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Clarification on Obagi please.

Ask about Obagi Skin Care and get answers from licensed Obagi skin care specialists and Obagi users from the community.

Clarification on Obagi please.

Postby MissJ521@aol.com » Fri Feb 22, 2008 3:56 pm

Clarification on Obagi please.

First, I'd like to mention there are 2 key prescription products for skin care:

1: Retin A (tretonin) prescription
2: Hydroquinone 4%, (e.g. Solaquin forte with sunscreen) prescription

I've noticed that the Obagi program relies on the person using those prescription products. I don't understand how Obagi isolates how good it is in it's own right when the program seems to be contingent on using those 2 key prescription products and the 2 key prescription product do have demonstrated efficacy.

Does Obagi have it's own product with tretonin in it and is it a prescription? Same with 4% hydroquinone; 4% is prescription strength or is just something one uses with those prescription products? If it's the latter, how do you differentiate the skin improvements from the prescription products from those of the Obagi products when they are used together? That's the part I don't understand.

For example: I use the 2 key prescription products along with some Vitamin C solutions I make myself and then some simple low cost moisture cream and exfoliate daily so I'm not in need of a peel. My prescription skin care products seem to be compatible with a variety of other over the counter products I could purchase or even make myself if I wanted to. I don't attribute the skin improvements to the cheap moisturizer I use but rather to the prescription products. It just seems to me that the Obagi product line piggy backs on the prescription products known to work.

That said, what does the Obagi system do when one is not using the prescription products along with it?
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Postby KadeeBelleMD » Fri Feb 22, 2008 6:30 pm

Hi MissJ,

Hope you don't mind me cutting in here. I am trained in the advanced obagi techniques, and work with the line daily for our non-surgical, and surgical patients (I work for a dual board cert. facial plastic surgeon). Also having a B.S. in chemistry helps with my skin care knowledge and background.


You pose very good points. I often laugh that Dr. Obagi could have called his system hydroquinone, as many of his products have this prescription ingredient. And, of course his Nu Derm and Condition & Enhance System (non-surgical and surgical systems) employ tretinoin as an active ingredient.

But, to respond to your question, it has been clinically proven (clinical trail groups with 3,000 people, so no small finding) that using the full system vs. using either tretinoin or hydroquinone increases that drug's efficacy by 2 to 3 (either or both, respectively) times.

That is no small finding, in my opinion and of many other clinical practitioners.

As a chemist, my next question was how is this possible?

FOAMING GEL/gentle cleanser: pH balanced for the skin, without soap properties, to remove superficial dirt/sluffing keratonocytes.

TONER: THIS toner, and this toner only drops the pH of the skin to aid in depth of penetration and even penetration (it actually decrease the tensile strength of the skin's upper stratum corneum--- how cool is that?!) And, it's non-drying as it has no alcohol component.

OBAGI's professional VIT C serum: clinically tested against leading vit c serums, and was shown (skin biopies) to have 2x the depth of penetration and stability!

CLEAR: upper epidermal "bleaching agent." It selectively targets melanocytes that have an accelerated production of tyronsinase, which stimulates melanin product. So, it doesn't bleach all melanocytes evenly, only your over active ones. (obviously, it's key ingredient being 4% hydroquinone) The difference between this and a generic prescription for 4% hydroquinone is the delivery mechanism of clear.

Exfoderm/Exforderm forte: enhances exfoliation, as exforderm main ingredient is phytic acid, and forte's is glycolic (6%). The forte being better for thicker skin, or more resistent skin.

BLENDER: LOWER epidermal beaching agent (vs. clear- that's why they have you use two different products). This is why you blend it with the tretinoin as well- you want maximum depth of penetration of BOTH. (delivery mechanism, once again, which I can explain if someone really wants to know).

SUNFADER: superficial epidermal bleaching agent, so that's why some patients use this to see results "faster" or... maintain results. As, when you are done with the system, sometimes only touch-up maintenance is required, and some can get away with the blender/tretinoin and sunfader.

OBAGI sunscreen differences: the physical block is great for post-procedure patients as it truly a "block." It has 18% zinc oxitate, so the strongest possible physical block. The healthy skin is a spf 35, and the obagi-c rx is a spf 30, both with UVA and UVB protection, AND they both have the deepest depth of protection over any other suscreen on the market at 285-390 nm. awesome.... makes me addicted, that's for sure.


So, MissJ, I hope this better helps you understand why the OBAGI nu-derm/C&E systems aid greatly in the efficacy of retin a and hydroquinone. every product has a physiological function, which is impressive. I know the temptation to mix and match is there, i'm guilty myself at times, but truly looking at the science and amount of data to support the chemistry makes obagi a truly impressive skin care line.

Best,

M
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Re: Clarification on Obagi please.

Postby KadeeBelleMD » Fri Feb 22, 2008 6:38 pm

A few other points not in my original response that I will address:



MissJ521@aol.com wrote:Clarification on Obagi please.


Does Obagi have it's own product with tretonin in it and is it a prescription?

Same with 4% hydroquinone; 4% is prescription strength or is just something one uses with those prescription products? If it's the latter, how do you differentiate the skin improvements from the prescription products from those of the Obagi products when they are used together? That's the part I don't understand.

That said, what does the Obagi system do when one is not using the prescription products along with it?


1. Yes, OBAGI does make a tretinoin product, but it's not mixed with any delivery system, so a prescription filled at any pharmacy is the same. So, either will suffice.

2. well, I did explain the differences in the 4% hydroquinone products that OBAGI makes, so I would stick with those. a generic prescription would not be the same.

3. What does the product do without the hydroquinone and retin a? Well, besides just being a great cleanser (subjective, I suppose) and a efficient toner allowing for better penetration of other ingredients, such as vit c or exfoderm, the nu-derm system is based on making prescription strength hydroquinone and tretinoin better at it's job. That's the true beauty of the system.

Best, M
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Postby MissJ521@aol.com » Fri Feb 22, 2008 7:36 pm

Thank you Kadee,
Your answers have helped me further refine my question.


KadeeBelleMD wrote:Hi MissJ,

it has been clinically proven (clinical trail groups with 3,000 people, so no small finding) that using the full system vs. using either tretinoin or hydroquinone increases that drug's efficacy by 2 to 3 (either or both, respectively) times.


So it was clinically proven that what you refer to as the "full system" was compared to using EITHER tretinoin OR hydroquinone alone? Did they look at using tretonin and hydroquinone together and compare that to using both together plus the obagi 'other stuff'? For example tretoinoin and hydroq. used together increase each other's efficacy and of course there are other products or actions that would tend to act synergistically to increase the efficacy of those 2 scripts.

For example, exfoliation techniques or products would tend to let the scripts absorb more thereby increasing efficacy as would things that lowered the ph of skin slighly while they are being applied. Although I understand the 'science' of it all, (I'm an MIT grad), that's why I have the questions I do as to whether ONLY the obagi products would increase the efficacy of the 2 main scripts. For example:


KadeeBelleMD wrote:FOAMING GEL/gentle cleanser: pH balanced for the skin, without soap properties, to remove superficial dirt/sluffing keratonocytes.


Soap properties are alkaline. So it stands to reason not to use an alkaline product to remove superficial stuff from the face. But I could do that with something else.

KadeeBelleMD wrote:TONER: THIS toner, and this toner only drops the pH of the skin to aid in depth of penetration and even penetration (it actually decrease the tensile strength of the skin's upper stratum corneum--- how cool is that?!) And, it's non-drying as it has no alcohol component.

A little diluted cider vinegar would tend to do the same as would if you put a little witch hazel in there.

KadeeBelleMD wrote:OBAGI's professional VIT C serum: clinically tested against leading vit c serums, and was shown (skin biopies) to have 2x the depth of penetration and stability!


Depth of penetration of a Vitamin C dilute would be related to concentration of the Ascorbic acid. One could easily make up a VC dilute with a hi concentratiion of VC.

KadeeBelleMD wrote:CLEAR: upper epidermal "bleaching agent." It selectively targets melanocytes that have an accelerated production of tyronsinase, which stimulates melanin product. So, it doesn't bleach all melanocytes evenly, only your over active ones. (obviously, it's key ingredient being 4% hydroquinone) The difference between this and a generic prescription for 4% hydroquinone is the delivery mechanism of clear.


hydroquinone will selectively target melanocytes too in the same way. Or one can use their own selective delivery mechanism by selecting to place the hydroquinone only on the brown spots and if they are big enough--bag that and have a derm cyro them off. Substitute with Solaquin Forte which has sun block in it.

KadeeBelleMD wrote:Exfoderm/Exforderm forte: enhances exfoliation, as exforderm main ingredient is phytic acid, and forte's is glycolic (6%). The forte being better for thicker skin, or more resistent skin.


That is an AHA but there are other AHA's in addition to some mechanical exfoliation that kick up exfoliation and thereby help the scripts efficacy. Substitute with another AHA or use mechanical exfolliation like shaving the skin.

KadeeBelleMD wrote:BLENDER: LOWER epidermal beaching agent (vs. clear- that's why they have you use two different products). This is why you blend it with the tretinoin as well- you want maximum depth of penetration of BOTH. (delivery mechanism, once again, which I can explain if someone really wants to know).


2% hydroquinone products can be sold over the counter and can also be blended with retin A.

KadeeBelleMD wrote:SUNFADER: superficial epidermal bleaching agent, so that's why some patients use this to see results "faster" or... maintain results. As, when you are done with the system, sometimes only touch-up maintenance is required, and some can get away with the blender/tretinoin and sunfader.

Is the sun fader a weaker form of the hydroquinone?

KadeeBelleMD wrote:OBAGI sunscreen differences: the physical block is great for post-procedure patients as it truly a "block." It has 18% zinc oxitate, so the strongest possible physical block. The healthy skin is a spf 35, and the obagi-c rx is a spf 30, both with UVA and UVB protection, AND they both have the deepest depth of protection over any other suscreen on the market at 285-390 nm. awesome.... makes me addicted, that's for sure.

What is "zinc OXITATE"??????? Zinc oxide is one of the best sunblocks there is and that stuff is inexpensive. I use zinc oxide all the time but mix with pigment to match my skin tone. Now, I really want to know what zinc "oxitate" is.


KadeeBelleMD wrote:So, MissJ, I hope this better helps you understand why the OBAGI nu-derm/C&E systems aid greatly in the efficacy of retin a and hydroquinone. every product has a physiological function, which is impressive. I know the temptation to mix and match is there, i'm guilty myself at times, but truly looking at the science and amount of data to support the chemistry makes obagi a truly impressive skin care line.


I invite you to try my suggested substitutions for all the obagi products you have listed as going along with the the 2 basic scripts. Why would any of the substitutions I have suggested not also work to increase the efficacy of the 2 scripts?
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Postby DCNGA » Fri Feb 22, 2008 8:36 pm

The INCI for Octinoxate (closest thing I could find to the item MissJ mentions):

Ethylhexyl Methoxycinnamate (INCI)
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Postby MissJ521@aol.com » Fri Feb 22, 2008 8:43 pm

Methoxycinnamates are (chemical) sun blocks. Zinc oxide and Titanium oxide are sun blocks too but more of a mechanical barrior as they are opaque (white)

DCNGA wrote:The INCI for Octinoxate (closest thing I could find to the item MissJ mentions):

Ethylhexyl Methoxycinnamate (INCI)
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Postby MissJ521@aol.com » Fri Feb 22, 2008 8:59 pm

Perhaps the ingredient is zinc "oxidate" and not zinc "oxitate" but still.......
Zinc Oxide could be said to be the"Oxidate" of Zinc. Ferrous oxide or iron oxide (commonly known as "rust") could be said to be the "Oxidate" of Iron. But one usually says: "Zinc Oxide" or "Iron oxide"
A company actually calling Zinc Oxide "Zinc Oxidate" is just coming up with words to 'mystique' something. However, that's what cosmetic companies do.
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Postby KadeeBelleMD » Fri Feb 22, 2008 11:40 pm

First and foremost, my apologies on my typo concerning the sunscreen, it is zinc oxide, and octinoxate (I was quickly writing as I was being beckoned to leave for dinner).

Second,

MissJ wrote: "So it was clinically proven that what you refer to as the "full system" was compared to using EITHER tretinoin OR hydroquinone alone? Did they look at using tretinoin and hydroquinone together and compare that to using both together plus the obagi 'other stuff'? For example tretoinoin and hydroq. used together increase each other's efficacy and of course there are other products or actions that would tend to act synergistically to increase the efficacy of those 2 scripts.

For example, exfoliation techniques or products would tend to let the scripts absorb more thereby increasing efficacy as would things that lowered the ph of skin slighly while they are being applied. Although I understand the 'science' of it all, (I'm an MIT grad), that's why I have the questions I do as to whether ONLY the obagi products would increase the efficacy of the 2 main scripts."

In response, yes. They compared the "system" to using cetaphil (most popular cleanser, a witch hazel toner, a AHA exfoliator of same active ingredient %'s, with a script for hydroquinone and tretinoin.

They tested both the "obagi system" (A) to the other system (B) for both tretinoin individually in each set A, B and hydroquinone in each set A, B, and then a combined tretinoin/hydroquinone.
So, the results showed that using A with their hydroquinone (vs. script) and a generic tretinoin VS. system B with generic hydroquinone and a generic tretinoin was 3x as effective.
Also, if you try system A with either tretinoin or hydroquinone vs. system B with either, comparatively and respectively, the effect was 2x as effective on system A.


Third,
KadeeBelleMD wrote:
FOAMING GEL/gentle cleanser: pH balanced for the skin, without soap properties, to remove superficial dirt/sluffing keratonocytes.

MissJ:
Soap properties are alkaline. So it stands to reason not to use an alkaline product to remove superficial stuff from the face. But I could do that with something else.


I understand, therefore their cleanser is sodium lauryl oat amino acid based (in conjunction with many others) in order to bring the pH down to 2.5-3.0; inline with the natural pH of the skin. And yes, you could do this with something else, as long as you knew exactly what pH you were getting.

Fourth, in response to the toner comment, the lay person is not going to be ale to dilute and manufacture with any consistency a perfectly balanced pH toner to use in conjunction with the system. Therefore, for ease of use and sterility, most people would benefit from a good high quality toner that obagi offers.

Fifth, I have to respectively disagree with your vit c comment;
"Depth of penetration of a Vitamin C dilute would be related to concentration of the Ascorbic acid. One could easily make up a VC dilute with a hi concentratiion of VC."

% of concentration does not lead to greater depth of penetration. You see, I have fitzpatrick type 1, thin fair skin. Now, a person who is a type 4 with thick skin, perhaps, will not get the same penetration as I would get if we both applied a 20% serum. This fact has been studied. (i will find old sources, if you's like).
So, the vit c serum is not just about %, it's about delivery mechanism. The propylene glycol in their serum gives maximum depth of penetration. The variation in % is due to skin type, thickness, oily/dryness, etc. Not about which one goes deeper.

Sixth, the hydroquinone's that obagi makes have, once again, different delivery mechanisms. Yes, all hydroquinones selectively target, but theirs are focusing on different levels.
Also, no sunfader is a 4% hydroquione with sunscreen mixed in as well. Once again, the difference is all in the target range of the hydroquinone. (in regards to the 2%, yes you can buy it and blend it with retin a, but you will not be getting the best result possible, and you won't be having your retin a be pulled to the dermal-epidermal junction which blender has proven to do.- so, if you are going to buy just one obagi product, I would suggest this one, as it alone is aiding in the efficacy of retin a.)

Ok, seventh; the exfoderm I can agree with you there- if you are implementing a good chemical exfoliator or even mechanical exfoliator you are of course aiding in the process (but, when you buy the kit, if you price it out, you are essentially getting this product free, and if you have to buy it from another company anyhow???)
In regards to shaving, I think that dermaplaning is much better, but shaving is obviously cheaper and is better than nothing. I myself, dermaplane.

And finally, (whew!) I too was skeptical of this whole system idea and tried just the retin a and started on hydroquinone for 12 weeks. Then, I switched to the OBAGI system, and I personally am able to appreciate a noticable difference, hence be becoming such an obagi advocate. :)

Thank you MissJ for this refreshing academic conversation on this forum.

Cheers
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Postby KadeeBelleMD » Fri Feb 22, 2008 11:47 pm

One more note, OBAGI is not a cosmetics company, they are, and are held to FDA standards of a pharmaceutical company.

And, for clarification the clear, blender, and sunfader are all prescription strength 4% hydroquinone (just target different depths in the epidermis), with the sunfader having an spf 15 in it as well.

cheers.
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Postby Fernia » Sun Feb 24, 2008 12:41 am

KadeeBelleMD,

I have thin Fitz 1 skin as well. Should I be using the Exoderm Forte or just the Exoderm? I've been using the Forte...

V/r,

Fern
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Postby KadeeBelleMD » Sun Feb 24, 2008 10:08 am

How are you handling the forte? It's a 6% glycolic, so if you skin is adapted, you certainly won't hurt your skin, it's more a matter of comfort at this point. You can also use less daily, or use every other day rather then buying more product if it gets too irritating. Best of luck!
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Postby Dee26 » Sun Feb 24, 2008 6:34 pm

KadeeBelleMD wrote:
BLENDER: LOWER epidermal beaching agent (vs. clear- that's why they have you use two different products). This is why you blend it with the tretinoin as well- you want maximum depth of penetration of BOTH. (delivery mechanism, once again, which I can explain if someone really wants to know).



I would like to know how the delivery mechanism works. I used to use Blender and was always curious to know how it helped Retin A penetrate so much better than on it's own. I had my own ideas such as the Blender lowered the PH of the Retin A, or the saponins made the stratum corneum more permeable to allow better absorption of the Retin A. But I never knew for sure.

Thanks,

Dee :D

Dee
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Postby KadeeBelleMD » Sun Feb 24, 2008 7:34 pm

Dee26 wrote:I would like to know how the delivery mechanism works. I used to use Blender and was always curious to know how it helped Retin A penetrate so much better than on it's own. I had my own ideas such as the Blender lowered the PH of the Retin A, or the saponins made the stratum corneum more permeable to allow better absorption of the Retin A. But I never knew for sure.

Thanks,

Dee :D

Dee


Hey Dee,

So the blender works by employing glycerin and saponins. The glycerin is a sugar alcohol which acts as a humectant, which is also water soluble and hydroscopic (meaning it attracts water). Since our skin is roughly 70% water, this aids in penetration. Also, glycerin is just an impure from of glycerol, which has a tendency to be more "fat" soluble, but still considered hydrophilic. Another huge component to glycerin in skin care products is that is plasticized the skin, making skin conductance independent of water content; so even if your not fully hydrated at approx. 70%, your product is stilling working for you. (plus, glyercin is said to be quite a good moisturizer, due to it's hydroscopic properties no doubt).

Saponins are most often thought of as natural detergents. They are amphiphilic, meaning they love both water and oils, making them perfect for absorption into our skin. They significantly increase transepidermal conductance, making for better stratum corneum permeability, deeper, and more even penetration!

Hope this helps!

cheers
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Postby Fernia » Sun Feb 24, 2008 7:49 pm

KadeeBelleMD,

I've been using the Forte for months so my skin is used to it...but now I have a quesion about the blender.

If I am on maintenance, should I still be mixing the blender with the trentinoin? I'm temped to just because I not used to having to try and make a peas-sized drop of cream stretch to cover my entire face. Last night was the first time I've ever used the trentinoin alone and it was frustrating.

To be honest, I'm a little lost about what maintenance entails. I'd planned on using the cleanser, toner, and trentinoin every night, but only using the other products (Forte, Blender, and Clear) about 3 times a week.

Is that what I should be doing? :?:

Thanks for all your help!
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Postby KadeeBelleMD » Sun Feb 24, 2008 8:04 pm

Fernia wrote:KadeeBelleMD,

I've been using the Forte for months so my skin is used to it...but now I have a quesion about the blender.

If I am on maintenance, should I still be mixing the blender with the trentinoin? I'm temped to just because I not used to having to try and make a peas-sized drop of cream stretch to cover my entire face. Last night was the first time I've ever used the trentinoin alone and it was frustrating.

To be honest, I'm a little lost about what maintenance entails. I'd planned on using the cleanser, toner, and trentinoin every night, but only using the other products (Forte, Blender, and Clear) about 3 times a week.

Is that what I should be doing? :?:

Thanks for all your help!


Great question.
I've often been stumped on eaxactly what to tell patients as well! I actually went to a advanced obagi training last week (9 hours of lecture!) where I asked tons of maintenance q's.
So, basically if hyperpigmentation was your first reason to be on obagi, then stay on the clear at least every other day, with the blender plus tretinoin mix every 2-3rd day. If you are not as concernedwith hyperpigmentation, just use the blender/tretinoin every 3rd night. Use the forte every third day. Just cleanse, tone, apply an anti-oxidant (such as a vit c or idebenone) then your sunscreen everyday, with the other additions as described above.
Happy maintenance!!! :)
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