Procell Microneedling Device Injures Dermis and Epidermis, Inducing Adverse Events in its Users

I was recently asked to review a cosmetic microneedling device white paper, meaning not a peer-review publications, rather an internal document generated by a company for sales purposes, from a company in Texas called Procell. As I’ve reported previously in peer-reviewed, PubMed listed papers, microneedling is a deep wounding procedure that activates the innate and adaptive immune systems and induces a wounded-proliferative state in the skin that is inflammatory and possibly pro-oncogenic. Sadly, this company, with its medical director (Mitchel Schwartz), who has no peer-reviewed publications and is paying for this study, is selling this product online and apparently making illegal sales to estheticians in states where microneedling procedures performed on others by estheticians is illegal.

The study in question here was performed by a physician in Canada who has no peer-reviewed publications, and the study, and the physician performing the study, were paid by Procell. The Procell device uses an array of needles that are 250 micrometers in length, with the thickness of the needles not reported. The device is run over the face such that these needles are puncturing holes in the epidermis and dermis at high rates, thus injuring both the epidermis and dermis.

The study design and the results are indicative of an inexperienced practitioner performing a study. First, the author states, “This study is a prospective, evaluator-blinded, single-site study, involving up to 30
subjects comparing clinical benefits after a treatment series versus baseline.” The claim of “evaluator-blinded” is ridiculous. Each subject serves as her own control, with photos being taken before and after treatment, and its easy for the evaluator to know who they are analyzing. Then they have a section called, “3.5 Randomization of Subjects.’ There is no randomization of the subjects. All are given the treatment. Next they say that “Photographic assessments will be conducted by a blinded expect evaluator.” I think they meant “expert” instead of “expect.” Although I think “expect evaluator” is the better descriptor, I’ll give them the benefit of the doubt. Regardless, the evaluator can easily identify each patient through their photos, and know what picture has been captured before and after the procedure. This is all just gobbledygook, and is either a consequence of ineptitude and/or fraud.

There are no results presented in the paper, only a conclusion. Yes, that’s right. No results are presented. What they do present in their “Safety Analysis” is a set on incongruous statements about how one patient was injured. Here’s what they reported in their “Safety Analysis”:

8.0 Safety Analysis
8.1 Safety Results:
To assess safety, all subjects were evaluated for adverse events during treatment and at all follow up visits. There was one event reported during the study duration.
The subject reported a “break out” along her jawline, which was evaluated by the
Primary Investigator. The effects were mild and transient in nature. The event was
coded as “possibly related to the procedure”. Upon further investigation and follow up
by the Primary Investigator, the subject was determined to have a baseline condition,
which should have eliminated her from study inclusion. The Investigator’s notes and
letter to file are included in the dataset for reference. All other subjects treated were
evaluated and no other events were reported.

My comment: (here they’re saying one of the patients had an adverse reaction)

9.0 Deviations from CIP
Based on the Primary Investigator’s assessment of the subject who has a possible
related event, he has concluded that this subject should not have been included in the
study based on her underlying clinical condition of inflammatory rosacea.

My comment: (here they’re saying the physician screwed up and shouldn’t have included this patient in the study)

10.0. CONCLUSION
During the study, all subjects tolerated the treatment well demonstrating only mild
erythema which was aniticpated [sic]. Improvement in the overall aesthetic appearance of
the skin was reported across all independent evaluators. Based on the results of this
study the ProCell .25mm Microchanneling system is safe to be used across all skin
types and can offer improvement in overall skin appearance as reported by both
patient and Independent evaluators.

My Comment: (here they contradict themselves, saying that the procedure is good for all skin types)

Here’s an image from the study so you can see for yourself:

Combine this inflammatory-proliferative, injurious procedure with the bone marrow mesenchymal stem cell cytokines that they sell, and one has set themselves up for adverse events, possibly long-term. There are skin conditions for which microneedling, when not performed repeatedly, is beneficial and the benefits out way the risks. Acne scarring and other types of scars can be an example. To quell the inflammation associated with the procedure and to set the immune system into a anti-inflammatory, pro-repair state, use the S2RM technology, found to be safe and efficacious, contained in Neogenesis Recovery.

Skin Cell Renewal and Collagen Production Without Injury

Wounding from procedures induces cellular replication, and replication may drive changes in cells and could push them toward a more tumorigenic state. “Tumors are wounds that don’t heal.”

Tissue specific stem and progenitor cells, such as the skin’s mesenchymal stem cells, fibroblasts, and keratinocytes, can persist during the lifetime or for extended periods of time in humans and contribute to both renewal and repair by giving rise to pools of progenitor cells that persist for various periods of time, replenish differentiated, i.e. mature cells, release many types of molecules involved in healing, and make short-term contribution to wound healing. Normally, these cell’s processes maintain and heal our skin throughout life. However, due to poor lifestyle, such as a diet that overfeeds us but under nourishes us, the nutrients needed to maintain proper function in these cells are lacking. Too much sun, leave-on products that are pro-inflammatory, and environmental exposures are other examples of lifestyle factors diminishing skin function. While hereditary and genetic factors may play a role, their contribution is minimal to developing diseases. Along with intrinsic aging, where our cells go through “wear and tear” to maintain themselves regardless of other impinging factors, what we do in life, i.e. our exposome is by far the most significant factor in maintaining health, including our skin health. Again, our exposome as a consequence of what we do in life, is the largest factor in our skin’s health. For example, if you don’t exercise, then the body won’t produce a normal complement of antioxidants. And, if you don’t eat a sufficient supply of fruits and vegetables, antioxidants will not be carried through the blood and pumped into the skin. And if you’ve induced chronic inflammation in the skin, perhaps through the continuous use of an inflammatory product or procedure, then the antioxidants and other nutrient may not be efficiently pumped from the blood supply into the skin. Yes, inflammation can interfere with the pumps in the blood vessels that bring nutrients from the blood supply into the skin.

As I have written, numerous studies have found that providing all the necessary nutrients, without an overabundance of calories, optimizes stem cell function in the body. Eating well also optimizes the cell function in cells other than stem cells, many of which act to support stem cell function. It’s all a tightly woven system, and the key here is to understand it’s a system. All of our cells work together. For example, even inflammation in the outer layers of the skin, the epidermis, leads to inflammation throughout the body. So what you do to your skin affects your whole body. If you’re using topical products that induce inflammation in the skin, you’re inducing inflammation in the body. If you’re having a procedure, such as laser, chemical peels or microneedling, you’re inducing inflammation in the skin and therefore inflammation in the body. As I have previously written, wounding the skin through the use of these procedures, induces not only inflammation, but proliferation too. This over-driving of cell proliferation leads to cellular exhaustion. Stem cell exhaustion or dysfunction increases with age, and especially with too many wounding procedures, and impedes the normal function of multiple tissues and systems. Dr. Leonard Hayflick, Ph.D., a professor at UCSF, discovered that cultured normal human cells have limited capacity to divide, after which they become senescent and can secrete inflammatory factors, a phenomenon now known as the ‘Hayflick limit’.  Increase inflammation and/or increase proliferation, and you can drive cells towards their Hayflick Limit. That’s what too many wounding procedures can do to the skin. Further, chronic inflammation coupled with chronic proliferation of cells is a hallmark of cancer.

If you are having one of these wounding procedures, something that can induce prolonged inflammation, I recommend using a product, such as NeoGenesis Recovery, that quells inflammation. Here’s why I recommend Recovery: Stem cell released molecules from adult stem cells derived from the skin are the key ingredient in Recovery. These molecules, the so-called S2RM technology, powerfully quell inflammation and reset the immune system from one of inflammation to one of anti-inflammation and pro-repair. The results are dramatic, and inflammation is quickly reduced. And because healing is hastened, proliferation is reduced too. Too much proliferation of the cells in the skin can lead to cellular exhaustion, senescence, and aging of the tissue. So key to healthy skin, particularly while we’re aging, is to control inflammation and, importantly, control the damage to the skin. Too many procedures that wound the skin, will lead to eventual aging of the skin. Thus, one may see short term positive effects, but long term negative consequences.

So how does one induce modest amounts of cellular turnover to remediate skin problems such as lines and wrinkles, sagging, and discoloration? The key is evolutionary science. How does mother nature naturally keep the skin healthy and keep the cells turning-over at a safe rate? The key is feeding the skin: from the inside-out through diet, and from outside-in through topical application of carefully chosen products. And what you feed the skin is critical. There is no magic bullet, not one ingredient alone that will yield the desired results. Rather, the skin is a system, composed of many different elements, each element depending on its own set of needs. So to feed the skin, many different ingredients are needed. For example, Vitamin C is needed as an antioxidant and also to induce the production of collagen as well as to facilitate the post-translational modification of the collagen protein that has been produced. There are other functions of Vitamin C in the skin as well. Many other antioxidants are present in the skin, and they work synergistically. To optimize the antioxidant capacity of the skin, and not to have too much of one thing, many antioxidants need to be fed to the skin. Too much of one can have disastrous results. Consider Vitamin E. Tocopherol and its esters are some of the most well described antioxidants and they are commonly used for their ability to minimize ultraviolet damage. However, overuse of Vitamin E can inhibit glutathione-S-transferase, responsible for the removal of cytotoxic compounds related to tumorigenesis in the skin. And if too much Vitamin C is present, then oxidative oxygen radicals are formed through interactions with other molecules in the tissue. The consequences of this Vitamin C overload and the production of oxidants is yet to be adequately described.

The bottom line is to use a combination of ingredients that are natural to the skin, and not overload on a single or just a few ingredients. This is the scientifically-based strategy that I use when formulating products for NeoGenesis. I use Vitamin C in some of our products to help in the natural production of collagen turmover and to repair those collagen fibrils that will be present for years to come. Some collagen protein is called long-lived protein and will remain in the skin for decades. It can accumulate damage over the years, and one way to protect it and repair it is with the use of multiple types of antioxidants. Therefore, when I formulate products, Neogenesis offers multiple types of antioxidants that work synergistically. Sometimes people ask me, why do the Neogenesis products have different colors, and why aren’t they all white and creamy like other products on the market? The simple answer, our products have a multitude of ingredients that are important to the skin and have different colors. Think about your diet. If everything you ate was white, you die pretty quickly from malnutrition because you’re not eating all of those colorful fruits and vegetables that provide colorful nutrients to the body. All of these ingredients are necessary for the natural turnover and repair of your skin’s cells. Mother nature gives you a balance of nutrients, and that is what we do at NeoGenesis.

At Neogenesis we offer safe and natural, mostly skin-identical, ingredients that support the natural turnover of the skin’s cells. Skin identical ingredients include the S2RM that our skin’s stem cells make and ceramide and urea that are made by other cells. Skin identical ingredients also include ingredients that our bodies don’t make, but are brought into the skin through diet, including vitamin C and carrotenoids. We don’t give you a product loaded with just one ingredient at high amounts, such as EGF so that face reddens and puffs up like a water balloon, nor do we offer a lip product loaded with gobs of peppermint oil to irritate, cause an inflammatory immune reaction, and swell the lips so that everyone looks like they have Melkersson-Rosenthal syndrome. A core technology that we use at Neogenesis is our S2RM technology. As our skin ages or is compromised by poor health and poor diet, our stem cell function can decline. The molecules that we use at NeoGenesis are from stem cells in the skin that help to induce collagen production, protect collagen, and help to control the turnover of keratinocytes in the epidermis that are key to barrier formation. So what we’re doing at NeoGenesis is simply returning to the skin what was naturally present when we were young and healthy. In this way we restore natural cellular turnover and collagen production, without the adverse side effects of inflammation and over-proliferation associated with wounding procedures. And remember, if you do have a wounding procedure, be sure to use NeoGenesis Recovery before and after the procedure to minimize inflammation, normalize proliferation, and reset the innate and adaptive immune systems of the skin to a pro-healing mode. Please avoid certain stem cell products that are made with pro-inflammatory and pro-oncogenic bone marrow mesenchymal stem cell cytokines. With the use of Recovery, better results are realized from the procedure with fewer adverse side effects and less down time.

Do You Have Bugs on Your Face – The Answer is Yes

I’ve had a couple of people ask me if there are really bugs on their faces. Apparently social media is abuzz with buggy skin. Here’s the scoop – The human skin has trillions of microorganisms on its surface, called the skin’s microbiome, and some components of the skin’s microbiota aren’t the typically talked about bacteria, viruses, and fungi. We are colonized by multicellular species including fungi, intestinal worms, and ectoparasites, such as lice, with nearly 2000 pathogen and parasite species characterized from human bodies Some are animals, micro-animals with enucleated cells, that inhabit and multiply within our skin’s pores. Demodex folliculorum and Demodex brevis are animals, called arachnids, present on facial skin. In one study,  “within our samples, 100% of people over 18 years of age appear to host at least one Demodex species, suggesting that Demodex mites may be universal associates of adult humans.” So, yes, you have bugs on your face.

D. folliculorum inhabit the area of the follicle above the sebaceous gland, where they appear to ingest cell contents. D. brevis, on the other hand, primarily inhabits the sebaceous glands associated with vellus hairs. For those of you who don’t like bugs, the good news is that typically these mites exist at densities of just one to a few mites per gland. Now the bad news for those of you who don’t like bugs: With approximately 5 million hair follicles spread across the body, you may have up to 5-10 million mites on your skin. One study used imaging techniques to characterize these mites. They found, the mite was measured to be 198 µm long and clearly showed 4 pairs of legs, a head and abdomen.” It’s a micro-animal as I mentioned. Some scientists have speculated that D. brevis may have colonized humans from wolves during their domestication.

They can be found in milia, but appear not to cause inflammation. However, abnormal proliferation of Demodex mites causes a skin disorder called demodicosis and has been linked to rosacea. Demodex mites can also cause local immunosuppression, allowing them to survive in human skin. Reduction of local immunity has been previously reported in patients who have been repeating facial application of topical steroids and other immunomodulators, resulting in an increased number of Demodex mites on their faces. Demodex mites also act as a carrier of the Bacillus oleronius bacterium that likely functions as a co-pathogen in the development of inflammatory process in rosacea by neutrophil induction and activation. Mites live for about 1-2 months on the skin. When they die, mites release chitinous exoskeletons and internal mite contents, including bacterial antigens that cause an increase in TLR-2 expression, triggering an inflammatory reaction and resulting in an immune response followed by neutrophil and macrophage activation.

To keep these mites at bay, don’t use products that suppress the skin’s immune system. You should cleanse your skin daily, using a gentle cleanser that doesn’t cause an immune reaction. NeoGenesis Cleanser is one that I formulated to be gentle on the skin, and meant to be used daily. If you need to remove makeup, use one that is gentle and doesn’t require scrubbing the skin. Scrubbing can irritate and strip away the outer layers of the stratum corneum. NeoGenesis Makeup Remover, called Erase the Day, is safe and gentle, and doesn’t require scrubbing. There are other gentle cleansers on the market, but carefully check their ingredients to make sure they don’t use irritating surfactants such as sodium lauryl sulfate (SLS). You can also use immune normalizing ingredients, such as the NeoGenesis S2RM technology. This technology was originally developed in my lab at UCSD to treat brain diseases. I did a podcast about this technology with the The Physiological Society, the oldest physiological society in the world. The technology I originally developed for the nervous system is now available in Neogenesis’ skin care products, Recovery, Skin Serum, Booster, and Eye Serum. Immunosuppressing ingredients include products that contain a significant amount of alcohol. For example, Martha Stewart uses a product on her face in which the 4th most concentrated ingredient is denatured alcohol. Not only is the alcohol bad for her skin, possibly suppressing immunity and disrupting the skin’s barrier function, but when alcohol is denatured, toxins are added to the alcohol. As I have written, be careful in choosing the products that you apply to your face, especially if they are a leave-on product that is used daily.

The Spread of Misinformation About Comedogenicity

Formulating a product with isopropyl myristate is non-comedogenic, especially as a wash-off product

The term comedogenicity refers to the potential of various chemicals to promote the abnormal keratinization (hyperkeratinization) and desquamation of follicular epithelium. These comedogenic chemicals lead to a partial (open comedone or blackhead) or complete obstruction of the pilosebaceous (closed comedone or whitehead) and accumulation of sebum. Basically the skin pores become blocked. FYI, The hair follicle, hair shaft, and sebaceous gland are known as the pilosebaceous unit. The comedogenicity of dermatological products was first demonstrated by Kligman AM and Mills OH in 1972 The comedogenicity of the ingredients, for example, apricot kernel seed oil, cocoa butter, corn oil, isopropyl myristate, mineral oil, acetylated lanolin, octyl palmitate, sunflower oil, sodium lauryl sulfate, tocopherol etc. has been described. However, how these data were acquired, and their meaning has been highly misconstrued by practitioners and lay people alike. The propagation of these misconceptions in the media, including social media, is ubiquitous.

To clarify, first, these results were conducted from testing of 100% concentration of the tested ingredients in animal models, namely on rabbit ears. However, the comedogenicity of ingredients should not be taken to be the same as finished products, given the mixtures of ingredients and application to human skin will alter the final comedogenicity of each product. 

I recently formulated a new product for the easy removal of makeup, without having to scrub the skin and without toxic, inflammatory ingredients. The product contains an ingredient called isopropyl myristate. Isopropyl Myristate has been given a ranking of “1” by the Environmental Work Group, their safest rating. It is a synthetic oil and is highly regarded as an emollient. I was asked after we introduced the product to the market if the Makeup Remover is comedogenic because of the inclusion of isopropyl myristate in the formula. Let’s look at this.

Neogenesis Makeup Remover is not comedogenic, and one of the ingredients it contains that has been mistakenly said to be comedogenic, Isopropyl Myristate, has been found by scientists in peer-reviewed publications to be non-comedogenic (Lee et al, 2015). Neogenesis Makeup Remover is a safe and effective makeup remover that features carefully chosen ingredients that are all ranked low in the Environmental Workgroup’s (EWG) analysis of an ingredient’s induction of, 1. Cancer, 2. Allergies & Immunotoxicity, and 3. Developmental and Reproductive Toxicity. The EWG’s analysis of Isopropyl Myristate gave it a “1,” the lowest ranking on a 10-point scale for causing all these 3 concerns and included no use restrictions.

NeoGenesis Makeup Remover is not comedogenic for two key reasons, 1. Isopropyl Myristate itself is non-comedogenic (Lee et al, 2015), and 2. Even if Isopropyl Myristate were comedogenic, the way NeoGenesis Makeup Remover is used as a product that is immediately washed-off, would not be comedogenic. As Dr. Zoe Draelos, M.D., a board-certified dermatologist has published in a peer-reviewed journal, “Finished products using comedogenic ingredients are not necessarily comedogenic” (Draelos and DiNardo, 2006). Whether an ingredient is comedogenic depends on many factors, including how the ingredient is used, such as is it left on the skin or washed-off, and the concentration of the ingredient, as well as what is the formulation in which the ingredient is used. In a formulation, some so-called comedogenic ingredients will be rendered non-comedogenic by other ingredients in the formula. Further, comedogenicity is a function of many factors not considered in these studies, including the phosphoprotein content of the lipid droplets in one’s skin and the other ingredients in the formula that may have anti-comedogenic potential.

How was the misinformation about Isopropyl Myristate started and why has it been propagated in the media and social media?  To understand the flaws in the comedogenic scale we need to know how these tests are performed. In 1972, Kligman and Mills developed a rabbit ear model for testing how skin pores can be clogged by ingredients. They would put the ingredient to be tested into the canals of rabbit ears for two weeks. Then they would sacrifice the animals, and measure whether the pores were clogged under a microscope. “Half of 25 facial cosmetic creams were found to be mildly comedogenic when tested in rabbits’ external ear canals” (Kligman and Mills, 1972). This is how the hoopla of comedogenicity started. Ten years later, Mills and Kligman (1982) developed a human model using “young adult, black men who have large follicles,” where the substances were applied under occlusion for one month to the upper part of the backs. Yes, you read it right, the substances were applied for one month using an occlusive dressing. Occlusion can cause many untoward effects including enhanced product absorption and penetration, therefore leading to a higher probability of comedone formation. And then, a “fast-setting cyanoacrylate glue to remove the follicular” was used to remove the follicles from the victim’s back. I say victim, because cyanoacrylates can cause contact dermatitis, i.e. irritation (Bitterman and Sandhu, 2017), and then the procedure involves ripping this set-glue off the backs of the volunteers. Irritation of the skin can change follicle architecture and lead to misleading false-positives. In using this flawed methodology, Mills and Kligman (1982) wrote that, “The rabbit model is more sensitive than the human.” I’ll finish the sentence for them, “The rabbit model is more sensitive than the human [model].” And a poor human model it is.

My take home from these studies is that I will not place Isopropyl Myristate on the ear canal of my pet rabbit for 24 hours straight, every day of the week, for one month because I don’t want my rabbit to have mildly clogged pores in his ears. I will, however, recommend using Neogenesis Makeup Remover to friends and loved ones that is quickly applied to the areas of the skin were makeup needs to be removed, and then using a gentle cleanser, such as NeoGenesis Cleanser, to wash away the Makeup Remover from the skin. As the American academy of Dermatology recommends, “Remove your makeup, including eye makeup, before going to bed. Use an oil-free makeup remover. After removing your makeup, wash your face with a gentle cleanser. Avoid scrubbing your face, even when removing makeup.” Your pores will thank you for having gently unclogged them of that makeup you applied in the morning.

References

Bitterman A, Sandhu K. Allergic contact dermatitis to 2-octyl cyanoacrylate after surgical repair: Humidity as a potential factor. JAAD Case Rep. 2017 Sep 23;3(6):480-481.

Draelos ZD and DiNardi JC (2006) A re-evaluation of the comedogenicity concept. JAAD, 54, ISSUE 3, P507-512.

Kligman AM, Mills OH. “Acne Cosmetica”. Arch Dermatol. 1972;106(6):843–850. doi:10.1001/archderm.1972.01620150029011

Lee E. et al (2015) Isopropyl Myristate and Cocoa Butter are not Appropriate Positive Controls for Comedogenicity Assay in Asian Subjects. J Cosmo Trichol 2015, 2:1.

Mills OH Jr, Kligman AM. A human model for assessing comedogenic substances. Arch Dermatol. 1982 Nov;118(11):903-5. PMID: 7138047.

Sorg O, Nocera T, Fontao F, Castex-Rizzi N, Garidou L, Lauze C, Le Digabel J, Josse G, Saurat JH. Lipid Droplet Proteins in Acne Skin: A Sound Target for the Maintenance of Low Comedogenic Sebum and Acne-Prone Skin Health. JID Innov. 2021 Sep 17;1(4):100057. 

Prebiotics, Probiotics, and Postbiotics as Part of the NeoGenesis Core Technologies

NeoGenesis is known for its core stem cell released molecules (S2RM) technology. Another core technology, the use of prebiotics, probiotics, and postbiotics is also key to the efficacy of Neogenesis products. These technologies are part of our therapeutic approach, using system therapeutics for physiological renormalization.

I coined the term “postbiotic” a few years ago in a peer-reviewed PubMed listed paper that details how important prebiotics, probiotics, and postbiotics are for human health. As a term that I recently coined, and that has rapidly gained wide popularity, I’d like to emphasize the definition of postbiotic. A postbiotic is a molecule that has been produced by a microorganism that provides benefit to the host, i.e. the person to which the molecule has been applied. Postbiotics can be naturally occurring, such as the butyrate that bacteria on our skin are producing. Butyrate is a short chain fatty acid that quells inflammation in the immune system of the skin. Butyrate can also be produced by bacteria in a laboratory, collected and added to a topical product, and then applied to the skin. This too is a postbiotic. We can describe the first instance, where bacteria on the skin are naturally producing butyrate as an endogenous postbiotic, and the second instance, where bacteria produce butyrate in the lab and then it is applied to the skin, as an exogenous postbiotic. Either way, butyrate on the skin is a postbiotic and providing benefits to the skin.

At Neogenesis, we use a form of butyrate in several of our products, including our probiotic product, MB-1. Yes, MB-1 actually has live bacteria and does not use antimicrobial preservatives that would kill the probiotic. So the MB-1 product has both postbiotics and probiotics. In an upcoming post I’ll tell you about another probiotic product that Neogenesis will be launching specially designed for atopic, inflammatory skin conditions. We also use butyrate in our Eye Serum, Booster, and our Barrier Renewal Cream. It’s a great postbiotic, and dermatologist researchers in Germany have found it to be particularly beneficial for modulating the immune system in atopic and inflammatory skin conditions.

Now for prebiotics. Hyaluronic acid (HA) is a prebiotic, and has been found to upregulate those short chain fatty acids, such as butyrate in the aforementioned paragraph. In this case, bacteria that are part of the body are fermenting HA and producing butyrate, a postbiotic. Hence, in this case HA is a prebiotic because bacteria on our skin are using it to produce butyrate, a beneficial molecules.

Now, for the kicker. HA can also be an exogenous postbiotic. That is, HA can be produced in the laboratory by bacteria, and then collected, packaged into a product, and applied to the skin. That’s a postbiotic, albeit an exogenous postbiotic because it wasn’t produced by bacteria on our skin. So in this case, HA is an exogenous postbiotic, having been produced by bacteria in the lab, but acts as a prebiotic because it is feeding bacteria on our skin that produce a postbiotic. Normally, HA is not a postbiotic in the skin. Rather, normally, HA is produced by our own cells in the skin. Fibroblasts in our skin normally produce the HA. I’ll have more about the microbiota of the skin in future posts, where we’ll learn about the skin’s microbiota in educating the immune system and in helping to maintain the acid mantle and barrier function.

Why I Don’t Recommend Ablative or Wounding Procedures of the Skin

Scientists appreciate that one of the most dangerous things a cell can do is to divide. That’s what happens following an ablative or wounding procedure to the skin.

I’ve previously published papers in peer-reviewed, PubMed listed journals explaining how wounds, including micro-wounding such as that caused by microneedling procedures, induces an inflammatory response in both the innate and adpative immune systems of the skin. Such wounding is especially problematic when performed repeatedly and when bone marrow mesenchymal stem cell cytokines are applied to the wound. Even with a properly performed procedure, without infection, sterile inflammation results. And as repeated wounding procedures result in chronic inflammation, oncogenic potential is increased. Cancer has been described as wounds that do not heal.

But wounding is more than inflammation. To close the wound and remodel the damaged tissue, many cells proliferate. That means they may grow in size, and importantly, replicate themselves. So when you have an ablative or wounding procedure performed on the skin, proliferation of cells will result. This happens following acid peels, laser treatments, microneedling and other procedures that wound the skin.

So what’s wrong with proliferation of cells? Let me give you a hint. Carcinomas arise from epithelial tissue and account for as many as 90 percent of all human cancers. Why so many cancer in epithelial tissue? Because epithelial cells, including some of the cells in the skin, have high rates of proliferation. When cells proliferate, replicating themselves, they must make a whole new set of DNA. During the replication of DNA, many errors are made. Mutations result. To maintain the normal processes of the genome throughout cell function and division, we have evolved a complex network of machinery known as the DNA damage response (DDR). At least 605 proteins organized in a hierarchy of 109 assemblies is involved in maintaining our DNA. It’s complicated and doesn’t work perfectly. According to the National Cancer Institute, “Each time a cell divides, it must first duplicate its genetic material in a process called DNA replication. Because defects in this process can cause mutations that eventually lead[s] to cancer.” One problem is that DNA replication errors, especially those occurring at regions that are hard to replicate, called fragile sites, can cause breaks in the DNA strands. This can increase the probability of cancer, primarily by making it more likely that fragments of chromosomes rearrange themselves, activating genetic regions in the DNA that lead to uncontrollable cell division. The more you wound the skin, the higher the probability of inducing such mutations and breaks in the DNA strands, and the higher the probability of cancer induction. The other cancer causing factor in wounds is that the cellular matrix and microenvironment in the skin are disrupted, and this has a profound influence on increasing the chances of cancer. This was taught to me many years ago by one of our professors, Dr. Mina Bissell, Ph.D., in the Dept of Molecular and Cell Biology at Berkeley.

So wounding in the skin, especially when repetitive, such has been promulgated by non-dermatologist physicians, such as John Sanderson, who lost his license to practice medicine because of incompetence, and Lance Setterfield in their blogs and books, who call for repetitive microneedling procedures for skin care, simply don’t know what they’re doing. Thanks to my pushback, of late, Mr. Setterfield (he has an undergraduate bachelor’s degree in medicine) has toned down his call for repetitive microneedling. I hope he stops promoting dangerous bone marrow mesenchymal stem cell cytokines too. I’ve published a number of papers on the problems associated with the use of these cells, even under the most stringent conditions where the cells are used for transplantation at hospitals for blood diseases.

Other physicians, such as Mitchel Schwartz have now joined in to the microneedling craze for the sake of money, and are selling automated microneedle stamping machines to whomever wants one. Schwartz claims his device doesn’t create damage or inflammation because the needles don’t roll over the skin at an obtuse angle, but are stamped, perpendicularly, into the skin. Utter BS. His device is electronically stamping thousands of wounds into the face, and generating an immune reaction in the epidermis and dermis, leading to inflammation in the skin and inflammation throughout the body. Schwartz is even selling these devices to estheticians in California where the state’s laws forbid such procedures to be performed by estheticians. Damn the laws and damn the inflammation and cancer, there’s money to be made by selling microneedling to everyone. And some physicians love their side hustles.

Skin Health is Important for Overall Health, Including Heart Health

Caring for your skin is not superficial. Your skin is not only a reflection of your overall health, but, indeed, the health of your skin contributes to overall health, and likely, your heart health. The popular idiom, “Beauty is more than skin deep” takes on new meaning when we consider how skin that is well cared for is not only beautiful, but as research studies teach us, skin that is well cared for can reduce inflammation throughout the body. As I described in my 2017 and 2019 PubMed listed papers, even the microbiota on the skin can influence overall health. In another post, I’ll be discussing the skin’s microbiome and how some of the products I have formulated facilitate a normal set of microbiota and can remediate dysbiosis of the skin. While we all understand that the appearance of the skin can be indicative of deep-rooted health issues, we now understand that poor skin health can be a contributing factor to inflammatory diseases throughout the body. The appearance of the skin is a biomarker for what may be happening throughout the body. Have you ever noticed that someone going through a particularly stressful event in life often has a haggard look? Stress is causing cortisol release in the body, affecting the skin through a decreased production and proper construction of collagen fibers. For you fellow geeks out there reading this, cortisol decreases collagen synthesis both by its direct effect on collagen polypeptide-chain synthesis and by decreasing the activities of enzymes involved in post-translational modifications. Stress also reduces the ability of mesenchymal stem cells to repair tissues, including the repair of collagen. This is why I recommend Neogenesis’ Skin Serum and Recovery, both of which use the molecules that are repair signals from mesenchymal stem cells, for people with compromised skin. These negative factors observed in the skin are potentially occurring throughout the body. It’s part of the reason why “stress is a killer.” Although heart health may be foremost to our thinking this past February, during what the CDC calls American Heart Month, skin health should also remain part of our thinking. Based on emerging evidence, many think the two are more intertwined than previously thought.

Chronic inflammation is a critical factor in almost all diseases, including cardiovascular disease. And given skin inflammation can induce general inflammation in the body, heart disease may be exacerbated by inflammation in the skin. Studies have found that more severe skin conditions, such as eczema and psoriasis, are associated with an increased risk of cardiovascular disease, likely associated with inflammation in the body. But as the 2019 study at UCSF found, skin problems don’t have to be severe to potentially lead to cardiovascular issues. Simply degrading the outer layer of the skin, the stratum corneum of the epidermis, can lead to skin inflammation and then to systemic inflammation. Stratum corneum provides a barrier to the outside world, and all the toxic insults from the world, and simple skin barrier degradation associated with age has been found to increase circulating blood markers of inflammation, so-called inflammatory cytokines that can easily be assayed from a small blood sample. Measures of these inflammatory cytokines in the blood are an important means by which scientists can measure overall inflammation in the body, and are predictive of overall health, including our health status as we age. The term inflammaging is used to describe this field of study. The common and most debilitating age-related health issues, such as heart disease, diabetes, osteoporosis, and dementia, are also associated with an increase in these markers of inflammation.

So, what do we do to restore barrier function in the skin? The aforementioned 2019 study, found that using barrier repair moisturizers, that included three types of lipids, could reduce pro-inflammatory cytokines in the blood, and the skin. I developed a topical product to restore the skin’s natural barrier without using artificial barrier products such as petrolatum. Yes, as the name implies, such products are derived from petroleum and they don’t build a normal stratum corneum replete with natural barrier formation. My product, called NeoGenesis Barrier Renewal Cream, has no petrolatum, and uses three types of skin-identical lipids, called 1. free fatty acids, 2. cholesterol, and 3. ceramide, including the lipids stearic acid and linoleic acid. These ingredients help to build the stratum corneum and once again provide a natural barrier to toxic insults, and to retain the skin’s moisture. Inflammation is thus reduced, both in the skin and in the rest of the body.

I also recommend using a gentle cleanser so as not to strip away your skin barrier lipids, and use warm or cold, but not hot water, to further reduce stripping of the barrier. Harsh cleansers and hot water can lead to xerosis, the scientific term for dry skin. This, of course, can lead to skin inflammation, and hence, systemic inflammation. To sum up, healthy skin is beautiful skin, and beautiful skin with a healthy barrier means less overall inflammation and a more healthy body.

New Device from Cooler Heads Helps Prevent Hair Loss During Cancer Chemo Treatment

I’m always excited to hear about new technologies that help people, especially during times of ill health. Today I send kudos to fellow San Diego entrepreneur,  Cooler Heads founder and CEO Kate Dilligan, who has brought a device to the market that helps chemo patients retain their hair during treatment. Essentially this portable device is applied over the scalp during chemo treatments to cool the scalp, thereby constricting blood vessels, resulting in reduced flow of the chemo drugs to the hair follicles. The hair follicles are largely spared the treatment and the follicle maintains its hair growth cycle. Brilliant!

Hair is an important part of self, and loosing one’s hair, especially so rapidly as happens during chemo treatment, is especially devasting to people. During any disease and treatment of disease, maintaining positive emotions is an important means of helping to regain one’s health. Further, hair loss is associated with inflammation, and inflammation in the skin (in this case the scalp) is associated with systemic inflammation. Many diseases, especially chronic diseases are associated with inflammation. Cooler Heads therefore, beyond promoting positive emotions, may be helping to control systemic inflammation during a time when the body is under tremendous insult and inflammation needs to be minimized.

At the San Diego-based company that I cofounded, NeoGenesis, we too are reducing hair loss during chemo treatment and helping to reduce inflammation. Our approach is different and complementary to how Cooler Heads solves the problem. Our approach uses the molecules that human adult stem cells derived from the skin (including the scalp) normally release into the skin. The approach we use is conceptually what I call, Systems Therapeutics for Physiological Renormalization.” Basically, we use multiple molecule types, called a system therapeutic, to restore the compromised tissue (scalp) to the normal physiological state. Normal tissue function is largely restored and inflammation is reduced. Hair growth can be restored for most people who use our technology. Our technology at NeoGenesis is also being successfully used to treat dermatitis associated with chemo and irradiation, and importantly, to prevent it from happening. If our stem cell released molecules are used before and during chemo and radiation treatment, most patients will prevent or greatly reduce the associated dermatitis. If our technology is used once the dermatitis has manifested, the condition can be greatly remediated. For the hair loss associated with chemo, I’m hoping to see whether the two technologies from Cooler Heads and NeoGenesis work together in a synergistic manner.

Why Beef Fat on Your Face is Harmful

Beef Fat Reduces Barrier Function, Increases Inflammation, and is Loaded With Toxins

Another social media craze is to slather tallow, beef fat, on your face. Some will say, oh, it’s from grass fed animals, so it’s OK. Before I discuss how suboptimal it is to smear beef fat on your face, let’s dispel the notion that grass fed is good. First, because of deregulation in the cattle industry, one has no idea if the slaughtered animal was raised in the USA and actually fed grass. The beef is likely coming from a highly deregulated, often highly corrupt country, where the animal was fed whatever was cheaply available. And that ain’t grass in the field. While the EU has banned all hormones in beef, most countries, including the USA, have not. If you’ve ever tasted 100% grass fed beef, you’ll know that it doesn’t taste very good. Most beef is given a diet of corn and grain and shot-up with hormones and antibiotics to make it fat and tasty. So-called grass fed beef is usually given corn and grains before being slaughtered, and hormones and antibiotics can be given to “grass fed” animals. Before I stopped eating meat, I tasted purely grass fed beef and it was horrible. Rarely is meat purely grass fed and not given hormones and antibiotics. Estrogen is one such hormone- can you say Cancer? Further, of those animals that are fed grasses before they’re given their finishing diet of grains and corn, each pound of grass-fed beef may produce 500 percent more greenhouse gases than grain-fed beef. This alone is a great reason to stop eating or using beef. The industry is unethical, and spends huge sums of money, including on social media, to fool you.

Now for those who are thinking of slathering dead animals on your face – namely the TikTok fashion of the day – smearing beef fat on your face. Once the animal has been killed, tallow is made from the boiled carcasses of slaughtered cows, from which the fatty product is then derived. Basically the producers skim off the fat from the boiled carcass, yielding suet (fat surrounding the visceral organs) and other fatty tissues. That’s what is to be slathered on the face – boiled carcass. Toxins accumulate in the fat of animals. Dioxins are one of many, and they accumulate in the fatty tissues of humans exposed to animal fat. So animal toxins applied to the skin will likely result in dioxins and other toxins and hormones to accumulate in the skin’s hypodermis, as well as in the epidermis and dermis.

People have been asking me are these tallow products on the market good? I always teach my students to ask a fundamental question when asking if something is good. One of the fundamental questions to ask is, Compared to What? Is smearing beef fat on your face better than smearing chlorine on your face. Yes it is. Is smearing beef fat on your skin better than smearing Crisco? Yes and no. Crisco is comedogenic and the people selling beef fat say it’s not comedogenic. I’ll give them the benefit of doubt. But beef fat, because it’s high in oleic acid just like olive oil, has been shown to disrupt the skin barrier and actually cause more irritation versus plant oils that are high in linoleic acid. And some beef fat products also contain olive oil – a double whammy to the skin’s barrier function. Now let’s ask if beef fat is better than using NeoGenesis Barrier Renewal Cream? The clear answer is no. Here’s why. While beef fat disrupts the skin’s barrier, Barrier Renewal Cream (BRC) uses a balance of human skin identical lipids that have been scientifically, clinically, and real world-use proven to restore the skin’s barrier. The lipids used in the BRC include linoleic acid, stearic acid, ceramides, cholesterol, and other free fatty acids known to optimally restore barrier function. Products such as BRC not only restore barrier function and reduce inflammation in the skin, they also reduce inflammation systemically – throughout the body. So please don’t use beef fat fat on your skin. Rather, use a product that is formulated using scientific evidence, finding safe and effective results, leading to better barrier formation and reduced inflammation.

Jennifer Aniston Uses Toxic Cream on Her Face

On my Google News feed this morning was an article in sheknows entitled, “Jennifer Aniston’s Fave $22 Face Cream is Actually Just As Good As La Mer’s $200 Version.”

So I decided to see what Jennifer is using and recommending. The product is Mario Badescu Seaweed Night Cream. The featured ingredient in this product is Fucus vesiculosus, or bladderwrack. This is a brown seaweed that contains variable amounts of iodine, up to 600 mg/g. The ingredient has positive effects in the skin, unless you’re sensitive to iodine. However, there are number of harmful ingredients in this product of which people need to be aware. If you’re interested in this topic of toxic, inflammatory skin care ingredients, I encourage you to read my recent published article on the subject and an interview I did to explain my new means of therapeutic development that renormalizes physiology and reduces inflammation.

The Seaweed product is full of toxic ingredients and probably digested animal hide (hydrolyzed elastin and collagen). This is the same Mario Badescu who was apparently selling creams that contained steroids – steroids are drugs with possible adverse side effects, and Mario Badescu didn’t list these drugs on the labels of their cosmetics. They didn’t like this in Korea either. Seriously, trusting a company that intentionally adds drugs to their cosmetic products without listing the drug ingredients should be a huge, tall red flag for anyone thinking to slather these Badescu ingredients on their skin.

Here are some of the questionable ingredients (that we know are listed) in the Seaweed Night Cream:

diazolidinyl urea: EWG=5, high for Allergies & Immunotoxicity
methylparaben and propylparaben: these are endocrine disruptors
hydrolyzed collagen and elastin: this is likely removed from dead animal hide
parfum: EWG=8, high for Allergies & Immunotoxicity
ci 19140: EWG=6, moderate for Allergies & Immunotoxicity
ci 42090: EWG= 8, moderate for Cancer and high for use restrictions

EWG is the non-profit Environmental Work Group.

While the Le Mer product that is compared does not contain these toxic ingredients, I’ve formulated a better cream product that contains none of these toxic ingredients, and doesn’t use a petroleum-derived ingredient, petrolatum in Le Mer, to restore the skin’s barrier function. Rather the product I formulated uses skin-identical lipid ingredients, ceramide, cholesterol, and free fatty acids, that are used by the skin to naturally restore the skin’s barrier function. Scientists at UCSF found this combination to be optimal for barrier formation. Without proper barrier function the skin becomes dehydrated, inflamed, and susceptible to environmental toxins, allergens, and pathogens. An inflammatory immune response results in the skin, and importantly, that inflammatory response is translated systemically to the rest of the body. Systemic inflammation underlies most, if not all, diseases. So skin inflammation can be a contributor to systemic inflammation and many diseases. Critical to your health, especially as we age, is caring for our skin and not using toxic ingredients in our skin care products – especially if the toxic ingredients are in leave-on products that are used daily. Jennifer Aniston is a beautiful lady, seems like a nice person, and she is a good actress – so I hope she stops using the Seaweed Night Cream, and if she doesn’t want to use our superior NeoGenesis Barrier Renewal Cream for some reason, the Le Mer is better than the Badescu product.

Seaweed Night Cream Ingredients: aqua (water, eau), glycerin, isopropyl myristate, stearic acid, propylene glycol, cetyl alcohol, fucus vesiculosus (bladderwrack) extract, hydrolyzed elastin, collagen, sodium hyaluronate, glyceryl acrylate/acrylic acid copolymer, carbomer, parfum (fragrance), sodium chloride, phenoxyethanol, potassium sorbate, methylparaben, propylparaben, sodium benzoate, triethanolamine, diazolidinyl urea, mica, titanium dioxide, caprylyl glycol, hexylene glycol, benzyl alcohol, benzyl salicylate, linalool, citronellol, amyl cinnamal, hexyl cinnamal, geraniol, limonene, ci 19140 (yellow 5), ci 42090 (blue 1), ci 77288 (chromium oxide green)