Everything this desk cites, with the date each was last read. A citation is not an endorsement — several are here because they contradict a claim rather than support one.
American Academy of Dermatology, 2026
Asymmetry, irregular border, varied color, diameter, and evolution as the features that should prompt an appointment — as should any spot that is new, different from the others, or changing, itching or bleeding.
Read 2026-09-02.
National Institute for Health and Care Excellence, 2021
Fixed-combination topical treatments — adapalene with benzoyl peroxide, or tretinoin with clindamycin — as first-line 12-week options at any acne severity, reviewed at 12 weeks. Sets referral criteria for nodulo-cystic acne, scarring, and acne causing psychological distress.
Does not establish: That any single topical outperforms the others, or that results should be judged before 12 weeks.
Read 2026-09-02.
US Code of Federal Regulations, 2024
The only skin-cancer claim permitted for broad-spectrum SPF 15+ is that it decreases risk *if used as directed with other sun protection measures*. Also the source of the 2 mg/cm² figure: that is the dose at which SPF is measured in the lab, in the test procedure itself. Reapplication is mandated at least every two hours, and after swimming, sweating or towel drying.
Does not establish: That 2 mg/cm² is a clinically derived recommendation. It is a laboratory test condition, which is why applying less does not simply scale the number down.
Read 2026-09-02.
Oxford University Hospitals NHS Foundation Trust, 2024
Studies show people frequently apply less than half the sunscreen needed for the protection on the label. Practical rule given as at least six teaspoons for the body.
Does not establish: A single agreed quantity — the WHO's 2025 review gives about nine teaspoons for the same job. The disagreement is real and worth stating.
Read 2026-09-02.
NHS, 2024
Urgent advice if skin is blistered, crusty, leaking fluid or has pus-filled spots; is painful, swollen or warm; suddenly gets worse; or comes with a high temperature or feeling generally unwell. These can indicate infection or eczema herpeticum.
Read 2026-09-02.
NHS, 2024
Skin that is painful, hot and swollen needs urgent attention. Emergency care for a very high temperature, fast heartbeat or breathing, purple patches, confusion, or cold clammy skin — these are sepsis signs.
Read 2026-09-02.
US Food and Drug Administration (Drug Safety Communication), 2022
Under the CARES Act, over-the-counter skin lighteners containing hydroquinone needed FDA approval to be legally marketed from 23 September 2020, and there are no approved OTC skin lighteners. Reported harms include rash, facial swelling and exogenous ochronosis, which may be permanent. At the date of the notice (April 2022) the only FDA-approved hydroquinone product was a prescription triple-combination cream for melasma.
Does not establish: That hydroquinone does not work — the finding is regulatory, not about efficacy. It says nothing about prescription products after April 2022, or about any market outside the US: the EU cosmetics ban this entry used to mention is not on this page.
Read 2026-09-13.
US Food and Drug Administration, Consumer Updates, 2022
Mercury is illegally added to some skin lighteners and anti-aging creams. Label terms to watch: mercurous chloride, calomel, mercuric, mercurio, mercury. These products are often sold in shops serving Latino, Asian, African and Middle Eastern communities, and online. Health effects are listed, and if exposed FDA's steps are to stop use, wash, contact poison control, and seal the product.
Does not establish: That every unlabeled product contains mercury, or how common exposure is.
Read 2026-09-13.
US Food and Drug Administration, Cosmetic Ingredients, 2022
FDA's own studies found four weeks of AHA use produced an 18% increase in UV-induced erythema and roughly doubled sensitivity to UV cell damage, reversible on stopping. Hence the recommended sunburn alert covering use and the week afterwards.
Does not establish: Wrinkle or collagen claims at cosmetic concentrations. The sun-sensitivity finding is the better-established fact about AHAs.
Read 2026-09-02.
US Food and Drug Administration, 2022
There are no federal standards or definitions governing the term, and manufacturers are not required to submit substantiation to the FDA.
Read 2026-09-02.
US Food and Drug Administration, NDA 021108, 2014
Adjunctive mitigation of fine facial wrinkles, alongside a comprehensive skin-care and sun-avoidance program.
Does not establish: The label states in capitals that it does not eliminate wrinkles, repair sun-damaged skin, reverse photoaging or restore younger skin, and that it has not shown effect on coarse wrinkling, roughness, mottled pigmentation, lentigines, telangiectasia or laxity.
Read 2026-09-02.
US Food and Drug Administration, 2011
SPF measures protection against UVB (sunburn). 'Broad Spectrum' means UVA protection in proportion to UVB protection.
Does not establish: Anything about visible light, which it does not address at all. The label rules in force today may have been updated since 2011; that was not checked.
Read 2026-09-13.
J Am Acad Dermatol, 2021
Organic and inorganic UV filters do not protect against visible light; tinted sunscreens do. Regulation of visible-light protection differs by region.
Does not establish: A standard for testing or labeling visible-light protection — it does not define one, so it cannot say how much a given tinted product blocks.
Read 2026-09-13.
Cochrane Database of Systematic Reviews, 2024
The largest current synthesis of acne topicals — 275 trials, 40,910 participants. Its headline finding is that there is no high-certainty evidence for the effects of any therapy included.
Does not establish: Any confident ranking of acne topicals against each other. This is the reason every acne rating on this desk is hedged: strong guideline recommendations sit on a low-certainty trial base.
Read 2026-09-02.
Drug Delivery and Translational Research 14(12):3512–3548, 2024
Pigment is niacinamide's strongest domain: 4% performed comparably to 4% hydroquinone in melasma, and 1–4% over 8–12 weeks reduced facial hyperpigmentation.
Does not establish: The oil-control claim. The review found essentially no published randomized trials measuring sebum — that claim rests on a 2002 conference presentation. Barrier claims are largely mechanistic.
Read 2026-09-02.
J Dermatolog Treat, 2024
22 randomized trials, 1,280 patients: tranexamic acid reduced melasma severity. The largest MASI drop was with oral use, then injection, then topical. Side effects included stomach upset and menstrual changes.
Does not establish: Long-term safety, which is not established. Heterogeneity between trials was high.
Read 2026-09-13.
Arch Dermatol Res, 2024
7 randomized trials: cysteamine beat placebo, with no significant difference from hydroquinone 4%. Irritation rates were similar to hydroquinone and higher than placebo.
Does not establish: That cysteamine and hydroquinone are equivalent — few, small trials cannot show that.
Read 2026-09-13.
British Journal of Dermatology 187(3):309–317, 2022
36 randomized trials. Topical tranexamic acid 2.5% against vehicle reduced MASI at high certainty — the only high-certainty rating in the review. Hydroquinone 4% beats placebo; triple-combination cream beats hydroquinone alone but with markedly more adverse effects.
Does not establish: A meaningful difference between hydroquinone 4% and tranexamic acid on MASI — that comparison found none.
Read 2026-09-02.
Cochrane Database of Systematic Reviews, 2020
120 trials, 29,592 participants. Benzoyl peroxide may improve self-reported acne compared with placebo (low certainty), with little to no difference against adapalene or clindamycin.
Does not establish: Superiority over a retinoid, or good tolerability — withdrawal for adverse effects was roughly doubled against placebo.
Read 2026-09-02.
Cochrane Database of Systematic Reviews, 2020
Salicylic acid shows little to no difference against tretinoin on treatment response (low certainty). Azelaic acid probably performs worse than benzoyl peroxide for acne (moderate certainty).
Does not establish: Any claim that salicylic acid is a leading acne active. Risk of bias and imprecision limit confidence throughout.
Read 2026-09-02.
British Journal of Dermatology 181(1):65–79, 2019
152 trials, 20,944 participants. High-certainty evidence for topical azelaic acid and ivermectin for the papules and pustules of rosacea.
Does not establish: Azelaic acid for rosacea redness or flushing — that evidence belongs to brimonidine and oxymetazoline, not azelaic acid.
Read 2026-09-02.
Cochrane Database of Systematic Reviews, 2017
77 studies, 6,603 participants. Moisturizers reduce eczema flares and topical steroid use, and work better alongside an active treatment than the active treatment alone.
Does not establish: That ceramide-containing moisturizers outperform other moisturizers — the benefit shown is for moisturizers as a class.
Read 2026-09-02. Published 2017 and not since updated.
Journal of Cosmetic Science 68(4):255–256, 2017
There is a hierarchy of comedogenicity test methods but no mandated one. An in-use clinical trial with dermatologist grading is described as the gold standard; the rabbit-ear model is the least rigorous of the recognized options.
Does not establish: That 'non-comedogenic' on a label guarantees any testing happened, or that per-ingredient comedogenicity ratings predict whether a finished formula will break out a given person.
Read 2026-09-02.
J Am Acad Dermatol, 2014
20 randomized trials, 2,125 participants: triple-combination cream beat hydroquinone alone (RR 1.58), azelaic acid 20% beat hydroquinone 2% (RR 1.25), and tretinoin beat placebo.
Does not establish: Long-term outcomes or relapse. Methodology was poor and the studies were short.
Read 2026-09-13.
British Journal of Dermatology 180(2):289–296, 2019
44 participants over 12 weeks. Both bakuchiol and retinol reduced wrinkle area and hyperpigmentation, with no statistically significant difference between them; retinol users reported more scaling and stinging.
Does not establish: Equivalence. There was no placebo arm, the dosing was unbalanced (twice daily against once daily), and 44 participants cannot establish non-inferiority — 'no significant difference' in a small trial is not evidence of sameness. The tolerability finding is the more credible half.
Read 2026-09-02.
Photodermatol Photoimmunol Photomed, 2014
68 melasma patients, all also using 4% hydroquinone for 8 weeks: a UV-plus-visible-light (iron oxide) sunscreen gave greater improvement than a UV-only sunscreen on MASI, colorimetry and melanin.
Does not establish: What a tinted sunscreen does on its own — everyone also used hydroquinone. Single-center and short-term, and it tells us nothing about dark marks after inflammation (PIH).
Read 2026-09-13.
Annals of Internal Medicine 158:781–790, 2013
903 adults under 55 in Queensland. Daily SPF15 against discretionary use produced 24% less skin aging by microtopography over 4.5 years (odds 0.76, 95% CI 0.59–0.98).
Does not establish: Generalization beyond a high-UV setting and a mostly fair-skinned cohort using SPF15.
Read 2026-09-02.
Journal of Clinical Oncology 29(3):257–263, 2011
1,621 participants followed to 2006: invasive melanoma hazard ratio 0.27 (95% CI 0.08–0.97).
Does not establish: A significant reduction in all melanoma — that result (HR 0.50, p=0.051) did not reach conventional significance.
Read 2026-09-02.
J Invest Dermatol 130(8), 2010
Controlled experimental study in 20 volunteers with skin types IV–VI: visible light produced darker and more sustained pigmentation than UVA1. There was no pigmentation in type II skin.
Does not establish: Anything about everyday sunlight or sunscreen. It used lab light sources on the lower back and measured no sunscreen effect.
Read 2026-09-13.