Celebrity American dermatologists are using their skills and prestige to sell anti-ageing, wrinkle-busting products both in pharmacies and in their surgeries. “The whole sector is exploding,” says Dr Bruce Katz, who sells products from his office. “Cosmetic companies are rushing to get aboard. They know this is the next big thing.”

But bioethicists worry that doctors will put profit ahead of their patients’ welfare. “You’re going where the money is,” says Dr Arthur Caplan, of the University of Pennsylvania. “If my doctor is an entrepreneur, maybe I don’t want that guy to be my dermatologist.” Certainly the marketing of so-called cosmeceuticals is a potent mix of the austere dignity of science with the seductive glitter of Madison Avenue: sober packaging, photos of white-coated doctors, scientific- sounding names…

The American Academy of Dermatologists says that doctors should sell products directly to patients “in a manner with the best interest of their patients as their highest priority”. The bar set by the American Medical Association is even higher. It stipulates that doctors should minimise conflicts of interests and disclose the nature of their deals with manufacturers. However, doctors who are paid to market creams and lotions say that they do not see this as an ethical problem.

Dr Katie Rodan, of Stanford University School of Medicine, and a leading figure in Estee Lauder’s Rodan + Fields wrinkle creams, defended her role. “The only reason we were able to create a product… was because of our training and experience. We’re not making pizza sauce and claiming that it is going to treat cancer.”

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