I recently wrote an article for Medelita about anti-aging, and I wanted to share it with all of you today! Hope this helps to kickstart your anti-aging regimen into high gear this upcoming season.
As we get older, our skin undergoes a multitude of changes that result in sagging skin lined with wrinkles and dark and light spots. Preventing these changes has grown into a million dollar industry with so many different products out there that claim “anti-aging.” But what really works? To figure out what ingredients are actually effective, we need to dive down into the molecular changes in the skin.
There are two types of aging, one that happens naturally with age and one that is caused by the sun.
As we age, our skin loses collagen and thins. Gravity and repetitive movements of our facial muscles in our daily expressions start forming wrinkles as we lose elasticity, or the ability of the skin to snap back into its original shape. We also lose hyaluronic acid, a powerful humectant that allows us to retain moisture in the skin. The sun also plays a huge role in photoaging, causing discoloration in light and dark spots, wrinkles, rough leathery texture, and small superficial blood vessels.
One of the key strategies to combat skin aging is prevention. Now that we know that the sun causes skin changes, we can start protecting our skin from UV radiation at an early age. There is no “right time” to start using sunscreen; I wish I had started as a teen!I recommend using SPF 30 broad-spectrum (blocking UVA and UVB) sunscreen daily, whether it’s a sunny day or a cloudy day, because UV radiation penetrates through all the time. Remember to reapply every 2 hours if outside under direct sun, and to try to avoid prolonged sun exposure during peak hours such as 10 am to 3 pm.
Side note: myths about sunscreen
I’ve heard some patients say they are concerned about the safety of sunscreen ingredients; I’ve taken a critical look into the literature and found that many of these myths about sunscreen components are just that, myths, without scientific basis (more on that here). Once you are comfortable with the idea of daily sunscreen application, you have to choose a sunscreen that’s right for your skin type (more information on that here).
Skincare ingredients to look for
Practicing sun safety is not only great for anti-aging, but it also helps decrease your chances of getting skin cancer, which has far greater implications for your health. Aside from prevention, there are a few other key ingredients that I like to keep in my anti-aging regimen.
First off, there are retinoids, or Vitamin A.Retinoids are on every dermatologists’ bathroom counter, a secret weapon against aging of sorts! It has an important role in dermatology because of its comedolytic properties, meaning it breaks up comedones that you seen in acne. Studies have shown that topical application of retinoids result in new collagen formation and increased epidermal thickness, as well as clinical improvement in wrinkling, dark spots, rough skin, and skin texture.Dermatologists can prescribe you retinoids in gel or cream format, and the FDA recently approved Adapalene 0.1% gel for use over the counter.
The main side effects are sun sensitivity and irritation, and you must NOT use it if you are pregnant or trying to conceive, because it can potentially cause harm to the developing fetus.
When you start out, apply a pea sized amount every other night and slowly build up to nightly as tolerated. If your skin gets too dry and irritated, which is the most common side effect, mix the retinoid with lotion or use some over the counter steroid cream to calm down the redness.
If you want to try retinoids but don’t want to go the prescription strength route, you can buy over the counter products with retinol, a slightly different formulation of vitamin A, which take a bit longer to work, but may be more gentle with less side effects for those starting out.
Another helpful ingredient in anti-aging is hyaluronic acid, a naturally occurring humectant in your skin that helps you retain an insane amount of water. One gram of HA can hold up to 6 LITERS of water! It doesn’t help us that we lose hyaluronic acid as we age, meaning our skin gets more dry and wrinkled faster. By choosing topical creams like serums or ampoules with HA, you can help replenish your supply.
Older patients can also consider injections of filler made from HA, which deposits the HA deeper in the skin mimicking naturally occurring HA to get a more youthful appearance. This is only temporary though, as the body will break up the injected HA over time and carry it away in the bloodstream.
The power of antioxidants
Lastly, antioxidants can play a big role in helping to reduce and even reverse sun damage. UV radiation causes reactive oxidative species to be generated in the skin, causing damage to the deeper structures. Fat soluble Vitamin E (also known as tocopherol) helps reduce inflammation in the skin and accelerates repair from sun damage. Vitamin C (ascorbic acid) is an all-star in anti-aging, proven to even out skin tone, help with DNA repair from photodamage, and assist with collagen production.
The two vitamins together have added effects, and both appear to be stronger when applied topically rather than ingested orally. Look for sunscreens or serums with Vitamin C or E (or both!) to help protect against sunburns and help with skin repair from the sun’s damaging rays.
All of these ingredients can be used at any age, and it is never too early to start investing in a good anti-aging regimen! What products do you use?
Paul Vella says
Hi Dr. Joyce, I really loved this post! We met at show in NJ. Can I send you samples of our product and get your opinion about our product, Aethern… http://www.aethern.com
My CEO is coming to New York November 26 to December 10. Would be very interesting to meet for coffee, breakfast, lunch, dinner, whatever works for you. If you have time, of course, given your schedule…
Take care, and hope we can connect. Paul Vella, Partner/ BOP USA Inc. Aethern Nutricosmetics
tara says
Hello! Which serum with c and e do you like best? Which retinoid and otc retinol do you like best? And finally which hyaluronic acid do you like best?
Joyce says
Hi! I’ve heard great things about the SkinCeuticals C E Ferulic, which is on my wishlist this Christmas! For retinoids I like prescription strength retinoids; I’m currently using tretinoin 0.025% cream every other night. For HA, Skinmedica has a great hydrating complex with tons of hyaluronic acid. More on these products in this Dermatologist beauty picks blogpost here.
Ethel Rose says
Hi Dr.! Should Tretinoin be applied before or after moisturizer? Thanks!
Joyce says
Ideally before (medicines should go on closest to the skin) but for my patients who get too much irritation I have them mix their tretinoin with moisturizer or serum
Su says
Was wondering if you had any more information on the different sizes of hyaluronic acids, such as in this article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3970829/
is this result scientifically solid? And if so, are there any products that take advantage of it?
Also, I’d love to hear from you and other dermatologists you interview about body skincare products and regimens as well. (I have perpetually crocodile skin.)
Joyce says
Hi Su, thanks for leaving this comment! I did a pubmed search and there are other studies in the literature that describe increased efficacy with smaller molecular weight hyaluronic acid (one here: https://www.ncbi.nlm.nih.gov/pubmed/22052267). I don’t know of products that take advantage of this at the moment; perhaps they are still in development. If I find any more information I will definitely share! I write often about skincare regimens from myself and from other dermatologists I work with. Check out some of the posts here: https://www.teawithmd.com/category/beauty/expert-beauty-picks/
Christina says
Hi Dr. Joyce, thank you so much for this article! I was wondering if you would suggest starting with Differin or an OTC retinol (like RoC) for those who want to start using retinols/retinoids? I was reading how Differin is good for anti-acne but not as much research has been done for anti-aging. Would love to hear your thoughts. Thank you!
Joyce says
Hi Christina, great question. If your skin can tolerate Differin, I would start with that, especially since it is over the counter and affordable. It probably costs as much as a retinol! If you cannot tolerate Differin, then I would transition to a retinol. Though tretinoin is the gold standard for anti-aging because it has been studied more often, Adapalene has shown efficacy in treating photoaging as well. Here is one such study showing those effects. Hope this helps!
Kate Brownell says
Nice article to know about the anti ageing ingredients and their mode of action. This content is very important for me as I am a gym-goer. As if now I am taking the pre workout serum of FITBEAUTY Australia. It is a good anti ageing product which prevents wrinkle formation due to heavy workout and also soothes the existing ones. Now I have got more options to take care of wrinkles. Thanks again.
Kara says
I came across your blog while searching on anti-aging products and I love your science backed opinions! I don’t usually comment on posts but I’m curious on your thoughts on the (newish?) drugstore products containing retinol (such as Olay Retinol 24 or Loreal Revitalift products) – how effective would these be vs the more expensive products?
Also, I’m early 30s and want to try retinol products but would skin be worse off if I stopped using these after a while or would a tolerance be built up and need to get “better” (higher concentration) products over time?
I look forward to hearing your thoughts!
Joyce says
Hi Kara, there are many great over the counter products that contain retinol and even retinoid (Differin). You don’t build up a tolerance over time, but I generally like to increase the strength of my patients’ retinol or retinoid to get more noticeable results. If you start off with a retinol, I generally switch it up to a prescription retinoid over time for more benefits!