Straight talk about cosmeceuticals

"Can these products make your skin look better? Of course they can. But are you going to get benefits comparable to prescription retinoids or (from) office procedures? Absolutely not. I think that is what dermatologists need to tell their patients so they do not have unrealistic expectations," Dr. Farris tells Dermatology Times.

Trimming hype

"Retinoic acid is probably ten to fifteen times more potent than retinol," Dr. Farris says. "If the retinol is stabilized and at a high enough concentration than you can get some retinoid effects."

There is a lot of data supporting the cutaneous use of antioxidants. Since they are functioning as free radical scavengers they are probably best positioned as photoprotectors.

"Green tea is a perfect example," Dr. Farris says. "There are animal and human skin studies confirming topical green tea as an antioxidant, anti-inflammatory and even as a chemopreventative for skin cancers."

But the question is, does it do anything to improve the appearance of skin that is already damaged? It appears that the jury is still out according to at least one recent study. Patients who applied a green tea cream and took oral green tea supplements for eight weeks failed to show any improvement in the appearance of sun damaged skin when compared to controls. This study was sponsored by NuSkin, which makes both topical and oral green tea supplements.

"We need more studies like this because at least it attempts to answer the questions that patients are really asking. They want to know, 'If I use this stuff will I look any better?'" she says.

There are several antioxidants that can improve the appearance of aging skin. Vitamin C will lighten pigmentation and improves mild to moderate skin wrinkling. It also seems to work better when coupled with vitamin E, according to Dr. Farris.

"These effects of vitamin C can be attributed to the fact that vitamin C acts as a cofactor for the enzymes that cross link collagen," Dr. Farris says.

Another promising active is niacinamide.

"There have been a lot of antiaging products introduced with niacinamide and there is good scientific evidence that it can improve the appearance of aging skin. " Dr. Farris says.

Keeping up with the Joneses

Dermatologists would be hard pressed to keep up with the overflowing cosmeceutical market.

Dr. Farris says she stays on top of new products by calling manufacturers and asking for studies. She also steers her patients in the directions of the generally less expensive products sold by the bigger companies, rather than the more expensive products sold at high-end department stores or on the internet.

"I tell my patients that they can probably get something that is equally effective at the corner drug store. Because, in reality, the bigger cosmetic companies generally have access to best actives," she says. "There is way too much at stake for them to launch things that do not work or that are irritating."