This “revolutionary” non-acid peel has received almost universal acclaim within the cosmetic blogosphere; the reviews on Sephora and YouTube are also glowing at the very least. With this much press and excitement, I figured it’s time to see if the ingredients have any tangible documentation to substantiate the overwhelmingly positive responses.
From a brief glance at the ingredients, this product may in fact be a bit revolutionary. Here’s why:
L-Carnitine Ingredient Profile : A Sebum Regulator?
Like many topical ingredients, L-carnitine has been shown to have antioxidant capabilities. They include: the scavenging of multiple types of reactive oxygen species (ROS), free metal ion chelation, and in vitro was shown to have an overall higher antioxidant capacity than vitamin E in terms of inhibiting the lipid peroxidation of linolenic acid. However, as much of these haven’t been demonstrated in topical clinical studies, to say that L-carnitine is more proven in terms of efficacy than vitamin E, would be an egregious and lazy conclusion.
But regardless of that, the most exciting characteristic of this ingredient has only been recently elucidated. In a study published in March of 2012, it was shown in vitro AND in vivo (in animal models) that L-carnitine is able to “effectively reduce sebum secretion in human skin!”
The study used 0.5% and 1.0% of L-carnitine in vitro to ascertain the mechanism of action, which was shown to be an affectation of the β-oxidation rates of fatty acids in human sebaceous cells: the experimental sebaceous cells (SZ95) exhibited “a significant concentration-dependent increase in β-oxidation compared to control cells,” which manifested with significantly reduced concentrations of intracellular lipids.
The same study then proceeded to do permeability studies of L-carnitine. The results suggest that unknown (though apparently efficacious) amounts of L-carnitine were able to reach the dermis, which is a good indication of clinical relevancy and efficacy. Therefore, to further substantiate these results, a vehicle-controlled, randomized, three week in vivo study was done on pig skin, which is physiologically similar to that of humans. At 2.0%, L-carnitine was shown to significantly decrease sebum secretion rates, when compared to treatment with vehicle.
While clinical human studies are necessary to further affirm these preliminary results, as someone with a very oily skin type, I can’t deny that I’m thoroughly intrigued. And since this ingredient is listed right after water, it’s likely that a much higher than 2% concentration is included! It wouldn’t be absurd to imagine that a 15% concentration is present.
I don’t know about you, but this is all very, VERY exciting news! As of right now, the only ingredient that’s been proven to significantly reduce sebum secretion is isotretinoin; and that only occurs via oral administration. Imagine if something that’s available OTC in topical form can achieve even a fraction of those results!
Now, there are a few potential caveats. One of which, is the claim that L-carnitine can increase the generation of free radicals. This study has been mentioned by some to support the disuse of L-carnitine in skin care products. However, there are a few things that need to be clarified. First, the study was about oral L-carnitine supplementation, not topical. Second, the study concluded that “oral L-carnitine supplementation results in an increase of long-chain fatty acid oxidation,” NOT that there was a direct generation of ROS like hydrogen peroxide.
So where does this free radical generation claim come from? To understand this, we need to understand what the study means by “long-chain fatty acid oxidation.” And the explanation really isn’t that complicated. (Yay!) This is simply referring to a form of cellular respiration, which is the process that ALL aerobic organisms (that includes us!) go through in order to um, EXIST! It is the process by which oxygen and bionutrients (such as carbs, fats, and proteins) are converted to energy in the form of adenosine triphosphate (ATP). Sound familiar? This is high school biology all over again!
While carbohydrates like glucose go through glycolysis, fatty acids instead go through β-oxidation. Have you seen that term before? Yep, it was mentioned in the first cited study above. β (Beta)-oxidation is rather complicated to explain, but it basically splits the long carbon chains in fatty acids and converts them to acetyl CoA, which then goes into the Krebs cycle. This is the biochemical step where both carbohydrate and lipid metabolism converge. From the Krebs cycle, the generated compounds NADH and FADH2 undergo oxidative phosphorylation via electron transport chains in mitochondria to form ATP. It is THIS final step that forms a surplus of free radicals.
So to draw the discussion back on topic, does this mean you shouldn’t use L-carnitine in skin care? Absolutely not. Yes, a slight increase in free radicals will occur from topical L-carnitine application. However, this free radical generation is going to occur anyways! You can’t and wouldn’t want to stop the process of cellular respiration! The benefits significantly outweigh any potential drawbacks. If I have to slightly increase the total free radical content in my skin in order to decrease sebum secretion, I’m all for it!
From a cosmetic point of view, not having super oily skin could reduce a lot of hassle: I wouldn’t have to worry as much about blotting, touching up, and taking extra steps to ensure my face stays put. From a dermatological point of view, less sebum means being less prone to breakouts, clogged pores, and seborrheic dermatitis (among other things); all of which, can cause free radical generation as well, and likely more compared to the little that comes from L-carnitine application. It’s a sacrifice that I’d be willing to accept, assuming that L-carnitine actually works to reduce sebum secretion.
All in all, the inclusion of so much L-carnitine is probably the most attractive and singularly appealing characteristic of this product.
Urea: A non-acidic chemical exfoliant?
The available studies suggest that at low concentrations, urea is an excellent water-binding agent, similar to hyaluronic acid. In this study, 10% urea cream demonstrated increased skin hydration and a reduction in scaling of the stratum corneum, which also suggests some type of exfoliative action. However, nothing is explicitly stated. Also, it’s important to note that this study was not vehicle-controlled, so another ingredient’s effects could have elicited this positive change.
In another study however, 40% urea was shown to be quite effective (and more so than 12% ammonium lactate, which likely converted to lactic acid) at alleviating moderate to severe xerosis or dry skin (by reducing skin roughness, fissure thickness, and overall dryness). This study supports the claim that at high concentrations, urea is an excellent ingredient to combat dry skin by increasing water content and surface elasticity.
As the third listed ingredient, this is likely present around 10%, though of course this is all theoretical guesswork.
Gluconolactone: A polyhydroxy acid
Polyhydroxy acids tend to be slightly less effective and less irritating than alpha hydroxy acids like glycolic acid, while possessing other qualities such as increased humectancy and being mildly antimicrobial. This ingredient was discussed in Part II of the series on hydroxy acids.
Overall, it is basically a milder form of glycolic acid that may also be effective against some forms of bacteria such as P. Acnes. Me likely!
CM-Beta Glucan: More Yeast?
The last ingredient that’s present in higher amounts than the chosen preservative phenoxyethanol, which typically is present at <0.1% in topical preparations, is the salt form of a glucan derived from the cell wall of yeast cells. There is limited evidence suggesting that this has the antioxidative capacity of reducing UVA irradiation-induced immunosuppression, by acting as a non-specific immune-stimulator. The same study also suggests that CM-beta glucan encourages keratinocyte proliferation, meaning that it enhances the renewel rate of the stratum corneum. Both attributes were demonstrated via placebo-/vehicle-controlled experiments.
Granted, there are several mitigating aspects to this study (such as the lack of blindness and more specific test parameters; and that this was an open-labeled study done by a commercial entity). And combined with a lack of corroborating evidence, it’s best not to place too much value on this ingredient. It’s inclusion is still a beneficial move, though.
While both hydrolyzed roe (fish eggs) and maltodextrin are present in very high concentrations, they have no evidence supporting efficacy. It’s likely that they act as water-binding agents.
Dimethylaminoethanol (DMAE): Skin Firming or Not?
This ingredient usually occupies one of the upper slots on the ingredients list of Perricone MD products. Here however, it is listed after the preservative, indicating that it’s present in very low concentrations.
While its inclusion does warrant some discussion, in the context of this product, the presence of DMAE is most likely irrelevant. Please see the Ingredient Profile on DMAE for more information.
***Note that while hyaluronic acid and phosphatidylcholine are both excellent water-binding agents and will increase skin hydration and membrane integrity, because they are present in such low concentrations like with DMAE, their inclusion is most likely irrelevant.
***Also note that the phosphatidylcholine content will not convert to choline, and then acetylcholine because the enzyme responsible for the first metabolic step (phosphatidylethanolamine N-methyltransferase) exists only in the liver.
Menthyl Lactate: An oxymoron?
Some claim that menthol is a potent irritant, and that may be true. However, it really just depends on the individual. What may be potent to someone may be mild or nonexistent to another.
As written about rather extensively in the Spotlight On: Menthol post, this ingredient was shown to be an excellent chemical penetration enhancer that’s used in multiple pharmaceutical drugs. It does so by extracting lipids, which can lead to increased dryness. Finally, it was shown that despite being a counter-irritant, the “inflammation” that occurs from menthol is not the same as what you’d see for example, with a pimple. In fact, studies indicate that menthol may even be anti-inflammatory in that regard. In vitro, it has been shown to inhibit the production of inflammatory prostaglandins (both lipooxygenase and cyclooxygenase pathways) and interleukin-1 cytokines.
As I wrote in the cited ingredient profile, “Menthol is just another ingredient that cosmetic manufacturers like to use in an attempt to trick the consumers into believing the misguided notion that, ‘If it’s burning/stinging/tingling, it must be working.’ Fortunately, it does also act as a very effective penetration enhancer. While it has proven benefits (and risks) for those having chronic pain and/or itch and has been widely recommended by dermatologists; for the average consumer, it’s really a matter of personal choice. It’s all about achieving maximal penetration and minimal irritation.”
So menthol can be a good or bad thing depending on the individual, which is why I delegated this ingredient to the “Neutrals” section.
***Note that while menthol isn’t present in very high concentrations, unlike the other ingredients enumerated above, it doesn’t take much to have a considerable effect.
There’s no ingredient present that’s all or mostly bad.
This is packaged in a medicinal-like dropper bottle. While I would prefer tube or pump bottle packaging, most of the important ingredients are rather stable in the presence of air.
Blue Plasma Conclusion:
Overall, like I noted above, this product is a bit revolutionary or at the very least, unique! It includes a rare blend of ingredients that all act towards a similar goal.
The inclusion of high concentrations of milder chemical exfoliants (urea, gluconolactone), water-binding agents (urea, gluconolactone, hydrolyzed roe, malodextrin), and of course the potentially sebum-reducing L-carnitine, makes this product an excellent and interesting choice for sensitive, and oily (but flaky) skin types, especially those that are suffering from conditions like seborrheic dermatitis (as the condition is characterized by all three attributes)!
Even someone like me, who has a very structured and well-thought out routine, is tempted to try this product (particularly to see the effects of L-carnitine). I’d love to measure how it holds up against the glycolic and salicylic acid products in my current routine. (I know, I know my current routine has not been updated).
Anyways in a word: LOVE the research behind the unique combination of ingredients included in this product. If you’ve tried this, PLEASE let me know your experience!
Thank you for reading and feel free to comment below!
PS = [[[PIS - 0] x WIC] x 100%
PS = [9.25/10 x 3/3] x 100%
PS = .925 x 100%
PS = 92.5%
AS = A
Check the Product Review Rubric for a full explanation on how I rate products.
Water, Carnitine, Urea, Hydrolyzed Roe, Maltodextrin, Gluconalactone, Sodium Carboxymethyl Beta-Glucan, Xanthan Gum, Phenoxyethanol, Capryl Glycol, Phosphatidylcholine, Menthyl Lactate, Hyaluronic Acid, Disodium EDTA, Dimethyl MEA, Magnolia Officinalis Bark Extract, Pterocarpus Marsupium Bark Extract, PEG-7 Glyceryl Cocoate, Carrageenan/Chrondus Crispus, Aloe Barbadensis Leaf Extract, Zinc Gluconate, Magnesium Aspartate, Sorbic Acid, Subtilisin, Copper Gluconate, Citric Acid, Blue 1 (CI 42090).
The texture is a very thin serum that leaves behind a slightly tacky finish, which becomes smooth after a few minutes. Similarly, the product itself leaves behind a slightly fishy smell due to the hydrolyzed roe (fish eggs) content, which dissipates soon thereafter as well.
Now, because this contains a polyhydroxy acid, you may wonder whether or not you have to wait a certain amount of time between application–something that I recommend doing for glycolic and salicylic acid products. Fortunately, because urea and gluconolactone are the main exfoliating agents, you don’t have to wait as long between applications since they operate at less acidic ranges compared to traditional hydroxy acids. However, I’d still recommend waiting about 10-15 minutes, depending in-part on how long it takes for the finish to become smooth.
As for my thoughts on the efficacy of this product, after trying it three times, I must say that I’m really enjoying it. It leaves my skin quite soft (though a tad dry, but not flaky), and does to an extent, seem to make my skin less oily throughout the day. The best part is that its very gentle exfoliating action makes my skin look very even, due to a lack of irritation.