Patients rely on dermatologists to be cosmeceutical experts

Key Points

Rancho Mirage, Calif. - As trusted skincare experts, dermatologists owe it to patients to know about cosmeceuticals, says Wendy E. Roberts, M.D., F.A.A.D., Women's Dermatologic Society (WDS) president.

"We are the No. 1 experts in cosmeceuticals because we are the No. 1 experts in skin, hair and nails," Dr. Roberts says. "The skin is our specialty, our turf, our foray; therefore, in my opinion, we need to know everything that encompasses skin."

The connection of "everything related to skin" is best exemplified by dermatologists' training in identifying the skin signs of systemic disease. Dermatologists have a similar opportunity to heighten their awareness about how skin components are impacted by chemicals - chemicals being cosmeceuticals, according to Dr. Roberts.

Dr. Roberts, who has a medical and cosmetic dermatology practice in Rancho Mirage, Calif., says that the selling of cosmeceuticals is unrelated to the knowledge of cosmeceuticals.

Even dermatologists who do not sell products in their practices should be able to expertly answer patients' questions about the products, she says, and should also know how the products their patients are using might be affecting patients' skin.

Building a knowledge base

Dermatologists have a built-in understanding of the importance of vehicles in prescription medications - choosing among creams and ointments, for example.

Dr. Roberts explains that many of the inactive ingredients in cosmeceuticals are the same ingredients found in some prescription topicals.

"We have an understanding of base and vehicle. The understanding of the inactive is a bridge to understanding the active," she says.

To learn more, dermatologists should turn to the literature, focusing on review articles about different cosmeceuticals, according to Dr. Roberts. "Be up to date," she says.

The aim is to understand the families of cosmeceuticals, including retinoids, peptides, etc.; then, grasp which are agents for redness, hyperpigmentation, collagen stimulation, antioxidants and more, Dr. Roberts explains.

Another great resource for practicing dermatologists is the professional meeting.

"All the meetings have updates about cosmeceuticals, because so many of us want to improve our knowledge about them," she says.

Tapping the literature and professional meetings only goes so far, according to Dr. Roberts.

Dermatologists should also be aware of what their patients are exposed to at local drug stores and other shops.

That means going into the local stores, she says, looking on the shelves and finding out what the products do and do not offer.

Armed with product and manufacturer names, dermatologists can do their own research using Web-based search engines, such as Google, Web MD and medical databases, and by asking the companies to provide clinical studies.

Part of what you do

Dr. Roberts asks her patients to bring the cosmeceuticals they use to their visits, and she records the products in the patients' charts.

"I like to see what patients are using and involve myself in their decision-making," she says. "Why? Because we have a real opportunity to give guidance to patients in terms of what has science and what does not."

Dr. Roberts says she finds that some of the products patients use on their skin do more harm than good - actually causing their skin problems.

"It is a vicious cycle of poor skincare that can lead to a skin problem. This is just basic information but, sometimes, we are so sophisticated as dermatologists that we forget to look at the obvious," she says.

Cover the basics

Dermatologists would be hard-pressed to keep up with all of the changes in the evolving cosmeceutical industry, according to Dr. Roberts. But they can become familiar with basic cosmeceutical vehicles and ingredients.

"I find it all extremely interesting," Dr. Roberts says. "It really involves a lot of detail. A lot of these products have interesting histories."

For dermatologists who become cosmeceutical experts, the benefits include better and more expansive patient care.

"Patients like it when their dermatologists know what they are talking about. And we are supposed to know everything about the skin," she says. "People tend to avoid experts who say, 'I do not know anything about that.'" DT

Disclosure: Dr. Roberts is a consultant for Allergan, BioForm Medical and Sanofi-Aventis/Dermik. She is on the advisory board for Cosmetic Bootcamp and OrthoDermatologics, and is an investigator for L'Oréal/La Roche-Posay.