on optimizing products to address the diurnal variation in skin needs.39 The Skin Health and Beauty Pyramid, and the Skin Health and Beauty Pyramid with environmental and lifestyle aggressors, are shown in Figure 1 and Figure 2, respectively.
CONCLUSION
The skin pyramid remains a useful concept for the organization
of cosmeceutical skin care. All three levels of the pyramid must
be addressed for optimal skin rejuvenation from the outer to the
inner skin layers. This includes the pyramid base representing
protection and repair, the middle of the pyramid representing
renewal with moisturization, exfoliation, and cell turnover,
and the top of the pyramid representing activation and skin
regeneration. This update of the 2014 original skin pyramid
includes many new discoveries in skin physiology that are
translating into ingredient driven technologies in the current
cosmeceutical market.
DISCLOSURES
Zoe Diana Draelos MD received support from Cantabria Labs for
the preparation of this manuscript.
ACKNOWLEDGMENT
The author would like to thank MSC (Medical Science Consulting)
for editorial services.
REFERENCES
1. Mayoral FA, Kenner JR, Draelos ZD. The skin health and beauty pyramid: a clinically based guide to selecting topical skincare products. J Drugs Dermatol. 2014;13(4):414-421.
2. Mohammad TF, Kohli I, Nicholson CL, et al. Oral polypodium leucotomos extract and its impact on visible light-induced pigmentation in human subjects. J Drugs Dermatol. 2019;18(12):1198-1203.
3. Liebmann J, Born M, Kolb-Bachofen V. Blue-light irradiation regulates proliferation and differentiation in human skin cells. J Invest Dermatol. 2010;130(1):259-269.
4. Ortiz-Espín A, Morel E, Juarranz Á, et al. An extract from the plant deschampsia antarctica protects fibroblasts from senescence induced by hydrogen peroxide. Oxi Med Cell Longev. 2017;2017:2694945.
5. Zamarrón A, Morel E, Lucena SR, et al. Extract of Deschampsia antarctica (EDA) prevents dermal cell damage induced by UV radiation and 2,3,7,8-tetrachlorodibenzo-p-dioxin. Int J Mol Sci. 2019;20(6):1356.
6. Lim HW, Arellano-Mendoza MI, Stengel F. Current challenges in photoprotection. J Am Acad Dermatol. 2017;76(3s1):S91-s99.
7. Fania L, Mazzanti C, Campione E, Candi E, Abeni D, Dellambra E. Role of nicotinamide in genomic stability and skin cancer chemoprevention. Int J Mol Sci. 2019;20(23):5946.
8. Parrado C, Nicolas J, Juarranz A, Gonzalez S. The role of the aqueous extract Polypodium leucotomos in photoprotection. Photochem Photobiol Sci. 2020;19:831-843.
9. Stoddard M, Herrmann J, Moy L, Moy R. Improvement of actinic keratoses using topical dna repair enzymes: a randomized placebo-controlled trial. J Drugs Dermatol. 2017;16(10):1030-1034.
10. Yarosh DB, Rosenthal A, Moy R. Six critical questions for DNA repair enzymes in skincare products: a review in dialog. Clin Cosmet Investig Dermatol. 2019;12:617-624.
11. Dréno B, Araviiskaia E, Berardesca E, et al. Microbiome in healthy skin, update for dermatologists. J Eur Acad Dermatol Venereol. 2016;30(12):2038-2047.
12. Burns EM, Ahmed H, Isedeh PN, et al. Ultraviolet radiation, both UVA and UVB, influences the composition of the skin microbiome. Exp Dermatol. 2019;28(2):136-141.
13. Green BA, Yu RJ, Van Scott EJ. Clinical and cosmeceutical uses of hydroxyacids. Clin Dermatol. 2009;27(5):495-501.
14. Ditre CM, Griffin TD, Murphy GF, et al. Effects of alpha-hydroxy acids on photoaged skin: a pilot clinical, histologic, and ultrastructural study. J Am Acad Dermatol. 1996;34(2 Pt 1):187-195.
15. Van Scott EJ, Yu RJ. Hyperkeratinization, corneocyte cohesion, and alpha hydroxy acids. J Am Acad Dermatol. 1984;11(5 Pt 1):867-879.
16. Bernstein E, Uitto J. Connective tissue alterations in photoaged skin and the effects of alphahydroxy acids. J Geriatr Dermatol. 1995;3(Suppl A):7-18A.
17. Lavker RM, Kaidbey K, Leyden JJ. Effects of topical ammonium lactate on cutaneous atrophy from a potent topical corticosteroid. J Am Acad Dermatol. 1992;26(4):535-544.
18. Draelos Z. Salicylic acid in the dermatologic armamentarium. Cosmet Derm. 1997;10(Suppl 4):7-8.
19. Roberts DL, Marshall R, Marks R. Detection of the action of salicylic acid on the normal stratum corneum. Br J Dermatol. 1980;103(2):191-196.
20. Goodman DS. Vitamin A and retinoids in health and disease. New Engl J Med. 1984;310(16):1023-1031.
21. Babamiri K, Nassab R. Cosmeceuticals: the evidence behind the retinoids. Aesthet Surg J. 2010;30(1):74-77.
22. Pérez Davó A, Truchuelo MT, Vitale M, Gonzalez-Castro J. Efficacy of an Antiaging treatment against environmental factors: deschampsia antarctica Extract and High-tolerance Retinoids Combination. J Clin Aesthet Dermatol. 2019;12(7):E65-e70.
23. Truchuelo MT, Jiménez N, Jaén P. Assessment of the efficacy and tolerance of a new combination of retinoids and depigmenting agents in the treatment of melasma. J Cosmet Dermatol. 2014;13(4):261-268.
24. Truchuelo MT, Jiménez N, Miguel-Gomez L, Hermosa A, Sánchez-Neila N, Cuevas J. Histological and immunohistochemical evaluation of the efficacy of a new cosmetic formulation in the treatment of skin photoaging. Dermatol Res Pract. 2017;2017:8407247.
25. Litner K. Peptides, amino acids and proteisn in skin care? Cosmet Toilet. 2007;122:26-34.
26. Gruchlik A, Jurzak M, Chodurek E, Dzierzewicz Z. Effect of Gly-Gly-His, Gly- His-Lys and their copper complexes on TNF-alpha-dependent IL-6 secretion in normal human dermal fibroblasts. Acta Pol Pharm. 2012;69(6):1303-1306.
27. Maquart FX, Pickart L, Laurent M, Gillery P, Monboisse JC, Borel JP. Stimulation of collagen synthesis in fibroblast cultures by the tripeptide-copper complex glycyl-L-histidyl-L-lysine-Cu2+. FEBS lett. 1988;238(2):343-346.
28. Zhang L, Falla TJ. Cosmeceuticals and peptides. Clin Dermatol. 2009;27(5):485-494.
29. Katayama K, Armendariz-Borunda J, Raghow R, Kang AH, Seyer JM. A pentapeptide from type I procollagen promotes extracellular matrix production. J Bio Chem. 1993;268(14):9941-9944.
30. Husein El Hadmed H, Castillo RF. Cosmeceuticals: peptides, proteins, and growth factors. J Cosmet Dermatol. 2016;15(4):514-519.
31. Blanes-Mira C, Clemente J, Jodas G, et al. A synthetic hexapeptide (Argireline) with antiwrinkle activity. Int J Cosmet Sci. 2002;24(5):303-310.
32. Brieva A, Philips N, Tejedor R, et al. Molecular basis for the regenerative properties of a secretion of the mollusk Cryptomphalus aspersa. Skin Pharmacol Physiol. 2008;21(1):15-22.
33. Mehta RC, Fitzpatrick RE. Endogenous growth factors as cosmeceuticals. Dermatol Ther. 2007;20(5):350-359.
34. Sundaram H. The mechanisms and potential impact of stem cell activation in skin rejuvenation: an evidence-based analysis. J Drugs Dermatol. 2017;16(4):378-384.
35. Espada J, Matabuena M, Salazar N, et al. Cryptomphalus aspersa mollusc eggs extract promotes migration and prevents cutaneous ageing in keratinocytes and dermal fibroblasts in vitro. Int J Cosmet Sci. 2015;37(1):41-55.
36. Matsui MS, Pelle E, Dong K, Pernodet N. Biological rhythms in the skin. Int J Mol Sci. 2016;17(6).
37. Plikus MV, Van Spyk EN, Pham K, et al. The circadian clock in skin: implications for adult stem cells, tissue regeneration, cancer, aging, and immunity. J Biol Rhythms. 2015;30(3):163-182.
38. Geyfman M, Andersen B. How the skin can tell time. J Invest Dermatol. 2009;129(5):1063-1066.
39. van Moorsel D, Hansen J, Havekes B, et al. Demonstration of a daynight rhythm in human skeletal muscle oxidative capacity. Mol Metab. 2016;5(8):635-645.
2. Mohammad TF, Kohli I, Nicholson CL, et al. Oral polypodium leucotomos extract and its impact on visible light-induced pigmentation in human subjects. J Drugs Dermatol. 2019;18(12):1198-1203.
3. Liebmann J, Born M, Kolb-Bachofen V. Blue-light irradiation regulates proliferation and differentiation in human skin cells. J Invest Dermatol. 2010;130(1):259-269.
4. Ortiz-Espín A, Morel E, Juarranz Á, et al. An extract from the plant deschampsia antarctica protects fibroblasts from senescence induced by hydrogen peroxide. Oxi Med Cell Longev. 2017;2017:2694945.
5. Zamarrón A, Morel E, Lucena SR, et al. Extract of Deschampsia antarctica (EDA) prevents dermal cell damage induced by UV radiation and 2,3,7,8-tetrachlorodibenzo-p-dioxin. Int J Mol Sci. 2019;20(6):1356.
6. Lim HW, Arellano-Mendoza MI, Stengel F. Current challenges in photoprotection. J Am Acad Dermatol. 2017;76(3s1):S91-s99.
7. Fania L, Mazzanti C, Campione E, Candi E, Abeni D, Dellambra E. Role of nicotinamide in genomic stability and skin cancer chemoprevention. Int J Mol Sci. 2019;20(23):5946.
8. Parrado C, Nicolas J, Juarranz A, Gonzalez S. The role of the aqueous extract Polypodium leucotomos in photoprotection. Photochem Photobiol Sci. 2020;19:831-843.
9. Stoddard M, Herrmann J, Moy L, Moy R. Improvement of actinic keratoses using topical dna repair enzymes: a randomized placebo-controlled trial. J Drugs Dermatol. 2017;16(10):1030-1034.
10. Yarosh DB, Rosenthal A, Moy R. Six critical questions for DNA repair enzymes in skincare products: a review in dialog. Clin Cosmet Investig Dermatol. 2019;12:617-624.
11. Dréno B, Araviiskaia E, Berardesca E, et al. Microbiome in healthy skin, update for dermatologists. J Eur Acad Dermatol Venereol. 2016;30(12):2038-2047.
12. Burns EM, Ahmed H, Isedeh PN, et al. Ultraviolet radiation, both UVA and UVB, influences the composition of the skin microbiome. Exp Dermatol. 2019;28(2):136-141.
13. Green BA, Yu RJ, Van Scott EJ. Clinical and cosmeceutical uses of hydroxyacids. Clin Dermatol. 2009;27(5):495-501.
14. Ditre CM, Griffin TD, Murphy GF, et al. Effects of alpha-hydroxy acids on photoaged skin: a pilot clinical, histologic, and ultrastructural study. J Am Acad Dermatol. 1996;34(2 Pt 1):187-195.
15. Van Scott EJ, Yu RJ. Hyperkeratinization, corneocyte cohesion, and alpha hydroxy acids. J Am Acad Dermatol. 1984;11(5 Pt 1):867-879.
16. Bernstein E, Uitto J. Connective tissue alterations in photoaged skin and the effects of alphahydroxy acids. J Geriatr Dermatol. 1995;3(Suppl A):7-18A.
17. Lavker RM, Kaidbey K, Leyden JJ. Effects of topical ammonium lactate on cutaneous atrophy from a potent topical corticosteroid. J Am Acad Dermatol. 1992;26(4):535-544.
18. Draelos Z. Salicylic acid in the dermatologic armamentarium. Cosmet Derm. 1997;10(Suppl 4):7-8.
19. Roberts DL, Marshall R, Marks R. Detection of the action of salicylic acid on the normal stratum corneum. Br J Dermatol. 1980;103(2):191-196.
20. Goodman DS. Vitamin A and retinoids in health and disease. New Engl J Med. 1984;310(16):1023-1031.
21. Babamiri K, Nassab R. Cosmeceuticals: the evidence behind the retinoids. Aesthet Surg J. 2010;30(1):74-77.
22. Pérez Davó A, Truchuelo MT, Vitale M, Gonzalez-Castro J. Efficacy of an Antiaging treatment against environmental factors: deschampsia antarctica Extract and High-tolerance Retinoids Combination. J Clin Aesthet Dermatol. 2019;12(7):E65-e70.
23. Truchuelo MT, Jiménez N, Jaén P. Assessment of the efficacy and tolerance of a new combination of retinoids and depigmenting agents in the treatment of melasma. J Cosmet Dermatol. 2014;13(4):261-268.
24. Truchuelo MT, Jiménez N, Miguel-Gomez L, Hermosa A, Sánchez-Neila N, Cuevas J. Histological and immunohistochemical evaluation of the efficacy of a new cosmetic formulation in the treatment of skin photoaging. Dermatol Res Pract. 2017;2017:8407247.
25. Litner K. Peptides, amino acids and proteisn in skin care? Cosmet Toilet. 2007;122:26-34.
26. Gruchlik A, Jurzak M, Chodurek E, Dzierzewicz Z. Effect of Gly-Gly-His, Gly- His-Lys and their copper complexes on TNF-alpha-dependent IL-6 secretion in normal human dermal fibroblasts. Acta Pol Pharm. 2012;69(6):1303-1306.
27. Maquart FX, Pickart L, Laurent M, Gillery P, Monboisse JC, Borel JP. Stimulation of collagen synthesis in fibroblast cultures by the tripeptide-copper complex glycyl-L-histidyl-L-lysine-Cu2+. FEBS lett. 1988;238(2):343-346.
28. Zhang L, Falla TJ. Cosmeceuticals and peptides. Clin Dermatol. 2009;27(5):485-494.
29. Katayama K, Armendariz-Borunda J, Raghow R, Kang AH, Seyer JM. A pentapeptide from type I procollagen promotes extracellular matrix production. J Bio Chem. 1993;268(14):9941-9944.
30. Husein El Hadmed H, Castillo RF. Cosmeceuticals: peptides, proteins, and growth factors. J Cosmet Dermatol. 2016;15(4):514-519.
31. Blanes-Mira C, Clemente J, Jodas G, et al. A synthetic hexapeptide (Argireline) with antiwrinkle activity. Int J Cosmet Sci. 2002;24(5):303-310.
32. Brieva A, Philips N, Tejedor R, et al. Molecular basis for the regenerative properties of a secretion of the mollusk Cryptomphalus aspersa. Skin Pharmacol Physiol. 2008;21(1):15-22.
33. Mehta RC, Fitzpatrick RE. Endogenous growth factors as cosmeceuticals. Dermatol Ther. 2007;20(5):350-359.
34. Sundaram H. The mechanisms and potential impact of stem cell activation in skin rejuvenation: an evidence-based analysis. J Drugs Dermatol. 2017;16(4):378-384.
35. Espada J, Matabuena M, Salazar N, et al. Cryptomphalus aspersa mollusc eggs extract promotes migration and prevents cutaneous ageing in keratinocytes and dermal fibroblasts in vitro. Int J Cosmet Sci. 2015;37(1):41-55.
36. Matsui MS, Pelle E, Dong K, Pernodet N. Biological rhythms in the skin. Int J Mol Sci. 2016;17(6).
37. Plikus MV, Van Spyk EN, Pham K, et al. The circadian clock in skin: implications for adult stem cells, tissue regeneration, cancer, aging, and immunity. J Biol Rhythms. 2015;30(3):163-182.
38. Geyfman M, Andersen B. How the skin can tell time. J Invest Dermatol. 2009;129(5):1063-1066.
39. van Moorsel D, Hansen J, Havekes B, et al. Demonstration of a daynight rhythm in human skeletal muscle oxidative capacity. Mol Metab. 2016;5(8):635-645.
AUTHOR CORRESPONDENCE
Zoe Diana Draelos MD zdraelos@northstate.net
