Attack of the wrinkled ladies

May 5th, 2007 by Ben Goldacre in bad science, cosmetics | 30 Comments »

Ben Goldacre
Saturday May 5, 2007
The Guardian

Wrinkly ladies nationwide have coordinated a stampede for Boots No 7 Protect & Perfect face cream, after it was endorsed by the BBC’s Horizon: so let’s do face creams. Basically they’re all the same. They all moisturise, like vaseline, but without the greasiness. And most also contain mashed up protein chains: these are long and mobile when they’re soggy, but curl up and contract when they dry, for instant tightening gratification. Companies give these proteins French sciencey names such as Tenseur Peptidique Vegetal.

Lastly, they may contain active ingredients: a double-edged sword. So vitamin A seems to be helpful on skin, but its active form, tretinoin, also causes burning, flaking and redness, so it’s prescription only. You can give weaker forms, with names such as “pro-retinol”, but they’re converted to tretinoin slowly, so they don’t work well: you could give lots but if it works, it might have tretinoin side effects too.

Now some have criticised research on the cream purely because Boots funded it. But what did the researchers do? They took nine volunteers with aged skin, and put some cream (moisturiser, weak cream, strong cream, and tretinoin) on to a row of 6mm patches on their arms, regularly, for 12 days. They put tretinoin on only for the last few days, because of side effects, but they used it because we know it works, so that helps you see if your outcome measurements are picking up true improvements.

Then they took biopsies, sliced them up, and compared them under a microscope, looking at the “extracellular matrix”, the supporting architecture around the skin cells, and particularly at fibrillin microfibriles. These are damaged by exposure to sunlight, and tretinoin partially repairs that network. They assessed how good the fibrillin looked, scoring from zero to four. Nobody involved knew which cream was which, until the end, and the paper will be published shortly. The results? The No 7 Protect & Perfect cream scored better than basic moisturiser, but not as good as tretinoin (and both caused some reddening). You may now stampede.

So what’s bad about this study? Well, it measures a “surrogate outcome”, a lab finding, that is one step removed from the real world, and one that may flatter the cream. And it compares No 7 Protect & Perfect against placebo (a simple moisturiser) instead of other competing creams on the market.

But this is the astonishing thing. Other manufacturers don’t submit their creams to a university dermatology lab, or publish academic papers: so these aren’t so much the best results, they’re the only ones. Why? The tests cost just £15,000. Cellular Radiance Cream by La Prairie, for example, costs £340 a pot. Fifty pots would fund one study.

But those tests could bite any company right back: because if they show no effect, then your business is trash; but if they do show an effect, then busybodies wade in to regulate your pharmaceutically-active product. If it was my cosmetics company, I’d stick with the sciencey diagrams and hope for the best.

· Please send your bad science to bad.science@guardian.co.uk


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30 Responses



  1. jackpt said,

    May 5, 2007 at 2:32 am

    Re the some that have criticised. It’s a shame when people with the best of intentions employ as much hasty reasoning as some of the things they’re against. The devil is in the detail and all that.

  2. JohnD said,

    May 5, 2007 at 8:33 am

    LEADING DOCTOR GUILTY OF SEXISM!

    Ben, Ben, Ben.
    “Wrinkly ladies”
    When the article above yours on the Guardian page says that the first five people in the queue at Manchester’s Boots were men who had been queuing since 5am, and that there were many more men in that queue. Moreover, they freely admitted that the cream was for them, not their wives.

    John

  3. iantanner said,

    May 5, 2007 at 9:58 am

    Don’t those in the know (models, etc) use Anusol to tighten the skin? If so we need a trial comparing it to No7!It costs £3+ for 30gms

  4. Andrew Clegg said,

    May 5, 2007 at 10:55 am

    Dunno about that but Preparation H works a treat on new tattoos.

    Smells a bit weird though, so one day I looked at the active ingredients — yeast extract and shark’s liver oil, I kid ye not.

    Andrew.

  5. Ben Goldacre said,

    May 5, 2007 at 8:39 am

    ha, the guardian journo may have successfully found some blokes to interview for a paradoxical opening line, but the moisturiser market is clearly mostly women. but yeah, go on then, fair ish cop.

  6. Ben Goldacre said,

    May 5, 2007 at 1:24 pm

    wiretrip i dont think that’s true about you and yours, they were not criticising boots for claiming that the research was independent, they were jumping up and down histrionically about who funded it, getting outraged customers, and so on. anyone wants to listen to it then it is here:

    www.bbc.co.uk/radio4/youandyours/listenagain/friday.shtml

  7. Wiretrip said,

    May 5, 2007 at 2:03 pm

    Yes they were. More accurately they were asking why the fact that the study was funded by Boots had not been made more public – listen again, the banner for the article is even ‘Should the fact that Boots paid for the research…have been more prominently displayed?’. They even gave Prof Griffiths about 5 minutes to talk about the research and to defend it. Yes it was a bit hysterical but what it was criticising was the use of an ‘independent’ endorsement that they’d paid for themselves. Also, the research, as you’ve pointed out, is rather weak anyway…

  8. PaulCarpenter said,

    May 5, 2007 at 2:43 pm

    So they proved that it works a bit, but not definitely better than anything else?
    Since that is true of every product, then if I were a cosmetics company, I’d fund that.

  9. La di Da said,

    May 5, 2007 at 11:36 pm

    Aside from anything else, unless they specifically say the cream is only for putting on at night, then it’s fairly pointless as anti-wrinkle if it doesn’t contain SPF15+ sunscreen. What with UV being a major cause of skin damage and all.

    And…

    – Unless it’s in a light- and air-tight package any active ingredients will likely become useless soon anyway.

    – Retinol can have some *modest*, tretinoin-like effects if you have enough of it and can get the amount right so it doesn’t cause the side effects. I wouldn’t bet on any cosmetic cream having such.

    – I bet the Boots cream contains fragrance. Whether synthetically or naturally derived, scents are all the product of volatile oils, the ingredients of which are all known skin irritants (check out dermatology journals).

    – It claims ‘white lupin extract’ as an antioxidant. It’s well-documented that free-radical activity (through various triggers) is what causes much skin damage, and that topical antioxidants ***MAY*** be of some help but it’s rare that a cosmetic cream has antioxidant ingredients in any quantity that could possibly have any effect. Again needs the light- and air-tight packaging. And lots of things that are claimed as antioxidants cause skin irritation anyway, so are extra-pointless.

    The best anti-wrinkle cream is probably a baby/toddler/sensitive-skin sunscreen of SPF 15 or greater, applied every single time before you go in the sun. Not terribly glamorous, but there you have it.

  10. Dudley said,

    May 6, 2007 at 8:27 am

    What’s wrong with wrinkles?

  11. desoi said,

    May 6, 2007 at 11:18 am

    I’ve never understood how the peddling of (face, cellulite, etc) creams costing billions that either don’t work or that may have some inconsequential minimal level of effectiveness, is permitted through the use of mealy words designed to skirt outright fraudulent representation.

    I’m not a lawyer but can’t a case be argued that the effect of the mealy words does not actually avoid the fact they make pretty specific claims and are selling snake oil?

  12. boberto said,

    May 6, 2007 at 1:22 pm

    There is some truly great science on the back of cosmetics products – radox has a relaxation versus time curve on the back and head & shoulders a dandruff vs. time graph, both without any units. We never did those at school though…

  13. Robert Carnegie said,

    May 6, 2007 at 3:37 pm

    La di Da: I speculate that you are speaking off-the-cuff from an office desk or a home computer in your living room, whereas the pro-Boots statements come from a proper laboratory with thest tubes and everything. I therefore accuse -you- of Bad Science.

    For instance, most cosmetic products come with a use-by date, and if you are supposed to keep the stuff in the fridge meanwihile, like a vaccine, I presume they will tell you so.

    I mean, if the stuff works then they’d be daft to package it so that it doesn’t.

    Some of the cosmetic adverts on TV are hilarious. One seems to be claiming to work in the same way that Polyfilla does – fill in the cracks with foundation gunk and then you can paint on top of it. (I’m no expert, so do not use Polyfilla without checking instructions.)

  14. bootboy said,

    May 7, 2007 at 2:03 am

    “If it was my cosmetics company, I’d stick with the sciencey diagrams and hope for the best.”

    Has somebody replaced Ben with a Bad Science apologist?”
    Nope, he’s just expressing the obvious logic of profit-based therapeutics. The point being that if you are a shareholder of a company that sells a therapeutic product, objectively measured outcome improvements are very much a surrogate measure.

    If you don’t understand this, you would make a very bad business person.

    Fair play Ben, your recent articles have all been very brave and have taken on difficult areas without any dip in scientific quality.

  15. Bryan Kitts said,

    May 7, 2007 at 6:42 pm

    “…[the study] compares No 7 Protect & Perfect against placebo instead of other competing creams on the market…”

    Unlike the Horizon programme which (if I remember correctly) did compare the Boots cream against various other more expensive creams.

    As Ben says, hard to blame the cosmetic companies for not rushing to do lose/lose research. Maybe that’s why Equazen’s fish-oil ‘trials’ are flawed: they worry a proper study might prove the pills work and so leave them open to expensive, pharma-style regulation…

  16. fnorman said,

    May 8, 2007 at 12:33 pm

    There was a funny piece in the Telegraph a while back about face creams and such like. The article is all a bit whimsical, but nicely de-bunks the weird ingredient names these cosmetics companies make up.
    tinyurl.com/ytz5ng

  17. Delster said,

    May 8, 2007 at 3:51 pm

    hmmm…. having a problem with wiretrip’s comment’s here.

    ok say i have a product… i can go to an independant lab (ie a lab outside my own organisation) and say to them i have a product that does “blah”. Please devise & carry out for me a comparison test with other products that also do “blah”. The once they have done that i get the test results and pay in invoice.

    The testing has been done independantly but i have still paid for it (or funded if you prefer).

    At the end of the day somebody has to pay for testing to be done and the only one’s who are going to do that are manufacturers of these products…. unless your going to put your hand in your pocket?

    feel free however to critique the study’s methodology… e.g. what they compared the product with for instance.

  18. Robert Carnegie said,

    May 9, 2007 at 2:44 am

    Well, when the newspapers had Mister MRSA test their hospital samples and discover flesh-eating bugs, that was independent testing, too. By choosing which tester you employ, you can influence the result in your favour, even so.

  19. jj_hankinson said,

    May 9, 2007 at 12:44 pm

    Re: 20, 21

    I agree with Delster here. The point remains that the source of funding of a study does not *necessarily* impact the methodology used. Assess the methodology used and see if that is faulty (as it is in the case of the Boots cream study and also the dodgy MRSA testing scandal).

    All that said, lets be honest here. A study’s source of funding can be used as an indicator of likely shortfalls in the methodology employed.

  20. Sour Grapes said,

    May 9, 2007 at 1:48 pm

    Is it my imagination, and nobody else sees it? I checked the comments first to see if anyone would say anything, but no sign. I refer to the second paragraph of this post, where I read: “So vitamin A seems to be helpful on skin, but its active form, tretinoin, also causes burning, fucking and redness, so it’s prescription only.”

    Not much chance of getting Charlotte Green to read that out on The News Quiz, so I thought I’d better draw it to your attention instead.

  21. manigen said,

    May 9, 2007 at 2:17 pm

    I’m seeing “flaking and redness” personally.

  22. Bryan Kitts said,

    May 9, 2007 at 8:52 pm

    Maybe I’m being unfair but it seems a little ironic for the article to claim that face creams “basically are all the same”, then to discuss the lack of any comparative studies. Isn’t ‘bold claim where there’s no experimental evidence’ the sort of thing that Bad Science is normally against?

  23. Robert Carnegie said,

    May 10, 2007 at 9:10 pm

    Have you tested your computer for the “Clint” virus? (Or the screen scrolling in your video driver.)

    I often see disjointed Web pages – and Opera’s zoom control is very useful but sometimes it struggles.

    But then again, way back, even before Windows, I think there was a virus program that would pop up whenever you typed Margaret Thatcher, but of course these days it could still be around and most the horrible old cow of the time we wouldn’t even notice.

  24. mikewhit said,

    May 25, 2007 at 12:17 pm

    Just looked among the other likely Boots No 7 products that /were/ in stock for one that contained ‘retinyl palmitate’ – and bought that one instead. Same active ingredient; OK might not be delivered in exactly same way, but prob as good as the out-of-stock one: well better since it’s there !!

  25. DHR said,

    February 21, 2009 at 3:19 am

    It’s the false oestrogen parabens preservatives. Not the active ingredient. Whatever that is anyway it’s probably rubbish.

    Boots No 7 Protect & Perfect face cream contains about 8 variations on the theme of parabens. All of which are bad for yer gonads boys. Might temporarily help your wrinkles though.

    Huge amounts of what happens to you and your face is hormonal but very little is known because you can’t patent a hormone so nobody is going to make money so nobody is going to bust a gut, much less an overdraft, with the research.

    We don’t talk about this because it mostly only affects the girls and PMS is such a joke but parabens preservatives cause swollen and painful breasts and really bad periods because it is a false oestrogen and messes up your hormones. Cue the big clever sexist jokes we’ve all been hearing for decades.

    Yawn.

    Medical oestrogen is given by patches or gells. Transdermally in other words. But products you put in your mouth or on your skin such as toothpaste, shampoo or wrinkle cream containing known false oestrogens can’t possibly do any harm!

    It’s odd though. How a number of products, toothpastes, shampoos etc I’ve had to avoid for years because of the horrible hormone problems I got from using anything with parabens in now suddenly don’t contain parabens anymore.

    Ooh! Maybe it’s the unproven cancer link!

    Sensodine toothpaste for example gave me problems for years but I didn’t know why, only that it did. Then when I realised it was the parabens preservatives, very cause and effect parabens: Take it get probs, stop taking it, month or so later probs stop. Start taking it again… etc.
    Now, oddly, and in the UK anyway, Sensodine no longer contains parabens. No explanation.

    Many effective, and some quite expensive, wrinkle creams still do contain parabens however. Often in large quantities. In the case of Boots No 7 Protect & Perfect face cream, LOTS of parabens. Read the lables. Many, many things ending in “Parabens”.

    I’m sure they are all totally safe.

    I also suspect they are the “active ingredient” in making your skin look better because they are basically a hormonal preparation because of the effects of the preservatives.

    Parabens is officially used as a preservative. The false oestrogen thing is something we don’t mention. It may shrink yer gonads like the fish in the rivers but at least your skin will look good.

    Some people say you’ll get better skin by applying oestrogen gel to your face. I think that’s basically what is going on here.
    You might well get better skin too. But you may find other stuff happens as well.

  26. Cscience said,

    June 30, 2009 at 12:57 pm

    Dear Ben,

    What is your view on Sirtuin and creams that stimulate stem cell regeneration?
    Surely this is poppy cock. How can a topical administration of a cream stimulate stem cell regeneration?

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  28. Pastorx said,

    September 24, 2011 at 9:07 pm

    Sorry to necromance this thread, but what Delster said is so true. My wife has been developing a range of skincare products and has been doing the responsible thing by making sure that they are all laboratory tested. This costs serious cash and our experience has been that the laboratories are not interested in simply green-lighting a product because they are being paid. There’s a reason: they are collectively responsible with us if a product causes damage. If it’s something that they should have spotted then they may be *solely* responsible.

    I love the work that Ben does and I’m a longtime fan but he possibly needs the commercial perspective. We’ve had to make adjustments to one formula to completely eliminate risk to pregnant women (a vanishingly impossible risk – the threat would involve the foetus ingesting over 8 gallons of an ingredient which comprises 0.5% of the product). So we made those changes. And then resubmitted the product for laboratory certification. It passed.

    The point is that paying for certification means the laboratory accepts a large amount of liability. No lab in its right mind will just pocket the money with a wink and certify a product.

    To be fair, my wife is being extraordinarily meticulous about this issue. It’s possible that some labs will skimp on tests. What we needed was an absolute and definitive state-of-play-certificate. We have it now. It cost a huge amount of money, but my wife can sleep nights knowing that the products can be used safely.

    Verified by science.

    This leads to another issue; Ben’s correct assertion in his book that things such as anti-wrinkle cream can be made by the litre for pennies.

    He’s correct, of course.

    But to go the market in a responsible manner requires the type of scientific validation I’ve mentioned and when you throw in sterile manufacturing, packaging, marketing and delivery the costs mount up quickly.

    Cheese costs pennies to make but pounds to deliver.

  29. mdomzalski said,

    January 4, 2012 at 8:42 pm

    So I’ve been browsing various pages on this site and happened across some of the cosmetics articles like the one above. I thought that if some of your readers are interested in scientific claims by cosmetic companies, they might be interested in a the blog that can be found by googling “the beauty brains.” I have no affiliation with the site and understand if this comment is too unrelated to post. (I apologize for making you go through that work if you have to remove it.)

    Anyhow, the writers are “cosmetic scientists.” I’m not sure what that means, but I think it’s supposed to sound less intimidating to lay people like myself. Anyhow, they analyze the claims that these companies make and look at the ingredients and tell you what they actually do. Sometimes they’ll call in another expert when they don’t know the answer, and they called in a microbiologist for a recent post about whether or not you can use natural extracts to preserve a product.

    Just thought some people might be interested. I wasn’t sure where to post this. Please feel free to remove if you don’t think it’s appropriate.

  30. charleski said,

    September 13, 2012 at 11:39 pm

    “So what’s bad about this study? Well, it measures a “surrogate outcome”, a lab finding, that is one step removed from the real world, and one that may flatter the cream. And it compares No 7 Protect & Perfect against placebo (a simple moisturiser) instead of other competing creams on the market.”

    I followed this link from Dean Burnett’s latest article and registered simply because I was shocked at the poor reasoning applied here. Ben, I honestly expected better from you.

    Firstly, there’s **absolutely nothing wrong** with measuring a surrogate outcome. Modeling the mechanisms that produce a final effect is part-and-parcel of the scientific process, indeed, it’s a critical element of it. They have formed a theory that wrinkle formation is related to degradation of extracellular fibrillin, and they are testing whether their preparation has an effect on that process. Now, you may wish to criticise their theory, but if you want to do that then you’ll need to state the reasons why you believe extracellular fibrillin is irrelevant to wrinkle formation. This you singularly fail to do. You suggest that this particular outcome was chosen because it would ‘flatter’ the cream. Yet you fail to suggest any other measurable property that should have been investigated instead.

    Your objection is sloppy and the implication that you’re applying a higher standard of scientific rationale is intellectually dishonest.

    Secondly, the criticism that they tested it against a placebo is manifestly absurd. This is surely *the central question* that must be answered – are any of these creams better than the most basic moisturiser? Is there any point in paying for their expensive product or should you simply get the cheapest moisturiser you can find (as long as it’s non-toxic)? The experiment was designed to address a single question, whether their product provided any measurable benefit, and you are merely criticising it for being well-designed – quite ridiculous.

    Finally, and, actually, most importantly, where’s the goddamn citation? You mention a BBC Horizon program, but where’s the paper where these results were presented? It’s mentioned in neither this article nor the previous one to which you linked. Again, this is very sloppy work.

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