A closer look at the technical literature on cosmetics of recent years reveals a phenomenal increase of papers including pharmaceutical, dermatological and medical issues. Cosmeceuticals, dermatological cosmetics, cosmetic medicine, doctor brands, dermopharmacy, corneotherapy are typical keywords giving the consumers a basic idea on the effects of the products and their treatment purpose. Of course, all that glitters is not gold, and, as so often is the case, the driving force here also is product marketing. A second look however clearly indicates the trend.
Medicine + Wellness
The field of cosmetics is continuously expanding into the boundaries of medicine. A further combination of two specific areas is medical wellness. Wellness today generally comprises balneological facilities like thermal spas, saunas and specialized health resorts, aroma therapy, massages and other treatments appealing to the sensory system. High-quality cosmetic treatments complete the range of wellness products and are a major precondition for customer loyalty. The term "medical wellness" was coined in the late nineties and has been defined by the German Wellness Association (DWV - www.wellnessverband.de) as follows:
"Medical Wellness stands for a synergetic cooperation between medicine and wellness, a specific combination that achieves better effects for the individual health than either competence field by itself.
Based on medical competence, appropriate therapies and programs have to provide the means to improve the quality of life as well as to strengthen the individual health through an enjoyable and healthy life style. Competent medical cooperation is imperative, at least in cases of known health problems or health injuries."
Hence, the medical element in the field of medical wellness additionally comprises preventive and therapeutic measures in order to achieve positive effects not only during the treatment but also in the long run. By incorporating appropriate products into the treatment, a long-term effect not only on the skin but also on processes in the body is intended. In other words, specific products or treatments are applied to influence particular organs or glands, to release hormones and to manipulate energy pathways or meridians. Stimulation of particular pressure points and massages as well as temperature stimuli play an essential role.
Only part of the treatments is based on recent scientific findings. The roots of medical wellness can frequently be found in the traditional folk medicine of different civilizations.
Ayurveda, Jamu and Co
It is widely known that ayurveda treatments not only emphasize the general well-being but focus on the overall health.
Individuals today have taken up the habit of strictly separating particular well-being and medical screening and therapy. Nevertheless, specifically Asian treatment techniques always have taken both the aspects as an integral whole. Certainly, the psychological framework like absence of stress situations and an agreeable ambiance play their role. Further important elements are the individual treatment of customers and the available time.
In terms of a scientific point of view, many of these treatments that date back to old traditions and also their effects can be logically explained. Just to state an example, treatments with the balmy smelling boswellia resin should be mentioned. Today we know that the effects of the resin consist in inhibiting an enzyme which releases inflammatory mediators. Or, whenever speaking of phytohormones in cosmetic applications, it should be realized that these specific drugs have already been used for quite some time not only for women but also for men. With the help of the chemical structures it could be illustrated that phytohormones will address specific receptors which in their turn show moderate reactions. An article in the Kosmetische Praxis 2007 (3), 8-11 has been dealing specifically with this phenomenon.
Vegetable drugs and extracts have passed particular processes so that they mix with fatty oils in order to be used as head, foot or body oils or packs or to be massaged into the skin with the help of herb stamps. In some cases, the oils, enriched with active agents are applied at a relatively high temperature. The active agents are released from the oils or herb stamps and integrate into the areas below the skin surface. During head, face and body treatments the energy points of the body are massaged with the finger tips in order to create relaxing effects which may also be transmitted to specific organs. Also dysfunctions may be influenced this way. In general, the micro circulation will be increased, the metabolism stimulated and tenseness will be loosened up.
Who is entitled to treat?
Due to the multitude of possible effects the therapeutic staff has to be very experienced on the one hand and should also be equipped with a comprehensive basic knowledge in medicine on the other hand. Or, in other words, the so-called "wizards" we can frequently come across are out of place here. Moreover, there is need for so-called generalists with a specific physical and physiotherapeutic sensitivity and a certain feeling for an agreeable atmosphere.
Analysts predict a high potential for the field of medical wellness as it combines well-being, prevention as well as therapeutic aspects. Accordingly, many of the hotels are now adapting to this trend in dedicating their conventional wellness division which formerly used to be part of the fitness department into a medical wellness oasis. This, however, is a wasted effort unless there is qualified medical staff as mentioned above or unless there are basic dermatological cosmetics for the external treatment. Criteria for dermatological cosmetics have been described in Kosmetische Praxis 2005 (5), 12-14. From a legal point of view, a qualified medical doctor has to be responsible for the medical wellness treatment or, at least, has to supervise the division.
Two concepts meet
About the same time when the idea of medical wellness was born, corneotherapy has developed and established a complementary concept in the field of non-invasive dermatology. Not well-being was the basic approach here but the prophylactic treatment and therapy of skin problems without the use of pharmaceutical agents. Professor A. Kligman could prove that a selective use of cosmetic active agents has clinically significant effects without the side effects of pharmaceutical agents. In this sense, corneotherapy with its individually adapted cosmetic products exactly meets the basic ideas of medical wellness.
Comprehensive skin diagnosis
Corneotherapy and medical wellness require a comprehensive skin diagnosis which logically complements the medical anamnesis. And, the other way round, hormone and gene analyses may supplement the skin diagnosis. These data inform on the sensitivities and particular needs of the individual persons. As in the meantime, the instrument-assisted skin diagnosis is supported by comfortable software solutions, the data may be compiled and processed. The result is an overview on the best bases and active agents for the respective treatments.
In spite of the high tech instruments and high quality software however, there is still need for the analytical competence of the therapeutic staff which means that it is expected to be part of the qualification for medical wellness treatments.
Corneotherapy focuses on a physiologically intact skin barrier as this is the only way to effectively protect the epidermis against external influences. In the meantime the original corneotherapy has been complemented by the technique of a controlled opening of the skin barrier, transporting active agents through it and subsequently closing the barrier so that it will resume its original function in chemical and physical respect.
This particular technique is specifically needed when active agents should be effective in deeper skin layers however cannot penetrate the skin barrier under normal conditions. Polar, water soluble agents for example belong to this group of actives and, for this purpose, they are encapsulated in liposomes that fuse with the barrier layer and thus make it permeable for the substances. Accordingly, lipid-like (lipophilic) substances are encapsulated in nanoparticles and then transported into the barrier. After the substances passed through the stratum corneum, a base cream will be applied which restores the barrier structure. This technique may also be interesting for the application of exotic extracts.
In combination with anti aging treatments
Frequently wellness therapies are offered in combinations with anti-aging treatments. Expectations are high in this field; however there is a wide gap between promised and real effects. The medical components of medical wellness in form of anamnesis, skin diagnosis, causal treatment and the criteria of corneotherapy guarantee the potential success by means of objectivity and transparency. A comprehensive guideline for applied corneotherapy and anti-aging treatment has recently been published in the magazine Ästhetische Dermatologie 2007 (3), 8-16. Subject to this guideline, the prevention of a premature aging of the skin can turn into an interesting and convincing field of medical wellness.
Additional benefit for customers
The development of medical wellness again shows that an interdisciplinary way of thinking and acting may achieve additional benefit for customers which at the same time is combined with a high increase of competence. Cosmetics itself can only win its share if it assumes its part within the field of medical wellness. An important aspect here is a complementing home care.
Dr. Hans Lautenschläger