Decoding the Fountain of Youth

One Dermatologist’s perspective on the most frequently asked questions regarding skin care.

What products should I be using to keep my skin looking young?

Contrary to what the cosmetic industry would have you believe, there is no magic fountain of youth cleverly disguised as a bottle of moisturizer at the cosmetic counter at the mall. The StriVectins and Lancôme products often do not contain secret ingredients, just high price tags.

The most effective way to maintain youthful skin is to avoid the accumulation of damage to the skin caused by solar radiation. UVA and UVB rays of sunlight can cause collagen to break down at a higher rate than normal aging, thus leading to premature aging. These rays also cause the development of brown spots and pigment irregularity that generally appear on sun-exposed parts of the skin. In addition to pigment changes, sun damage can make our skin age prematurely and increase our risk of developing certain types of skin cancer. A priority for any effective skin regimen is the daily use of a good sunscreen product with SPF 30 or greater covering both UVA and UVB rays.

Despite even the most diligent attempts at wearing proper sunscreen, skin damage does accumulate. Products such as Retin-A and Retinol have credible scientific and clinical data establishing the ability to make valuable and measurable effects on the skin’s production of new collagen and elastin. Additionally, the active ingredients of these two products can slough abnormal skin and even out the pigment irregularities that accumulate with time. Ultimately, these products are the most proactive means of addressing solar damage and the accumulation of free radicals in the skin. Given the ability of one’s skin to tolerate and accommodate these products, I utilize them as the workhorse in a skin care regimen.

Finally, a proactive skin care routine should incorporate a gentle cleanser and a moisturizer with active antioxidants. Although these products cannot solely salvage years of accumulated sun damage, they do help decrease the accumulation of oxidative stress that results from pollution, solar radiation, ionizing radiation, inflammation, and metabolic stress, along with the natural aging process.

What is Retin-A? How does it work? Should I be using Retin-A?

Retin-A is a general term used to refer to prescription products that contain the active ingredient tretinoin. Tretinoin can be combined with different delivery vehicles and at varying concentrations. These combinations are labeled with trade names such as Retin-A Micro®, Renova®, and Atralin®.

The benefits of any product containing tretinoin come directly from the properties of tretinoin. This molecule can penetrate the skin barrier and bind to specific skin cell receptors. The ultimate effect is increased elastin and collagen fiber production and stabilization of normal skin activity. This helps your skin look younger and healthier with fewer fine lines. It also speeds up the turnover of the skin, thus preventing the accumulation of abnormal cells. These beneficial effects are not linked to the concentration of tretinoin. Several studies have shown that increasing concentrations only increase side effects such as redness and peeling but does not add to the beneficial effects.

I consider tretinoin the workhorse of a good regimen; however, it is not tolerated by all skin types. For most, tretinoin can be successfully added and tolerated if incorporated slowly into a regimen. I recommend starting off using the product once weekly as this allows the skin to transition smoothly. There are some skin types that will still be continually plagued by redness, skin irritation, skin sensitivity, and intolerable peeling. It may be more beneficial for these skin types to start with a mild, non-prescriptive form of a retinoid called Retinol.

Retinol does not provide the same degree of effect on the skin as tretinoin due to the difference in its molecular properties. It is valuable in smoothing out pigment irregularities and is likely to affect collagen and elastin fiber production positively. The benefit to this product is that it can be found over the counter and is usually easily tolerated. I would still recommend slow incorporation into one’s weekly regimen.

What are antioxidants, and should I be using them?

The cosmeceutical industry has begun to bombard the market with products containing higher levels of antioxidant ingredients. These ingredients aim to scavenge skin free radicals resulting from daily exposure to radiation, pollution, sun, and general aging. It is believed that the accumulation of these free radicals leads to skin cell DNA mutation, loss of elasticity, and pigment irregularities. We know the skin has the intrinsic ability to scavenge these free radicals to minimize the accumulation of cellular damage. However, we believe many of these intrinsic mechanisms are overwhelmed by the numerous assaults on the skin by modern lifestyles and the increasing number of pollutants in today’s world. The cosmeceutical industry is attempting to mimic the body’s natural occurring mechanisms.

Many of these synthesized or purified antioxidants have proven effective in the lab; however, not all products are created equally. Consumers should be aware of expensive products with little data to substantiate their claims. More reputable companies have developed delivery systems that enable these antioxidants to penetrate the skin barrier at an effective concentration within the skin.

As noted before, I do not believe that one antioxidant can cure all of the damage accumulated over the years. I find great value in incorporating these products into general skin care maintenance. There are many of these products available, and each has its area of proficiency. I would encourage consumers to discuss these products with a trusted Dermatologist or Cosmetic Specialist to ensure that the most effective and appropriate product is chosen for their skin type and areas of concern.

If you are ready to delve into how these products can help maximize your skin care routine, make an appointment with one of our Providers at Advanced Dermatology & Skin Surgery.  We have four locations to serve you. Book an appointment here.

About Our Provider

Staci Hestdalen, M.D., FAAD – Dr. Hestdalen is a Board-Certified Dermatologist specializing in Medical Dermatology, skin cancer treatments, and Cosmetic Dermatology. She is passionate about providing continuity of care across different areas of dermatology, and it is important to her to be able to help people feel good about the skin they are in. You can find her at Advanced Dermatology & Skin Surgery Spokane Valley and Spokane North, WA locations, as well as the Coeur d’Alene, ID location.