The Expert Interview #3: The Voice of the Dermatologist

Dr. Sivamani, Dermatologist and principal investigator in the British Journal of Dermatology’s publication, answers all the questions you wanted to know about the clinical study Bakuchiol vs Retinol.

Dear Dr. Sivamani, could you describe your background in a few words ?

I am a board-certified dermatologist and an Ayurvedic practitioner with a passion to build evidence for integrative approaches to dermatology. I am both a physician and a research scientist. My background in bioengineering, Ayurveda, research, dermatology, and clinical trials allows me to take an innovative approach to dermatological care and research.

Since retinol is known as the golden standard in anti-aging, have you ever compared a defined compound or natural extracts to retinol clinically? If so, what is your opinion on the outcome of these studies?

I have not compared any other compounds or natural extracts to retinol besides the study that we conducted with Bakuchiol. The Bakuchiol comparison is published and it serves as initial evidence that Bakuchiol may have similarities to retinol without as many side effects. 

One question about the protocol*, why is the lotion containing 0.5% Bakuchiol applied twice a day, when the one containing 0.5% Retinol is only applied once?

I was the principal investigator on the study. When we design studies, we typically utilize previous studies to develop a future study. In previous studies, retinol is used nightly while Bakuchiol was applied twice daily. Our goal in a pilot study is to build the protocol based on previous evidence whenever possible. Because the previous evidence for Bakuchiol relied on twice daily application, we did the same time for our study.

Could it have an impact on the results you observed?

Our study was not intended to assess whether Bakuchiol and retinol are equivalent when dosed the same. Rather, it was intended to understand if the previously published use of Bakuchiol would have similar effects to the standard of care usage of retinol.

Can you also tell us about the identity of this Bakuchiol? 

We sourced the Bakuchiol from Sytheon Ltd (99% Bakuchiol).

Bakuchiol is natural, yet do you think it can provide the same benefits compared to Retinol (anti-aging, anti-acne, …)? Why?

Retinol is a naturally derived compound as well. The source of whether a compound is natural or not has no bearing on the evidence. Also, I can only report on what we found in our studies rather than what I may feel or think about Bakuchiol. As such, I can say that Bakuchiol has a similar effect as retinol on the appearances of wrinkles and the appearance of even skin tone based on our study. Also, the Bakuchiol had less issues with scaling and stinging than retinol.

Asian skin is very sensitive to retinol products. Why did you pick Caucasian skin types for the study, do you think the results can be extrapolated to other skin types?

We elected to recruit lower Fitzpatrick skin types since these skin types have a higher chance for sun-related damage so that we may be able to track changes in the appearance of wrinkles. The results here are only representative of the patient population recruited and a separate study would be needed to assess higher Fitzpatrick skin types.

*Prospective, randomized, double-blind assessment of topical Bakuchiol and retinol for facial photoageing» published in British Journal of Dermatology – 180:289–296, 2019