What Does Evidence-Based Skincare Actually Mean?

And why “clinically proven” doesn’t always tell you as much as you think

“Evidence-based” is one of those phrases that gets used a lot in the skin industry. You’ll see it on clinic websites, skincare packaging and social media, usually alongside other words like clinical, medical-grade, scientifically formulated or clinically proven. They all sound reassuring, but they don't necessarily mean the same thing — and seeing one of them on a product doesn't automatically tell you whether that product is going to be right for your skin.

When I talk about evidence-based skincare at Curated, I'm not talking about having the strongest products, using the most advanced technology or following research so rigidly that we forget there's an actual person sitting in front of us. For me, it's about making decisions that have a sound scientific reason behind them, using the best available evidence alongside what we know about skin biology, our clinical experience and, importantly, the individual skin we're treating.

My background in Dermal Sciences probably influences the way I think about this quite a lot. At university, you're constantly being taught to ask why. Why are we using this ingredient? What biological process are we trying to influence? What evidence supports it? What are the limitations of that evidence? Is it appropriate for this particular person? That way of thinking has stayed with me far more than memorising any particular treatment protocol.

And I think that's really what evidence-based skin care should be.

Not just knowing what to do, but understanding why you're doing it.

Evidence-based doesn't mean following every new study

Science is constantly evolving, and that's a good thing. Our understanding of skin, ingredients and treatment modalities changes as new research emerges. But one study being published doesn't suddenly make something a universal truth, just as an ingredient having research behind it doesn't mean every product containing that ingredient will produce exactly the same result.

Research has to be looked at within context. We need to consider how a study was designed, how many people were involved, what was actually being measured, how long the study ran, whether the findings have been replicated and whether the research being referenced actually relates to the claim being made.

This is something that gets lost very easily in skincare marketing. A brand might be able to say an ingredient has been clinically studied, but that doesn't necessarily mean the finished product sitting in your bathroom has been studied in exactly the same way. Similarly, a product being described as “clinically proven” sounds incredibly definitive, but the useful question is always: clinically proven to do what, under what conditions, and in whom?

That doesn't mean we need to become suspicious of every skincare claim we see. It just means there is usually more context behind a marketing statement than can fit on the front of a bottle.

An ingredient can be evidence-based and still be wrong for your skin

Vitamin A is probably one of my favourite examples of this.

There is extensive evidence supporting retinoids and their effects within the skin, which is one of the reasons Vitamin A forms such an important part of many of the skin plans we create. But knowing Vitamin A has evidence behind it doesn't mean I want every person using the strongest retinoid they can tolerate from day one.

The form matters. The formulation matters. The concentration matters. How it's introduced matters. What else you're using alongside it matters. And most importantly, your skin matters.

The same applies to exfoliating acids. There are very legitimate reasons we may use ingredients that influence keratinisation or exfoliation, but that doesn't mean someone with an inflamed, reactive and compromised skin barrier needs more exfoliation simply because glycolic or salicylic acid has scientific evidence behind it.

This is where I think evidence-based skincare can sometimes be misunderstood. Evidence helps inform the decision. It doesn't make the decision for us.

You still need clinical reasoning.

More active doesn't automatically mean more effective

There is a tendency within skincare to assume that if a little bit of something is good, more of it must be better. Higher percentages sound more impressive. Stronger treatments feel more results-driven. More active ingredients make a formula look more sophisticated.

But skin doesn't really care how impressive your bathroom cabinet looks.

An active ingredient can only be useful if your skin can actually tolerate and utilise it appropriately. There is very little value in creating such significant irritation that someone can't consistently use their routine, particularly when the goal is long-term skin health.

This is one of the reasons our approach at Curated tends to be quite considered. We don't want to chase the highest percentage for the sake of it. We want to understand what we're trying to achieve and then choose an appropriate way of getting there.

Sometimes that does mean using something stronger or introducing a more advanced treatment. Other times, the evidence-informed decision is actually to pull things back.

Advanced doesn't automatically mean better. Appropriate does.

Formulation matters more than the hero ingredient on the front

Another thing I've changed my thinking on throughout my career is how I look at individual ingredients versus complete formulations.

Earlier on, I probably thought about skincare in categories. You need your cleanser, exfoliant, Vitamin A, Vitamin C, serum, moisturiser and so on. It was easy to think about building a routine by ticking ingredients off a list.

Now, I'm much more interested in the formulation as a whole.

A product isn't just its hero ingredient. The delivery system, supporting ingredients, stability, pH where relevant, packaging and overall formulation can all influence how a product behaves and whether it's suitable for a particular skin.

This is why looking at the ingredient list and seeing “Vitamin C” doesn't necessarily tell you everything you need to know about a Vitamin C product. There are different forms of Vitamin C with different characteristics, and the finished formulation matters just as much as the ingredient being highlighted on the front.

It also means you don't necessarily need one separate product for every ingredient you want your skin to receive. A thoughtfully formulated product may contain a combination of ingredients that allows us to keep a routine much simpler.

For me, this comes back to something I've started valuing more and more:

quality over quantity.

“Medical grade” isn't the same thing as evidence-based

“Medical grade skincare” is another phrase that clients ask us about quite often because it has become associated with products that are supposedly stronger, more effective or somehow more legitimate than other skincare.

The problem is that the terminology used to market cosmetics isn't always as straightforward as it sounds. A phrase can feel scientific without necessarily being a standardised clinical classification that tells you everything about the quality or effectiveness of the product.

That's why I care less about whether something is described as luxury, cosmeceutical, clinical, clean or medical grade and more about what is actually in it, how it's formulated, what evidence exists for what we're trying to achieve and whether it's appropriate for the person using it.

A beautifully marketed product can be great. A very clinical-looking product can be great. A simple product can be great. And all three can also be completely wrong for your skin.

The label doesn't make that decision for us.

Evidence-based also means knowing the limits of what we know

I actually think one of the most important parts of being evidence-based is being comfortable saying, we don't know yet.

Skin science isn't finished. There are areas where we have decades of high-quality research and others where the evidence is emerging, limited or conflicting. That's particularly relevant when conversations start moving into areas like the gut-skin axis, hormones, supplements and some of the newer treatment technologies that become popular very quickly online.

Something being interesting or promising doesn't make it useless, but it also doesn't mean we should present an early association as an established fact.

I would much rather tell a client, “There is some interesting research around this, but we don't have enough evidence to say that definitively,” than give them a confident answer simply because it sounds better.

That applies to our scope as clinicians too. We can recognise when something in someone's skin or health history gives us a reason to investigate further, but that doesn't mean we diagnose everything ourselves. Sometimes the evidence-based decision is referring someone to their GP, dermatologist or another appropriately qualified practitioner.

For me, knowing where our knowledge ends is just as important as knowing where it begins.

Evidence still needs a human being attached to it

This is probably the part of evidence-based practice that matters most to me.

You can know the research incredibly well and still create a terrible treatment plan if you aren't listening to the person sitting in front of you.

Someone's lifestyle matters. Their budget matters. Their previous experiences matter. Their tolerance for downtime matters. Whether they're actually going to use seven products every morning matters. Whether they've spent years feeling embarrassed or frustrated by their skin matters.

A technically perfect routine that someone can't realistically follow isn't a very good routine.

That's why our consultations involve more than simply looking at the skin under a light and deciding which products would theoretically work. We want to understand what you've already tried, how your skin has responded, what you're currently doing and what you're actually hoping to achieve.

Then we take what we know from the evidence and apply it to you.

That is where the science becomes useful.

Good skin treatment should make sense to you too

One of my biggest goals when someone leaves Curated is that they understand why they're doing what they're doing. I don't want you using a product simply because we told you to. I want you to understand what we're trying to achieve with it, where it fits within your plan and what we're going to look for to know whether it's working.

The same goes for treatments. If I'm recommending skin needling, I should be able to explain why needling makes sense for your skin and your goals. If I'm telling you I don't think your skin is ready for it yet, I should be able to explain that too.

Education is a huge part of what we do because the more someone understands their skin, the less vulnerable they become to constantly changing direction every time a new ingredient, product or treatment starts trending.

And I think that's particularly important now. There is more skincare information available than there has ever been, but more information doesn't necessarily mean more clarity. Sometimes it just gives you more things to second-guess.

So, what does evidence-based skincare mean to us?

For me, evidence-based skincare isn't about making skin sound complicated or proving how much science we know. If anything, good clinical education should make skin feel less complicated.

It means understanding skin biology, looking critically at the available research, recognising the limitations of that research and combining it with clinical experience and the individual person sitting in front of us. It means choosing treatments and products because there is a reason for them, rather than because they're new, popular or impressive.

It also means changing our minds when better evidence becomes available. There are things I think differently about now than I did earlier in my career, and I'm sure there will be things I think differently about ten years from now. I don't see that as inconsistency. I think that's exactly how evidence-based practice is supposed to work.

We learn more. We question what we're doing. We adjust. And through all of that, we keep coming back to the same question:

Does this actually make sense for the skin in front of me?

Because ultimately, evidence should never be there just to make skincare sound more scientific. It should help us make better decisions.

— Shae
Founder & Dermal Clinician
Curated Skin Aesthetics