Observations Medicine and the Media

Cosmetic approval

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e6046 (Published 14 September 2012) Cite this as: BMJ 2012;345:e6046
  1. Margaret McCartney, general practitioner, Glasgow
  1. margaret{at}margaretmccartney.com

Promotion of many cosmetic products and toiletries boasts medical approval, notes Margaret McCartney, but why are the companies reluctant to describe the testing that underlies such approval?

For many cosmetic and beauty products, medical approval is so highly rated that it appears with big letters in advertising and on the packaging itself. “Dermatologist approved,” “gynaecologically tested,” and “dermatologically tested” are stamped on retail products from shower gels to baby cream and even things like lipstick. But what do these indicate, and what does “testing” or “approval” actually mean?

Persil says that its non-biological liquid detergent, for example, is “the ideal choice for new-borns . . . it’s dermatologically tested with research recognised by the British Skin Foundation.”1 Femfresh Daily Intimate Wash is advertised as being “gynaecologically tested unlike regular soaps and shower gels.”2 Aveda, which is owned by Estée Lauder, offers products for children that are “paediatrician-tested, safe and effective for people aged six months and older. They are allergy- and dermatologist-tested.”3

I contacted six companies that use these types of claim to promote their products, asking them what tests had been done, and by whom, to support these statements. Johnson and Johnson said that many of its baby products are “dermatologist and allergy-tested,”4 but the company declined to comment, as did Elizabeth Arden, which claims that its make-up and skincare products are “clinically and dermatologically tested.”

The UK retail pharmacy chain Boots said that its own brand products, including No 7 cosmetics, are “dermatologically tested” but declined to explain what this meant. Aveda said that its products were “clinically tested on volunteer panelists who were examined by a dermatologist for various signs of irritancy at specified points during the test period” but that other data were considered “proprietary” and would not be released. Persil, owned by Unilever, responded by saying that tests were done “by independent laboratories, under the supervision of appropriately qualified staff.” It continued: “To support our own research, we ask the British Skin Foundation to undertake an independent assessment.

“British Skin Foundation dermatologists visit our laboratories, discuss skin health issues with their scientists and are given full access to product research and data. Only once the British Skin Foundation has approved the research can products carry the British Skin Foundation logo.” Persil declined to give any more information on the kinds of test carried out, citing “commercial confidentiality.” So did Femfresh, owned by Church and Dwight, which would only say that products are “extensively tested,” with the results reviewed by “board-certified dermatologists and gynaecologists.”

Companies that are so keen to promote their products with the allure of medical approval seem distinctly coy when it comes to explaining exactly what that means. Chris Flower, director general of the trade association the Cosmetic Toiletry and Perfumery Association, said that “dermatologically tested” has been assessed by the European courts to mean that the product was tested to study its effects on skin and that the product was well tolerated. He said, “There is no set procedure for any such test or tests, and companies are free to establish the tests that are most appropriate for their product.

“There is no requirement for the studies to be publicly available, and indeed many companies choose not to publish their results since it would provide competitive information for others.” This means, therefore, that “dermatologically tested” written on two different products may mean entirely different things—and may indicate only an absence of proved harm rather than evidence of benefit. Flower said that the testing information would be made available to the Advertising Standards Authority and trading standards authorities but not to customers. But if medical approval is openly promoted by a manufacturer, surely there should be a higher standard or expectation of explaining that meaning clearly?

Some products, such as Persil, use a logo in advertising and on packaging to show approval by the British Skin Foundation. The foundation is a charity and is supported financially by commercial companies such as Boots, Leo Pharma, and Persil. Unilever said that the foundation sends dermatologists into its laboratories to carry out “independent assessments” and to “discuss skin health issues with their scientists and are given full access to product research and data.” The foundation said that two consultant dermatologists review the data on a product and ensure that “it is not harmful to users or detrimental to skin health,” but it also made it clear that its stamp of approval is “neither an endorsement of efficacy nor an indicator of market leadership.” The foundation does not charge for this approval but says that it prefers “that companies concerned recognise its main aims and objectives and choose to charitably support skin disease research.”

But what does any of this mean for the customer trying to decide the meaning of a claim of medical approval cited on a product’s packaging? The European Commission is currently working to produce a paper on common criteria for claims made by cosmetic companies, the Cosmetic Products Regulation, to replace its Cosmetics Directive.5 Obviously, the current medical claims on products are aimed at helping with promotion and advertising, but what they mean or imply is vague and inconsistent and seems more to do with lack of harm than evidence of benefit. Unless companies can show customers the rationale for their claims, they should stop using them.


Cite this as: BMJ 2012;345:e6046


  • Competing interests: None declared.

  • Provenance and peer review: Commissioned; not externally peer reviewed.