April 2002
Dear Paula,
During my local PBS [Public Broadcasting System] fund drive, they showcased dermatologist Nicholas Perricone's video and book on The Wrinkle Cure. The PBS host who interviewed Perricone during breaks said she had been using products containing his recommendations (she, apparently, had not been using HIS products before this) and she was amazed and thrilled with the results.

It has occurred to me that were this interview not on PBS, I would have thought it an infomercial. I have purchased every one of your books and just reread your opinion on vitamin C and that it does not live up to its reputation. In fact, you even mention Perricone and his book. I did purchase Cellex-C when it first came out and had to return it to the company because of the extreme burning of my skin.

Please advise me about your latest opinion on Perricone's claims of vitamin C as an anti-inflammatory, and thus using it on the face causes the sagging to firm up. I am in my late 50s and, much to my dismay, my face appears to have dropped an inch since menopause.

Judi, via e-mail

Dear Judi,
I actually don't know where to begin when discussing the nature of Perricone's work. In many ways this embodies some of the worst elements of what is taking place in the world of dermatology (starting with Dr. Murad of infomercial fame), namely using the cloak of medical expertise to promote the sale of skin-care products. The physician allure attributes medical connotations to products that end up not being different in any significant way from other skin-care products being sold from many lines without a doctor's endorsement.

In regard to vitamin C, while it's clear that it is a good anti-inflammatory, it is not the only, nor the best, one to use. What is even more significant is that there is no research showing that vitamin C (or any anti-inflammatory) makes skin stop sagging or lifts it up in any way. In Perricone's book The Wrinkle Cure, he more often than not refers to his own research or his own patients' experience as proof for what he states about a particular antiaging treatment (always his own products, by the way). That may sound convincing, but it's not anyone's definition of science.

Moreover, vitamin C is a substance that still suffers from stability issues. A study in Dermatologic Surgery, February 2001 (pages 137-142) states that "L-ascorbic acid must be formulated at pH levels less than 3.5 to enter the skin." That low a pH can cause skin irritation (which probably explains your irritation when you purchased Cellex-C). Similar conclusions about vitamin C were drawn in an article in the Journal of Pharmaceutical and Biomedical Analysis, March 1997 (pages 795-801), which explained that magnesium ascorbyl phosphate was more stable than ascorbic acid and ascorbyl palmitate, all of which are forms of vitamin C. I won't burden you with all the research on the issue, but this smattering may give you the idea.

It's interesting to note that even Perricone wavers on the issue of what is the "best" skin-care ingredient. His own line has an array of products with ingredients other than vitamin C. These range from tocotrienol (a potent form of vitamin E), to alpha lipoic acid, DMAE, olive oil polyphenols, and glycolic acid. If vitamin C was the best, why bother with these other ingredients? Vitamin C is also not a proprietary ingredient; it is available and used by many cosmetics companies. None of this means that vitamin C can't be helpful for skin, but it is not the miracle that Perricone or others make it out to be.

I too am disappointed that PBS has either inadvertently or blatantly put themselves in the infomercial business, but your letter and others I've received about Perricone's appearance have questioned their judgment on this one.