Recent reports that a prescription drug for acne can reverse wrinkles and other signs of aging caused by the sun could change the face of the cosmetics industry.
In the 10 days since The Journal of the American Medical Association published an article about the drug tretinoin, which is sold under the name Retin-A, age-conscious consumers have beaten a path to dermatologists' offices.
A number of Washington area pharmacies last week reported that they were out of the relatively cheap drug -- it costs $18 to $20 for a 20-gram tube -- and had prescription orders waiting. There also were reports of the drug being brought in from Mexico -- where it is not classified as a prescription drug -- and sold for as little as $2 a tube.
Cosmetics industry officials are quick to point out that Retin-A is a drug, not a cosmetic, and that they believe consumers will continue to use cosmetics for which antiaging powers are claimed.
But other industry observers say the cosmetics firms should be worried about losing a major part of the $1.3 billion skin-treatment business.
In the Retin-A study, 30 patients from age 35 to 70 showed significant reversal of skin damage, including wrinkles, caused by the sun. The Food and Drug Administration has approved Retin-A only for use in acne treatment, but doctors can prescribe the drug for other uses.
Johnson & Johnson, which makes Retin-A, is seeking the FDA's approval for other uses, and some in the industry industry believe it may eventually be sold over the counter.
"Ultimately, it could mean major, major changes in the cosmetics industry," said Brenda Lee Landry, an analyst for Morgan Stanley.
"It has to hurt the cosmetics firms," said Gary Grove, vice president of research and development for the Skin Study Center in Philadelphia.
Once consumers see the results Retin-A can bring, Grove said, they'll be reluctant to go back to cosmetics.
In the recent 16-week study of tretinoin conducted at the University of Michigan, every patient showed significant reversal of skin damage caused by the sun on forearms treated with tretinoin, and all but one showed improvement of facial wrinkles.
Cosmetics firms officially claim little worry about competition from Retin-A.
"Avon is not concerned about it taking away from its business," said Marjorie Glaser-Sommer, a spokeswoman for the company, which markets BioAdvance cream as an anti-aging product. "People who want cosmetics will continue to use cosmetics."
"We don't think it's going to have a tremendous effect on our products," said Walter Smith, vice president of research and development for Estee Lauder. "Our products are pleasant to use and over the long term do diminish wrinkles," he said.
Smith said Retin-A users may not find it the miracle drug some have claimed it to be.
Using the drug, he said, "is a horrible experience," causing redness and irritation in many patients as well as sun sensitivity and dryness.
But the irritation experienced by many users is slight and can be controlled by changing dosages, dermatologists say. In fact, some doctors agree with cosmetics manufacturers that wider use of Retin-A may initially mean that consumers will buy more moisturizers to combat the dryness caused by the drug.
And at least 10 academic centers are doing research with tretinoin, working on a second generation of products that will eliminate some of the drug's side effects.
"This is just the beginning," said Heinz J. Eirmann, director of the Food and Drug Administration's division of colors and cosmetics. "People now know there is something there."
While cosmetics firms ponder the effects Retin-A will have on their business, Johnson & Johnson's stock soared on news of the University of Michigan study, gaining $6.50 a share in the past week.
Analysts who follow cosmetics firms said last week that they had seen little effect on the stocks of cosmetics firms, perhaps because none of the publicly owned firms relies solely on antiaging products for its profits.
The widely published results of the Retin-A study are considered by some to be another blow to an industry already grappling with FDA problems.
The FDA has told a number of firms that they cannot make certain claims about their products' ability to change the skin unless they allow their products to be regulated as drugs.
Meanwhile, another group is trying to knock down some of the claims about Retin-A.
"For years we have known about the positive effects of Retin-A in diminishing fine-line wrinkles," said Dr. Ferdinand F. Becker, a spokesman for the American Academy of Facial, Plastic and Reconstructive Surgery. "But the drug does have its limitations. ... The public should not be misled into believing that by only using Retin-A, they can eliminate the signs -- sagging jowls, drooping eyelids, baggy neck -- of an aging face."