Skin care has been around since ancient Egypt. Botanicals, plant oils, animal fat, blood, and naturally occurring acids have been used for centuries to smooth and brighten the skin. Ironically, these components are still being utilized today, though they have been refined and purified for daily use.
- Botanicals: Anti-oxidant equivalent
- Animal Blood: Growth factor equivalent
- Animal Fat: Moisturizer
- Plant Oil: Moisturizer
- Natural Fruit Acids: Alpha hydroxy acids and chemical peels
An effective daily skin care regimen is one of the most important components to prevent early aging and reverse and prevent the negative effects of sun exposure. Aging, environmental pollution, smoking, genetics, and sun exposure can all lead to thinning of the skin and underlying skin damage. These skin changes lead to fine lines, wrinkles, and pigment changes which are tell tale signs of aging. Face lift surgery and minimally invasive procedures like volumetric fillers and laser resurfacing, can all help reverse the specific effects of aging, but effective skin care before and after these procedures can really improve the face as a whole.
Skin Care Can Help To:
- Brighten the skin through encouraging the removal of the thick dead layer of skin and evening the texture of the skin
- Lighten the skin by reversing the pigment changes from photo-damage
- Tighten the skin by actually thickening the undersurface of the skin through collagen production.
Dr. Trussler selects products to be carried in his office that are effective and easy to use. He will help develop a daily regimen to meet your goals and fit into your lifestyle. All products are physician grade and only available in physician offices.
What Are My Options?
Skin care can be a very confusing and an expensive process if not directed by a knowledgable skin care provider. Active skin care regimens do not need to be complex and can be accomplished with a couple of steps morning and night. The products do not need to be overly expensive, but they need to be effective. Skin care is not only for women, but simple steps can be easily accommodated by men.
Basic skin care includes a cleanser, toner and moisturizer with sunscreen. Selective additions include an anti-oxidants, growth factors, pigment lighteners, and retinol. Eye creams can be applied at night for increased moisture and lower eyelid skin repair.
- Moisturizer with sun screen
- Growth factors
- Eye cream or gel
- Retinol/Pigment lightener
Skin care needs to personalized for your goals, your skin, and your lifestyle. Other considerations include the climate and season, as well as any past or future skin resurfacing procedures.
Goals For Skin Care:
- Prevention: appropriate for younger patients to prevent sun damage and improve the texture and glow of the skin
- Fine lines and texture: active skin care with retinol, anti-oxidants and/or growth factors can help to smooth and thicken the skin
- Pigment: genetics, hormones, sun, and previous resurfacing can lead to pigment irregularities which can be lightened and evened with skin care products directed at the melanocytes or pigment producing cells in the skin.
- Sun Damage: skin which has been repetitively exposed to the harmful UV rays of the sun has predictable damage which can be reversed with an active and aggressive skin care regimen. This is usually combined with a resurfacing procedure.
- Normal, dry, oily: skin care products can be selected specifically for any skin type, as well as combination type skins. Some products do aggravate pre-existing skin types, so choosing the right product for your skin type is important.
- Fitzpatrick Scale: this scale is related to the propensity of the skin to burn in the sun. Darker skin is higher on the scale and factors into skin care goals.
- Acne prone: skin care regimens directed to acne prone skin can help prevent acne flare-ups and help with acne scarring.
- Active: patients may want to simplify their skin care regimen and stick to the basics or use combination type products with moisturizer and growth factors.
- Outdoors/Travel: limit the potential for irritation and maximize sunscreen and anti-oxidants.
- Pollution/Smoking: these two factors have a detrimental effect on the skin. Avoidance of environmental factors is key, but a combination of gentle textural improvements with retinol and an anti-oxidant and growth factor daily regimen can help.
- Public eye/TV/ Media: limit the potential for irritation and limit build-up of make-up and debris with a gentle, but effective cleanser and toner. Maximize tone and texture with a light moisturizer, growth factor and anti-oxidant regimen.
Patients using active skin care regimens should expect 6 weeks before realizing the positive effects on the skin. There may be a phase of mild peeling and redness which will subside with continued but less frequent use. Long term and regular use with of a personalized and physician directed skin care regimen can produce significant results. Patients can achieve smoother, healthier skin with improved texture and tone. With realistic expectations and good overall health, patients are very satisfied with the results and skin resurfacing can be added if and when they are needed.
Daily Skin Care Regimen
Cleansers should be gentle and effective. For dry and skin prone to irritation a very gentle cleanser like is available. A good daily cleanser that can be used twice a day with warm water are. For oily and acne prone skin an LHA/AHA cleanser will help dissolve oils in the pores. Exfoliating cleansers should be used 2 to 3 times per week. A good one is.
Skin toners help to balance the skins pH and remove impurities. Just like cleansers, they need to be gentle enough for twice daily use and they can be selected for different skin types.
These skin care agents are found in botanical products, but in their purified form they are more effective and potent to help repair and revive the skin. Vitamin C and E are common anti-oxidant formulations that can be used once or twice per day to help protect and strengthen the skin.
Moisturize And Sunscreen:
This is the most important component and probably the most complex. There are numerous products and components to both sunscreen and moisturizers. It is important to have the right ones to avoid over hydration, irritation, and skin reaction. Moisturizers have three components that vary in ratio to produce a thicker or thinner product. Over moisturizing is a common mistake, that can lead to skin dryness and irritation because the skins natural balance is thrown off. Finding the right moisturizer for your skin is important. Sunscreen can be applied in a separate step and an SPF 30 to 50 would be appropriate for daily use, especially after resurfacing or with retinol use. Tinted sunscreens can help to blend pigmented skin without looking white.
SPF was measured in the first 30 minutes of sun exposure so reapplication is important to maintain protection, especially when in the water or with perspiration.
Collagen stimulation and skin regeneration can be promoted with growth factors. Like anti-oxidants purified and potent forms can have a positive effect on skin thickness and tone. Growth factor lines, like the SkinMedica TNS products have indications for repair and regeneration. These products should be used sparingly with anti-oxidant formulations because of pH differences and their effects canceling out because of poor skin penetration. SkinMedica TNS Essential Serum does have a combination of both growth factors and anti-oxidants which can be used twice daily.
Eye Cream Or Eye Gel:
The skin around the eye is thin and is prone to premature aging. Hydrating and thickening the lower eyelid skin can help freshen the face. Overnight and active eye formulations in a cream or gel, either containing an anti-oxidant or growth factor regimen really can help rejuvenate this area.
These are Vitamin A derivatives which can penetrate through the skin to affect the undersurface of the skin (dermis) to help remodel and thicken this area. Retinols can help to smooth fine lines and help condition the skin. They must be used carefully and commonly cause some redness and peeling which is only temporary. Retinols do make the skin more photosensitive and sunscreens should be used when exposed to UV rays. Lower concentration retinols can be used daily. Stronger strengths can be used every other day until the skin remodels.
Skin Pigment Regulators:
Lightening products can actively fade the uneven pigment in the skin caused by sun damage and hormones. These agents affect the release of pigment in the skin (melanin) by the cells in in the dermis (melanocytes). With any injury, including sun damage and laser light, the melanocytes are activated and release pigment. Skin pigment regulators can help blunt the release of pigment after the injury. These products should be used at night and can be alternated daily.
Skin Care For The Neck, Declotage, Hands And Body
Can help to smooth and tighten these areas. The skin of the body and neck is thinner and responds differently to products designed for the face. These products are typically milder and may have different components to achieve desirable effects in these areas. Skin lighteners are incorporated into these products to help fade pigment in these often sun damaged areas.
Skin Care Use
Skin care works if you are compliant and patient. For most regimens, results will be visible in the first 4 weeks. Skin care should be continued but regimens can be altered and adjusted depending on activity, season and if any skin resurfacing is planned. Most products do last about 3 to 4 months, so follow-ups and adjustments can be made at those intervals. Skin care regimens can be refined with the addition of products such as stronger retinols and skin pigment lighteners.
Combination products are available and can be introduced into a daily regimen to add increased regenerative and repair capabilities, or convenient protection with sunscreens and moisturizers.
- Herbig K, Trussler AP, Khosla R, Rohrich RJ. Combination Jessner’s Solution and TCA Chemical Peel for Facial Rhytides: Technique and Outcomes. Plast Reconstr Surg. 2009 Sep;124 (3):955-64. (Chemical peel)