What's happening in skin care today?
The manufacturers of skin-care products spend more money on marketing than on research, according to dermatologist Gerald Krueger. "They spend their money in three ways," he says, "on advertising, advertising and advertising."Manufacturers are more alert now, says dermatologist Leonard Swinyer, but the awareness of how cosmetics help to cause skin problems - such as acne - has only come in this decade.
The real research into skin-care products is being done by the Japanese and Europeans, Krueger says. They will be the ones, in the not-too-distant future, to invent a cream that peels off pigmented lesions (brown spots).
Meanwhile the average American consumer remains confused about which skin-care products are best.
The choices are bewildering. An array of attractive products meet the eye in every department store: Estee Lauder, Clinique, Lancome. Each is more expensive than the last.
There are the products your friends sell, as well: Mary Kaye, Nu Skin, Avon, Elysee or Amway. And when you go in for a facial at your local beauty shop or skin-care emporium you will hear of even more products.
To further confuse the issue, skin lotions will contain mysterious ingredients such as royal jelly, placenta, seaweed, estrogen or carrot oil.
And each salesperson will tell you that this brand is unique, specially formulated, Ph balanced and rejuvenating.
They will believe, fervently, in their own product. They will say they know it is best.
But Krueger says even dermatologists don't know what to believe.
There have been studies, to be sure. The ears of rabbits and the derrieres of prisoners in Pennsylvania have contributed to our understanding of what clogs pores and what causes wrinkles.
Currently the Food and Drug Administration rates cosmetics by how likely they are to cause comedos (the backed-up pores that can lead to acne). The studies are done on the delicate skin inside rabbits' ears.
And from a study done at the University of Pennsylvania, we have learned that wrinkles are more than heredity. Researchers compared the skin on a person's face to the skin on his derriere (which has not been exposed to the aging effects of the environment) and concluded that the best way to prevent wrinkles is to stay out of the sun.
With little to go on, we remain hopeful: Knowing there's nothing we can buy over the counter to remove wrinkles, we keep lining up at the counter anyway.
We remain confused: We hear there's a controversy over mineral oil. Does it clog pores? Do its molecules really come in different sizes?
Swinyer says not to worry about mineral oil if it's diluted to less than 1/4 of the product, as it is in most products. "Other products are much more acne-producing than mineral oil," he says.
So if mineral oil isn't bad and wrinkles can't really be removed, are there any criteria for choosing a product?
Just trial and error, dermatologists say.
Swinyer's wife, Thalia is an R.N. who works in his office testing skin-care products. She says in Utah we have an extra challenge. "The frustrating part is that most of these skin-care regimens work well in a high humidity. Inside some Salt Lake homes, in the winter, the humidity is 5 percent."
The good news is, she says, "If you find a moisturizer that works here, it will work for you anywhere."
Dr. Swinyer recommends a skin care regimen for many of his acne patients that includes cleansing with Cetaphil Lotion, applying prescription drug Retin A, and using Eucerin cream over that, as a moisturizer.
About skin care, Krueger won't make any recommendations at all.
But, he says, he soon might be able to. Krueger is president of a national organization, the Dermatology Foundation, which does skin research. He says, "What we do is collect money from numerous sources, distribute it to people who do skin research. We are giving away $830,000 a year now."
Within a year, he says, the foundation will have a task force in place to review products. If a manufacturer wants to submit its research on a non-irritating soap or a moisturizing lotion, the independent panel will see if the manufacturer's claims are valid.
If so, the panel will issue a seal of approval.
Krueger has no idea how many skin-care products would merit a dermatologists' seal of approval. Fewer than half, he estimates. "Maybe none."
But he hopes some will pass because he hopes to be able to guide consumers to a good product. "Someday when a patient asks me if I think Neutrogena soap is better than Avon, I'll be able to say one of them meets standards, or neither, or both do."