The following is an excerpt from the Glow Journal Podcast. You can listen to the full interview now on iTunes and Spotify.
Dr Des Fernandes’ working life began as a surgeon, before moving into plastic surgery in 1975 as the Head of the Cleft Lip and Palate Division at Cape Town’s Red Cross War Memorial Children’s Hospital. It was during that time that tragedy struck, and Dr Des’ research into skincare began.
“It was the problem of dealing with two people, a guy and a girl, who developed melanoma when they were about 19 years old,” he remembers. “We couldn’t save them. When they were young, they they just didn’t believe that they could have a fatal condition- the age of 18 is probably when it started.
“We tried to save them. They were dynamic, wonderful people. The sort of people that you wish were here in the future. My response to this was to try and find out if there was a way to prevent it, because in medicine we’re always saying that “prevention is better than cure,” and it’s certainly easier than cure.”
It was this loss that served as the catalyst for Dr Des’ lifelong commitment to skin research. “I used to go to the libraries go and walk around the library. It was an arduous task, but fortunately, at that time, I had the time. My practice hadn’t yet to become busy, so I had the time. I was fascinated to try and see if there was something that people had missed. It was quite audacious of me to think that people had missed something, but I also realized that maybe this was one of my strengths- that I’m a lateral thinker and I do things a little bit differently, and I can collate information from various different sources. Eventually what I found was the power of vitamin A.”
At this time, the topical use of vitamin A was something of a mystery- nobody was using it, and the few studies that existed were buried beneath more mainstream research. “There was a study from Switzerland that was written in German, and that study showed that you could use vitamin A acid to treat skin cancers and precancerous lesions. At that stage, I didn’t know that vitamin A was a sun sensitive molecule, but I thought ‘If you can keep on applying for them in a onto your skin then maybe you can prevent skin cancer.’ That was right, but it didn’t apply to melanoma.
“Some early research work done in the late 60s and early 70s had shown that vitamin A was making changes. They were using it on mice! The man who did that [research], I often regret that he never saw that eventually vitamin A would become such an important molecule for skin. He said it at the time, and nobody actually wanted to believe him because it always caused skin irritation.”
Compelled to discover the effects of topical vitamin A application for himself, Dr Des began to create his own formulas. “I started in ’82 and I was making my own little creams in the beginning with retinoic acid. I thought ‘I’ll just see if this works,’ and then after a while I realised it does work. I had no intention of it ever becoming a business. I had no intention of setting up a laboratory, but then I did set up a laboratory because I realised that I was making bad creams. I wrote to two big companies that made skin care products and I said to them ‘Look, I’ve scoured I’ve scoured through the ingredients of all these famous brands, and nobody is promoting vitamin A.’ At that stage it was like ‘No, you’re crazy,’ if you spoke about antioxidants. No creams had that. You could get vitamin E in some creams, but that was about it. I wrote to these companies and said ‘This is the skin care of the future.’ That’s what I actually said. This is the skin care of the future. One company wrote back and said ‘No,’ and the other company didn’t even bother to respond.”
Knowing that his own formulations had potent skin healing properties, Dr Des began to distribute his work amongst his existing clients. “Initially, I just gave it to my patients. I had realised that if you do a facelift on somebody with sun-damaged skin, when you’re finished you look at them and you think ‘Well, what did you spend your money on?’ The quality of the skin doesn’t reflect what you’ve just done to it. I realised that we’ve got to get a way of introducing vitamin A into the skin and getting the patient into a much younger looking skin.
“About a year later, my consultation waiting list had lengthened to such a degree… I phoned my sister and I said ‘They come and they sit in front of me and they say No, I don’t want an operation. I just want that cream!’ We decided that we would try and see if we can sell it. I sent some creams up to her, and she sold it. Next thing, people wanted more. As we progressed further we decided ‘Look, let’s make a company.'”
The largest challenge Dr Des faced in Environ Skincare’s infancy was convincing the public of just how integral vitamin A is to skin health. “When I started, I said to people ‘Ageing is a disease.’ I had lots of doctors smack me, verbally, because I said ‘Photo ageing is is a disease that we have to treat. It is a skin disease as a result of exposure to light. The wrinkle is just the early stages of the same problem that will give you a skin cancer.‘ That was not accepted.
“First of all, what you’ve got to do is realise that the sun is damaging your ability to absorb vitamin A into your cells. We’ve got to reverse that first of all, because if you can’t get the vitamin A inside the cells then, of course, it’s going to lie outside the cells and irritate them. The Paradox is that vitamin A is the only thing that will make the receptors to absorb more vitamin A. That’s why we started the Step-Up System where you introduce vitamin A at very low doses. It’s the continuous use of it- eventually you start making more receptors than you can go to a stronger cream. That, in turn, will bring you to the situation where you can make even more receptors and go onto a stronger cream etc. When we are young, we are born with an extremely rich content of Vitamin A receptors on the cell wall. We never re-achieve that. When you realise that sunlight destroys vitamin A, you realise that you should you better you start using it soon after you get introduced to sunlight.”
“Virtually everybody is deficient in vitamin A,” Dr Des explains. “Unless you are using it, you’re deficient in it. Generally, the average person can be quite sure of one thing it’s that they walking around with deficient levels of vitamin A. We unaware of it. It is relentless and it starts affecting the basic mechanisms of your cells. So eventually, after time, you start getting pigmentation marks. I actually believe that pigmentation arises because you don’t have enough vitamin A to control it.”
With vitamin A’s prominence in mainstream, topical skincare rising, so too is marketing surrounding the ingredient. What we’re repeatedly told is that the use of vitamin A increases our skin’s sensitivity to the sun- but is this entirely accurate? “That’s only true if you’re using retinoic acid,” Dr Des explains. “What that does is sensitise the skin to sunlight. That’s why they tell people that if you’re using it, use it at night because then it can get a be absorbed into the skin and it can be go into the cells and it’s less damaging. If you use it during the day time then you make your skin even worse. If you use the storage form of vitamin A- that’s retinol palmitate- it’s actually a sunscreen. While the acid form is photosensitising, the storage form (retinol palmitate) is actually photo protective. When I was looking at this [the beginnings of Environ] I thought to myself ‘I really want quite a number of different versions of vitamin A that I want to work with’. We use retinol palmitate, we use retinol acetate, we use retinol propionate and we use retinol itself.”
At the core of the Environ portfolio is the STEP-UP System- a collection of moisturisers with increasing amounts of vitamin A, allowing consumers to gradually build up their receptors and decrease their sensitivity to the vitamin. With five “steps” in the system, is it possible for the skin to ever grow entirely desensitised to its effects? “That is a natural concern and I think an important concern,” confirms Dr Des, “but what we have to realise is that we are constantly destroying vitamin A. The only way that we can stop destroying Vitamin A is by going into a dark room and staying there. It’s like if you’ve got a bucket and it’s got a hole in the bottom and you keep on pouring water into the bucket. The water is running out, so you can’t overfill it.
“If you’ve got a very sensitive skin, I’d say to you ‘Use this once or twice a week in the beginning when you start.’ Then slowly start to use it every day. From there, go to twice a day. We make it in progressively stronger levels as you go up the ladder- you start at the bottom, introduce it slowly and then progressively increase, increase, increase. I think that it’s never too late to start.”
Another widely publicised skin care “rule” is that vitamin A should not be used with other acids- such as vitamin C. This, however, is another myth that Dr Des is happy to debunk. “I always include vitamin C when I use vitamin A,” he tells me. “When we when we make the formulas, I always want vitamin C and as many antioxidants as I can together with the vitamin A, because the fact is that there is no one single magic bullet that does it all. You’re always going to need as many antioxidants as you can present to the skin. They all have slightly different functions. They work at different temperatures. They work at different oxygen tensions and things like that. This is why you need to have many different antioxidants as your formula can permit you to do.”
Given that Dr Des has, quite literally, always been one step ahead of mainstream skincare, I took the opportunity to ask him what he believes we can expect to see from the industry in coming years. “I would like to see that well trained skincare therapists get better respect from the general public,” he tells me. “The skincare therapist, if they are well trained and they understand what they’re doing, will help a significant number [of people]. We’re talking about over three quarters of the people that they see- their acne will be corrected and their pigmentation helped. If you recognise that wrinkles are the early steps of the disease of skin cancer- somebody comes to them who’s worried about wrinkles, then the skincare therapist helps them, and she’s significantly reduces the chances that this person is going to get a skin cancer. This is why I believe that skin care therapists need to be appreciated for what they do. They need to be paid better, to be honest.
“People think of it [seeing a skincare therapist] as a luxury but it’s not really a luxury. To have good-looking skin also means that you have healthy skin. If there are people who are going to live to be 120, they need to keep their skin as healthy as possible for as long as possible. That’s why I think that we have to develop greater respect for the skincare therapist and see their role as an important health component of getting older.”
