Skin Care

The term “medical-grade” is a little bit misleading because there is no technical definition of it. All skin products are either available by prescription only, or are considered “cosmeceuticals”, which is a made up term that just means “cosmetics that claim to affect skin function”. The trick to understand is how FDA (Food and Drug Administration) regulation differs from FTC (Federal Trade Commission) regulation. The FDA regulates drugs. The definition of a drug is a product that alters bodily function. Pharmaceutical companies have to prove that their products do actually affect skin function to be considered drugs. This costs tens of millions of dollars to do, and then limits access to those products by requiring prescription (except in the case of OTC, or over the counter, drugs like sunscreen). By contrast, the FTC regulates “cosmetics”. The definition of a cosmetic is a product that only affects the appearance of skin, but not its function. “Cosmeceutical” has no legal definition. This is a category of products whose sellers try to imply or quietly claim they do actually affect skin function, but without having to prove it, because then it will be more expensive and highly regulated as a drug, which limits sales.nnAll of this to say: True “medical grade” skin care includes real prescription medications, such as tretinoin and other products (which still may not be covered by your insurance even though they are prescription-grade, because when used for cosmetic purposes, they are not covered). But cosmeceutical companies also like to claim that when they make higher quality skin care they would like to sell at higher price points, that it is “medical grade”. The problem here is with proof. Because if they proved that their products do change the skin, they would not be able to sell direct to the public. nnTechnically speaking, any skin product that does not require a prescription is “over the counter”. Including the so-called “medical grade” non-prescription cosmeceuticals. However, many companies try to create an exclusivity by limiting access, such as selling via physicians’ offices only. In the past there was much more of a dichotomy between physician-office products and mass market OTC products. But now there is a lot more access to all levels of skin care in many venues.nnAnd even drug store skin products sometimes do plenty. But…. they can’t prove that to you.

Medical-grade skin care can include prescription products like tretinoin and other prescription retinoids, or it may just be a legally meaningless marketing term for fancier OTC products.

The best way to determine which products are best for your own skin type is to go to see a board-certified dermatologist in person so they can discuss your skin habits and regimen with you and see your skin in person, to help you plan a regimen. “Skin type” itself is a bit of a made up marketing term, so it’s best to see a professional trained in the science of skin health.

Everyone should see a dermatologist once a year for a head-to-toe skin cancer screening. If you are happy with your skin routine and happy with your skin, no more needs to be done. If you would like more guidance on skin care, your dermatologist will address what they can during your annual visit, but if you have more questions or want to go into more detail, they may ask you to come back separately or more often to continue to review. This will be based on your individual situation.

Some skin care products can help some skin care issues within days. Other products that do help may take several months, even 6 to 8 or more, to show recognizable but real change.

Some skin care may help with wrinkles and fine lines, but each person’s skin is different and may benefit differently from different products, or different ways to apply each product. Some products are better at more directly addressing fine surface lines than others. Some, like retinoids, may biologically be able to help with fine lines over many months to years, but in the short term can cause irritation, dryness, and acne when used incorrectly, which adds to chronic inflammation, which can ironically increase the appearance of fine lines and redness.

Some skin care ingredients may absolutely help with acne and rosacea. If over-the-counter products do not help, seek a dermatologist to get a true medical exam and a plan for acne or rosacea that may include some prescription skin care, since these conditions are actually more complex than many realize.

Some skin care products may help to improve texture, brightness, and tone, but those same products may also cause irritation in some people, which can worsen these features. Again, remember that skin care is legally considered just “cosmetic”. The products that really do something are technically drugs, but they have no regulation since they have skirted the FDA process and no promises you can bank on.

There are so many products that combine differently and will react differently with individual skin types, it’s really best to see a board-certified dermatologist in person to create a regimen that will give you your best results while wasting the least amount of your time and money.

The best way to monitor progress with skin care would really be to take photos occasionally (far apart) in the same exact lighting and angle conditions, to try to see if your concerns are indeed improving. There is a lot of misleading advertising and fake before and after photos out there. If you aren’t sure what will work or whether you are progressing, the best plan is to team up with your board-certified dermatologist to make a plan and monitor progress together in the office.