For starters, these pictures only show what the condition was before the skin care treatment and what happened after using it. Take note that there is no set time interval listed between these two, and most skin care product reviews don't really mention it either. The truth here is that, contrary to the impression that the pictures might give, using any sort of skin care product is unlikely to produce “instant and immediate results.” The pictures show the effects, but conveniently ignore the time interval that the medication needs to achieve the effect shown in the picture. It is best to keep one's expectations of the effects realistic, and not jump to conclusions about what the drug can do and in what time it can be done in.
Another thing to keep in mind is that pictures can be doctored, with everything being produced, edited, and exhibited on a digital level nowadays. All one really needs is a computer, the original picture, the right software, and a little bit of know-how. There are several programs out there that are designed for the specific purpose of manipulating pictures, and not all of them are expensive pieces of software like Adobe Photoshop. Less-than-honest businesses and skin care product reviews sites can easily slip in a doctored photo into the “after” section, making the treatment look more effective than it actually is. Another tactic is to put a doctored picture in the “before” section, with the picture modified to look much worse than the actual condition of the skin. This can make it so that the positive effects of the medication are exaggerated.
Pictures that are used in these advertisements or infomercials, even if they aren't doctored or manipulated, are taken from the best case scenarios of the product. That means that the pictures may not necessarily reflect the average user of the product, who might not have had results as good as the pictures would lead consumers to believe. It is natural to show pictures of the best results, of course, because it wouldn't make marketing sense to do so otherwise. However, people tend to take these pictures as representations of the typical result, which leads to them feeling misled and disappointed when expectations aren't fulfilled. One should keep in mind that different bodies may react to medication differently, and how effective a drug is for one person does not always reflect how effective it would be for someone else.
Finally, while it is a relatively simple matter to fake pictures or use various tricks to make the product more appealing, not all skin care product reviews and dermatologists resort to this sort of “false advertising.” While it is prudent to always exercise caution and not get caught up in the pictures, there is always the chance that the pictures are real and reflect what the treatment is capable of.