Wander among the cosmetic counters at your local department store and you might think that you've been transported to some Swiss sanitarium. White-coated doctors step out from behind exotic botanicals. European nameplates compete with pharmaceutical trademarks. And the prices range from unreasonable ($35 for cleansers) to outright silly (as much as $525 for wrinkle cream).
Skin care today is nothing less than a riddle, bottled in pretty glass and wrapped in perfumed boxes, promising extraordinary results and remarkable powers — "in just 48 hours." Clearly we have lost our way.
Somewhere near the intersection of hope and science, marketing has launched a thousand hyperboles. Advertisements blur the lines between drugs and cosmetics. Manufacturers trot out studies that reveal little about how a substance works. And high-priced products carry the false promise of quality and effectiveness.
Given the onslaught, the shrill announcements, the breathless claims, even the most attentive cosmetic dermatologist must feel like a student who hasn't studied for the final exam.
"There are more companies, more products, more ingredients touting more effects," says Dr. Jacqueline Calkin, a Sacramento dermatologist. "Even as a dermatologist, it's very difficult for us to look at a cream and tell you if it's worth your money. Frankly, I'm confused."
Trying to combat time
LET'S be honest. Consumers want to look like that 20-year-old behind the cosmetics counter with bright smooth skin free of discolorations, large pores, acne and wrinkles.
Up to a point it's not an unreasonable goal, says Dr. Leslie Baumann, who in the course of her career as a Miami-based dermatologist has criticized and championed the vicissitudes of the skin-care industry. Many products on the market today, containing sunscreens and moisturizers, will help maintain a younger look.
However, turning back the clock and erasing wrinkles is more difficult, and here, consumers are often misled and disappointed. Lost in the conversation is the sensible reminder that cosmetics and drugs are not the same thing.
Blame Retin-A for the oversight. Before 1971, consumers relied mostly on night creams to keep skin moist. Then with the approval of this acne medication, a synthetic form of vitamin A, the field suddenly became more complicated and crowded. Clinically proven to diminish fine lines and wrinkles, the prescription drug launched a cosmetics industry that for four decades has blurred the line between cosmetics and drugs and produced few effective products, according to experts.
Today, cosmetic manufacturers like to refer to anti-aging skin-care products as cosmeceuticals, a figment entirely of their own creation. In addition, these manufacturers are under no obligation to show that their products work, only that their ingredients are safe (conversely, drug manufacturers spend millions of dollars over many years on studies to prove effectiveness). This is why carefully worded skin-care advertisements will not claim to "remove wrinkles" but "diminish the appearance of wrinkles."
At one time, the government took it upon itself to weed out the snake oils, but with limited resources, the Federal Trade Commission, which regulates advertising practices, has a difficult time monitoring the promises.
"Anti-aging products are a concern to us," says Janet Evans, an attorney in the division of advertising practices at the commission. "The advertisements are expected to be truthful and nondeceptive. The claims are required to be substantiated."
To be fair, though, there are some over-the-counter cosmetics that seem to be as effective as a drug. For example, dozens of products contain retinol, a milder chemical cousin of Retin-A that helps soften fine wrinkles. But because it hasn't been approved as a drug, the hype is somewhat muted.
"Retinol likely works for wrinkles, but the companies can't say so. They can only imply it," Baumann says. "They often list retinol as an inactive ingredient."
Beware the pseudoscience
THE challenge posed to cosmetic researchers begins with time itself. Long-term exposure to the sun inhibits collagen production, and elastin — the fibers that allows skin to remain taut — loses its ability to recover after being stretched. In addition, the replacement of dead skin cells with new cells slows down.
Reviving exhausted skin cells is key, and only through scientific testing can skin-care chemists learn whether the remedies they concoct work. But not all science is created equal.