Cosmeceuticals: Thoughts of a skeptic and a hypocrite

Las Vegas

- Everyone needs a working knowledge of cosmeceuticals, even if you’re a skeptic, says Hilary E. Baldwin, M.D, vice chair and associate professor of dermatology, department of dermatology, State University of New York, Brooklyn, N.Y., in a presentation here at the Fall Clinical Dermatology Conference.

The luxury skincare market is rapidly growing due to the aging U.S. population, along with the baby boomer’s mentality that "there is nothing remotely graceful about the aging process," Dr. Baldwin tells Dermatology Times. This is made evident in cosmeceutical sales, with $6.4 billion sold in 2003 to 2004 and projected sales in 2008 at $7.2 billion.

In addition, Dr. Baldwin says women are confused by the mass of products on the market, and are inclined to believe cosmetic claims, cosmetic salespeople and dermatologists equally about the effectiveness of a product, "which is something we really can’t put up with. We need to have better knowledge than the cosmetic counter," she says.

The goals of a cosmeceutical are to protect from UV damage (sunscreen), reduce free radical formation (antioxidants), improve skin lipid barrier (moisturizers), brighten and unify color and tone (bleaching agents and antioxidants), and smooth texture, reduce pore size and decrease fine lines and wrinkles (retinoids and collagen stimulators), Dr. Baldwin says, but these goals are only attainable to a limited extent.

"Cosmeceutical ‘science,’ we have to remember, is really taking a biologically active ingredient in vitro and putting it into a bottle, and in vitro success, of course, does not prove in vivo success," she says.

A critical evaluation of cosmeceuticals would require rigorous clinical trials, she says, but that may not be possible, because anticipated outcomes are very subtle changes that may not achieve statistical significance.

For the skeptic, Dr Baldwin says "nothing is more important than obsessive-compulsive use of well-formulated sunscreen," and the use of topical retinoids and hydroxyl acids also have sound scientific backing.

Lastly, she says no single cosmeceutical active is going to do everything."Combinations of retinoids, sunscreens, antioxidants, collagen stimulating peptides, bleaching agents and hydroxyl acids will be more effective than any agent alone," Dr. Baldwin says. DT