Proteins from a glacier. Extracts from rice. Eye cream from white peonies. Face-firming activators. Swiss cellular de-agers. Chanel. La Prairie. Creme de la Mer. Dr. Jessica Wu. Dr. Nicholas Perricone. Dr. Sebagh. Drs. Rodan & Fields.
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).
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, Calif., 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."
Let's be honest. Consumers want to look like that 20-year-old behind the cosmetics counter.
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.
The Retin-A effect
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."
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 said. "They often list retinol as an inactive ingredient."
It's difficult to find unbiased sources in the field of skin care. Most research scientists are affiliated with a particular product or company. As for products developed by doctors? Not always trustworthy, Calkin says.
"The truth is that if a doctor has his name on a label, most of the time he didn't actually create it," she says. "It's disingenuous. It conjures up the idea of him stirring up these products and creating it."
Exotic ingredients, high prices and fancy names are other trip-ups - and tip-offs - for consumers.
Many companies infuse their skin creams with natural substances that can have health benefits when consumed in foods and drinks. Green and white teas, for example, are antioxidants that reduce inflammation in the body, and there is some evidence that, when applied topically, they can help protect the skin from environmental stresses, like sun and wind.
Be skeptical, however, of exotic ingredients that sound as if Indiana Jones was hired to deliver them. Labels that read "glycoprotein extracted from microorganisms sourced from sea glaciers" or blends offering "the perfect dose of cryoextract of Arctic Raspberry" or anything "unearthed in the farthest reaches of Madagascar" elicit weary sighs from dermatologists.
"Probably just nice moisturizers," Calkin says.