From Counter to Clinic: Making Sense of Cosmeceuticals  

In this wide-ranging and deeply practical episode of The Spot Check, host Jamie Restivo, MPAS, PA-C, welcomes Cheri Frey, MD, board-certified dermatologist, residency program director at Howard University, and internationally recognized expert in evidence-based skincare, for a conversation on how cosmeceuticals and over-the-counter products meaningfully support medical dermatology.  

Dr Frey begins by reframing the modern cosmeceutical landscape, emphasizing the increasing scientific rigor behind formulation development—from longevity medicine and cellular senescence to peptides and the expanding role of exosomes. She underscores that many OTC products now reflect years of clinical testing, and that dermatology clinicians are increasingly involved earlier in product conception and validation.  

The discussion then turns to photoprotection, with a particular focus on visible light and hyperpigmentation, especially in skin of color. Drawing on work from Dr Henry Lim’s group, Dr Frey explains how visible light, especially high-energy blue light, stimulates melanogenesis through Opsin 3 activation, stabilizes tyrosinase, and contributes to long-lasting dyspigmentation even with standard sunscreen use. Both speakers emphasize the foundational role of tinted sunscreens containing iron oxides, which block visible light while providing cosmetic camouflage, and discuss practical considerations such as shade matching, seasonal skin tone changes, and adherence.  

From there, the conversation expands into adjunctive skincare across common inflammatory conditions, including acne, rosacea, atopic dermatitis, and melasma. Dr Frey reviews the emerging role of microbiome-targeted acne therapies, such as bacteriophage-based products that selectively reduce pathogenic C. acnes without disrupting beneficial phylotypes. She also highlights barrier-supportive cleansers and moisturizers, emphasizing patient experience, tolerability, and cost accessibility as key drivers of adherence.  

The episode closes with a thoughtful examination of novel pigment-targeting and barrier-repair strategies, including thiamidol as a human tyrosinase inhibitor for melasma and lentigines, DNA repair enzyme sunscreens for high-risk patients with actinic damage, and sodium hypochlorite washes as a modern, approachable alternative to traditional bleach baths in atopic dermatitis and other inflammatory conditions.  

Dr Frey’s central message is clear; patients are already using OTC skincare, and when clinicians guide those choices intentionally, cosmeceuticals can meaningfully enhance outcomes, tolerability, and long-term disease control.