Skincare has been at the heart of anti-aging for centuries. The market has become flooded with hundreds of brands making it difficult to know which one is right for you. We can find ourselves chopping and changing every time we hear about the newest latest and greatest product only to find dozens of half-used expensive bottles in our cupboards. And then we are on to the next!
Household names such as L’Oreal, Olay, and Boots have kept up with the high-end brands by introducing more advanced products with the same anti-aging ingredients such as Retinol, peptides, and antioxidants such as Vitamin C.

Sought after luxury brands such as Elizabeth Arden, Crème De La Mer, and Chanel have also maintained their place in the market with advanced anti-aging products. With an existing long-standing name behind them, consumers would instinctively trust their products.   But high-end luxury brands inevitably come with a higher price tag.

The other category gaining momentum is medical-grade skincare brands, such as Obagi, ZO, Alumier, and Skinceuticals, which you can only buy from medical aesthetic clinics.  A lot of people assume you would need to book an actual treatment to gain access to these exclusive products, which is not the case.  Another misconception is these types of brands are far more expensive than high street brands.

I want to demystify these presumptions and illustrate them in a clear and categorical way to help distinguish the differences between these products.  Over the last seven years, I have researched and worked with various skincare brands, medical experts and seen the results firsthand of different products.

What are the scientific differences behind these different categories?

The two main differences are the purity of the ingredients, and the technology used to deliver the ingredients to the various layers of the skin.

The most superficial layer where we can see aging is the Epidermis.  The deeper layer where the actual healing happens (where elastin and fibroblasts are produced) is called the dermal layer.  This is where the cellular turnover process begins.  The period of time it takes for adult skin to complete the cellular turnover process takes around six weeks.  Whereas children take around two weeks.  It can take adults four times as long to heal from wounds than children.  This is why our skin becomes thinner as we get older and we begin to see the effects of aging on our skin as we grow older.

The ultimate goal of skincare is to repair signs of aging, protect it from sun damage and other pollutants as well as stimulate natural hydration and healing process with the goal of preventing and slowing down the signs of aging.  In order to do this, specific ingredients need to be delivered to the appropriate layers of the skin through advanced systems.

I must preface this by saying that anti-aging is complex and involves multiple approaches including sun protection, antioxidants, properly cleansing, protecting the skin’s barrier from moisture loss, and preserving one’s natural hydration production at the deeper layers.

Ingredients

We see the same ingredients within the different brands.   And we are told these ingredients are what achieve dramatic anti-aging results.  For example Retinol, peptides, Hyaluronic acid, Vitamin C, A, and E.

For the sake of this comparison, let us look at the world’s oldest anti-aging ingredient: Retinol.

Known as a hero anti-aging ingredient, Retinol is proven to help improve skin firmness and elasticity, reduce fine lines and wrinkles, reduce pigmentation and sun damage and ultimately make your skin appear fresher and younger.

Even at different strengths on the label (IE. Percentages), the bottom line is that “Retinol” comes in various forms and will be stronger (purer) in medical-grade products and even stronger as a prescription which is actually known as Retinoid and Tretinoin.   One cannot presume it comes down to the percentage rating on the bottle…0.25%, 0.5%, and 1%.  Tretinoin, Retin-A, Retinoic Acid, Retinol, and Retinol esters are from the same family, but the compounds are synthesized to make it safer to use, and therefore available in high street brands.

The top purity of this hero ingredient is so strong, it requires a prescription.  In order to make it accessible over the counter, the compounds are synthesized to “dilute” the purity making it more tolerable and safer for most people to use daily.  That does not mean it will not help improve your skin, it just means, you will not achieve the desired results you would achieve with the purer form.   Were you to get your hands on pure Tretinoin and just start slapping it on your face twice a day, without the guidance of a qualified practitioner, your skin would turn red, flaky, dehydrated and look as though you had a deep chemical peel.

“Retinoids, when prescribed by an experienced professional, are de-aging wonder drugs. Essentially, they turn back the clock on the skin, convincing it that it has returned to a state where it was less susceptible to the blemishes and damage we develop as we get older. Because of this, it is essential that we protect skin undergoing retinoid treatment as we would our children’s skin. Retinoids and Tretinoin can help undo blemishes, sun damage, scars, and hyperpigmentation and facilitate the skin’s ability to repair itself. This is something that comes very easily to children’s skin. The cosmetic industry is not permitted to use retinoids in its formulations, and are limited to using far less active analogs, True Retinoids, or Vitamin A derivatives can only be prescribed and used under the supervision of a qualified prescriber and medical professional, because, just as they can work wonders, they can also be harmful if not issued by a clinician who knows what they are doing.”

Dr. Gero Baiarda,
Primary Care Dermatologist and GP
Clinical Director of Marlow Face & Body
As seen on BBC, ITV, Sky, ITN, and National RadioIn the simplest of terms, here is a step-by-step breakdown of how Retinol is synthesized in order to be safely distributed in high street brands.

  1. Retinoic Acid (also known as Tretinoin and Retin-A): this is the purest form of Retinol that can only be prescribed. It is used under the guidance of a qualified specialist, and it would be introduced gradually, slowly, and only used for up to 5 months.  It can achieve a dramatic transformation but comes at the cost of developing a tolerance that usually involves a period of redness, flaking, and dehydrated skin.
  2. Retinoic Acid: this is achieved after one synthesis action from Retinoic Acid. This can be found in medical-grade skincare products. Although it does not require a prescription, it still needs the guidance of a qualified practitioner to distribute and recommend it.  If not used properly, it can result in similar side effects as the purer forms.   This is significantly stronger than the purity you would find in a high street brand.  But in the form, it still takes longer to achieve the results than it would from a prescription-grade.
  3. Retinol: this is the next level down. Further syncretization results in the Retinol we can easily access in high street products.  While still capable of resulting in some redness and flaking, this is far safer can be used long term.  Again, the more it is synthesized, the more the purity is diluted, and the longer it takes to achieve the desired results.
  4. Retinol Ester: this is the lowest purity which is unlikely to cause redness and flaking. But it is harder to see major benefits.

The Delivery Mechanism

One of the distinguishing differences between the different types of skincare is the advanced methods used to deliver the ingredient to the appropriate layer of the skin where the benefits are achieved.   High street brands can be occlusive.  This means the molecules are too large to penetrate the skin and sit on the outer layers of the skin.  Therefore, the therapeutic effects happen primarily at the superficial layers of the skin resulting in a more short-term benefit.

Medical grade products, such as the aforementioned brands, have developed more advanced delivery methods to allow the molecules to penetrate the skin and deliver the ingredient to the layers where the benefits are achieved.  When the Retinol reaches the Dermis, it Stimulates fibroblasts to increase collagen and elastin production, improving skin firmness and elasticity and reducing the appearance of fine lines and wrinkles. The purer the Retinol is, the quicker the body will absorb it, then the product is converted in the skin resulting in more dramatic results.

“A consultation with a skin care specialist in a medical environment is an opportunity to discuss your individual needs, experiences with other products as well as existing conditions and sensitivities. The process should be in-depth and a qualified professional takes the time to understand your goals as well as your medical history so that a bespoke program can be recommended. It also gives you the opportunity to learn things about your skin you may not have previously known that could potentially cause issues in the future. You may have rosacea and not even know it!” Georgina Griffith, Registered Nurse, Obagi Ambassador.

At the end of the day, you need to find the right products and the right ingredients for you.   Most medical aesthetic clinics offer free skin consultations and can give you an educated recommendation of the right products and the right ingredients for your individual skin type and conditions, safely and effectively.   If you want to go down the prescription-grade purity, most clinics will be able to provide this if it is appropriate for you.  If budget is a concern, due to your due diligence as a consumer.  You might be pleasantly surprised at the cost of medical grade and prescription skincare.  Most of these products last anywhere from three to six months.  Do the maths and decide if your skin is worth the ongoing monthly cost.  You will wear your skin forever, so take care of it.  After all, it is far easier to slow down the aging process, than it is to turn back time.

Elisabeth Bester