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Cosmeceuticals for the Dermatologist

“Who needs cosmeceuticals?” asked Hilary E. Baldwin, MD, during her presentation at the 2019 Fall Clinical Dermatology Conference in Las Vegas, NV. Dr Baldwin is a medical director of the Acne Treatment and Research Center and clinical associate professor of dermatology at Rutgers Robert Wood Johnson.

According to Dr Baldwin, patients who ask about cosmeceuticals are usually looking for a “magic cream” to address wrinkles, brown spots, and look rested. They usually are afraid of undergoing surgery or toxins or can’t afford those options, she added. The average woman uses about 15 cosmetic every day, she said, and applies about 150 to 170 chemicals to the skin.

In addition, she noted that patients like to use cosmeceuticals and there is sometimes a “fear of wrinkles with fear of doing something.” While dermatologists know there is no “magic cream,” magazines, celebrities on social media, and Dr Oz, all recommend products, saying they are “better than Botox.”

Dr Baldwin stressed the importance of managing expectations. Cosmeceuticals protect against UV damage, reduce free radical formation, brighten the skin, smooth skin texture, improve the barrier, stop shine, and “take a stab at wrinkles,” she said.

Dr Baldwin said she liked antioxidants because they get to where they are supposed to be. They naturally occur in the epidermis, and act and intervene in the aging process. However, oxidative stress can overwhelm the system. Today, most products include a combination of many agents, she noted.

Repairing the microbiome is all the rage at the moment, said Dr Baldwin, but she doesn’t think this will be a long-term trend in the cosmeceutical space. According to her, moisturizers are prebiotic because they fix barrier defects, which has been shown in studies on atopic dermatitis skin where the skin returns to normal following use of moisturizers.

Dr Baldwin also covered discoloration, which is listed as one of the top 5 reasons patients seek treatment. There are several cosmeceuticals that can help with hyperpigmentation, such as exfoliation, and agents that stop the production of pigmentary changes.

For fine lines and wrinkles, products that exfoliate, create volume, and encourage cellular turnover can help improve the appearance, such as signal peptides and growth factors. Although, the use of growth factors is not well studied because it has been primarily used in wound care.

“Retinoids seem perfect for fixing aging skin,” added Dr Baldwin. The problem, she noted, is that patients will not use a product that creates a lot of irritation every day.

Bakuchiol, which are seeds of the babchi plant, appear to be clinically comparable to retinoids without the irritation, she noted. It does not breakdown in sunlight and is safe for pregnancy. While Dr Baldwin is skeptical that it will “replace retinoids,” she said it would be a good option for patients who are pregnancy or have sensitive skin.

Hydroxy acids promote skin exfoliation and is usually not used as a solo agent, said Dr Baldwin. For patients who “love to glow but hate to shine,” methacrylate copolymer can absorb oil and control shine for up to 8 hours, she added.

“Even if you do not have an opinion on cosmeceuticals, you need one” concluded Dr Baldwin, adding that without a consultation with an expert, patients will turn to marketers, and other sources, for product recommendations.


Baldwin HE. Cosmeceuticals. Presented at: 2019 Fall Clinical Dermatology Conference; October 19, 2019; Las Vegas, NV.


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