As a professional in the medical aesthetics field, we often hear these common questions from our clients: What is the difference between a “professional” skin care cosmeceutical vs. a brand you can find “over-the-counter” at a drug or department store? Is there really a difference, or is it all a bunch of fancy marketing talk and pretty pictures? Can you get nice results with drugstore cosmetic brands, or will your results be better with professional cosmeceuticals? Too often, consumers fall under the spell of cosmetic company marketing and advertising claims, and will spend a lot of money on expensive over-the-counter cosmetics that really don’t work in the skin.
The US Food and Drug Administration (FDA) divides skin care products into two distinct categories: pharmaceutical and cosmetic. Topical pharmaceuticals penetrate through the layers of the epidermis and affect the structure and function of the skin (think of prescription topical steroids or Retin-A). Cosmetics are defined as ” … articles intended to be rubbed, poured, sprinkled, or sprayed on, introduced into, or otherwise applied to the human body or any part thereof for cleansing, beautifying, promoting attractiveness, or altering the appearance …” Pharmaceutical drugs may undergo more than 10 years of drug approval testing that may cost hundreds of millions of dollars — whereas, cosmetics do not have to prove their claims, but they can cite “scientific studies” of the ingredients used in their product formulations to validate the safety and efficacy of the ingredient formula.
Cosmeceuticals are the “happy medium” between a pharmaceutical and a cosmetic. The word “cosmeceutical” really is not categorized by the FDA, but it is a word that is used in the professional skin care arena to describe a cosmetic that actually has biological action, but is regulated as a cosmetic — meaning, again, the formula does not technically have to prove efficacy or safety, but it does contain an ingredient that may have activity in the skin.
You will find many of the same catch phrases when you read an advertisement for skin care: “Dermatologist-Tested,” “Clinically Proven,” “Clinical Studies show that …,” “Clinically Tested.” But interpret these phrases with caution, especially when trying to choose a skin care line that works best for your practice and clientele. Since cosmetic companies really don’t have to prove efficacy claims, the special active ingredient touted in the formula only has to appear somewhere on the ingredient list – ingredients are listed in content order, from most to least, so if you see that “active” on the last half of the list (usually alphabetically) you can bet you are getting a tiny percentage (enough to be effective in the formulation?) of that specific ingredient. When you see these types of claims, start asking questions:
· What was tested — an individual ingredient or the finished formulation?
· How was it tested, in-vitro (in a test tube or petri dish, in an ideal environment), or was it tested in-vivo (on actual skin)?
· Were the studies double-blinded (meaning, the person applying the product and the person evaluating the results each have no knowledge of what they are applying or evaluating; it is strictly objective)
· Was the formula tested against placebo cream (like glycerin or petrolatum), or against nothing, or against another type of similar product?
· How long was the test conducted? On how many participants?
Because many consumers “self-diagnose” when choosing a skin care product to try from a drug or department store, these products must be made safely, meaning, big cosmetic companies cannot afford to have masses of consumers with issues from using very active products — so, that skin care product may feel good and smell good, but it likely won’t have a lot of activity in the formulation.
Over-the-counter cosmetics are also manufactured and distributed in very large batches, and are packed with almost as many preservatives as “active” ingredients! In addition, many over-the-counter cosmetics simply do not penetrate the skin barrier, where the ingredient formula would have a therapeutic benefit to the health of the skin. Remember too, it’s not just about one really fabulous ingredient — it’s the mixture of the right amounts of active ingredients working synergistically together that work best in the skin, similar to how oral multivitamins work internally in our bodies with a mixture of vitamins and minerals for best absorption.
It is important to note that many single ingredients that test very well in in-vitro testing actually have no function in human skin when mixed into a formulation — yet, we still believe the “clinical study” claims from in-vitro studies. As well, many companies that cite clinical study results will notprovide clinical study documentation. Rare is the cosmeceutical company that tests their finished formulations and then offers full clinical study details for the public to see. You will sometimes find peer-reviewed cosmetic formulation studies in dermatology or cosmetic surgery journals, which lends more credibility to the testing process.
