Age isn’t kind to skin. Years of accumulated sun exposure leave their mark in the form of fine lines, wrinkles and discoloration. By the time you reach your 60s or 70s, much of the damage already has been done, but that damage isn’t indelible.
“There are a lot of things you can do about the changes that time, aging and sun exposure have brought about,” said Dr. Kenneth Arndt, clinical professor of dermatology at Harvard-affiliated Beth Israel Deaconess Medical Center in Boston, Mass., and medical editor of the Harvard Medical School special health report, “Skin Care and Repair.”
The first step is to slow the pace of further damage by staying out of the sun and wearing adequate sun protection whenever you are outside. That means completely covering exposed skin with an SPF30 or higher sunscreen and wearing sun-protective clothing, wraparound sunglasses, and a wide-brimmed hat that shields your face, neck, and ears.
To minimize wrinkles and age spots that have already etched themselves into your skin, Arndt suggested the following nonsurgical cosmetic techniques.
1. Smooth and fill: The most common skin rejuvenation tools Arndt uses on his patients are dermal fillers and neuromodulators.
Neuromodulators (Botox, Dysport, Xeomin) are injections to relax the muscles that create the appearance of wrinkles when you smile, frown or laugh. “These products diminish the frown lines and forehead lines and sometimes the crow’s feet, and they do it well, reliably, and safely. People are almost always happy with the results,” he said.
Dermal fillers are injections that plump up sagging areas of skin. They’re sometimes called “liquid facelifts,” because they can create a more youthful look without the downtime and risks associated with cosmetic surgery. Dermal fillers are often used to soften the “laugh lines” that run from the side of the nose down to the mouth.
Often the two treatments are used together. Neuromodulators diminish frown lines, while fillers plump up the appearance of the lower face, cheeks, chin and laugh lines. Combining the two enhances and prolongs their effects. Arndt said both techniques are safe, with very few side effects.
Botox and similar injections may cause a little bruise at the injection site or a slight heaviness of the brow, but these effects are temporary. Fillers also may cause some slight, temporary bruising. Also remember that the effects of these treatments are temporary. To keep seeing results, you’ll need to return for repeat sessions – Botox two or three times a year, and fillers once or twice a year.
2. Rejuvenate: For skin discoloration, including freckles, age spots and liver spots, Arndt recommended laser resurfacing or pulsed light therapy.
Fractional laser resurfacing aims very small beams of high-energy light at the skin to smooth and tighten the surface and stimulate the development of collagen – the protein that gives skin its elasticity. Because fractional laser resurfacing works only on fractions of the larger areas treated at a time, redness is minimized and healing is quick. However, you may have some itching and swelling in the treated area.
Pulsed light therapy exposes the skin to intense broadband wavelengths of light energy, unlike the laser, which emits one specific wavelength. This technique, which also stimulates collagen production, reduces the look of sun damage and brown spots and minimizes wrinkles. Side effects are usually mild, but there may be some redness afterward.
Less costly options
The treatments listed above can be pricey – Botox injections range from $300 to $700 per session, and fractional laser resurfacing can exceed $1,000. If you don’t want to invest quite as much money, consider these options:
• Chemical peels use chemicals such as glycolic acid to strip away the outer layer of damaged skin.
“They’re reasonably mild,” Arndt said. “The skin is left refreshed, a little pink, and shiny.” A glycolic acid peel can cost as little as $80, but it needs to be repeated every few weeks or months to continue showing an effect.
• Microdermabrasion uses tiny exfoliating crystals to buff off the top layer of skin and reveal the smoother surface below. Although the technique is different from a chemical peel, the results are similar, Arndt said. The cost is around $100.
• Mild laser resurfacing (Clear and Brilliant) is a gentler version of fractional laser resurfacing. It involves smaller areas of skin, and the beam is less intense, so there’s less downtime and discomfort afterward than with a traditional laser resurfacing procedure. The cost ranges from $200 to $500, depending on the area of skin treated.
WHERE TO GO
Most of these techniques are available at both dermatologists’ offices and “medspas” – nonmedical facilities that offer a range of cosmetic services. Well-trained estheticians can perform some of these procedures. However, Arndt cautioned, “In some spas and similar offices, people who are not well trained do some of the treatments. That’s where it gets dangerous.”
In October, a study in JAMA Dermatology found that the percentage of lawsuits from skin laser surgery performed by nonphysicians more than doubled from 2008 to 2011, calling into question the safety of some medspas.
If you do decide to see an aesthetician instead of a dermatologist, make sure the practitioner is licensed in your state and is certified by the National Coalition of Estheticians, Manufacturers/Distributors and Associations (NCEA).