides •  twice a day during 3 months

Efficacy after 3 months 85%

Deep (dermis) ‏



Dr. Nikolova et Kazandjieva Medical University, Sofia, 2007

Day 1 3 months

MelaClear® = Efficacy



Dr. Nikolova et Kazandjieva Medical University , Sofia, 2007

Day 1 3 months

MelaClear® = Efficacy



Dr. Tosa, Mayumi Clinic, Japan, 2008

Efficacy

45 patients

Skin pigmentation: satisfaction >50% (14 patients) ‏

Anti-aging effects: satisfaction >70% (18 patients) ‏

Contraction of skin pores: satisfaction > 50% (13 patients) ‏


MelaClear® International Clinical Program


Efficacy




23 octobre 2008 - 28 ADVANCE IN DERMATO - COSMETOLOGY



23 octobre 2008 - 29 ADVANCE IN DERMATO - COSMETOLOGY


Clinical case 5 : decolleté lentigines

Baseline 2 months Melaclear


Objectives

The primary objective of the study was to compare the efficacy Melaclear Intense Depigmenting Care to HQ 4 % on skin pigmentation

  Secondary objectives were:

§  the evaluation of the tolerance to the products §  the assessment of the effect on the skin structure


Material and methods

  Tolerance : assessed by measuring the level of erythema

  Skin Biometries were performed at each visit


Results : effectiveness

HQ 4 % Melaclear HQ 4 % Melaclear

Baseline 13 weeks



HQ 4 % Melaclear HQ 4 % Melaclear

Baseline 13 weeks


Results : tolerance

More erythema with Hydroquinone 4 %

Melaclear Hydroquinone


Results on effectiveness

Melaclear Intense Depigmenting Care

is EQUAL to 4 % of HQ

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