Laura J. Martin, MD
At 21, Alisha Pierre, an Albany, N.Y., hairdresser, is already fretting about crow’s feet, the faint creases that run from the sides of her nose to the corners of her mouth, and the dark under-eye circles she inherited from her mother. To combat what she sees as early signs of aging, she follows a skin care regimen that includes a night cream containing what she calls "earthworm poop" and a moisturizer with a peptide that’s a synthetic version of snake venom.
"I try everything I can to prevent wrinkles, lines, and bags," she says. "I learned in beauty school that after age 20, your body produces less and less collagen every year."
There’s something else she picked up at beauty school: a smoking habit. And when it comes to shielding her skin from the sun, "That’s the other problem," she admits. "I'm Italian and I don’t burn, so I never use sunscreen."
For all her attention to her appearance, Pierre is pretty much a poster child on what not to do when it comes to keeping young skin looking its youthful best.
A hefty body of research shows that the most important steps people in their 20s and early 30s can take to maintain their skin is avoid smoking and practice diligence in using sunscreen.
"I can’t stress enough that the No.1 thing young adults can do to limit the signs of aging is use a broad-spectrum sunscreen that protects against both UVA and UVB rays with an SPF 30 or higher every single day," says Adam Friedman, MD, director of dermatologic research at the Albert Einstein College of Medicine.
Robin Ashinoff, MD, the chief of dermatologic surgery at Hackensack University Medical Center, agrees: "Prevention is absolutely the best medicine against skin aging, and that means staying out of the sun."
If Pierre laid off the cigarettes, she’d have far less reason to be concerned that a decrease in collagen will lead to a loss in skin tautness anytime soon. Studies show that smoking interferes with the body’s ability to produce new collagen and also leads to premature wrinkling. Combine a heavy cigarette habit with regular, unprotected sun exposure and you’re more than 10 times more likely to develop wrinkles than people your same age who don’t smoke and stay out of the sun.
"Control the environmental causes of aging, and while you might see fine lines in your early 30s, you can minimize dilated blood vessels, deeper wrinkles, and loss of elasticity to your late 40s or 50s,” says Joshua Zeichner, MD, director of cosmetic and clinical research in dermatology at New York’s Mt. Sinai Medical Center.
With good habits, dermatologists say there’s little reason to invest in anti-aging creams that contain ingredients such as peptides and growth hormones that promise to speed cell turnover and build elasticity.
For starters, there’s scant evidence that these creams work. Because these products are cosmetics and not drugs, they don’t need to go through the rigorous clinical studies that the FDA requires of drugs, Zeichner explains. "You have to take the claims that beauty companies make with a very large grain of salt," he says.
Secondly, using these products in your 20s is like watering your lawn in the rain: wasteful and unnecessary. "Some skin care products claim to increase cell turnover or to repair collagen breakdown," Zeichner says. "In your 20s, you have excellent turnover without any help and your skin is fully capable of repairing itself. The downside is that these products may irritate your skin or make it more sensitive to the sun."
Claire Duplantier, 23, a YouTube beauty vlogger from Atlanta, discovered the toll of pricey skin care creams on both her wallet and her complexion. She was bothered by forehead crinkles and the beginning of crow’s feet. "It was nothing major," she says, "but enough to notice in pictures and when I’m tired." She says she has spent over a thousand dollars on her "proactive" anti-aging skin care regimen in the past nine months, including three purchases of a $195 "skin defense cream."
"At first, I liked the idea that I was rubbing something that was practically gold on my face day and night," Duplantier says. "But luxurious face creams hurt your bank account and make your shoe collection dwindle."
What’s more, a pile-up of rich ingredients can actually cause the biggest skin care woe for young people: breakouts. "My acne wasn’t improving," Duplantier says. "Instead, come midday, my skin was oily and aggravated." These days, she’s replaced the skin defense cream with a $13 SPF 30 moisturizer, and, she says, "I have fewer blemishes and it feels good to sign a bill that’s less than $20."
When Zeichner sees members of the Millennial Generation who want to know how they can maintain can their still-dewy skin, he suggests they add a daytime antioxidant moisturizer or serum to their regimen. These products contain ingredients such as vitamin C, vitamin E, green tea, niacinamide, and alpha lipoic acid. They may minimize the oxidative damage caused by stressors such as sun exposure and pollution.
Friedman, for his part, believes that after sunscreen, the next most effective damage-preventive product a 20-something man or woman can use is a prescription retinoid or over-the-counter retinol. "I think every young adult should use one," he says. "There is a ton of solid research showing that retinoids work to regulate skin function."
These vitamin A derivatives reduce acne, shrink enlarged pores, even out skin tone, treat precancerous skin lesions and, yes, build collagen and speed cell turnover.
Retinoids, however, should not be used by women who are pregnant or breastfeeding. And retinoids can cause redness, dryness, and flaking during their first few weeks of use. "They should be introduced into a skin care regimen gradually and cautiously," Friedman says.
Not long ago, Friedman's 23-year-old cousin approached him about getting Botox injections. She had heard that injections of the botulinum toxin, which are used to smooth horizontal forehead furrows and the vertical "11" lines between the brows, were also effective in preventing these wrinkles from every forming.
Friedman turned her down. "I don't believe in treating wrinkles you can't see," he says, "and there’s no evidence that Botox is effective as a preventative tool." What's more, he says, "long-term overuse of the drug could possibly lead to atrophy of the muscles. That can cause the face to appear inadvertently aged, despite the lack of wrinkles."
Zeichner says he sometimes turns away 20-something Botox seekers because they’re seeing flaws that aren’t apparent to anyone else. "We live in an age of Photoshopping," he says, "and some young people believe the retouched images of celebrities they see in magazines are attainable. They're not."
Likewise, Ashinoff is wary of injecting Botox in patients in their 20s or early 30s, saying, "To me, if you erase every tiny line you can look fake and older than your actual age like all those Real Housewives." Still, she says, she doesn't believe in imposing a minimum age for cosmetic drugs like Botox that have a long track record of safety in well-qualified hands. "Light-skinned people with light eyes, like those of Celtic descent, can have a lot of lines at a very young age," she says. "Some of my happiest Botox patients are people in their 20s."
For her part, Duplantier says she's started a Botox fund for the future with all the money she's saved by switching from expensive anti-aging products to drugstore brands. "My ideal skin when I’m older is some wrinkles, but not many," she says. "I don't want to look plastic. I want my skin to reflect light and look like it has some history but is also timeless."
SOURCES:Alisha Pierre, Albany, N.Y.Claire Duplantier, Atlanta.Adam Friedman, MD, assistant professor of dermatology, assistant professor of physiology and biophysics, director of dermatologic research, Albert Einstein School of Medicine, New York.Joshua Zeicher, MD, director of cosmetic and clinical research, department of dermatology, Mt. Sinai Medical Center, New York.Robin Ashinoff, MD, chief of dermatologic, Mohs and laser surgery, Hackensack University Medical Center, New Jersey.Morita, A. Journal of Dermatological Science, 2007.Yin, L. Photodermatology, Photoimmunology, and Photomedicine, August 2001.Katiyar, S. International Journal of Oncology, June 2001.Briganti, S. Journal of the European Academy of Dermatology and Venereology, November 2003.Darlenski, R. British Journal of Dermatology, December 2010.Thielitz, A. American Journal of Clinical Dermatology, 2008.
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