At the 2026 Fall Clinical Dermatology Conference in Las Vegas, Cheri Frey, MD, discussed how dermatologists can guide patients through a saturated skincare market. In her presentation titled “So Many Products, How Do I Choose? Sorting Through Skin Care and Cosmeceuticals,” Frey emphasized the need for a structured framework to assess skincare products based on ingredient efficacy and clinical evidence.

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Frey pointed out that many consumers are inundated with marketing terminology such as clean, physician tested, and medical grade, which lack official US Food and Drug Administration (FDA) definitions. According to FDA classifications, products are categorized as either drugs or cosmetics, with many skincare products falling under the latter.

A positive trend in the industry is the increasing number of products backed by clinical studies, moving away from a marketing-driven landscape. Frey encouraged dermatologists to utilize a consistent method for evaluating the scientific support behind various skincare products.

Frey introduced an adapted evidence pyramid for skincare assessment, with the manufacturer's claims at the base, suggesting their reliability depends partially on the clinician's trust in the brand. The subsequent levels of the pyramid encompassed the biological plausibility of ingredients, in vitro and ex vivo studies, biomarker analysis, and instrumentation methods. Randomized clinical trials, positioned at the top tier, remain crucial for validating product efficacy.

Frey emphasized the importance of distinguishing between ingredients and formulations, highlighting that effective concentrations and product stability significantly affect outcomes. Therefore, solely relying on an ingredient list for evaluation can be misleading.

To illustrate her points, Frey compared two products aimed at reducing pigmentation. Thiamidol (isobutylamido thiazolyl resorcinol) was shown to outperform hydroquinone in clinical settings, demonstrating significant improvement in patients with moderate-to-severe melasma. In contrast, an exosome-derived product showed in vitro promise but failed to deliver visible results in clinical tests, attributed to issues with skin penetration.

Frey concluded her discussion by noting that product packaging can also affect efficacy, using L-ascorbic acid and retinol as further examples.