The internet has changed many facets of modern life, and the practice of medicine has certainly not gone untouched. Just consider, for better and worse, the many websites and apps that patients use for self-diagnosing their skin before consulting with a physician.
Long before the internet era patients would self-diagnose their skin type using tools such as the color bars popularized by Clinique in the 1980s. In my research i have found that 80 percent of people who misdiagnose their own skin type. Studies have demonstrated that people are often wrong about their sebum production leading them to misdiagnose themselves as a dry type when they should be classified as oily. This results in the use of incorrect skincare products that can compromise skin health by causing inflammation, bacterial overgrowth, excess dryness, clogged pores and other skin issues.
Clearly, patients who receive advice from a trained medical professional who properly diagnoses their skin type and prescribes a skincare regimen will have better outcomes. One reason for this is that the doctor or aesthetician spends time with the patient explaining what products to use and in which order to use them and then follows up with the patient to assess the outcome. At each visit the skin is evaluated and the products are adjusted as needed.
Buying products on the internet makes it very easy to fall prey to compelling marketing or pretty packaging instead of purchasing the proper products for your skin type. I recommend that everyone see their doctor for an initial evaluation and skin type diagnosis.
The Role of the Internet
Only about 30 percent of patients buy refills from their doctor for second purchases, and just 15 percent purchase products from their doctor the third time around. Why is this? It’s likely that the convenience of the internet and lower costs drive patients to purchase from sources other than their physician or aesthetician. This desire to save money online carries significant risks. Many of the products found online are expired, counterfeit, or merely old containers refilled with a different formulation. Patients should be cautioned to only buy products from a source that they trust.
I have had dozens of patients bring me counterfeit products in the last few months. It seems that the problem is becoming more common. I interviewed several companies to see if they were seeing the same trend. This is what I found:
Some companies report that they have seen their samples and trade size containers being sold on eBay. Joe Ragosta of Topix Pharmaceuticals (USA) reports that when his company has asked such sellers if they are obtaining these products, which are marked as samples, from the company, they hear a range of defensive responses. These have included: “I got it at a show,” “My doctor gave me samples and I decided to sell them,” and “I work at a doctor’s office and they let me take products as needed.” This shows just how important it is to make sure that your staff is not taking samples and selling them online.
NeoStrata is also concerned about the fraudulent use of their products. They recommend that patients purchase their products only from a known physician, and ideally from their office rather than their website. The company understands that customers may want to save money wherever they can and might prefer to buy products on the internet. Still, NeoStrata urges customers to make online purchases through physician-affiliated websites where the doctor is clearly identified. At the very least, the company urges patients to only choose sites where they can contact someone and obtain the name of a physician. Further, they strongly discourage using eBay or other auction sites that do not vouch for the safety and authenticity of products sold through their services, and NeoStrata does not permit sales on such sites.
5 Potential Problems with Buying Skincare Products Online
1. Counterfeit Products
According to the California-based The Counterfeit Report, pharmaceuticals and personal care products, including cosmetics, are among the top five types of products seized by U.S. Customs and Border Patrol agents. Such products include old bottles refilled with inexpensive imitation creams, or bottles made to look like legitimate products that are filled with imitation creams. I once had a patient present with an adverse reaction to a retinol product, which she brought with her to the visit. I sent the bottle to the company, which confirmed my suspicion that the product was counterfeit—a different bottle with a similar label.
CBS New York ran a segment on the potential inclusion of carcinogenic and other harmful ingredients found in online personal care products touted for their low prices. Not even two weeks later, CNN reported on the arrest of two brothers in New York alleged to have masterminded a multimillion-dollar counterfeit health and beauty product ring. ABC’s Good Morning America followed suit with another segment that exposed aspects of the use of knock-off cosmetic products.
The FBI has also posted memos concerning counterfeit and potentially compromised and hazardous cosmetics and fragrances, offering tips aimed at readily identifying or avoiding unauthorized products (see sidebar).
Torie Hardee of EltaMD summarized that counterfeit products can sometimes be identified by lack of an expiration date on the bottle, discoloration or slightly different fonts on bottles and packaging, and lack of the manufacturer’s address on the bottle.
Jan Marini Company representative Stuart Mohr noted that their company has received returns of products that they had not manufactured, as well as their own current or discontinued products returned years after the expiration date. The Jan Marini Co., as other companies in general, will not guarantee any product purchased via non-authorized resellers, as the authenticity and safety of such products cannot be verified.
“These unauthorized resellers are sophisticated, often even working in rings, and find it easy to hide their real identity,” said Mohr. “Addresses are often hidden or vague, emails are not linked to any specific person, and it’s easy to use false names. If a person is caught in an unauthorized online transaction, it’s easy to change the email address or name and start again,” he added.
2. Expired Products
Unscrupulous online retailers may slash prices on expired products and remove the expiration date from the package. In my practice, a patient experiencing an erythematous reaction brought in a “SkinMedica” product bottle, which looked suspicious to me. The packaging that the product was in had been discontinued eight years earlier! It’s important to remember that ingredients, particularly retinol, degrade with exposure to air, sun, and heat, and over time. This is doubtlessly what caused my patient to experience her adverse reaction, with her initial savings from the product causing her two to three weeks of irritated skin and the cost of multiple visits to my office.
3. Diverted Products
SkinMedica reports seeing diverted products as a trickier issue than counterfeit products, owing to the fact that their packaging and formulas are sufficiently complex to render counterfeiting too difficult to be profitable. Their products have been sold on the so-called “gray market” below the manufacturer’s suggested retail price (MSRP), typically online. In these cases, the company cannot help patients with returns or complaints because they cannot verify the chain of custody of the purchased product.
They are addressing this problem, though, with an awareness campaign called “Authentic and Authorized.” Its goal is to alert patients as well as the physicians who dispense their products of the benefits of a physician-dispensed model of skincare, with best outcomes achieved when doctors are prescribing a skincare regimen. SkinMedica emphasizes that no website can guarantee outcomes comparable to a skincare professional, and product quality and safety can only be enforced when dispensed through authorized channels.
4. Potentially Illegal or Toxic Ingredients
Several products that have entered the U.S. marketed as skin lighteners, anti-aging agents, and acne treatment products have been found to contain mercury, according to the FDA. Arsenic, lead, beryllium, and other harmful toxins, as well as allergy-inducing fragrances or preservatives not approved as safe in the U.S. may also be found in such products of dubious origin.
5. Improper Storage
Products purveyed online are often stored in hot warehouses. As mentioned above, heat degrades and alters ingredients, rendering compounds such as retinol, benzoyl peroxide, peptides, and ascorbic acid worthless. Extreme cold can also damage the chemical integrity of products. Notably, organic products are more vulnerable because they lack preservatives to guard them against temperature variations and microbes that grow in hot, damp environments.
6. Lookalike Imposters
Generic formulations are packaged to piggyback off of the success of well-known products. Such products found in drugstores may be packaged to look like Cetaphil or Aveeno items, but cost less… and deliver less. While the ingredients on the copycats are identical to those found in the branded preparations, the order in which ingredients are added, the temperature, pH, and even when and how fast ingredients are stirred are part of the proprietary recipe of the company and play a significant role in the potential of the end product and, in turn, the actions the product exerts on the skin.
What can you do?
Only buy skincare from sources you trust, such as your dermatologist or aesthetician. I have an online store called SkinTypeSolutions.com that handles the online sales for many doctors. Other options are buying directly from the brands or from a brick and mortar store. The point is that you need to know who the seller is to be sure you are getting good products. EBay and Craig’s List for example are not trustworthy places to purchase skincare.
Do not skimp when it comes to the health of your skin. Getting the proper recommendations and the proper products from your doctor will save you money by preventing you from wasting money on unnecessary, improper, or counterfeit products. This will save you money and time by helping you avoid skin irritation and all its related expenses and hassles. If you do choose to purchase from an unknown source online, here are some tips to prevent you from using counterfeit products on your skin.
Tips for Spotting Counterfeit Cosmetics & Fragrances
The product is a sample size
The packaging differs slightly from the authentic brand (different color or font)
The product’s wrapping appears to be haphazard
The product is being advertised as “limited edition” even though the authentic manufacturer doesn’t offer it as such
The product is not listed on the manufacturer’s website
The price is drastically lower than MSRP
The product’s consistency or texture just doesn’t feel or look like the authentic brand
For fragrances, there’s something a little off about the scent, and the color of the fluid in the bottle might be different than the original
They are being sold at non-authorized retailers, including flea markets and discount stores
The label does not contain:
Lot number
Bar code
Manufacturer’s address
Expiration date
Your skin is the largest organ on your body. Every ingredient that touches it plays a role in your skin’s health. Make sure you take the time to see your doctor to diagnose your skin type and get a prescription for the proper skincare products for your Baumann Skin Type®. Then, buy those products from a reputable source. Then the last step is- remember to use those products every day as prescribed to achieve beautiful healthy skin.
Dr. Leslie Baumann, M.D. and her team at Baumann Cosmetic Dermatology believe in proof, not promises. World-recognized for both cosmetic and general dermatology, our treatment strategies rely exclusively on evidence-based, scientifically verified products and procedures that promote skin health and a natural appearance. We combine effective medical procedures with individualized instruction on proper skincare, nutrition, supplementation and lifestyle in order to maximize the health of the skin and body as a whole while minimizing the effects of aging. For more, visit Dr. Baumann’s blog for daily updates Monday through Friday, or inquire about an appointment through Derm.net.