Want to hear an expert dermatologist’s advice on your skincare regimen? Singapore Dermatologist Dr. Teo Wan Lin is the author of the Skincare Bible – Dermatologist’s Tips on Cosmeceutical Skincare. She is a prominent dermatologist practising at TWL Specialist Skin & Laser Centre and is widely regarded as an expert in cosmeceutical skincare regimens.
In this article we ask her about her thoughts on including vitamin A derivatives like retinol, retinoids and a newcomer, bakuchiol into your skincare regimen. A good skincare regimen must be backed up by scientific evidence. Dr. Teo heads the research and development at Dr TWL Dermaceuticals, which focuses on skincare is suitable for eczema, rosacea, sensitive skin and acne prone skin. In this series, she shares on how trendy or new active skincare ingredients compare to traditional formulas. Join her as she weighs the pros and cons of each when customising your skincare regimen.
“The science behind functional dermatology is the harnessing of botanical actives with good safety and efficacy profile, to augment or potentially replace prescription medications for treatment of common skin diseases like acne, rosacea, perioral dermatitis and eczema. The Custom Mask Bar by Dr.TWL Pharmacy allows a pharmacy technician to personalise your skincare actives according to a dermatologist’s recommendation, for your skin type,” Dr. Teo Wan Lin accredited dermatologist at TWL Specialist Skin & Laser Centre.
Dr.TWL Dermaceuticals is a dermatologist formulated cosmeceutical line that provides skincare solutions suitable for eczema, rosacea, sensitive and acne prone skin. The pharmacy is a collaboration with the teledermatology service which has an additional functional dermatology research about department by Dr. Teo Wan Lin. Botanical derivatives such as berberine and chlorella are used for treatment of acne, maskne and eczema, with ingredients that are the risk of skin irritation. WhatsApp us for your skincare recommendations.
What is bakuchiol and how does it compare with retinol?
Basically, both bakuchiol and retinols regulate gene expression. The important limiting factor of retinols and retinoids is in the lack of tolerability by people with sensitive skin. That is something I’ve discussed before in my digital skincare masterclass. Individuals with sensitive skin, include those with pre-existing skin conditions, such as rosacea, facial eczema, other forms of dermatitis such as seborrheic dermatitis and perioral dermatitis, and we are referring to the ability of these individuals to tolerate an anti-aging cosmeceutical.
We are aware that a lot of anti-aging dermocosmetic ingredients are mostly irritating for the skin. That’s actually how it stimulates collagen production as well, and reverses signs of photoaging. More importantly, retinols and retinoids are considered the gold standard of anti-aging molecules which have been used in cosmeceutical research in the last two decades. This is simply because of their robust research data and pharmaceutical interest. The data that has been gathered from clinical trials on these active ingredients is simply very robust and it has also been used in all dermatology clinics internationally.
This interest in better tolerated anti-aging cosmeceuticals definitely comes in a very timely way. That’s why bakuchiol has been most prominently evaluated in a study. In fact, it’s a clinical trial, undertaken by a group in the US, and subsequently published in the British Journal of Dermatology in 2019. We find that the results are actually very promising.
In this study, bakuchiol cream and retinol cream at the same concentration of 0.5% were administered in a randomized, double-blind fashion over a period of 12 weeks for a total of 44 patients. It’s a small group, but in terms of the scientific rigor of the design of such a study, it does qualify as one of the best standards available in terms of scientific evidence.
Specifically, a facial photograph and an analytical system were in place to obtain and analyze high resolution photographs of patients involved in the study at 0, 4, 8, and 12 weeks. At the same time, there was a tolerability assessment questionnaire that was administered to review side effects. There was also a board-certified dermatologist who was blinded to the study group, and was involved in the study to grade the levels of pigmentation and redness.
The results of this study was that both bakuchiol and retinol at 0.5% concentration in cream formula actually decreased the wrinkle surface area as well as hyperpigmentation. Both characteristics are key markers in the photoaging scale. The results were also statistically significant and it was equivalent across both arms. However, on the arm of the study that involved users of retinol, there was significantly more facial scaling and symptoms such as stinging, compared to the arm that was using bakuchiol. Consequently, all this backs up our understanding of the use of this particular phytochemical as a retinol alternative with less skin irritation and better tolerability.
What is noteworthy is also that in the British Journal of Dermatology study, the author’s postulated that bakuchiol on its own, has additional pathways that activate in terms of anti-aging properties. It influences many antioxidant processes and this is the main reason why I am always for the use of botanical extracts where the signs tell us that it is effective. This is because it is safe to say that every botanical extract, any plant in fact, has innate antioxidant properties.
In addition, bakuchiol has been shown to activate a specific nuclear factor, erythroid-2 related factor. That is a mouthful but it is essentially what we call a transcription factor. Just so that we make it a little bit simpler for our readers to understand, it is a factor that plays a very big role in reversing skin damage. Skin damage occurs due to either environmental exposures, or by the fact that we are simply getting older day by day, i.e. the process of chronological aging. All these together is what we call oxidative stress.
In addition to the study, the author stated that there is another pathway that bakuchiol can work by and that is in terms of disrupting melanin synthesis by blocking tyrosinase. We are aware that most anti-pigment treatments active ingredients are tyrosinase inhibitors. However, bakuchiol also blocks an additional hormone activation pathway known as the alpha melanocytes stimulating hormone.
Consequently, bakuchiol can be viewed as an anti-aging ingredient that addresses a multitude of photoaging concerns, a multifunctional approach to photoaging as opposed to just retinols or retinoids alone. These have been used in the treatment of hyperpigmentation as well, but we are not really sure how it works and it certainly doesn’t have these antioxidant properties which preserve the health of the skin.
One should also bear in mind that retinols will always be a staple in terms of its anti-aging collagen stimulating properties. We have to keep our minds open because the small studies so far are very interesting in terms of the chemical structure of both the phytochemical bakuchiol as well as retinol. They induce similar gene expression and it’s exactly in the extracellular matrix, which is where much of the skin’s fullness comes from. That’s what provides the superficial skin support called the epidermis. Subsequently, if we’re able to plump it up, we will improve the appearance of fine lines and wrinkles.
What we know from limited studies, which is really just a handful compared to the robust data we have over many decades for retinol, bakuchiol does seem to compare favourably with retinol on a head-to-head basis. I feel that at the end of the day, it is a new skincare ingredient that is going to gain more attention, such as from large cosmetic companies, especially those that work with clinical cosmeceuticals. When we start to see that being incorporated into cosmeceutical skincare and being enrolled in larger trials via a dermatology practice overseen by a dermatologist, we can then see its greater efficacy of addressing the issues of tolerability.
With its potential efficacy in tolerability, bakuchiol could be especially helpful to patients with cosmetic intolerance syndrome and who still want to be on an anti-aging regimen. As a phytochemical, I feel that there is still a risk of it. It can be a trigger for allergic contact dermatitis. We have to be quite aware that anything botanical in nature can trigger an allergic reaction. That has very little to do with the tolerability which we’re talking about, and more to do with irritant contact dermatitis.
Dermatologist’s top tip for trying new skincare actives:
Always do a patch test before trying out the products on your face, including bakuchiol skincare. What I tell my patients is they can apply the product over the inner aspect of your arm overnight. If you want to be more careful, you can apply it under the chin as that’s still part of the facial skin. Some individuals have more sensitive facial skin than body skin. Certainly, if you have an allergic reaction, you’re going to see redness, swelling and irritation. However, if you have irritation, which is more often the case with retinols and retinoids, then that’s an adverse event that will only show up only after repeated use.
Book an appointment with Dr. Teo Wan Lin for your dermatology concern. Or check out Dr.TWL Dermaceuticals’ Customised Mask Bar System which allows you to personalise dermatologist recommended skincare actives for your particular skin concern.Tags: Anti-Ageing, Skincare, Wrinkles