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Cosmetic Conundrums


The importance of this cosmeceutical trend to the dermatologist is the need to ask patients about the use of such products, especially patients who will be undergoing physician- administered peels or patients that present with facial irritant contact dermatitis.

What are the new cosmeceutical trends in 2005?

At home chemical peel kits contain everything necessary to deliver an 8 percent to 10 percent glycolic acid peel. Some of the kits contain the peel solution on a premoistened towelette that is wiped over the face and left on for one to two minutes and rinsed with water. The towelettes are purchased several to a jar to provide a weekly peel experience for one to three months. Some cosmetic companies are marketing the peel as a three-step procedure with a pre-peel conditioner, a peel solution and a post-peel moisturizer. The pre-peel conditioner is claimed by some companies to function as a penetration enhancer allowing the 8 percent to 10 percent peel to achieve the results of a prescription 20 percent glycolic acid peel administered in a dermatologist's office. It will be interesting to see how long these stronger products last in the marketplace, since they can possibly result in barrier damage and the creation of artificial sensitive skin.

Another adaptation of clinic-administered procedures entering the home is the introduction of the at-home microdermabrasion machine. One such device is marketed by a cosmetic company in conjunction with a dermatologist. It operates on the same principle as professional microdermabrasion machines, but probably cannot produce quite the degree of exfoliation in a single pass. Dermatologists may wish to question patients about the use of this device, as well, since it potentially could alsoproduce artificially created sensitive skin.

Why the current cosmetic industry interest in procedurally oriented treatments? I believe that the industry has exhausted the permissible repertoire of novel active ingredients. Everyone is still searching for the next blockbustercosmeceutical active, which has not yet materialized. In the interim, at-home peels and microdermabrasion offer a novel consumer product and a corporate revenue stream. In an industry dominated by marketing, selling the consumer the promise of clinical efficacy at home is appealing. The consumer, of course, will need to decide if the at-home technologies provide the skin benefits that can be delivered by a dermatologist.

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