Illuminating Skin Care
Modern skincare and dermatology products come in a variety of forms, from basic home remedies and specialised treatment lines, to prescription only medicine and treatments. Whether they are grown in a garden or produced in lab, the best skincare products are highly sought after to be the next ‘Holy Grail’ or ‘Fountain of Youth’. How modern is modern skin care? In this article, I am going to explore the roots of skincare, the development of the secret business of women, and take a closer look at some of the ingredients we are still using in cosmeceuticals today.
Historically, beauty has been closely linked with health, happiness, and wellbeing. Greek philosophers wrote extensively on these various subjects. For example, Aristotle culminated his ideals of beauty and happiness into the concept of eudemonia. It is no wonder that, even today, many cultures across the globe continue to link beauty, health, happiness and wellbeing. For thousands of years, skincare for both beauty and health, in particular washing and aromatherapy, have been an important part of daily hygiene practices. Communal baths have dated back as far as 5000BC in Mohenjo Daro in Pakistan, documentary evidence shows the use of deodorant in ancient Egypt, and the utilisation of aromatherapy in ancient Greece and Babylon (Worwood, 1992).
The regular routine of skincare might seem a world away from the technological advancement of ancient civilisations. Great importance was placed on health and the regular skincare routine was indeed more advanced than first thought. We must understand that the primitive technology of our ancestors did not make for naive people. Our ancestors were innovative, observant and methodical in the understanding, development and use of skin care. Philosophers, doctors and women’s collective wisdom, were largely responsible for the development and transition of knowledge of skincare, beauty, health and wellbeing.
Though archaeology can reveal the practice of skincare and hygiene, systematic documentary evidence of skincare did not occur for thousands of years, and sparsely appeared until the Dark Ages. A review by Cavallo, Proto, Patrono, Del Sorbo & Bifulco (2008) investigates thefirst volume of work produced specifically on skincare, known as the Trotula Minor. It was written by one of the most unexpected physicians in medieval history: Trotula of Salerno. Trotula was thought to be a female physician who trained at the University of Salerno and was one of many female doctors to graduate from the university. The University of Salerno was a unique institution, as the first separatist university, it allowed females to enter studies. Trotula of Salerno was a notable physician, who actively practiced and lectured widely. She is believed to be the first gynaecologist, and had authored three health manuals, one of which was the first book on skincare. The Trotula Minor was the most detailed reference manual on skincare for hundreds of years, and the ingredients of her tinctures, creams and ointments are still used today in modern cosmeceuticals.
Rose and Rose Hips
Rose is one of the few florals used by Trotula of Salerno, in her mixtures and topical creams, alongside lily, violet and verbena. Trotula described rose as useful for the treatment of dry skin and lips, as well as rosehip for anti-aging. A recipe for make-up consisted of honey, cucumber and rose water. Trotula also advised rose water was to cleanse the skin.
Rose water is a result of the steam distillation of rose petals to make the oil rose otto. Extracting oil is a laborious process, and modern forms of oil extraction such as solvent extraction using hexane, and CO2 extraction methods have enabled, respectively, the absolute and cold extraction oil varieties.
Two most common forms of rose are often used in the production of essential oils used in skincare: Damask rose and cabbage rose. Damask rose (rose damascena) is primarily grown in Bulgaria, Turkey, Iran and China. Cabbage rose (rose centefolia) is produced in Egypt, France and Morocco. Briar rose, or elgatine, is the source of rose hips and has been cultivated in Western Europe. During the Dark Ages, Trotula’s Italy was amongst the trading of these regions. Roses were cultivated in monastery gardens for their medicinal properties, and would have been included in the first recorded medicinal garden, Matteo Silvatico’s Garden of Minerva in the 14th Century.
Rose and rosehip extracts are used today in many anti-aging skin care products. Rosehips are a very fashionable ingredient in skincare because of their chemical composition, with high concentrations of linolenic acids, vitamin C, and vitamin A (Examine, 2014). These chemicals encourage cell renewal and turnover. In current practice, patients are using rose in mature skincare lines, and applying rosehip oil to manage premature aging, pigmentation, scarring and dryness.
Sulphur was used by Trotula as a remedy for bad breath. Little did she know that her exfoliating chemical peel for acne made from onions, was also high in sulphur. Today, topically applied sulphur is used in acne skin washes and spot treatments.
Sulphur is a mild antimicrobial and is active against propionobacterium acnes, one of the bacteria naturally present on our skin, responsible for acne and flare ups (Dermalogica, 2012). By eliminating the infection causing bacteria, there is a reduction in severity of breakouts and flare-ups. Additionally, sulphur has an exfoliating effect on the skin: sloughing excess dead skin, and preventing congestion.
Interestingly, acne and other inflammatory skin lesions at the time were considered to be caused by skin worms. The lexicon at the time did not distinguish between acne, rosacea, and psoriarsis, and the conditions were labelled as scabies. The literature highlights that this lack of distinction makes it difficult to test the efficacy of Trotula’s acne recipes (Cavallo, et al, 2008).
Trotula had observed the benefits of exfoliation, and included crystal or quartz in her treatment of damaged skin conditions. Again, nomenclature of the time does not elaborate or make distinct the nature of damaged skin. The appearance of damaged skin arises from sun exposure, acne, infection or irritation. What may be common amongst these conditions is dehydrated or crusting skin. Mechanical exfoliation, as used by Trotula and her contemporaries, is a method to remove the damaged skin, to reveal soft, new skin underneath.
The concept of using quartz is not unknown in the skin therapist world of today. Microdermabrasion is a popular treatment performed at treatment centres or during homecare routines. Mechanical exfoliation is the most basic type of exfoliation. It uses small particles to slough off dead skin cells – which can contribute to the appearance of dull skin – and encourage cell turnover. During microdermabrasion, sand-like quartz is used to exfoliate the skin, improve skin texture and clarity.
Many lines of skin care product also offer physical exfoliants, also known as facial scrubs, and these are a popular choice among consumers. Skin types and conditions that are known to benefit from physical exfoliants are combination, oily, congested and hyperpigmented. These skin concerns are not enigma of our modern era, and women of the Dark Ages would have benefited from exfoliation to improve the appearance of their skin.
“Tuesday’s child is fair of face”
Beautiful skin has been regarded for centuries as a desirable quality for women. Fair did not always mean what we use it for today (light in colour). Fair skin was akin to clear skin, without marks or wrinkles, and of an even colour. Though religion may have looked down upon vanity and the wearing of makeup, for women to keep up with social norms of the era, makeup and skincare went hand in hand. The Trotula Minor captures these practices in one volume of work, drawing on her practice and womenfolk knowledge of the time.
Trotula was not only person to utilise aromatherapy and botanicals to enhance skin care. From beyond the Dark Ages, skincare continued to develop in the family home. Common people of the bygone era became quite adept at recognising illness and skin ailments. Common folk could not often afford a doctor, and looking back, we wonder if they really wanted to employ one. Medicine was not the life giving practice it is today: doctors had high mortality rates amongst their patients because of radical treatments such as blistering, bloodletting, and poor hygiene practices (Dossey, 1999). This combination of both access and necessity has grown novelty treatments for common skin conditions sourced from the garden. We do not often assume that people living 500 years ago cared much about their skin. This not only shows and aptitude and breadth of knowledge, it also highlights the social importance of skincare and health.
Other historical developments in skin care
Lavender (lavandula) is one of the most well known, and common essential oils. The term describes a group of plants of the lavender family, and there are many varieties, each with their own scent. The lavender story is linked to the study of modern aromatherapy, and it has been recognised for centuries as an anti-inflammatory agent across many cultures. In the 1920’s, Gattesfosse, a chemist, had received substantial burns to his arm, and doused the flames in lavender oil (Worwood, 1992). Remarkably, he healed without complication or scar, and he continued to research the properties of lavender oil, and thus, aromatherapy was born.
Lavender extracts are used today in anti-inflammatory and calmative preparations. The calming properties of lavender are considered to be both physical when applied, and psychological when inhaled (Worwood, 1992). Lavender allergies do occur, and the oil should never be applied directly to the skin. Alternatively, preparations with diluted extracts are recommended, or hybrid types such as lavandin grosso are considered safer.
Studies into the localised effect of lavender show an impact on the inflammatory, healing response in the skin. However; research into the systemic effects of lavender has been often been inconclusive (EBSCO Publishing, 2014; Examine, 2014). More rigour is required in testing, however high level scientific studies of aromatherapy remain difficult to test due to the diffuse nature of inhalation.
Europe was not the only hub of developments in botanical skincare. Australian Aboriginies developed a range of successful treatments for skin ailments. One of the most iconic botanical ingredients used by the indigenous Australians is mellaluca, also known as tea tree.
Tea tree has long been used to treat skin infections and irritations, and it has antimicrobial properties (EBSCO Publishing, 2014). Control studies into the effectiveness of tea tree have highlighted its efficacy against superbug methicillin resistant staphaurea [MRSA] (May, Chan, King Williams, French, 1999). Results suggest that tea tree is active against the bacteria and inclusion of the oil into hand hygiene products can help stop the transmission of MRSA. Tea tree oil can also be found in adult and teenage skin care products such as cleansers, moisturisers and spot treatments.
The terms aromatherapy and botanicals are used interchangeably in the marketing of skin care. The two words should not be confused, and consumers must discern their uses. Aromatherapy is the use of concentrated extracts by inhaling, topically applying or ingesting to alter a physical, spiritual or emotional state. The practice of aromatherapy is that of the aromatherapist, and one must have an understanding of the dangers, toxic properties and interactions of these extracts. To increase patient safety, it is important that health care providers ask about complementary and alternative medicine practices when updating a medication history. Though low doses of these extracts are delivered in modern skin care and are locally acting, direct use of concentrated oils can have a much larger systemic effect (Worwood, 1992).
Aromatherapy has become a buzzword, and often botanical or natural fragrance is used to describe anything floral or plant derived. Consumers need to be alert for the ingredient fragrance. Fragrances can be made naturally derived substances or petrochemicals, and some are known allergens and carcinogens (Sarantis, Naidenko, Gray, Houlihan & Malkan, 2010). In its report Not So Sexy (2010), the Environmental Working Group in the United States found that hundreds of different synthetic chemicals were used by the fragrance and cosmetic industry to perfume their products, and often not disclosed. Though some of these fragrances may be ‘naturally’ derived, they are still hazardous to skin health, are not comparable to essential oils and have no therapeutic benefit to the skin.
The use of plant and earth extracts on the skin has long been established in homecare routines for many concerned about their health. Though the works of Trotula serve as a rare artefact of Dark Ages medical history, the impact that one book has had on skin care routines reaches a lot further than topical applications. For the first time in written history, the way that people perceived their appearance had medical value. Women’s wellbeing had value, and was brought out of the shadows of the Dark Ages. Health was no longer just the absence of disease, but was reflected in how people were seen: beauty was health.
For a free Dermalogica Face-mapping Skin Analysis and to discuss illuminating skin care, make an appointment with our skincare nurse Alex. Contact us today.
- Cavallo, P., Proto, C., Patrono, C., Del Sorbo, A., & Bifulco, M. (2008). The first cosmetic treatise of history. A female point of view, International Journal of Cosmetic Science, 30, 79-86.
- Dermalogica. (2012). The book, California: Dermalogica.
- Dossey, L. (1999). Reinventing medicine: beyond mindbody to a new era of healing, San Francisco: HarperSanFrancisco.
- EBSCO Publishing. (2014). Aromatherapy.
- Examine.com. (2014) Rosehip.
- May, J., Chan, C.H., King, A., Williams, L., & French, G.L. (1999) Time–kill studies of tea tree oils on clinical isolates.
- Sarantis, H., Naidenko, O.V., Gray, S., Houlihan, J., & Malkan, S. (2010) Not so sexy. Environmental Working Group, accessed 11 April 2014
- Worwood, V.A. (1992). The fragrant pharmacy. New York: Bantam Books.