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There’s a lot of misinformation about how “medical grade”, “clinical” or “professional” skincare products are guaranteed to be better than drugstore or “over-the-counter” (OTC) products you can buy at the supermarket.
Like a lot of other myths, this myth has mostly been promoted by some well-intentioned people who have unfortunately been fed the wrong information by brands who know better (or should know better, if they’re not being negligent).
But there are also a lot of people (mostly estheticians based in the US, it seems) who use this myth to bully and belittle other people: for “ruining their skin” by using non-medical-grade products in their routines, or for being stupid enough to believe that non-medical-grade products can achieve results, or for not having the means to pay for more expensive products.
This is shitty behaviour even if it was the truth, but since it’s a myth, it’s even worse. While this myth might not be as directly harmful as, say, myths about sunscreen being dangerous, it’s definitely a myth that leads to harm. So let’s bust it.
Why do people claim that “medical-grade skincare” is better?
(Note: We’re talking about products you buy and use at home, not peels etc. that can only be used in certain clinics.)
“The FDA regulates medical-grade skincare differently”
A lot of the confusion comes from the frequently-promoted idea that there’s an official difference between how medical-grade skincare and “over-the-counter” (meaning drugstore) skincare are approved by the FDA, or other government regulatory authorities. This isn’t the case.
In the US, the vast majority of skincare products fall into the cosmetic category, which means they don’t require regulatory approval or proof of efficacy (outside of not containing banned ingredients, or restrictions on ingredient concentrations) whether they’re medical-grade or not. This is also the case in most places around the world.
The confusion partly comes from the fact that “over-the-counter” is a term used in drug regulation to describe drugs that can be bought without a prescription, like sunscreen, aspirin, cough medicine and antihistamines. In contrast, prescription medications require a prescription from an appropriately authorised health professional, like a doctor or nurse practitioner. Both over-the-counter drugs and prescription drugs are regulated by authorities like the FDA or TGA.
There are a few skincare products that are usually regulated as drugs. For example, there are prescription-only tretinoin and tazarotene creams, and over-the-counter sunscreen, benzoyl peroxide, sulfur, salicylic acid and adapalene products. Ironically, these are usually found in drugstores rather than in “medical-grade” ranges.
Related post: My Routine for Starting on Tretinoin (Retin-A) Cream
For drugs, depending on the actives and the claim, testing methods differ – some products aren’t tested for efficacy (e.g. benzoyl peroxide products just need to contain a certain percentage). Products that are regulated as drugs will be clearly labelled. For example, in the US, there will be a “Drug Facts” label, and in Australia there will be an AUST R or AUST L number and active ingredient concentrations on the front. In some countries (Japan, Korea), cosmeceuticals and quasi-drugs are regulated in addition to drugs, but again these will be clearly labelled.
So… “medical-grade” skincare IS “over-the-counter” skincare, since it isn’t prescription-only.
“There’s rigorous testing/clinical studies/research so it does what it says” “They use higher quality ingredients”
Because “medical-grade”, “professional” and “clinical” aren’t regulated terms, there’s no guarantee of any sort of testing.
Some medical-grade brands will do rigorous testing and clinical studies, but anyone can use the term “medical grade” and decide to only sell their products through skin clinics.
Many drugstore products will have rigorous testing and clinical studies too. Some of the ones regulated as drugs, like sunscreen, will have mandatory clinical trials. Many of the more dermatologist-friendly brands targeted at sensitive skin, like QV or Bioderma, will also have conducted clinical trials on their products.
“They contain higher percentages of actives” “They’re allowed to penetrate deeper than over the counter and drugstore products”
Unless they’re drugs, again there isn’t any regulatory difference. You can get the highest percentages of actives with brands like Paula’s Choice, The Ordinary, Drunk Elephant etc.
Medical-grade skincare is just like any other type of skincare. Whether they’re good, or effective, or worth the price, or have clinical studies to back up their effects has to be judged on a brand-by-brand or product-by-product basis.
When I posted about this myth on Instagram, I had a bunch of estheticians tell me my opinion wasn’t worth shit and block me. I did also have lots of estheticians who thanked me, along with a few medical-grade brand educators, so no, it’s not attacking medical-grade brands or estheticians… just those who knowingly perpetuate this myth and use it to harass others.
So here are some reasons why perpetuating this myth is NOT a good idea, if you’re an esthetician:
- If a product is honestly amazing, it doesn’t need to be puffed up with myths about FDA regulation, or how deep they’re allowed to go into the skin, or how toxic drugstore products are, etc. If a product has worked wonders for you and others you know in the past, just say that! If there’s an amazing team of researchers and formulators who made it, if there are great B&A photos to back it up, if it has effective actives that you rarely find in other products – again, just say that.
- Deceptive marketing is unethical and illegal, and you can be reported for it.
- People who discover that they’ve been sold a myth tend not to be repeat customers.