What Are the Topical Creams, Lotions, and Gels for Wrinkles?
A good discussion of topical applications to treat wrinkles.
Although the single most effective treatment for aging skin is protection from the sun, various therapies are available once damage occurs. Almost every effective wrinkle treatment increases the sensitivity to the sun. It is therefore especially important to include sunblocks and avoid over-exposure when undergoing treatments.
Anti-Wrinkle Creams and Lotions
Tretinoin (Retin-A). Retinoids are vitamin A acids; they are usually referred to as retinoic acid or tretinoin, (commercially called Retin-A).
Tretinoin was originally approved for the treatment of acne but is now widely prescribed for aging skin. Tretinoin is available in prescription (Avita, Renova, Differin).
Retinol against wrinkles
Retinol is actually vitamin A. Until recently it could not be used in skin products because it was unstable. Now, however, it is available over the counter in a number of stable preparations, which, in the right concentrations, may be as effective as tretinoin with fewer side effects.
The FDA warns that retinol skin products are unregulated; the amount of active ingredients is unknown, and some preparations, in fact, may contain almost no retinol.
Retin-A produces a rosy glow, giving the skin a youthful appearance and increasing the uniformity of its pigmentation. It will reduce large wrinkles, brown spots, and surface roughness. One study found that it did not intensify the risk for sun burning, as some experts believe, and that it may, in fact, help prevent sun damage. Still, more research is needed to confirm this.
Some studies, in fact, indicate that it blocks metalloproteinases, enzymes stimulated by UV radiation that destroy collagen and elastin but that also may protect against melanoma. One study found that long-time use of tretinoin damages Langerhans’ cells, special immune cells that help prevent skin cancers. It has not yet been studied in people over 50 years old or in those with darker skin.
Oral tretinoin can cause birth defects, and women should avoid Retin-A when pregnant or trying to conceive. Almost all patients experience redness, scaling, burning, and itching after two or three days that can last up to three months.
Side effects tend to be more pronounced with higher concentrations (.1%); very low concentrations (.025%) may offer the same improvement with less irritation.
A daytime moisturizer or low-dose corticosteroid cream, such as 1% hydrocortisone, may be used with Retin-A to reduce irritation. If therapy is discontinued, side effects may recur when therapy is resumed.
Some patients apply Retin-A to their neck, chest, hands and forearms as well as the face; Retin-A may be even more effective in non-sun exposed areas. The cream should be applied at least twice a week. Noticeable improvement takes from two to six months. Because Retin-A may increase a patient’s sensitivity to the sun, a thin coat is best administered at bedtime. A sunblock should be worn during the day, and overexposure to the sun should be avoided.
No one should take oral supplements of vitamin A for dry skin; the vitamin is toxic in high doses and can even produce a dry-skin condition called phrynoderma.
Topical Alpha Hydroxy Acids and Similar Substances
Alpha hydroxy acids facilitate the shedding of surface cells by softening the glue that holds them together, thus giving older skin a youthful rosy glow. They may even stimulate the production of collagen and elastin. They are naturally found in:
- apples and pears (malic acid),
- oranges and lemons (citric acid),
- grapes (tartaric acids),
- sugar cane (glycolic acid),
- and sour milk (lactic acid, mangoes).
Lactic and glycolic acids are used most often in commercial products. Acid concentration in over-the-counter preparations are 2% to 10%.
The first clinical study to be conducted on low-concentration AHA products (either 8% glycolic or 8% lactic acids) found that they actually did show modest improvement over creams without AHA. The preparations containing lactic acid seemed to be slightly more effective than those made with glycolic acid.
Some examples include:
- Avon’s Anew Intensive Treatment (8% glycolic),
- Pond’s Age Defying Complex (8%),
- Elizabeth Arden’s Alpha-Ceramid Intensive Skin Treatment (3% to 7.5%),
- BioMedic’s home product (10%).
Prescription strength creams (at least 12% glycolic acid) or glycolic acid peels of 30% to 70% concentration administered in a doctor’s office given at weekly or monthly intervals. Response varies, and the treatment is not without risk. Experts advise that such preparations be applied for a very brief period, followed by thorough rinsing and sun protection.
Side effects from over-the-counter creams, prescription products, and professional AHA peels can include burns, itching, pain, and possibly scarring. In one study, people who applied only 4% glycolic acid twice a day for 12 weeks developed some skin redness at 13% lower sun exposure than those who didn’t use the AHA.
Another study found that skin treated with AHA had twice the sun damage as areas not treated with it. The degree of acidity (the pH) of the product also can affect irritation.
Experts advise that people should purchase products with AHA concentrations of 10% or less and a pH of 3.5 or higher (the higher the pH the lower the acidity). If any adverse effects occur, the product should be stopped immediately. In any case, people are advised to avoid sunlight or use proper protection when using them. Research is underway to determine conclusively long-term adverse effects.
New products have been developed that are made from larger molecules called poly-alpha-hydroxy acids and others from beta-hydroxy acids or BHAs (usually containing salicylate acid, the primary ingredient in aspirin). Manufacturers claim that such products are less likely to irritate the skin.
Antioxidants and Vitamins
A number of skin-care products now contain antioxidants, which are substances that prevent free-radical damage, but no evidence exists that they reverse sun damage and help restore aging skin. Such products may contain vitamins E or C, beta carotene, coral extracts, aloe, topical aspirin, or ibuprofen.
Of particular recent interest is the substance silymarin, found in the milk thistle family (which includes artichokes); this substance appeared to inhibit UVB-promoted cancers in animals. Some dermatologists recommend that their patients take 400 IU of vitamin E daily.
Vitamin E, as well as the trace mineral selenium, are believed to help decrease sun damage. One study reported that a 5% to 8% concentration of tocopheral (a form of vitamin E) cream decreased skin roughness, length of facial lines, and wrinkle depth. Large amounts of vitamin C, or ascorbic acid, appear to help reduce swelling from sunlight, and long-term use may promote production of collagen.
Vitamin C is unstable, however, and until recently could not be delivered to the skin in any effective way. Topical vitamin C products that solve the delivery problem, include Cellex-C and Avon’s Anew Formula C Treatment Capsules. One small study found that taking a combination of vitamins C and E oral supplements may help reduce sunburn reactions, although the protection is much less than from sunscreens. (Taking the vitamins singly does not appear to have the same effect.)
Microsponge-based vitamin K is being promoted to clear bruises, spider veins, and other small blood vessel damage. Vitamin K is important for blood clotting.
Moisturizers help prevent dryness, bruising, and tearing. They should be applied while the skin is still damp.
There are two main types of moisturizers:
- occlusives, such as petroleum jelly, prevent water from evaporating;
- humectants, including glycerin, act by pulling water up to the surface of the skin from deep tissues.
Most moisturizers contain both types, but people with oily skin generally should use the humectant type.
More powerful compounds, such as one called monolaurin (Glylorin), contain mixtures of fatty molecules called lipids, which may help restore the skin’s natural barriers against moisture loss and damage. Products with collagen and keratin leave a protein film and temporarily stretch the skin.
The skin under the eyes is very thin and does not produce as much of the protective oils that keep skin soft and supple. Under-eye gels are aimed at reducing puffiness and dark circles.
They work in one of two ways: temporarily constricting blood vessels to prevent the build-up of fluids or firming the skin with an invisible film. Never rub under the eyes, as this may cause more wrinkles to form; instead, apply these products with a light tapping motion to stimulate the skin.
Anti-age skin care and make up (plus – some photos)
Cosmetics, if properly applied, can be surprisingly effective in camouflaging the signs of aging skin, including wrinkles and age spots. Moreover, they offer additional benefits by retarding water loss and providing a physical barrier to UV radiation.
Large areas of the face are best covered with a moderate-coverage facial foundation with a matte or semi-matte finish. Moisturizers should be applied before the foundation. When blemishes are especially prominent, colored undercover foundations called neutralizers are very effective.
Green neutralizers mask red lesions, purple helps camouflage yellowish blemishes, and a white, pearled base is recommended for people with dark lesions and also helps to minimize wrinkles.
Blushes and color washes can help conceal the spidery network of dilated capillaries on the nose and cheeks. Powder blushes are preferred because they blend easily on top of foundation.
If reddish discoloration is extensive or the skin is sallow, a water-based, high-oil-content color wash may be helpful and can be worn alone or under foundation. Facial powder reflects light and thus minimizes wrinkles but should be avoided by people with dry skin.
Powder eye shadows applied on top of a moisturizer are preferred to cream-based shadows. The appearance of deep-set eyes is best offset with light-colored shadow, which should be applied along the upper eyelid crease and above the iris. A slightly deeper shade of the same color should then be applied to the lower part of the eyelid and drawn out to the corner.
A lip-setting cream or facial foundation should be applied before lipstick to help prevent it from bleeding into surrounding wrinkles. The lips should be lined with a lip-pencil, which acts as a border. (Some women use the pencil itself for the full lip, which gives color but appears natural.) Matte lipsticks with a low petroleum content are especially recommended.