May 2013: Anti-Aging Skincare

May 2013: Anti-Aging Skincare


If you’ve ever found yourself wandering around a department store or cosmetics boutique, confused by the number of products that claim to turn back time and make your skin look better than ever, you are definitely not alone. Many of my patients come in with a bag full of expensive products, unsure whether or not any of them are working and overwhelmed by the complicated regimen they are supposed to follow. Patients often ask me to help them cut through the hype, and to recommend an anti-aging skin care regimen that is effective, simple, and won’t break the bank.  So here, in a nutshell, is my advice:

1. Wear sunscreen- every day, rain or shine. Yes, yes, I’m sure you’ve heard this before many times, but it really is great advice! The sun can wreak havoc on your skin in so many ways. It can greatly increase your risk of getting skin cancer, which I will talk about in a future post, but for the purposes of this article, let’s focus on the other types of damage ultraviolet light can cause to the skin. Over time, excessive unprotected sun exposure can cause fine lines, wrinkles, sun spots, scaly patches (which may be pre-cancerous), and a rough, leathery texture to the skin. As with pretty much everything else in medicine and health, prevention is better than cure, so start protecting your skin as soon as possible with daily use of a broad-spectrum sunscreen that blocks both the UVA and UVB rays of the sun. I recommend SPF 30 for daily protection, and SPF 45-50 for more intense or prolonged sun exposure (outdoor exercise, skiing, beach or sunny vacations, etc).   Two favorite sunscreens of mine that patients love are Elta Clear SPF 46 (great for acne or rosacea-prone skin) and Skinceuticals SPF 30 Sheer Physical Fusion (a good choice for both daily use and post-procedure, such as lasers or chemical peels). If you like to multitask (I know I do!), try Revision SPF 45Intellishade Tinted Moisturizer; it has a magic one-shade fits all formulation, and layers beautifully under makeup. Keep in mind that the SPF rating only gives an indication of UVB protection; we do not currently have a rating for UVA protection, so your best bet is a sunscreen that states it is “broad-spectrum.” If you only do one good thing for your skin each day, wear sunscreen. Pure and simple.

2. Exfoliate your skin on a regular basis. The two most well known exfoliants are retinoids (such as retinol and tretinoin) and  alpha-hydroxy acids (such as glycolic acid). Incorporating one or both of these compounds in your skincare regimen can result in dramatic improvement over time.

Of all the anti-aging products out there, I think retinoids have the strongest scientific evidence behind them to prove their effectiveness.  Retinoids help build new collagen, increase turnover of skin cells, and unclog pores. Translation? Fine lines and wrinkles are improved, your complexion is brighter, and pores appear smaller.  Retinoids can also help treat and prevent acne, and can help fade the discolored marks that acne can leave behind. Milder strength retinoids (such as retinol0 are available in many over-the-counter formulations; stronger retinoids (such as tretinoin or tazarotene) require a prescription.  Any retinoid has the potential to cause irritation, redness and peeling of the skin, so I suggest that you work your way up slowly to regular use. Start by applying a pea-sized amount of your retinoid cream only two nights per week, and wait at least 15 minutes after washing your face before applying it (application on damp skin can increase irritation).  After two weeks of twice weekly use, increase to three times per week for a few weeks, and increase to nightly use after that only if you can tolerate it. You will still get good benefit by sticking to retinoid use three times per week, but maximal effects may take longer to see.  Ask us about the retinoids we carry in our office: Avene Retrinal Cream, Neocutis Nouvelle, and Renova; we can help you decide which product is best for your skin type.

Alpha-hydroxy acids (such as glycolic acid) can be added to your skincare regimen along with retinoids, or, if your skin is too sensitive for retinoids, can be used in place of them for exfoliation. These acids are naturally occurring, often derived from sugar or sugar cane (glycolic acid) or milk sugars (lactic acid). These products sweep away dead skin cells on the surface of the skin, revealing the healthy skin underneath and resulting in a rejuvenated, more luminous complexion when used regularly over time. These exfoliants may also help increase the penetration of other anti-aging products into the skin, increasing their efficacy.

If tolerated, you may use a glycolic acid lotion every morning (such as Glytone Step 1 Exfoliating Lotion) and a retinoid cream every night.  Alternatively, you may do a glycolic acid peel or mask at home once a week. You should not layer retinoids with alpha-hydroxy acids because they will render each other ineffective; separate them out into AM & PM products. Make sure you use a broad-spectrum sunscreen every day (see point #1), since these products may make you more sensitive to the sun. Vivité Daily Lotion with SPF 30 is a great glycolic acid lotion with a built-in sunscreen, making it an ideal choice for morning use.

3. Fight DNA damage with antioxidants. I’m sure you’ve heard that a diet rich in antioxidant foods is good for your overall health. Similarly, topical products containing potent antioxidants are crucial for the health of your skin. Well known antioxidants in skincare products include vitamin C, vitamin E,  ferulic acid, phloretin, green tea, and coffeeberry, among many  others. These compounds neutralize free radicals created by ultraviolet light, pollutants and oxidative stress; these free radicals can damage DNA and initiate the cascade that results in skin cancer, sun spots, wrinkles, and the textural changes that are caused by photodamage.  Antioxidants are available in various forms, most commonly serums and lotions; they can be layered under sunscreen and makeup in the morning, be used as part of your nighttime regimen, or both.  We love the antioxidant serums by Skinceuticals: CE Ferulic and Phloretin CF.

4. Strengthen and repair the skin with a growth factor. Growth factors are small proteins that stimulate the formation of new collagen and elastic fibers, and promote the repair of damaged skin; use of growth factor products can improve the texture and elasticity of the skin, and minimize the appearance of wrinkles and discoloration. Neocutis Biocream is a wonderful growth factor cream that many of our patients use as a night cream, and is a bestseller in our office.

Of course, your regimen should be uniquely tailored to your skin type, and should address your specific skincare goals.. I recommend that you use the above guidelines as a starting point for building your skincare regimen, and let us help you answer any questions you may have along the way.

Thanks for reading- and stay tuned for more posts from D&A. 

Dr. Patel