Can Taking A Supplement Give You Better Skin?

To walk down the skin care aisle of Sephora or Ulta — once you’ve dodged the preteens making smoothies in the Drunk Elephant testers, that is — is to be faced with a multitude of brightly packaged pills and potions claiming to do everything from strengthen your skin barrier to help clear your breakouts. Ingestible collagen, hyaluronic acid, and vitamin A are now all common sights on the shelves alongside their topical counterparts. Ten or 20 years ago, the beauty supplement market looked much less sophisticated, with combination hair and skin biotin formulations as the predominant option, with the occasional dermatologist-backed daily regimens thrown in for those willing to take a handful of pills and spend almost $100 on skin supplements.

But, as the general public started to catch on that what you put in your body is just as important for your skin as what you put on it, the “beauty from within" category exploded and self-care became practically a competitive sport among Millennials and Gen Z. More than 50% of people in the US take some form of dietary supplement and the global market is projected to be worth $300 billion by 2028. Skin care supplement sales made up $3.3 billion in 2022 and are expected to grow at an annual rate of 7.9% from 2023 to 2030.

Anyone who lived through the ephedra debacle of the ‘90s might be rightly skeptical of the fawning reviews and clout supplements seem to be racking up these days. And that skepticism would be well-warranted considering that the regulation of supplements does not fall under the same type of stringent guidelines for approval as pharmaceutical drugs. They’re regulated more like cosmetics, with the FDA and FTC monitoring manufacturing and claims, but not the clinical testing and efficacy of the products.

That doesn’t mean the entire category is BS — in fact, many experts believe combining topical products with quality supplements can create superior results that you can’t get with a skin care routine alone. “It’s not unreasonable to use something that works by a different mechanism of action,” says Dr. Richard Granstein, M.D., a NYC-based dermatologist and chair of the department of dermatology at Weill Cornell Medicine. “Maybe use an oral agent and also use retinol. There’s no data that says that’s what should be done, but it’s reasonable to think so.”

Not to mention the fact that many supplements contain ultra-high doses of ingredients that in order to get from foods, you’d have to eat what Granstein says is an “unreasonably high, even impossible number.” Or, as Taylor Fazio, MS, RD, CDN, a registered dietician and wellness adviser at The Lanby, points out, “There are some nutrients that are essential, meaning we do not make them in our bodies.” Some of those we can easily get through a well-rounded diet, but others like vitamin D, she notes, need to come from a supplement in order to get what your body and skin require to avoid being deficient.

With thousands of options to choose from — and not all of them playing by the rules — how do you ensure you’re separating the healthy from the hype without having to get a mini Ph.D. in supplements? To help bring some clarity to this rapidly evolving category and dispel some persistent misconceptions, TZR spoke with experts to get the scoop on everything from what’s really in those brightly labeled bottles to how regulation actually works (or doesn’t) and how you can be a smarter supplement shopper.

What Supplement Brands Can (& Can’t) Say

Just like skin care brands can’t make wild claims about a cream giving you the youthful complexion of a nine-year-old, supplement brands are also beholden to their FTC overlords. There are two main types of claims: health and structure/function. Health claims are those that say a product can prevent, treat, or cure a disease and those are illegal for supplement brands to make if they do not have the science and testing to back them up. It’s why you’ll see many supplements carry the disclaimer that the product is not intended to diagnose, treat, cure, or prevent any disease. A structure/function claim describes how a nutrient affects the normal structure or function of the human body. As Mark Morris, chief product officer at Elysium, notes, there’s exact language you have to use to be able to put those claims on your label and a process that brands must go through to get an approved health claim by the FDA. He uses the example of vitamin D and calcium at appropriate dosing as a preventative for osteoporosis — that’s an approved health claim. He notes that if a brand does not have the studies to back up a health claim, they can make a structure/function claim that it supports bone function. Brands that violate health claims are sent warnings and, if they don’t comply, face product seizure, shutdown, and legal action.

Structure/function claims can be made by supplements, but according to Daniel Fabricant, Ph.D., CEO and president of the Natural Products Association, and the former director of the Division of Dietary Supplement Programs at the FDA, companies have 30 days to notify the agency of the claim and provide the exact language. If they don’t, companies are sent warning letters to fix their labels. If they don’t comply, the FTC can then file lawsuits against those companies seeking civil penalties.

There are a significant portion of brands existing in what Eric Marcotulli, founder and CEO of Elysium, calls a gray zone between health claims and structure/function claims. “What happens if you want to take that vitamin D and calcium claim and instead of attaching it to osteoporosis and just saying it supports bone health, what if you wanted to say it improves bone density by 50%?” he asks. “You haven’t mentioned a disease, and the data may show it’s beyond the structure/function claim. That’s where a lot of companies exist right now. They stay away from the need to get approvals on their claims. In some cases it might be perfectly acceptable, but in others, maybe it’s misleading because it only improved bone density by 50% in people over 50. For people with healthy bones, it did nothing. That’s where greater clarity and regulation would be more useful.”

What’s In The Bottle?

If you thought reading a skin care label was hard, try deciphering a supplement bottle. In addition to the standard ingredients, you’re also now looking at a nutrition facts label, complete with serving sizes and daily values. Because things aren’t confusing enough, now you get to add percentages into the mix. According to Fazio, what’s equally as important as what’s in the bottle is what’s not in the bottle. “The three most important prongs I look at when I’m looking at a supplement overall is that they have the appropriate amounts of the ingredients, the ingredients are bioavailable, and they’ve done third-party testing that show there’s no negative ingredients like heavy metals,” she says. If a brand is advertising a potent ingredient, but you look on the label and see that it is not represented on the nutrition facts, or that it is listed in a negligible amount, odds are good you won’t see any real benefits from that ingredient. Similarly, an ingredient does no good if it can’t be absorbed by the body — aka if it’s not made bioavailable. Collagen, for instance, is a helpful molecule for skin moisture and elasticity, but only if it’s been hydrolyzed — otherwise it’s too large of a molecule to be properly absorbed.

Speaking of things not being in bottles, some major retailers got themselves in hot water back in 2015 when New York’s attorney general surprise visited GNC, Target, Walmart, and Walgreens and pulled a sampling of store brand supplements off the shelf for DNA testing. It found that only 21% of the products tested actually had the DNA from the plants advertised on the label. Many were contaminated with other plant materials not listed anywhere on the labels, some of which were major allergens. The products in question were voluntarily recalled from shelves. It was an eye-opening moment for many consumers who were blindly trusting that they could just pick a cheap bottle off the shelf and be perfectly fine with what was inside.

Keep It Regulated

You might have noticed that the responsibility lies on the brand to self-report its claims, evidence, and even ingredients. That’s because the FDA technically considers supplements to fall under the umbrella of food and not drugs, meaning it doesn’t analyze the contents of a product prior to it hitting the market. Supplements fall under the Dietary Supplement Health and Education Act (DSHEA), passed in 1994, which requires manufacturers to self-report any claims of adverse effects after products are already on the market, as opposed to the strenuous testing and safety standards that pharmaceutical drugs are put through before they are approved to be sold.

But that’s not to say there aren’t any governmental guardrails in place. Supplements are regulated by the FTC and the FDA under DSHEA, with the FTC monitoring claims and the FDA monitoring the safety of products. According to Fabricant, one of the most important aspects the FDA monitors is something called good manufacturing practices (GMP). “The GMPs are an important rule — during my time at the agency, we shut companies down for not adhering to GMPs,” he says. “We’ve put padlocks on their doors so they can’t operate their business. Those are real rules, critical rules.” GMPs encompass everything from the manufacturing to the packaging, labeling, and holding of products.

Unfortunately, not a lot has changed in the 30 years since DSHEA was passed, despite supplements’ explosive growth. According to Fabricant, one semi-recent change enacted by the FTC is a crackdown on social media influencers and a set of guidelines for what can and can’t be said in social media testimonials. “The FTC has pretty clear guidelines on advertisements, and influencers now have to disclose whether they’re paid or not paid,” he says. “That’s important because I think it adds a layer of transparency.” There was also talk around last year's amendment of the Federal Food, Drug, and Cosmetic Act about creating mandatory product listings (MPL) for supplements, which would require brands to provide the FDA with information about each of their supplements, along with ingredients and warnings; however, that didn’t make the final cut — a move that had both supporters and detractors. “The FDA was started to test and inspect. That’s the most important thing the agency does,” says Fabricant. “Everyone wants to talk about transparency, but transparency is the agency having access to your facility. I don’t want the FDA to be the doorman at a nightclub — I want them out there inspecting and testing.”

Lindsay Dahl, supplement brand Ritual’s chief impact officer, disagrees and considers MPLs a bare minimum move for the FDA, and brands to be more transparent about the products and ingredients they are offering. “Mandatory product listing is the concept that supplement companies would share with the FDA what products they make and what ingredients are included at what doses,” she says. “We see it as a simple step that should be a ticket to entry for anyone hoping to enter the supplements space. To us, it is appropriate that the FDA would know what products and ingredients are on the market.”

The Wild World Of Clinical Testing

Clinical testing is a phrase that’s been slapped on many a supplement package to help prove a brand’s scientific street cred; however, it’s a term that has about as much meaning as the word “natural” does in today’s beauty market. According to Dahl, there’s no real regulation around how brands are conducting (or not conducting) studies. “We see it being misused, and [it] can potentially be misleading to consumers,” she says. “Brands like to link the clinical studies that are referenced for those ingredients on their website. Check the dosing — if there’s a clinical study [where] you click on the link and it’s at a particular dosage, the efficacy that was studied in that clinical trial should be around that particular dosage. If the brand is using a significantly smaller dose or pixie dusting a formula but using clinically tested to signal efficacy, that’s a flag for a misleading claim.”

The type of study also makes a big difference, notes Granstein. “Placebo-controlled, double-blind studies where neither the subject nor the investigator knows who’s getting the real stuff and who’s not are crucial to determining if something really works.” A brand that uses placebo-controlled, double-blind studies and makes that information readily available for consumers is usually a brand with nothing to hide. However, notes Granstein, someone claiming clinical testing with results boasting 85% of respondents seeing an improvement is a subjective result, not a true clinical test. “They’ll say, ‘We gave this to three people or six people. They used it for 12 weeks, and they reported that their wrinkles looked better or their brown spots were less.’ That’s the lowest type of experimental evidence because they didn’t even have an unbiased observer looking at their skin to determine it,” he explains. “They didn’t have profilometry done to see how deep the lines were in a quantitative sense.”

Generally speaking, that’s a lot more science than anyone really wants to get into when they're shopping for their skin care routine. But, sadly, since the supplement industry tends to have more bad actors operating in the gray zone than legitimate players putting in the time and money for the proper independent testing, we all need to strap on our safety glasses and get more science literate about what we are putting in our bodies. “There’s no silver bullet here — it’s not like you can click a button and ask is this legit or not?” says Elysium’s Marcotulli. “From our standpoint, rather than asking a company ‘What do your supplements do?’, the better question is ‘Has this formula been tested in people and has that been published under peer review?’ What really grinds my gears is when you see the claim ‘backed by 30,000 clinical studies.’ That’s because they’ve included something like vitamin D3 in there. They didn’t study it, it’s not their formula — they just included an ingredient people have studied for decades.”

The Savvy Supplement Shopper

It’s very easy to get discouraged by all the shadiness and just walk away from the whole supplement market, but you’d be missing out. Several promising studies show the benefits of adding ingestible skin-care ingredients, from hydrolyzed collagen and ceramides to hyaluronic acid and carotenoids, to your beauty routine. Not to mention old standbys like omega fatty acids and probiotics. Just remember, warns Fazio, that not every ingredient is going to work for every skin issue. “There are a lot of supplements that are intended for skin care benefits that can actually in excess cause more skin issues, like vitamin B12 or biotin. Because the labels say a lot of positive things, you just buy into it. You’re really vulnerable when you have acne, so you don’t really think of the downsides, even though a supplement isn’t indicated for everyone and you get into a sticky situation where it actually might make things worse.” She points to compound diindolylmethane (DIM), found naturally in vegetables like broccoli and kale, and which is used in some supplement blends that target hormonal acne. “It works really well for people who have high estrogen levels,” says Fazio, “but not everyone that is acne-prone does [have high estrogen], and an uninformed consumer might take that and actually diminish their healthy estrogen levels.”

As the market gets more crowded, it’s important to think critically about what you are looking at. As Marcotulli notes, many brands are jumping into the space simply to gain a foothold, not because they’ve found a new formulation or ingredient worth shouting about. “If someone is taking biotin and vitamin E and saying ‘Hey, let’s figure out a way to make a claim that’s unique to us,’ and there’s no additional data, then it’s just more people trying to sell the same product,” he says.

While there’s no stamp of approval that can tell you that a product has been deemed safe and truthful by the FDA and FTC, there are some third-party associations that are considered a gold standard by many in the industry, according to Dahl. There’s “Clean Label Project, which tests for over 200 contaminants ranging from pesticides like glyphosate to plasticizers, phthalates, and heavy metals, in addition to microbes,” she says. “The second is the United States Pharmacopeia (USP), which is the gold standard. It tells consumers what is on the label is actually in the product. That seems like a basic thing that you would expect, but the testing that USP does helps make sure that the ingredients are standing up to the shelf life, so by the time a product ends at shelf life, it’s the same nutrients and dosing that you see on the back of the label.” Fazio also mentions the National Sanitation Foundation (NSF), whose certified for sport label is trusted by professional athletes for verification that supplements do not contain contaminants, prohibited substances, or masking agents, and that the labels match what’s in the bottle. “It gives another layer of trust in the whole equation that has no affiliation with the company that’s selling the product,” she explains.

While it might not be feasible to do in-depth research on a product while you’re standing in the aisles at Sephora, it’s worthwhile to take a beat to look at a brand’s clinical research and see if it looks legit. “If you’ve done a clinical study, trust me, you put them on your website,” says Marcotulli. “But even if you have to email someone for it, it shouldn’t take that long. And you’ll probably get an offer to buy while you’re waiting and some kind of discount.” It’s also helpful to talk to a doctor before you purchase any dietary supplements to make sure the ingredients won’t interact with your existing medications — you can also find out where you might be deficient in vitamins and minerals to help better understand which supplements make the most sense for your skin concerns. And, of course, don’t forget that supplements are not a substitute for a healthy diet full of anti-inflammatory foods that are high in fiber, plus proper hydration, says Fazio.

At the end of the day, simplicity is almost always the best option, notes Elysium’s Morris. “If you’re seeing proprietary blends with 14 different things in it, that’s pixie dust,” he says. “You just don’t have the footprint to put things at efficacious doses like that. So it’s really looking at a label that is cleaner, that has a few key ingredients that you could at that point easily Google because you know that must be what’s powering the product. If the label looks overwhelming, put it back on the shelf.”