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Mon Aug 12, 2013 3:29 am  |
As per Bethany's idea heres a thread just to discuss the above book.
Not quite sure how to transfer the few post relating to the book! 
As I said earlier it is a very comprehensive , book aimed at professionals, but having said that I dont think its beyond any of us here to work our way through it and gain real insights.
I have only just skimmed it as it has only just arrived but am will start it properly now  |
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46 got (PMD,Caci,QuasarMD,Tria , skin spatula) Using, environ , myfawnie serums, lacsal, retinol, GHk probably more but too embarrased to say |
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Mon Aug 12, 2013 3:35 am |
Cross-posting so we can keep the Epionce thread about Epionce products, and we can talk about any products that meet Dr T's guidelines here!
All,
Here is the initial book review, since I know there are some people interested in what it contains. I will share more info on each chapter later, including some info I personally found interesting.
Book review: New Ideal in Skin Health: Separating Fact from Fiction (Bourne, Krista; Thornfeldt, Carl)
In a nutshell, this was a very extensive read which caters to professionals thinking about starting a med spa, adding services to an existing practice, or trying to decide which skincare products to carry in their office. It contains a LOT of information…some beneficial now, as well as being a reference guide for ingredients/actives (their uses, clinicals, etc.). I think there is something for everyone in this book (meaning skin-focused consumers), but I don’t think the book is for everyone simply because not everyone likes to wade through tons of info. If you are looking for a book that says “buy this and this,” this is NOT that book. Dr. Thornfeldt presents info on many different options, along with many references to stats and clinical studies so that you can make up your own mind as to what choices you want to make.
This book was also NOT an advertisement for his products or services….”Epionce” appeared one time in reference to a skin barrier repair study, but no other Epionce products were discussed. However, in the protocol section I was able to figure out which products he was using, which I appreciated as an Epionce user.
This book is also so extensive in data that I can’t send you “a quick summary” in PM, though I can tell you this:
- He views maintaining the skin barrier as absolutely critical - without barrier repair/protection everything else is for naught (except sunscreen) . But if you focus on the barrier, you can actually reverse extrinisic aging.
- You need 3 components for barrier repair – ceramides, cholesterol, and free fatty acids in a ratio of 3:1:1. Forty-five minutes after a barrier injury, restoring the three key lipid ratio and the function of the permeability barrier results in over 90 percent recovery as measured by TEWL.
- Anyone using traditional moisturizers, acids, retinols, or doing microdermabrasion, facial scrubs, etc. is damaging their barrier and needs to focus on barrier repair.
- Most cosmecutical/drugstore products do not contain the appropriate level of actives, nor have they been typically been clinically tested in the final formulations nor the appropriate human body part.
- There are 9 complete steps for delivery of an active at the right level to the right place in the skin. Just because you slather it on, doesn't mean it actually gets absorbed.
- Clinical studies can be misleading. The bottom line is to look for the p-value in the Results section. If the p-value is higher than 0.05, then the clinical data is not scientifically strong enough to support claims that the product works.
- The skin is an indicator of what else is happening inside the body. Various skin issues should be telling you that there are other aspects of your health that you should be considering.
To sum it up, this book tells you how to take care of your skin for the long term, how to find the best products available (and the criteria to judge them against), and helps identify the best solutions for various skin problems....whether it is a topical, an oral supplement, or a procedure.
More to come on the chapters below....
Section I Welcome to Esthetics
Chapter 1 Defining Roles
Section II Understanding the Skin
Chapter 2 Skin Basics
Chapter 3 Application of a New Understanding of Skin Health
Section III Cosmeceuticals
Chapter 4 Cosmeceuticals— OTC/ Prescription/ Professional
Chapter 5 Cosmeceutical Ingredients— What are the Claims, What are the Facts?
Chapter 6 Cosmeceuticals: Botanical Ingredients
Chapter 7 Topical Delivery of Cosmeceuticals
Chapter 8 Controversial Ingredients
Section IV Application
Chapter 9 Putting it into Practice: Choosing the Right Products
Chapter 10 Putting it into Practice: Other Therapeutic Options
Chapter 11 Putting it into Practice: Treatment Protocols
Chapter 12 Putting it into Practice: Success Tools
http://www.amazon.com/The-New-Ideal-Skin-Health/dp/1932633693/ref=sr_1_cc_1?s=aps&ie=UTF8&qid=1376267087&sr=1-1-catcorr&keywords=thornfeldt |
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No longer answering PM's due to numerous weird messages. |
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Mon Aug 12, 2013 1:36 pm |
| YAY! |
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♥I'm flattered by all the lovely PM's, but I don't get here much these days. Please don't be afraid to post your quearies to other DIY members who will be glad to help you (or sell you their wares..lol) Still happy with LED, dermarolling and a DIY antioxidant regime. Peace & Hugs to all.♥ |
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Mon Aug 12, 2013 1:36 pm |
| bethany and 10Sylvia5, does the book mention dermrolling at all? |
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Mon Aug 12, 2013 4:01 pm |
| RussianSunshine wrote: |
| bethany and 10Sylvia5, does the book mention dermrolling at all? |
No it does not mention needling at all.
They only mentioned microdermabrasion, LED, chemical peels and microcurrent as possible add-on services for a practice. There was some positive info on LED, and they also mentioned an ultrasonic scrubber. But that was pretty much it. |
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No longer answering PM's due to numerous weird messages. |
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Mon Aug 12, 2013 4:07 pm |
| bethany wrote: |
- There are 9 complete steps for delivery of an active at the right level to the right place in the skin. Just because you slather it on, doesn't mean it actually gets absorbed.
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Thank you for your review Bethany. When time permits, could you please go in depth on the above? |
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Tue Aug 13, 2013 2:22 am |
No no mention of derma roll , as Bethany says he talks about protocols with dermabrasion, laser, led, IPL treatment, peels and talks about , pre treatment preparation and post treatment care.
I think though his opinions would still be the same regarding at all times maintaining the integrity of the skin barrier.
Therefore I think I am going to re-think my rolling approach!!!
I think I will use products that encourage skin barrier repair immediately following a roll, but wait with products like CPS till day 5 as per Setterfield ( until his updates come out or after Ive read Des Fernandes book!!!) |
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46 got (PMD,Caci,QuasarMD,Tria , skin spatula) Using, environ , myfawnie serums, lacsal, retinol, GHk probably more but too embarrased to say |
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Wed Aug 14, 2013 1:37 pm |
For those looking for products sharing the Epionce skin barrier approach of 3:1:1 ratio, I am cross posting this from the Epionce thread.
| h.kitty wrote: |
| Barefootgirl wrote: |
There have to be less expensive products out there that contain the 3 magic ingredients, which in and of themselves don't appear to be expensive. Researchers price their own products in a way to recover their R&D costs. Generic products don't have this issue.
I am still looking, but feel free to let us know if you also find any.
BFG |
I think there might be patent issues preventing others from using the optimal ration of those three ingredients.
Take a look at the Epionce Patents. I am guessing that patent #5,643,899 is the one covering the barrier repair products.
http://www.epionce.com/about/dr-carl/patents/
Epiceram also lists this patent #5,643,899(amongst others which would appear to be for the delivery system but I haven't researched those patents to say for sure) and if you read up on Epiceram you will see that it does have the optimal ratio of lipids.
http://www.epiceram-us.com/physician.html
Easiest way to find the patent numbers seems to be to look at the prescribing information.
http://www.epiceram-us.com/prescribing_information.html
The now discontinued Osmotics TriCeram had this patented lipid ratio mix and I believe that the SkinMedica Ceratopic had it too. Some of the other Osmotics products may have had this patented mix but I am not sure. I am also not sure if the SkinMedica Ceratopic now has the patented mix.
I believe that this patent #5,643,899 expires in 2014. |
Some other products that may be considered are CeraVe and SkinActives Every Lipid Serum which both have the 3 recommended barrier repair ingredients, though I don't know the ratios.
Any others that should be considered and why? |
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No longer answering PM's due to numerous weird messages. |
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Wed Aug 14, 2013 2:38 pm |
I wish I could remember where I read it...oh I think it was that link I posted from DermTube where the researcher stated recently that the optimal ratio is no longer considered necessary, only the 3 ingredients...
I should probably go watch that again.
BFG |
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Wed Aug 14, 2013 2:48 pm |
Here is some info related to barrier repair from the book:
| Quote: |
| The reason we know these 3KL are required for barrier function is because upon disruption of the skin barrier, synthesis of these three lipids are the first processes activated for repair. Although during the first 30 minutes, pre-formed packets of biologic response modifiers including cytokines such as TNF, IL-1, growth factors, histamine and nuclear receptors are released along with barrier lipids from lamellar bodies. During the next 30 minutes synthesis of cholesterol and free fatty acid are markedly upregulated to drive repair, then ceramide synthesis increases during the next hour. Forty-five minutes after a barrier injury, restoring the three key lipid ratio and the function of PB results in over 90 percent recovery as measured by TEWL. Between two and six hours, DNA synthesis and secretion of newly formed lamellar bodies containing the three key lipids are extruded. |
| Quote: |
| A key discovery by researchers was that the optimal PB occurred when these three lipids existed in a specific equimolar ratio. Moreover, repair of the barrier is activated by several different specific ratios of these three same lipids, but very different degrees of repair result with each of the different ratios. The 3: 1: 1 with cholesterol or ceramide dominated as the most effective reparative ratio. |
| Quote: |
The most hydrating moisturizers due primarily to high concentrations of humectants include in descending order: prescription LacHydrin ®,Renew ® Moisturizing Cream, Eucerin ® Plus Lotion, and Aveeno ® Active Naturals Advanced Care Moisturizing Cream. Each has only mild barrier improving effect. 4 Notable SCB improving products that are available OTC are: Neutrogena ® Norwegian Formula Hand Cream, Vaseline ® Intensive Care Lotion, Cetaphil ® Moisturizing Cream, Nivea ® Cream, and Curel ® Moisture Lotion. Each of these products has less than half the effect of petrolatum on reducing transepidermal water loss (TEWL).
An example of a commercially available barrier optimizing product designed for reversing and preventing diseased skin conditions by employing the three key barrier lipids (3KL) plus precursors and nonphysiologic lipids (NP) ingredients for barrier effects and hydration is the Epionce ® Renewal product line. The function of this one product line is superior to all products listed in the paragraphs above. When compared to prescription 12% ammonium lactate, Epionce ® produced statistically superior increased water holding capacity with both a single application and with eight applications over a four-day period. Comparing its barrier modulation defined by TEWL with 100% petrolatum, Epionce ® was more than twice as effective as petrolatum at 45 minutes, and 92% of the clinical trial panelists were pleased, or very pleased, with this designed formula’s cosmetic elegance. |
| Quote: |
| Activation of the destructive chronic inflammatory cascades must be prevented to produce visible reversal of aging skin. It is impossible to do if the first step of repairing the barrier is not met. Should a product meet that first step, then it must work to inhibit all of the seven pathways. Simply inhibiting one pathway or even two will allow the other proinflammatory pathways to function, resulting in shifting around the blockade by a different pathway, activating more chronic inflammation, and in turn, more damage to the skin. This effect appears to explain tachyphylaxis, where the skin stops responding to a specific therapy after prolonged continual use. For example, vitamin C will block certain epidermal signaling molecules that activate the inflammatory cascades IL-1α and IL-1β, but do not stop the other proinflammatory cascades, as evidenced by significant rates of contact irritant dermatitis when vitamin C products are used as treatment for extrinsic aging. |
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No longer answering PM's due to numerous weird messages. |
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Thu Aug 15, 2013 9:04 pm |
| I have just received the book, and oh boy, is it technical or what? It is like a textbook, I skimmed through it and I am already overwhelmed. |
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Thu Aug 15, 2013 9:37 pm |
| RussianSunshine wrote: |
| I have just received the book, and oh boy, is it technical or what? It is like a textbook, I skimmed through it and I am already overwhelmed. |
Take it one chapter at a time. I read the while thing in a couple of days, and I was so overwhelmed, brain dead, and eye strained when i was done that I haven't been able to bring myself to write the chapter overviews yet. But there is some great info in there!
My other takeaway was that Dr T has VERY high standards and expectations, which is part of the reason he has independent clinical studies on his products. He is making sure that the Epionce products actually deliver, just like the standards he recommends when assessing other products. At least he practices what he preaches! |
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No longer answering PM's due to numerous weird messages. |
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Fri Aug 16, 2013 4:27 am |
This is very helpful, thank you.
Can I ask where you all are buying it? guess I need to check Amazon? and pricing...
Thanks, BFG |
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Fri Aug 16, 2013 4:37 am |
bethany, I am really glad I bought the book, it contains tons of info one the subject of skincare that I would probably never encounter without reading it. It does really feel like a textbook, which I like. There are no empty statements like "dermal rollers are mostly about creating the next skin care industry gimmick" (Paula Begoun).
I really like the book, albeit it is the first serious book I have on the subject. |
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Fri Aug 16, 2013 5:07 am |
| rileygirl wrote: |
| bethany wrote: |
- There are 9 complete steps for delivery of an active at the right level to the right place in the skin. Just because you slather it on, doesn't mean it actually gets absorbed.
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Thank you for your review Bethany. When time permits, could you please go in depth on the above? |
I have not got to the 9 steps of delivery yet, but he does mention different methods to enhance the penetration of actives: external energy (ultrasound, LED. etc), inducing damage to the barrier (chemical peels, microdermabrasion, microneedling; note: after those methods skin barrier damage should be restored), biochemical(through chemical enhancers, lipid ratios, etc.). |
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Fri Aug 16, 2013 5:23 am |
| The book mentions an interesting trick on how to minimize irritation due to retinoids: one may rinse it off after 1 hour without compromising its activity. |
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Fri Aug 16, 2013 9:55 am |
yes, I have heard this too...I think this practice is called "short contact therapy" and helps with other potentially irritating actives.
It's helpful when googling for more info....
BFG |
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Fri Aug 16, 2013 11:53 am |
| RussianSunshine wrote: |
| rileygirl wrote: |
| bethany wrote: |
- There are 9 complete steps for delivery of an active at the right level to the right place in the skin. Just because you slather it on, doesn't mean it actually gets absorbed.
|
Thank you for your review Bethany. When time permits, could you please go in depth on the above? |
I have not got to the 9 steps of delivery yet, but he does mention different methods to enhance the penetration of actives: external energy (ultrasound, LED. etc), inducing damage to the barrier (chemical peels, microdermabrasion, microneedling; note: after those methods skin barrier damage should be restored), biochemical(through chemical enhancers, lipid ratios, etc.). |
Thank you, RussianSunshine! |
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Fri Aug 16, 2013 2:07 pm |
You said he mentions microcurrent in the book, does he give any specific recommendations? device specs? frequency, etc.?
Thanks, BFG |
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Fri Aug 16, 2013 3:13 pm |
| Barefootgirl wrote: |
You said he mentions microcurrent in the book, does he give any specific recommendations? device specs? frequency, etc.?
Thanks, BFG |
Nothing  Dr T provides no specifics at all. Well, I have not read the whole book yet but I get a sense that he focuses more on the composition of skincare products and skincare ingredients. |
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Fri Aug 16, 2013 4:42 pm |
| RussianSunshine wrote: |
| Barefootgirl wrote: |
You said he mentions microcurrent in the book, does he give any specific recommendations? device specs? frequency, etc.?
Thanks, BFG |
Nothing Dr T provides no specifics at all. Well, I have not read the whole book yet but I get a sense that he focuses more on the composition of skincare products and skincare ingredients. |
Correct...he only mentions it as as add on therapy. The ultrasonic scrubber was mentioned as a useful esthetic device. |
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No longer answering PM's due to numerous weird messages. |
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Sun Aug 25, 2013 8:59 pm |
I would love to know if I'm on the right path with the actives I use regularly;
L-Ascorbic Acid
Niacinamide
Glutathione
Coq10
Alpha Lipoic Acid
Hyaluronic Acid
Panthenol
Amino Acids
Ceramides
Vitamin E
Assorted tea extracts
Fav oils are:
Walnut
Evening Primrose
Borage
Palm
Almond
Rice Bran
Meadowfoam Seed
What I really need to know is do I want to have this book in my library
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♥I'm flattered by all the lovely PM's, but I don't get here much these days. Please don't be afraid to post your quearies to other DIY members who will be glad to help you (or sell you their wares..lol) Still happy with LED, dermarolling and a DIY antioxidant regime. Peace & Hugs to all.♥ |
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