Two Orange County dermatologists give their best nonsurgical advice for optimal skin care. Dr. Neda Mehr is the medical director for Pure Dermatology and Cosmetic Center in Newport Beach, and Dr. Lenore Sikorski is the founder of Natural Image OC in Laguna Niguel.
IN YOUR 20s
The challenges: Acne, melanoma, and “angry” wrinkles
Skin damage accumulates throughout your life, so the most important tip for people is to limit exposure to sunshine. Too much sun is the main cause of aging because it stirs up the production of free radicals, turning today’s acne into tomorrow’s acne scars, causing broken capillaries and Two Orange County dermatologists give their best nonsurgical advice for optimal skin care. Dr. Neda Mehr is the medical director for Pure Dermatology and Cosmetic Center in Newport Beach, and Dr. Lenore Sikorski is the founder of Natural Image OC in Laguna Niguel. brown spots, and even leading to melanoma, the most common cancer killer for women in their 20s.
Mehr says her advice is universal. “Even if you come in for an acne breakout—a huge and unexpected problem for women in their 20s, due to hormonal changes and birth control—I’ll give you a lecture on sun exposure.”
There are ways to be safe in the sun. “Ten to 20 minutes of peak-hour sun exposure is good for you, as it enables the skin cells to convert vitamin D to its active form,” Sikorski says. “But don’t go to a soccer game without sunglasses, a hat, or an umbrella.”
Solutions: Nonclogging 30-plus SPF sunscreen, sunglasses, hats, Retinol, and Botox
While sunscreen is a must, acne prone folks should choose wisely. The majority of sunscreens clog pores, Mehr says. She recommends one that won’t: ELTA MD UV Clear SPF 46. Available over the counter, it’s made with willow bark extract, which contains a derivative of salicylic acid, an exfoliant to remove the uppermost dead skin cells.
Sikorski recommends creams with Retinol, a chemical compound that the skin converts to vitamin A, which many studies have found promotes skin-building and is effective at treating acne, reducing the appearance of fine lines, and preventing discoloration. It works by increasing cell turnover, spiking collagen and elastin production, fading hyperpigmentation, and keeping skin hydrated.
Although wrinkles are not a major issue in the 20s, targeted Botox can be used to slow the development of the harsh vertical wrinkles between the eyebrows. But Mehr says to leave crow’s feet alone at this point. “Those are your ‘happy lines’ around the eyes. They show up faster in animated, expressive people, indicating that you live a happy life and smile a lot. Keep those. Botox them too much and they can change your smile.”
IN YOUR 30s
The challenges: Slowed skin renewal, wrinkles, collagen breakdown
Skin begins to show wrinkling, brown spots, and even some sagging—all effects of long-term exposure to sun and pollution, hormonal changes, and slowing skin-cell turnover (cells are replaced every 40 days instead of every 20 to 30 days).
Solutions: Add glycolic acid, antioxidant cream, and collagen PIN with PRP to your routine
Mehr advises a two-step process: maintenance to stop damage, and treatment to reverse damage. Step one begins with sunscreen and an antioxidant cream to stop skin aging and collagen breakdown; then glycolic acid pads and a prescription strength retinoid, which respectively exfoliate dead skin and stimulate collagen production. Step two rebuilds skin by using collagen percutaneous induction needling (PIN) with PRP—platelet-rich plasma. Plasma from the patient’s blood is loaded with natural growth factors. Similar to plowing fields and fertilizing crops, the technique uses lasers and needling to insert tiny holes into the skin. The body sees these as injuries, prepares for healing, and welcomes the PRP, which is poured into the skin channels. Mehr calls it “putting its own Miracle Grow on your face.” Mehr uses PRP treatment for face and neck rejuvenation, especially undereye dark-circle elimination, for those in their 30s.
IN YOUR 40s
The challenges: Wrinkles, dull skin, dark spots
People this age have a top layer of clogged, wrinkled, spotted skin, a legacy of decreased cell turnover, collagen breakdown, and sun exposure.
Solutions: Chemical peels, laser resurfacing, intense pulsed light treatment
Skin treatment in your 40s starts with topical lotions and graduates to top-layer skin removal. Mehr starts with three topical items: a double medical-grade sunscreen; a prescription brightening cream with vitamin C and kojic acid (a skin-lightening agent that inhibits melanin production); and exfoliation.
For more pronounced lines and spots, dermatologists typically move on to chemical peels (acid on the face) and photo rejuvenation techniques such as laser resurfacing and IPL (intense pulsed light), which remove the top layer of skin. “Even with the light peels, there is a burning sensation, temporary discoloration, and up to a month recovery,” Sikorski says.
For that reason, quicker-healing IPL and laser therapies are often preferred. IPL treatment destroys melanin spots and broken capillaries with a computer-adjusted, hand-held light gun. “With lasers, it’s just three days of pink and puffy, and that’s it,” Mehr says.
50s, 60s, AND BEYOND
The challenges: Sagging, drying skin, in addition to previous issues
Keeping skin moist and tight is a challenge for postmenopausal women. The lack of estrogen means lesser function in the glands that secrete sebum, an oily, waxy lubricant. Skin and hair lose their sheen and collagen breaks down.
Solutions: Powerful moisturizers, microneedling
To supplement falling oil production in the skin, Mehr recommends increasing PRP treatments to three per year (up from once annually for those in their 30s and 40s), heavy-duty moisturizers, and Retinol.
Several nonsurgical techniques can help tighten sagging skin and zap acne scars and wrinkles, Sikorski says. Microneedling—a relatively new 30-minute treatment that uses a pen with a pulsating, 36-needle tip that stimulates collagen by provoking healing—is done in three or four 30-minute sessions over several months. Sikorski also offers ultrasound treatments that use sound waves to bring heat to the skin, which helps to tighten it and stimulate collagen regeneration.
Published in Orange Coast Health 2018