Research Article| Volume 19, ISSUE 4, P365-366, July 2001

Commentary: cosmetic dermatology

  • Ronni Wolf
    Address correspondence to Ronni Wolf, MD, Department of Dermatology, Ichilov Hospital, 6 Weizman Street., Tel-Aviv 64239, ISRAEL
    Department of Dermatology Tel-Aviv Sourasky Medical Center, and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv Israel
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      The eye of the beholder

      Does anybody still believe in the adages of “growing old gracefully” and that “beauty is in the eye of the beholder,” or that “beauty and wisdom are rarely conjoined”? While beauty may be skin deep, ugliness and blemishes can be bone deep and can even break hearts.
      We live in a youth-oriented culture in which enormous importance is placed upon attractiveness, beauty, and physical perfection—refraining from dying those gray hairs is tantamount to an act of courage for both men and women. The cosmetics industry played their cards right and there is no turning back: appearance counts. It counts in all walks of life and it counts not only throughout life but beyond as well—even the dearly departed doesn’t get to lie in state until having undergone the skillful ministering of a specialist in the art of “necrocosmetology.”

      Footing the bill

      Madison Avenue has done its job well and it is the rare individual who hasn’t swallowed the bait, hook, line, and sinker. Cosmetics and skin care products have become integral and even essential parts of daily grooming. The average American adult uses at least seven different skin care products each day and keeps an estimated $500 worth of cosmetics around the house. More than 2,000 agents manufacture and distribute these products and share the wealth in the United States alone. Add to this number the prestigious European and Japanese perfumes and cosmetics houses and we are dealing with very, very “serious” wealth, indeed. It is no wonder that the cosmetic industry is a huge, global, extremely competitive business that uses every trick in the book to capture and hold market share.

      The pursuit

      After having succumbed to the charms of the Loreleis of fashion who set the tone of what it takes to look young and desirable, we are ignited by “The Look” and no holds are barred: we want healthy-looking, velvety, soft, supple, wrinkle-free, ageless-looking skin or bust! We are willing to pay whatever it takes and, lucky us, the marketplace is willing to sell. It is replete with a plethora of cosmetic products, each one promising us eternal youth and touted by beauticians and beauty counselors who are dedicated to guiding us along the path of beauty and desirability (the path of their employers to the bank is paved in pure gold).

      The call for help

      Today, more than ever, patients turn to their dermatologists for help in choosing which cosmetic products are best suited for them and for instructions on how to use them. They expect appropriate, unbiased, and scientifically correct information. Although our own interests tend to focus on treating and managing “real” medical problems of the skin, we must respect the no less “real” needs of our patients and be able to advise them on how to maintain healthy and aesthetically attractive skin and, when need be, how to cope with adverse reactions to cosmetic products. To do so, dermatologists need to be familiar with the physiologic action of cosmetics and skin care products that are available on the market and be aware of their chemical composition, application, cosmetic benefits, and safety, as well as with their potential hazards. This knowledge can only be acquired from independent, peer-reviewed scientific literature that is utterly free of personal gain. This service to our colleagues motivated the design of the current work.

      Responding to the call

      The past decade has witnessed an explosion of new information relating to the biochemistry and pathology of the skin and, particularly important for the present issue, its complex interactions with topically applied substances. This has been accompanied by the emergence of the field of bioengineering and its many devices for measuring quantitative data on various properties of the skin. Although these methods are generally objective, they can be, and often are, manipulated by manufacturers to support the claims and superiority of their own products. Thus, even the experienced dermatologist finds it difficult to separate the wheat from the chaff and cope with the voluminous and sometimes contradictory scientific and pseudoscientific material.

      The essentials in compact form

      It is my hope that our readers will find this issue of Clinics in Dermatology both interesting and valuable, we have tried to provide the fundamental and specific information dermatologists need for assisting patients in caring for their skin, in keeping it healthy and attractive, and in tailoring products to the individual patient’s needs. We have attempted to provide a comprehensive summary of the current knowledge on various aspects of cosmetics and skin care products, including moisturizers, soaps, detergents, antiperspirants, deodorants, camouflaging and makeup preparations, eye cosmetics, hair care products, hair removal methods, nail care products, oral care products, sunscreens, depigmenting and bleaching agents, retinoids, hydroxyacids, antioxidants, botanicals, and others.
      I consider myself especially fortunate in having been able to bring together a group of the world’s first-rate specialists, the top “players” in the lively, complicated, and multifaceted field of cosmetics and skin care science. They have consented to give their valuable time and vast experience to cover this complex issue in a systematic, scientifically well-founded, and critical manner. If you enjoy reading the issue as much as we have enjoyed planning and producing it for you, and if you find the information it contains to be of value to you, it will all have been worth the effort.


      This issue is the final product of the efforts and cooperation of an extraordinary team. The credit must first go to the contributors, all first-rate and extremely busy scientists and dermatologists, who have nevertheless been so generous to give their valuable time to the success of this project. Thanks to their talent, experience, skill, and knowledge, we are able to offer our colleagues a comprehensive, intelligent, and interesting collection of papers that will impact many thousands of patients. At first, covering such a broad subject seemed to me a daunting proposition but very quickly became a satisfying and enjoyable venture, thanks to the enthusiastic feedback of my colleagues who know only too well the frustration, bewilderment, and even pain that can go with the downside of the pursuit of beauty.
      Ms. Anna Saar, Associate Editor at Elsevier Science, and Dr. Hirak Behari Routh, Managing Editor, did a masterful job in coordinating, organizing, and assuring the completion of this issue of Clinics in Dermatology, and for this I thank and applaud them. My heartfelt thanks also go to Ms. Esther Eshkol, my literary right hand, for her close assistance and great editorial work.
      My friends, colleagues, and family members supported me throughout, but none so much as my wife, Osnat. She is a rare woman whose personality and charm never fail to uplift my own spirit. Without her, I would not be what I am and this issue would not have been what it is. Her love and indefatigable support are the cornerstone of my existence and the source of my strength to carry out all my scientific work. This wonderful woman has played an important part in every step I have taken in my life, in every achievement and success, in everything I have created and, finally, in this important issue of Clinics in Dermatology.
      Last but by no means least, I thank and exalt the Editor-in-Chief, Professor Lawrence Charles Parish, for conferring upon me the great honor and unique privilege to be Guest Editor of this important issue of Clinics in Dermatology. His confidence and faith in me and in the success of the enterprise, his encouragement and valuable advice, and his unfailing help from the earliest steps of preparation of this venture sustained me throughout and will always be cherished.