beauty

Are Medical-Grade Brands That Doctors Sell Better Than the Skin Care in Stores?

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Dear Beauty Editor,

Is medical-grade skin care (like Alastin or SkinBetter) mandatory as you age? I’m in my early 40s and wondering if it’s really worth the investment. 

Best, Lena

There are two things we need to get out of the way before I answer your question. First, when it comes to your appearance, nothing is mandatory. I’m sure you know that, but the fact that you used that word implies you feel some pressure to opt into the whole world of anti-aging skin care — and I want to remind you that is not the case. Second, the term “medical-grade” is essentially meaningless. People who work in (or with) the personal-care products industry (including dermatologists, aestheticians, formulators, cosmetics executives, journalists, and content creators) tend to use it to refer to cosmetic skin-care products that are sold at doctor’s offices, but “the term is generally considered a marketing term — it is not an FDA-regulated term,” says Noreen Galaria, M.D., a board-certified dermatologist in Virginia.

Cosmeceutical, clinically effective, professional-strength, and dermatologist-tested are some other similar terms that get thrown around in the skin-care world, according to Mary Schook, a licensed aesthetician and industry consultant who is the founder of M.S. Apothecary. But the government doesn’t regulate those terms either, just as it doesn’t regulate marketing terms like hypoallergenic, noncomedogenic, or clean beauty.

Now that we have that out of the way, let’s get practical.

I suggest you look in the mirror and decide what skin concern(s) you’d like to address, then choose a product with good evidence of its effectiveness to treat that concern. The best evidence is a clinical trial that shows some proof of the improvements you’ll get when you use the products. But clinicals are expensive to conduct, and most companies don’t think they’re worth the money. (That’s because we, the customers, don’t tend to value the objective evidence clinical tests provide. We’re more swayed by less expensive marketing tactics, like packaging, branding, and the endorsements of celebrities, experts, or influencers.)

However, there are some companies — and I’d put Alastin and SkinBetter in this group — that have made the business decision to do clinical tests on at least some of their products. These tests don’t always meet the standards I laid out above, but they do provide some objective evidence that the products work. And the reason these companies are willing to pay for testing is because they know doctors like to see the results of clinical tests when they evaluate products. (If these brands conduct fancy tests to prove to doctors that their products work, then the doctors may be willing to sell the products in their offices, and then the companies can charge premium prices that will cover the costs of the clinicals, and people will be willing to pay those higher prices because they trust their doctors.) In short, “The real difference between a product that is carried in a doctor’s office and one sold at a regular retailer is the fact that dermatologists have vetted these products and looked at the data and the ingredient lists and have given their blessing on what it contains and says it does,” says Galaria.

But just because medical-grade products have some of the best evidence that their products are effective doesn’t mean they are the most effective. For example, 100 women in a clinical trial may have fewer age spots after using Product X for 30 days, but that doesn’t mean you, Lena, are going to have fewer spots after using it. In fact, Product Y that’s half the price and sold at Sephora might work better for you. And Product Z, which is a quarter of the price and sold at Walmart, could work for you, too.

So, the question becomes this: Do you have the desire or time to research ingredients, learn how to decode an ingredient label, interview dozens of experts, set up your own personal trial on your face, and try different products for at least 30 days at a time to find what works best for you? If you do, by all means, go for it! But, as Galaria points out, “It can be a lot to decipher, and at the rate that new products are being released onto the market I know I can’t keep track of them all.” If you don’t want to deal with that hassle and just want some insurance that you’re not completely wasting your money, then I think the investment in a brand like Alastin or SkinBetter makes sense for you.

But that doesn’t mean you should buy all of your skin care from medical-grade brands. “I always tell my patients, ‘Do not spend a lot of money on your cleansers — you are literally washing that money down the drain,’ and do not invest in a medical-grade moisturizer,” says Galaria (you can find products with proven moisturizing ingredients like glycerin at almost any price point). Instead, she says, “put your money into your active ingredient — a high-quality vitamin C or retinol, or a prescription Retin-A will absolutely be worth it.”

So, the final takeaway here isn’t that medical-grade skin care is always worth the money — that’s too simplistic. Instead, I want to leave you with a little more information about how the beauty industry operates, so you can come up with a skin-care plan that doesn’t just work, but works for you. Hope this helps!

Send your questions to AskABeautyEditor@nymag.com. (By emailing, you agree to the terms here.)

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