Friday, 13 September 2019 04:45

Skin Care: Style Versus Substance

Written by   Dr. Elliot Hirsch

Skin care is a multi-billion dollar industry in the United States – take a quick walk through any pharmacy or name brand store and see aisles and aisles of flashy skin care lines promising more youthful, moisturized, happier skin. And, with sophisticated-sounding formulas and all-natural options in shiny packages, who needs medical-grade skin care anyway?


Your clients do. Over-the-counter products (even those labeled as clinical strength) have only a fraction of the active ingredients found in physician-only products. Products sold without a supervising physician are not allowed to exceed a certain level of active ingredients. This helps guarantee that a product will not harm someone who does not use it as directed or who should not be using it, but it also means that over-the-counter products are often too weak to achieve the desired effect. Medical-grade skin care contains much higher concentrations of active ingredients and is subject to inspection from the FDA, which ultimately benefits clients. Over-the-counter products, on the other hand, are self-regulated by the cosmetics industry. There’s no consistent standard in place for their production. By law, medical-grade skin care must contain 99.9% of the active ingredient in the purest form.




Most of the medical-grade companies will use more consistent, stronger ingredients that can penetrate deeper into the skin. Some popular brands sold at the mall may state their products are innovative, but most of the time, their main ingredients are water and fillers. Medical-grade skin care products contain higher levels of such ingredients as antioxidants, retinols, and peptides. Because of their clinical nature and strength, these skin care lines usually result in more noticeable results than their counterparts sold in stores. Many brands sold in those stores are just as expensive as medical-grade skin care lines sold in spa offices, and many clients are pleasantly surprised when told how inexpensive the recommended products are.


A doctor’s or physician’s assistant’s medical credentials means they can guarantee that each product they sell is safe, results-driven, and has the correct amount of the active ingredients. Because they get these products from a medical professional, clients receive customized advice regarding the regimen that’s right for them. The professionals will examine their skin and recommend products that are suited to their skin’s type and needs, taking into consideration medications they are taking, as well as health history, allergies, and other factors. This assessment is based on an in-depth knowledge of product lines. Clients can expect positive results from a product that is recommended specifically for them and can talk to a physician’s assistant or aesthetician, after they try the recommended products, to tweak their regimen for optimum effects. Employees at the local department store can’t tell your client if they will have a drug or allergic-reaction to a product they sell.



Ingredients on product labels are listed in order of their concentrations. The first five ingredients or so are typically the substance of the formula. The concentration of each ingredient gets smaller the further down the list they are. With medical-grade products, the concentrations of the important ingredients (like retinol or glycolic) are much higher than those used in over-the-counter products. For example, a medical-grade vitamin C serum may be formulated with 30% strength. Additionally, the ingredients that are important for efficacy are at the top of the list. This means not only are clients getting the product they paid for, but the results, too.


Hydroquinone is the active ingredient in skin care products that can lighten hyperpigmentation. It is also referred to as a depigmenting agent. Hydroquinone is used in medical-grade skin care in concentrations up to 5%. But over-the-counter concentrations are capped at 2%, since a 1982 FDA limit was put in place.


 Retinoids are vitamin A derivatives that have many skin benefits, including stimulation of collagen production, repair of photoaging, alleviation of acne, and unclogging of pores. Most over-the-counter retinols contain 0.6% retinol. In contrast, some medical-grade retinols have a similar moderate strength version at 0.5% retinol, but also a 1% formulation.


Hyaluronic acid is another key ingredient in medical-grade skin care. Clients want to use one with both short and long-term effects. Short chain hyaluronic acid gives an immediate plumping, whereas long chain gives a moisturizing effect. Over-the-counter products that claim hyaluronic acid as the main ingredient usually do not use short and long chain versions, while many medical-grade products use up to five chains of hyaluronic acid.


Medical-grade skin care lines often look more medical in their packaging – they usually are non-scented and dye-free, lacking the flashy bells and whistles of over-the-counter skin care lines that are designed to lure clients with their pretty packaging. Let your clients know not to judge the effectiveness by the packaging. More money goes into the third-party research and FDA inspections than fancy boxing. The investment in a medical-grade skin care routine will provide them with healthier skin for years to come.


 2019 Dr.Elliot HirschDr. Elliot Hirsch is a board certified plastic surgeon who practices the full spectrum of plastic and reconstructive surgery, specializing in both cosmetic and reconstructive breast surgery, including breast reconstruction, breast reduction, and breast implant removal and revision. Dr. Hirsch’s primary office is in Sherman Oaks, California and treats patients from not only Los Angeles, but from all over California and beyond. Dr. Hirsch attended the prestigious Johns Hopkins University. For medical school, he attended the Keck School of Medicine at the University of Southern California. Dr. Hirsch completed his integrated plastic and reconstructive surgery residency at the prestigious Northwestern Memorial Hospital program in Chicago, Illinois. He has been an active researcher in the field of plastic surgery and has co-authored over 40 manuscripts and book chapters, and has received several grants for original research projects and holds patents for wound care devices.


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June 2021

Skin Care Blogs

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