DermApproved Got a Makeover

DA site makeover

DermApproved went through a big makeover this month. This week we asked the folks at DermApproved about the recent changes, as well as some tough questions surrounding conflict of interest, advertising, and the skincare industry in general.

DermApproved went through a makeover recently.  Can you tell us the reasons behind the changes?

Conceptually, DermApproved is a goliath of a project with huge ambitions. Our end goal is to provide  users with as close to a free personalized consultation service with a dermatologist as possible. Thus, our problem finder algorithm was created, which attempted diagnosis ranging from Lupus to the common acne. It turns out that most of our users had far more common concerns, most of them cosmetic, and were well aware of their own skin concerns. DermApproved’s diagnostic algorithm was a bold attempt at an online diagnosis, given its inherent limitations (there is no direct contact between patient and doctor), however, it resulted in an overly complicated set of questions which hurt the overall user experience.

Rather, we decided to focus on the more common concerns. As a rule of thumb, milder concerns are far more likely than severe ones, even though as dermatologists, the patients we see are often skewed towards the more severe concerns. We simplified the site to make sure that the largest amount of users can get from their skin concerns to our recommended list of solutions, as fast as possible. DermApproved focuses on over the counter products as this is by far the most accessible and used solution, however, our education page is comprehensive, providing all types of solutions as well as lifestyle advice.

Will DermApproved replace a real consultation with a dermatologist? Certainly not, but DermApproved can provide you with the key information about your skin concerns, how to prevent, treat, and manage your concerns, as well as provide various treatment modalities to consider, and when your skin concern may be more serious, and should consult a dermatologist. It’s now organized, practical, and relevant information from dermatologists.

Is conflict of interest a problem when dermatologists endorse a skincare product brand?

This is a misconception. Dermatologists do not regard anti-aging skin products as a competitor. Product manufacturers, I doubt would feel that cosmetic dermatologists are competitors either. Even though they both deal with solving beauty concerns, they solve fundamentally different types of skin problems.

First, there are cosmetic products that can be found over the counter, or without a prescription. These are not drugs, and are not regulated as such. They cannot fundamentally alter or affect the function of or structure of the body, and also cannot claim that they do. Second, there are what many call “soft procedures” which are becoming increasingly popular in the last decade, that include neuromodulators like Botox or Dysport, or soft-tissue fillers to correct fine lines and wrinkles and plump the skin. Light treatments like lasers are also included in this category. Finally, there are surgical procedures, such as facelifts or eyebrow lifts that involve cutting the skin.

Although they all aim to solve beauty concerns, there is a sharp divide between these three categories in terms of costs, efficacy, risk, and required recovery time. As you go up the ladder of treatments, costs, risks, and recovery time all increase, as well as how much improvement the patient can expect to see. Stated simply, no over the counter the product can replace Botox; this is empirically, factually, untrue. DermApproved is not about selling unrealistic expectations; it is about providing evidence based advice to our users. DermApproved helps educate users about their expectations with each type of product or procedure.

On DermApproved, there is plenty of information, not just on over the counter products, but also on procedures that are typically done at the dermatologist’s office.  Aren’t over the counter anti-aging products a competitor to the practice of cosmetic dermatology?

Certainly, conflict of interest is a hugely important problem. The skincare industry has been under some sharp criticism recently. The salient point of these criticisms is that over the counter products are minimally regulated by organizations like Health Canada and the FDA in the United States, as they are not considered drugs–substances which alters the structure or function of the body. The article above also criticizes dermatologists who endorse products on behalf of the beauty industry just as fiercely:

In order to lend itself legitimacy in the absence of real information, the cosmeceutical industry has cleverly courted dermatologist-entrepreneurs, credentialed medical doctors who partner with beauty industry giants as paid consultants or clinical researchers. Some even create namesake product lines like Murad and Perricone MD. It’s an egregious conflict of interest, at odds with every medical code of ethics, as some within the field will attest.”

Blatant partnership of dermatologists and beauty industry creates a problem–first, by straightforwardly deceiving consumers regarding the expert’s intent, and secondly, by adding confusion to what it means to be “approved by a dermatologist.” It should be mentioned, however, that we shouldn’t automatically discount “dermatologist brands” or labels like “dermatologist tested” due to a potential concern with conflict of interest. Consumers should certainly keep in mind that dermatologists were paid for their opinions, but dermatologists are, in fact, experts in the biology of the skin and it makes sense for dermatologists to act as consultants when working with products that affect the skin. It’s the type of association that is crucial; did the dermatologist get paid to say “your product is the best?” Did the dermatologist help to test, or consult about the product, or did they simply lend their name. The nature of the relationship matters as much as the association.

Isn’t DermApproved partnered with the industry?

While DermApproved certainly deals with over the counter products as its main service to consumers, it does not endorse any particular brand, and this is hugely important. Issues like conflict of interest are not ignored at DermApproved; we think it’s a serious concern, and we’re tackling the problem as part of our process. As is true with any organization, relying on individuals to resist temptation is not a great model. The process needs to take into account, conflict of interest.

DermApproved keeps an arm’s length approach with all product submission requests, and the dermatologists that serve on the panel are not made public. DermApproved shortlists products that are likely to be effective for a given skin type or skin concern, given the key information available to dermatologists. DermApproved takes an evidence based approach, which is important to me as a doctor and a scientist. For example, where important information is not made public (some manufacturers do not disclose their ingredients as they aren’t required to do so by law), DermApproved simply does not list these products. This is not to say that these products cannot possibly be effective; DermApproved simply prefers to work with manufacturers that value transparency and open information.

DermApproved is not about miracle cures, celebrity endorsements, or guaranteed satisfaction. It simply lists products that are likely to be effective for the user’s skin concern or skin type and provides a mini consultation service regarding their skin concerns.

  • DermApproved does not endorse any particular brand; each product is assessed based on its individual merits
  • DermApproved will never exaggerate the efficacy of a product
  • DermApproved will never claim that a product will work for everyone; individual skin varies–there will never be a product that is best for everyone

What do you think is the most appealing thing about DermApproved?

To me, the biggest appeal is that it’s evidence based, doesn’t exaggerate its claims, and organizes the relevant information well. DermApproved is likely disappointing to someone who wants to hear extravagant claims, because there is none of that–but for people who are seeking out legitimate sources of information about skincare, it is a great resource. We live in the information age, and while it’s certainly true that information moves faster and is of greater abundance, this doesn’t mean that consumers can drop their guard. If information can be used to shine light on the truth, it can also be used to spread misinformation just as quickly and efficiently, and we see evidence of this everywhere on the Internet. If you type in a medical condition, chances are, the search engine advertised products on the front page is filled with products that don’t have one iota of scientific evidence backing it. From sketchy folk medicine claims to powerful lobby groups, everyone has access to a microphone. To paraphrase Cornelius Fudge, “the enemy can use the Internet too.”

Another important point is that it’s not enough that there is an abundance of information available. In fact, confusion through information pollution is a favorite tactic of those that make it their business to misinform people. Information needs to be filtered and organized to be useful. For information to simply exist is not enough. It needs to be organized, and accessible to the public for it to be a legitimate resource.

What’s next for DermApproved?

We are focused on providing our users value, not on our terms, but on theirs. Too often, website owners have a conception of what users want, and enforce it upon them. We listened to the feedback from our users.

One important lesson that we learned was that, how users evaluate product satisfaction is quite different from what experts look for. It wasn’t just a disagreement, but a difference in what mattered to them–the criteria that was being used to evaluate a good product was substantively different. Texture, price, branding, and fragrance are often important considerations for consumers that are typically not emphasized by dermatologists. Since, the website is for users, not dermatologists, we decided to incorporate this–and score products based on the average user reviews from several reputable websites.  

Dermatologists will continue to look at the base criteria for inclusion: Sensible ingredients and formulation as well as transparency in disclosing the information publicly, manufacturer reputation and history, and skin tolerance. For example, if a manufacturer does not disclose information about their ingredients, we still believe that this is contrary to the interests of our users, and have excluded these products.