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21 June 2013

The Truth Behind Anti-Aging Claims

Kevin Pinski MD; Dermatologist and Owner, Pinski Dermatology & Cosmetic Surgery, Chicago, Ill.

The anti-aging movement has fostered an increased public awareness that many of the cutaneous changes associated with aging can now be prevented and reversed. Yet sorting through anti-aging claims in today’s skin care market can often become a lesson in separating fact from fiction.

It’s important to look beyond the buzzwords. For example, topical products that tout ingredient call-outs like hyaluronic acid or collagen may very well contain these substances; however, the molecules are too large to penetrate the skin. Many over-the-counter products may be formulated with active ingredients, but in low concentrations that are not likely to deliver any real benefit to the skin. Even with proper ingredients and an adequate concentration, products must be sufficiently absorbed to reach the necessary target within the skin.

The blurry divide between pharmaceutical agents and cosmeceuticals can further compound the difficulties of navigating an increasingly complex anti-aging market. The FDA regulates pharmaceutical agents closely; less regulated are cosmeceuticals, which are not recognized by the FDA as a category under law. Items defined as drugs—meaning they are “intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease,” according to FDA mandates—must make legitimate claims and validate those claims with substantial evidence. Examples of FDA-regulated drugs known to reduce the signs of aging are beta hydroxy acids, retinoids and sunscreen.

Many of the so-called signs of aging stem not from the true aging process, but from photo damage that manifests itself in the form of textural changes like wrinkles, decreased elasticity and dyspigmentation of the skin. In fact, much of the photo damage that accumulates over time could be prevented by dedicated sunscreen use.

Sunscreen sits atop my list of true anti-agers—its use should be implemented in childhood and carried throughout adulthood. Regardless of a patient’s age, it is never too late to start wearing an SPF daily. Broad-spectrum sunscreens (specifically those containing zinc oxide, titanium dioxide or Mexoryl) block UVA and UVB rays that not only lead to skin cancer, but that cause over 90 percent of the skin changes commonly attributed to aging, including brown spots, wrinkles and skin laxity. In addition, antioxidants such as vitamins A, C and E work in tandem with sun protection to inhibit oxidation, a process that produces aging- and cancer-causing free radicals.

Retinoids are equally crucial in maintaining long-term skin health. Commonly known as vitamin A derivatives, retinoids help to strengthen the dermal-epidermal junction and increase collagen synthesis, leading to firmer, suppler skin and decreased wrinkling.

An effective anti-aging regimen should also include alpha hydroxy acids, which encourage cellular turnover to improve the tone and texture of the skin, along with growth factors, which increase cell differentiation and promote the production of collagen and elastin.

I also recommend in-office procedures such as chemical peels, microdermabrasion, laser treatments, fillers and photodynamic therapy to improve skin texture and volume. The use of neuromodulators (Botox, Dysport) is a primary way to improve the visible signs of aging, as studies document their ability to prevent etched-in lines from developing when started at an early age.

Prevention is always best. A true anti-aging regimen starts before the aging process even takes hold. Based on genetics and sun damage, patients can work with their dermatologist to develop a skin care plan that focuses on preventative steps and proven anti-aging ingredients.

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