What Are Wrinkles & Why Do We Get Them?
Wrinkles (rhytids) are caused from the break down of your underlying
collagen and elastin fibers. I don't care what anyone says, you keep
"making a face": frown, smile, squint, sneer -- you will
eventually develop creases and lines where your skin "folds"
repeatedly. Please look at the below diagram to understand what the skin
structure is.
! Yes They're Fake ! - Cutaway of the
Human Skin (Diagram)
These fissures being to show their ugly heads around 27 years of age,
but in some individuals they may show up in the teens. It depends upon
your facial "habits", your skin care regimen and your
genetics. They may be fine lines, deep folds or jagged ravines, All the
same though, they aren't welcome by many of us.
Over The Counter Lotions, Creams & Potions (OTC)
These are less expensive, easy to get and the first course of therapy
people usually go for. Most wrinkles are because of collagen and elastin
break down due to simple aging or Photo damage. If you would like to
learn how to care for your skin properly please visit the Skin Care
Page. Here are the available products by category and sometimes by name.
For more product reviews, visit the Product Review Page.
Retinol:
Considered a Cosmetic, these products are available OTC. This are low
level Retin A (Tretinoin) creams. Some brands that I like (in order of
favoritism) are: L'Oreal Line Eraser, RoC and Neutrogena Healthy Skin.
Patients who have trouble with Renova and Retin A can use these with
less, if any, irritation.
Hydroxy Acid "Peels"
I have had a few of these and I consider the ones you can get at an
esthetician/aesthetician/ facialist to be rather mild. Of course you may
visit a dermatologist and they have access to strengths that are much
more penetrating -- we will cover these as well. They make you peel a
few days later on your own. They increase cell turnover rate and thicken
the dermis as well as correct hyperpigmentation or texture problems. Of
course the amount of improvement depends on the strength or number of
treatments you have. The ones that you can get in a spa by a facialist
are not that strong. Normally, my esthetician charges just $5.US extra
for a glycolic treatment on top of her normal $65.US fee for a European
facial. If you aren't accustomed to it or don't know what to expect, I
think 'sting' would be too harsh a word, rather it is irritating.
*Ladies: I don't recommend any type of glycolic or similar treatment
when you are nearing your menstrual cycle, your skin tends to be more
sensitive around these times and you will be climbing the walls.)
Alpha Hydroxy Acids (AHA):
Water soluble, these products such as 8% Glycolic acid cream can help
remove hyperpigmentations and help with photo damage, thickening of the
dermal collagen and increase cellular turnover. It shows the same type
of improvements in other treatments but offer no neoangiogenesis (blood
vessel formation) so that telangiectasias are not increased or inflamed.
Includes Lactic Acids. Higher concentrations work better, of course. Low
pH causes irritation, irritation represents stimulus BUT one needs to
change strengths. You must determine if your physician knows the
difference about high concentration, high free acid concentration and
low pH -- irritation is symptomatic of it working. Although extreme
irritation should be avoided.
BetaHydroxy Acids (BHA):
(Salicylic Acids most common); lipid soluble. It is an exfoliant, an
anti-inflammatory (acetylsalicylic acid -- aspirin family), a
comedolytic (de-clogging agent for pores). It is in many products. There
are BHAs in Oil of Olay's Age Defying Series, Pond's
Prevent/Correct Neutrogena has products with BHA's and are recommend by
Dermatologists.
Combination Hydroxy Acids (CHA):
Equal concentrations of AHA and BHA. These are not recommended as mixing
of the two different pH's cause the delivery of only one product at the
right pH and the other at a lesser strength. This is a marketing ploy -
don't fall for it.
Triple Hydroxy Acids (THA):
Lactic, malic citric, glycolic acids, usually has three of the
aforementioned acids. It is another marketing ploy. Another not to fall
for.
Topical Vitamin C:
(Ascorbyl Palmitate, Ascorbic acid) First it was thought that the
molecules were not small enough to penetrate but it DOES penetrate, but
very irregular and unstable. Different sizes do not work on different
people. Many arguments have arisen due to this fact and quite frankly
some molecules work differently in you or I. Yet, how do we know? The
benefits of a correctly absorbed molecule can stay in the tissues for up
to 3 days and is considered an anti-oxidant and benefits the skin my
seeking out and destroying free radicals. Unfortunately you may have to
go through hundreds of dollars to figure out which works for you.
Topical Vitamin E:
(Tocopheryl Acetate) Considered an antioxidant and has anti cancer and
anti sunburn properties but can cause contact dermatitis and possible
worsened scar healing. Just went against everything you thought, huh? Be
careful.
Topical Vitamin A:
(Retinyl Palmitate) Such as Retinol Products but specifically Vitamin A
in OTC creams/lotions such as in, well just about every night cream
these days. One such product is a product I use but not for its Vitamin
A content but more for its Niacin/Niacinamide - BeautyControl SPA
Organic Enzyme Masque with Niacin and Niacinamide (which dilates your
superficial capillaries) to bring oxygen rich blood to the surface of
the skin. You will appear flushed after use of a Niacinamide/Niacin
containing product. This particular product contains Retinyl Palmitate
as well as papaya and pineapple enzymes and pineapple-derived Bromelain.
Niacin/Niacinamides/Niacinamates:
As I said, I use products with these additives to flush my facial skin.
These products deliver increased oxygen to the skin, increase
circulation and help transport toxins from the epidermis. I find that I
break out less with use of this masque. Although sensitive skins beware
it can irritate and sometimes make your skin feel itchy in addition to
the normal sense of heat due to the flushing. Niacinamides are making
their way to Dermatologists office more now. I once used this regularly
- although not anymore.
Enzymes:
The enzymes (protein complexes) dissolve the horny layer (stratum
corneum) They are not an irritating product and only "digest"
the dead skin layer. They stimulate cell turnover and allow other
products to penetrate better into the skin. Papaya and Pineapple are the
most common. They are unfortunately unstable and can't be kept fresh for
long.
Prescription or Physician Supplied Lotions, Creams & Potions
These are more expensive but more effective. Some can be found on the
web, or eBay - some you just have to get from your doc.
Kinerase (N6-Furfuryladenine 0.1%) (KEYEN-er-ace or KINN-er-ace)
Now, Kinerase™ is not a "Brandnew" product - but it is
relatively HOT item that I wanted to bring to your attention. Kinerase
is a moisturizing cream or lotion that actually delivers...
"Scientifically Proven Results: In clinical studies conducted by a
dermatology department at the University of California, Irvine, Kinerase™
was shown to help improve the signs of photoaging. After 24 weeks of
treatment, physicians saw improvement in 100% of Kinerase™ patients.
Improvement was seen in roughness, blotchiness, and fine wrinkles.
Kinerase™ Leaves Skin With a Smoother Look and Feel: Kinerase™
provides moisturizing qualities that outshine and outlast other
moisturizing products you may be using. While some of these products may
temporarily lessen the appearance of fine lines through improved
hydration, that effect disappears a few hours after application.
Kinerase™ enables the skin to retain more moisture, leaving it with a
softer, smoother feel.
The complete article can be read on the YTF! Wrinkles Page.
Topical Retinoids:
The first drugs that increased neoangiogenesis (blood vessel formation)
therefore increasing vascularity, cell turnover, dermal thickening, etc.
In a hand basket - the first wrinkle eliminator. Can cause more
telangiectasias to form. Persons with telangiectasias should stay away
from retinoid topicals. |
Retinol: (aka baby Retin A)
Medicus' "Affirm" is one brand, in 3 strengths, 1X 2X and 3X.
This are less irritating but still stronger than OTC Retinol formulas. I
have used this and it still causes peeling at first but does not last.
Watch it around the eyes.
Retin A (aka Tretinoin):
It is the only FDA approved photo damage treatment lotion/cream. Retin A
is the strong stuff, whereas the Renova is the emollient based and can
be too heavy for some and cause break outs.
Renova:
Vitamin A Aldehyde. This product is Tretinoin 0.05% in an emollient
based cream and not as harsh as the Retin A. Hence, less effective than
Retin A, more effective than Retinol. The product gets converted into
small amount of Retin A.
Retin-A Micro:
0.1% Tretinoin in microsphere form. It is a strong drug BUT in time
release formula so very little irritation is seen where normally
patients would experience irritation. I use this and it ROCKS - I would
never use a "regular" Retin A now, ever. Micro is where it's
at!
Avita: (brand)
Tretinoin in a less irritating formula.
Refinity Peel:
15% lactic acid (AHA) product with cosmederm- 7 and a 70% glycolic
peel with .06 pH and cosmederm-7. This product increases the cellular
turnover rate, helps with hyperpigmentation and corrects skin mottling.
Irritation can be moderate - individualistic. (by Collagen Corp) I have
used it and honestly, after using Retin A Micro and Obagi/Hydroquinone,
I AM SPOILED. But if you need something that is gentle and not so
aggressive and trust me my Obagi regimen was AGGRESSIVE! - Refinity is a
good product.
Cosmederm (strontium nitrate):
This product prohibits epidermolysis (blister formation), irritation
blocker. It is added to other products (AHAs) to reduce the stinging,
burning by 70% and erythemia (redness) by 30%.
Beta-Lift by Medicus:
B-Lift X (salicylic acid peel). May cause exfoliation , peeling skin,
slight pinkness for a few days. Medicus markets a peel per pack kit,
that includes enough product for 1 peel with complete instructions for
both patient and physician.
PolyHydroxy Acids (PHA):
(Neostrata is one brand) These are larger molculed acids that in theory
are supposed to decrease the dermal penetration so as not to irritate
the skin. Has not really shown any more than a 6% difference in
reactivity. Not worth the time if it is more expensive.
Alpha-Lipoic Acid:
Perricone has this patented, It is an anti-oxidant that is both water
and lipid soluble. It does penetrate the skin even into the subcutaneous
area. 3% has shown wrinkle reduction. BUT! not enough to prove this
claim. If you have the opportunity to try it I would be interested in
any feedback.
Topical Hormone Therapy (THT):
Studies showed that topical applications of 0.03 Estriol or 0.01
Estradiol for 6 months have shown decreases in ore size and wrinkle
depth by 60%, an increase in collagen/elastin firmness and water content
in the tissues. Unfortunately it is showing an increase in prolactin [:
a protein hormone of the anterior lobe of the pituitary gland that
induces and maintains lactation in the postpartum mammalian female
--called also luteotropic hormone, luteotropin, mammotropin] percentage
as well. I wouldn't mess around with these.
Copper (Copper Peptide):
(Neova is one brand) Copper Peptide Complexes can increase fibroblast
stimulation, hence collagen formation. This stuff ROCKS!! At first I was
a non-believer and then I was shown the light. Worth your buck, heals in
a flash!
Hydroquinone (BLEACHING agent):
This is the standard "bleaching" product that actually
prohibits your melanin production. 4% used to be thought to be the best
and irritation would erupt in higher strengths. This has been proven as
not so and strengths up to 10% are routinely formulated for patients.
Although Hydroquinone is used by itself, it can be mixed with others
such as...
-arbusome
-azelaic acid
-glycomelanin
-kojic acid
-licorice extract
-melawhite
...for increased effectiveness. These products are frequently used
before and after Laser surgery or dermabrasion or intense Pulsed Light (IPL)
treatments. Especially in ethnic patients.
Lustra Bleach (brand name, BLEACHING agent):
(Medicus) 4% Hydroquinone, 4% Glycolic and emollient. It is richer and
is less reactive and drying. It is used as standard Hydroquinone.
Proteque (name brand):
An all-in-one anti-inflammatory, antimicrobial, anti-itch and
water-resistant skin protectant for sufferers of eczema and dermatitis.
Safe for children of all ages, face, around eyes, body, hands, feet. Key
ingredients are dimethicone (silicone derivative), aloe Vera, vitamin E,
honeysuckle extract and triclosan. Non-prescription recommended by
allergists, pediatricians and dermatologists. I have used this and it
healed a rash I had under my watch (contact dermatitis of sorts) in TWO
DAYS! I TRULY recommend this product. It also made Marc's Eczema flare
up more tolerable and helped it heal!
Education Website: http://www.proteque.com
Updated Laser Page: New Additions!
Cool Touch 1320 Laser: (technically: thermescent Nd: YAG 1320 LASER)
This is also a selective dermal heating type of procedure such as NLite.
This laser supposedly can be used on any skin color, any skin type, and
on any part of the body without the risks of hypo- or hyperpigmentation
or the healing times associated with conventional lasers. It is
considered a non-ablative lasing device. Outer skin and sensitive nerve
endings with a unique cooling spray, then use precise laser pulses to
stimulate cells called fibroblasts which produce the natural collagen
that is the foundation of your skin. As the collagen layer thickens,
skin tone and elasticity improve.
According to a lecture I listened to by Dr. Robert A. Weiss, the
assistant professor of dermatology at the University of John Hopkins
School of Medicine in Baltimore, Maryland by on non-ablative treatments:
Thermescent CoolTouch 1320 treatments
are usually performed 3-4 times at one month a part although you will
not see results until the 2nd or 3rd treatment. Also the improvement
may appear immediate although this is due to edema (swelling), etc.
The patients sometimes use moist gauze or goggles. It was reported
that 50% of the patients opt for an EMLA cream (topical anesthetic).
As with NLite, this type of laser delivers the amount of infrared
energy to trigger a thermal wound response but without the harmful
effects to the epidermis. In other words, the laser heats up where
your dermis/epidermis meet, thereby stimulating your collagen
production and correcting the rhytids (wrinkles) from within. The
difference with CoolTouch 1320 is that the cryogen spray cools the
epidermis allowing the penetration of the Nd: YAG to depths of 200-400
microns in the dermis layer with a surface temperature of no more than
44º to 48º Celsius (111.2º to 118.4º Fahrenheit). Improvements
were seen on rhytids (wrinkles), acne scars, pore size reduction and
"crepiness". Also it was mentioned that the subcision
(undermining of scar bands under an acne pock) was beneficial to the
patient when treated with the CoolTouch 1320 as well.
NEW :
You may be given a bovine mucalpolysacharide solution or wash, this is a
cow-derived cartilage extract that has the anti-inflammatory properties
of 1-2% hydrocortisone. It accelerates epidermal healing. The skin wash
is like having a steroid application without the risk of steroid induced
atrophy or telangiectasia formation. Catrix is one brand, Correction
Cream Wash, CX-10 Correction ointment and CX-5 Correction cream
One more thing...
It seems as though there is a new topical anesthetic in town. If you are
familiar with EMLA, there is a product called "Ela-Max". It is
cheaper, available over the counter (OTC), faster and doesn't have to be
occluded (covered). It contains 4% Lidocaine and is making it's way to a
surgeon/derm/micropigmentation technician near you.
|
