antiwrinkleA long, long time ago in a world not as far away as we’d like,  people spent boatloads of gold and salt to find the fabled “Fountain of Youth”.  The search for Youth spurred Jose Ponce de León to sail West in 1513 from Spain until he bumped into Florida.   Poor Jose….he found lots of swamps but it wasn’t until 300 years later that someone discovered Miami and, well, that’s another story.  The Fountain of Youth has yet to be discovered, but today millions of people are spending breathtaking amounts of their gold and silver (and paper) on over-the-counter anti-wrinkle cream in an effort to find their youth.  Consumers spend billions of dollars each year on such creams and lotions, according to the American Academy of Dermatology. We tried counting up all of the various anti-wrinkle concoctions being sold and our computer collapsed from exhaustion.  We settled upon the official count of “A LOT”.

Most all of these creams successfully moisturize the skin, making it appear more supple and healthy.   However, many of these creams, lotions and vitamin supplements go even one step further and claim to reduce wrinkles or slow down aging.   Yes, they are taking on the laws of nature.  So the question is whether these anti-wrinkle creams really combat aging and whether they are worth the often stratospheric price charged.

There appears to be consensus among experts that most cases skin creams are harmless, although they are not likely better than moisturizers like Vaseline or Cetaphil that sell for less than a 10th or a 100th of the price.   Consumer Reports frequently tests anti-wrinkle skin creams and are consistently “underwhelmed”.   In 2012, the reputable consumer testing group tried out 7 skin creams and recommended none of them.   It found that retinoids, or vitamin A derivatives, (Retin-A) remain the only proven topical prescription remedy for wrinkles. Clinical studies suggest that retinoids smooth out a few fine lines and wrinkles but don’t banish them completely, nor do they affect frown lines and other deep wrinkles.

But then there’s Nerium Skin Care products, the focal point of this blog.   They are different largely because it is a multi-level marketing company that sells a number of beauty products which feature the extract of nerium oleander.    This oleander is a very hardy small evergreen shrub or tree grown for ornamental purposes.   However, it is among the most poisonous of common garden plants;  it contains a wide range of toxins and secondary compounds that will kill animals and sicken humans if ingested.  Notably, the FDA has not approved any product to date that has claimed to use oleander extract for use with humans and has,  in fact,  documented two deaths pertaining to products that use the extract.   Nerium products are created by a company called Nerium International.  We acknowledge that it takes a lot of chutzpah to name a company and health products after a toxic plant.  So they win the 2014 Chutzpah Prize for a name that no focus group would ever choose unless it was heavily inebriated.   However, Nerium’s products are controversial for three other reasons:

1.  It may not be safe.

2.  It may not work or, if it does, it is attributable to the Placebo Effect.

3.  Its distribution through a controversial multi-level marketing scheme.

 

Is Nerium Safe?

The disturbing answer is that no one knows, and if they do, they’ve not proved it.   The majority of over-the-counter skin creams are made from relatively benign products, most of which could be ingested…..although you’d never want to include them any recipe for a dinner party.   However, Nerium is  produced from a highly toxic plant that contains cardiotoxic oleandrin, folinerin, digitoxigenin, and oleandringen.   These are apparently nasty elements, according to Dr. Jen Gunter, who hosts a fairly comprehensive discussion of Nerium that is worth reading.

She notes that the efficacy (and hopefully safety) studies quoted by the manufacturer that were conducted by ST&T Research on behalf of Nerium have not been submitted to any peer-review publication.   Her issue is that NeriumAD is made from a highly poisonous plant and there is inadequate safety data to prove its long-term safety.   She warns that without published studies it is not possible to know whether the product is safe and she is very critical of the company’s refusal to publish the studies upon which they rely.

Her concerns are heightened by the many reports of people receiving serious rashes and allergic reaction to the Nerium Beauty Cream.   In our Internet review of anecdotal experiences, it is quite common to find people who saw no major or any improvements after using the Nerium creams.  This is not uncommon — most high-end skin creams have both advocates and detractors.   Some folks swear by the product and the results and are willing to fork out $100 per bottle to try the creams.     What makes Nerium more marketable…..but more alarming as well…..is that its results become apparently more quickly than other creams.   Some have stated that the quick results are due to the fact that it causes your skin to swell slightly.  So rather than getting rid of wrinkles, you just get puffier.  Their theory is that it is destroying the cells on your skin in the same way a chemical peel would.  Notably,  chemical peels on a periodic basis may be healthy, but a mild chemical peel on a daily basis could have long-term ramifications. The fact that many people report that after the first month or two they develop rashes and report headaches should be a concern to customers.

Another thoughtful discussion on the safety of Nerium products is at Barefaced Truth.   It notes that the same ingredient is used in anti-cancer drugs which are sold by Nerium Biotechnology, the parent company of the Nerium Skin Care.   There is extensive peer reviewed published scientific research on the effects of oleandrins (which are extracts from oleanderplants).  They have been found to cause “massive oxidative stress”, reduce protein synthesis, and can promote cell death (apoptosis).  If absorbed into bloodstream, these same chemicals can have effects on the heart, including heart block, which can be fatal. The bigger the dose, the bigger the risk of untoward effects.  Nerium has consistently declined to disclose the dosage in its skin care formulations, so consumers don’t know how much of this poison is being absorbed into their bodies.   This is an issue, according to this blog, because topical application of oleander plant extracts may result in cardiac poisoning.

Nerium asserts that it shouldn’t have to publish its studies.   Because cosmetics are only lightly regulated by the FDA,  companies selling face creams routinely decline to publish studies showing their products are effective.   They will often cite scientific evidence that anti-aging ingredients work, but they won’t provide those studies to show that the product contains enough of the substances to have an effect.  It also has posted a highly-edited video on YouTube depicting a panel of alleged experts describing the health effects of Nerium.   You be the judge…..but notice how they skirt around the issue of long-term effects.   That’s because most cosmetic tests are limited to whether the creams cause skin irritation.   In Nerium’s case, because it is made from a highly toxic substance there may be longer-term and subtle health ramifications that go beyond just skin irritation  (which is, by the way, among the most common complaint about Nerium on the Internet).     As Dr. Gunter points out, the absence of any peer-reviewed studies is disconcerting and, for the good doctor, a dealbreaker.

Does Nerium Work?

At a very basic, level, all skin creams are essentially the same. They contain oils to moisturize the skin – like Vaseline. They also contain ingredients designed to maintain that moisturizing, but without the greasy feeling of Vaseline. Beyond that, there’s no scientific consensus that over-the-counter creams really work.   Thus, we are left to assess effectiveness based upon anecdote — which never a desirable basis.   We note that on Amazon, the most popular Nerium product is “age defying night cream.”  It garnered 894 reviews, of which 412 were three stars or less.   So about 50% of the purchasers thought it worked and 50% didn’t.   This is curiously similar to the 50% effectiveness of placebos.   A number of customers on Amazon and elsewhere complained of skin irritation after long-term use.

A quick note about The Placebo Effect.   The placebo effect is the measurable, observable, or felt improvement in health or behavior not attributable to a medication or invasive treatment that has been administered.  Dr. Irving Kirsch, a psychologist at the University of Connecticut, tested to determine the effectiveness of Prozac and similar drugs.    His team analyzed 19 clinical trials of antidepressants and concluded that the expectation of improvement, not adjustments in brain chemistry, accounted for 75 percent of the drugs’ effectiveness.  In an earlier study, his co-researcher analyzed 39 studies, done between 1974 and 1995, of depressed patients treated with drugs, psychotherapy, or a combination of both. He found that 50 percent of the drug effect is due to the placebo response.   Subsequent studies have borne out the Placebo Effect.

In regards to skin creams, there are reportedly  thousands of scientific studies showing that active ingredients featured in anti-aging products have the potential of reducing wrinkles, but there are also those that say a simple emollient can do the same.   Could it all be in the mind?  Scientists are increasingly recognizing the placebo effect as an authentic neurochemical reaction in the brain.  In one reported study, the experimenter rubbed a skin cream on subjects’ wrists, telling some it was an experimental salve and others that it was a placebo cream. In reality it was all placebo cream. A third of subjects who got what they thought was the painkilling cream reported less pain, showing a clear placebo effect.  It became increasingly clear that when a patient improved on placebo, it wasn’t just some delusion or an effort to please a person in a lab coat. It was a measurable brain event and reflected an actual reduction in the experience of pain. But scientists are increasingly recognizing the placebo response as an authentic neurochemical reaction in the brain.    It is highly likely that the anti-aging marketing gurus have figured out that compelling ads, fancy packaging and high prices will combine to persuade the mind that a product works even though there’s no biological support for the product’s effectiveness.

Is Nerium’s Multi-Level Marketing Distribution a Scam?

Multi-level marketing (MLM) schemes are not illegal and, often, are perfectly acceptable methods of product distribution.   Avon, for one, is a multi-level marketing company.    However, MLMs are often characterized by high-margin products  (meaning: overpriced relative to the cost of manufacturing them), high-pressure sales by economically  “motivated” salespeople and the potential for overblown claims.   If you want to learn more about how MLMs work, check out this “mokumentary“.  At their worst, MLMs are pyramid schemes in which only a small percentage of sellers make any money and most everyone else (including customers) are the losers.    Nerium doesn’t appear to be a pyramid scheme, but it does suffer from two characteristic MLM excesses.

First, it places a strong financial incentive upon its marketers to sell product — perhaps too strong. The sellers of Nerium products are usually obligated to buy product, whether they sell it or not.   Like most MLMs, Nerium products are sold and distributed via independent consultants known as “Brand Partners”. Nerium’s “Brand Partners” are allowed to choose their own methods to sell the products. However they must meet a certain sales requirement every month otherwise they pay out of pocket.   By way of comparison, an Avon Representative has to pay $15.00 to join, gets a free web page and has an upfront commission structure in which they get paid in cash or product.  Nerium “Brand Partners”  have to pay a significant amount upfront ($500 or more), pay $29.95 a month for a web site and compensation is reportedly complicated.  It would appear that most sellers just get free product rather than cash payments.   Eddy Salomen hosts a very informative blog about the selling of Nerium products.    Anyone considering becoming a “Brand Partner” or being sold product by a Brand Partner should take ten minutes to read his blog about Nerium.    Many former “Brand Partners” share their experience about having tried to sell Nerium Products.   In short:  it is a very mixed bag.

As to the accuracy of the advertising claims, one of the big controversies has been the involvement of the reputable MD Anderson Cancer Center in formulating Nerium products.   The claims became so widespread….and unfounded….that the Center itself published a rebuttal on its own webpages and denying any endorsement or connection to Nerium products.   Similarly, well-known actor Ray Liotta sued Nerium in 2014 claiming that his photos were used in Nerium ads even though he’d never used the product.   TMZ reports Liotta saying ““Ray Liotta says (Nerium Internation” is like a pimple on his ass, and he’s gonna pop it … in court.”

Nerium also makes claims about results that border on “too good to be true”.   It offers a product called “Nerium Firm” that claims to “reduce the appearance of cellulite”.   It contains “white willow bark” which contains an active ingredient known to cause kidney damage.  The clinical studies of this product consist solely of a questionnaire given to users — no other physiological evaluation was conducted.   Nerium’s pitch is”try it and see for yourself”,  which is really what most all anti-aging cream sellers want.   Even if you only try the product for two or three months, the companies make money because the product has insanely high profit margins;  that is, it is cheap to make but they charge extremely high prices.

Ultimately, it is up to the individual as to whether to use a skin-care product that contains a known cardiotoxin and has chosen not to publish safety studies. We recommend that if you want to potentially spend/waste your money on high-end skin care products that you consult the Comestics Database to look up the ingredients in products to check their toxicity levels.   There, you can find low-toxicity alternatives at a fraction of Nerium’s cost.   Ultimately, the best — and lowest cost — strategy to combat wrinkles (and aging, in general) continues to be:

Wear sunscreen

Don’t smoke

Treat your skin well

Eat healthy

Manage stress.

Try these first time-tested and very low-cost strategies…………and only after that should you consider anti-wrinkle cream.   As for Nerium, well, we can only say “caveat emptor” and “good luck”.   If you really feel that you need to spend the money on Nerium, we recommend you take 10 minutes of your time to read this opinion about the merits (and demerits) of Nerium.    Or if you only have four minutes, check out this news report by KPIX in San Francisco.  It’ll be well worth your time.