Most facial wrinkles come from ultraviolet rays, from the sun or tanning beds. So, the best way to avoid getting more is to avoid getting sun damage. Avoiding midday sun, wearing protective clothing and hats, and, of course, using a good sunscreen. I recommend a sunscreen that is SPF 30 or higher with a high concentration of zinc oxide and/or titanium dioxide. These are physical blockers that act like little mirrors that reflect all of the suns rays.

Another common cause of wrinkles is smoking. No surprise here. Smoking affects the blood vessels, which has an effect on the skin. With so many aids to help one in quitting, there is no better time than now to give up the cigs.

A good topical regimen can help reduce sun damage, improve skin texture, even out skin tones, and reduce fine lines and wrinkles. Without question, the most studied drug in this category has been Retin A. This Vitamin A derivative is a great medication to improve the skin. In fact, it is more effective than virtually any other cream available and is often much less. Retinol, an over the counter product, is a pro-drug–it gets converted into tretinoin, the active ingredient in Retin A once it gets in the skin. But beware!!!! Not all Retinols are the same. In fact, nearly all have no clinical studies on them showing how effective or ineffective they are!!! So, if you decide to go the over-the-counter route, or even buy one in your local spa or Doctor’s office, ask to see the clinical studies on that product (not just a general study on Retinol, but on their exact product).

Topical antioxidants have been hot in the last decade. These help by reducing free radicals in the skin and therefore reduce damage in the skin, mostly caused by the Sun’s ultraviolet rays. Vitamin C has been the most well studied. There are some good Vitamin C products out there and a lot of bad ones. Choose carefully as these products are not cheap. One’s that oxidize quickly (turn brown) will not work well. Several other antioxidants have been put into products, but are less well studied.

In short, a good topical anti-aging regimen should contain:

1. A titanium-dioxide and/or zinc oxide containing sunscreen, preferably SPF 30+

2. A well-studied Vitamin A derivative product, such as Retinol or Retin A

3. An anti-oxidant, such as topical Vitamin C. But, just any topical Vitamin C product will do.

Robert S. Bader, M.D., Dermatologist

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