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Skincare: A Top Dermatologist's 5 Best Anti-Aging Tips

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Wish your skin looked younger? Aging can change skin's appearance as early as your 30th birthday or by later in midlife, depending on your habits. You can't control certain factors, like falling estrogen levels that lead to sagging skin or the genetics that give you a particular bone structure. But there are also plenty of external influences on how your skin ages -- and the right anti-aging care can help blunt their damage.

"When people first see signs of aging -- fine lines, brown marks, smile lines, crow's feet -- is when they become better about anti-aging care," says dermatologist Diane C. Madfes, assistant clinical professor at Mt. Sinai School of Medicine in New York City and a spokesperson for the American Academy of Dermatology. "The good news is that it's never too late to respond to what you see."

Her best anti-aging tips:

Skin anti-ager #1: Focus as much on what you put in your body as on what you put on your skin.

You might expect a dermatologist to emphasize only skin-care products and techniques, but Madfes says that younger skin starts with the nutrients that reach it from inside the body. The skin is the body's largest organ, after all. So diet directly affects how you visibly age.

How to do this:

     * Take a vitamin D supplement. Madfes recommends 1,000 IUs per day.

     * Eat plenty of omega-3 and omega-6 fatty acids. Ideally they should come from natural sources, including olive oil, ground flaxseed, and fish such as salmon. Fish-oil supplements are another source of these important fats, which help protect the moisture barrier. This is the protective top layer of skin that keeps moisture in but tends to thin as you age, causing dry skin.

     * Drink water -- in all its forms -- all day long. A liter a day is a good minimum start, Madfes says. Different body types, such as athletes, need more. Count GREen tea and coffee in your daily total, but go easy on the alcohol. Red wine does contain beneficial antioxidants, but it can also dilate blood vessels, contributing to the ruddy-faced skin inflammation called rosacea that tends to strike women in midlife.

     * Cut way back on processed foods and sugars (another reason to watch the wine intake). They promote inflammation, a biochemical process that damages the normal production of dermal cells.

Skin anti-ager #2: Halve your sun exposure.

If you've heard a version of this one before, it's because dermatologists aGREe that UV exposure is the number-one skin-ager out there. Sun damages elastin and causes a loss of collagen, which translates to drooping, a lost jawline, and wrinkles. It also adds discoloration and roughens texture. Not least, UV rays are the main cause of skin cancers, an aging risk that goes beyond the mere cosmetic.

"Simply saying, 'Stay out of the sun!' isn't practical, though," Madfes says. "So I tell patients to just try to cut your exposure in half -- that seems more doable."

How to do this:

     * One word: sunblock. Use a full tablespoon of sunscreen with a sun-protection factor (SPF) of at least 30 on your face, spreading it to your neck and ears. Know that older skin tends to be more vulnerable to the effects of the sun than younger skin.

     * If you tend to forget sunscreen, try the newish makeup bases and moisturizers with UV-protection built in. On the downside, you might not get the optimum amount of SPF, but Madfes says that the plus for many women is that at least they remember some protection every day -- which is better than going without.

     * Walk on the shady side of the street. "You really can decrease your exposure with little things," Madfes says.

     * Wear UV-protective clothing. A host of new apparel blocks UV rays while wicking away moisture, making these clothes especially good for outdoor exercise.

     * Exercise outside in the early morning or late afternoon. If you can, avoid sun between 10 a.m. and 4 p.m., when UV rays are most potent.


Skin anti-ager #3: Use a retinoid.

Yes, there's a vast medicine cabinet full of anti-aging "cosmeceutical" products out there. But the very best kind of topical cream to repair the aging process, Madfes says, is a retinoid. Retinoids are vitamin-A derivative compounds that have been shown to boost collagen production and cell turnover, as well as to unclog pores and stimulate blood vessels in the area. This reduces oil and acne, smoothes skin, and gives you a brighter, healthier appearance. Retinoids have been around since the 1970s. Depending on the formulation, users typically see results within a month or two.

How to do this:

     * Ask a doctor about prescription-strength retinoids, which are generally most effective, Madfes says. These include tretinoin (Retin-A, Renova, Avita) and tazarotene (Tazorac, Avage). Some insurance plans cover the cost.

     * Follow directions carefully. Usually, starting a retinoid involves a gradual introduction of the product to avoid irritation. Eventually, most people apply it just once a day.

     * Know that you can still get lesser, but noticeable, benefits with an over-the-counter product, according to Madfes. Look for the inGREdient retinol, or retinoic acid.

     * Apply at night on a clean face; that's when retinoids work best. They're also sensitive to sun, which is why night is a good application time. (But if you use a sunscreen by day, you won't be hypersensitive to the sun by using a retinoid.)

     * Use a moisturizer on top of the retinoid, or use a moisturizer that contains retinoid.

     * Know that retinoids aren't recommended for women who are pregnant or breastfeeding.

Skin anti-ager #4: Spend time -- not necessarily money -- on a smart morning-night routine.

Skin care doesn't have to be complicated, but it does require the right basics, Madfes says. By day, that mostly means adding UV protection. But night care is equally important. "Your skin is amazing in how it can be exposed to so much all day and still regenerate," Madfes says. "But as you get older you need to help it do that."

How to do this:

     * Start every day with sunscreen, even if you'll mostly be inside. "You don't want the sun to kill all the new collagen you GREw overnight," Madfes says.

     * Remove all makeup and wash your face before you go to bed. All day, your skin is assaulted by chemicals in the air that break down collagen and cause other damage. If you don't clean your face, your exposure to these pollutants will continue all night long, too.

     * After cleansing, apply a retinoid and then a moisturizer -- and sleep on a clean pillow (don't go weeks before you wash it).

     * Know that you don't have to spend a lot of money to get effective products. Look for companies that do a lot of safety testing, Madfes says; reputable manufacturers tend to invest more in this. Trust your instincts -- if claims sound improbable, they usually are. Because everyone's skin is unique, you may need to tinker until you find products that work best for you. Ask a dermatologist for recommendations if you're stumped.

Skin anti-ager #5: Pick cosmetic procedures that also help skin regenerate.

A host of skin products and procedures that are available over the counter or from specialists such as spas or dermatologists can give more than the illusion of youth -- they can actually help regenerate cells. While they can't turn the clock back forever, these choices may slow the rate of changes that cause deep wrinkles and a dull texture.

How to do this:

     * Try peels. Exfoliating (through facials or microdermabrasion creams applied at home) can make skin look brighter. This is because the turnover of cells grows slower as you age. A chemical peel is a deeper process that does the same thing while also stimulating collagen growth, Madfes says.

     * Find out if you're a candidate to resurface your surface. If the top layer of skin is looking brown, with a rough texture -- hallmarks of sun damage -- a relatively new procedure called fractional resurfacing can actually reverse some of the damage by increasing collagen production. Done with lasers in a doctor's office, resurfacing can improve skin texture while minimizing wrinkles, sun spots, and acne scars. This procedure can create visible improvements in patients who have significant skin damage.

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