Doctors around the globe rely on the regenerative power of stem cells to heal burns and injuries, but what can they do in skin-care products? We find out.
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LIQUID GOLD
Augustinus Bader, founder of the eponymous skin-care line, is one of the many experts fascinated by the beauty benefits stem cells have to offer. “Human stem cells [not to be confused with plant stem cells; more on that later] have the unique ability to divide, renew and develop into specific types of cells such as muscle, hair and skin, and they play a critical role in the body’s ability to heal itself,” says professor Bader. “These extraordinary cells can be translated to skin care, as they help to produce healthier, more youthful-looking skin.”
A common assumption is that actual human stem cells are formulated in the creams and serums we’re slathering on, when in fact, “skin-care products often only contain the liquid the stem cells are cultured in at the lab, referred to as ‘human stem cell conditioned media,’” says cosmetic chemist Stephen Alain Ko. “Think of it like beer: You could describe beer as yeast cell conditioned media—the yeast grows in the water and grain mixture, culturing and conditioning it, but is then removed to make beer.” In this magic stem cell liquid is a mixture of growth factors, potent proteins called cytokines, enzymes and other molecules that “produce biological signals to carry out the mission of the stem cell by amplifying the skin cells’ ability to talk to each other,” explains Knoxville, TN plastic surgeon David B. Reath, MD.
X FACTOR
The most valuable proteins released by human stem cells are growth factors, which when applied to the skin, bind to its cells to stimulate wound healing and tissue remodeling. “Growth factors work in a ‘lock and key’ manner, with each individual growth factor (key) having a specific receptor (lock) that it attaches to on the cell surface,” says Gail Naughton, PhD, a regenerative medicine researcher. “Since the ‘90s, clinical studies have shown that topically applied growth factors can help reverse signs of aging in the skin by significantly reducing fine lines, wrinkles and sagging, as well as supporting an evening of pigmentation, increasing elasticity, and improving skin tone and texture.”
A number of beauty brands have incorporated growth factors into their products over the years, and continue to evolve their formulas as new scientific developments arise. For example, SkinMedica’s TNS (Tissue Nutrient Solution) Recovery Complex debuted in 2001 and was the first commercial cosmetic product made with growth factors cultured from human skin cells; its newest product launching early next year, TNS Advanced+, contains MRCx, a next-level growth factor technology derived from human stem cells that Dr. Naughton says has demonstrated “unprecedented effects on aging skin.”
In a recent study, subjects applying TNS A+ twice daily for 12 weeks reported looking six years younger. “Visual results were consistent with histological results of skin biopsies and lab data that showed an increase in collagen, elastin and other important skin proteins associated with wrinkles,” says Dr. Naughton.
THE EGF EQUATION
Some companies utilize the EGF (epidermal growth factor) protein, which was discovered inadvertently by doctors looking for nerve growth factors, who realized it could be used for tissue regeneration and wound healing. “Once EGF was bioengineered in quantities sufficient for research, it was eventually tested for other applications and proved to be a powerful anti-aging active,” says plastic surgeon Dr. Gregory Bays Brown, who founded RéVive based on his research on burn therapy 25 years ago and now incorporates a proprietary form of EGF in the brand’s products.
“We have a patent that states: ‘EGF reverses epidermal senescence.’ Translation: EGF reverses skin aging.” Icelandic skin-care brand BIOEFFECT harvests a replica of human EGF using barley, which founder Dr. Björn Örvar says has the same amino acid sequence and 3-D structure as its counterpart, and therefore can recognize and bind to the same stem cell receptors in the skin. “Our barley-produced EGF signals skin cells to maintain their youthfulness and renew themselves in the same way EGF extracted from human tissue would.”
SOURCE CODE
Stem cells are also no stranger to controversy, which is largely due to how they are sourced. The National Institutes of Health (NIH) sets and upholds standards to make sure stem cells are ethically obtained in a controlled process: Typically, researchers take a few stem cells from human tissue that were donated to science, and then cultivate them in a lab where they are developed into multiple cell lines that can be licensed by brands to procure growth factors for their products. Nevertheless, it’s often misconceived that in order for thousands of skin-care products to be created, an endless source of the human tissue is needed, when in fact, “the original few cells can be replicated in a lab and used continuously over time,” Dr. Naughton says.
However, some brands still undergo scrutiny. One in particular, NeoCutis, formulates its products using proteins cultured from human embryonic stem cells, and has received backlash from pro-life watchdogs for doing so. (Although, the terminated pregnancy was medically necessary and donated to medical research with parental consent). Experts also stress that not all types of human stem cells are beneficial for aesthetic rejuvenation. “The industry seems to have the mindset that anything these cells produce will be great for the skin and anti-aging, but that’s not the case,” Dr. Reath says. “While they all produce biological signals, each stem cell yields a very different pattern and array of them—some proteins will be anti-inflammatory and others pro-inflammatory. We know definitively that aging and inflammation run hand in hand, so cosmetic companies must make sure they’re sourcing anti-inflammatory molecules.”
SUPER SERUMS
Growth factor serums to try: Root of Skin Revitalizing Face Renewal Serum ($78), RéVive Intensité Complete Anti-Aging Serum ($485), AnteAGE Serum ($150), DefenAge 8-in-1 BioSerum ($220), SkinMedica TNS Essential Serum ($281), FactorFive Regenerative Serum ($199), BioEffect EGF Serum ($160), and Le Mieux EGF-DNA Serum ($110).
POWER PLANT
What do roses, lilacs, grapes and Swiss apples have in common? They’re some of the most commonly used plants in skin-care products for their stem cell cultures. “Entirely different from human stem cells, plant stem cells are specialized cells found in plants—fruits and flowers included—where their growth takes place,” says Lisa Reinhardt, director of education at Epicuren Discovery, which utilizes orange stem cell extract in its products. And while they do have a place in skin care, the experts interviewed for this story agree plant stem cell technology is widely misunderstood. “Although plants do contain their own unique cell lineage, the stem cells found in a plant’s meristem cannot be compared to the stem cells found in a human,” says Dr. Reath. “They cannot increase the communication potential in human skin cells because plants and humans do not speak the same biological language.”
NATURAL REMEDY
What plant stem cells can offer the skin, however, is a variety of antioxidant, antimicrobial and/or anti-inflammatory benefits collected during the extraction process (plant stem cells are often lysed, or broken apart, to release the chemicals contained in the cells, Ko says). The thinking behind plant stem cells used in skin care, Santa Monica, CA dermatologist Ava Shamban, MD says, is that “many plants are able to survive or thrive in extreme environmental conditions, using nutrition or moisture to keep them alive, so these powerful abilities should be able to be reproduced within our skin.” Experts also point to the fact that plants have been used in Ayurveda and Chinese medicine for centuries for the treatment and healing of chronic ailments and inflammation, and we’re just scratching the surface of their stem cells’ capabilities and physiologic effects on the skin.
BOTANICAL BENEFITS
Valid scientific, peer-reviewed studies on these effects are scant, but some experiments reveal promising results: Switzerland-based company Mibelle AG Biochemistry tested the effects of cultured Swiss apple stem cells (Malus domestica) on human fibroblasts [cells within the dermis] induced with cellular DNA damage typical of normal aging and reported “significant potential to reduce wrinkles in the crow’s-feet area,” which became shallower by 8 percent after two weeks and 15 percent after four weeks. Reinhardt says additional studies have shown “plant stem cells can also provide a brightening effect and an increase in fibroblast activity for a boost in collagen.
GARDEN PARTY
Plant stem cell serums we’re loving: Naturopathica Plant Stem Cell Booster Serum ($84), Éminence Organic Skin Care Lavender Age Corrective Night Concentrate ($68), DermaQuest Stem Cell 3D Complex ($248), Peter Thomas Roth Rose Stem Cell Bio-Repair Gel Mask ($52).
IOPE Plant Stem Cell Emulsion ($40), Juice Beauty Stem Cellular Vinifera Replenishing Oil ($72) and Epicuren Discovery InjecStem BioFirming Serum ($220).
OFFICE SPACE
Though not FDA-approved and frequently disputed, these stem cell–inspired in-office treatments promise big benefits.
1. Injectables
Human stem cell proteins are being utilized in injectables overseas, and Dr. Shamban expects they will make their way to the U.S. in a year or so. “In Europe, doctors are injecting growth factor–laced fluid into the upper level of the dermis—the same way hyaluronic acid fillers are used there as skin boosters— to stimulate cell turnover and collagen production as cytokines are released,” she says.
2. Lasers
“The biggest trend I’m seeing with in-office stem cell treatments is the combination of growth factor products with other technologies like fractionated lasers,” says Chicago dermatologist Lana Kashlan, MD. “We apply the topicals post-laser, which allows for faster healing and enhanced outcomes.”
3. Facials
The “vampire facial” (growth factor–rich platelet-rich plasma, or PRP, from the patient’s blood is applied to microneedled skin) was big in 2018, but new stem cell facials are on the rise. Though controversial and unproven, some doctors’ offices now offer facials using stem cells from human and animal placentas, which they claim is the best way to get young cells into aging skin for the ultimate youth boost. “Some places are using human placental extracts, but those from sheep are more common because of availability,” says Dr. Kashlan. (La Jolla, CA plastic surgeon Robert Singer, MD notes the FDA has significant legal issues with doctors doing these experimental procedures without proper protocols.) “The jury is still out on whether PRP is effective, and whether this new modality is any better,” Dr. Singer says.
THE DOCTOR IS IN
Q: Why can’t actual stem cells be applied to skin?
A: “They can’t survive outside of their optimal lab environment because they break down when exposed to light and air,” says Beverly Hills, CA dermatologist Ava Shamban, MD. “They’re also essentially the size of a cruise ship compared to other skin-care ingredients, so they can’t penetrate the skin’s deeper layers where they are needed.”
Q: Should any ingredients be avoided when using growth factor products?
A: “Products that are highly acidic, such as vitamin C and alphahydroxy acids, can break down growth factor proteins,” says Dr. Naughton. “Although skin has an excellent ability to restore a normal pH quickly, if such ingredients are used, you should wait 10 to 15 minutes before applying growth factors.”
Q: Can growth factors help boost collagen, too?
A: “SkinMedica scientists have shown that topical application of growth factors on a 3-D human skin model upregulates the genes responsible for collagen production,” says Dr. Naughton. “Some research suggests the use of growth factors early on can help us ‘bank’ collagen, too, leaving us better off later in life, but more studies are needed.”
Q: How did SkinMedica TNS get nicknamed “the penis cream”?
A: As fun as it sounds, there are no male organs in the beloved TNS cream. “The growth factors in TNS were derived from neonatal foreskin cells taken from a donor more than 20 years ago for the purpose of treating acute burns, but were eventually found to also help reverse signs of aging,” Dr. Naughton says.
—Medically reviewed by La Jolla, CA plastic surgeon Robert Singer, MD, Eugene, OR plastic surgeon Mark Jewell, MD and Montclair, NJ dermatologist Jeanine B. Downie, MD
