Skin Flaws, Correcting (cont.)

The brown spots are caused by chronic daily sun exposure. They're also known as liver spots. Larger patches across the cheeks and nose in women of childbearing age are called melasma. Melasma is caused by the combination of hormones and sun exposure.

You asked how best to lighten these unattractive brown discolorations. In order to do that, you need to accomplish three tasks.

  • First, you must exfoliate daily to remove the scale so medications can better penetrate, and also to enhance cell turnover and lifting of that discoloration.
  • Second, you need to use a hydroquinone-lightening agent over your entire face. The reason being is that the brown spot you may be fixated on is merely the tip of the iceberg. The discoloration may be far more widespread beneath the top layer of skin, causing your skin to look uneven.
  • Third, it is imperative that you use a UVA-protective sunscreen. These sunscreens must contain either zinc oxide or avobenzone. Because it is UVA light that triggers the formation of these brown patches and spots.

By omitting any of these three steps, you will not see results.

Patients often ask me whether lasers can work to remove these brown spots. In some cases they can be quite successful; in others they can be highly risky and darken an already dark mark.

My jaw and mouth areas are sagging. Is there anything I can use or do to tighten these areas without surgery? I have been using StriVectin SD for four to five months, twice per day, and I don't see a difference.

I can relate completely to your question and concerns as a 47-year-old with early sagging in my face.

Unfortunately, laser technology has failed to lift sagging changes. Thermage, which is basically heat energy pumped into the skin, does a minimal if modest improvement in this area for tightening, whereas three out of ten may see visible tightening using this device. Unfortunately, this aggressive heat-generating neck procedure can lead to scarring.

At this time a facelift is still the gold standard to take away the loose skin in the neck juncture. If there is considerable fat in the chin/neck area, liposuction of the neckline can be accomplished with skin tightening for a very satisfying low-risk result.

Topical creams are modestly helpful, but unfortunately will not pull up loose skin. Strict sun avoidance will also help lessen the fall of the skin.

I'm starting to wear turtlenecks, how about you?

Many of my friends are using the new peptide creams for
wrinkles. I would also like to try them but currently use benzoyl peroxide, Differin and a sulfur wash for acne. Would it be unwise to try one of these creams on top of the regimen?

We are also very excited about this new peptide technology.

Peptides are small protein fragments that work by tricking the collagen-producing cells (fibroblasts) into believing that the skin has been injured, so that new collagen is made in an effort to heal the skin. This new collagen helps to thicken up the skin filling in lines and wrinkles.

You can take advantage of this new technology by using it in the morning and it should include a UVA sunscreen with zinc or avobenzone, and continuing your acne medication at night.

Hydroquinone has not worked for me. How long should I use this cream? It costs about $100.00 a jar!

If your pigmentation is not resolving after the methods we described above, we encourage you to see a dermatologist for more advanced therapy.

"The last bit of advice is to avoid the sun, because nothing ages you faster, and use a sunscreen every day, because every day is sun day. "

We are almost out of time. Before we go, do you have any final words for us today?

The best aging remedies you can start with today that are free:

  • Pick your parents carefully.
  • Sleep on your back so there are no sleep crush lines.
  • Remember -- every day is sun day, so wear sunscreen.
  • Never smoke and minimize your alcohol.

The last bit of advice is to avoid the sun, because nothing ages you faster, and use a sunscreen every day, because every day is sun day. That sunscreen must contain either zinc oxide or avobenzone in an SPF 15 or greater.

Wishing you all a lifetime of healthy, gorgeous skin.

Our thanks to Katie Rodan, MD, and Kathy Fields, MD for joining us today. Members, thanks for all of your great questions. I'm sorry we couldn't get to all of them.

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