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Exuviance, CoverBlend and NeoCeuticals by NeoStrata Exuviance, CoverBlend and NeoCeuticals by NeoStrata

       
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Most Frequently Asked Questions

1.     What is the difference between NeoStrata products and Exuviance Products?

Both the NeoStrata and Exuviance brands offer high quality, advanced anti-aging and therapeutic skin care using NeoStrata Company’s patented AHA, PHA and bionic acid technology.

The NeoStrata brand products are formulated for use by physicians and their patients to maximize skin care in conjunction with other treatment modalities. The products generally do not contain ancillary ingredients that may interact with skin during treatment, including fragrances and colors. NeoStrata brand products are only available through a physician.

The Exuviance brand products are designed to provide ‘physician-quality’ while also including additional skin benefit ingredients such as vitamins, marine and botanical extracts, and colors and fragrances to appeal to the prestige product user. The Exuviance products are available through various retail outlets. Exuviance Professional products are available for use by skin care professionals in spas and salons, and some are available for resale to their patients.

2.     What percentage of AHA is in the Exuviance products?

Exuviance products contain up to 11% of hydroxyacids; product selection depends on the intended use of the products. Exuviance Professional products contain up to 12% hydroxyacids and the Exuviance Professional Revitalizing Peel contains 30% glycolic acid.

3.     What are the effects of AHAs on skin?

Alpha-hydroxyacids have been shown to decrease the bonding properties between surface skin cells stimulating transient exfoliation and cell turnover. Epidermal structure has been shown to normalize, or become more youthful, with AHA use leading to normal melanin distribution (evening of pigmentation/clarity), thickened cell layers and skin plumping. Histology studies with higher concentrations of AHAs have shown dermal effects including: collagen deposition, reversal from globular elastotic fibers to elongated, functional elastic fibers, and glycosaminoglycan (GAG) deposition that leads to significant skin plumping and the reduction in appearance of wrinkles and fine lines. Aside from prescription retinoids, there are NO other ingredients on the market that can demonstrate these significant skin benefits.

4.     What is the difference between AHAs and PHAs?

Polyhydroxy acids are alpha hydroxyacids with additional (i.e., poly) hydroxy groups on the molecule. The added hydroxys make the PHA compounds more moisturizing due to their strong humectant properties. In addition, the PHA compounds have been found to be more gentle without the stinging and burning that often accompanies AHA use. Since PHAs share the same fundamental structure as AHAs, they provide similar anti-aging benefits and exfoliation. Some PHAs such as gluconolactone and the complex PHA lactobionic acid are antioxidants. Studies with the PHA gluconolactone indicate that it can increase the skin’s resistance to chemical challenge thereby making it very useful for sensitive skin.

5.     How do the PHAs function as anti-oxidants?

Gluconolactone and lactobionic acid are chelating agents that trap oxidation-promoting metals in skin. Interestingly, lactobionic acid is currently used in organ transplant preservation (as a component of Viaspan by DuPont) due to its potent anti-oxidant properties.

The PHAs have also been shown to function as an antioxidants by inhibiting the oxidation of other readily oxidizable substances including the drugs anthralin and hydroquinone, as well as banana peels. Since oxidation and skin degradation due to UV induced free radical damage are a cause of skin aging, the potent antioxidant benefits of PHAs may play an important role in its anti-aging effects.

Additionally, research with organ preservation has revealed that lactobionate is a cryptic inhibitor of matrix metalloproteinase (MMPs) enzymes obtained from human liver effluents during transplantation. Implications for benefits in skin are great considering that MMPs are responsible for the degradation of the skin’s extracellular matrix and structural integrity thereby contributing to wrinkle formation, skin laxity and telangiectasia. Naturally occurring tissue inhibitors of MMP protect the skin from degradation caused by the MMPs, however UV exposure and aging lead to an increase in MMP activity and the resultant visual and morphological signs of photodamage. The use of lactobionic acid to inhibit MMPs may provide a significant benefit to photoaged skin.

6.     What is the compatibility of NeoStrata and Exuviance products with other cosmetics and drugs; what is the order of application?

NeoStrata and Exuviance products can be used in conjunction with other cosmetic and therapeutic skin care regimens. In general, the recommended procedure is: (1) wash and dry face; (2) apply topical medications if appropriate and allow to absorb (a few minutes); (3) apply leave-on skin care products and sunscreen (not wipe off toners or solutions); (4) apply make-up. Consult your physician for any specific questions regarding drug compatibility with skin care products.

7.     What products do you recommend for acne prone patients?

  1. Use a gentle, non-drying cleanser to remove sebum without over drying:
  2. Apply anti-acne medication:
  3. Use adjunctive products to enhance anti-acne effects and condition the skin:
  4. The NeoStrata and Exuviance glycolic acid peels can be used adjunctively with other topical and systemic anti-acne regimens.

8.     What products can be used for sensitive skin?

The NeoStrata and Exuviance brand PHA products are recommended for use on sensitive skin since they provide anti-aging and adjunctive therapeutic benefits while being gentle, non-stinging and skin conditioning.

9.     What products do you recommend for rosacea?

The NeoStrata and Exuviance brand PHA products are recommended for use on sensitive skin including rosacea since they provide anti-aging and adjunctive therapeutic benefits while being gentle, non-stinging and skin conditioning. A clinical study with the Exuviance Gentle Cleansing Creme, Soothing Toning Lotion, Multi-Protective Day Fluid SPF 15 and Evening Restorative Complex showed excellent compatibility of the PHA products with rosacea and atopic dermatitis, and some users were able to lower or discontinue their topical medicines to treat these conditions. Additionally, the Exuviance/NeoStrata Anti-Bacterial Facial Cleanser is recommended for skin cleansing twice daily since there may be an infective organism promoting the condition of rosacea.

10.   Which NeoStrata and Exuviance products can be used in conjunction with microdermabrasion?

To smooth the skin before microdermabrasion and promote a more uniform, even microdermabrasion to the skin, NeoStrata recommends use of hydroxyacid products at least two weeks prior to receiving the procedure. Following the procedure, the following products should be used as long as the skin is intact and not open or wet. Daytime use of one of the SPF 15 containing Exuviance or NeoStrata PHA products is strongly recommended including, Exuviance Multi-Protective Day Fluid/Creme, NeoStrata Daytime Protection Cream or NeoStrata Oil Free Facial Lotion. Additionally, the following products are suggested:

11.   When can peels be performed after microdermabrasion?

A sufficient period of time should pass following the use of any of treatments and products that affect the skin’s barrier to allow the skin to heal before a peel is performed. If the peel is performed too soon after a microdermabrasion procedure there may be an increase in the reactivity of the skin to the glycolic acid leading to a deeper peel and the potential for unintended results and longer healing. If a superficial microdermabrasion is performed, at least two weeks should pass before peeling. If a deeper microdermabasion is performed, allow at least one month before peeling.

12.   Which products should be used prior to a glycolic acid peel?

If the person has never used glycolic acid, a glycolic acid containing product should be used for two weeks prior to the peel to test the skin’s reactivity before applying the peel. The Exuviance Multi-Defense Day Fluid or Creme SPF 15, and the NeoStrata Skin Smoothing Cream are good choices. If skin tolerance to glycolic acid is known, then either a PHA or AHA product should be used for two weeks prior to the peel to initiate preliminary exfoliation and smooth the skin.

13.   What is the expected response of a peel? How often should peels be performed?

Following a superficial peel, stinging, itching, burning, tightness, minor swelling and peeling of the surface layers of the skin may occur depending on individual skin responsiveness to the glycolic acid. These sensations will gradually diminish over the course of the week as the skin returns to its normal appearance. If hyperpigmentation occurs, apply skin lightening products as soon as tolerated. For example, Exuviance Professional Intense Lightening Complex or NeoStrata Gel for Age Spots and Skin Lightening.

Timing between peels is determined by the response to the previous peel. Peels can be performed as soon as two weeks later if there is minimal discomfort and desquamation after the previous peel and the skin has healed completely. However, if a subsequent peel is conducted within a week or two, skin reactivity to glycolic acid may be increased resulting in a stronger effect than desired with a longer healing phase. If a greater effect occurred with the previous peel, the next peel should be scheduled at least four weeks apart, after the skin has fully healed.

14.   What is the maintenance after the peel?

  • Wash the area very gently as directed by the physician. Following superficial peels, NeoStrata Facial Cleanser or Antibacterial Cleanser, or Exuviance Gentle Cleansing Creme, Purifying Cleansing Gel or Moisturizing Anti-Bacterial Facial Cleanser can be used.
  • Apply NeoStrata NutriCream or Bionic Face Cream, or Exuviance Professional Ultra Rich Restorative Creme twice daily for at least one week until the skin returns to its normal appearance. Then resume regular use of the NeoStrata or Exuviance AHA or PHA products.
  • Do not use abrasive or exfoliating sponges on the area.
  • Avoid sun exposure until the skin returns to a near-normal appearance. Use a broadspectrum (UVA/UVB) sunscreen with at least SPF 15 as soon as tolerated by the skin.
  • To avoid the possibility of scarring:
    • Do not peel, pick, scrape or scratch the skin
    • Do not use a mask or any exfoliating facials on the skin
    • Do not wear tight head bands, hats, etc. (if the face has been peeled)
    • Do not expose the skin to sun
  • Call your physician or skin care specialist for any questions or concerns.

15.   Can a person with a history of Herpes infections receive a glycolic acid peel?

Recurrent Herpes infections have been attributed to minor traumas, exposure to other infections, UV radiation, neural or dental surgery, dermabrasion, and emotional stress. Experience with the Skin Rejuvenation System has shown that superficial peeling can stimulate Herpes outbreaks in prone individuals. In order to prevent a Herpes breakout, prone patients should be instructed by the physician to take an oral antiviral drug (acyclovir, valacyclovir, etc.) as directed by the manufacturer (usually a couple of days before the procedure continuing for a few days after the procedure). Any patient that experiences moderate to severe Herpes infections should not undergo peeling with the Skin Rejuvenation System. Any patient with an ACTIVE herpes breakout should not be peeled until fully healed.

16.   Which products do you recommend before laser surgery? (also see number 15)

Prior to non-ablative laser surgery in which the surface of the skin is not removed, an AHA or PHA product is recommended for use to smooth the skin and prevent light scattering of the laser beam. Skin lightening products are also useful prior to performing laser or peels on individuals with the potential to hyperpigment following the procedure.

Suggested products:

17.   Which products do you recommend following laser surgery?

Non-ablative laser surgery targets the deeper skin layers where collagen and elastic fibers are found. To target the top layers of skin and promote skin smoothness with an even skin tone, use of the AHAs and PHAs is recommended.

18.   NeoStrata recommends the use of NeoStrata and Exuviance products with non-ablative laser procedures to provide the following benefits: (as per Dr. BERNSTEIN)

  • pre-procedure to reduce and make compact the stratum corneum. This allows the laser light source to penetrate the skin without significant light scattering thus providing an optimal effect.
  • pre-procedure to reduce pigmentation in the skin; skin melanin absorbs the light energy and causes the skin to heat up which causes negative side effects.
  • pre-procedure and post-procedure to enhance epidermal cell turnover to provide an epidermal benefit to complement the dermal effect of non-ablative laser.
  • pre-procedure and post-procedure to provide an enhanced skin benefit to all levels of skin. Dr. Eric Bernstein has just published an article showing collagen gene induction in the dermis.
  • Intermittent use of glycolic acid peels after skin has fully healed from laser to optimize the effects of laser.

ü  Suggested product regimen:

  • pre-procedure am: SPF 30 sunscreen
  • pre-procedure pm: Exuviance Intense Lightening Complex* then NeoStrata Skin Smoothing Lotion with PHA over it (NeoStrata/Exuviance Bionic Face Cream or Bionic Serum)
  • post-procedure am: SPF 30 sunscreen
  • post-procedure pm (first week): PHA (Bionic Face Cream or Bionic Serum) only for one week while the skin is somewhat sensitive
  • post-procedure pm (one week later): Skin Smoothing Lotion with PHA (Bionic Face Cream or Bionic Serum)

* The goal is to provide a more even skin tone before the laser procedure to minimize side effects from excessive heat build up in the skin. The length of pre-treatment depends on the skin tone and may be up to 2 months.

19.   What is the difference between Bio-Hydrating Cream and Bionic Face Cream

The Bio-Hydrating Cream contains 15% gluconolactone and is promoted for use with adult acne and as the “NeoStrata-15” PHA product. The Bionic Face Cream contains 8% gluconolactone with 4% lactobionic acid and is intended for intense moisturization of dry, photoaged skin, or for use following non-ablative laser, microdermabrasion and peels.

20.   What is the purpose of the Renewal Cream?

The Renewal Creme and Exuviance Professional Rejuvenating Complex contain 12% PHA with 1% retinyl acetate (pro-vitamin A). It is recommended for use once daily on more severe photoaged skin and can also be used adjunctively for acne as long as other retinoids products are not being used.

21.   What products can be used on dry skin?

The PHA products are recommended for use on dry skin since the PHAs are potent moisturizing compounds.

22.   What are the results of using Vespera Bionic Serum?

Text Box: Results of a twelve week clinical study on 26 women with twice daily Vespera Bionic Serum application indicate significant improvements in photoaging at the evaluated 6 and 12 week time points for all of parameters including: fine lines, wrinkling, pore size, laxity, roughness, sallowness, pigmentation, and clarity. Analysis of silicone replicas revealed significant improvements in texture parameters representing the depth, number and spacing of fine lines and coarse lines thus providing strong support for the clinical grading scores. The product was well tolerated by the users.

To assess skin plumping, Vespera was applied to the forearms three times daily and skin thickness was measured using calipers. Results showed a statistically significant increase (p<0.05) in skin thickness measurements at 12 weeks when compared to the untreated arm, and in comparison to baseline with a total increase of 9.7%. Untreated forearm skin thickness measurements were not statistically changed between baseline and endpoint. There were no significant increases in irritation on the treated arm demonstrating tolerability with exaggerated use of three times daily.

Refer to publication: Green BA, Edison BL, Wildnauer RH, Sigler ML. Lactobionic acid and Gluconolactone: PHAs for Photoaged Skin. Cosmet Dermatol 2001; 9:24-28.

23.   How does Lactobionic acid affect pore size, and improve uneven pigmentation?

It is believed that the AHAs/PHAs affect pore size by helping to cleanse out cellular debris and also enhance skin elasticity. The epidermal cell turnover effects and normalization process help to correct hyperpigmentation and promote a more even appearance.

24.   Can AHAs and PHAs be used to improve skin under eye circles?

A visit to a dermatologist can determine whether the circles are due to hyperpigmentation (increased melanin production), and if so whether it is epidermal (surface) or dermal (deep) in its location, or due to blood deposits (hemosiderin) in the skin. The latter is common and does not respond well to topical treatments. Epidermal hyperpigmentation can be treated successfully with skin lightening products such as the NeoStrata Bionic Skin Lightening Cream, SPF 15, or the Exuviance Skin Lightening Gel or Exuviance Professional Intense Lightening Complex (available through skin care professionals). Dermal hyperpigmentation does not respond as well to topical treatments. It is also advisable to use the CoverBlend Multi-Function Concealer with PHA to cover the dark circles and the Exuviance Hydrating Lift Eye Complex for moisturization and diminishment of the appearance of fine lines and wrinkles.

25.   What is the difference between CoverBlend and the Exuviance Foundations?

The Exuviance Foundations with SPF 15 sunscreens and 4% PHA provide medium coverage for daily cosmetic use. CoverBlend Concealing Treatment Make-Up SPF 20 with 4% PHA provides a natural appearance and heavy coverage/opacity for use by individuals desiring to conceal a mark or coloration on the skin. This product is ideally suited for those with vitiligo, port-wine stains, birth marks, burn scars, and for use in theatre. CoverBlend is smudge-proof and water-resistant.

26.   Explain CoverBlend application techniques and various uses.

CoverBlend is an opaque concealing makeup designed to cover areas on skin with deep pigmentation or coloration, for example, Port-Wine stains, vitiligo, birth marks, post-laser redness, etc. The products are applied to clean skin using a layering technique to provide the desired degree of opacity. There is an optional finishing powder to reduce skin reflectance.

27.   Does NeoStrata Company test on animals?

NeoStrata Company, Inc. does not conduct animal testing on its marketed skin care products including the NeoStrataÒ and ExuvianceÒ brands. All routine product safety testing is carried out on human volunteers or using in vitro models.

28.   Does NeoStrata Company use animal derived ingredients?

NeoStrata Company endeavors to use non-animal derived ingredients whenever possible, by substituting plant-derived and synthetic materials in their place.

29.   Can AHAs/PHAs be safely used for long periods of time? Is there an increase in sun sensitivity?

NeoStrata Company is not aware of any data indicating that there are safety issues with long-term use of alpha-hydroxyacids (AHAs). On the contrary, there are people with ichthyosis (severe dry skin) that have been using high concentrations of AHAs over large portions of their bodies for many years (since the early 1970s) and there are no reported long-term adverse events.

One negative effect that has been reported with the use of AHAs pertains to a small, but statistically significant increase in the skin's susceptibility to UV light as measured by the sunburn cell model. Notably, this effect can be prevented with use of a low level sunscreen (SPF 3). As a general rule, we recommend use of at least SPF 15 sunscreen in combination with daytime AHA use. All of NeoStrata’s daytime products are formulated with SPF 15 sunscreens. Use of the PHAs (gluconolactone) has not demonstrated this increase in sun sensitivity, and therefore may be another option.

Clinical studies have demonstrated that there is a regression in skin benefits after AHA use is discontinued. Therefore, skin will no longer improve after AHA use is discontinued.

30.   How will the labeling of NeoStrata’s AHA-containing products change to reflect FDA’s concern of increased sun sensitivity?

We will strengthen our existing recommendation: “Daily use of a sunscreen recommended with this product”, on all NeoStrata and Exuviance formulations that contain glycolic acid or lactic acid, that do not contain a sunscreen. (Note, the statement will appear on the outer carton only, not the inner package, and not samples. The peels are not going to contain this warning because there are extensive warnings listed in the printed physician guidelines booklet. The new wording will appear on the next productions of new cartons and will be phased-in over the next year.)

Daily use of sunscreen or sun avoidance is recommended with use of this AHA product and for one week after to minimize the risk of sun sensitivity/sunburn.

31.   What is the meaning of the term ‘oil-free’ in cosmetic products?

NeoStrata and Exuviance products are considered oil free if they do not contain mineral oil, petrolatum (petroleum jelly), or other natural oils such as peanut oil or macadamia nut oil.

32.   What is the meaning of the term ‘non-comedogenic/non-acnegenic’ in cosmetic products?

  • Non-comedogenic: product use does not cause black heads and white heads (comedones).
  • Non-acnegenic: product use does not cause acne.

33.   Can someone with celiac sprue use NeoStrata and Exuviance products?

The alcohol in some NeoStrata and Exuviance products is derived from a grain source. Some of the long chain fatty acids, lecithin, etc. are also obtained from a plant source. As a result, NeoStrata and Exuviance products may not be safe for use by people having celiac sprue. We welcome any experiences with NeoStrata and Exuviance products from celiac sprue customers to help build our understanding of the success of product use with this condition; please send correspondence to Bgreen@neostrata.com.

34.   Can NeoStrata and Exuviance products be used during pregnancy?

Unfortunately, it is nearly impossible to conduct product safety studies on pregnant women. As a result, there are no controlled clinical studies describing the safety of AHA products on pregnant or lactating women. While glycolic acid and gluconolactone are naturally occurring compounds, which are considered to be very safe, NeoStrata recommends that all pregnant and lactating women seek the advice of their physician before using AHA containing products. In addition, NeoStrata recommends that all drug products including, skin lightening topicals with hydroquinone or kojic acid, and acne treatments with salicylic acid be discontinued during pregnancy and lactation. Furthermore, NeoStrata does not recommend the use of skin renewal peels during pregnancy and lactation since many women experience significant skin changes during this time and therefore the response to a peel is less predictable.

For additional information, the Cosmetic Ingredient Review (CIR) board reviewed the safety of glycolic acid and lactic acid as formulated in cosmetic formulations. Their final report addressed the issue of safety in pregnancy, and in their conclusions they did not recommend any restrictions of use in this population. However, it is important to note that the CIR conclusions pertained to AHA products containing a maximum of 10% glycolic acid or lactic acid and a minimum pH of 3.5. For further information, the publication can be obtained from the Cosmetics, Toiletries and Fragrances Association (CTFA) at 202-331-1770.

The polyhydroxy acid (PHA) gluconolactone, is converted to gluconic acid in the presence of water in the body. Both gluconolactone and gluconic acid are found naturally occurring in the human body. There are several drugs on the market including vitamin supplements that are prepared as the gluconate salt. Often times a substance that is irritating to the gastrointestinal tract can be made less irritating by formulating it as the gluconate salt. Common vitamin supplements include ferrous gluconate and calcium gluconate, which are safely given both orally and intravenously.

35.   What are anti-oxidants, Vitamin E and Vitamin C ingredients.

Many NeoStrata and Exuviance formulations feature combinations of AHAs and/or PHAs with anti-oxidant vitamins including vitamin C and vitamin E to help neutralize free radicals generated by exposure to sunlight and prevent them from damaging skin and causing skin aging.

36.   Explain Retinol and Retinyl Acetate as an ingredient in comparison to Renova, Retin-A or Vitamin A.

Vitamin A is the generic term for a variety of fat-soluble substances including retinol, retinyl palmitate, retinyl acetate, retinaldehyde and the provitamin A carotenoids such as beta-carotene. Vitamin A or retinol is found in foods and biological tissues as retinyl esters such as retinyl acetate and retinyl palmitate. Retinyl palmitate is the major storage form of Vitamin A in the body, primarily in the liver. The best known function of vitamin A is in vision where it participates as the metabolite retinal (retinyl aldehyde) in the visual cycle.

Retinoic acid is formed from retinol in the body and is the active ingredient in Renova and Retin-A. It plays an important role in the development of skin by regulating growth, and has demonstrated benefits in treating acne and photoaging and naturally enhances the repair of photodamaged skin.

Retinol and retinaldehyde (retinol in the aldehyde form) are commonly used in cosmetic formulations, but are very unstable and quickly degrade in the presence of oxygen. Retinol in the ester form, including retinyl palmitate and retinyl acetate, is called ‘pro-retinol’ because these compounds require conversion to retinol in the body before being active. Retinyl palmitate is highly stable and therefore most often used in formulations. However, there is an excess of retinyl palmitate in the skin naturally because it is the storage form for retinol in the body. Retinyl acetate is more stable than retinol and retinaldehyde and can be easily formulated in skin care products. In addition, the acetate form is not stored in the body and therefore would not already be present in excess, which may make this form preferable over retinyl palmitate.

37.   Explain sunscreen protection ingredients including Avonbenzone/Parsol 1789.

Sunscreens protect skin from sun by absorbing ultraviolet (UV) light, instead of your skin cells and DNA absorbing the UV light. Common UVB absorbing sunscreens include octyl methoxycinnamate, octyl salicylate, and homosalate, and the newest sunscreen which protects in both the UVA and UVB range is avobenzone (Parsol 1789). Physical sunscreens, such as zinc oxide and titanium dioxide, protect the skin by reflecting the sun’s rays away from skin.

38.   What is the reason for including a PHA in the NeoStrata Daily Protection Sunscreen SPF 29?

The gluconolactone in the Daily Protection Sunscreen is intended to provide anti-oxidant protection. Since this sunscreen is a companion product to the other NeoStrata and Exuviance formulations, it is not intended to be used alone as a ‘treatment’ product. AHA and/or PHA benefits should come from additional product usage.

39.   Are NeoStrata and Exuviance product Kosher for Passover?

Some NeoStrata and Exuviance products contain ethyl alcohol derived from corn. Some of the conditioning/emollient ingredients are derived from other plant sources. Beta glucan, derived from a grain source, is contained in our Exuviance prestige line of skin care products. Unfortunately, NeoStrata cannot guarantee that all products meet the strict dietary guidelines of Kosher law, or the restrictions required during the Passover holiday.
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NeoStrata brands: NeoStrata.com, CoverBlend.com, Exuviance.com, Psorent.com

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