Cosmeceuticals that deliver

Not all cosmeceuticals are created equal. Before making a recommendation to patients, peruse this list of products that dermatologists say deliver what they promise.

UV Clear SPF 46 (Elta MD): This oil-free sunscreen contains nine percent zinc oxide, 7.5 percent octinoxate and vitamin B3 (niacinamide).

"Niacinamide helps reduce UV damage as well as hyperpigmentation," says Vivian W. Bucay, M.D., clinical assistant professor of dermatology, University of Texas Health Science Center, San Antonio. Additionally, "Data demonstrate that four percent nicotinamide gel is of comparable efficacy to one percent clindamycin gel in the treatment of acne vulgaris (Shalita AR, Smith JG, Paris LC, et al. Int J Dermatol. 1995;34(6):434-437). Because topical clindamycin, like other antimicrobials, is associated with emergence of resistant microorganisms, nicotinamide gel is a desirable alternative treatment for acne vulgaris."

Sunforgettable SPF 30 (Colorescience Pro): This brush-on, refillable, water-resistant sunscreen is highly portable and comes in several shades, Dr. Bucay says. It contains 12 percent titanium dioxide and 12 percent zinc oxide.

Intellishade SPF 45 (Revision Skincare): "The ultimate multitasker, this tinted moisturizer evens out skin tone, hydrates and provides sun protection. It gives a nice glow but will also be available in a matte version," Dr. Bucay says.

Eau Thermale Avene High Protection Tinted Compact SPF 50 (Pierre Fabre): Jeannette Graf, M.D., recommends this for patients with skin types 1 through 3.

"It's water resistant, preservative-free, and goes on like a makeup. It's also a broad-spectrum sunscreen made entirely of pure minerals." As such, patients can use it around the eyes, Dr. Graf says, "And it's great for patients with melasma." She is assistant clinical professor of dermatology, Mount Sinai School of Medicine, New York.

Glytone Antioxidant Antiaging Serum (Pierre Fabre): Keys to its success include vitamin C in the form of tetrahexyldecyl ascorbate (THD), Dr. Bucay says.

"THD penetrates better through the epidermis than ascorbic acid does. It's actually three times more potent at the same concentration (Barnet Products Corp. Stable forms of vitamin C. Technical Bulletin. Englewood Cliffs NJ: Barnet Products Corp., 2001)." It also produces more collagen synthesis (Fitzpatrick RE, Rostan EF. Dermatol Surg. 2002; 28(3) 231-236). Other ingredients include vitamin E (delta-tocopheryl glucoside complex) and red tea flavonoids.

Dr. Graf says, "I like the fact that Glytone Antioxidant Serum has been shown by manufacturer studies to remain in the skin upwards of 40 to 48 hours."

DNA Youth Recovery Serum (CELFIX): With BID use for three months, Dr. Bucay says, more than 100 of her patients who used this product achieved a 40 percent to 50 percent decrease in UV spots as measured with a Visia (Canfield) imaging system (unpublished).

Tensage Intensive Ampoules SCA 40 (Biopelle): This product's ingredients include a snail (Cryptomphalus Aspersa) growth factor secretion, Dr. Bucay says. The product works well for photodamage and is an excellent choice for speeding post-procedure (such as chemical peels, ablative and nonablative laser treatments) recovery, she says.

Replenix Power of Three Cream (Topix): Its green tea polyphenols, resveratrol and caffeine provide a powerful antioxidant and anti-inflammatory cream, according to Dr. Bucay. Based on personal observation, "It reduces irritation associated with retinoid use."

gloRefine Hydrator (glotherapeutics): Containing Renovage (Sederma) and teprenone, this product works on telomeres to extend cell life by one-third, according to its manufacturer. It is also said to decrease transepidermal water loss and provide up to a 56 percent decrease in UV spots (data on file, Sederma), Dr. Bucay says.

Purifying Lytic Toner and Lytic Lotion Plus (Epionce): With ingredients including salicylic acid, these cosmeceuticals are "great for acne-prone skin and postinflammatory hyperpigmentation (PIH)," Dr. Bucay says. They are also hydrating, and well-tolerated by patients with rosacea because of the anti-inflammatory properties of salicylic acid, she says.

Gly Sal 10-2 Pads (Topix): These pads - presoaked with 10 percent glycolic acid and two percent salicylic acid - work well for acne, keratosis pilaris and PIH, Dr. Bucay says. "They're easy to use and, with 60 pads per package, a great value."

Avene Thermal Spring Water (Pierre Fabre): "Thermal spring waters are rich in silicates and trace elements. This product also has a very low salt mineral content, so it doesn't dry the skin," Dr. Graf says.

With a pH of 7.5, "It's a perfect balance of anions and cations. Because it's very calming, soothing and softening to the skin, I love it for patients with rosacea." She also uses it to cool the skin before and after certain laser procedures such as the Isolaze (Solta).

Strovite Advance Oral (Everett Laboratories): Jeanine Downie, M.D., a dermatologist based in Montclair, N.J., says, "The vitamin and mineral supplementation this prescription vitamin provides is great for women as they start to get older. But many women do not realize that they could be taking a multivitamin that's a prescription - or that maybe they should be."

TNS Essential Serum (SkinMedica): This serum offers several antioxidants and a patented growth factor combination, Dr. Downie says. As such, "It builds collagen, evens out skin tone, decreases fine lines and wrinkles."

Retinoids represent the gold standard for these purposes, "But many people can't tolerate them." She says, however, that even patients with sensitive skin tolerate TNS Serum very well.

Vibrance Vivite (Allergan): This product improves skin texture and tone, Dr. Downie says. In these areas, she says, "In some small studies, it was found to be as efficacious as hydroquinone (data on file, Allergan)."

Disclosures: Dr. Downie is a consultant for Allergan, Galderma and Medicis. Dr. Bucay is a consultant for Medicis, Allergan, Novartis, Johnson & Johnson, Aveeno, Eleme Medical, Ferndale/Biopelle, Galderma, Azure/HydroPeptide, Bioform/Merz Aesthetics and Syneron. Dr. Graf is a consultant for Allergan, Medicis, Johnson & Johnson, OrthoNeutrogena, Mercer/BioForm, Aveeno and ROC, but she reports no relevant financial interests in any products discussed in this article.