By Colette Bouchez
From the WebMD Archives
Wanting to look young is not exactly a new idea -- the search for the fountain of youth has been going on for centuries. And while this past year didn’t deliver the perfect elixir, the year did introduce some scientifically solid, significant advances in anti-aging skin care. To home in on what can truly make a difference in your skin, WebMD asked medical experts to evaluate the cream of the crop.
Antiaging Breakthrough No. 1: Fractional CO2 Laser Skin Resurfacing
The antiaging breakthrough of the decade, according to many doctors, is a skin-resurfacing treatment known as CO2 fractional laser therapy. Combining the effectiveness of traditional carbon dioxide lasers -- long thought to be the gold standard in wrinkle removal -- with a new application technique, it delivers powerful results without the traditionally harsh side effects.
"Essentially, you are getting all the benefits of laser resurfacing, still the best way to remove wrinkles, but you’re getting it without the downtime and without the horrendous complication rate," says David Goldberg, MD, director of Skin Laser and Surgery Specialists of New York and New Jersey and clinical professor of dermatology at the Mt. Sinai School of Medicine in New York City.
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How does it work? The natural aging process, combined with exposure to sun and pollution, destroys collagen -- the main protein of connective tissue that keeps skin plump and line-free. Laser resurfacing uses beamlets of energy light to bore tiny holes in the skin, which works to put the body’s natural collagen production on fast-forward. Here’s what’s new: Fractional CO2 laser resurfacing does this in a way that prevents damage to the top layer of skin, offering maximum results with minimal recovery time.
While laser resurfacing doesn’t come cheap -- the procedure will cost you about $5,000 -- it is quick, accomplished in one or two sessions, with about four days downtime. Goldberg says effects are thought to last eight to 10 years.
According to the American Society for Dermatologic Surgery, patients with darker complexions may be at risk for pigmentation loss with any laser surgery. Common minor side effects for fractional laser resurfacing include redness and swelling that lasts about two days.
Antiaging Breakthrough No. 2: The New Wrinkle Injections
Wrinkle injection technology soared to new heights last year when the FDA approved four fillers: Perlane, Juvéderm, Artifill, and Radiesse. Along with Restylane, approved in 2003, each uses a slightly different substance to fill wrinkles.
But according to Rhoda Narins, MD, professor of dermatology at NYU Medical Center in New York City, that’s just the beginning. "What’s really significant is that we can now use these fillers to volumize skin anywhere on the face, so you can really sculpt a lifted, youthful look without surgery," she says.
Dermatologist Bruce Katz, MD, the director of Juva Skin and Laser Center in New York City, agrees. "Unlike a face-lift, which pulls the skin taut and tight, volumizing plumps up the skin so the look is youthful but more natural," he says.
In even more good news about wrinkle injections, studies conducted by Frank Wang, MD, at the University of Michigan Medical School found that those containing hyaluronic acid (such as Restylane and Juvéderm) led to "robust collagen production" while also interfering with collagen breakdown. So not only do you get a filling effect, says Narins, but you also have an actual increase in natural collagen production.
Currently, most fillers last up to one year, or longer. Only one -- Artifill -- offers permanent results, but not without concern. According to a published report by the FDA, it increases the risk of granulomas, bumps that form under the skin and may be permanent, as well as an increased risk of allergic reaction.
Still, Narins says all currently approved wrinkle injections have been used in Europe for several years, and the track record on safety is generally good. Most often, side effects are mild, usually limited to redness or swelling at the site of injection, she adds.
The cost of wrinkle-filling volumizers is between $600 and $1,000 per syringe.
Antiaging Breakthrough No. 3: Antioxidants
Topping the list of over-the-counter antiaging ingredients making the most noise these days are antioxidants. These skin-care nutrients fight aging by destroying free radicals, the unstable molecules that occur from sun exposure or pollution and that can literally gobble up the skin’s collagen supply.
"Antioxidants are nutrients that, when topically applied, disarm and neutralize free radicals before they harm skin -- so they can play an important role in antiaging skin care," says Sumayah Jamal, MD, an assistant professor of dermatology and microbiology at NYU Medical Center in New York City.
Scores of studies demonstrate the power of topical antioxidants (particularly CoQ10 and vitamins C and E) to rejuvenate and protect skin. However, the ingredient generating the loudest buzz in 2007 was clearly coffee berry, which some experts now believe is the single most powerful antioxidant discovered to date.
Two independent studies found that the same plant that gives you your java jolt in the morning is ready to provide a powerful antiaging boost to your face. The research conducted by David McDaniels, MD, at the Institute of Anti-Aging Research in Virginia, and Zoe Draelos, MD, at Dermatology Consulting Service in North Carolina, reported that coffee berry extract significantly improved the appearance of fine lines and wrinkles without allergic reactions or skin irritations.
Although Goldberg says it will be a few years before the full extent of coffee berry’s rejuvenating properties is known, he adds that it is "so powerful in its antioxidant rating that even if 1/1,000th of what’s applied gets into the skin it’s probably going to have an effect."
Dermatologist Ken Beer, MD, director of Palm Beach Esthetic in Palm Beach, Fla., says he’s seen the science and he’s impressed: "I think this is going to be a major cosmeceutical ingredient."
Other cosmeceuticals with new and powerful antioxidants include:
Prescriptives Super Line Preventor Xtreme with seven antioxidants (1 ounce, $48)
Neutrogena Antioxidant Age Reverse Day Lotion and Night Cream (1.7 ounces, $17.99 each)
Lumene Vitamin + Energy Cocktail (1 ounce, $17.99)
Clinique Continuous Rescue Antioxidant Moisturizer with eight time-release antioxidants (1.7 ounces, $39.50)
Antiaging Breakthrough No. 4: Peptides
Small proteins that stimulate the production of collagen, peptides have been on the cusp of antiaging skin care for a while. The excitement began several years ago with NIH-backed research on the ingredient Matrixyl (palmitoyl pentapeptide-3), showing its ability to stimulate collagen production in skin. Today, further studies on additional peptides continue to generate research news.
According to Jamal, studies on formulations such as Argireline (acetyl hexapeptide-3) show they can produce a mild, Botox-like effect, inhibiting the release of neurotransmitters that keep facial muscles from forming wrinkles. Even newer peptide formulations act like growth factors, stimulating skin cells to make a quicker turnover, much like young skin.
What’s new for peptides? Formulations that seem to yield overall improved results. "They are really getting the science down now, learning how to stabilize the peptides and at the same time inhibit collagenase [the breakdown of collagen] so we have better, more tailored peptide products," says Beer.
Products containing the newest versions of that peptide technology include:
Olay Regenerist Micro-Sculpting Cream with amino peptide complex (1.7 ounces, $29.99)
Lumene Premium Beauty Rejuvenating Instant Serum (1 ounce, $29.99)
Avon Anew Clinical Eye Lift (0.5 ounce, $28)
Osmotics Blue Copper 5 Face Lifting Serum (1 ounce, $75)
Emerge Bio-Peptide Night Repair Cream with 10% peptides (1.12 ounces, $43)
Antiaging Breakthrough No. 5: Vitamin A
Among the most medically studied topical antiaging treatments are the retinoids -- derivatives of vitamin A. They are offered as prescription treatments such as Retin A or Renova, but also available in weaker strengths in over-the-counter products, listed as the ingredient retinol.
Retinoids are "thought to work on aging skin by increasing collagen production and decreasing collagen breakdown," says Jamal -- and a ream of studies backs her up.
But while many doctors believed only the prescription-strength retinoids were powerful enough to cause significant change in the skin, 2007 was the year that idea changed. In a study published in the Archives of Dermatology in May, researchers from the University of Michigan found that 0.4% retinol lotion applied three times a week for 24 weeks yielded significant difference in skin wrinkling when compared with a similar lotion without retinol used on a separate group of people in the study.
Even more surprising: The average age of study participants was 87, meaning it’s truly never too late to look younger.
"For those who can’t or don’t want to have an office procedure for wrinkles, I suggest starting with retinol products, and if there are no problems, such as redness or irritation, you can work up to a prescription-strength Retin A product. But we now know that both have the power to produce measurable antiaging results," says Goldberg.
Products containing retinol include:
Vichy Reti-C Intensive Corrective Care (30 milliliters, $31)
Neutrogena Healthy Skin Anti-Wrinkle Intensives with retinol and antioxidants (Serum, 1 ounce, $16.99; Eye Cream, 0.5 ounce, $16.99)
Clinique Zero Gravity Repairwear Lift with retinol, antioxidants, and peptides (1.7 ounces, $52)
L’Oreal Advanced RevitaLift Double Lifting Gel (1 ounce, $16.99)
RoC Retinol Correxion Deep Wrinkle Serum (1 ounce, $19.99)
Antiaging Breakthrough No. 6: Antiaging Sunscreens
Among the most exciting new ways to fight skin aging are two dramatic breakthroughs in sun protection: Helioplex, a new technology that makes current sunscreen ingredients more effective, and Mexoryl SX (ecamsule), a new protective agent. Representing the first innovation in skin sun protection in more than 20 years, each is specifically designed to defend against the aging effects of short UVA rays.
"They are truly the best we have, and they are a major, major advance in terms of antiaging protection," says Katz.
Most of us know about the dangers of burning UVB rays, but you might be less aware of the damaging and aging effects of UVA. "These are the ones that go deep -- UVA rays cause the deep collagen and elastin damage that contributes to aging skin," says Katz.
While most sunscreens effectively protect against UVB rays, protection from UVA was mostly limited to the "long" waves, with ingredients that were unstable and frequently degraded in the sun.
But Mexoryl SX (ecamsule), a UVA-blocking sunscreen developed by L’Oreal, and Helioplex, a technology created by Neutrogena to stabilize traditional sunscreen ingredients avobenzone and oxybenzone, are proving not only to protect against the damaging short UVA rays, but to offer long-lasting protection without the need to constantly reapply.
"They have been available in Europe for some time now, and there is no question they work -- and from an antiaging standpoint, they can be your best friend," says Goldberg.
Even more exciting: In 2007 these sunscreen advances were combined with antioxidants and other antiaging ingredients in moisturizers and day creams that offer Fort Knox-level protection against the aging effects of the sun.
Products containing the latest Helioplex technology include:
Neutrogena Healthy Defense SPF 45 Daily Moisturizer (1.7 ounces, $11.99)
Neutrogena Ultra Sheer Dry-Touch SunBlock SPF 70 (3 ounces, $9.99)
Products containing Mexoryl SX include:
Vichy Capital Soleil SPF 15 Sunscreen Cream (3.4 ounces, $29.99)
L’Oreal Revitalift UV Moisturizer and Sunscreen (1.7 ounces, $22)
LaRoche-Posay Anthelios SX (3.4 ounces, $29)
Lancome UV Expert 20 (3.4 ounces, $35)
Originally published in the November/December 2007 issue of WebMD the Magazine.
WebMD Magazine - Feature Reviewed by Michael W. Smith, MD on October 10, 2007
© 2007 WebMD, Inc. All rights reserved.