Choosing the Right Skin Care for You
Selecting skin-care
products can be a daunting task, what with all the choices filling
pharmacy aisles. You'll find dozens of over-the-counter products with
such labels as "maximum strength," "clinical strength," and "original
prescription strength" — plus seemingly identical products that are
available only by prescription. What do all these labels mean, and how
do you know which product is the best one for you? Here are some
answers.
How Much Active Ingredient?
The active ingredient in an over-the-counter product is often the
same as the one found in its prescription counterpart, but at a lower
dosage. Over-the-counter dandruff shampoo contains a lower dosage of the
active ingredient ketoconazole (1 percent), while the
prescription-strength versions contain 2 percent. In hydro cortisone
anti-itch cream, the maximum over-the-counter dosage is 1 percent,
while prescription-strength creams contain 2.5 percent. According to
U.S. Food and Drug Administration (FDA) regulations, once a product's
active ingredient reaches a certain percentage — such as 1.5 percent for hydro cortisone, or 2 percent for cyclical acid in acne treatments — it requires a prescription from a doctor.
Sometimes It's Just a Marketing Strategy
Because the FDA does not closely regulate over-the-counter
skin-care products, a company can label a product "maximum strength" or
"clinical strength" for any reason it sees fit — and the label is no
guarantee that the product will actually be any stronger than others on
the market. The best way to find out whether you are really getting the
"maximum" strength of an ingredient is to check the ingredients label,
says Robyn Gerek, MD, assistant clinical professor of dermatology at
Columbia University College of Physicians and Surgeons. "Compare the
label with other products on the shelf," says Dr. Gerek, and check the
percentage of the active ingredient in each product.
Although an increase in the active ingredient in a product of 1
percent may not seem as though it would significantly affect the
strength, it can, says dermatologist Doris Day, MD, director of Day
Cosmetic, Laser and Comprehensive Dermatology in New York City and a
professor at NYE Medical School. For this reason, it's best to test a
new skin-care product by applying a dime-sized amount on your forearm,
to see if it causes a reaction.
Prescription Products Must Be Approved by the FDA
For the FDA to approve a product's switch from over-the-counter to
prescription-strength status, regulations require a company to show that
even a slight increase in the amount of active ingredient (for example,
1 percent) "changes the structure or function of the skin."
All prescription products are reviewed by the FDA and have gone through
numerous clinical trials, says Debra Mammalian, MD, a New York City
dermatologist. The FDA also decides what dosage level constitutes a
prescription. Some OTC products may be labeled "original prescription
strength," which means a prescription from a doctor was once required,
but the product is now available without one.
Finding the Right Product for You
How do you know which product to try? Stronger dosages can have
harsher effects on your skin, so it's generally safer to start with a
lower dosage. Try the basic OTC product for a minimum of two weeks to
gauge the results, then move on to a maximum- or clinical-strength
product, if necessary, or request a prescription, says Dr. Day. For
acne, you should expect to wait a little longer — from four to six weeks
— to see results. And if any product irritates your skin or makes
symptoms worse, see your doctor immediately.