Tag Archive for: anti-aging

Taking Control of Your Skin Care Routine

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By Koji Ota, MD

If you don’t have a daily skin care routine, it can feel overwhelming to start one. -There is a dizzying amount of information and recommendations, whether it be from skin care brands advertising their products or a TikTok influencer raving about the newest skin care hack. Contrary to some recommendations, you don’t need 12 steps or to break the bank to have an effective skin care routine. Here are some recommendations to get you started:

Basic Skin Care Routine

A basic skin care routine starts with a gentle cleanser, moisturizer, and sunscreen.

  • Cleanser is the important first step in a skin care regimen to clean the oil, dirt, sweat, make-up, and pollutants that accumulate on your skin throughout the day. This helps prevent clogged pores and breakouts, as well as prepare your skin for other skin care products to penetrate properly into your skin. Generally, you should select a gentle cleanser that will not overly strip your skin of moisture and oil that can lead to dryness and irritation.

Some cleansers can contain ingredients that address specific skincare problems, such as benzoyl peroxide or salicylic acid to treat acne, or some with chemical exfoliants such as glycolic acid that can help reveal a brighter complexion and correct an uneven skin tone. It’s important not to overuse these products as they can lead to irritation of the skin.

  • A facial moisturizer should be applied every day to keep your skin hydrated. Dry skin can lead to flaking, and redness, and make it more prone to irritation. A moisturizer should be selected based on your skin type. For anyone with dry skin, or during dry and colder months, a thicker, more hydrating moisturizer may be needed to keep your skin adequately hydrated.
  • Sunscreen is one of the most important steps in a skin care routine. Anytime you plan to be outside during the day, you should apply sunscreen with SPF 30 or higher. This will protect your skin from the sun’s harmful ultraviolet rays which lead to accelerated skin aging and increased risk of skin cancer.

 

Next Steps

Once you have the basics down, you can consider adding more products that contain active ingredients to address your specific concerns. Next, we will review vitamin C and retinoids.

  • Vitamin C is a potent antioxidant that can protect the skin against environmental factors including sun damage and pollution. When used consistently, it can help reduce the appearance of dark spots on your skin, improve skin complexion, and help slow skin aging.

There are many formulations of vitamin C including creams and serums. Some formulations may cause irritation and lead to breakouts, so it’s important to select the products based on your specific skin type. Vitamin C should generally be applied in the morning, after cleansing and before sunscreen.

  • Retinoids are a group of Vitamin A-derived chemicals that have a wide range of uses in dermatology. They are one of the most effective types of products to improve acne, fine lines and wrinkles, even skin tone, and correct dark spots.

Retinoids can vary from over-the-counter retinols to prescription medications, most often prescribed to treat acne. They should generally be used at night, after cleansing and before application of moisturizers.

It is important to note that retinoids can be drying and irritating to the skin, so you should only apply a pea-sized amount to your whole face, and to start slow; for example I generally advise my patients to start using retinoids once every other day for a couple of weeks and increasing frequency to every night if you are not having irritation. One strategy that helps reduce the irritation of retinoids is to do a “moisturizer sandwich,” where you apply a layer of moisturizer before the retinoid, followed by another layer of moisturizer after the retinoid. Retinoids should not be used by anyone that is pregnant or is actively trying to conceive.

If you have any specific questions or concerns about building a skin care routine, or if you have a skin condition, talk to a dermatologist who can help you build a skin care routine that is tailored to your specific skin needs.

 

 

 

 

 

References

Al-Niaimi F, Chiang NYZ. Topical Vitamin C and the Skin: Mechanisms of Action and Clinical Applications. J Clin Aesthet Dermatol. 2017 Jul;10(7):14-17. Epub 2017 Jul 1. PMID: 29104718; PMCID: PMC5605218.

Farris P. SUPPLEMENT ARTICLE: Retinol: The Ideal Retinoid for Cosmetic Solutions. J Drugs Dermatol. 2022 Jul 1;21(7):s4-s10. doi: 10.36849/JDD.SO722. PMID: 35816071.

Ludman, P. Dermatologist-recommended Skin Care for your 20s. American Academy of Dermatology. Accessed 2/16/2025. https://www.aad.org/public/everyday-care/skin-care-basics/care/skin-care-in-your-20s

Skin Care In Your 40s and 50s. American Academy of Dermatology. Accessed 2/16/2025 https://www.aad.org/public/everyday-care/skin-care-basics/care/skin-care-in-your-40s-and-50s

Skin and the Relation to Bone Density

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Do you look in the mirror and see a furrowed brow? Thinking about how to erase those lines that suggest you are worried or angry even when you’re not? You’re likely very aware that Botox does the trick and safely erases “the elevens” between the eyes. But did you ever wonder if forehead lines are an indicator that other tissues, not visible to the naked eye, are also showing signs of wear?

Bone Density Study

Researchers at Yale posed the same question about a decade ago and looked at bone density in 114 women in their late 40s and 50s who were within three years of menopause and not on hormone or bone density drug therapy. They measured the number and depth of the women’s forehead, face and neck wrinkles, as well as the skin’s firmness or rigidity, and then tested their bone density by x-ray and ultrasound. They excluded women who had undergone any cosmetic skin procedures or who may have damaged their skin by tanning beds or extensive sun exposure. The small study demonstrated only an association between decreased bone density and early skin wrinkling, and to my knowledge, there haven’t been larger follow-up studies confirming the observation.

Collagen

Although there may be insufficient data to confirm the association, it’s an interesting idea to think about since the scaffolding of both skin and bones is a group of proteins called collagens. As we age, the changes in collagen that visibly cause the skin to sag and wrinkle are also invisibly affecting bone quality and quantity. According to the CDC, the prevalence of low bone mass, a precursor of osteoporosis, at either the femur neck or lumbar spine or both among adults aged 50 and over was 43.1%. This was higher among women (51.5%) compared with men (33.5%).

Osteoporosis

Of the estimated 10 million Americans with osteoporosis, about eight million or 80% are women. Approximately one in two women over age 50 will break a bone because of osteoporosis. Furthermore, a woman’s risk of breaking a hip is equal to her combined risk of breast, uterine and ovarian cancer. There are 1.5 million osteoporotic fractures in the United States each year, leading to more than half a million hospitalizations, over 800,000 emergency room encounters, more than 2,600,000 physician office visits, and the placement of nearly 180,000 individuals into nursing homes. Hip fractures are by far the most devastating type of fracture, accounting for about 300,000 hospitalizations each year.

Bone Density Screening

Many women (and men) don’t know they have low bone density until it has progressed to the point of fracture that requires both surgical intervention and the initiation of treatment with bisphosphonates. The key is finding out early when you can do something about it. Talk to your physician about a screening bone scan, especially if you have a family history of osteoporosis, if you are a woman over age 65 or if you have risk factors (such as past fracture, certain medical conditions or medications, or cigarette or alcohol use).

Healthy Lifestyle Habits for Skin & Bones

We don’t know whether wrinkles really are a sign that your bone density is low, but we do know that many of the same measures that keep your skin healthy are also beneficial to your bones. Some lifestyle habits you can adopt that promote both healthy skin and bones:

1. Don’t smoke: Avoiding or quitting smoking is strongly recommended for bone health because smoking cigarettes is known to increase bone loss.

2. Alcohol in moderation: Excess alcohol decreases bone density by 2%, dehydrates the skin and exacerbates conditions such as rosacea.

3. Exercise: Weight-bearing exercise increases bone density and it’s also great for your skin: By getting the heart rate up and improving blood circulation, exercise can help to deliver oxygen and nutrients to the skin which stimulates collagen production, and promotes new skin cells, keeping the skin glowing and also helping with anti-aging. An interesting study in Japanese post-menopausal women demonstrated increased bone density in the hip after standing on one foot for 1 minute 3 times per day.

4. Diet: Sufficient Calcium and Vitamin D (through diet and not the sun in order to protect your skin!) are foundational for good bone health. Topical solutions include Solaana MD Healthy Base Layer, which is a Vitamin D enriched cream (available through our online store). Also important is a diet rich with fruits, vegetables and seafood in order to obtain sufficient Vitamins A, B, C, E, K, Potassium, Magnesium and Silica, which are all beneficial to both your skin and bones.

So as you embrace the Mediterranean diet and exercise regularly, you can be assured that you are simultaneously doing what’s best for your skin AND bones. Get your Vitamin D through your diet and supplements and apply sunscreen regularly; you can even apply it while standing on one leg to continue multitasking!

 

 

 

 

Sources:

Brooks M. Skin wrinkles may provide a glimpse into Bone Health. Medscape. https://www.medscape.com/viewarticle/744027. Published July 25, 2020.

Office of the Surgeon General (US). Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville (MD): Office of the Surgeon General (US); 2004. Available from: https://www.ncbi.nlm.nih.gov/sites/books/NBK45513/

Sahni S, Mangano KM, McLean RR, Hannan MT, Kiel DP. Dietary approaches for bone health: Lessons from the Framingham Osteoporosis Study. Current Osteoporosis Reports. 2015;13(4):245-255. doi:10.1007/s11914-015-0272-1

Sakai A, Oshige T, Zenke Y, Yamanaka Y, Nagaishi H, Nakamura T. Unipedal standing exercise and hip bone mineral density in postmenopausal women: a randomized controlled trial. J Bone Miner Metab. 2010;28(1):42-8. doi: 10.1007/s00774-009-0100-8. Epub 2009 Jun 12. PMID: 19521657.

Sarafrazi N, Shepherd JA, Wambogo EA. Osteoporosis or low bone mass in older adults: United States, 2017-2018. NCHS Data Brief No 405. March 2021. doi:10.15620/cdc:103477 What women need to know. Bone Health & Osteoporosis Foundation. https://www.bonehealthandosteoporosis.org/preventing-fractures/general-facts/what-women-need-to-know/. Published February 24, 2022.

Trending Now: Collagen Supplements for Anti-Aging

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If you read beauty blogs and magazines, chances are you have heard of the latest craze to hit the anti-aging market — collagen supplements. Collagen supplements claim to make the skin look younger, may help with brittle nails, and may even reduce the appearance of cellulite. But do they really work? We examined the current scientific literature to determine if collagen supplementation can transform your skin and make you look years younger.

What is collagen?

Collagen is the most abundant protein in the body and is responsible for the structure, stability, and strength of the underlying tissues. The deposition of collagen into the skin gradually decreases over time as the skin ages, but it can be accelerated due to photoaging from excessive sun exposure. Aside from aging, the biggest reason individuals are deficient in collagen is a poor diet. Consuming animal and vegetable sources that are protein-rich, such as beef, chicken, fish, beans, eggs, and dairy products can help ensure adequate intake of collagen.

The science:

Several limited studies have shown promising results in individuals taking collagen supplements for their skin. These studies have noted benefits in transepidermal water loss (skin hydration), skin elasticity, roughness, and wrinkles. Two separate studies showed a possible benefit of collagen supplementation in patients who have brittle nail syndrome as well as in women who suffer from moderate cellulite. Animal studies further revealed that administering collagen hydrolysates to mice for 6 months led to significantly increased collagen content and density of the skin.

Can I benefit from taking a collagen supplement?

If you are eating a healthy diet and feeding your body all of the nutrients it needs to make collagen, you probably do not need a supplement. However, as the body ages, you may no longer absorb or synthesize nutrients as efficiently as you used to. Taking a collagen supplement can make up for a deficiency if it is present. A 2017 study in the Journal of Agriculture and Food Chemistry showed that collagen hydrolysates can be transferred through the bloodstream directly to the skin, which explains the probable pathway for the beneficial effects of taking a supplement. However, some scientists postulate that the skin is a much lower priority to the body than major muscles, like the heart, diaphragm, and brain, where collagen will be distributed first. Therefore, only patients with a significant deficiency will likely benefit from taking collagen supplements. In addition, the cost and bulk of supplementation may be prohibitive for patients. Supplements in pill form require swallowing six a day to get a 6-gram dose. Powders are often double the price of pills, running from $15-$40 for a month’s supply.

Bottom line:

Limited studies on the benefits of collagen supplements have shown some promise, however, questions remain regarding which patients will benefit and how much collagen is actually absorbed into the skin. Cost and administration may be factors in compliance. It should be noted that for individuals who wish to add more collagen to their diet, bone broth—while not in hydrolysate form—offers six grams of collagen-rich protein and may be a tastier way to get your collagen fix.

 

 

References

  1. Jhawar, N., Wang, J. & Saedi, N. Oral collagen supplementation for skin aging: a fad of the future? Journal of Cosmetic Dermatology, August 14, 2019. https://doi.org/10.1111/jocd.13096
  2. Choi, F.D., Sung, C.T., Juhasz, M., Mesinkovska, N.A. Oral collagen supplementation: A systematic review of dermatological applications. Journal of Drugs in Dermatology. 2019; 18(1): 9-16.
  3. Vollmer, D.L., West, V.A., & Lephart, E.D. Enhancing skin health by oral administration of natural compounds and minerals with implications to the dermal microbiome. J. Mol. Sci.2018, 19(10), 3059.
  4. Hexsel, D., Zague, V., Schunck, M., Siega, C., Camozzato, F. & Oesser, S. Oral Supplementation with specific bioactive collagen peptides improves nail growth and reduces symptoms of brittle nails. Journal of Cosmetic Dermatology; August 2017, available online at: https://doi.org/10.1111/jocd.12393.
  5. Krieger, E. Collagen supplements show early promise for skin and joints, but don’t stock up yet. March 26, 2018, The Washington Post. Available online at: https://www.washingtonpost.com/lifestyle/wellness/collagen-supplements-show-early-promise-for-skin-nails-and-joints/2018/03/23/1cd480e2-27d6-11e8-bc72-077aa4dab9ef_story.html
  6. Schunck, M. Zague, V., Oesser, S., & Proksch, E. Dietary supplementation with specific collagen peptides has a body mass index-dependent beneficial effect on cellulite morphology. Journal of Medicinal Food. Dec 17, 2015: Available online at: https://doi.org/10.1089/jmf.2015.0022
  7. Cruel, J. Does drinking collagen supplements actually do anything for your skin? Self, August 22, 2017. Available online at: https://www.self.com/story/collagen-supplements.
Older woman's hands on keyboard, aging hands

What Can Be Done For Aging Hands?

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Did you know that your hands can reveal your true age, well before other areas of the body begin show signs of aging? While aging of the hands typically begins by age 50, with the first signs being discoloration and age spots, hands can start to age sooner if individuals are frequently exposed to the sun without the proper protection. By age 50-60, people also tend to lose volume in their hands, making veins and tendons more prominent and further contributing to aging hands. The good news is there are treatments available that can slow or reverse some of the signs of aging hands. Treatments can be tailored to the individual, depending on their specific concern:

Age spots:

Pigment-specific lasers are used to treat dark brown spots on the hand by delivering a beam of light that penetrates the skin surface. Following treatment, brown spots appear darker for about a week and then will scab, fall off, and turn pink as the skin begins to heal. One to two treatments are usually needed before improvement is noted. Results can last for years as long as proper care is taken to avoid sun exposure to these areas.

Topical retinoids and bleaching creams, like hydroquinone, can also be used to diminish the appearance of dark spots. They can be used either alone, or in combination with lasers, to reduce the appearance of age spots.

Volume loss:

Injecting fillers into the back of the hand is a quick, in-office procedure that can be achieved by using a non-allergic product called calcium hydroxylapatite. Results are immediate and can last for 1-2 years.

Applying a lotion or cream after washing your hands helps to trap water in your skin, and can provide a temporary plumping effect.

Rough, scaly patches:

If you have fair skin and spent a lot of time in the sun, you may notice rough spots or patches on your hands. These rough patches may be actinic keratoses (AKs), which are pre-cancerous growths that need to be evaluated and treated by a dermatologist. Liquid nitrogen (cryotherapy) can treat the individual AKs, while topical medicated creams or photodynamic therapy can treat the entire area at once.

Wrinkly “crepey” skin:

Applying sunscreen to your hands every day can prevent wrinkly skin on your hands. To treat wrinkles that are already there, your dermatologist may recommend a lotion containing retinol or glycolic acid or light chemical peels.

Radiofrequency treatments, which use heat directed deep into the skin, can help tighten loose skin. Most people only need 2-3 treatments on their hands to see results.

Brittle nails:

Brittle, aging nails typically present as lines running lengthwise on your nails, appearing like ridges. You may also notice that your nails peel or break easily. Certain activities such as cleaning with harsh chemicals or spending a lot of time with wet hands, can cause brittle nails, so it is important to wear rubber gloves when cleaning and doing dishes.

It is also important to moisturize the hands regularly with a urea- or petrolatum-containing moisturizer, preferably after every hand washing and before bed.

The nails reflect overall health. Changes in nail color or shape can signify a systemic problem that should be evaluated by a dermatologist.

Follow up:

It is important to follow up with your dermatologist after your treatments to help maintain your results as long as possible. Sun protection is essential at all times, and can be achieved by using a broad spectrum water-resistant sunscreen with SPF 30 or higher and reapplying regularly throughout the day. UV-protective driving gloves are also helpful in blocking out the sun’s harmful rays.

References:

American Academy of Dermatology. “What can make my hands look younger?” Available online at: https://www.aad.org/public/skin-hair-nails/anti-aging-skin-care/younger-looking-hands

American Academy of Dermatology (August 2012). “Busy moms deserve a hand: Dermatologists offer tips to prevent premature aging of the hands.” Available online at: https://www.aad.org/media/news-releases/busy-moms-deserve-a-hand-dermatologists-offer-tips-to-prevent-premature-aging-of-the-hands