Elixir of youth comes with an eye-watering price tag

Prevage, which costs US$100 ($135) for 28g, and was launched two months ago by Allergan, the makers of Botox, has fast become the beauty substance of desire.

The magic ingredient is idebenone, one of the most effective topical antioxidant products available.

It is so potent that it is used to protect organs from environmental damage during transplant operations, slows the progress of Alzheimer's disease and stimulates nerves in stroke victims.

So who wouldn't want to use it to reduce their wrinkles?

Antioxidants are substances that protect cells from the damaging byproducts, called free radicals, of environmental stresses such as UV light, smoke and air pollution.

It's not the first time antioxidants have been used in face creams: vitamins C and E are widely used, and Coenzyme Q10 is an ingredient in Q10 Plus Wrinkle Control products by Nivea.

But, says the pharmaceutical company that created the Prevage formula, idebenone is the first and only clinically tested antioxidant.

A study involving 21 women aged between 18 and 65, who had moderate premature ageing of the skin and used the cream twice a day for six weeks, found a 29 per cent reduction in the appearance of fine lines and wrinkles, a 26 per cent reduction in skin roughness or dryness, a 37 per cent increase in skin hydration and a 33 per cent overall improvement in the appearance of skin.

Further research, conducted at the University of California in Los Angeles, found it reduced sunburned cells (skin cells that die from UV exposure) by 38 per cent, while the use of tocopherol, a form of vitamin E, resulted in only a 31 per cent reduction. It also outscored its rivals in several other tests.

Prevage, a non-prescription cream, is now available from about 1000 dermatologists' and plastic surgeons' offices in the United States.

Allergan says it decided not to sell it over the counter so consumers can receive advice on whether it is the best product for them.

Samples were included in the goodie bags for the Screen Actors Guild awards, allowing award nominees Cate Blanchett, Teri Hatcher and Hilary Swank to bypass the waiting lists that have sprung up across America.

Dr Andrew Scheman, an associate professor of clinical dermatology at Northwestern University in Chicago, had a waiting list of 25 people at his private practice in the first two weeks it came out. And, despite the hefty price tag, he sold four dozen bottles within days of receiving his supply.

So does he think that Prevage does what it says on the bottle?

"The trouble with the antioxidants is that, although the concept is good, many of them work better in a test tube than they do on humans," says Dr Scheman, who isn't on the Allergan payroll.

"It's very hard to get one that actually gets absorbed into the skin and does some good. Many products sound good, but are nothing but snake oil ... Allergan does have good data that shows that Prevage really gets into the skin and it does have a protective effect against ultraviolet light in humans.

"I was actually rather impressed with the data."

But one or two of his patients have complained about the yellowish-orange colour. "If you put it on too thickly it can discolour skin," he says.

Dr Nick Lowe, a consultant dermatologist and senior lecturer at University College Hospital, London, and clinical professor of dermatology at the UCLA School of Medicine in California, has also been using Prevage with his patients in the US.

"It's actually one of the better antioxidant topical creams. It's doing very well in the United States."

Dr Lowe, author of Away With Wrinkles, says he recommends the product as part of an overall skin-care programme.

"Often, I recommend that patients use it in the daytime, or on alternative nights, as an antioxidant. As part of a routine skin-care programme I would recommend applying a good sun-protection cream in the morning, and then using the idebenone once the sunscreen has fully dried.

"If you want to prevent further sun damage, I would recommend using one of the retinoid creams in the evening. These are vitamin A derivatives, and they stimulate increased cell turnover, outer skin renewal, and new collagen and elastin formation."

He welcomes the fact that the product's availability is restricted.

"It's no good just having someone sticking on an antioxidant cream. The idea of going to the dermatologist is that they will give you the correct information on what else you need to be doing."

So when will overseas youth junkies be able to get their mitts on the cream?

"Right now, we are focusing on the US," an Allergan spokeswoman explains, "but we are going to be considering bringing it abroad in the future. It's been doing fabulously. It's been flying off the shelf."

In the meantime, beautyholics travelling to America might want to consider booking themselves an appointment with a dermatologist.

The new botox

* What is it? Prevage is a new anti-wrinkle face cream from Allergan, the makers of Botox.
* How does it work? An ingredient called idebenone protects skin cells from the damage of UV light, smoke and air pollution.
* Who's using it? Hollywood stars have been given free samples. Other Americans have to ask their dermatologist or plastic surgeon - and the rest of the world has to wait.
* How much does it cost? About US$100 ($135) for 28g.

- INDEPENDENT