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Soothing effect of Vichy thermal spa water after glycolic acid peelings: A clinical randomized study
Abstract
The buffering and soothing action of Vichy water has been evaluated and compared to that of a Pharmacopoeia bicarbonate solution (SBP) in a clinical study conducted in 50 volunteers. The volunteers' skin was treated by spraying one of the two treatments, in a randomised design, immediately after peeling with a solution of 34% of 50% glycolic acid. On the evening after the peeling and on subsequent days the subjects applied sprays at least twice per day using the treatment allocated to them. Clinical assessments were performed on DO immediately after the peeling and on D7 (7 dcys cfter days after the peeling). Self-assessments were performed on D1 (24 hours after peeling), on D2 (48 hours after peeling) and on D7. Clinical examination immediately after peeling demonstrated a similar frequency of redness, vesicle formation, oedema and white coloured blotches reactions for the two treatments. Clinical examination also demonstrated on immediate buffering effect (on diffuse reactions) which was equivalent after peeling with a 35% glycolic acid solution. The relative buffering effect of SBP was greater when peeling was performed with a more concentrated glycolic acid solution (50%). Results of the subjects self-assessment showed that the soothing action was greater with Vichy water on D2, acting mostly on persistent redness and dryness. Overall this study has shown that after peeling with a 35% solution of glycolic acid, Vichy water has a similar buffering effect to that of a Pharmacopoeia bicarbonate solution and greater and earlier soothing activity acting mostly on redness and dryness.
Introduction
Minéral 89 (M89), comprised of 89% Vichy mineralizing water and hyaluronic acid, has been formulated to help strengthen and restore skin barrier.
Aim
Assess tolerance and efficacy of M89 in post‐aesthetic procedures and dry skin‐related facial dermatoses.
Method
Adults post‐aesthetic procedure or presenting with inflammatory dermatoses (47 subjects; mean age 40.9 ± 13.2 years; any Fitzpatrick or skin phototype), applied M89 for 4 weeks, once or twice daily, as an adjuvant treatment. Information on clinical signs and subject‐reported symptoms, skin characteristics, tolerance, and subject and investigator satisfaction were collected.
Results
Following 4 weeks of M89 use, significant decreases with complete resolution of erythema (27.6%), desquamation (29.8%), irritation (32%), and skin dehydration (35.8%), as compared to baseline signs and symptoms, were observed. Overall grading improvements for erythema (84.8%; p < 0.001), desquamation (91.7%; %; p < 0.003), irritation (91.7%; %; p < 0.015), and skin hydration (46.2%; p < 0.015) were noted. There was no significant improvement in papules and pustules.
Evaluation of subjective signs demonstrated significant decreases in skin sensations such as burning (‐73%; p < 0.0001), itching (‐71%; p < 0.0001), stinging‐tingling (‐66.7%; p < 0.0001), as well as in skin dryness (‐60%; p < 0.0001). M89 texture was rated very pleasant by 90% of patients. Investigators assessed M89 tolerance to be either good or very good (93%), and satisfactory or highly satisfactory impact on patient’s skin (91.5%).
Conclusion
M89 is a highly tolerable adjuvant treatment that significantly improved clinical signs and symptoms related to a compromised skin barrier in various facial dermatoses and post‐aesthetic procedures.
Introduction:
M89, containing 89% of Vichy mineralizing water and hyaluronic acid, has been developed to reinforce the skin barrier and to improve skin quality.
Aim:
To assess efficacy and tolerability of M89.
Method:
Observational survey of subjects with facial dermatoses or after esthetic procedures. M89 served as adjunct to conventional therapy. Clinician assessments of erythema, desquamation, irritation and patient-reported dryness, burning, itching, and stinging/tingling were conducted at baseline and 4 weeks. At 1 week and 4 weeks, patient assessed tolerance and satisfaction with M89.
Results:
A total of 1630 subjects participated; 92.5% were females. Mean age was 41.1 ± 11.3 years. Dermatological indications accounted for 32.5%, procedures for 67.5%. At 4 weeks, in subjects with dermatoses, erythema had resolved or improved in 68.0%, desquamation in 83.4%, and irritation in 93.3%. Dryness, burning, itching, and stinging/tingling scores had decreased by 63.8%, 81.8%, 70.9%, and 85.2%, respectively (all P ≤ .0001); 75.7% considered that their skin was sufficiently hydrated. In the procedure group, erythema had resolved or improved in 72.5%, desquamation in 75.2%, and irritation in 88.1%. Dryness, burning, itching, and stinging/tingling scores had decreased by 62.1%, 78.8%, 70.0%, and 84.2%, respectively (all P ≤ .0001); 74.1% considered that their skin was sufficiently hydrated. Almost all subjects reported soothed skin and satisfaction with product texture. Subject and investigator satisfaction was very high.
Conclusion:
M89 significantly improves skin signs and symptoms after 4 weeks of continued use with no tolerance issues in subjects with dermatological indications. Moreover, subjects who have had recently undergone esthetic procedures M89 allowed a satisfying skin recovery.
Neurogenic inflammation of the skin observed after topical application of an irritant substance or environmental stimulation induces vascular changes and the production of inflammatory mediators. Substance P (SP) is one of the main neuropeptides which trigger an inflammatory response in the skin. So, with the aim to develop an alternative method to study neurogenic inflammation of the skin, we used an organ culture of human skin. SP was added onto epidermis or directly to culture medium in an attempt to reproduce ex vivo the effects described in vivo. Even disconnected from systemic blood circulation, in skin fragments in culture, we observed dose-dependent edema, vasodilation and extravasation of lymphocytes and mast cells through the microvascular wall. Moreover, the release of proinflammatory mediators interleukin 1alpha and tumor necrosis factor alpha was evidenced.
Vicky spring water, essentially from Lucas spring, has been known since the 18 th century for its anti-inflammatory activity against hepatobiliary and cutaneous disorders. These properties seem to be related to neurogenic mechanisms. Indeed, nerve free endings in the skin are connected both with blood vessels and cutaneous cells of the dermis. In the epidermis, nerve free endings are in close contact with keratinocytes. Under stimulation, neuropeptides such as substance P are released from nerve free endings. The neurogenic inflammation observed after applying an irritant substance on the skin induces vascular changes and the release of inflammatory mediators. We reproduced similar effects using organ culture of human skin following topical application of 50 μm of substance P. We observed microvascular vasodilation, edema formation, an increase in mast cell and lymphocyte counts and production of Il-1α and nitrites. When Lucas spring water is applied to the epidermis, the effects of substance P are inhibited as reflected by all analyzed parameters. On the other hand, demineralized water (MilliQ® water) has no protective effect against substance P-induced irritation. In conclusion, Lucas spring water protects skin from the deleterious effects of substance P.
Vichy spa water is essentially known for its therapeutic action on liver and bile duct functions. Its mechanism of action may be partially explained by the activation of certain digestive enzymes. A literature survey showed that Vichy water has also been used for local application in the treatment of certain dermatoses. Based on these data, the effects of Vichy spa water on the skin were studied using cutaneous enzymatic systems. The first studies were carried out on catalase, an oxidoreductase. The results showed a statistically significant increase (p<0.05) in the activity of the enzyme in the presence of Vichy spa water both in vitro and in vivo. Considering the involvement of catalase in skin defence against oxygen-derived free radicals generated, its increased activity may explain the beneficial role of Vichy water observed in various dermatoses.
L'eau thermale de Vichy est essentiellement connue pour son action curative au niveau du foie et des voies biliaires. Une partie de son mécanisme d'action s'expliquerait par l'activation de certains enzymes digestifs. Une recherche bibliographique a permis de mettre en évidence que l'eau de Vichy avait aussi été utilisée en application externe pour le traitement de certaines dermatoses. A partir de ces données, nous avons choisi d'explorer l'action de l'eau thermale sur la peau à travers l'étude de système enzymatique cutané. Nos travaux ont porté sur une oxydo-réductase, la catalase. Ils mettent en évidence in vitro et in vivo, une augmentation statistiquement significative (p < 0.05) de l'activité de cet enzyme en présence d'eau thermale de Vichy. L'augmentation de cette activité enzymatique impliquée dans les défenses antiradicalaires de la peau pourrait être un élément d'explication du rôle bénéfique de l'eau de Vichy observé dans les cas de dermatoses.