Don’t Break the Bank on Facial Creams

So there it sits on the desktop, this ridiculous, ever-growing collection of moisturizers, seemingly endless bottles and stand-up tubes that rise like little mountain peaks amid the stacks of floppy disks and piles of papers.

There’s the tall, squirt bottle of lotion billed as “moisture rich therapy,” which might be true, judging by the way it makes fingers slide off the keyboard. There’s the oh-so-cutesy spray whose nozzle could drive a woman crazy the way it spins around, spraying the room instead of dry skin.

There’s a supposedly “natural” moisturizer with olive and aloe that, for mysterious reasons, seems to get runnier and messier over time. There’s the good-smelling but paradoxically skin-drying lotion filled with lavender, rosewood and sage. For sheer kinkiness, there’s a moisturizer originally designed for cows, whose directions begin, “Wash udder and teat parts thoroughly.” And, of course, the all-time favorite, a big tub of petroleum jelly.

American women, including this one, collectively spend billions a year on moisturizers in hopes of looking younger, healthier and more smooth-skinned.

Are we wasting our money?

Not exactly, dermatologists say, at least in the narrow sense that it’s a good health practice to keep skin moist. That’s because the skin is a crucial barrier against infection. Once it becomes dry or cracked, infectious critters can sneak in more easily. Of more concern to most people is the aesthetic issue: Well-hydrated skin does look and feel better to the touch.

But moisturizers, or at least some of them, can indeed be a waste of money in the sense that something that costs $30 or more an ounce may not really keep skin any more moist than a big glob of Vaseline, though the high-priced spread may go on more easily and smell nicer. In fact, this anti-capitalistic message was the basic conclusion of an extensive Consumer Reports investigation in January 2000 and a recent report in the UC Berkeley Wellness Letter (January 2001).

Why don’t moisturizers, like wines, generally get better the more they cost? Because most moisturizers, despite their baffling array of ingredients, work basically the same way: They trap water that’s already inside the skin, as opposed to adding moisture from the outside. “Moisturizers help seal things off and allow less moisture to escape,” says Dr. Tom Rohrer, a dermatologist at the Boston University School of Medicine.

To accomplish this, moisturizers are made up of “some combination of oil and water,” says Dr. Richard Glogau, a dermatologist at UC San Francisco. “You can go from pure oil at one end to pure water at the other.”

The more oil you have, the greater the moisturizer’s ability to trap water underneath it. The more water it has, the lighter and easier to rub in and disappear. “So you are constantly fiddling with the proportions to change the feel of the skin,” Glogau says.

“Once you get away from the basic combination of those two agents,” he adds, “everything else is aimed at making a moisturizer feel better to the skin at touch or making it smooth on better--’better slip.’ But that doesn’t really affect the way a moisturizer prevents evaporation of water.”

If it’s so simple, why, then, do moisturizer manufacturers bombard us with technical-sounding words like “liposomes,” “humectants” and the like? The answer, of course, is marketing, or as the U.S. Food and Drug Administration, which regulates the cosmetics industry, puts it, “cosmetic puffery.”

“The average consumer has no idea what these things mean,” says one FDA spokesman who asked not to be named. “People throw out these terms because they seem mystical or magical,” he says. And the FDA lets such pseudo-scientific hype slide, he adds, unless it can prove in court that the cosmetic labels are downright “false or misleading.”

How, then, does a winter-wizened or sun-scorched consumer begin to unravel the mysteries of moisturizers? One good place to start, perhaps surprisingly, is the industry itself, specifically, Martin Rieger, an organic chemist who consults for the Cosmetic, Toiletry and Fragrance Assn., a trade group based in Washington, D.C.

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Asked how moisturizers work, Rieger pulls no punches: “Moisturizers are stupid materials. They have no brains. They pick up water from wherever they can find it, steal that water and hold on to it. They will not let this water go and give it back to skin cells, no matter how attractive that concept may appear. . . . They don’t really penetrate the skin. I take a very dim view of some of the claims made for moisturizers.”

Take humectants, substances such as glycerin that attract water and hold it against the skin. “I have very little faith in humectants,” Rieger says, though dermatologists, Rohrer of Boston University among them, say humectants can make the skin somewhat more moist in some people.

Occlusives, on the other hand, substances like petroleum jelly and oils, are quite effective. They are heavy, greasy and work precisely because they “sit on top of the skin and preclude evaporation of water,” says Rieger. The downside is that because occlusives coat the skin so well, they can leave a residue that many people don’t like, notes Dr. Diane Berson, a dermatologist at New York University School of Medicine.” They can also clog pores and lead to acne.

In addition to humectants and occlusives, moisturizers often contain emollients and other ingredients designed to make the skin feel slick and soft, though they have nothing to do with moisturizing per se. Some manufacturers add silicone, for instance, to make a moisturizer more slippery; others add dispersing agents like soaps to make the oil in a moisturizer break down into smaller particles.

Some manufacturers add liposomes, delivery vehicles made from lecithin or other fatty molecules whose job is to bring a substance into the skin. The trouble is, if liposomes are too big to penetrate the skin, and many are, whatever product they are carrying won’t get in, either.

Many moisturizers also contain collagen. In its natural form, this fibrous, connective tissue is important for maintaining firm, healthy-looking skin. But collagen that’s taken from cows and then slathered on human skin does not penetrate because the molecules are too big. The same goes for elastin.

“It would be wonderful if we could replace old, damaged collagen and elastin with a cream. But unfortunately at this point, it is physically impossible,” Rohrer says.

As for that cheap old trick, drinking water to make your skin look better? Go ahead, dermatologists say. But water probably only makes your skin look better if you were dehydrated to begin with, and most people aren’t.

The bottom line, says Rohrer, is that “most moisturizers don’t penetrate your skin. They only penetrate your pocketbook.”

That doesn’t mean you shouldn’t use them, adds Dr. Melanie Grossman, a dermatologist in private practice in New York City. But don’t break the bank to do it. Buy something that you will really use, she says, nothing too “thick and goopy.” And nothing that will wind up in the garbage. Or behind the piles of papers on your desk.

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Judy Foreman writes a syndicated column on health issues. She is a fellow in medical ethics at Harvard Medical School. She can be reached at foremanj@bellatlantic.net. Her column will run occasionally.