The Evidence Problem in Aesthetic Medicine - Why You Should Always Read the Small Print
The Issue of Evidence - be skeptical about the claims of miracle skin products
The statistic that should make you pause:
“ 80% of women saw an improvement in fine lines in two weeks “
You probably will have seen versions of this claim many times.
Before you trust a treatment claim, it is worth asking a few simple questions.
Here is what it does not tell you
how many women were in the study ?
whether there was a control group ?
who assessed the improvement ?
how the improvement measured ?
And here is the biological question it cannot answer
how is it possible to demonstrate meaningful collagen improvement in fourteen days, when established science tells us that true collagen growth takes months ?
The statistic tells you the company wanted you to feel impressed. Beyond that, it tells you very little.
Who paid for the research?
Who funds clinical research in aesthetic medicine ?
Most clinical research in aesthetic medicine is funded by the companies that manufacture the products being studied. Those same companies design the studies, select the endpoints, and decide which results are submitted for publication.
Studies with unflattering results are under no obligation to appear in the literature. This is not unique to aesthetics. But it is a particular problem in a field where the regulatory requirements for pre-market evidence are far less demanding than in pharmaceutical medicine.
What to ask before you trust a claim
A few questions are worth forming a habit of asking.
Who funded the study ?
Was there a control group ?
How was improvement measured, and by whom ?
How long was the follow-up ?
Does it actually correspond to the biological timeline of what is being claimed ?
Has the result been independently replicated ?
Does the entire evidence base consist of studies conducted by the manufacturer ?
These are not complicated questions. They are the basic tools of clinical judgement, and patients deserve to use them.
What this means in practice
None of this is an argument against aesthetic treatment. The evidence base for established treatments is considerably stronger than for many newer arrivals, and a modest but genuine evidence base can still support real clinical benefit.
What it is an argument for is the habit of reading the small print — calmly, consistently, and without being dazzled by a percentage.
For a deeper examination of the evidence problem in aesthetic medicine, including the science of publication bias and outcome reporting, read the extended version in our Clinical Perspectives section.