By Dr. Kirsten Vin-Christian
House Calls
The skin is the body’s largest organ - and the most visible. Because our skin’s health and beauty often translate into how attractive we appear, cosmetic dermatology is growing in popularity.
Many former “healthy tan” seekers are now getting rejuvenating skin treatments to diminish the damage caused by years of sun exposure. Sun exposure is the biggest reason for deep wrinkles, sallow color, irregularities, rough patches, brown spots and cobblestone-like textural changes of the skin.
All skin becomes thinner and loses some elasticity with age, but sun damage greatly accentuates these aging changes. Other factors contribute to wrinkling and aging of skin - smoking is among the most notable. A person’s genetic predisposition to wrinkling also plays a role in how he or she ages cosmetically.
Unfortunately, many people didn’t realize how much damage could be caused by sun exposure when they sunbathed 20 years ago. The good news is that cosmetic dermatology offers many options to diminish or reverse damage caused prior to the current “safe sun” era.
There’s no magic wand that provides immediate, risk-free, complete skin improvement.
The French saying “Il faut souffrir pour etre belle” (One must suffer to be beautiful) can be true. Most treatments that provide relatively dramatic improvement require some “down time,” when the skin may look bad as it heals.
Medical regimens range widely in procedure and cost, but all take time - often months - before the improvement becomes apparent. Retin-A is the best-known topical regimen for improving aging skin symptoms, such as fine wrinkling and color changes, but it’s relatively difficult to use and doesn’t work for everyone.
Other topical anti-aging agents include glycolic acids (light fruit acids), topical vitamin C, Kinerase and many others. The creams don’t erase the signs of aging, but the recuperation time is minimal. Some acid peels and microdermabrasion, a light sanding procedure, also require little to no healing time.
Deeper chemical peels and laser resurfacing can leave skin red and raw for several weeks. Although laser resurfacing can dramatically diminish deep wrinkles, it’s a relatively difficult procedure to undergo and should probably only be considered by a very motivated individual who is very bothered by his or her wrinkling.
There is a new skin-rejuvenation treatment called “non-ablative resurfacing.” This involves using various lasers and laser-like machines with relatively low energy over repeated treatment sessions to improve deep sun damage without harming the skin’s surface.
Another popular treatment is Botox, which is injected into the upper face muscles to diminish crow’s feet and frown lines which don’t respond to superficial treatments.
Dr. Kirsten Vin-Christian is a dermatologist at the Palo Alto Medical Foundation. The Palo Alto Medical Foundation and column editor Arian Dasmalchi provide this monthly column.
