Saturday, May 13, 2006

Anti-Aging Skincare FAQ, ver 4.1

ANTI-AGING SKINCARE FAQ ver. 4.1, October 2004

This FAQ may be reproduced if it is referenced as the Anti-Aging Skincare FAQ, version 4.1, posted to alt.skincare.

--------------------------------------------------------------------- Anti-Aging Skincare Frequently Asked Questions, Version 4.1 Revised October 2004 Posted to alt.skincare Author code 91587355


1. Introduction 2. What is the anatomy of the skin? 3. What factors affect skin health and aging of the skin? 4. What are Retin-A (tretinoin) and retinoids? 5. What is retinol? 6. What is copper peptide? 7. What are alpha-hydroxy acids and skin exfoliation? 8. What other topical treatments are available? 9. What is skin resurfacing? 10. What are nonablative treatments? 11. How can I treat excessive skin oil? 12. How can I treat scars? 13. How can I treat visible capillaries?

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1. Introduction

Most people start seeing aging effects in the skin by their late 30s.  Over the years you may also accumulate scars from cuts, scrapes, and burns.  This FAQ answers common questions about how to slow skin aging and improve the appearance of aged or scarred skin.  The information applies to both men and women.  It does not cover cosmetics, injected fillers or Botox (botulism toxin).  It does not cover plastic surgery procedures, except for skin resurfacing and scar revision.  Rather, it deals with products and medical procedures that can improve skin structure.  It is based on a review of medical research, dermatology textbooks, popular skincare books, Internet consumer reviews and personal experience.  

The pharmaceutical information and product brand-names are for customers in the USA.  Products with the same active ingredients are obviously available in other countries.  Brand-name ! products from the same company will often have slightly different nam es in different countries.  If a generic version of a prescription product is available from your pharmacist, it is simply identified by the active ingredient name.  For example, the active ingredient in the brand name product Retin-A is called tretinoin.  Generic versions usually cost much less than brand-name products.  Prices for the products mentioned in this FAQ, in USA dollars, were current as of the revision date.   The information on importing prescription products into the USA under the FDA regulations should not be considered legal advice and should be used only at the reader's own risk.

This FAQ does not constitute professional medical advice.  Most internal medicine specialists and general practice physicians can provide you with basic medical skincare information, but for specialized advice and procedures you should consult a dermatologist or a nurse or physician-assistant who specializes in dermatology.  Plasti! c surgeons also understand skincare and do procedures such as resurfacing and scar revision.  The information about medical professionals and cosmetologists in this FAQ applies to the USA.

2. What is the anatomy of the skin?

The outer layer of the skin is the epidermis, and the next layer is the dermis. The epidermis, which is generally less than a millimeter thick on the face, is constantly being regenerated as surface cells are shed.  As epidermal cells are pushed to the skin surface, they become flattened, and a hard protein called keratin is formed in them.  The thicker dermis under the epidermis contains collagen and elastin fibers that give skin its elasticity.  The pores contain fine hairs and secrete sebum (skin oil) to keep your skin moist.   Sweat glands open onto the skin surface to cool the body in high temperatures. Both the pores and sweat glands are sources for new cells that spread out on top of the dermis to form ! the epidermis.  The appearance of your skin is governed by the c ondition of both the dermis and epidermis.

As we age, changes occur in the structure of the skin that affect its appearance.  The dermis becomes less elastic and the epidermis becomes thinner.  Because of these changes, wrinkles and fine lines develop, pores appear larger, and the surface texture becomes more coarse.  Dynamic wrinkles, which are caused by making various facial expressions over the years, become more prominent.  Discolorations also often appear.  Some of these changes are cause by intrinsic cellular aging, but most are caused by extrinsic damage from sun exposure (called photoaging or photodamage).  Solar ultraviolet light damages all types of cells in the skin and can also cause skin cancer.   Dark-skinned people usually have much less photoaging because the melanin pigment in their skin partially blocks sunlight from reaching the lower dermis.  The best-looking skin most people have is in areas without ! much sun exposure - under the arms, on female breasts or on the rear.  Note that you probably haven't been using any special cleansers or expensive skincare products on these areas, and the skin there still looks like a baby's.  

The dermis can also be damaged by injuries.  If a wound penetrates deeply into the dermis, thick, uneven scar collagen can form as the wound heals.  This produces a raised scar.  If a wound causes significant tissue loss in the dermis, a pit or depressed scar may form.  Burn scars can have an irregular appearance with both raised and depressed areas.

While the condition of the dermis is reflected in wrinkles, lines and scars, the condition of the epidermis affects the surface texture of your skin.   Generally, the best appearance is produced by a thick epidermis.  A thicker epidermis also tends to minimize the appearance of pores and depressed scars. However, if the epidermis grows abnormal! ly or is excessively dry, the skin can appear rough or scaly.  A t the other extreme, stripping off the upper epidermal layers with excessive scrubbing or over-use of cosmetic acids can temporarily produce an uneven surface texture and increase the size of the pore openings.  Scraped or burned areas sometimes have a thinner epidermis, even after complete healing.

You should not expect the texture of the epidermis to be porcelain-smooth. The openings of the pores and sweat glands cause small indentations, and there are small ridges covering the surface.  Many people have a false sense of how smooth adult skin should appear because they see models and celebrities who seem to have perfect skin in magazine photos, on TV and in movies.  Only children or people who have generally avoided sun exposure have this type of skin.  Most close-up magazine photos are touched-up to smooth skin texture, and both men and women wear a lot of makeup on TV and in the movies.  (There is a Net site with candid photos sho! wing that many celebrities have the same skin problems as everyone else.)  Even politicians and news-people wear a lot of makeup on TV.  Special camera lenses, filters, lighting, and digital image processing help to hide wrinkles and rough skin.   A recent magazine article and companion network news report had an interview with a famous actress who showed exactly how her skin was "cleaned up" for magazine photos with computer software.  Remember too, that after about age 50, many celebrities have facelifts, which stretch the skin and make the surface appear smoother than normal (often unnaturally smooth, with a stretched appearance ).

Based on skin anatomy, we can say that a true anti-aging skincare treatment   will produce one or more of the following effects:

1. Prevent or repair damage to collagen and elastin in the dermis; 2. Promote the growth of new collagen and elastin; 3. Repair other damaged cells in the dermis! ; 4. Promote epidermal growth to thicken the epidermis; or 5. Smooth the epidermal surface.

There are scientific methods to determine if a substance or procedure has any of these effects, and research in this field is ongoing.  However, despite advertising claims, most skincare products sold today, such as cleansers and moisturizers, don't produce any significant effects in skin structure.  The "special" ingredients advertised in some of these products (such as vitamins, proteins, and plant extracts) generally don't penetrate into the lower epidermis or dermis, so they can't improve collagen or elastin.  Any improvement in appearance they produce is confined to the upper epidermal cell layers and is usually temporary.  Because of this, you will generally find that inexpensive cleansers and moisturizes work just as well as expensive products.  (We will cover the products that do affect skin structure below.)

3. What factors affect skin health and aging of the skin?

Scientific research h! as identified a variety of factors that affect extrinsic and intrinsic aging of the skin.  Many of these factors are controllable by simply modifying your behavior and diet.  This section covers ways to prevent skin aging, and the following sections cover ways to treat it.

Avoiding sun damage is the most effective thing you can do to prevent aging of your skin.  The sun is a huge nuclear fusion reactor, producing not only visible light and heat, but also intense ultraviolet (UV) light that can damage your skin.  Sunlight is the major cause of extrinsic skin aging because it damages collagen and elastin, and produces abnormal changes in other cells. Doctors call aging due to sun exposure photoaging, that is, aging produced by light.  While photoaging is usually described as a cosmetic problem, it is also a serious health concern since it can lead to skin cancer.   Unfortunately, apart from dermatologists, many healthcare providers! don't warn their patients adequately about the risks of sun exposure .  

Everyone is susceptible to photoaging, even people with dark skin.  Though more skin pigment reduces sun damage, the intensity of sunlight and cumulative exposure will eventually cause photoaging in people of all skin colors. ...


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