Anti‑aging products are everywhere — from retinol serums and glycolic acid peels to bee venom creams and hormone‑based supplements. But what actually works, and how should clinicians counsel patients when the evidence is mixed or limited?
In this episode, NatMed editors Jeff Langford, PharmD, BCPS, BCCP; Andrea Stafford, PharmD; and Kelly Daniels break down the evidence behind common aging‑skin ingredients and discuss how pharmacists can help patients set realistic expectations while navigating a hype‑heavy space at the point of care.
Questions we answer in this episode:
- What aging‑skin treatments have evidence to support their use — and which ones deserve more skepticism?
- How do topical vitamin A (retinoids) and glycolic acid compare in terms of effectiveness, tolerability, and safety?
- How should clinicians interpret “insufficient evidence,” and how can that nuance be communicated clearly to patients?
We also cover:
- How study design, formulation, and safety considerations (including cancer risk with DHEA) affect how clinicians interpret aging‑skin evidence.
- Why trendy ingredients like bee venom may sound compelling but lack strong clinical support.
- Practical counseling tips pharmacists can use when patients ask, “What should I try first?”
🏷️ Our listeners can get 10% off a new or upgraded subscription with code natmed1026b at checkout.
NatMed / TRC Healthcare Editor Hosts:
- Jeff Langford PharmD, BCPS, BCCP (Managing Clinical Editor)
- Andrea Stafford, PharmD (Assistant Editor)
- Kelly Daniels, BA (Content Production Manager)
CE Information:
This podcast is sourced from the NatMed March 2026 Newsletter. To claim CE credit, subscribers should read the newsletter and click “Take the CE Quiz” link to take the quiz.
The clinical resources mentioned during the podcast are part of a subscription to NatMed:
- 🌱 NatMed Pro
- 💊 TRC Healthcare
- Newsletter
- Infographic
- Monograph: Vitamin A
- Monograph: Glycolic Acid
- Monograph: DHEA
- Monograph: Bee Venom
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The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
Natural Medicines: Evidence in Practice is a production of TRC Healthcare.
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Transcript:
Introduction
Kelly Daniels
Everywhere you look, K-beauty products, social media, someone’s promising a miracle cure for aging skin. Retinol, glycolic acid, even bee venom.
Jeff Langford
And patients want to know which ones are actually worth trying.
Andrea Stafford
Or which ones deserve a little skepticism at the point of care.
Jeff Langford
Welcome back to Natural Medicines Evidence in Practice. I’m Jeff Langford, managing editor at NatMed, here with other members of our team, Andrea Stafford and Kelly Daniels. If Kelly sounds new to you, we’re excited to introduce her today. She’s another great NatMed voice, a big part of how we keep this show tuned into the questions clinicians and patients are actually asking.
Kelly Daniels
Thanks, Jeff. So happy to join you both. No pressure or anything.
Jeff Langford
Well, we’re very excited to have you, Kelly. And on this show, as you know, we cut through trends and marketing to bring practical, evidence-based guidance you can actually use.
Andrea Stafford
And quick note before we dive in today, CE Credit is available for the podcast through our monthly NatMed newsletter. So check the show notes for details.
Jeff Langford
So why is this topic about aging skin coming up now? Kelly, I’d love to pick your brain a little bit here. Part of your role, of course, with our team is listening really closely to natural medicine’s trends and helping us keep our content really pointed toward answering the questions that matter most to both clinicians and to patients.
Kelly Daniels
Well, anti-aging is a hot topic, spanning social media, med spas, dermatology TikTok, and even just mainstream beauty aisles. Patients are hearing promises about wrinkles, texture, skin renewal. And it’s often linked to ingredients that sound scientific or even exotic.
Jeff Langford
Absolutely. And that can put our clinicians in a hot seat. These aren’t just cosmetic questions that they’re coming up in settings ranging from community pharmacies to physician clinics. And we’re being asked about safety considerations, realistic expectations, and really how these products may compare to prescription therapies.
Andrea Stafford
Exactly. And while aging skin isn’t a traditional disease state like hypertension or diabetes, it is universal, which makes counseling on it important. And full transparency, this topic is important to me too. As I’m getting older, I don’t know about the both of you, but I’m starting to see those changes. And I also wonder what works. And I have fallen victim to the marketing claims and thought 10 years younger. Sign me up. But some of these ingredients have solid evidence, others have limited or mixed data, and some raise safety concerns and some are hype. And also just one quick caveat I want to bring attention to is that some of these outcomes that we are going to discuss today are patient reported, while a few report objective measures like wrinkle depth, or they use high-definition imaging to assess changes. So just keep that in mind when we kind of discuss the evidence.
Kelly Daniels
So today, Jeff and Andrew will be breaking down a few ingredients for aging skin that patients might ask about vitamin A, glycolic acid, DHEA, and something trending, bee venom.
Jeff Langford
So for each one of those things, we’re going to try to cover practical and important questions. What is it? Why are patients using it? What benefits do clinical trials actually show for aging skin? And what are the key counseling and safety points that we need to keep in mind?
Andrea Stafford
And we’ll be sticking to what the evidence shows, being clear about where the data is strong versus limited, and focusing on how that translates into real-world expectations without over-promising.
Kelly Daniels
So let’s start with one that’s very familiar, vitamin A. Patients see these products on the shelves all the time, but there’s some nuances surrounding them, right? Can you tell us more, Jeff?
Jeff Langford
Yeah, when we’re talking about skin, we’re really focused on vitamin A in its topical forms, such as retinol or retinoic acid. These forms are collectively kind of put under the umbrella of retinoids. That means they’re derivatives of vitamin A that can be applied directly to the skin. And they come in a variety of formulations over the counter as well as prescription. And people are frequently using these retinoids to improve skin health, promote cell turnover, and treat signs of aging.
Andrea Stafford
Yes. And I think it’s important too to know that prescription tretinoin is one of these retinoids that’s FDA approved to reduce fine wrinkles, hyperpigmentation, and skin roughness. However, these over-the-counter retinols aren’t exactly the same. You see, prescription tretinoin is already in its active state, retinoic acid, while over-the-counter retinol must be converted to that state within the skin. So, with that being said, as far as evidence, there are small studies that show that applying over-the-counter retinol formulas, such as a cream or a lotion, can improve fine and deep wrinkles, skin pigmentation, and or elasticity when used consistently. The concentrations used in these studies ranged from that 0.04% to 0.5%. But keep in mind that a couple of these studies lacked a comparator group.
Jeff Langford
Okay, Andrea, so let’s just kind of build on that theme. We have that evidence for retinol topicals by themselves. We also have some data for combination products. Retinol is frequently used with other ingredients like niacinamide or resveratrol. And similar to what you pointed out for the data you were discussing, these combination product studies often lack comparator groups and the formulations may vary widely from product to product. However, we still do see some improvement in wrinkling skin tone or texture. So possible benefits, but some limitations around the data. With that in mind, Andrea, what about safety considerations with these products?
Andrea Stafford
Great question. So retinoids are known to cause irritation, dryness, and photosensitivity, especially when just starting out. So counseling on how to use them does matter. We want to tell patients to start with the lowest concentration and apply it at night and wait until the skin is fully dry, kind of after washing your skin before applying. That alone can reduce some of that irritation. And then once the retinoid is dry, you can layer on a gentle hydrating moisturizer. And then over time, you can increase gradually the frequency and the concentration based on tolerance. And then just remember that tolerance is very much patient-specific, meaning some are going to tolerate it better than others. And then one key point is don’t forget sunscreen. Because of that photosensitivity, sun protection is essential.
Jeff Langford
Great. And I think one thing we want to call out here, Andrea, is really we are emphasizing topical vitamin A. Oral vitamin A is an option, but it’s really a different conversation because we do know an excessive intake of oral vitamin A can be unsafe. So focusing on topical here. And I think our bottom line takeaway is that for topical vitamin A, overall it’s going to have the best evidence for aging skin when we compare it to other topical data. If patients do want to try one of these products, we can help them set expectations. Like improvements may be modest and it may take several months to get there. And really reinforcing the great counseling points you had about appropriate use. Start low, consistently use sun protection.
Glycolic Acid
Kelly Daniels
Okay, so bottom line, sun protection and patience are really key there. Okay, great. Let’s talk about something patients might be using alongside a retinoid, glycolic acid. Most of us know this one from peels, toners, exfoliating serums. Can you walk us through the data on that one?
Jeff Langford
Yeah, absolutely. So glycolic acid, first of all, just for some background, it’s an alpha hydroxy acid. Other things in this category include lactic and malic acid. And glycolic acid is found in foods, but it’s also used in skin care as an exfoliant. And the idea here is really just to remove dead skin cells, leading to the potential for improved skin texture.
Andrea Stafford
Yes, I think it’s good to know kind of how it works. And the evidence here shows that topical glycolic acid can reduce fine wrinkles around the eyes and some other signs of photoaging. When used in short contact peels at concentrations of 20% to 70%, and that’s usually applied every two to four weeks over three to four months. Or we see that benefit as well when used in a cream or a lotion at reduced concentrations of 8% to 25%, applied once or twice daily consistently. However, just a quick uh caveat to call out one study did show that short contact peels at those higher concentrations did not seem to be as effective as applying an over-the-counter retinol cream for improving skin texture. And also just a couple of additional limitations. These clinical trials were small and they did not include a blinded comparison.
Jeff Langford
Okay, Andrea, I think it’s really important to drill down on something you kind of gave us a nice lead-in to there, and that’s the concentration of these glycolic acid products very widely, and it can be really important, particularly in regard to safety. Most patients tend to tolerate these glycolic acid products well at lower concentrations, like 10% or less. In that range, side effects are usually mild, some irritation or tingling. However, when we get to those higher concentrations, that’s where side effects can become much more pronounced and important, like bleeding, blistering, and burning. But in any concentration, glycolic acid can increase that sun sensitivity, leading to damage and raising the risk of skin cancer. So, once again, use of sunscreen is imperative, just like we said with the retinol products.
Andrea Stafford
Yes, and that’s where, as pharmacists and clinicians, we can really help. Advising patients to start low, use caution, especially when layering multiple exfoliants and/or ingredients, and again, using that sunscreen consistently. And just a quick practical pearl irritation can compound or get worse when patients stack those products. So combining glycolic acid with retinoids, especially without sunscreen, can exacerbate that irritation and compromise the skin barrier. So just use caution and kind of watch to see how your skin reacts.
Kelly Daniels
Okay, so with all those variables in play, how solid is the overall evidence?
Jeff Langford
So this is one Kelly in our NatMed database we rate as possibly effective. That’s because topically glycolic acid does seem to reduce wrinkles and other signs of aging and sun damage. But as Andrea noted, the underlying data are somewhat limited. We’re often dealing with small studies that may be unblinded. And when we look study to study, they’re often using different concentrations, different frequencies and regimens, and the formulations vary. So possibly effective is a fair space to consider this one.
DHEA
Kelly Daniels
Great. Let’s talk about DHEA next. It may not be as familiar to some patients, but it’s often marketed as anti-aging from the inside out. Jeff, can you explain what DHEA is?
Jeff Langford
Yeah, so DHEA or dehydroepiandrosterone is a hormone secreted by the adrenal gland, independently produced in the brain. And it’s been dubbed the mother steroid because it serves as a precursor to lots of other hormones, including estrogen and testosterone. Now, in the space of anti-aging or slowing aging, this one has generated some interest because DHEA levels naturally taper or decrease with age. And mechanistically, specifically for aging skin, it may work by stimulating or boosting the synthesis of collagen.
Andrea Stafford
With that beautiful pronunciation that I’m glad Jeff took, and the mechanism that he just described, kind of keeping that in mind, we can look at the clinical data and see how that may be contributing to some of the success observed with oral and topical DHEA. Some research shows that DHEA improves some skin aging, epidermal thickness, skin hydration, facial skin pigmentation in elderly and postmenopausal patients, with both the use of oral, 50 milligrams daily, or topical, which is 1% daily DHEA. Again, it’s important to note here that this is compared to baseline and not a comparator group. Additionally, just kind of highlighting that specific patient population. When we think skin aging, we think an older population, but here it was specific to elderly and postmenopausal patients.
Jeff Langford
And other considerations here, Andrea, really are that safety, once again, is going to be key to our conversation. In the DHEA space, we have studies that suggest safety with oral use, but those are mostly small and generally short term, like six months or less. Topically, again, we have data suggesting safety, but that’s typically been limited to 12 months or less. And there are concerns that higher doses or long-term oral use could increase the risk of cancer, specifically hormone-sensitive cancers like breast or prostate cancer. That’s based largely on animal data, but there are some population data that link the higher concentrations in the blood in postmenopausal patients specifically to an elevated risk of breast cancer. And we do have to think about general side effects as well. Androgenic side effects like acne, oily skin, or hair growth have been reported. These seem to be dose-dependent.
Bee Venom
Andrea Stafford
Okay. Thank you for all of that safety consideration, Jeff. And the bottom line then is DHEA shows promise for aging skin, but it’s not without its concerns. So avoid use in patients with hormone-sensitive conditions such as breast or uterine or ovarian cancer, as well as maybe endometriosis and uterine fibroids.
Kelly Daniels
Okay. We’ve covered the standard ingredients everyone knows, but social media loves a curveball. And lately we’ve seen a ton of hype around unconventional therapies, specifically bee venom. Yes, bee venom. Uh Jeff and Andrea, what do we actually know about this?
Jeff Langford
All right. Well, let’s start with the basics. bee venom is that colored liquid produced by the glands associated with the sting apparatus of a bee. It can be applied topically by injection or acupuncture or via even a live bee sting. And these different modalities are used for lots of different conditions or have there are interest in them for lots of conditions. Specifically when we think about aging skin, bee venom has typically been tried as a topical application.
Andrea Stafford
Okay, and now this is where that evidence really comes into play because if it says it works, I might consider applying bee venom topically. However, the evidence for topical bee venom has only been evaluated in combination with other ingredients, including manuka honey, royal jelly, and a blend of botanical extracts. So we don’t really know how it performs on its own. But one small study did suggest that this combination may improve self-reported skin appearance. So self-reporting and skin elasticity, fine lines, overall skin appearance. But objective improvements looking at moisture and pigmentation and texture through high definition imaging were inconsistent. And the study also lacked a comparator group. So there’s really a limit to how much we can kind of lean on these findings.
Kelly Daniels
Okay, so sounds like, you know, some people might see some benefits from this, but realistically, we don’t know what the evidence says. There isn’t a lot out there to report that it actually does help.
Jeff Langford
Yeah, I agree with that, Kelly. And I think it’s important to call out here that the safety data for topical bee venom are lacking. We know that the injections can cause allergic reactions, including anaphylaxis. And so we don’t have that answer for topical products, but probably reasonable to be somewhat cautious.
Andrea Stafford
Yes. So bottom line here, topical bee venom shows some small patient-reported improvements like we’ve discussed, but only in combination with other ingredients. And the objective data isn’t there to back it up. Until there’s more robust evidence, this one might just be hype.
Jeff Langford
Quick spotlight.
Andrea Stafford
And NatMed Pro gives you exactly that. Evidence, safety, drug interactions, pregnancy, and lactation considerations, all in one place. For example, today we just scratched the surface on skin aging and focused on products applied topically, but there is a whole other conversation around collagen peptides, which there are several studies suggesting benefit for skin aging. And also information on trending ingredients like beef tallow that patients are increasingly asking about. All of that is in NatMed Pro too.
Kelly Daniels
Plus, CE options in our monthly newsletter for ongoing updates and clinical pearls.
Andrea Stafford
And the best part, listeners can save 10% with code NATMED1026 at checkout. Links are in the show notes. Now back to the show.
Kelly Daniels
So Andrea, a patient comes into your pharmacy and says, What should I try first? What’s your go-to answer?
Andrea Stafford
I think the first place I go to is kind of zoom out to see what is available. And when you pull up NatMed Pro’s effectiveness by condition tool for aging skin, a handful of ingredients come up as possibly effective, three of which we did cover today: vitamin A, glycolic acid, and DHEA. Meanwhile, there are over 60 ingredients that fall into the insufficient reliable evidence category.
Jeff Langford
And that doesn’t mean these products never work. It usually just means the studies are small, the results are inconsistent, or the benefits may depend heavily on how the product is formulated. That can make it kind of hard for us to counsel definitively on these options.
Andrea Stafford
Yes. And then that kind of comes down to how the study was designed. A lot of this research looks at hydration or texture rather than clinically meaningful wrinkle reduction. And when those outcomes kind of get stretched into this anti-aging claim, the evidence doesn’t always support this.
Kelly Daniels
And honestly, that explains a lot of the confusion from the patient side. Nuanced study outcomes get translated into these huge marketing promises. So patients hear anti-aging, even when the evidence was never designed to answer that question. But on the flip side, similar to what we were noting with bee venom, sometimes a product without strong evidence genuinely works for someone. So a patient notices that their skin feels better, their wrinkles look smaller. And that experience can be important even if it wasn’t captured in a clinical trial. So where does that leave us?
Andrea Stafford
Yes. So thinking back to your question, what do I try first? I’m thinking topical. And I’m going to recommend topical vitamin A or glycolic acid. Those do have the strongest human data and the most predictable safety profiles. Now, are there patients where I would choose one over the other? Absolutely. If someone’s primary concern is deeper wrinkles and they can tolerate that initial dryness, retinol is my first pick. It has the strongest evidence for deep and fine wrinkles. But if a patient has sensitive skin and they are already reactive or they just can’t tolerate retinoids, glycolic acid is a good alternative. It tends to be better tolerated and works more on a surface level texture, tone, and mild fine lines. But honestly, kind of back to your point, Kelly, if a patient loves something, it’s affordable, and there’s no safety concerns, that’s okay. I’m not here to take away, or we’re not here to take away what’s working for them.
Kelly Daniels
Right. But it is helpful to make sure patients understand that more expensive or more exotic doesn’t necessarily mean better.
Jeff Langford
And we need to continue to ask those right questions to guide safe use. So asking patients about skin conditions they may have, any cancer history, what other products they’re using that may be photosensitizing, including prescription medications. So the takeaway, I think, for today is to help patients aim for realistic expectations, not chasing dramatic anti-aging promises, and really remind patients that the results may be dependent on the product formulation, how long they use it, and importantly that sunscreen use is imperative to protect the skin and reduce additional skin damage.
Andrea Stafford
Yes, and building on what Jeff just gave us, when patients ask about these products, what they really appreciate is kind of that why behind the recommendation, not just a yes or no. So, for example, explaining those safety concerns with DHEA or telling patients that bee venom, while definitely interesting, has limited evidence and has only been studied in combination with other ingredients. Kind of being able to explain that distinction is key.
Kelly Daniels
NetMed Pro, our newsletter and this podcast are around for that exact reason.
Jeff Langford
So to claim CE, follow the instructions linked in our show notes. We’ve also included links to the monographs for the topics we’ve discussed today, the newsletter article and other tools so you can bring these tips straight to practice.
Kelly Daniels
Also, in the March newsletter, we cover some other interesting and timely topics, including fiber maxing for colorectal cancer prevention, quick takeaways for patients around the new dietary guidelines, and on our most recently published April newsletter, we dive into managing migraines and protein powders.
Andrea Stafford
So follow and subscribe to this show in your podcast app so new episodes land automatically. And thanks for listening to Natural Medicines Evidence in practice, evidence not. Hype.
Jeff Langford
See you next month.
Natural Medicines: Evidence in Practice
