How to Responsibly Recommend OTC Skin Care Products to Patients

Do you want to make more money in your medical practice?  Today with insurance reimbursements going down, many physicians are looking for alternative sources of income. You may be considering selling skincare products; if so, there is a right way and a wrong way to do this.  Here are some tips on how to ethically and scientifically sell skincare products in your practice.

If you decide to retail skincare products in your medical practice, you must do so in a way that does not jeopardize the physician-patient relationship. (2009: Ethics of selling skin care.Clinics in Dermatology, 27(4), 355-358.) The goal is to achieve good patient outcomes with minimal side effects, which strengthens the physician-patient relationship. In order to achieve this goal, you need to find the most efficacious products and properly match them to your patient’s skin type. In addition, patients must be compliant with the prescribed regimen.

Selling efficacious skin care is not as easy as it seems. The difficulty in separating fact (science) from fiction (marketing claims) takes time because there is a lot of background science to know.  If you are a dermatologist, you have a huge head start because you already know the skin science, but the cosmeceutical science is daunting unless you have a degree in cosmetic chemistry.  Customizing the proper skincare regimen for a patient is also difficult because of time constraints with each patient in a busy medical practice.  In addition, the need for staff training and patient communication can complicate this process.

In my practice, we use the Skin Type Solutions® system that I developed to make my practice more efficient in customizing skincare regimens for patients. (Fitzpatrick’s Dermatology in General Medicine, 8th Edition, 2012, Ch. 250, p. 1343). This system accurately diagnoses a patient’s Baumann Skin Type® (there are 16) and prescribes a pre-set regimen that is designed to address that particular skin type’s needs. The system has been tested in over 100,000 people around the world of all ethnicities and ages, as well as both genders.  It was shown to improve patient outcomes by giving patients clear instructions about what products to use for their Baumann Skin Type. (Dermatol Clin. 2008;26(3):359-73; Journal of Cosmetics, Dermatological Sciences and Applications. 2014;4:78-84).

Using the Baumann Skin Typing System to prescribe skin care regimens saves my staff time by streamlining the process. It works like this:

  1. The patient takes the Baumann Skin Type Indicator (BSTI) questionnaire and is diagnosed as one of the 16 Baumann Skin Types.  

  2. A staff member matches the Skin Type to the pre-set regimen.

  3. The doctor (or designee) reviews the regimen and makes any necessary changes or additions (including prescription medications).

  4. The patient is given a printed step-by-step skin care regimen.

  5. The patient purchases the correct products.

  6. The patient is given instruction sheets to increase compliance.

  7. The patient returns in 4 weeks for follow-up with the staff designee to ensure that the regimen is being properly followed.

Sounds easy, right? The hard part is choosing what products to use for each skin type. In order to ethically sell skin care products to patients, you must ensure that they are getting efficacious products to address their skin concerns (Clin Dermatol. 2012;30(5):522-7).

The following are the important steps to consider when choosing skin care products:

Step 1: Know your ingredient science

There is so much interesting research on cosmetic ingredients, but there is also plenty of hype and misinformation. One important point is that no one ingredient is right for all skin types. It’s essential to know which ingredients work well together and which do not. The order in which ingredients are placed on the skin is crucial as well, because they can inactivate each other and affect absorption. All of my ingredient columns are available at SkinandAllergynews.com and will be published in my book Cosmeceuticals and Cosmetic Ingredients (McGraw-Hill). It is important for you to understand which ingredients are worthless (like stem cells and peptides) and which ones are crucial (such as retinoids and antioxidants), so that you can arm your patients with products that work. When products do not work, your patients will have poor outcomes, your physician-patient relationships will be damaged, and patients’ trust in you will decrease.

Step 2: Choose ingredients appropriate for the Skin Type

It is important to understand the characteristics of various ingredients and match those to your patient’s skin type. The process of assessing the patient’s skin type can be long because you need to ask numerous historical questions (invariably including “Do you get irritated from skin care products?”, “What happens if you do not use a moisturizer?”) Looking at a patient’s skin at one point in time is not as accurate as asking a series of questions about how their skin has behaved in the past under varying conditions. I use a validated questionnaire to streamline this process in my practice. The questionnaire takes 3 to 5 minutes, does not require a staff member, and is done on a tablet device in the waiting room or exam room.

Step 3: Properly identify the Baumann Skin Type® using a validated questionnaire

To determine a patient’s true skin type, a scientifically-validated questionnaire is used to assess skin oiliness, dryness, sensitivity, uneven skin tone, and risk factors for wrinkles. When these parameters are combined, there are 16 possible Baumann Skin Types, which yield an accurate history of the patient’s skin characteristics.

Step 4: Choose products for each skin type

There are many factors to consider in choosing what brands and SKUs (“stock keeping units”, in industry parlance, but particular products for our purposes) to use for each skin type. I use a brand-a