Truth Pair o’ Docs

“Docs? I thought they said ducks!”

Who runs this place, anyway? Introducing Dr. John and Dr. George, your hosts here at  barefacedtruth.com.  BFT is “owned and operated” by us. We alone are responsible for its content.  The world classifies us as “beauty bloggers”.  We like the moniker. We are proud to join the ranks.

Dr. George is a physician & research doc who is taking a deep dive into the world of regenerative medicine and therapeutics.  A former anesthesiologist, he has put ~25,000 people to sleep, but promises to try to keep you readers awake. Dr. George is also a principal in Cellese, where he plays several roles.

Dr. John is the CEO and chief scientist at Cellese, with a passion for stem cell biology as it relates to skin and wound healing.  His background includes research (physiology, cell biology, neurophysiology), clinical practice (nutrition, diabetes & regenerative medicine), and was formerly Medical Director for Johnson & Johnson. He also dabbles in terrestrial radiolocation and bending spacetime as a principal in Locata (www.locatacorp.com).  When he has spare time he watches over BFT as a labor of love.

Our interest in stem cell biology grew out of our work in diabetes. Diabetics heal wounds very slowly. We discovered some years ago that we could coax bone marrow-derived mesenchymal stem cells to do all sorts of marvelous things. They are the ones whose natural function is to respond to emergencies anywhere in the body. They communicate via cytokines (biosignaling molecules), to each other and to nearby cells. There are hundreds of cytokines, generally peptides and glycopeptides), and they have a superbly complex family tree. We have spent the last few years learning their “language” (cytokines patterns, like words in a sentence), which is the key to our discoveries. That, and stuff like understanding the differences between wound healing and photoageing (some overlap, some key differences), where the key metabolic entry points are, how to deliver these tiny signalling molecules to the right place. Fun!

While we thought it important to disclose our day jobs and research interests, we also want you to know that  any companies we work for, and/or consult for, and/or have ownership in, have not approved anything we say here.  Cellese has no control over the content of this blog, and therefore is not responsible for anything we say.  Time spent answering questions and writing posts are not compensated by Cellese, or anyone else for that matter. We volunteer our time as a public service. Any opinions expressed herein  are entirely our own, DrJohn’s and DrGeorge’s, as individuals, as beauty bloggers.   With an occasional guest blogger, we hope. Oh, and your opinions, if you care to comment.  See disclaimer below. And terms of use.

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This web site accepts no ads. Even our own companies are not allowed to advertise at barefacedtruth.com. (although we might make an exception if they want to test an ad or something, if it fits within our editorial vision). No commerce is conducted here. We are not here as professionals (our profession is science entrepreneurs) but as amateurs (beauty bloggers, if you will).  We claim no special qualifications for that role. But we do know how to read and write (although a spell checker is sorely needed .. . any volunteers?).

We are not here to sell products. To that end, we declare that this blog is not an advertisement  or inducement of any sort for any product or commercial venture with which we may be associated. We mention our day jobs ONLY so that you know where some of our knowledge and opinions are coming from, and why we care about any of this.  But we will mention our own work, and products, because it is part of who we are.  Not so you will buy products from us, but because we want to share our excitement with you about the underlying science.  And to give you proper context for evaluating our opinions. We do have confidentiality agreements with companies we work with, which means we can’t tell you everything we know. We are quite happy to tell you what we don’t know (which is a lot, and why we ask so many questions).

The above serves as a disclosure statement as well.  We are not without our biases (and will clearly state them, often) but we have been trained to be able to evaluate scientific topics objectively. We recognize that uncovering “the good, the bad, and the ugly” about beauty, inc, is going to make us unpopular in some circles. Our goal is not to make enemies, it is to seek the truth. In that regard we need to remain humble, because separating truth from fiction is not always as easy as it sounds. We are going to stick to basic scientific principles that values evidence over opinion. Within the evidence base itself, there are “levels” of evidence ranging from quite high to very low quality.  We will strive for objectivity in our judgments, in full recognition of tour own human nature, meaning that we  have biases, prejudices, and blind spots just like everyone else.  But we will also work to stay aware of where our weaknesses and biases are, and be disclosing about them.  We work in the field, and like most entrepreneurial scientists we believe our work is pretty special. We care deeply about the bigger truths, and the impact that science progress can have on health as well as aesthetics.  Science guys are steeped in a tradition that values truth, and holds it dear.  We ask  you, our readers, to hold our feet to the fire.  If you think we are straying from our mission, or our stated principles, please challenge us.  You are our partners in this process, and we will be relying on you to keep us firmly planted. Help us to become better “beauty bloggers”.

How can you do that?

We get asked from time to time how can we (who work on active ingredients – biochemicals – for a company) legitimately review the work of others? Isn’t that a conflict?  We all have conflicts of interest, just like we all have biases. But if we openly reveal our potential conflicts, then others can evaluate our opinions with the full knowledge of our inherent conflicts, or biases. That’s pretty much the way it is done in medicine.  If I perform an NIH-sponsored research study, or author a paper, and it deals with something  I know a lot about, and that same knowledge is useful to a company, and they also pay me to consult with them on this same topic, then I have an inherent conflict. I must reveal that (research conflict of interest, or financial conflict of interest). Having a conflict by itself doesn’t disqualify us from stating our opinion, or having our work published, as long as it is fully disclosed. Now, the internet blogosphere has no such rules, but we adhere to a higher standard here. And remember, we are here on our free time, as beauty bloggers, not representing our company in any way.

As we keep repeating , “Consider our biases disclosed”.  We don’t pretend to be objective.

Here is a related question — if guys like us don’t step up to the plate and review the world of cosmetic actives, who would?  What august body would be guarding the interests of the public? Are there cosmetic scientists in the academic world, with no conflicts of interest?  Hardly any, because academic institutions thrive on government grants (e.g. NIH, or NSF grants).  But the government has no research agenda for things like wrinkles, so there are no grants available.  So the research comes from companies, all of whom have commercial interests, in other words inherent conflicts.  So, practically speaking, all the experts in the world in this field have conflicts of interest (based on the source of their income).  So, the choice is no watchdogs, or watch dogs who need to disclose their conflicts.  The NIH doesn’t have the resources to watch over this stuff like they do drugs – so they concentrate on the claims associated with products. Until we showed up, it seemed like nobody was willing to step up to the plate.  Nobody wants to rock the boat. The ingredient that scares me today  may come from my employer tomorrow (or a worse one).  Best to shut up.

But again, we are not here as science professionals, but as beauty bloggers, watching over things in our spare time.  Call us crusaders or whistle blowers or whatever.  We actively research published science, raise legitimate questions, and when we see things that are scientifically whacky or troublesome,  we raise an issue.  We don’t make a lot of friends in the industry as a result. But we sleep better at night. We think beauty blogging  is a fun hobby,  but also one that could do some public good.

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The materials available at this web site are for informational or entertainment purposes only and not for the purpose of providing medical advice or guidance. You should contact your physician to obtain advice with respect to any particular issue or problem of a medical nature. Use of and access to this Web site or any of the e-mail links contained within the site do not create an doctor-patient relationship between you and us.   We operate here only as educated “beauty bloggers”, not as practitioners of the healing arts.  We make no offer of services of any kind.

The opinions expressed at or through this site are the opinions of the authors (posts) and contributing readers (comments on posts), as individuals.  We do not attempt to fact check everything written by readers who leave comments.   We endeavor to present multiple sides to any controversial issue, and regularly publish comments expressing opinions contrary to our own.   If you see something you thinks is incorrect, let us know and we will correct it.  We publish corrections.  If you disagree with our logic or interpretations or opinions, feel free to counter us with your own opinions.  We value a good debate.  But we will not approve (or may edit) comments that contain offensive language, present  blatant advertising messages,  are ad hominem in nature (that is, attack individuals rather than ideas), are repetitive, or just fail to live up to our standards as editors.

This is a nonprofit, non-commercial beauty blog choc full of opinions.  Ours and yours, if you care to share.

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49 Comments

  1. cindy says:

    Dear Drs,
    I’m really enjoying your site! I wish it were more active.
    A thought I will leave you with from my Italian mother: as kids there was only one cure for dry skin, frizzy hair, dandruff, scaly feet and on and on. Olive oil. We had olive oil in the kitchen and in the bathroom in a pretty little jar.
    To this day, when I cook I always dab a little on my hands and rub well. I can’t say that my hands look younger, but they sure are soft and nothing smells better!

    • drjohn says:

      OK , so we will get more active. Olive oil as a hair grooming accompaniment was the fashion of day back then for Mediterranean folk (actually goes back to ancient Roman times). Also explains the doilies on the backs of the easy chairs.

  2. Heather says:

    What do you think of the science behind Dr Perricone’s products?

    • drjohn says:

      We respect Dr. Perricone, and consider him a pioneer in helping the world to understand the nexus between inflammation and aging, especially aging skin. He was writing and speaking about it a decade ago. He has been widely criticized as having “mixed a pinch of science with a gallon of imagination”. I think perhaps some of this reflects the fact that he long ago sold his company and is now has a strictly PR/marketing role. The current crop of products from the company bearing his name are a bit fanciful in terms of the underlying science. Interestingly, if you hear him speak nowadays he stays with the same basic message he did on the PBS infomercials that made him famous. For him, it is basically about diet and oral supplements, not about current Perricone products. Interesting, huh?

  3. KIM says:

    I am also enjoying your website; thank you very much for volunteering your time on behalf of those of us who simply don’t know where to find the science, or how to interpret complex studies and data. I for one, TRY to find science to back up the products I use; I also ask my dermatologist a lot of questions and I try to stick to products that (from what I can tell) that do what they actually SAY they’re going to do.

    That said, are you able to point me in the direction of studies that support topical, low-dose Retin A and Vitamin C (MAP) in this battle so many of us wage against aging?

    I would love to see an article to the effect of “TOP 5 or TOP 10 Products that Deliver the (anti-aging) Goods”, as well as a brief scientific explanation about how/why they work, and studies which support them.

    Happy New Year,

    Kim

  4. Sue Kolbas says:

    I am so loving this blog! Right up our alley! Thank you for your philosophy and openness! Gigi and I are not doctors but have an insane passion for the truth! Especially in skin care. The lies and marketing manipulations from the majority of companies out there causes our blood to boil! We too preach the truth, in more simplistic terms, just being consumers with a handful of apps and a cosmetic ingredient dictionary by our side! Oh . . . and The Cosmetic Cop too! Again . . . thank you!!!

  5. Laurie says:

    I am not sure why my post was removed, but I will re-post it. Thanks for the information. Can you please recommend effective, ethical and natural products to diminish lines on the face? I currently use Dr. Hauschka, and have had decent results with the Rejuvenating mask. What are the longterm effects from Botox? Has it been studied?

    • drjohn says:

      Recommending products without knowing detailed specifics about a person in terms of skin, health, etc is not something we do. We will say that ethical and natural are easy – lots of those. Effective against lines and wrinkles is another story – not too many of those. We favor products that have a rational basis (e.g. does not defy known skin physiology) based on leading edge science, from reputable sources (real scientists). Since our work is primarily in the realm of stem cells (and their cytokines and growth factors), we have a disclosed bias in thinking that the best answers are in that realm. But we also like other well tested helpers (some peptides, vitamins, co-factors, etc). We think consumers should educate themselves. If you have a scientific bent, try searching on PubMed (http://www.ncbi.nlm.nih.gov/pubmed) for the latest publish articles in the science world.

      Here is a study by a well known plastic surgeon on the complications of Botox.

      http://www.drdayan.com/pdf/publications/complications-of-botulinum-toxin-a-use-in-facial-rejuvenation.pdf

  6. Lisa says:

    Hi!
    I am curious to learn more about the science of growth factors used in anti aging product. I have my own biases and appreciate yours. I also have a lean toward solid science. Can you direct me towards some papers that you consider to be solid science on this topic?

    • drjohn says:

      Lisa – it is a large topic. If you go to pubmed and search on “growth factors” & “skin” you will get nearly 4,000 citations. Here are just a few that are specific to anti-aging, clinical in nature (product trials), and recent. But again, there are thousands.

      J Drugs Dermatol. 2009 May;8(5 Suppl Skin Rejuenation):4-13.
      Topically applied physiologically balanced growth factors: a new paradigm of skin rejuvenation.

      J Drugs Dermatol. 2007 Oct;6(10):1018-23.
      Human growth factor and cytokine skin cream for facial skin rejuvenation as assessed by 3D in vivo optical skinimaging.

      J Drugs Dermatol. 2008 Sep;7(9):864-71.
      Reduction in facial photodamage by a topical growth factor product

      Dermatol Ther. 2007 Sep-Oct;20(5):350-9.
      Endogenous growth factors as cosmeceuticals

      J Cosmet Laser Ther. 2008 Jun;10(2):104-9.
      Clinical, histologic, and ultrastructural changes after use of human growth factor and cytokine skin cream for the treatment of skin rejuvenation.

      J Drugs Dermatol. 2009 May;8(5 Suppl Skin Rejuenation):3.
      Role of physiologically balanced growth factors in skin rejuvenation.

      J Drugs Dermatol. 2007 Feb;6(2):197-201.
      Efficacy of novel skin cream containing mixture of human growth factors and cytokines for skin rejuvenation.

      J Clin Aesthet Dermatol. 2010 Dec;3(12):37-42.
      Human growth factor cream and hyaluronic Acid serum in conjunction with micro laser peel: an efficient regimen for skin rejuvenation.

      J Oral Maxillofac Implants. 2014 Jan-Feb;29(1):e59-65.
      A novel approach for skin rejuvenation by regenerative medicine: delivery of stem cell-derived growth factors through an iontophoretic system.

  7. Mary Beth Gibbons says:

    I love the info on your blog. I am an ER nurse who has migrated into skin health and medical esthetics. I would like to chat with you through email… Is that possible?

  8. Lauren says:

    I am so encouraged by the research efforts that you have put forth into your articles. You break this information down for people so that they can understand what they are truely buying into. Thank you for your hours of time in this endeavour, keep up the good work!

  9. Jim Wright says:

    I’m looking at a product called Asea, do you have an opinion on this product?

    • drjohn says:

      Miracle water out of Utah (Literally, out of tap water – not even a fancy sounding spring). Sold in typical MLM fashion. Lots of other opinion out there that it is pseudoscientific bunk. I would agree, except that I don’t even think it reaches the level of pseudoscience. More like non-science (or just plain nonsense).

  10. Jim Wright says:

    Do you have an opinion on a product called Asea?

  11. Jan Bouma says:

    I am on my third order of AnteAge, and can’t say enough good things about it. I am wondering how the MD line differs from the original line, and why it cannot be ordered online. Also, can Retin A be used in conjunction with AnteAge? If so, what would be the protocol?

    • kris says:

      Jan,

      Did you ever get a response to your question about using Retina A in conjunction with AnteAge and why we cannot purchase AnteAge MD online? I have those same questions. Thanks.

      • drgeorge says:

        Using Retin A in conjunction with AnteAGE is not necessarily contraindicated, but may result in increased potential for Retin A related side effects such as redness, dryness, peeling and irritation. AnteAGE Accelerator contains retinol, a congener of retinoic acid (Retin A). It is part of the formulation for the very same beneficial reasons dermatologists recommend Retin A. We should clarify that the “side effects” of Retin A result from the physiologic effects of increased skin cell turnover. Skin requires a period of acclimatization to Retin A, with some people more sensitive to its effects than others.

        AnteAGE MD is sold via medical practices and medical spas, not on the internet.

  12. Mary White says:

    I am so pleased I have found this page. I can’t stop reading all the information. Thank you for taking the time to educate us. I am a skin therapist with a background in nursing who runs a small home based business in Tasmania. I enjoy learning about skin, products and ingredients to help educate myself and my clients. I will be recommending your page to some of them. I look forward to future posts. Keep up the good work.

  13. Bruce says:

    It would be very interesting to see a third expert weigh in on nutraceuticals and their claims on health benefits as well. Has that been considered? I too work in clinical research (pharmaceutical and biotech) and I’m appalled by all of the claims companies make without objective scientific research being conducted to come to such conclusions.

  14. Ros says:

    I’ve been taking Hyaluronic Acid in capsule form for some time now because I read it alleviates dry eye syndrome, and it does seem to have done this. I was pleased that HA was also supposed to keep skin looking younger. Please could you give me your opinion on the value of using this supplement in this way, and if in your opinion any health risks associated with taking HA outweigh the perceived benefits? I use NHS Labs 225mg capsules. I think when I first started using these capsules they contained HA from chicken combs, but this supplement is now described as vegetarian.

    The ingredients are: Sodium Hyaluronate 225mg. Other ingredients: Calcium Carbonate, Magnesium Stearate. Vegetable Capsule contains: HydroxypropylMethylcellulose, Sorbitol, Silicon Dioxide

    • drjohn says:

      Hi Ros. HMW HA does get absorbed and reaches tissue “in small amounts”. (http://pubs.acs.org/doi/pdf/10.1021/jf8017029). I don’t see any major risks with its use. If you find benefits from dry eyes (which makes sense) – go for it. C0Q10 is also often touted for dry eyes and although the evidence base is still a bit quiet, we do know that C0Q10 levels in the retina decline with age.

  15. Ros says:

    Hi drjohn,

    Would you be prepared to give an opinion on Deciem’s NIOD products, in particular the Copper Amino Isolate Serum (see link below):
    http://niod.com/product/copper-amino-isolate-serum-1pct-15ml

    Is this safe to use? I have a vague memory of reading about dangerous human growth factors in cosmetics/skincare, and the potential risks involved in stimulating epithelial cell growth. Please forgive my ignorance but do copper peptides increase cell turnover, and is this dangerous?

    Many thanks for your time and attention.

    Ros

    • drjohn says:

      Gly-His-Lys (GHK) and their copper complexes, are physiologic (occur naturally in humans) and have demonstrated anti-inflammatory and antioxidant effects. Effects on wound healing, tissue repair and skin inflammation have been demonstrated – possibly mediated through stem cells and their paracrine secretions (growth factors). GHK has a strong affinity for copper. The GHK-Cu complex is found in human plasma. But the unbound GHK is fully functional on its own. As you may know, there is considerable controversy concerning copper peptides whether slathering the copper bound variety is necessary, or even harmful. Many people report copper peptide “uglies” which could relate to this factor (the copper bound variety is NOT natural to skin). Both GHK and GHK-Cu are quite polar and absorption through the epidermis is minimal. Copper peptides do stimulate fibroblasts to produce more collagen, but they do so indirectly by affecting of number of regenerative cytokines. It is not a “single growth factor” treatment like EGF in isolation. GHK is not directly mitogenic, and is not associated with cancer. In fact it has positive effects on caspase, growth regulatory, and DNA repair genes that are associated with cancer suppression.

      The only issue I have with copper peptide is the copper part. The GKH part is clearly associated with many of the same good things as mesenchymal stem cells cytokines and growth factors.

      Having said all this I notice that this company puts low molecular weight HA into its cu-GHK product. I would stay away from this (sends all the wrong biosignals) and look for a different source.

      Hope this helps, Ros.

  16. Ros says:

    Thank you very much for getting back to me on this, drjohn, with your thorough, detailed reply. I am no scientist, and struggle a bit with some of the technicalities, so may I just ask for some clarification on a couple of points, please – what do you mean by “Having said all this I notice that this company puts low molecular weight HA into its cu-GHK product. I would stay away from this (sends all the wrong biosignals) and look for a different source.” Why are the biosignals wrong?

    This company’s treatment consists of two separate applications to the skin, the first being the copper amino isolate serum, followed by the HA. Is it the HA in conjunction with the copper serum that worries you? So would using the copper amino isolate serum alone be all right? I must admit I worry about using something which allegedly keeps the skin in a heightened state of repair (see quotation below from the company’s founder):

    ‘Copper peptides heighten your skin’s repair mechanisms all the time even when nothing seems really wrong that needs repair. The fact is that something is always wrong. It’s the small bits of ongoing oxidation, pollution, physical trauma (including acids, peels, scrubs and all sorts of really bad things that people do to their skin for “anti-ageing” purposes), metabolism by-products, advanced glycation end-products (AGE), etc that are always “wrong” and this heightened state of repair simply means your skin can deal with these small bits better all the time.’

    Is this really a good idea?

    Finally (I promise), I’m interested that you say some people report “uglies” as I wanted to ask you about something I read online, that copper peptide treatment for skin can lead to deep, hidden skin damage becoming visible – in other words, the “uglies” you mention – is that plausible? If so, I don’t want to risk that potential effect.

    Thank you so much for your time and expertise, and patience with those of us not well versed in matters scientific.

    Ros

    • drjohn says:

      “Heightened state of repair” includes both increased proteins and increased proteinases.I think that is great for diabetic wound healing (which needs a bit on an inflammatory kick to s=get started) but not sure how that translates to daily topical application. Is it inflammatory, or anti-inflammatory? What is the balance between building and tearing down matrix molecules? Maybe all this “depends”. Maybe that is why starting small and sneaking up helps, because you are building a defense against it. But why apply things to skin that require defensive responses? Is that good in the long run – to be chronically on defense? I wonder along with you. Uncovering deep hidden damage? Or causing deep hidden skin damage? Or curing deep hidden skin damage? or all of the above??

      • Ros says:

        Apologies, drjohn, for not responding sooner to this – I hadn’t checked the site for a while. Thank you for dealing with my concerns about using the NIOD/Deciem copper amino isolate serum (CAIS), I really appreciate your sharing your expertise and bothering to spend time trying to enlighten scientific ignoramuses like me. NIOD are offering a one-off special offer on CAIS plus their Multi Molecular Hyaluronic Complex (MMHC), but maybe I’ll forego this opportunity. I don’t really want to send my skin into skin cell renewal hyper-drive. I’ve noticed a change in my attitude over the last few months – I just turned 61, I love the products I normally use, my skin’s looking pretty decent for my age, and I don’t want to become hooked on pseudo-scientific products, however cutting edge, just to fend off the natural process of ageing. Trying to prevent the ageing process can so easily become an obsession, and there are more important things in life to care about, it seems to me. NIOD/Deciem claim they are on a global mission to revolutionise the beauty industry, which may well be a laudable goal, given the amount of downright nonsense perpetrated on consumers, but they’re too high-tech for me, too Brave New World for comfort. I could be wrong, but I’ll take that risk, as opposed to the risk of using products that may cause undesirable effects.

        Thanks again.

        Ros

  17. Kenneth Hurwitz MD says:

    Very informative website. When and where can I attend a training session?
    Thank you.

    • drjohn says:

      Hi Dr. Ken. Sorry for the delayed response. We just opened a research clinic in Newport Beach, CA. We had our first professional training session last week (topic: laser vaginal rejuvenation) and plan to sponsor many more. We have relationships with a number of aesthetic device manufacturers, and are engaged in protocol research on our own topical growth factor (etc) product line, both standalone as as adjuncts to energy-delivering procedures. While we are on the West Coast, we do have some key colleagues in Florida (Fort Lauderdale) who partner with us in research and who may also be doing training in the future. Meanwhile we are also giving academic presentations at many aesthetics trade shows in the U.S. and abroad. Sometimes these are sponsored by our joint venture partners. Watch for Dr. George and Dr. John. – we are doing a lot of speaking & demos this coming year.

  18. Stephanie says:

    Could you please tell me your opinion behind DNAskin’s DNA cryostem therapy?

    • drjohn says:

      They don’t even list product ingredients on their website. Shame on them. But it is filled with pseudoscientific gobbledegook, so i would speculate that science took a holiday with this company. And a really crappy old fashioned do-it-yourself web site – so bad I would tend to dismiss the whole mess. Oh, and they rely on “celebrity endorsements”. Companies with no real science tend to do that. Overall I give them an F.

  19. Carrie Griffith says:

    I very much appreciate your openness on this site and your willingness to offer information to consumers. Thank you. In a post, you listed the source of growth factors in AnteAge as bone-marrow adult (youth) stem cells. Can you please clarify how these cells are collected? I unwittingly was using a Neocutis product until I happened to do some research on the origin of its PSP. In the future I would like to be certain that any skin care product to which I might be recommended was not developed at the expense of harming or destroying a living human (in this case, unborn) person. (Though Neocutis informs the public that the male fetus in question would not have been born viable in any case, there are ethicists who question whether just one child was destroyed in developing the product.) I understand not everyone has such qualms, but I hope you can appreciate that there are those of us who would rather have wrinkles than use a beauty treatment that was developed by causing harm to another human being. All that being said, in the interest of transparency would you be so kind to inform me then the source of the stem cells used in your research for Cellese? Thank you.

    • drjohn says:

      Carrie – We agree with your ethical concerns. We have approached the company you mention at trade shows and asked their sales people “where do these proteins come from?”. They hem and haw and pretend they don’t know. They hide the information, make it very hard to find. Seems like they are ashamed.

      AnteAGE contains cytokines and growth factors derived only from carefully screened and selected paid adult human volunteers, with informed consent. The average age of donors is 22 years old (typically college students). Taking a marrow sample is not much different than drawing blood (local anesthetic is used) – and it is a renewable resource, so no harm is done! The stem cells are sourced and processed by the same highly expert medical labs that harvest bone marrow for transplantation.

      We have no idea why others in the industry continue to pursue growth factors from fibroblasts which are harvested from fetal tissues or baby foreskins (waste tissue of circumcision). The truth is that fibroblasts are very poor producers of regenerative biochemicals, as compared to stem cells. Mesenchymal stem cells from bone marrow make 10-50 times as much of these growth factors as fibroblasts!

      We also have issues with medical waste products being used to source stem cells to derive growth factors for products. In particular, liposuction. Yes, it is cheap (the donors are paying to have liposuction rather than being paid for their tissues / cells) but the average donor age is then 50+ years. That makes a difference in terms of the growth factors being produced. And because of the way they are harvested – they also tend to mix in a lot of adipose precursor (i.e. white fat) cells that are producing the wrong growth factors (e.g. leptin – associated with inflammation and cancer). Here the ethical issue is one of adding risk (to the end user) in order to make more profit for the company (they charge more than AnteAGE, not less, despite the use of far cheaper / free medical waste materials.

  20. Lisa says:

    Can you give your scientific opinion on the Rodan & Fields product lines? I have been asked to use it but heard from my kids pediatrician that the Proactive isn’t worth spending your money on so how is their MLM products any different? Are there any pro or cons to using any of their products?

    Thank you!

    • drjohn says:

      I am going to agree with your kid’s pediatrician. I can see nothing special at all about the products. I think the derms named in the brand are good marketers but are not hard core scientists.

      I tend to be a bit suspicious about any product being fronted by a pretty face (or two). If the science is good, you shouldn’t need celebrities or personalties. If you want a face how about my wizened mug on the front – that way you will know majority of dollars got spent on research and science not marketing and fluff.

  21. Rachael says:

    I am so glad I found you guys and I am very grateful for sharing your knowledge!

  22. Dear Doctors,

    I started using one of the most highly reputable 50 years old European skin care line littered with international awards for scientific research and innovations in the field of skin care. One of their advanced serums that I massage into the skin is a combo of HMW and LMW HA. I was reading your site in connection with microneedling and topical products to use and not to use with it when I came accross your opinion on LMW HA. I am just an esthetician, not a Doctor or a scientist and I am at a loss, I just refuse to believe, that their product would be metodically used to create all the terrible things you describe LMW HA does. Please read the description of the product below:

    Best regards, Tatyana

    BI-ACTIVE HYALURONIC CONCENTRATE
    Anti-age serum
    Highly concentrated formula based on the combination of hyaluronic acid with high and low molecular weights and a multilamellar ceramide complex that contribute to complete overall hydration and restructuring of facial skin.

    Protects the skin against the formation of wrinkles leaving it soft.
    Prevents the loss of suppleness in the skin providing it with hydration.
    Regenerates the stratum corneum avoiding water loss.

    It consists of the following ingredients:

    Hyaluronic Acid with high molecular weight. Film-forming agent that avoids water loss. It provides the skin with hydration and smoothness.

    Hyaluronic Acid with low molecular weight. Innovative molecule capable of penetrating the dermis. It works on detoxification and cellular adhesion mechanisms as well as on the suppleness and firmness of the skin, while reducing roughness and depth of wrinkles.

    Multilamellar Ceramide Complex. A mixture made up of different ceramides that play a key role in the regeneration of the stratum corneum, as well as in avoiding the loss of transepidermal water.

    It provides the skin with deep hydration, a diminishment of wrinkles, suppleness and firmness, softness and smoothness.

    The Bi-Active Hyaluronic Concentrate has a gentle and velvety touch.

    It is suitable for dry, dehydrated skin.

    It is compatible with any skin type.

    Dermatologist-tested.

    • drjohn says:

      These guys wouldn’t be the first to fail to consider the real science. Here are several recent abstracts of peer-reviewed studies in highly respected journals:

      Wounds. 2016 Mar;28(3):78-88. Hyaluronic Acid in Inflammation and Tissue Regeneration.

      Abstract
      Hyaluronic acid (HA), the main component of extracellular matrix, is considered one of the key players in the tissue regeneration process. It has been proven to modulate via specific HA receptors, inflammation, cellular migration, and angiogenesis, which are the main phases of wound healing. Studies have revealed that most HA properties depend on its molecular size. High molecular weight HA displays anti-inflammatory and immunosuppressive properties, whereas low molecular weight HA is a potent proinflammatory molecule. In this review, the authors summarize the role of HA polymers of different molecular weight in tissue regeneration and provide a short overview of main cellular receptors involved in HA signaling. In addition, the role of HA in 2 major steps of wound healing is examined: inflammation and the angiogenesis process. Finally, the antioxidative properties of HA are discussed and its possible clinical implication presented.

      ACS Biomater Sci Eng. 2015 Jul 13;1(7):481-493. High and low molecular weight hyaluronic acid differentially influence macrophage activation.
      Abstract
      Macrophages exhibit phenotypic diversity permitting wide-ranging roles in maintaining physiologic homeostasis. Hyaluronic acid, a major glycosaminoglycan of the extracellular matrix, has been shown to have differential signaling based on its molecular weight. With this in mind, the main objective of this study was to elucidate the role of hyaluronic acid molecular weight on macrophage activation and reprogramming. Changes in macrophage activation were assessed by activation state selective marker measurement, specifically quantitative real time polymerase chain reaction, and cytokine enzyme-linked immunoassays, after macrophage treatment with differing molecular weights of hyaluronic acid under four conditions: the resting state, concurrent with classical activation, and following inflammation involving either classically or alternatively activated macrophages. Regardless of initial polarization state, low molecular weight hyaluronic acid induced a classically activated-like state, confirmed by up-regulation of pro-inflammatory genes, including nos2, tnf, il12b, and cd80, and enhanced secretion of nitric oxide and TNF-α. High molecular weight hyaluronic acid promoted an alternatively activated-like state, confirmed by up regulation of pro-resolving gene transcription, including arg1, il10, and mrc1, and enhanced arginase activity. Overall, our observations suggest that macrophages undergo phenotypic changes dependent on molecular weight of hyaluronan that correspond to either (1) pro-inflammatory response for low molecular weight HA or (2) pro-resolving response for high molecular weight HA. These observations bring significant further understanding of the influence of extracellular matrix polymers, hyaluronic acid in particular, on regulating the inflammatory response of macrophages. This knowledge can be used to guide the design of HA-containing biomaterials to better utilize the natural response to HAs.

      Cytokine. 2014 Dec;70(2):97-103. Low molecular weight hyaluronan mediated CD44 dependent induction of IL-6 and chemokines in human dermal fibroblasts potentiates innate immune response.

      Abstract
      Complex regulation of the wound healing process involves multiple interactions among stromal tissue cells, inflammatory cells, and the extracellular matrix. Low molecular weight hyaluronan (LMW HA) derived from the degradation of high molecular weight hyaluronan (HMW HA) is suggested to activate cells involved in wound healing through interaction with HA receptors. In particular, receptor CD44 is suggested to mediate cell response to HA of different MW, being the main cell surface HA receptor in stromal tissue and immune cells. However, the response of dermal fibroblasts, the key players in granulation tissue formation within the wound healing process, to LMW HA and their importance for the activation of immune cells is unclear. In this study we show that LMW HA (4.3kDa) induced pro-inflammatory cytokine IL-6 and chemokines IL-8, CXCL1, CXCL2, CXCL6 and CCL8 gene expression in normal human dermal fibroblasts (NHDF) that was further confirmed by increased levels of IL-6 and IL-8 in cell culture supernatants. Conversely, NHDF treated by HMW HA revealed a tendency to decrease the gene expression of these cytokine and chemokines when compared to untreated control. The blockage of CD44 expression by siRNA resulted in the attenuation of IL-6 and chemokines expression in LMW HA treated NHDF suggesting the involvement of CD44 in LMW HA mediated NHDF activation. The importance of pro-inflammatory mediators produced by LMW HA triggered NHDF was evaluated by significant activation of blood leukocytes exhibited as increased production of IL-6 and TNF-α. Conclusively, we demonstrated a pro-inflammatory response of dermal fibroblasts to LMW HA that was transferred to leukocytes indicating the significance of LMW HA in the inflammatory process development during the wound healing process.

  23. Ryan says:

    Hi John, first let me say thank you for the amount of quality information you provide on this website such a nice change to actually know what I’m reading is scientifically backed up rather than wasting money on products and getting no real results. I decided to start investing a lot more of my money in skincare to try and resolve my prematurely aged facial skin at the age of 23 I unfortunately have very thin eye skin which shows clear purple veins, under eye lines/crows feet, sagging skin and deep mid face lines. I purchased the Ante Age Serum + Accelerator from swedishface.co.uk as its the only site that delivers to the UK and have begun using it can I just ask if there is any specific way to enhance the effectiveness of your product and make sure it gets fully absorbed? maybe by a certain application method or prepping the skin in a way.. How long after the serum do I apply the accelerator? and is the combo suitable for use straight after dermarolling? I appreciate in advance any advice you provide me with and really hope I see some results so I can stick with your products 🙂 All the best

    • drjohn says:

      Hi Ryan, we will soon be in in the UK officially. The AnteAge products are designed for easy absorption using nanoliposomal technology. Wet tell people to wait a minute or so (as long as it takes to brush your teeth) after applying serum to apply accelerator. We do not recommend using it or any other product not specifically designed for microneedling) right after needling. That’s because non-native (to humans) molecules present in almost all products can acause allergic reactions when needled into skin. You need to wait at least several hours. We make a product called AnteAge microneedling solution designed to use during and right after microneedling. It is “all human native” in composition. Human growth factors & HA. It’s very popular here in the U.S. If you write me at docs@barefacedtruth.com I will try to find a way to get you some.

  24. Jenny says:

    Did you by chance write “Clinical Applications of Cytokines and Growth Factors” or is that another Dr John and Dr George?

    • drjohn says:

      Jenny, that looks like a text by another DrJohn and DrGeorge. But it does remind us we need to do a textbook. So much has happened in that past few years. I think we will restrict ours to “Clinical Applications of Cytokines and Growth Factors in Dermatology and Aesthetics”.

  25. rebekah hammerlund says:

    Hello,

    I am on yet another research quest regarding rosacea and have spent some intriguing time on bft. I do not want a life on doxycycline. I just ordered the AnteAGE system and THEN saw your comment about a discount for bf readers. Is it too late for me to be considered for a discount?

    Thanks much for all your work,

    Rebekah

    • drgeorge says:

      It is never too late for our BFT friends: at check out use the coupon code: bftfriend and receive a 30% discount off your purchase.

  26. Chavy says:

    What are your thoughts on these copper infused textiles purported to provide anti-aging benefits? They claim that the copper oxide is clinically proven to improve appearance of skin but I couldn’t find anything on pubmed so I wanted to check with you guys over here on BFT before buying! Is there any evidence to back up their products? Thanks in advance!

    • drgeorge says:

      Chavy, your B.S. meter is working well and BFT applauds you for skepticism regarding anti-aging benefits of copper infused textiles. Snake oil all the way. There is, however, substantial proof of efficacy of copper oxide in fabrics imparting significant anti-microbial benefit. In fact, there are several metals whose oxides and ions help combat bacterial growth, of potential benefit in preventing the spread of “super bugs” in medical settings.

      From the article cited below: “Textiles can provide a suitable substrate to grow micro-organisms especially at appropriate humidity and temperature in contact to human body. Recently, increasing public concern about hygiene has been driving many investigations for anti-microbial modification of textiles. However, using many anti-microbial agents has been avoided because of their possible harmful or toxic effects. Application of inorganic nano-particles and their nano-composites would be a good alternative. This review paper has focused on the properties and applications of inorganic nano-structured materials with good anti-microbial activity potential for textile modification. The discussed nano-structured anti-microbial agents include TiO2 nano-particles, metallic and non-metallic TiO2 nano-composites, titania nanotubes (TNTs), silver nano-particles, silver-based nano-structured materials, gold nano-particles, zinc oxide nano-particles and nano-rods, copper nano-particles, carbon nanotubes (CNTs), nano-clay and its modified forms, gallium, liposomes loaded nano-particles, metallic and inorganic dendrimers nano-composite, nano-capsules and cyclodextrins containing nano-particles. This review is also concerned with the application methods for the modification of textiles using nano-structured materials.”

      Biocidal textiles can help fight nosocomial infections

      http://www.medical-hypotheses.com/article/S0306-9877(07)00568-3/abstract?cc=y=sings/

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