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Japanese authorities have created their own laws in response to the problem that many skin care products are neither pure drugs nor pure cosmetics in the traditional sense female cialis 10 mg without prescription breast cancer 6s jordans, but mixtures of the two buy female cialis 10mg amex pregnancy stages. They allow cosmetics to include pharmacologically ac- tive ingredients discount female cialis 10mg with mastercard women's health center fredericksburg va, provided that the medicinal effects are mild and the products have been demonstrated to be safe purchase avana 50 mg visa. The legal wording leaves a lot of room for ambiguities and ad hoc interpretations that some perceive as a trade restraint discount kamagra polo 100mg without a prescription. Even a cursory look at these regulatory disparities shows the detrimental effects of not establishing uniform order 100 mg nizagara free shipping, international standards. The following exam- ples illustrate the quandaries which now exist, a situation which is bound to get nasty without an international consensus. In the United States, the following agents are regulated as drugs while in Europe (according to the European commission on cosmetics) they are sold as cosmetics. Sunscreens This classification is detrimental to industry in the United States, especially in the case of sunscreens, which are more advanced and more effective in Europe because there is greater choice of ingredients. For example, retinol (vitamin A) can be sold as a cosmetic, but its oxidation product, retinoic acid, is regulated as a drug. On the other hand, minoxidil, a drug that purports to grow hair and improve attractiveness, satisfies the basic definition of a cosmetic and is available without a prescription. Sometimes, there are too many statutory exceptions and loopholes that are downright dangerous. For example, theophyllin is a powerful drug with a narrow therapeutic index, and is used in the treatment of asthma; blood levels should be monitored frequently. Yet, this same agent can be sold as an unregulated cosmetic when incorporated in topical formulations for the treatment of cellulite. I recommend that all interested parties read the scholarly treatise prepared by Vermier and Gilchrest, respectively (6). They argue that cosmeceuticals al- ready exist and are in fact desirable as intermediates between cosmetics and drugs and that they should continue to be regarded as cosmetics. They move toward the European position and recommend that it is in the interest of manufacturers to prove the efficacy of active cosmetics. Recent papers strongly express the feelings and beliefs of major players in this field. Is it an attempt to convince the consumer that their skin care product is really a topical medicine without a proper license, or is it a genuine category that attempts to provide a mild product that has been more stringently tested than a normal skin care product? He recommends reading an official medicine leaflet as a guide to deciding what comprises a medicinal product. He considers ‘‘that the existing legal regulations are precise and clearly distinguish between cosmetic and pharmaceu- tical efficacy. They do not allow for the introduction of a new class of products such as cosmeceuticals. The piece de resistance of the cosmeceutical imbroglio is the article by Urbach (10), who states: Cosmeceuticals 7 At the moment, there is hardly a topic in the cosmetic industry as controver- sial as cosmeceuticals. From a consumer and regulatory point of view, having a separate cosmeceutical class in neither helpful, scientifically suitable or juridically necessary.