Anti-Aging (Fighting Wrinkles)
Why do I look older?
Skin aging is a normal process, but evidence suggests that most signs of aging (fine lines, wrinkles, and age spots) are caused by sun damage from ultraviolet (UV) rays. Theoretically, if you protect your skin from birth with sunscreen and sun-protective clothing, you would minimize most skin issues that make us look old.
How do I get my skin looking younger?
While nothing exists to reverse aging, you can minimize fine lines, wrinkles, spots, and sun damage for $15-25/month. If you hear about complicated regimens or fancy products from friends or on social media, they are usually trying to sell you something expensive.
There are 3 simple steps: (1) Correction, (2) Moisturization, and (3) Sun protection.
What is a simple (the best) skin care routine?
BEDTIME ROUTINE:
Rinse face with gentle facial cleanser (hydrating or foaming)
Apply thin layer of adapalene (step 1)
Apply a thicker layer of Vaseline or CeraVe cream (step 2)
Go to bed a bit shiny
MORNING ROUTINE:
Rinse face with gentle facial cleanser (hydrating or foaming)
Apply a daily facial moisturizer with sunscreen (SPF 30+) (step 3)
Moisturize as needed with CeraVe cream throughout the day
Step 1 – Correction
The best family of medicines to improve aging skin is the retinoid family, including tretinoin (Retin-A), tazarotene (Tazorac), adapalene (Differin), and retinol. The first two are prescriptions, the last two are over-the-counter. Adapalene is better than retinol and used to need a prescription. See instructions below.
At bedtime, dab the adapalene gel on the outside of your face (forehead, sideburns, chin). Massage it into the outside of your face first. Then, with the tiny bit left on your fingers, massage it over and around the nose, cheeks, and lips (these are more sensitive areas to peeling and redness).
NOTE: This will dry you out. It dries everyone out! The goal is to minimize the red and flaky skin until your skin gets used to the adapalene after a few weeks.
WARNING: Adapalene gel should not be used if you are pregnant. It can cause problems for growing babies in the womb.
Right after the adapalene gel goes on, apply a lot of moisturizing cream or ointment. My favorites are CeraVe cream, Vanicream cream, or Vaseline (#SlugLife). Put a thicker layer on your skin and go to bed shiny. It will soak into your skin while you sleep.
NOTE: It takes a month to see results, so stick with it for at least 30 days!
My face is peeling with adapalene. What do I do?
This is very common. Many people tell me their skin is too sensitive for adapalene or it made their skin peel. The problem is that the correct way to use adapalene is NOT how we naturally want to use it. Most people use too much adapalene or only put it around the eyes and lips (most sensitive areas).
Follow the steps above to get improvement over your entire face. It helps new skin grow evenly and shrinks your pores It takes a full month for your skin to grow out from the base layer, so it takes a full month to start seeing the results.
But adapalene starts drying out the skin and making the skin red right away, and you have to deal with this for a full month before you see any benefits. This first month is when most people give up and tell me that adapalene doesn’t work for them.
TIPS for proper adapalene use:
Don’t use too much. A pea-sized amount is enough for the whole face. Follow the steps above.
Start on the outside of your face, not the center. Peeling skin at your hairline is much less bothersome than around your nose and lips.
Moisturize! You cannot over-moisturize. You are fighting the dryness and peeling until your skin adjusts to adapalene.
Stick with it! Do it every night for a month to see the benefits. And the benefits are great! It shrinks your pores, makes acne better, and helps with aging!
If you can’t handle every night, then apply it every other night, just be consistent!
Some patients “sandwich” the adapalene at the beginning. Place a thin layer of moisturizer on the face first, then the adapalene, then a thick layer of moisturizer.
Step 2 – Moisturization
Expensive ≠ better results. In fact, my favorite facial moisturizer is just Vaseline (100% petrolatum) nightly before bed. Try a thin layer of Vaseline one night before bed. You will love how your face feels in the morning! My family and my staff have all switched to Vaseline. However, when we get free samples, my wife loves La Roche-Posay Toleriane moisturizer. Serums, toners, vitamins C and E, or hyaluronic acid are not necessary. Your skin needs to feel loved, so love it by moisturizing it.
Step 3 – sun protection
This picture of a truck driver shows what the sun does to our skin. If you really want younger-looking, healthier skin, you have to protect your skin from the sun every day, year-round. This has never been easier because every skincare company (Aveeno, Neutrogena, Elta MD, La Roche-Posay) has a daily facial moisturizer with SPF. It needs to be an SPF of 30 or higher. But, sun hats and shade are better than any sunscreen.
What else can I do for fine lines, wrinkles, and age spots?
Usually, the steps above help most people see visible improvement in their skin. Sometimes prescription tretinoin (a.k.a. Retin-A) is needed. For deeper, permanent wrinkles, Botox often provides the best results but needs to be done about every 3 months. I would do it for my forehead if I weren’t so cheap, so I stick with adapalene.
Chemical peels, microneedling, and lasers (especially IPL) can make a huge difference, but these are all considered cosmetic and not covered by insurance. If you are considering cosmetic options, do NOT go cheap. I see referred patients from local medi-spas when a complication happens with a cosmetic procedure, and the medi-spa doesn’t know how to treat it. This is especially true for those with darker skin tones – certain peels and lasers can make things worse. Look for a board-certified dermatologist in your area. If you are in or near Utah, see one of my excellent colleagues at the University of Utah.
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