| When is comes to skin care, the majority of my | | | | products. A cosmeceutical is a product that does |
| patients are interested in anti-aging products when | | | | more than adorn or beautify; it actually has a |
| they ask, "What should I use on my skin?" | | | | biologic effect on the skin, due to the inclusion of |
| Have you ever looked in the mirror and seen | | | | any number of active ingredients.) |
| some lines that weren't there before? If you're | | | | The term retinoid refers to a chemical in the |
| over 40, especially if you're pale like me, you | | | | vitamin A family. This includes the prescription |
| probably have. Not a good feeling. I'll digress a | | | | products Retin-A®, Renova®, |
| minute here to recount a visit I had with a very | | | | Avage®, and Tazorac®, and |
| sweet lady a few years ago. She came to see | | | | nonprescription retinol, retinoic acid, and |
| me in the office and was quite upset about all the | | | | retinaldehyde. This is the best studied class of |
| wrinkles that had suddenly appeared on her face | | | | antiaging products and has the most supporting |
| two months previously. She was 82 and had deep | | | | scientific evidence for efficacy. When it comes to |
| lines on her forehead and cheeks; the result of | | | | treatment of sun damage (dullness, rough |
| years in the Texas sun, time spent on the lake, | | | | texture, fine lines and brown spots,) I routinely |
| etc. | | | | recommend a prescription retinoid, such as |
| In other words, a full life. But she insisted that the | | | | Renova® or Retin-A®. Retinoids work at |
| wrinkles hadn't been there until two months earlier! | | | | the cellular level to regulate proper growth and |
| She wanted something done! I stalled for time, | | | | turnover of cells, decrease inflammation, enhance |
| puzzled. We discussed what was going on in her | | | | immunity, inhibit tumor formation, and inhibit |
| life, what her grandkids were doing, etc. Later in | | | | collagen breakdown. Retinoid therapy results in |
| the conversation, she mentioned that her | | | | smoother skin, enhanced light reflection (skin that |
| daughter had taken care of her when she had her | | | | "glows",) diminishment of fine lines, and decreased |
| cataracts removed...two months before. Ah, | | | | pigmentation. |
| mystery solved. One of the downsides to better | | | | Prescription retinoids can cause irritation and |
| vision, I guess. I ended up reassuring her that she | | | | redness in some people. This can sometimes be |
| was beautiful and gave her a prescription for | | | | dealt with by decreasing application frequency, or |
| Renova® (and a referral to a plastic surgeon; | | | | mixing with a moisturizer. If these measures fail, |
| there is only so much I can do!) | | | | then nonprescription retinol, which is weaker, is a |
| Was Renova® going to erase 60 years of | | | | good second choice. There are many good over |
| sun damage and make the wrinkles disappear? | | | | the counter retinol products, such as Neutrogena |
| No, but it couldn't hurt. In fact, retinoids such as | | | | Healthy Skin Anti-Wrinkle Cream or RoC |
| Renova® and RetinA® are the "gold | | | | Multicorrexion Intensive Night Cream. These |
| standard" when it comes to topical anti-aging | | | | products are usually used at night. Because they |
| cosmeceuticals. (A bit of explanation is in order: | | | | decrease the thickness of the stratum corneum |
| the term "cosmeceutical" refers to a class of | | | | (the dead skin cell layer), retinoids do make the |
| products that lie in the gray zone between drugs | | | | skin more sensitive to the sun; thus, daily |
| and cosmetics. Some cosmeceuticals are available | | | | sunscreen use is a must! |
| by prescription, but most are over-the-counter | | | | |