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Fine Lines Between Hype and Hope

There's big business in helping consumers lessen the marks of aging. Some treatments do little, some carry risks and some show promise.


Heaven in a jar, my friend Carla calls it. Walking toward the skin-care counter, I wonder what's in the baby-blue cream she swears makes her feel as if she's had a "mini-face lift."

The lavender-scented cream, the sales rep says, is made from a "patented copper peptide complex" used on burn victims' ravaged skin and diabetics' slow-healing wounds. If it can stimulate the production of collagen for them, he says, consider the power it could unleash on aging skin--a casualty of collagen breakdown.

I feel myself drawn in. After all, there's just enough science here to make me think the cream might work.

Across the country and around the world, women--and men too--are looking to eliminate wrinkles, those records of stress, smiles, smoking and, most of all, sun exposure.

A flourishing industry stands ready to accommodate us, proffering over-the-counter and prescription creams and lotions, injectable wrinkle fillers, chemical peels and laser resurfacing that generally smooth, Spackle or burn away skin defects.

Much of the demand is being met by cosmetics manufacturers, which have branched out into a lucrative area they call cosmeceuticals, where cosmetics meet pharmaceuticals.

These aren't your mother's lipstick and mascara makers. No, these are multinational corporations engaged in "a very serious worldwide war" over skin rejuvenation, says Dr. James J. Leyden, a University of Pennsylvania dermatologist. Companies such as Revlon, L'Oreal and Shiseido have beefed up their research and development, employing battalions of researchers to study plant extracts, minerals, proteins and other promising molecules.

Just listen to some of the science-inflected descriptions: Renergie Lift Contour Skin Firming and Contouring Complex ("a high-tech serum fortified with a special Dermo-Cohesion Complex"), Re-Surface Eye Retinol Concentrate Wrinkle Corrector (with "advanced Retinol technology") and Extra Triple Lifting Day Cream (promising "a 60% improvement in fine lines and wrinkles" in a week).

The problem is, many product promises are supported by results forged in a test-tube or in laboratory mice, which don't automatically translate to people, even though they're widely tested for safety, as required by federal regulators. Many skin treatments are so new that long-term effects aren't known. That leaves consumers to take their chances on results.

Apparently they do.

Anti-aging skin care, which grew in sales nearly 25% from 1999 to 2000, is the fastest-growing segment of the cosmetics business, said Bill Martineau, a senior research consultant for the Freedonia Group, a Cleveland market research firm. This year, he estimates, Americans will spend $950 million for anti-wrinkle creams alone.

They'll also shell out $935 million for chemical peels, $235 million for collagen and Botox injections and about $250 million for laser resurfacing. Not to mention nearly $1 billion more for face lifts and eyelid surgery.

But with new treatments coming on board at a rapid pace, often without a long track record, "it's caveat emptor," says Dr. Richard Glogau, a UC San Francisco dermatologist.

Wrinkle potions, for example, fall into a regulatory gray area. If the components are found in nature, or work only superficially, they escape the regulatory reach of the Food and Drug Administration. Although manufacturers may not make drug claims, they can, and do, carefully craft phrases such as "reduces the appearance" or "helps eliminate signs" of fine lines and wrinkles.

Dr. William P. Coleman III, a cosmetic surgeon who also teaches dermatology at Tulane University, cautions: "Anything sold to you by a cosmetic company or drugstore that you pick up, you're relying on the honesty of that manufacturer to tell you what's really in it and what it does."

The Louisiana dermatologist says many over-the-counter products are "really questionable in efficacy and may cost more than things that are truly proven to work."

Even some of the treatments available in dermatologists' offices aren't universally endorsed within medical circles.

Some doctors prefer laser skin treatments to rejuvenate aging skin; others advocate chemicals they've grown comfortable using over several years.

For those attracted to the promises of a better complexion, keep in mind that basic anti-aging remedies can do only so much. For the deepest wrinkles and facial sagging, it's off to the plastic surgeon. But if you're looking for something less risky, you can begin with topical preparations:


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