Anti-Aging Skin Care | Rajani Katta MD

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The Dermatologist's Guide to

Skin Renewal Skin Care Products

(“Anti-Aging Skin Care”)

As a dermatologist, one of the most common questions I’m asked is this: "What products should I use to help slow down the visible signs of skin aging?"

When we’re talking about skin renewal approaches (also known as “anti-aging“ skin care), it’s important to realize that there are many different approaches.

Achieving A Youthful Glow

How do you achieve a youthful, healthy glow? While plastic surgery may help reverse some of the visible signs of skin aging, achieving a youthful glow requires more than just a procedure. I like to talk about the impact of food, skin care, and lifestyle. When it comes to youthful, glowing skin, all of these can make a big difference.

Lifestyle factors such as sleep, stress management, and exercise can help improve blood flow to the skin and limit the impact of damaging hormones such as cortisol
Nutrient-rich foods can help support skin circulation, combat free radicals, and also contribute to a healthy glow
Skin care has an important role to play as well

QUICK LINK TO 2020 SKIN RENEWAL PRODUCTS

The Role of Skin Care Products in Skin Renewal

There are multiple skin care ingredients and procedures that can help renew your skin's appearance.

At a basic level, removing the top layer of dead skin cells from the skin's surface can help "brighten" and "freshen" the skin's appearance. This is called exfoliation, and it can either be done with ingredients in skin care products ("chemical exfoliants" such as glycolic acid or salicylic acid) or it can be done with physical methods (such as scrubs or devices).

Ingredients such as retinoids are another important category of skin renewal ingredients. Retinoids help increase cell turnover, important for skin renewal. Studies have also shown that retinoids actually help contribute to the production of new collagen in the skin.

Certain procedures can lead to collagen remodeling, with new collagen produced in the skin after controlled damage to the skin. These procedures include microneedling and certain laser procedures.

With all of these, though, there's a delicate balance. You need an intact skin barrier: it provides protection against UV radiation, microbes, and more, and it's a key part of maintaining healthy skin. So while "remodeling" the skin may help with skin renewal, it has to be done extremely carefully.

I've actually treated many patients who have over-exfoliated. Afterwards, they developed very sensitive skin, because their skin barrier no longer worked as well. Some have even developed allergic reactions to skin care products.

As we discuss skin renewal ingredients, it’s really important to keep that idea of balance in mind. You have to balance your goal of skin renewal with the need to protect your skin barrier.

The Visible Signs of Skin Aging

Although there's some variation in how we describe the features of aging skin, there's a general agreement in the medical community that these features include:

1. Fine lines and wrinkles. While some of this is due to aging itself, a significant factor is the amount of UV radiation that reaches our skin and damages the collagen and elastic fibers in the skin.

2. Sagging. Think about an elderly person with jowls, and how that contrasts with the firm jawline of a 20-year-old.

3. Atrophy. If you've spent time around elderly persons, especially those who've sustained a lot of sun damage, you'll know that their skin becomes more fragile as they age. This is because our skin thins (or in medical terms, atrophies) as we age.

4. Loss of elasticity. Someone in their 20s has tight, taut skin that bounces back when you pinch it. As you age, your skin loses that ability to bounce back.

5. Pigment changes. As we age, we accumulate a lot more freckles and dark spots. The medical term for one type of these dark spots is solar lentigos. I call these sun spots, because they're due to cumulative UV exposure catching up to us.

6. Changes in skin texture. Older skin starts to show more changes of roughness and dryness. The skin just doesn't hold onto moisture as well. And it doesn't matter how many glasses of water you drink--the loss of natural oils in the skin predisposes us to dry, rougher skin as we age.

7. Changes in microvasculature. Microvasculature is the medical term for the small blood vessels in our skin. Some people report that their skin looks more "sallow" as they age, meaning that they no longer have that healthy glow or freshness of youthful skin.

Skin Care Products Can Target Some of These Visible Signs of Skin Aging

There are a number of over-the-counter (and prescription) skin care ingredients that can help reduce or minimize some of these features of aging skin. The right skin care routine and the right skin care products can help treat and even reverse:

Fine lines and wrinkles
Pigment changes
Changes in skin texture

It's important to recognize the limitations of skin care, though: we just don't have evidence that skin care products can help reverse loose, sagging skin or deep wrinkles.

Key Active Ingredients To Look For in Skin Renewal (Anti-Aging)

Skin Care Products

Retinoids: The Skin Smoothers.
- I call these the “smoothers” because they help smooth out fine lines and wrinkles by increasing collagen production and helping smooth out the skin’s surface texture. These are considered one of the most effective skin renewal ingredients available.

Vitamin C: The Dark Spot Preventer.
- This is the dark spot preventer because it helps block the production of melanin. It’s also a strong antioxidant, so helps provide an extra layer of free radical protection.

Vitamin E: Extra Defense.
- This antioxidant provides an extra dose of free radical defense.

Hyaluronic acid: The Temporary Plumper.
- This is “the temporary plumper”, because as a humectant it attracts water to the skin’s layers. This produces a temporary plumping effect that helps diminish the look of fine lines and wrinkles.

Niacinamide (vitamin B3): The Gentle Skin Renewer.
- While its effects are not as strong as retinoids, clinical trials have demonstrated improvements in dark spots, improvement in fine lines and wrinkles, and improvement in epidermal barrier function resulting in less skin irritation.

Caffeine: More Hype Than Science.
- I consider this ingredient “more hype than science”. In one study, a cooling gel worked just as well in diminishing the appearance of dark circles with and without caffeine.

Designing a Skin Care Routine: The Basics

Retinoids: A Review

Retinoids: Common Mistakes

Vitamin C: A Review

The Main Ingredients That I Avoid When I'm Choosing Skin Care Products

I specialize in the treatment of sensitive skin, eczema, and allergic reactions of the skin. That means that I'm hyper-aware of ingredients that commonly trigger either irritation or allergic reactions. That's the main reason I avoid certain ingredients.

For my patients, I usually recommend products that do NOT contain:

Fragrance. Of all the ingredients that I test for, the category of fragrance additives is one of the top triggers of skin issues. Among my patients, fragrance additives are the most common cause of allergic contact dermatitis (aka allergic skin reactions).

Fragrances are challenging. To start with, when you see a product label that lists "fragrance", that's a little misleading. It sounds like it's just one ingredient. It's not. In fact, that single word may indicate the presence of 40 or more different fragrance additives.

Because of labeling laws in the US, manufacturers do not need to tell you the ingredients that make up their secret "fragrance" mixture. To make it more challenging, products that are labeled as "fragrance-free" may in fact (quite legally) contain fragrance additives, due to loopholes in the labeling laws. For more information about fragrance allergy, please see my handout.

Formaldehyde preservatives. If you look at the top 10 causes of allergic skin reactions in North America, formaldehyde and formaldehyde-related preservatives are in the top 10 (not a great list to be on). For this reason, none of my recommended products contain formaldehyde or related preservatives

Methylisothiazolinone (MI). This ingredient is used as a preservative in skin care products. Unfortunately, over the last decade we have started to see an epidemic of allergic skin reactions to this chemical. I never use products that contain MI anymore.

Formulation Matters: Why Vehicles are So Important

The right active ingredients are critical. However, it's just as critical to get the formulation correct.

For the best function, you need the right product. The “right” product has:

The right active ingredient…
Along with a formulation that can effectively deliver those ingredients to the skin layer where they can actually work.
That formulation also needs to work well for your skin type.

I'm really focused on formulations when it comes to certain active ingredients. For example, formulation is incredibly important when it comes to retinoids. Most people can use a retinoid, but you’ll need to pay close attention to the formulation. That’s why retinoids come in vehicles ranging from creams, lotions, gels, and moisturizing creams to special microspheres.

2020 Skin Renewal

2020 Skin Renewal (Anti-Aging) Skin Care Products

*Fragrance-free and hypoallergenic

*May cause irritation in some

The products below are examples (there are multiple other options) of products that are free of: Natural and synthetic fragrance additives, formaldehyde, lanolin, and methylisothiazolinone.

NOTE: Many skin renewal skincare products contain active ingredients that are known to be irritating. Always follow product directions very carefully. If you have a history of sensitive skin, you may not be able to use some of these products.

NOTE: These recommendations only apply for the exact products listed. Products that are the same brand and have a similar name may not be a safe choice. While we make every effort to provide up-to-date information, product formulations frequently change, so read labels and use caution.

NOTE: All products contain some potential allergens. Patch testing may be required.

NOTE: While these products have worked well for many of my patients, they are not appropriate for everyone. I have found that individuals may react very differently to the same exact product, so always use caution when using a new product. For those with sensitive skin, I recommend testing on the forearm or jawline twice daily for one week before using elsewhere.

Active Ingredients

The listed products contain certain ingredients that may be helpful in promoting skin renewal and combating the visible signs of aging skin (or that may be helpful in temporarily alleviating these signs).

AHA = alpha-hydroxy acids
Caffeine
DGR = dipotassium glycyrrhizate
GA = glycolic acid
HA = hyaluronic acid
Kojic acid
NC = niacinamide
NH = sodium hyaluronate
Retinoids
Vitamin C

**Please note that certain anti-aging/ skin renewal ingredients may cause skin irritation, redness, and burning in some individuals. Always use products with caution

Higher risk of irritation: retinoids
Also with risk of irritation, although less common than with retinoids: vitamin C, niacinamide

Other Ingredients

While none of the listed products contain natural or synthetic fragrances, formaldehyde, lanolin, or methylisothiazolinone, all skin care products contain ingredients that may trigger allergic reactions in some individuals. The products listed below contain ingredients that are less common causes of allergy.