Have you ever wondered why you can find some products with a specific ingredient in beauty stores and some are only in pharmacy? That’s due to whether the product is a treatment (or designed to help you manage a medical condition or skin concern) — called a therapeutic product, or if it is a product that will only enhance the visible appearance of your skin — called a cosmetic.

Take the ingredient azelaic acid for example — there are plenty of products out there saying how great it is for your skin, but will it actually work to help you with specific skin concerns?

First up, some regulations and insight into ingredient distribution in Australia. The Poisons Standard (SUSMP – Standard for the Uniform Scheduling of Medicines and Poisons)1 is the government legal document that classifies medicines and chemicals into different categories (Schedules) to regulate their availability and safety in Australia.

The Poisons Standard tells us that an ingredient like morphine, which is a strong pain reliever, is a controlled drug in Schedule 8 — which means there are restrictions on manufacturing, supply, distribution, possession and use to limit the abuse or misuse of this medicine. The Poisons Standard also governs the use of ingredients like Eucalyptus Oil.

When used in medicines for therapeutic use, Eucalyptus Oil is included in Schedule 6 which includes substances with the potential for harm, though this is mitigated through the use of packaging with warnings and label safety directions. 

Azelaic acid is in the Poisons Standard (SUSMP)¹ and may be included in both therapeutic and cosmetic products. If the product containing azelaic acid has a therapeutic function (like assisting with acne), it is a therapeutic product (also known as therapeutic good), and needs appropriate registration.

If the product containing azelaic acid only makes cosmetic claims, such as “help improve the appearance of your skin”, then it is a cosmetic product and can’t claim to provide a therapeutic benefit.

The therapeutic products you can find only in pharmacy have clinical data to ensure they work for their intended use. Cosmetics on the other hand won’t necessarily be able to treat a problem — they will only help improve the visible appearance of your skin and do not require any clinical data.

If you are not sure if the product you are looking at is a cosmetic or therapeutic product, look at the packaging for AUST L or AUST R followed by a number. Seeing this on a label means the product is a therapeutic product. If it is missing you are looking at a cosmetic.

Another distinct difference between therapeutic products and cosmetics is their regulatory oversight — therapeutic products have been reviewed, approved and monitored by appropriate authorities across the world (TGA in Australia, US Food and Drug Administration – FDA, European Medicines Agency).

This ensures the ingredients are checked, claims are backed by evidence and that manufacturing is governed by GMP (good manufacturing practice) and quality control — ensuring products are made to the same recipe, with the correct amount of ingredients, obtaining the same product each and every time. 

Cosmetic products do not have this level of oversight, are far less regulated, can make vague or unverified claims and have the potential to have a variable product, meaning the efficacy (the ability to do what it says it will) is unknown. In short, therapeutic products are held to a much higher standard.

Therapeutic products contain medically active ingredients at clinical concentrations. Cosmetics may contain similar ingredients, though in lower concentrations which is often not adequate to aid in specific skin concerns, such as acne.

The clinical concentration of an active in a therapeutic product is designed to treat a condition or symptoms of the condition, such as bacterial infection or inflammation. A cosmetic product will aim to improve the visible appearance of the skin temporarily or superficially by cleansing, moisturising, brightening or exfoliating.

You can feel assured that in the unlikely event that something goes wrong with your therapeutic product, or you have an adverse reaction, the regulating body (TGA in Australia) can intervene and take action.

Cosmetic companies have less accountability for misleading claims or adverse effects unless it causes serious harm. Ego Pharmaceuticals has a strong reputation as a credible, scientifically-backed, Australian-owned skincare company, with its products recommended by healthcare professionals and a growing international presence. The company is recognised for its high-quality, evidence-based formulations.

If you’re wanting help with a medical skin condition like acne that requires treatment, it is better and safer to use a therapeutic product as it will have evidence-based claims, has proper regulatory oversight for your safety and protection, and is much more likely to be effective — it will do what it says it will do.

So when looking for a product for your specific skin concern ask yourself: do I want to superficially cover or enhance the look of my skin, or do I want a product that is actually going to get to the root cause of my skin concern and provide real treatment? Knowing the difference helps you make an informed choice, so look for a product with an AUST L or AUST R when you need proof over promises.