Facial cosmetic creams

The other day one of my patients showed me a 1 oz bottle of facial skin moisturizer she had bought from a department store for $400.  That’s a lot for a month’s worth of facial cosmetic cream, I thought.

Our skin is the biggest organ in our bodies, and as a cosmetic plastic surgeon I deal with it every day. Skin cells rejuvenate in an orderly process, rising from lower portions of the skin to flaking off as a dead cell every six weeks.

As our main interface with our environment, skin is subject to a great deal of abuse from many factors, including:

  • Sun
  • Environmental toxins in water
  • Traumatic cuts and bruises
  • Insect bites
  • Plant oils
  • Metabolic diseases from within
  • Rashes from humidity and skin rubbing together

In defense of our skin, we have for millenia protected it from the environment as best as we could, first with mud, then with clothes and oils and now with creams.

Apart form the obvious protections of the skin by clothes, the cosmetics industry, which has been flourishing since the time of Cleopatra, has used creams and oils in an attempt to:

  1. Protect skin
  2. Maintain of skin
  3. Rejuvenate/enhance skin

Protection of skin

Sunblock is the single most important product you can apply to your skin to protect it from the worst environmental factor: the sun’s ultra-violet (UV) rays.

UV rays dry out the skin, physically break down elastic and collagen proteins and damage the DNA of skin cells, leading to abnormalities in replication that can cause skin cancer.

SPF 30 is all you need. Lower-SPF sunblock does not work, and higher is a waste of money! Did you see I said sunblock? Sunscreen is just not good enough.

Maintenance of skin quality

Moisturizers are the mainstay of the cosmetic industry’s income generation and are an important part of helping the skin fight against the environment.

We constantly lose water through the skin. When we’re hot, we actually sweat, and you can see the water loss; in a dry environment, such as in high-altitude mountains, you also lose a large amount of water through vaporization. Skin actually acts to reduce water loss by regulating fluid passage. Imagine the weeping from a burn wound when skin has been injured and the blister fluid that forms. Moisturizers actually work by reducing water loss by providing an oily barrier. They do not add water to the skin. Think about it. Your skin does not swell up when you take a bath; a humid environment just decreases the rate water loss.

Here is where the cosmetic industry takes us for s slippery ride. Vaseline is as good a moisture barrier as anything else. Many cosmetics products atually have it as their prime ingredient. Additions and differences between cosmetics are based on other materials added to decrease or increase the oiliness of a product to get it to a point that each individual likes. Some like a more oily product, some a less oily one. The increases in cost to the ridiculous $400/oz rate is just playing on our naivete and making us dupes of marketing!


To actually improve skin quality, we must apply medicines that will change the rate of skin cell division, organize disparate rates of growth and pigment production and increase blood flow to the skin. One such medicine is Retin-A with hydroquinone (a skin bleacher). This medicine creates a reorganization of healthy skin cells that restores the skin’s natural function as a barrier to water loss.

More recently hyaluronic acids have been added to creams to give some of the benefits of the chemical on improving the skin elasticity though how it penetrates the skin without a needle is still a mystery to me.

Lasers, peels, dermabraisons, thermage and astringent creams all act in one way or another to remove dead cells and stimulate the regrowth of healthy skin cells, which then perform their proper function.

There, I just spilled the beans on the whole conspiracy of the magic of Facial Cosmetics. Sorry if I spoiled it for you.


Morad Tavallali, M.D., FACS