Television and print advertising is always overflowing with sales pitches for the latest and greatest skin care product that will take years off your appearance. Elegant pictures of young women who have never so much as darkened the door of a plastic surgeon’s office are shown, while voice-overs describe products with sophisticated, european sounding names. How do you make heads or tails out of all the hype, and is there really anything to “skin care”.
Why Our Skin Looks Older
Several things happen to our skin as the years pass. I will list them here for easy reference:
1) Cell turnover: New cells are constantly being born in the lowest layers of our skin. As the process goes on, older cells are gradually pushed to the surface. As they rise to higher layers and get older, they make a substance called keratin (the tough stuff that makes callus, and mechanically protects our skin). Ultimately they get old and die, flaking off our skin. When we are in our teens, cells go through this cycle in about 14 days. As we get older that turn over time gets longer and longer. We tend to have a lot of those old flaky dull cells stuck to the skin surface, giving our skin a dull, chalky appearance.
2) Collagen content: Collagen is a protein that special cells spin out like rope yarn. It is the tough, elastic material that give skin much of it’s thickness, and most of it’s elasticity. The collagen layers also hold a lot of moisture in the skin. As we age, those special cells make less collagen, so our skin gets thinner and “dryer”. This is why you can see through the skin on your grandmother’s hand, and why older people suffer such easy trauma to their skin.
3) Skin pigment: Chronic long term irritation to the skin, like sun-exposure, chemical exposure (like my surgeon hands getting constantly scrubbed with antiseptic soaps), develops splotchy pigmentation; what people call “age spots”. This pigment is different from the normal pigment that gives your skin it’s basic color. This pigment is produced by cells that are more superficial in your skin.
Skin Care Strategy
There is a little bit more to it, but if we know these three basic issues, we can understand a lot about how to do good for our skin.
1) Cell turnover: If we aggressively strip away the old dead skin that is stuck to the surface layers, it polishes off the surface and removes the old chalky look. It also seems to stimulate cell turnover, so the cycle from new cell to dead cell happens faster. This can be done mechanically (buffing pad, microdermabrasion, chemical peels like glycolic acid, salicylic acid etc.). The most effective way, is to do laser peels.
2) Collagen: Those cells that make collagen respond to anything that wounds the skin, or otherwise irritates it. Collagen is the chief ingredient in scars after all. If we do things to uniformly irritate or wound the skin, those cells will make collagen. Chemical peels, and laser peels are very effective at stimulating collagen production. Furthermore, if we treat the skin afterwards with products that contain ceramides, we will increase the moisture content of the skin, making it thicker, more elastic, and therefore younger not just in appearance but in behavior.
3) Pigment: This is the toughest part. Since that “age spot” pigment is superficial, we can reduce it by applying ingredients that suppress pigment production (mostly hydroquinone, but also some newer soy-based substances), and we can strip the pigment away with microdermabrasion, and laser peels. It is a very slow process, and we have to be ready to work at it for many months. Aggressive treatments tend to irritate the skin, causing more rather than less pigment.
None of the topical treatments for younger skin are permanent, but then neither is brushing your teeth. These are things we do a couple of times per day to maintain health an appearance.
Talk to your Plastic Surgeon, or Dermatologist about these issues, so that your particular concerns can be addressed without a lot of wasted time and money.