Skin care

What's the secret to great skin throughout time?

Drink more water?

Buy an expensive cream that you apply nightly?

There's a lot of skin care tips floating about the Internet based on hype or biased by folks interested in selling you a skin cream. 

Our approach is to summarize the expert skin care tips offered by the hundreds of dermatologists and plastic surgeons that participate in our community.

Drinking water probably won't help your skin

Water is essential for nearly all body functions, but the adage of "hydrate to get great skin" or "drinking water is fantastic for your complexion" is likely untrue.  Professors from the University of Pennsylvania and The Journal of the American Society of Nephrology reported last year that research showed most people did not need to worry about having the recommended 8oz glasses of water a day. There is no clinical evidence that your skin tone improves with increased water consumption.

• Skin care tip: keep getting 6 to 8 glasses of fluid per day, but ignore marketing claims about hydrating your skin with water.

Sun exposure really is a threat to healthy skin

There really isn't such a thing as a "healthy tan." Likewise, getting tan by using sunscreens is not a healthy approach to browning skin. The tanning industry argues otherwise, but medical experts are able to point to large bodies of clinical evidence that photo damage (i.e. a tan) causes long-term harm to your skin. The same holds true if you have dark skin tone and get overexposed to sun. 

There are 2 wavelengths that affect the skin: UVA and UVB (in the ultraviolet spectrum). UVB is stronger than UVA but it is more superficial. Brown spots, color irregularities, skin texture abnormalities result from UVB exposure. Also UVB triggers the mutation changes which cause basal cell and squamous cell cancers.

UVA has a longer wavelength, thus penetrates deeper into the skin. UVA is more responsible for photoaging (although it also contributes to skin cancer formation. It is much more abundant than UVB.

• Skin care tip: Chose a good sunscreen with moisturization rather than a moisturizer with some sunscreen thrown in. Most SPF (sun protection factor) indexes measure chiefly UVB.

Get yourself a physical sunscreen

Shade helps protect the skin, but you should still apply a sunscreen (even on cloudy days). The best sunscreens are what are termed physical sunscreens.

These sunscreens are zinc oxide and titanium dioxide. Both compounds are less reactive, less irritating and less allergenic. They are more stable than their chemical sunscreen cousins.

Physical sunscreens work by deflecting UV radiation away from the skin. The UVB and UVA rays bounce off them.

Newer chemical sunblocks utilize a combination of UVA and UVB filters. These manufacturers usually use a UVA filter (Avobenzone and UVB filter (oxybenzone.) It has been much more difficult for the companies to find a good UVA blocker since Avobenzone is not so stable.

Neutrogena's addition of a chemical has caused increased stability in what they call Helioplex technology. Aveeno uses the same technology in their products. Look for Aveeno's Active Naturals Daily Moisturizing Protection SPF 15, Neutragena Ultra Sheer, Bull Frog Surfer Formula Gel ( for active people, not everyday use), Coppertone Sport Stick, Cetophil Daily Moisturizer,Ti Silk, Eucerin Extra Protective Moisturizing Lotion, and Anthelios SX.

• Skin care tip: Keep sunscreen next to your makeup cabinet, in your car, and at work. Get two sunscreens: one with an SPF 15 and one with an SPF 30 or above. Use the SPF 15 with daily routines and the stronger one when you anticipate long and strong sun exposure.

Skip expensive wrinkle creams, get Retinoid cream from your dermatologist

Most dermatologists believe in Retinoids for routine skin care. Retin A is one of the most effective topical creams for photoaging, i.e. aging as a result of sun damage. Retin A can reverse skin damage, decrease your chances of skin cancer, improve fine wrinkles, decrease unwanted pigmentation in mild to moderate degrees.

This is a topical medication and is available through prescription only.  Retin A can also help with Acne as well. It is also used to prepare the skin for laser resurfacing.

The reason why most dermatologists recommend Retin A is because it has 20 years of good science behind it to show it does actually make a difference whereas so many other creams and potions on the market have no comparable peer reviewed studies to back them up. The science behind Retin A has been validated.

• Skin care tip: Retinoids like Renova or Retin A work very slowly and have side effects. If you want quick wrinkle reduction results, you'll need to undergo a cosmetic treatment.

Treating wrinkles - options beyond Botox

Botox is effective and may prevent future wrinkles by calming down the muscular contracture responsible for wrinkles. But Botox isn't the only option.

Fillers: when you age you lose volume, and replacing this volume can do wonders to fill in the facial contours. This can get rid of general wrinkles and highlight the face in ways to bring youth to the face. Restylane, Juvederm, Perlane are hyaluronic acids and last from 4 months to a year or more. Radiesse is made out of bone and will last about a year. Sculptra is a permanent filler that is FDA approved for the nasolabial folds.

Skin resurfacing: is a way to remove wrinkles, make pores smaller, take away unwanted pigmentation and tighten the skin. Chemical Peels, CO2 laser resurfacing, dermabrasion, aggressive microdermabrasion, fractionated lasers can all do this to some degree. They can be tailored to fit your lifestyle and schedule.  This is the only way to really improve the etched in wrinkles on the surface aspect while fillers can help do this from a deeper level. Fillers, however, will not change the surface characteristics as much as resurfacing modes can.

IPL: Intense Pulsed Light is light that is concentrated and filtered to allow a selected range of light to target skin pigments, brown spots, and vessels and the red spots they create.The reduction of the spots can  make your skin look clear and younger using the photorejuvenation settings. Buying a package of 4 should be relatively inexpensive (about $600). Realize the mechanism is the destruction of collagen. Its reformation takes a couple of months so you do not see the benefit of this treatment until that time. 

Don't scrub away your skin blemishes

When you wash your face with harsh chemicals or expose it to the environment in a extreme way it will react with redness and hyperpigmentation.

Wash twice a day at most. If you can only wash once, do it at night. More grime and makeup accumulates during the day so a night wash is better and should take a bit longer. Wash your face gently.

Do not scrub. If you have blackheads realize that it is melanin that makes them dark - not dirt. There's no need to try to scrape them away. Cleansing cloths are especially good if you apply a lot of makeup since they gently loosen grime and dirt, leaving the skin alone.

Dove Facial Cleansing Cloths or Neutragena Make-Up Remover Cleansing Towelettes are good inexpensive choices. Use a wash that is as gentle as possible, while still being effective.  The wash should not be so strong that it takes away your own natural oils. If your skin begins to feel irritated, dry or tight your cleanser may be too strong.

Dermatologists recommend toners for particularly oily skin or for those that use very heavy makeup. Use only at night. Cleansers have improved over the years. Toners were once needed (as astringents) to remove soap scum and detritus, but are usually not necessary today. So most people can save their money and cut out this step.

• Skin care tip: Save money on skin cleansers. Most people only need a simple, inexpensive wash. Realize that the wash is only going to be in contact with your face for seconds. While some companies put in some ingredients to make your skin feel refreshed, these add cost and do not help your skin any more than an inexpensive wash. Tingling sensations may feel good, but they are due to chemicals such as menthol or peppermint which may actually be irritating.

Contributors and Sources: Mary Lupo, MD; Bryan Chen, MD; Arnold Oppenheim, MD, Philip Young, MD