Critics dismiss these over-the-counter anti-aging creams as mere marketing in a jar.
But Dr. Jeffrey Dover, an associate clinical professor of dermatology at Yale School of Medicine, believes that's not necessarily fair.
"Price doesn't determine quality but science has really improved the quality of those products, although people shouldn't expect miracles," said Dover.
Just as the anti-aging products at the cosmetic counter have evolved, so have the anti-aging treatments changed at the doctor's office.
For years, cosmetic dermatologists could prescribe nothing but Retin-A and advise a little common sense — wear sunscreen. But that all changed in 2002. "The Botox kick started everything. We went from having nothing to having something that works well and is safe and effective 99 percent of the time. And that was the beginning of a whole new generation of fillers," said Dover.
Those derma fillers, such as Restylane and Radiesse, have revolutionized what plastic surgeons like Dr. Vito Quatela, president of the American Academy of Facial Plastic and Reconstructive Surgeons, can do.
"We are not using these as crack-fillers any more, we are using them to put volumization back in the face," said Quatela.
And instead of lasting 3-6 months, now treatments can last 1-3 years.
"We are combining fillers now. Any given patient might have three different fillers — one for around the eyes, then the lips. I can get creative with fillers, it's something like sculpture and I just never had that ability before," said Quatela.
As for the next new thing, Quatela said watch out for something called neuroablation.
"You can knock out the nerve that causes the frowning. Preliminary results have showed it to be as effective as Botox."
And liquid silicone may be due for a comeback, said Quatela. "It got a very bad rap when breast implants were taken off the market but I know that behind the scenes there are investigations and studies with liquid silicone once again and it could be a permanent filler for the treatment of certain acne scars or lip augmentation."
Breakthroughs may grab the headlines, but dermatologists like Jeffrey Dover still counsel the basics.
"For the most part I try to make it really simple. Wear a moisturizing sun-screen and use a prescription-strength retinoid. We know that reverses the signs of chronological aging," said Dover.
And reversing those signs of chronological aging is a booming billion-dollar business with no signs of slowing down any time soon.
"I think going forward we are going to see stem cells play a future in this. There's a lot of work being done right now. If people are provided with stem cell therapy, either topical or internal, then the rejuvenation of epidermal cells may be just a few years away. We're not there yet but some exciting things are being done in Belgium and Thailand," according to Dr. Sharon McQuillan, a board-certified physician who is affiliated with the American Academy of Anti-Aging Medicine.
"We are just starting to make inroads into the idea that we can encourage skin health. We learn in medical school that our skin is the largest organ in the body and yet we consider it an envelope, and we don't treat it as we should," said Dr. Sharon McQuillan.
Maybe with a little help from science, that's about to change.