Hi, beauties. Before we get into today's show, I wanted to take a minute because for those of you who've been listening for a while, first of all, thank you so much. But you will notice a small change in the top of the show today. And that's because when we started the show in 2018, we really wanted a place where we could talk honestly and candidly about beauty without having brands pay us to say, well, what they wanted us to say. And when we started, we were having fun.
It was a passion project and we came up with this tagline, The Real Truth about the Fake Shit. We were talking about plastic surgery. It was a lot of fun. But since then, and almost over 200 episodes later, we realized that we're talking about real stuff and stuff that's really important. And so we are tweaking our tagline a little bit to be always reaching for truth and beauty. Why is that important?
Because the brands are still not paying us to be on the show and that allows us to have these candid conversations with experts, with founders about everything from products to technologies and everything in between. And I hope that you will appreciate this new change. I think it's just a small tweak in our evolution of bringing you content that matters because at the end of the day, we want you to be informed so you can make the best decisions for yourself.
And I couldn't kick off this new branding them with a better, more exciting guest. We are talking today to the founder of Citrus Labs about clinical testing, how we can understand that, how we can see through the claims. And I think you're going to love it. So thank you so much for your continued support. Enjoy the show. This is the Art Beauty podcast, where we are always reaching for truth in beauty.
Now remember, this is an UNsponsored podcast, which means the brands who are on here are not paying to be on here, which allows us to have honest and candid conversations because at the end of the day, we believe you deserve to be informed so you can make the best choice for yourself. I'm Amber, and today my fabulous co-host is Suzanne Mitschke, she is the CEO and founder of Citrus Labs. And I could not imagine having a better show to kick off our new branding with than with you.
Suzanne, thank you so much for being here. Thank you so much for having me. I'm really excited. So, you know, part of this, you know, ideas, when we started this podcast, we wanted a space where we could talk candidly and honestly with brands like yourselves, you know, about the products.
But one of the things that is so fascinating why I'm so excited today is because so many of us who have bought a product, who've done any even like the most basic research on a product, have seen the term clinically proven, clinically tested clinical trials. You know, and in the spirit of education, I'm so excited to have you on because Citrus Labs is where a lot of these clinical studies happen. Correct. For beauty. Yeah, that is correct.
So basically what we do, what Citrus Labs does as we conduct clinical studies on behalf of consumer brands like skincare, we also do supplements, superfoods, devices, and then we help these brands to actually make research backed product claims. And the prime example of our work is a claim like 75% reduction in the appearance of fine lines and wrinkles. Right? And so we've all heard these before.
And what I'm hoping today is for us to talk a little bit about what that process is with you so that we know how to sort of interpolate that data, how we know how to make sure that that's data that we want to follow. Also to talk about the difference between things like clinical perception studies and then also like clinical research studies and kind of understand a little bit more of the claim. So let's get right into it.
When a company approaches you like a skincare company, what goes into doing a clinical study? What goes into doing this clinical research and making those claims? Yeah. So if you specifically look at the cosmetics, the beauty space, beauty has conducted clinicals since forever.
And typically what you need to launch a brand is obviously a product, you need a website, you need to pick it Instagram account and typically either a clinical trial or a consumer perception study to then substantiate product claims. And at this point, most of these brands have clinicals attached to them, which is, as I mentioned, either perception or an actual clinical trial in most cases for cosmetics.
So it is a perception study and I'm happy to talk a little bit more what the difference is, because I guess what you're probably interested in. Well. Well, you know, before we get into the two types of studies, you know, I know that, you know, beauty, cosmetic, skincare, it's it's a highly sort of unregulated industry.
However, from what I understand now, I used to work with Murad, and I know that working with QVC, QVC takes its clinicals and making those claims very seriously, and especially when it comes to marketing, if you're going to make a claim, there has to be it has to be substantiated. Right? So where. Yeah. Okay. So that these clinical you know, when you're when you're talking about clinicals and we're going to talk about the difference between sort of a a clinical study and a perception study.
But they have to they have to have actual like truth and science and fact behind them, Correct. They should have, yes. Okay. Okay. But they don't have to as a regulation on that there. So there is a new regulation called MACRA. I think it stands for the Modernization of Cosmetics Regulation Act. And it's actually the first change in regulation of these personal care products since I think it's 1938. So since a very long time.
And now we are seeing in this new regulation actually mandatory safety substantiation. But at the same time, the FTC actually also submitted new regulation around how to actually substantiate claims. So that is very interesting now. So you actually have to have four claims substantiate, you have to have clinical backing. But then obviously the claims you see, we don't know if you know, in most cases we don't know who conducted the study.
We don't know how big the sample size was, and we don't know if they might have done some statistical calculations in the background, maybe left out some groups. So this is all, you know, not regulated. Okay. So let's get into, you know, let's start at the beginning, because I I'm assuming that everybody else is is fascinated with this as I am. So when it comes to, you know, clinicals, what are the different types of studies that brands can be doing right now?
Yeah. So clinical trials in cosmetics, research studies that evaluate if a product works and basically does what it's supposed to do. For example, I have four months to research the goal of a moisturizer. It's to hydrate and maybe I want to make some claims around obviously hydration, maybe even fine lines, wrinkles, skin texture, glow.
So the clinical study then would assess, obviously, first and foremost hydration and then also would look how fine lines and wrinkles develop, how my skin texture changes. And also if I get a nice glow now, you know, clinical trials and clinical trials, especially in skin care, I see that clinical trials and consumer perception studies are actually often used interchangeably. But you know, as we already established, there is a huge difference.
Clinical trials typically involve objective data measurement. For example, they involve a skin analyzer that objectively measures things like wrinkles, fine lines, hyperpigmentation, sensitive skin parts seen in rosacea, for example, usually damage brown spots. Skin monster Objective data measurement can also happen through instruments like a corneal reader, a tattoo imager or to a meter. And then there's also expert skin grading done by a dermatologist, which also is objective data measurement.
And then typically clinical trials involve statistical data analysis, and then you can make claims like significantly improve skin hydration. Right. And also, if you test if you test to protect against a placebo, you can also see increases hydration by X percent, significantly greater than a placebo. But testing against the placebo is very rare. Unfortunately, in cosmetics. And then we have perception studies, perception studies as more subjective.
They only involve questionnaires and frankly, there can also be a huge difference in these questionnaires. For example, a higher standard is when you have a questionnaire that uses the like hard scale from 1 to 5 and you have, for example, the question how would you rate your dark circles under eyes and then go number one, not noticeable. Number two, barely noticeable. Number three, mild, number four, moderate. And then number five, severe. Then the same question, can we ask in a different way?
You can ask, do you agree or disagree that your dark circles under eye improves and then you go 1 to 5 from strongly agree to strongly disagree?
And, you know, basically that gives you better change a better chance to have like a claim like X consent decree that they're under I dark circles improved and then you have actually a third option for question you can do like do you agree that your dark circles under your eyes improved compared to when you first started using the product and then you just have yes or no? Right. And typically the best questions that I always have to smile on is when they are around hydration, right?
When you have a super hydrating moisturizer and then ask like, do you agree that your skin gets more hydrated after using that product? Of course any person would say yes. And then you have these claims that stayed like 100% of participants agree. You know, you bring up a good point. Is there any way So just I want to make sure that I'm clear. So a clinical trial is something that is generally more scientifically backed about collective data using scientific measurements.
I know we had Dr. Murad on the show once. He talked about a product that he was doing that actually did skin puncture like a skin punch stance, and they were looking at this under a microscope. So so those are really scientific claims versus the consumer perception, which is not that they're not important, but then have maybe a greater degree of variability. Is there any way for us to be able to read into those and decipher them?
Yeah. So, you know, first of all, when something sounds too good to be true, it typically is. But generally when when I see something that states 100% sets and 100% accrete to me, this is a super, super red flag. And of course, you know, their products achieve all of that in 2 to 4 weeks. To me, I highly doubt that, especially as our skin typically needs about 30 days to show any results because that is how long, you know, skin cells turn over.
The exception isn't moisturizer you pretty much told me to be if it if it helps, if it works or not. But interestingly, for for me and also my work is that most of our clients actually met when they don't get results, the high 92 or even 100% claims. But then when you look at a company like Skinceuticals, for example, they are like the Holy Grail, right? The super science forward brand, their C Ferulic, which I think is their bestseller, that vitamin C serum has results in the 20 to 30%.
And that is something that I can get behind. Like 30 something percent said that their firm is increased, 30% reduction in the appearance of wrinkles. These are like results that are actually coming from clinical studies and that's great. And they like a 30% decrease in fine lines. Wrinkles is actually really, really meaningful. Yeah. Now I go, so it's funny, I get to go. In my career, I've gotten to go to a lot of different launch events.
I see a lot of the time with, you know, these noninvasive procedures. And sometimes I'm they're looking at their before and afters and I'm like, well, okay, you know, her neck in one picture it was like this. And then the other one, yes, of course, it looks a lot better. Or, you know, you can tell like sometimes they're hunched over, so her stomach looks a little more flabby and then she's standing up straight. You know, I think braids have gotten better at this.
I'm talking about like, you know, 15 years ago, I used to go and be like, really? Are you trying to pull that over on us? But, you know, nowadays I will see a lot of these studies. And then sometimes, you know, looking at the sample size, that's important to. Right, because sometimes they'll see something. And it's like in a study of 20 people, 100% said this, but it's 20 people. Or is that kind of a normal sample size? I think 10 to 20 people is quite low, obviously.
And so each study should have a power calculation and, you know, to basically get to choose the sample size that you can make statistically significant claims. But training people seems fairly low.
But typically that is again, what we see specifically in perception studies and also it's funny that you mentioned before and after photos, often when we work with brands, they are coming to us with examples from other brands and they tell us, I want professional before and afters and I want them to look like this. And then we look at the photos and they clearly show a model and they were clearly taken in a studio and the results are obviously amazing.
It's like, you know, a person has severe acne and then, you know, 12 weeks later, all of their pitfalls are gone. Right. And, you know, it basically gets sometimes to a point where I think the the ethics of running an objective clinical trial or even a fairly objective perception study are a little stretched. Gosh. So, I mean, is there anything that a consumer can do? You know, you we hear these terms and of course, they sound really powerful.
But like, you know, I know you said if it you know, maybe if it sounds too good to be true, it might just be. Is there anything else that we can be looking for? So we try to push our clients to be more transparent. And I think the more transparent the brands are, the better they are, you know, because looking at looking at study results, right. Most of them put something on their website like, you know, based on a third party clinical trial. But again, who conducted this clinical trial? Right.
Is it is it like, well, the qualified people that were actually third party or was it your cousin was a dermatologist or was it a marketing agency that, you know, self perception studies and markets them as clinical trials? So we are really pushing our clients to actually tell who the studying in this case study results.
And then also if it was a clinical study link to the clinicaltrials.gov page, which is basically a history where all clinical trials are registered and then anybody can read about the methodologies, right? Methodologies meaning, you know, what kind of assessment was used? Was it a skin analyzer? Was it an instrument? Was it expert skin creating done by a dermatologist?
And also talking a little bit about, you know, questionnaires, because all studies involve questionnaires even when they are clinical trials that also include objective data, they also include questionnaires. You know, how are these questionnaires structured, for example? And that's, you know, gives you as a consumer more transparency and also gives you a chance to interpret these results. So now does every clinical trial have to be registered on clinicaltrials.gov?
Unfortunately, there is no law, no regulation. That's, you know, basically because it's cosmetics, Right. Cosmetics don't need to don't need to get registered. But for me personally, I think it's best practice. We talked previously a little bit about MACRA right. That that new regulation that came out and I think it's a step in the right direction but especially for, you know, consumers transparency, making misleading false claims.
I think they really need to, you know, push it more towards we have the good manufacturing practices. Maybe we also need good clinical trial practices. Yeah. You know, it's funny, too, because I know when it comes to claims legally like brands, you said at the beginning, this can improve the appearance of longer fuller lashes. They're not saying it's going to give you longer fuller lashes because they can't necessarily guarantee that. Right. But they also.
Are not allowed to do that because that's a claim. That's a drug claim. Got it. Okay. So so what what what is the drug claim entitled? What does that for example? Oh, yeah. So, for example, acne. Acne is a skin condition. Acne is the health condition. And you cannot say if your cosmetic you cannot say that this product reduces acne. That would be that would be a health claim and that is flagged by the FDA because now you are basically falling under FDA regulation.
But you can say it reduces the appearance of ethylene. Wow. And so I guess because I see that in a lot of like hair growth serums or like, Oh, yes, because I guess hair loss would be a medical condition. Alopecia. It is a medical condition. But I can make those claims. They don't look at aging and wrinkles as a medical condition. No, that is not a medical that is just, you know, our body doing start it. Got it. So, you know, I mean, I feel like this is so fascinating. Do you have any thoughts?
So some cosmetic brands are actually owned by medical companies. So I know, you know, Skin Medica is one of them. And I know that they have to be very careful about the claims that they're making because they, as a brand, do fall under other regulations of the FDA, that they fall under. Yeah. You know, I think it really comes down to so we actually work with with a law group that is only focusing on these claims for cosmetic companies and also supplement companies.
And they always tell everybody that it always comes down to the risk profile of a brand. So I'm friends, you know, don't worry about the FDA sending them a warning letter because they can make that fine. Right. But once they are penalized, they have to pay a fine and then, you know, they can make that with that claim in like a week or two. And it's fun, right? But other brands are a little bit more conservative when it comes to how they are making claims.
And I think most of small brands are conservative. How they are making claims. And then you see the appearance claims.
The thing is that, you know, also how the claims are phrased does not necessarily show you if it was a clinical it was an actual clinical trial or a perception study, because again, coming down to the risk profile, we have many clients that, you know, decided to invest in a full clinical trial, sometimes even with the placebo risk and analysis instruments and expert skin craving.
But their claims still look as if they would have conducted a perception study just because this is how they decided they are appraising their claims. So how so? Because I feel like the perceptions are like 99% of consumers. They generally say, well, how wouldn't they take a clinical one and make it sound like a consumer one? Like, for example, 50% showed a 50% presented threat. Instead of saying, you know, 20% reduction in wrinkle. Got it. Oh, my gosh. So this terminology is is nuts.
You know, I have to ask just as know a fellow consumer, are there brands that you really get behind or you love to say. Yeah, I love most of our brands. But are these brands that you do the study with? Like you don't have any they're hiring you right as a third party. You don't have any sort of affiliation or anything to them, Correct? Okay. We don't have any affiliation. Obviously.
I do test a lot of these products myself, and I do have a lot of friends that I love and that I probably would not have, you know, bought in Sephora if I would have seen them. But so some of our some of the brands we work with, they are really science forward and they have really, really good products. Well, tell us, I mean, let's get on that. Are you allowed to tell us some of them? Yeah, Yeah. Of course, of course.
So one of my favorite brands is actually called Common Air, and they are clean beauty. I think right now they've three products. They have vitamin C, then they have retinol, then they have that product it and fortunately just forgot. But they are retinol is amazing. The vitamin C is really, really great. And all of that is also clean, clean packaging, you know, plastic. There they have the portions basically cut my little capsules. Okay?
And it's like super easy when you travel a lot and it gives you right the exact amount you need for your face and neck, which is awesome. Then another one we we love with tremendous results and say beauty, for example, they are, I think, a makeup with skin care combined brand and you know, we love our makeup that also has that also nourishes skin or is amazing. Yeah other brands we really like for example naked puppy they they have amazing amazing product.
Another brand we recently worked with, they only have one product so far. It's called a super light skin. They are entirely new on the market and their moisturizer is nuts. Oh really is probably one of the best. It's actually a zero moisturizer, zero hydrating serum and you know, just from I remember when I first used it on my skin, I was like, wow, that is an amazing, amazing product. And here we had the same.
So they actually went through a full clinical study with implementation, with expert skin grading, and their claims weren't in the 100% because you don't get that right in an objective study. There's no way that your fine lines and wrinkles will improve by 100%. That's just impossible, right? And they were quite you know, they were happy with the process, but quite unhappy with their claims.
But then when we showed but this is what skinceuticals, you know, the science forward brand Skinceuticals says. So then they were like, Oh yeah, that is actually true. So yeah, because we conducted a clinical study and not a perception study that makes a ton of sense. So again, you know, if I see claims that I, you know, percentage wise too high for me, that's the super red flag. Oh man, I kind of want to send you a whole list of things that I'm like, What do you think about what?
We're not going to get into that now. You know, I want to think because I feel like this is something that, you know, hopefully I feel like the world is shifting. Consumers are brands are certainly getting more transparent. And a lot of that has been because of the consumers. Consumers are more educated. They know how to look. They're doing more research. They talk a lot more. We all talk a lot more. Social media has sort of been the great equalizer in a lot of that.
But then certainly it helps to have experts like yourself on, you know, who are really have that third party view and who also have the scientific backing to say yes or no. I feel like I could talk with you for hours about this, Suzanne. But, you know, in the interest of time, if people want to know more about citrus labs, if they want to know more about what you do, if they want to know more about maybe some of your studies, is there somewhere they can go? Yeah, absolutely.
Just check out w w w dot citrus dot com. And we are always looking for volunteers for our studies. There is a prescreening process and also not everybody gets enrolled. But yeah, if you're interested in becoming a product tester, a subject for a research study, then you can also send an email to hello at Citrus Lipscomb. Or find out before you do these. Like so as a lab, do they have to have some safety protocols before your calling people in to try this? Yeah, absolutely.
So clinical studies are typically approved by an IAB, an institutional review board that is reviewing studies based on if they are ethical, if there are any risks involved for participants. And then once they are approved, the study, then after that we start recruitment. And then obviously for each study there's an exhaustive set of inclusion, exclusion criteria. And based on that, we then screen participants and enroll participants. Amazing. Now, is this only your base?
I love this to your citrus Labs is based in Los Angeles. We are based in Los Angles. Most of our studies conducted nationwide, though. Oh, okay. Oh, great, great. Amazing. Hey, listen. Maybe sign me up. I'm excited. Maybe sign me up. If there's something that you think is really, really promising. I. I want to thank you, Suzanne, so much for being on here. I'm going to make sure to get that list of the brands that you work with to put in the show notes.
The people can go and check those out for themselves and just thank you so much for being on today. I feel like this is so fascinating and I hope that people just have a little bit more information and a little bit more of that inside information to again, be able to make these choices for themselves, to be able to decipher some of the data that we're seeing out there. Yeah, that was a lot of fun. Thank you so much. Thank you.
And of course, if you the question you want me to pass on to Suzanne or her teammates at your lab, I'm always happy to do that. You can email us at hello at art beauty podcast dot com. You can find us on Facebook Instagram and of course YouTube @ArtBeautyPodcast. And as always, we will see you next Tuesday. Hopefully a little bit smarter. Bye.