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Speaking today at the American Academy of Dermatology's SKIN academy(Academy), dermatologist Patricia K. Farris, MD, FAAD, clinical associateprofessor of dermatology at Tulane University School of Medicine in NewOrleans, discussed how to separate fact from fiction when evaluatingcosmeceuticals and tips for gauging the validity of product claims.
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"When consulting with our patients, dermatologists can suggest skin careproducts that have strong science behind them and that have been proven to besafe and effective in human studies," said Dr. Farris. "The biggest problemwith cosmeceuticals is not that they don't work, but that their benefits aregreatly exaggerated."
Cosmeceuticals can be divided into categories based on their activeingredients. Anti-oxidants represent the largest category. They are followedby peptides (small proteins that stimulate the production of collagen andthicken the skin) and growth factors (compounds that act as chemicalmessengers between cells and play a role in cell division, new cell and bloodvessel growth, and the production and distribution of collagen and elastin).More recently, Dr. Farris noted that the new trend is toward combinationproducts. For example, cosmeceuticals with multiple anti-oxidants, retinolplus anti-oxidants, growth factors plus vitamin C and other uniquecombinations that are now being mass marketed. Consumers tend to favorcombination products, embracing the philosophy that if one ingredient is good,then two must be better.
"The important thing to understand about combination products is thatoften the individual ingredients have been studied, but the combination ofactive ingredients has not," said Dr. Farris. "More rigorous scientificstudies are necessary to assure that biologic activity is maintained wheningredients are formulated together, and clinical studies should be done todetermine if combination products really offer any added benefit."
Consumer demand is high for cosmeceuticals containing "natural" or"organic" ingredients. However, Dr. Farris advised that the notion that theseingredients are safer than synthetic ones is a common misconception. Inreality, there is no data to support the notion that natural or organicingredients -- derived from the root, stem, leaves, flowers and fruit ofplants -- are safer or even more effective than their synthetic counterparts.
"The problem with cosmeceuticals labeled 'natural' is that the labelsthemselves don't mean anything because these products are not regulated by theFood and Drug Administration (FDA)," said Dr. Farris. "In fact, 'natural'skin care products are less tested and scrutinized than synthetic products andpharmaceuticals."
Dr. Farris noted that most compounds as they exist in their natural statecannot be formulated into skin care products. They must be chemically alteredbefore they can be incorporated into cosmetics. For instance, compoundsincluding retinol, vitamin C, and soy are among those that require chemicalalteration -- after which they are referred to as enhanced naturalingredients. Enhanced natural ingredients tend to be more stable, penetratebetter and have more long-lasting effects on the skin than unaltered plantextracts, which is the reason why most cosmeceuticals containchemically-altered ingredients.
"There are a number of cosmeceutical ingredients that are completelysynthetic, such as collagen-boosting peptides and synthetic forms of vitaminA," explained Dr. Farris. "These compounds are among the most potentanti-aging ingredients and have been used extensively by dermatologists. So,it's important for consumers to understand that synthetic ingredients are notnecessarily bad and, in fact, skin care products containing these ingredientsare probably among the most effective in the marketplace."
Dr. Farris explained that the key to evaluating the effectiveness ofcosmeceuticals is understanding how they are tested. After an activeingredient has been identified, it is evaluated using polymerase chainreaction (PCR) testing, which is used to characterize biologic activity anddetermine if the ingredient is an anti-oxidant or anti-inflammatory. PCRtesting also can tell if an ingredient increases collagen production orreduces collagen breakdown. Although PCR testing is a valuable part of thetesting process, many of the claims made as a result of PCR testing are notsubstantiated by human studies.
"For dermatologists, the gold standard for confirming a product's efficacyremains the double-blind, vehicle-controlled study," said Dr. Farris. "Inthis type of objectively designed study, the product containing the keyingredients is tested against the vehicle, or the product formulation that issimilar to the product being tested but without the key active ingredients."Dr. Farris explained that even though a compound may stimulate collagenproduction in PCR testing, it does not mean that the ingredient will cause anyvisible improvement in fine lines and wrinkles.
"Since cosmeceuticals are not subject to the FDA's rigorous approvalprocess, most cosmetic manufacturers do not perform double-blind,vehicle-controlled studies," said Dr. Farris. "Instead, they rely on what arecalled open-label user studies where subjects apply test creams for a fewweeks and then assess their improvement over baseline. Unfortunately, thesetypes of studies are of no real value in determining product efficacy becausethey do not assess the vehicle's effect and there are no objective measures.People participating in these studies want to believe that they look betterafter using the product, but that does not necessarily mean it works."
Dr. Farris offered these tips when purchasing cosmeceuticals:
-- Ask yourself what the product claims to do and what kinds of studieshave been performed.
-- Trust your instincts. If it sounds too good to be true, then itprobably is.
-- Stick with products and brands that you know to be reputable.Well-known manufacturers have more money behind their active ingredients andproduct testing.
-- Beware of Web site claims, as many are biased even if they say theyare objective.
-- For day, use products containing anti-oxidants, as they havesun-protection properties. At night, use products containing retinoids,peptides or growth factors for their repair properties.
-- Talk to your dermatologist about the best options for your skin careneeds.
For more information on aging skin, go to the "AgingSkinNet" section ofhttp://www.skincarephysicians.com, a Web site developed by dermatologists thatprovides patients with up-to-date information on the treatment and managementof disorders of the skin, hair and nails.
Headquartered in Schaumburg, Ill., the American Academy of Dermatology(Academy), founded in 1938, is the largest, most influential, and mostrepresentative of all dermatologic associations. With a membership of morethan 15,000 physicians worldwide, the Academy is committed to: advancing thediagnosis and medical, surgical and cosmetic treatment of the skin, hair andnails; advocating high standards in clinical practice, education, and researchin dermatology; and supporting and enhancing patient care for a lifetime ofhealthier skin, hair and nails. For more information, contact the Academy at1-888-462-DERM (3376) or http://www.aad.org.
SOURCE American Academy of Dermatology
