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Cosmetic dermatology is a rapidly growing field that can attribute its popularity to aging baby boomers. Although many dermatologists perform cosmetic procedures and millions of dollars are spent each year on cosmetic products, there is a paucity of published research in this field. I was stimulated to write this text because I have found it challenging to conduct thorough research in preparation for my lectures and articles on cosmetic science as there exists no undisputed reference at the moment. Of the research performed by cosmetic scientists, much of it, unfortunately, is proprietary information owned by corporations and is not published or shared in any way for the immediate benefit of the medical community and other cosmetic professionals. This results in each company or cosmetic scientist having to “reinvent the wheel.” My goal, with this book, is to create a link, featuring a better streaming flow of information, between the fields of dermatology and cosmetic science. This text is designed to help cosmetic dermatologists understand the available information on various cosmetic products and procedures. It should also help cosmetic chemists to understand the issues that cosmetic dermatologists deal with on a frequent basis. In addition, this text should fill the gap in knowledge among professionals such as aestheticians who need to know what to apply to patients’ or clients’ skin and about the products that people purchase over-the-counter and apply to their skin. This text should help these professionals answer the questions that their clients/patients ask about skin care products and their scientific validity. It is my hope that this text will encourage cosmetic dermatologists, cosmetic scientists and aestheticians to insist upon well researched cosmetic products and procedures. By working together in this way we can preserve the integrity of an exciting and rapidly developing field of study.

Research in the field of cosmetic dermatology should be encouraged for many reasons. Obviously, it is vital to maintain the hard earned integrity of the field of dermatology. In addition, the discoveries made though cosmetic dermatology research will likely benefit other fields of dermatology. For example, research into the anti-aging effects of antioxidants may lead to enhanced knowledge of chemopreventive techniques to be used to prevent skin cancer. Advances in acne therapy, vitiligo and other disorders of pigmentation are also possible. In fact, it is interesting to note that the development of Vaniqa™, a cream designed to slow hair growth in women with facial hair, has led to the availability of an intravenous treatment for African Sleeping Sickness, a major cause of death in Africa. Without the financial incentive to develop Vaniqa, which is used for purely aesthetic purposes, this life-saving drug would not be available. For many reasons, all pharmaceutical, medical device, and cosmetic companies should be encouraged to research their products.

Although there is much research performed by cosmetic companies on the effects of cosmetics on the skin, much of this data is proprietary and is not published nor shared with the rest of the scientific community. The reasons for this are numerous, but competition between companies and the desire to be the first to come out with a new “miracle product” are prominent among them. However, the issue is even more complex. The FDA has different definitions for drugs and cosmetics. Cosmetic products do not have to be researched in any standard way because FDA approval is not required. Instead, cosmetic products are voluntarily registered by the companies that develop them. However, drugs must undergo years of expensive trials establishing both safety and efficacy before receiving FDA approval (see Ch 28). This disparity means that a company is more reluctant to publish data that could cause their product to be labeled as a drug.

The dearth of published data on cosmetic products has forced physicians, aestheticians, and lay people to rely on sales people and marketing departments to obtain information about cosmetic formulations. This has led to much misinformation that has diminished the credibility of cosmetic products and the cosmetic field in general. Because an ever-increasing number of dermatologists and other physicians are practicing “cosmetic dermatology,” it is imperative that the cosmetic dermatologist practice evidence-based medicine in order to distinguish efficacious treatments from mere marketing hype. This text sifts through the knowledge of the effects cosmetic products and procedures have on the skin and its appearance. The amount of research that should still be performed is daunting; however, the field is young and the rewards are great. I encourage everyone to join me in the exciting endeavor to find scientifically proven methods of improving the appearance of the skin.

Leslie Baumann, MD

“Don’t worry if your job is small, And your rewards are few. Remember that the mighty oak, Was once a nut like you.”

Anonymous

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