Skin Care and Rejuvenation

Friday, December 24th, 2010

The majority of what is generally considered skin care are habits passed down from one generation to the next or products containing a minimally or non-effective form of the latest ingredient shown to improve the skin. Almost none is based on a thorough understanding of the skin, its aging or how to reverse this aging. In fact, most of what we do to our skin is actually harmful. Take, for instance, moisturizers. Almost everyone uses them because we have been told that we should. In fact, moisturizers are one of the worst things we can put on our skin. They disrupt the normal protective barrier by modifying the surface lipid content, and they weight the skin down, markedly accelerating wrinkle development. More of what we should do instead later.

Skin ages in two distinct ways. First, certain changes occur to all of us. For one, our cells just stop or markedly reduce the efficiency of actively renewing the structure of our skin. This generally occurs around 30 years of age. Our genes determine the time this occurs and the speed of other aging effects. The second type is “solar aging.” This is the direct result of sun damage. Our habits affect both. Studies of twins demonstrated that certain skin care methods, sun exposure, and smoking markedly increased skin aging. Sun exposure causes predictable changes to the skin. Smoking speeds these changes about 20 fold. Improper skin care can also increase these changes.

Sun damage causes:

• Thickening of the outer dead cell layer. This is, in childhood, very thin. The thicker this layer is, the dryer the skin feels.
• Loss of moister of the living layer
• Spotty distribution of pigment (freckles, dark areas and spots)
• Change in the cell nucleus in the layer of reproducing cells. This can lead to rough spots or skin cancers.
• Loss of the normal blood supply of the skin. When this happens, the aging process speeds up.
• Production of abnormal small blood vessels. This is a form of “Rosacea.” The only effective treatment for this is an IPL (Intense Pulsed Light) or Laser.
• Loss of collagen, the support of the skin. This, together with the weight of the outer dead layer, results in wrinkles.

Our genes determine which of these predominate. Thus, one person may show mainly spots and another, wrinkles. The trick is to determine what problem exists and how best to correct it. Once corrected, we need to prevent any further damage. Therefore, a part of any skin care regimen should be protection from further sun damage. Presently, there is only one product that blocks both UVB (causing sun Burn) and UVA (causing skin Aging) and is practical. This is micronized Zinc Oxide (which goes on clear). You need to apply this only once a day unless you wash or wipe it off. You should use a product containing at least 5% of this every day, since UVA is present all day, every day. An article in Oprah Magazine described sunblocks as “the closest thing we have to a Fountain of Youth.” In addition, the young need only a good cleanser and something to return the skin pH to normal after washing. Some pH balanced Toners will do this. However, we prefer products like Vitamin C Serum or Prevage MD®, since each is also an antiinflammatory and an antioxidant, thus also providing further sun protection.

Once the dead cell layer thickens and the skin begins to feel dry, we need to add a step to reduce this layer and restore the normal moist feeling of the skin. You can do this with regular use of alpha hydroxyl acids (AHA’s) that are in many over the counter products, or frequent micro-peels, dermaplaning, or microdermabrasion. All these are available in our office and Medi-Spa.

As the amount of sun damage increases, we must address the other problems. Several products can reduce spots. Many work well for minimal spots, but the ultimate spot remover is hydroquinone. Occasionally a peel can increase the color correction. Although several magazines have touted retinols as conjuring up “a prettier complexion while you sleep,” only prescription Retin-A (tretinoin) has actually been shown to do so. It reduces the stickiness of the dead cells, vascularizes the skin, and causes thickening of the skin that reduces wrinkles.

Since our skin is designed as a barrier, the challenge has been to get these products to the cells where they can act. No product by itself can do this. However, when combined into a system, so that they penetrate to the cells deep within the skin, we increase their effectiveness significantly. To totally rejuvenate the skin, we at the Center for Plastic Surgery, therefore, use only total skin care systems where all products are designed to work together and have FDA approval as being effective in skin rejuvenation.