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Thursday, 01 November 2012 07:44

To Tone or Not to Tone

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Throughout history, the ways in which a society feels about the pursuit of healthy, beautiful skin is a direct reflection of their culture and climate. Many varied uses of skin care products have been documented throughout history – from the Egyptians through the modern day U.S. The cultural reasons for the uses of different types of products are fascinating and the use of products as "toners" has a long history. Although multi-step skin care regimens were not truly marketed until the 1960s, the use of a cleanse, tone and moisturize routine became common around the 1930s in the U.S.

With the abundance of products on the market today, it can be difficult for consumers and clinicians alike to determine which steps are necessary to keep their skin healthy and beautiful. Understanding the different types of toning products available today and their effects on the skin can help the clinician effectively determine whether a toner is a good option for each of their patients.

Early Skin Care
In the harsh deserts of Egypt, the likes of Cleopatra and Nefertiti used natural oils, milk and botanicals to protect and moisturize their skin. Due to the dry climate, astringent products were not common. The Greeks enjoyed a more temperate climate and successful agriculture, which led to the use of many locally grown botanicals in lotions and waters to achieve healthy, glowing skin. Having untanned skin has long been a mark of aristocracy, as those who had to work outdoors for a living would become dark. For this reason, many cultures used topical concoctions to bleach their skin; lemon juice and vinegar were used for this purpose and as early tonics.
The connection between makeup use and skin health has evolved over the decades. During the time periods when women wore heavy makeup as a sign of beauty rather than focusing on inner radiance, there was less of a focus on skin care. At times when makeup has fallen out of fashion, women have used topical skin care to encourage their skin to glow. In the early 1900s, women often made use of skin care products using toning agents like milk, witch hazel and lemon juice to open the pores and brighten the skin. It was not until after the Great Depression that skin care products really came to the masses.
By mid-century, most every woman used cold cream to remove their makeup and cleanse their skin. The oily nature of these creams caused more women to use a toner afterward to remove the excess. Today, toners can be used for a variety of purposes, depending on their formulations.

The Truth About Toners
Considering the wide array of different toners currently on the market, it is important to understand their function, formulation and benefits of their use. The toning step in a daily regimen is often misunderstood and is truly not always necessary. Many people feel that toning must be done on a daily basis to ensure clean skin. If a well-formulated cleanser is used, however, then this is not the case.
The use of toners became popular as a way to balance the skin's pH after cleansing with soap, which can be more alkaline and drying to the skin. Because of this alkalinity, toners with a more acidic base helped to lower the skin's pH, bringing it back to its normal range. For example, the skin has a pH of 5.5 to 6.5; if a person uses a soap that has a pH of 11, then applies a more acidic toner with a pH of 3.0 after cleansing, this will help to bring the pH level back down.
Since there are many facial cleansers available today that do not disrupt the natural pH of the skin, the use of toners for this purpose is not essential; but many patients still like the feel of the temporary tightening of the skin when using a bracing toner. In this case, be sure to recommend products that do not excessively dry the skin, like those with a high alcohol content. Oily patients especially enjoy the use of toner, although it is essential that they do not over-use them and dehydrate the skin, causing an increase in sebum production. Any daily regimen can be enhanced with the use of non-drying toners formulated with alpha hydroxy acids, topical nutrients, flower waters and antioxidants. Because toner formulations are liquids, they do not contain any vehicle or base ingredients designed to sit on the surface of the skin, allowing them to penetrate easily. This makes adding nutritive toners several days a week a boost to skin health.

Professional Use
Astringent toners can also be used by professionals to prepare and degrease a patient's skin prior to the application of a chemical peel. Only simple, non-fragranced or non-colored astringent toners should be considered for this purpose.

Toner Formulation
Depending on what function a toner is being expected to perform in a patient's regimen, different sets of ingredients should be sought out. If a formulation is designed for astringency, pore minimization and breakout control, look for witch hazel, cucumber, salicylic acid, glycolic acid, and eucalyptus and peppermint extracts. These types of ingredients reduce sebum production and rid the skin of dirt and debris, while giving the skin a temporary tightening effect. Do beware of formulas with high alcohol content, as mentioned previously.
If a patient is using a toner as more of a soothing, nutritive tonic, look for vitamins, amino acids and antioxidants, as well as flower extracts (rose, orange blossom, et cetera). Aloe vera, willow herb, willow bark and echinacea also provide soothing relief to dry or irritated skin. There are a wide variety of beneficial ingredients being used in a plethora of toners available today. The key is to find the right combination while avoiding high alcohol content, excessive fragrances colors.
Toners have had an interesting history and have fallen in and out of favor over the years. If chosen properly with the appropriate ingredients and frequency of use for the particular patient, they can be an excellent addition to any skin
care regimen.

Jennifer Linder, M.D., serves as Chief Scientific Officer for PCA skin®, guiding all product development and clinical trials for the company. A board-certified dermatologist and a fellowship-trained skin cancer surgeon using the Mohs micrographic technique, Dr. Linder is one of the foremost U.S. experts in the use of the cosmetic filler, Sculptra. She holds a clinical faculty position in the Department of Dermatology at the University of California, San Francisco.

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