Reversing Sun Damage Cosmetically

Despite popular belief that the majority of skin damage occurs before we turn 20, we now know that safe skin practices at any age can prevent and even reverse sun damage. The best way to prevent sun damage is to liberally and regularly apply sunscreens that contain both UVA and UVB protection and wear clothing from one of the excellent lines that offer UV-protective clothing. Prevention is important, as exposure to UVA and UVB rays account for over 85% of the symptoms of premature skin aging, such as wrinkles, discolorations, decreased elasticity, thinning skin, and lesions that may be cancerous. But if the harm has already been done, there are ways to reverse some of the damage caused by excessive sun exposure. Whether your goal is to reverse the visible signs of photo aging or to prevent the development of skin cancers, start by meeting with a board certified dermatologist. Begin by requesting a complete body assessment: this simple five minute exam can literally save your life. If your dermatologist delivers the good news that you have no precancerous or cancerous lesions, then you could discuss erasing evidence of sun damage.

As a physician, I look to evidence based medicine to guide me in making recommendations for patients who want to reverse the signs of sun damage in a cost effective way. Hydroxy acid products and retinoid have a lot of science showing their effectiveness. I often recommend an over the counter alpha hydroxy acid, and/or a retinoid three times a week to be increased gradually over several weeks to daily. As over the counter products have a lower concentration of the effective ingredients, they may not yield the results you want. Your doctor can then dispense a prescription strength hydroxy acid and prescribe one of several prescription strength retinoids, based on the sensitivity of your skin and the season (e.g. starting in the winter, when skin is dry, may be more challenging). I advise patients to use a mild cleanser and wait until the face is completely dry before applying any product. Wait another 10 to 15 minutes before applying moisturizer.

What about antioxidant creams containing ingredients such as green tea, copper peptides, kinetin, soy, vitamin C or pomegranate? There has been some credible research to indicate that green tea and copper peptides are effective, and so I dispense antioxidant products in my office, with some positive feedback (these are often a good alternative for those with sensitive skin). But when it comes to most advertised antioxidant, anti-aging products, keep in mind that this is a huge money making industry based on claims not backed up by well-controlled clinical trials. Some products containing growth factors in combination with various antioxidants also have some good science behind them, and I find they are effective to reverse photo aging to a certain degree (though they are too expensive for some patients).

Taking care of your skin is like exercising to stay in shape. I tell my patients that someone who exercises three times a week on a regular basis is better off than the person who exercises for two weeks straight then skips the gym for three months. And the same holds true if you want to reverse the effects of sun damage: applying one or two effective topical agents on a consistent daily basis yields better results than burning and over-drying your skin by slathering on six different over-hyped cosmetic creams. Many times patients come in with bags of creams that cost hundreds of dollars, all of which end up in the garbage can once they start effective treatments.

Emmanuel R. Loucas, MD, is the Director of the Alpha Aesthetic Dermatology and Laser Center of Manhattan at 69 East 76th Street and an Assistant Clinical Professor in the department of Dermatology at Mount Sinai School of Medicine. He has been in private practice for 15 years.

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Dr. Loucas was listed as one of New York Super Doctors 2012 in the May 20th 2012 issue of The New York Times Magazine.