Skin care cosmetics

Cosmetic skin care is both an easy subject to understand and an exceedingly difficult one to master! Your board-certified plastic surgeon can help you meander through this complicated world that is full of hype, ads making unprovable and misleading claims and huge pharmaceutical companies vying for your dollars as you weigh your cosmetic options.

I would like to tell you first about the causes of skin damage, the differences between young and old skin and the treatment options for each of the conditions we typically call “bad skin.”

Causes of skin damage

  1. Sun exposure
  2. Environmental effects (wind, humidity, heat)
  3. Genetic predisposition
  4. Effects of aging

Characteristics of healthy young skin

  1. Normal cellular turnover rate; a smooth texture; lack of cancer cells
  2. Normal oil production; absence of acne, rosacea or dryness and scalyness
  3. Even distribution of pigment; no melasma or dark spots
  4. More fat in the subcutaneous tissues
  5. More moisture
  6. More collagen and elastin (skin structural proteins)

Old, bad skin has the opposite of each of the above, and skin care products try to reverse or prevent the progression of each characteristic.

No single product, chemical or laser can perform all the actions necessary to transform old damaged skin to the healthy young kind we want. You need a combination of products.

Normalizing cellular turnover rate

Turnover rate is the rate of growth and death of skin cells, normal processes that occur continuously.

Sunlight is the primary disruptor of normal cellular turnover. Sun radiation (UVA and UVB) actually breaks cell DNA and prevents normal growth. In some cases, this can lead to abnormal cells growing—skin cancer. Sunblock is the best option you have to prevent this from occurring. Zinc oxide and titanium dioxide are two great chemicals in sunblocks that prevent damage from UVA and UVB rays. Vitamin A, vitamin C and vitamin E are chemicals that work in synergy and also regulate cell turnover. Vitamin A, better known as retinoids like Retin A and Retinol, is particularly potent in this way.

Oil production

Skin glands produce oil that keeps our skin lubricated. These glands are at the base of every hair shaft. Excess oil production leads to acne, and too little oil leads to dryness.

Retinoids, Glycolic acids, Salicylic acids and Benzoyl peroxide are some products that affect oil production.  Lasers like intermittent pulse lasers (IPL) can also improve oil production in acne patients. Pulse dye lasers (PDL) improve the color of red acne scars, and Fractional lasers can improve the texture of acne scars.


Dyschromia is the term for abnormal production of melanin, which leads to blotches and areas of uneven pigmentation. A number of products decrease pigment production. These include hydroquinone, kojic acid, Retinol and lactic acid. IPL and Q-switched lasers also improve color mismatches.

Increasing fat in the skin

The only way we can increase the fat of our skin is to either get fat (eat more) or use a substitute for such as skin fillers. Fillers include Juvederm, Radiesse and Sculptra.

Increasing skin moisture

Almost all cosmetics companies have a product to increase hydration. Such products include hyaluronic acids, glycerine, aloe vera, silicones, alpha and beta hydroxy acids (AHAs and BHAs) and Retinols.

Augmenting collagen and elastin

Augmentation of these two structural proteins is important, and so is decreasing their rate of breakdown. These are the proteins that keep the skin from becoming loose and droopy. Vitamin C, Retinoids, and palmitoyls enhance collagen production and decrease its degradation. IPL, fractional lasers (Fraxel) and radio frequency can also produce the same results by stimulating increased collagen production.

The products you use should include some of the products noted here, depending on what problem you need to have corrected. If you do nothing else, at least use a sunblock; this is the single most important thing you can do to improve your skin’s health and prevent aging.

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