Advanced Night Restore
Ingredients overview
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Key Ingredients
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Medik8 Advanced Night RestoreIngredients explained
Good old water, aka H2O. The most common skincare ingredient of all. You can usually find it right in the very first spot of the ingredient list, meaning it’s the biggest thing out of all the stuff that makes up the product.
It’s mainly a solvent for ingredients that do not like to dissolve in oils but rather in water.
Once inside the skin, it hydrates, but not from the outside - putting pure water on the skin (hello long baths!) is drying.
One more thing: the water used in cosmetics is purified and deionized (it means that almost all of the mineral ions inside it is removed). Like this, the products can stay more stable over time.
It seems to us that squalane is in fashion and there is a reason for it. Chemically speaking, it is a saturated (no double bonds) hydrocarbon (a molecule consisting only of carbon and hydrogen), meaning that it's a nice and stable oily liquid with a long shelf life.
It occurs naturally in certain fish and plant oils (e.g. olive), and in the sebum (the oily stuff our skin produces) of the human skin. As f.c. puts it in his awesome blog post, squalane's main things are "emolliency, surface occlusion, and TEWL prevention all with extreme cosmetic elegance". In other words, it's a superb moisturizer that makes your skin nice and smooth, without being heavy or greasy.
Another advantage of squalane is that it is pretty much compatible with all skin types and skin conditions. It is excellent for acne-prone skin and safe to use even if you have fungi-related skin issues, like seborrhea or fungal acne.
The unsaturated (with double bonds) and hence less stable version of Squalane is Squalene, you can read about it here >>
A super common emollient that makes your skin feel nice and smooth. It comes from coconut oil and glycerin, it’s light-textured, clear, odorless and non-greasy. It’s a nice ingredient that just feels good on the skin, is super well tolerated by every skin type and easy to formulate with. No wonder it’s popular.
Probably the most common silicone of all. It is a polymer (created from repeating subunits) molecule and has different molecular weight and thus different viscosity versions from water-light to thick liquid.
As for skincare, it makes the skin silky smooth, creates a subtle gloss and forms a protective barrier (aka occlusive). Also, works well to fill in fine lines and wrinkles and give skin a plump look (of course that is only temporary, but still, it's nice). There are also scar treatment gels out there using dimethicone as their base ingredient. It helps to soften scars and increase their elasticity.
As for hair care, it is a non-volatile silicone meaning that it stays on the hair rather than evaporates from it and smoothes the hair like no other thing. Depending on your hair type, it can be a bit difficult to wash out and might cause some build-up (btw, this is not true to all silicones, only the non-volatile types).
- A natural moisturizer that’s also in our skin
- A super common, safe, effective and cheap molecule used for more than 50 years
- Not only a simple moisturizer but knows much more: keeps the skin lipids between our skin cells in a healthy (liquid crystal) state, protects against irritation, helps to restore barrier
- Effective from as low as 3% with even more benefits for dry skin at higher concentrations up to 20-40%
- High-glycerin moisturizers are awesome for treating severely dry skin
It's one of the important lipids that can be found naturally in the outer layer of the skin. About 25% of the goopy stuff between our skin cells consists of cholesterol. Together with ceramides and fatty acids, they play a vital role in having a healthy skin barrier and keeping the skin hydrated.
Apart from being an important skin-identical ingredient, it's also an emollient and stabilizer.
A common multi-tasker fatty acid. It makes your skin feel nice and smooth (emollient), gives body to cream type products and helps to stabilize water and oil mixes (aka emulsions).
- It's a helper ingredient that improves the freeze-thaw stability of products
- It's also a solvent, humectant and to some extent a penetration enhancer
- It has a bad reputation among natural cosmetics advocates but cosmetic scientists and toxicology experts do not agree (read more in the geeky details section)
We don't have description for this ingredient yet.
A copolymer is a big molecule that consists not of one but of two repeating subunits. This particular copolymer is a handy helper ingredient to form nice gel textures.
It usually comes to the formula combined with emollients (such as C13-14 Isoparaffin, Isohexadecane, Isononyl Isononanoate or Squalane) and can be used as an emulsifier and/or thickener to produce milky gel emulsions with a soft and non-tacky skin feel.
An extremely common multitasker ingredient that gives your skin a nice soft feel (emollient) and gives body to creams and lotions. It also helps to stabilize oil-water mixes (emulsions), though it does not function as an emulsifier in itself. Its typical use level in most cream type formulas is 2-3%.
It’s a so-called fatty alcohol, a mix of cetyl and stearyl alcohol, other two emollient fatty alcohols. Though chemically speaking, it is alcohol (as in, it has an -OH group in its molecule), its properties are totally different from the properties of low molecular weight or drying alcohols such as denat. alcohol. Fatty alcohols have a long oil-soluble (and thus emollient) tail part that makes them absolutely non-drying and non-irritating and are totally ok for the skin.
One of the many types of ceramides that can be found naturally in the upper layer of the skin. Ceramides make up about 50% of the goopy stuff that's between our skin cells and play a super important role in having a healthy skin barrier and keeping the skin hydrated. It works even better when combined with its pal, Ceramide 1.
We wrote way more about ceramides at ceramide 1, so click here to know more.
A type of ceramide that can be found naturally in the upper layer of the skin. Ceramides make up 50% of the goopy stuff that's between our skin cells and play a super important role in having a healthy skin barrier and keeping the skin hydrated.
We have written way more about ceramides at ceramide 1, so click here to know more.
Ceramides get quite a lot of hype recently and good news: there is a reason for that. But before we go into the details, let's just quickly define what the heck ceramides are:
They are waxy lipids that can be found naturally in the outer layer of the skin (called stratum corneum - SC). And they are there in big amounts! The goopy stuff between our skin cells is called extracellular matrix that consists mainly of lipids. And ceramides are about 50% of those lipids (the other important ones are cholesterol with 25% and fatty acids with 15%).
Ok, so now we know what ceramides are, let's see what they do in our skin: research shows clearly that they play a super important role in keeping the skin barrier healthy and the skin hydrated. If ceramides in the skin are decreased, more water can evaporate from the skin and there is less water remaining in the skin. So ceramides form kind of a "water-proof" protecting layer and make sure that our skin remains nice and hydrated.
Now the question is only this: If we put ceramides all over our face do they work as well as ceramides already naturally in our skin? Well, the answer is probably a no, but they do work to some extent. The BeautyBrains blog made a fantastic article about ceramides and they have listed a couple of examples about studies showing that ceramides - especially when used in certain ratios with cholesterol and fatty acids - do hydrate the skin and can help to repair the skin barrier.
So far we were writing about ceramides in plural. It's because there are lots of different ceramides, a 2014 article writes that currently 12 base classes of ceramides are known with over 340 specific species. Chemically speaking, ceramides are the connection of a fatty acid and a sphingoid base and both parts can have different variations that result in the different types of ceramides.
Our current one, Ceramide 1, or more recently called Ceramide EOP, was the first one that was identified in 1982 and it's a special snowflake. It contains the essential fatty acid, linoleic acid and has a unique structure. It's believed that ceramide 1 plays a "binding role" in the lipid layers of the extracellular matrix. Along with ceramides 4 and 7, they also play a vital role in epidermal integrity and serve as the main storage areas for linoleic acid (a fatty acid that's also very important for barrier repair).
Oh, and one more thing: alkaline pH inhibits enzymes that help ceramide synthesis in our skin. So if you use a soap and you notice your skin is becoming dry, now you know why.
We don't have description for this ingredient yet.
We don't have description for this ingredient yet.
We don't have description for this ingredient yet.
A fatty acid that can be found naturally in the skin. In fact, it's the most common saturated fatty acid found in animals and plants.
As for skincare, it can make the skin feel nice and smooth in moisturizers (emollient) or it can act as a foam building cleansing agent in cleansers. It's also a very popular ingredient in shaving foams.
The famous omega-6 fatty acid, the mother of all ω-6 fatty acids in our body. It is a so-called polyunsaturated fatty acid meaning it has more than one (in this case two) double bonds and a somewhat kinky structure that makes LA and LA-rich oils a thin liquid.
It is also an essential fatty acid meaning our body cannot synthesize it and has to take it from food. This is not hard at all as plenty of nuts (such as flax, poppy or sesame seeds) and vegetable oils (such as sunflower or safflower) are rich in LA. The hard thing seems to be eating enough omega-3-s, more specifically eating a healthy ratio of omega-6 to omega-3, but that is a topic for a what-is-good-to-eat-site and not for us.
As for linoleic acid and the skin, LA is a really important little guy found naturally in our skin. It is the most abundant fatty acid in the epidermis and it serves as a structural precursor for important skin lipids called ceramides. Knowing this, it will not come as a surprise that Linoleic acid has a central role in the structure and function of stratum corneum permeability, aka healthy skin barrier. LA deficiency leads to an impaired more permeable skin barrier and the topical application of LA-rich sunflower oil can fix this issue rapidly (while oleic-rich olive oil did not have the same barrier repairing effect).
LA is not only important for dry, barrier damaged skin types but also for acne-prone skin. Research shows that problem skin has lower levels of linoleic acid (and higher levels of oleic acid) than normal skin. So LA-deficiency in the skin seems to be connected not only to an impaired skin barrier but also to acne and smearing LA all over your face might help with your problem skin. A double-blind study using a 2.5% LA gel for 4 weeks found a 25% reduction in the size of microcomedones, the tiny blocked pores that can later lead to acne.
If that was not enough, we have one more thing to report about LA. It lightens hyperpigmentation (aka UVB caused sun spots) both by blocking the melanin production of melanocytes (the skin cells that make the pigment melanin) and by enhancing the desquamation of melanin pigment from the upper layers of the skin.
Overall, linoleic acid is a multi-functional skin goodie with barrier repairing, acne-reducing, and skin-lightening magic abilities. It's a nice one to spot on the ingredient list pretty much for any skin type.
An amino acid sugar that can be found in the skin and does there good and important things. One of them is that it's a precursor for the biosynthesis of superstar moisturizer, hyaluronic acid. So acetyl glucosamine itself is also an important skin-identical ingredient and natural moisturizing factor.
But that is not all, acetyl glucosamine has two other great properties proved by double-blind clinical trials. First, it's a promising ingredient against wrinkles: 2% can improve wrinkles, particularly in the eye area.
Second, the same amount can also fade - always stubborn - brown spots. (Do not expect magic, though - the photos from the study show the difference after 8 weeks of daily use. The difference is visible, but not that big. It's always good to have realistic expectations. :)) Combined with skincare superstar niacinamide the duo is synergistic and is more effective at improving hyperpigmentation, so if you are after the skin-lightening benefit look out for products that contain both.
We don't have description for this ingredient yet.
We don't have description for this ingredient yet.
It's the chemically chopped up version of normal lecithin. Most often it's used to create liposomes and to coat and stabilize other ingredients.
The essential oil coming from the flowers of bitter orange (which is the sister of the sweet orange we all know and eat). It contains several fragrance components including linalool (around 30%) and limonene (around 10%) and has a lovely sweet smell.
As it's an essential oil with lots of fragrant components, be careful with it if your skin is sensitive.
It’s the most commonly used version of pure vitamin E in cosmetics. You can read all about the pure form here. This one is the so-called esterified version.
According to famous dermatologist, Leslie Baumann while tocopheryl acetate is more stable and has a longer shelf life, it’s also more poorly absorbed by the skin and may not have the same awesome photoprotective effects as pure Vit E.
An ester that comes from Cetearyl alcohol and the fatty acids of olive oil. It often comes to the formula coupled with Sorbitan Olivate as the two together form the well-known, natural emulsifier trade named Olivem 1000.
Other than helping oil and water to blend, the main thing of Olivem 1000 is generating liquid crystal structures that are similar to the lipid structures of the stratum corneum (the outermost layer of the skin). Thanks to this, Olivem 1000 doubles as an active ingredient with significant moisturizing, barrier-repairing and soothing properties.
It also helps to deliver water-soluble actives such as caffeine more effectively, and can even boost SPF in sunscreen formulas. Its typical use level is 1-5% and has wide compatibility with other actives and oils.
Overall, a real multi-tasker with nice sensorial properties. No wonder it is so popular.
We don't have description for this ingredient yet.
We don't have description for this ingredient yet.
An ester coming from sorbitol and the fatty acids of olive oil. It is part of the popular emulsifier trade named Olivem 1000 that is well-known for generating biomimetic liquid crystal structures. We have more info on Olivem 1000 at Cetearyl Olivate >>
It's a type of lipid, a so-called sphingoid base that can be found naturally in the upper layer of the skin. It's found both in "free-form" and as part of famous skin lipids, ceramides.
There is emerging research about Phytosphingosine that shows that it has antimicrobial and cell-communicating properties and is considered part of the skin's natural defense system.
A 2007 study showed that Phytosphingosine even works against evil acne-causing bacteria, Propionibacterium acnes and shows promise as a complementing active ingredient in treating acne-prone skin thanks to its anti-inflammatory and antimicrobial activities.
A nice one to spot in the ingredient list. :)
The essential oil coming from the second most common type of chamomile, the Roman Chamomile. It also contains the biologically active anti-inflammatory components, bisabolol, and chamazulene, but less than the more commonly used German Chamomile. It's not clear what Roman Chamomile knows that the German one does not.
It's one of those things that help your cosmetics not to go wrong too soon, aka a preservative. It can be naturally found in fruits and teas but can also be made synthetically.
No matter the origin, in small amounts (up to 1%) it’s a nice, gentle preservative. Has to be combined with some other nice preservatives, like potassium sorbate to be broad spectrum enough.
In high amounts, it can be a skin irritant, but don’t worry, it’s never used in high amounts.
If you have spotted ethylhexylglycerin on the ingredient list, most probably you will see there also the current IT-preservative, phenoxyethanol. They are good friends because ethylhexylglycerin can boost the effectiveness of phenoxyethanol (and other preservatives) and as an added bonus it feels nice on the skin too.
Also, it's an effective deodorant and a medium spreading emollient.
The essential oil coming from the leafs of the lovely herb, rosemary. It contains several fragrant components, including the well-known irritant, camphor (around 15%). It has a nice smell, is a potent antioxidant and it's also an antimicrobial agent.
If your skin is sensitive, it's probably a good idea to avoid it.
It's a sweet tasting sugar substitute that helps your skin to hold onto water when used in cosmetic products. It also helps to thicken up products and give them a bit more slip.
A polysaccharide (a big sugar molecule) coming from the edible fruit bodies of the Silver Ear mushroom in China. It's claimed to be an awesome moisturizer with slightly greater water-holding capacities than HA. We wrote more about Tremella here >>
A helper ingredient that helps to make the products stay nice longer, aka preservative. It works mainly against fungi and has only milder effect against bacteria.
It is Ecocert and Cosmos approved, works quite well at low concentrations (0.1-0.6%) and is popular in natural products.
A fatty alcohol (the non-drying type with a long oil loving chain of 22 carbon atoms) that is used to increase the viscosity of the formula and it also helps the oily and the watery parts to stay nicely mixed together (called emulsion stabilizing).
- Primary fat-soluble antioxidant in our skin
- Significant photoprotection against UVB rays
- Vit C + Vit E work in synergy and provide great photoprotection
- Has emollient properties
- Easy to formulate, stable and relatively inexpensive
We don't have description for this ingredient yet.
We don't have description for this ingredient yet.
The essential oil coming from the rind of the orange (the sweet one). In general, the main component of citrus peel oils is limonene (83-97% for sweet orange peel), a super common fragrant ingredient that makes everything smell nice (but counts as a frequent skin sensitizer).
Other than that, citrus peel also contains the problematic compound called furanocoumarin that makes them mildly phototoxic. Orange peel contains less of it than some other citruses (like bergamot or lime), but still, be careful with it especially if it is in a product for daytime use.
It’s pretty much the current IT-preservative. It’s safe and gentle, but even more importantly, it’s not a feared-by-everyone-mostly-without-scientific-reason paraben.
It’s not something new: it was introduced around 1950 and today it can be used up to 1% worldwide. It can be found in nature - in green tea - but the version used in cosmetics is synthetic.
Other than having a good safety profile and being quite gentle to the skin it has some other advantages too. It can be used in many types of formulations as it has great thermal stability (can be heated up to 85°C) and works on a wide range of pH levels (ph 3-10).
It’s often used together with ethylhexylglycerin as it nicely improves the preservative activity of phenoxyethanol.
- Works best between a concentration of 5-20%
- Boosts the skin’s own collagen production
- Fades pigmentation and brown spots
- If used under sunscreen it boosts its UV protection
- Extremely unstable and oxidizes very easily in presence of light or air
- Stable in solutions with water only if pH is less than 3.5 or in waterless formulations
- Vit E + C work in synergy and provide superb photoprotection
- Ferulic acid doubles the photoprotection effect of Vit C+E and helps to stabilize Vit C
- Potent Vit. C serums might cause a slight tingling on sensitive skin
A form of skincare superstar, vitamin C. Even though we are massive vitamin C fans, Ascorbyl Palmitate (AP) is our least favorite. (Btw, if you do not know what the big deal with vitamin C is then you are missing out. You must go and read our geeky details about it.)
So, AP is one of the attempts by the cosmetics industry to solve the stability issues with vitamin C while preserving its benefits, but it seems to fall short on several things.
What's the problem?
Firstly, it's stability is only similar to that of pure ascorbic acid (AA), which means it is not really stable. A great study in the Journal of Cosmetic Dermatology compared a bunch of vitamin C derivatives and this derivative was the only one where the study said in terms of stability that it's "similar to AA". Not really that good.
Second, a study that examined the skin absorption of vitamin C found that ascorbyl palmitate did not increase the skin levels of AA. This does not mean that ascorbyl palmitate cannot penetrate the skin (because it can, it's oil soluble and the skin likes to absorb oil soluble things) but this means that it's questionable if ascorbyl palmitate can be converted into pure Vit C in the skin. Even if it can be converted, the palmitate part of the molecule is more than the half of it, so the efficacy will not be good and we have never seen a serum that contains a decent (and proudly disclosed) amount of AP. We are highly skeptical what effect a tiny amount of AP has in a formula.
Third, another study that wanted to examine the antioxidant properties of AP was surprised to find that even though AP does have nice antioxidant properties; following UVB radiation (the same one that comes from the sun) it also promotes lipid peroxidation and cytotoxicity. It was only an in-vitro study meaning that it was done on cell cultures and not on real people, but still, this also does not support the use of AP too much.
The only good thing we can write about Ascorbyl Palmitate is that there is an in-vitro (made in the lab, not on real people) study showing that it might be able to boost collagen production.
Regarding the skin-brightening properties of pure vitamin C, this is another magic property AP does not have, or at least there is no data, not even in-vitro, about it.
Overall, Ascorbyl Palmitate is our least favorite vitamin C derivative. It is there in lots of products in tiny amounts (honestly, we do not really understand why), however, we do not know about any vitamin C serum featuring AP in high amounts. That is probably no coincidence. If you are into vitamin C, you can take a look at more promising derivatives here.
We have to start by writing how fascinated we are by the amazing lavender fields of Provance and we do love pretty much everything about lavender: its look, its color, its scent.... but, when it comes to skincare, lavender is a questionable ingredient that you probably do not want in your skincare products.
First, let us start with the pros: it has a lovely scent, so no wonder that it is popular as a fragrance ingredient in natural products wanting to be free from synthetic fragrances but still wanting to smell nice. The scent of lavender is famous for having calming and relaxing properties and some smallish scientific studies do support that. Inhaled volatile compounds seem to have a soothing effect on the central nervous system and studies have shown that lavender aromatherapy can improve patient's anxiety and experience in hospitals.
Another pro is that lavender oil has some nice antimicrobial and antibacterial properties. It also has some local pain relieving and muscle relaxing magical powers. Lavender oil is also often claimed to have anti-inflammatory properties. We have found a study confirming this but it was the essential oil of the leaves and not the much more commonly used flowers and the two differ in their main chemical compounds very much. (The main components of the flower essential oil are linalyl acetate and linalool [around 80% the two together] while it is 1,8-Cineole [around 65%] in the essential oil of the leaves.)
Now, let us look at the cons: similar to a bunch of other essential oils, the main components of lavender oil are potentially irritating fragrant components. The two main components are linalyl acetate (about 50%) and linalool (about 35%) and both autoxidise on exposure to the air forming strong contact allergens. To make things even worse, lavender oil seems to be cytotoxic from concentrations as low as 0.25% (concentration up to 0.125% were ok).
There is also an often cited Japanese study that made patch tests with lavender oil for 9 years and found a huge increase in lavender oil sensitivity in 1997 (from 1.1% in 1990 to 8.7% in 1997 and 13.9% in 1998). This was the year when using dried lavender flowers in pillows, wardrobes, and elsewhere became fashionable in Japan, so it seems that increased exposure to lavender results in increased risk of sensitivity.
Overall, it makes us sad to write bad things about such a lovely plant, but when it comes to skincare, you will be better off without lavender.
A big molecule created from repeated subunits (a polymer of acrylic acid) that magically converts a liquid into a nice gel formula. It usually has to be neutralized with a base (such as sodium hydroxide) for the thickening to occur and it creates viscous, clear gels that also feel nice and non-tacky on the skin. No wonder, it is a very popular and common ingredient. Typically used at 1% or less in most formulations.
We don't have description for this ingredient yet.
A so-called fatty (the good, non-drying kind of) alcohol that does all kinds of things in a skincare product: it makes your skin feel smooth and nice (emollient), helps to thicken up products and also helps water and oil to blend (emulsifier). Can be derived from coconut or palm kernel oil.
If you are into perfumes, you must know patchouli as an important essential oil in the perfume industry. It boasts a pleasant woody, earthy and camphoraceous scent and has fixative properties (makes the fragrance long-lasting).
Its composition is pretty unique: it does not contain any of the EU's 26 most common fragrance allergens, but its most important components are patchoulol (30%) and alpha-patchoulene (6%) which are responsible for its aroma and antifungal properties.
Among essential oils, the allergen profile of patchouli counts as pretty good (much better than ylang-ylang or lemongrass oils), but if your skin is sensitive, it's still best to avoid it.
A helper ingredient that's used as a co-emulsifier (meaning next to other emulsifiers in the formula it helps water and oil to mix) and as a stabilization agent for foams. Also, has some antimicrobial activity so it can help to boost the effectiveness of the preservative system.
Citric acid comes from citrus fruits and is an AHA. If these magic three letters don’t tell you anything, click here and read our detailed description on glycolic acid, the most famous AHA.
So citric acid is an exfoliant, that can - just like other AHAs - gently lift off the dead skin cells of your skin and make it more smooth and fresh.
There is also some research showing that citric acid with regular use (think three months and 20% concentration) can help sun-damaged skin, increase skin thickness and some nice hydrating things called glycosaminoglycans in the skin.
But according to a comparative study done in 1995, citric acid has less skin improving magic properties than glycolic or lactic acid. Probably that’s why citric acid is usually not used as an exfoliant but more as a helper ingredient in small amounts to adjust the pH of a formulation.
It's one of the most commonly used thickeners and emulsion stabilizers. If the product is too runny, a little xanthan gum will make it more gel-like. Used alone, it can make the formula sticky and it is a good team player so it is usually combined with other thickeners and so-called rheology modifiers (helper ingredients that adjust the flow and thus the feel of the formula). The typical use level of Xantha Gum is below 1%, it is usually in the 0.1-0.5% range.
Btw, Xanthan gum is all natural, a chain of sugar molecules (polysaccharide) produced from individual sugar molecules (glucose and sucrose) via fermentation. It’s approved by Ecocert and also used in the food industry (E415).
Super common little helper ingredient that helps products to remain nice and stable for a longer time. It does so by neutralizing the metal ions in the formula (that usually get into there from water) that would otherwise cause some not so nice changes.
It is typically used in tiny amounts, around 0.1% or less.
A super common and cheap fragrance ingredient. It's in many plants, e.g. rosemary, eucalyptus, lavender, lemongrass, peppermint and it's the main component (about 50-90%) of the peel oil of citrus fruits.
It does smell nice but the problem is that it oxidizes on air exposure and the resulting stuff is not good for the skin. Oxidized limonene can cause allergic contact dermatitis and counts as a frequent skin sensitizer.
Limonene's nr1 function is definitely being a fragrance component, but there are several studies showing that it's also a penetration enhancer, mainly for oil-loving components.
All in all, limonene has some pros and cons, but - especially if your skin is sensitive - the cons probably outweigh the pros.
Linalool is a super common fragrance ingredient. It’s kind of everywhere - both in plants and in cosmetic products. It’s part of 200 natural oils including lavender, ylang-ylang, bergamot, jasmine, geranium and it can be found in 90-95% of prestige perfumes on the market.
The problem with linalool is, that just like limonene it oxidises on air exposure and becomes allergenic. That’s why a product containing linalool that has been opened for several months is more likely to be allergenic than a fresh one.
A study made in the UK with 483 people tested the allergic reaction to 3% oxidised linalool and 2.3% had positive test results.
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