War on wrinkles

A 'miracle' face cream is walking off the shelves in America. Now it's coming here - at £135 a tube. Jane Feinmann discovers if money can really make you look younger

Psst! Want to know the secret of eternal youth? Apparently, it's an oligopeptide, a protein component known as Pal-KTTK. It's the active ingredient in a skin cream that has been flying off the shelves of American beauty counters because of its reported ability, when applied to crow's-feet, to relax the muscles under the skin and thereby reduce wrinkling in a manner that is, the manufacturer claims, "better than Botox".

Psst! Want to know the secret of eternal youth? Apparently, it's an oligopeptide, a protein component known as Pal-KTTK. It's the active ingredient in a skin cream that has been flying off the shelves of American beauty counters because of its reported ability, when applied to crow's-feet, to relax the muscles under the skin and thereby reduce wrinkling in a manner that is, the manufacturer claims, "better than Botox".

The cream, StriVectin-SD, was launched in the US a year ago. But its alleged properties were discovered quite by accident, so the story goes. It was originally marketed as a remedy for stretchmarks. When the cream was being tested, samples were handed out without an instruction sheet - and people mistakenly daubed it all over their faces. "We began to get comments back from people who said that they looked '10 years younger' and 'can no longer notice [their] crow's-feet'," says Gina Gay, a spokesperson for Klein-Becker, the Utah-based manufacturer of the cream. "At that point, we knew that we had something more than America's most effective stretchmark cream."

StriVectin has already earned Klein-Becker $60m from sales, according to a feature in Time magazine - nearly double the sum that a new skin-care product is expected to earn in its first year. It seems that hard science backed up anecdotal evidence of a remarkable breakthrough in the smoothing of the skin.

Destiny stepped in, the makers say, when "a series of studies, reported at the 20th World Congress of Dermatology in Paris in 2002, detailed the superior wrinkle-reducing properties of an oligopeptide versus retinol and vitamin C", the last two components being the most effective anti-ageing cream ingredients around so far.

The company realised that the oligopeptide was none other than Pal-KTTK, and further research showed that the cream achieves "a smoother, younger complexion, with less irritation and faster results" - underpinning the "better than Botox" advertising slogan.

Dr Natalie Chevrau, the company's director of women's health, says that "Botox has been the preferred treatment for moderate to severe frown lines between the brow", but that this is no longer the case. "Ever since it was discovered that StriVectin could reduce the appearance of fine lines, wrinkles, and crow's-feet, which can take 10-15 years off your appearance, and which costly medical treatments often leave behind, the leading skin-care professionals have been recommending, and using, StriVectin," she says.

As you might guess, StriVectin doesn't come cheap. It is currently on sale at Harvey Nichols for £135 for a 6oz tube. But that's the kind of money you have to pay for miracles these days. Ever since Crème de la Mer was launched five years ago as the most expensive face cream in Britain (£115 per pot), paying the earth to ward off wrinkles has become an essential item in the modern woman's budget. The UK beauty industry, currently worth around £6bn, with about a fifth from sales of anti-ageing skin-care products, has increased by around 71 per cent since 2000.

And the trend is definitely upwards. Botox, the company which produces the toxin-based wrinkle treatment, is about to launch its own "Wrinkle Fighter", Idebenone - a cream containing "the most effective antioxidant discovered to date" - costing around £90 a treatment and already generating "enormous excitement" among US dermatologists, according to press reports.

The more dramatic a product's claims and the more exotic the ingredients, the higher the price. Or is it the other way around? Estée Lauder's Re-Nutriv Re-Creation, reportedly coming to Harrods beauty counters in August, is made from "4,000-year-old deep-sea water from Hawaii and minerals from the islands of Okinawa in Japan", and will cost £450 a bottle. La Prairie Caviar Luxe contains concentrated caviar extracts and sea proteins and costs £370 for a 100ml pot.

Still more extreme, the latest Crème de la Mer regimen, reported to be preparing for an autumn 2005 launch and so far known only by its code-name,"Project Precious", will contain such rare and expensive ingredients that its price will be set at more than £1,000 for a three-week treatment. Test tubes containing the magical moisturiser will be kept in magnetised chambers, held in specially constructed safes under beauty counters.

It is hardly surprising that stores such as Harvey Nichols are already installing security cameras around their beauty counters stacked high with "Botox in a Jar"-style products. "We have to. People will kill for this skin care," a spokesman is quoted as saying. Apparently level-headed women talk publicly of a desperate need for these anti-ageing creams. "Personally, my ambition is to die when I can no longer afford to buy Crème de la Mer," the successful female editor of a national magazine has been quoted as saying.

But what exactly are they paying for? How well does the science stand up to scrutiny? With StriVectin-SD, the answer is: not verwell. It is true that the product's website (www.strivectin.com) appears to offer copper-bottomed proof of the cream's success, with a section entitled "Clinical Studies" headlined "Clinical Studies Don't Lie". A reference to "a ground-breaking series of studies", however, confusingly, relates to research on stretchmarks. And there are no journal references, no descriptions of the trials or names of the laboratories in which they were carried out.

"It's hardly surprising that a cream designed to tighten up stretchmarks is not going to be very good at relaxing muscles that cause wrinkles," says Dr Nick Lowe, author of Away with Wrinkles (Kyle Cathie Ltd, 2005) and a dermatologist at the Cranley Clinic in London. "In fact, there's only been one independent study of StriVectin: research carried out in Florida compared it with Botox and found that while Botox did have a visible effect on wrinkles, Strivectin did not."

Such a finding does not surprise Rajiv Grover, consultant plastic surgeon at King Edward VII Hospital and Harley Street. "Botox works at a deep level by temporarily freezing the action of muscles that are the cause of overlying wrinkles by reducing the signals from nerve to muscle. A cream cannot penetrate anywhere near as deeply as that. It's very difficult indeed to make a cream that will penetrate the top layer of skin. It is certainly unrealistic to imagine that any cream could have the same effect as Botox."

There is similar scepticism about the claims made by Estée Lauder that Crème de la Mer contains water molecules that have been divided, dramatically enhancing the action of the various ingredients within the "miracle broth". "It's absolute nonsense. There's not a scrap of evidence to show that Crème de la Mer is anything more than a very nice moisturiser," says Dr Lowe, who recommends Vaseline Intensive Care as "an excellent example" of a moisturiser that contains "a multiple vitamin complex just like that hyped in some of the very expensive creams".

He says that the only face creams that have been proven to be effective at reducing wrinkles are those containing retinoic acid, available as Retin-A, a high-strength prescription medication (available on private prescription) and in lower strengths (with the ingredients retinol, retinaldehyde and vitamin A) in over-the-counter beauty creams. "These medications stimulate the skin to produce more collagen, stimulate certain enzymes to reduce ageing, and also correct precancerous changes. I use them on patients with great success alongside Botox and a good moisturiser," says Dr Lowe.

But surely the increasingly extravagant prices for skin creams must hold some promise of success. Not necessarily, says Liz Sutton of the Women's Environmental Network. "Our research over four years suggests that the difference between very expensive and relatively cheap products is minimal. Frequently, the same ingredients are used."

Mr Grover says that it may be no coincidence that expensive skin creams have started to appear at the same time as products such as Botox and fillers have become available. "Pictures of before and after Botox treatment show a visible difference and inevitably that has created a belief in some people that anti-ageing products really do work," he says.

A cynical view, he says, is that cosmetic companies are cashing in on that belief by claiming that very expensive (and therefore unusually effective) creams can get the same effect as Botox without the needle - "appealing," says Mr Grover, "to people who are frightened of needles but are still prepared to pay to look good".

Nevertheless, expensive anti-ageing products must be doing something right. According to Mr Grover, there are four ways that an anti-ageing cream can work: by hydrating as a moisturiser (from Vaseline Intensive Care upwards); by protecting against environmental and lifestyle damage (sun creams); by repairing the damage caused by scavenging at a cellular level (using antioxidant ingredients such as vitamin C and Coenzyme Q10); and by promoting extra turnover of cells in the ageing skin (vitamin A and fruit acids).

"Any of these methods can be improved upon with the addition of new ingredients. But as far as the vast majority of skin creams are concerned, the improvements can only go so far," he says.

Need to know

Modern skin-creams contain ever more scientific-sounding ingredients. But can these really help to rejuvenate our skin?

Retinol

Vitamin A, or retinol, in high doses, has a marked rejuvenating effect on the skin, but it is also quite hazardous. It's available only on prescription, usually to treat acne. Over-the-counter creams contain much smaller amounts. Some "may offer a modest benefit," says Dr Nick Lowe.

Vitamins C and E

It is possible that creams containing Vitamin C may help to quench free radicals, reduce sun damage and stimulate collagen-forming chemicals. But "generally they are extremely varied in their benefits," Dr Lowe says. The healing properties of Vitamin E creams have not been proven on humans.

Coenzyme Q10

Another vitamin-like substance. "There is some evidence to suggest that coenzyme Q10 in products such as Eucerin or Nivea can help in skin protection."

Ceremides

This is a mixture of skin barrier lipids, often combined with humectants or glycerine. "An effective moisturiser."

Peptides

Strings of amino acids that stimulate enzymes in skin cells to produce more collagen. "Research is needed to discover their true benefits."