Cosmeceuticals - substances that exert both cosmetic and therapeutic benefits - will be a $16 billion business in 2010, according to Dr. Michael H. Gold.
While consumers can purchase hundreds of cosmeceutical products over the counter, many have never been subject to safety and efficacy testing, he said at the annual Hawaii Dermatology Seminar sponsored by Skin Disease Education Foundation.
As a result, dermatologists have an important role to play in advising their patients, said Dr. Gold, of Vanderbilt University, Nashville. More and more, reputable cosmeceutical companies are subjecting their products to independent testing, with the results appearing in peer-reviewed scientific literature.
Antioxidants are the most commonly used active ingredients in most cosmeceuticals. "We're doing anything we can to use natural-based ingredients, plant derivatives, fruits, and vegetables, to reverse free-radical damage and to prevent skin aging," he said in an interview. "But I think we need to understand that not every fruit, vegetable, and plant has got something in it that's good for your skin."
The list of proven antioxidants is long, but it is important to remember that while antioxidants can slow the progression of wrinkles and other signs of skin aging, they cannot reverse the progression alone.
There is one exception, according to Dr. Gold. While Vitamin C is an antioxidant with the proven ability to prevent aging and ultraviolet-induced skin damage, it has another property. Through a separate mechanism, topically applied vitamin C induces collagen formation, and, thus, can be used to treat wrinkles.
Many other products claim to improve wrinkles, but this ability is almost always due to swelling or hydrating effects. Wrinkles return in full force once the product has worn off.
Because of its unique properties, vitamin C is a component of many cosmeceuticals, but it is important to consider how each product is packaged before recommending it, he said. Vitamin C, like many other antioxidants, is quite unstable, and can easily become oxidized and inactivated long before reaching the skin.
Vitamin C is rapidly inactivated by light or UV radiation. If the product is not in a dark container, the Vitamin C will quickly degrade.
Dr. Gold also noted that many antioxidants work synergistically. Cosmeceuticals that include more than one active ingredient are likely to be better than those based on a single antioxidant.
He is particularly interested in a line of cosmeceuticals manufactured by Neocutis. (Dr. Gold acknowledged serving as a consultant to that company, and his clinic sells their products.) In addition to antioxidants, many Neocutis products are based on growth factors that have shown synergy in improving skin.
Dr. Gold has conducted studies for the Neocutis product, Bio-restorative Skin Cream. One such study found the product to be effective in treating adverse events associated with photodynamic therapy (J. Drugs Dermatol. 2006;5:796-8). Another study demonstrated that the product is effective for facial skin rejuvenation as assessed by 3D in vivo optical skin imaging (J. Drugs Dermatol. 2007;6:1018-23). And a third study, presented at the annual meeting of the American Academy of Dermatology in 2006, showed that the product was effective in treating facial elastosis.
Although the Food and Drug Administration does not regulate cosmeceuticals, and they can be sold freely over the counter, Neocutis makes its products available only through physicians. Other companies do the same, and these products tend to be stronger and more efficacious than those sold in a local pharmacy.
Dr. Gold reserved particular scorn for cosmeceuticals that are sold through multilevel marketing schemes. "There are products out there that are snake oils," he said. "If you purchase anything in a pyramid scheme or a multilevel marketing company, you're just throwing good money away. We try to buy products from reputable companies, products that have had skin testing and appropriate clinical work done on them."
Photo Courtesy Dr. Michael H. Gold
Dr. Gold also disclosed being a consultant for Obagi Medical and Steifel, and being a consultant, researcher, and speaker for numerous other pharmaceutical and medical device companies.
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