Most Cosmetics Do Not Work

Study Suggests Most Claims Reported on a Beauty Product Are Not Considered Truthful.

CBS News (7/29) reports on its website that “a new study found fewer than one out of five” beauty product “claims was considered truthful by a panel of readers – and ads that used scientific language to describe the benefits were even less persuasive.” The study that was cited was published in the Journal of Global Fashion Marketing: Bridging Fashion and Marketing.

This comes as no surprise as most companies do not perform studies on their products to prove that they actually work. Others “perform” poorly constructed studies, that would never be published in a peer-reviewed medical journal, using photographs as “evidence” of effect. Photographs alone prove nothing unless they are standardized (same exact lighting, same exact positioning, etc) so when one looks at photographic claims, one should be wary–is the lighting the same, is the person smiling in one picture and not in another.  I never base proof on photographs alone, unless used in a well-performed trial.

Many companies will put the same “active ingredient” in their product and use the claims from other products. Well, while that may sound fine, it is not. While an active ingredient may be essential to achieving a desired result, it is the other ingredients that allow it to penetrate the skin and work. These other ingredients differ, thus changing the result. The active ingredient itself may be different–not as pure or a different percentage. In short, there are many variables.

Therefore, one should be very skeptical regarding claims that are made. Additionally, the same holds true for many products that are sold in Spas, Plastic Surgeon’s offices, and Dermatologist’s offices. Many of the products that I have found on the shelves in these offices were not tested, but based their claims on studies performed on other products from other companies.

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High deductible: choose your Dermatologist wisely!

Nowadays it is common to have a very high deductible. This is a big problem as patients are bearing a significant cost. In this case, it is very important to choose your doctor wisely!!!  Let me give you a few examples and some critical information.

  1. Contracted Rates–some plans pay doctors very differently. In fact, one may get paid almost twice as much as another.  One way to check this is ask, “What is your reimbursement for a 99202 New patient visit”.  This will compare apples to apples.
  2. Get some good opinions on the doctor–when he/she takes biopsies are they almost always cancer? Are they often negative (non-cancerous). Does he/she prescribe inexpensive medications?

It is important to look at BOTH of these. I’ll give a couple of examples.

Doctor 1 gets paid $100 for a 99202. He is very conservative and only does biopsies that are necessary. He is uses inexpensive prescriptions when possible.

Doctor 2 gets paid $75 for a 99202. He is fairly conservative, but tends to take a biopsy at most visits. He uses some inexpensive medications and some that are expensive.

Who would cost less? How much?

In this case, Doctor 2 may cost a patient more than double of what Doctor 1 gets, even though Doctor 1 gets paid at a higher rate. With a biopsy you have the fee for the procedure and the pathology as well. The cost difference between a generic inexpensive prescription and a brand-name can be $50 or more to the patient if it is covered. If the medications are not covered, the cost difference can be over $300 difference for products that do the same thing.

In short, look at the reimbursement rate and get good recommendations. Even if you have to pay a little more for the doctor in terms of reimbursement, it will likely save you money in the long run if he/she is a good physician who practices ethical medicine.

Free skin cancer screenings are offered all of the country. These are usually offered around May and is a no-cost opportunity to get screened. Nothing else will be evaluated during these visits–no treatments, no prescriptions, no biopsies. This is a great option for those unable to afford their deductible.

 

 

CO2 Laser a Good Option for Acne Scar Treatment

Acne scars remains one of the most challenging condition to treat. In short, there is no one single treatment that is best for everyone. That being said, I see many patients whom are extremely frustrated after trying treatments that are not effective for their type of acne.

The carbon dioxide (CO2) laser is an effective treatment for atrophic (slightly depressed) scars. In the recent years, it has been used less as others are trying “simpler” procedures with little or no downtime, although with far less benefit. In this study over 77% of participants reported at least mild improvement, while 40% of the participants noted moderate to significant improvement.

That being said, this is not the only treatment for this type of scarring. Dermabrasion and medium depth chemical peels (i.e. TCA – trichloroacetic acid) are good options as well. Short term options include fillers, such as Restylane.

Citation: Elcin G, Yalici-Armagan B. Fractional carbon dioxide laser for the treatment of facial atrophic acne scars: Prospective clinical trial with short and long-term evaluation. 2017;32(9):2047-2054. doi:10.1007/s10103-017-2322-7.

Dry Skin Care – it’s that time of year again.

With the dry air seen in the Winter, people are more susceptible to having dry skin or flares of eczema. Here are some simple tips that can help keep your skin well-moisturized.

  1. Shower no more than once daily. NEVER use hot water.
  2. Use a mild soap, like Dove fragrance-free soap. Pure soaps or those from “specialty stores” should be avoided. Try using soap only where needed (groin, armpits, under the breasts) most of the time.
  3. It is best to apply moisturizer immediately after showering, while the skin is still moist.
  4. Never sit is soapy bath water. Use soap immediately before exiting.
  5. Oils and Ointments are better than creams, which are much better than lotions.
  6. Good examples of moisturizer include: Eucerin cream and Cetaphil cream, both of which are readily available. For those who just cannot stand putting anything on their skin, Nivea In Shower Lotion for Severely Dry Skin (dark blue bottle) is good for those that have mild dryness and are not overly sensitive. For those on a budget, Crisco oil works great as a moisturizer too and is easy to spread.
  7. Use laundry detergents and fabric softeners that are mild–“free of dyes and perfumes”. Dreft and Ivory Snow, for babies, is a good alternative.
  8. Avoid irritating clothing–i.e. wool.
  9. Apply perfume or cologne to clothing and not directly to the skin, as these contain alcohol which is irritating.

The Acne One-Two Punch–the best over-the-counter treatment

Finally, patients are able to self-treat mild to moderate inflammatory and comedonal acne with over-the-counter treatments.

Blackheads and whiteheads can now be treated effectively with Differin gel, which went over-the-counter earlier this year. This medication is similar to Retin A, the drug everyone knows about. These medications help to unclog pores are and more effective than any other over-the-counter medication.

Inflammatory lesions, such as red bumps and pustules, can be treated using a 5% benzoyl peroxide gel (use 5% or less as higher concentrations result in more skin irritation).

I do not recommend spot treating as acne is a chronic disease, so the idea is to treat the lesions that one has, but we also want to prevent new lesions from coming up.

Those with cystic or very inflammatory lesions will benefit from oral antibiotics and/or Accutane, both of which require a prescription.

Those with scarring should seek professional advice from a board-certified Dermatologist as soon as possible.

“Better than Botox?”

Revance Therapeutics Inc. said that an experimental drug RT002 [injectable daxibotulinumtoxinA] can smooth wrinkles for longer than Allergan’s Botox, according to the results of late-stage studies. We will have to wait for the published data to see, but at least early reports look promising.