Clinical Evaluation of a Nature-Based Bakuchiol Anti-Aging Moisturizer for Sensitive Skin

December 2020 | Volume 19 | Issue 12 | Original Article | 1181 | Copyright © December 2020


Published online November 5, 2020

Zoe Diana Draelos MD,a Hemali Gunt PhD,bJoshua  Zeichner MD,c Stanley Levy MDd

aDermatology Consulting Services, PLLC, High Point, NC
bBurt’s Bees, Durham, NC
cMount Sinai Hospital, New York, NY
dChapel Hill Dermatology, PA, Chapel Hill, NC

Abstract
Background: Patients with sensitive skin find topical retinoid use for anti-aging purposes challenging due to irritation. Bakuchiol, a meroterpene from the Psoralea corylifolia seed, has retinol functionality through retinol-like regulation of gene expression.
Objective: This research examined the tolerability, efficacy, and barrier effects of a nature-based bakuchiol-containing cleanser and moisturizer in subjects with sensitive skin.
Methods: 60 female subjects Fitzpatrick skin types I–V age 40–65 years with sensitive mild to moderate photodamaged skin were enrolled in this 4-week study. A sensitive skin panel was constructed: 1/3 eczema/atopic dermatitis, 1/3 rosacea, 1/3 cosmetic intolerance syndrome. Subjects used a nature-based cleanser and moisturizer twice daily and underwent transepidermal water loss (TEWL), corneometry, tolerability assessments, and efficacy assessments at baseline, 5–10 minutes post-application, and week 4.
Results: The skin care products were well tolerated and efficacious (P<0.001) in terms of investigator assessed improvement in visual smoothness, tactile smoothness, clarity, radiance, overall appearance, and global anti-aging. Cheek corneometry measurements demonstrated a statistically significant 16% increase in skin moisture content (P<0.001).
Conclusion: A bakuchiol nature-based anti-aging moisturizer is well tolerated and effective in individuals with sensitive skin.

J Drugs Dermatol. 2020;19(12):1181-1183. doi:10.36849/JDD.2020.5522

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INTRODUCTION

The poor tolerability of the retinoids has limited their use in sensitive skin patients, even though retinoids are some of the most effective anti-aging cosmeceutical ingredients. Prescription retinoic acid, also known as tretinoin, and OTC retinol, which can be converted in the skin to retinaldehyde and then retinoic acid, can cause irritation due to an overload of the retinoic acid-dependent pathways with supraphysiological amounts of exogenous retinoic acid.1 Retinoids are effective because they activate retinoic acid receptors and retinoid X receptors, each with three isotypes (alpha, beta, and gamma) and multiple isoforms, responsible for regulating growth, differentiation, and apoptosis.2

Sensitive skin patients desire to use anti-aging cosmeceuticals, but may find it difficult to combine retinoid efficacy with tolerability frequently experiencing pruritus, erythema, and xerosis with product use. In order to determine the suitability of anti-aging cosmeceuticals for sensitive skin subjects, a sensitive skin panel must be developed. One approach to studying sensitive skin is to enroll subjects with dermatologic conditions, such as rosacea, atopic dermatitis/eczema, and cosmetic intolerance syndrome. Cosmetic intolerance syndrome is defined as individuals who frequently experience noxious sensory stimuli (stinging, itching, burning) when topical products are applied to the face.

Rosacea is characterized by vascular hyper-reactivity, atopic dermatitis/eczema by barrier disruption, and cosmetic intolerance syndrome by sensory hypersensitivity.

An ingredient with retinoid-like effects is bakuchiol, a meroterpene from the Psoralea corylifolia seed. Bakuchiol, a Sanskrit name derived from the plant name Bakuchi, has been used in Indian and Chinese medicine for its antioxidant, anti-inflamatory, anti-bacterial, anti-acne, and anti-tumor activities.3,4,5 Bakuchiol and retinol both modulate genes involved in the product of the extracellular matrix and dermal- epidermal junction.6 Thus, bakuchiol has been said to possess retinol functionality through retinol-like regulation of gene expression.7 Prior clinical studies have demonstrated the efficacy of bakuchiol in comparison with retinol.8 However, the goal of this research was to evaluate the tolerability, efficacy, and barrier effects of a cleanser and anti-aging cream containing bakuchiol in subjects with sensitive skin.