| SKin Care ProDuCTS | praCTiCe managemenT The stratum corneum is very important
to the health and beauty of the skin. Simply hydrating this layer of the epidermis will improve the appearance of fine lines and improve skin's elasticity. The exfoliation of dead corneocytes and replenishing the lipids between the living keratinocytes gives the skin suppleness and a healthy glow. Barrier repair and protection is very important for many skin diseases as well as before and after such procedures as chemical peel and laser resurfacing. emollients that replenish the lipid layer of the skin can be essential to the success and long-lasting improvement of several procedures and to complement prescription treatments of many diseases such as eczema and psoriasis. ageing skin often experiences dryness as a result of lipid barrier disruption. Barrier repair products are typically applied at bedtime since they can be heavier and do not contain necessary sun protection that is required for daytime products. Table 1 lists several effective ingredients known to repair and protect the epidermal lipid barrier.
Ethical business practices The decision of whether to incorporate cosmeceutical suggestions into your patient treatment plan is usually easy and necessary. There are very good mass-market products that, as cosmeceuticals, improve skin condition and make prescription remedies work even better. The decision of whether one should sell cosmeceuticals in the office can be more difficult. The ethical side of this issue has many opponents and proponents. each physician must decide how best to handle product sales. The american
academy of Dermatology (aaD) has a formal position on the subject. in their medical practice booklet they specifically highlight their position(8). in summary, the decision to dispense must be in the best interest of the patient, with dermatologists never placing their personal
financial
interest above the welfare of patients. Patients should never be coerced into making a purchase. Listing of ingredients, advising the patient of less expensive
mass-
effective, and able to be incorporated into the patient's lifestyle so compliance can be achieved. once a decision to dispense is made, the
products offered
incorporated into the patient’s lifestyle so compliance can be achieved.
marketed options and fair pricing are also mandated. Products cannot be misrepresented as exclusive or unique unless it is true and all products should have valid claims of potential benefit. These recommend-ations are not only in
line with the aaD, but also recommend- ations that will not diminish the reputation of dispensing dermatologists with patients, fellow physicians, and the general public. it is important to work with the patient so that they understand the product, use it as directed, and communicate reasonable expectations for what the cosmeceutical can realistically accomplish. it is just common sense and good business practice to conduct one’s practice in such an honourable way. most dermatologists are comfortable dispensing cosmeceuticals because they feel it improves compliance with skin care regimens and offers patients significant convenience. Products offered should be safe,
should be safe, effective, and able to be
dermatologist must choose a company that manufactures the desired products. Published data to support claims is essential in order to believe you are offering products that will help the patients. Customer support issues such as brochures, credit for product
returns,
employee training, and volume
purchase
discounts are all important to financial success of adding cosmeceutical dis- pensing to the practice. Storage of products, purchase of correct amount to avoid expiring before sale as well as local and state regulations on sales tax collection, and sub- mission are all part of the internal logistics of retail sales. employee training and data collection will take time from this medical part of the practice, and must be efficiently managed. in general, the sale of physician- dispensed cosme-ceutical products is an ethical and practical way to increase income while providing a benefit to patients.
Conclusion if accomplished in an ethical, knowledgeable and responsible manner, the incorporation of cosmeceuticals into the practice of dermatology is good for both patients and doctors. Deciding if to dispense, what to dispense, and how to do it ethically and profitably are all necessary for success.
Ascorbyl phosphate Ascorbic acid Ellagic acid Coffeeberry Retinol Soy extracts Ferulic acid Niacinamide
N -Acetyl glucosamine Kojic acid Azaleic acid
SKIN-LIGHTENING AGENTS Glabridin
Arbutin Aloesin
Hydroquinone
BARRIER REPAIR AGENTS
Linoleic acid Glycerin
Borage oil
Safflower oil Ceramides Omega oils Allantoin
Magnesium ascorbyl phosphate
Fatty acids Cholesterol
COMMON EXFOLIATING INGREDIENTS Glycolic acid Lactic acid Malic acid
Polyhydroxy acids (gluconolactone, lactobionic acid)
Salicylic acid
ACKNOWLEDGEMENTS This article is a slightly edited version of a book chapter featuring in Cosmeceutical Science in Clinical Practice, edited by Neil Sadick, MD, FAAD, FAACS, FACP, FACPh; Mary P Lupo, MD, FAAD; Diane S. Berson, MD, FAAD; and Zoe Diana Draelos, MD, FAAD. The book is available from Informa Healthcare at www.
informahealthcarebooks.com
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