The skin care market may pull in $9 billion per year, but three cosmeceutical experts agreed that the best over-the-counter antiaging products come down to two words: "moisturizer" and "sunscreen."
Speaking in separate presentations at the annual meeting of the American Society of Cosmetic Dermatology and Aesthetic Surgery (ASCDAS), Dr. Zoe D. Draelos, Dr. Ellen S. Marmur, and Dr. Michael H. Gold agreed that there is little science to back up claims made by cosmeceutical companies.
Sherry Boschert/Elsevier Global Medical News
Dr. Zoe D. Draelos
Cosmeceuticals fall somewhere between cosmetics and pharmaceuticals; therefore, they are not regulated, and manufacturers are not required to show evidence of antiaging effectiveness. When evidence does exist, it generally points back to the moisturizer and sunscreen properties.
Dr. Draelos, a dermatologist in High Point, N.C., and a consulting professor of dermatology at Duke University in Durham, N.C., studied the ingredients in over-the-counter skin care products. She found that 80% of products are basically moisturizers that serve as a vehicle to deliver a high-profile ingredient being touted by the manufacturer (Plast. Reconstr. Surg. 2010;125:719-24).
Dr. Michael H. Gold
"Hands down, it’s the moisturizer" that’s the most important cosmeceutical choice, she said. "All the products that make antiaging claims are making moisturizer claims," and most antiaging products also have sunscreen ingredients in them.
Dr. Michael Gold said he has been dispensing cosmeceuticals for 22 years and has seen the market explode. "There is now a $700 moisturizer," he said. "There may be no difference" between that and a $10 moisturizer, "but some people will pay the $700 because it’s $700."
Dr. Gold, the founder and medical director of a skin care center based in Nashville, Tenn., urged his colleagues, "If you dispense, do it ethically."
Dermatologists have an important role to play by assessing the marketing claims of cosmeceuticals, not just listening to them. "Even though we don’t have a lot of good research right now, patients want something their doctor feels good about," said Dr. Marmur of Mount Sinai School of Medicine, New York, who is also president of the ASCDAS.
Dr. Ellen S. Marmur
She took that approach in her book, written with Gina Way, "Simple Skin Beauty: Every Woman’s Guide to a Lifetime of Healthy, Gorgeous Skin" (Atria Books, 2009). The book "perhaps put me at odds with some of the industry, but we’re challenging them to produce better science," she said.
Dr. Marmur and her associates are conducting the first independent, randomized, blinded, controlled trial comparing over-the-counter antiaging creams. With more than 130 subjects enrolled, the study will evaluate 28 biomarkers in seven lines of products, with the people who apply the products blinded to the product being used.
Not all antiaging cream manufacturers are included, however, "Some brands refused to participate" perhaps because they were afraid that the study would show that their product is effective but is a pharmaceutical, she said.
Dr. Draelos echoed that observation during a question-and-answer session. "The industry doesn’t want closer scrutiny," she said.