A new name in skin care: Johns Hopkins

The clear pitch to consumers is that the products' performance is backed by science, not merely beauty hype. Behind the promise is an extraordinary pact between a New York company, Klinger Advanced Aesthetics, and Johns Hopkins Medicine, an umbrella organization made up of the university's health system and medical school. John Hopkins's name is prominent in product displays and in online descriptions of the products, which are sold by Sephora, a unit of LVMH Moet Hennessy Louis Vuitton.

The connection is raising ticklish questions about the venerable medical institution's role in creating and selling a commercial beauty product. It's a line that the university has never crossed before. "It has been a big deal for all involved," says Frederick Brancati, a professor of medicine and epidemiology who championed the Cosmedicine-Klinger relationship. Prof. Brancati says he worked to overcome significant faculty opposition.

One factor motivating Johns Hopkins Medicine to enter the relationship was its need for funding for its traditional research and teaching mission. "That is what sold it for me and to the leaders around the institution," Prof. Brancati said. "We have to be inventive and creative," he adds, because conventional funding sources are declining.

He and other officials declined to disclose the fees Johns Hopkins Medicine received from Klinger or to estimate how much revenue the venture may one day bring. Klinger, a unit of a publicly traded company, TrueYou.com Inc., plans to give the institution a yet-to-be-determined equity stake.

Edward Miller, chief executive of Johns Hopkins Medicine and dean of the School of Medicine, says that Johns Hopkins isn't endorsing Cosmedicine product: "We have been pretty clear about our role. We are reporting on the scientific validity of studies that were done by outside testing agencies."

But at least one medical ethicist says Johns Hopkins is walking a tightrope. "I can't find any evidence of a school that has associated itself with a product line in this way," says Arthur L. Caplan, chairman of the University of Pennsylvania's Department of Medical Ethics. "Unless you have acute vision and a lot of time to read (the small print), this is going to look like a product endorsement."
Dr. Caplan says Klinger's plans to give Johns Hopkins equity in the company raise a red flag. There aren't many rules for managing conflicts of interest in the academic world, but it is a clear violation to "study what you own," he says. Johns Hopkins emphasizes that its role -- evaluating clinical trials done elsewhere -- doesn't constitute research. That's "a difficult stance to reconcile," Dr. Caplan says.

Dean Miller says the institution scrutinized the deal to make sure it didn't represent a conflict between financial and research interests. Johns Hopkins scientists who are validating the Cosmedicine studies don't own any equity in Klinger, he says. About 10 faculty members who are working on the project have received consulting fees from Klinger.

The relationship goes beyond skin care. Johns Hopkins also will work with Klinger to develop clinical "best practices" for the company's chain of spa-clinics. Klinger has 12 such facilities in major U.S. cities and is rolling out new ones this year. The clinics offer salon treatments and "light medical" services, such as Botox and Restylane shots. Johns Hopkins also has designed an 11-week training course for nurse practitioners at the spas.

Prices for Cosmedicine products range from $28 for a 0.36-ounce lip "plumper, hydrator and exfoliator," to $85 for a one-ounce skin "fortifying serum." Invoking the 130-year-old medical-research institution's reputation puts Cosmedicine into direct competition with such "cosmeceutical" brands as dermatologist-owned N.V. Perricone M.D. and M.D. Skincare. The makers of many skin-care products have sought to sound more serious and scientific, but most are regulated as cosmetics. In recent years, several cosmetics companies have drawn regulatory warnings from the Food and Drug Administration because of unsubstantiated product claims, such as "reduces deep wrinkles up to 70 percent."

Most of the Cosmedicine products are classified as over-the-counter drugs because they contain 1 percent of the ingredient Dimethicone. Cosmedicine's Opti-mologist PM eye cream, for example, boasts of a "24 percent increase in hydration." Backing up its claims, Klinger says, are the clinical studies designed and evaluated by Johns Hopkins.

Rich Rakowski, Klinger's chief executive and an investment banker, says he started the product line partly because he found anti-aging claims being made in the marketplace "frivolous and ridiculous" and recalls thinking, "What if we approach this through the lens of healthy skin and not anti-aging?"
The company adopted what he calls a "healing strategy" for its products. Klinger is "trying to create the solution to a void in the market," Mr. Rakowski says. "It's a gray area we're trying to fill in on. We don't see our product as a cosmetic. We're trying to address health."

In 2004, he and other investors acquired the Georgette Klinger beauty salons and rights to the brand name. Klinger Advanced Aesthetics aimed to offer products and services with "measurable" benefits for consumers and Mr. Rakowski approached Johns Hopkins to help design such tests. He says he expected "they would laugh me out of my office." But after much discussion and debate, the institution ultimately gave its blessing to a deal.

Starting last year, in February, a Johns Hopkins panel worked with Klinger executives to figure out what kind of safety and performance claims could be measured in scientifically valid clinical trials. The Johns Hopkins experts didn't test the products, but did design the tests and, starting in August, evaluate the results. "We ... told them that whatever they wanted to say in their marketing and information materials had to conform precisely to the data," according to a Johns Hopkins statement.

The executive committee of the Johns Hopkins Medicine board of trustees gave Klinger final approval for use of the Johns Hopkins name on the products in January.

"The ability for Klinger to use our name and acknowledge our scientific contribution is a line that had never been crossed before," says Steve Libowitz, a senior administrator at Johns Hopkins Medicine. "We think we are in a relationship that will provide safety to the public" in a rapidly expanding field, he adds. "It's not cancer or coronary care, but it's where the people are."