Skin: Taking Care of Aging Skin with Diane Young (cont.)

Dr. Young: Well, mainly by neutralizing with vitamins A, E, and C

Moderator: What improvements result from treatment with anti-oxidant skin creams?

Dr. Young: It's preventative in many ways; it prevents premature aging of the skin, stopping a problem before it begins. It's preventative, not corrective.

Moderator: What is the role of genetics in aging of the skin?

Dr. Young: Less than we think in this age of genetics, less than we think. You inherit certain expressions, ways of moving muscles in your face. Get the family album out and you'll see, because we inherit the way we move those muscles.

Dr. Young: Most of aging is because of light exposure. People like to say that you inherit good skin, but really you create it more from what you do.

Dr. Young: I have seen the numbers on photo-aging. I would say 85-90% of aging is from light exposure, the rest from picking good parents (laughs).

Moderator: Is it true that the sunburns you receive as a child are what determine the lines and wrinkles at age 40?

Dr. Young: The bad sunburns that we all remember getting as a child are responsible for melanomas that show up later in life. Aging is more a result of everyday exposure, the constant daily exposure that adds up by the time you get to forty that is responsible for premature aging. Day-in and day-out light exposure adds up.

There are two types of rays from the sun; UVA is responsible for lines and wrinkles, and UVB is what burns the skin. Those burning rays help contribute to sagging of the skin, so sun protection is really important. A few bad burns won't help your skin, but the long-term protection is from day in and day out, from your house to the car, the car to the office. It's the day-in day-out exposure that adds up.

Dr. Young: An exception to that are people who live in the sunbelt or areas where they have intense sun most of the year, but there are very few people who spend most of their time in the sun.

sundown218_WebMD What should I look for in an anti-oxidant cream and can it be purchased over the counter?

Dr. Young: Yes you can purchase anti-oxidant cream over the counter. Look for formulations that use retin-A, vitamin C, l-ascorbic acid, it may just say ascorbic acid, e-tocotheryl acetate...that's vitamin E. We have A, E and C, the basic anti-oxidants, any one or combination. These are very common now in all means of distribution. You can find them in salons, department stores, drug stores, or prescription products from a dermatologist.

Moderator: Is there a certain percentage of these ingredients that is recommended?

Dr. Young: It would vary from formula to formula. The percentages on the formula, in a cosmetic formula, the highest percentage is listed in a descending order. In a prescription product, it will say what the percentage is.

Moderator: What scientific research has been generated regarding anti-oxidants?

Dr. Young: Using topical anti-oxidants helps prevent damage by free-radicals. Go to and there is a research study there on anti-oxidants used in skin care products

sundown218_WebMD What can be done about imperfections/spots on the lower neck/upper chest area?

Dr. Young: Again, we have formulations that are over-the-counter that contain hydroquinone at about 2% concentration. A more effective result will come from a dermatologists' prescription of hydroquinone at 4% though. These are great for the upper chest and neck where we get freckles.

Moderator: What dermatological breakthroughs have occurred over the past few years?

Dr. Young: The biggest one was the use of vitamin A technology. Actually it was developed for acne, but in the course of observing mature women with acne, a side effect was a visible reduction in lines and wrinkles. That's Retin-A and Renova; these are prescription products that use vitamin A technology to reduce the appearance of lines and wrinkles.

Dr. Young: The second greatest breakthrough would be the use of fruit acids in higher strengths for mini-peels and surface peels.

Dr. Young: I would say the third would be the use of laser technology to do deeper peels of the skin and the use of hydroquinone in the higher levels to reduce pigmentation.

Moderator: Are American women catching up with their European counterparts in taking care of their skin?

Dr. Young: American women are better now than there European counterparts in this sense; European women start earlier and they have a longer tradition of educating their children, mother to daughter. However, the exciting breakthroughs in technology have come from this country. We're way ahead of them. European women think preventatively, American women think correctively.

Dr. Young: As in everything, Americans want to fix it. Europeans think an older woman with lines and character in her face is gorgeous. American women take advantage of a fix for that. They'll fight the aging process, where women in other cultures will accept it. Americans want things fixed.

Moderator: Do you recommend collagen and botox injections on a regular basis?

Dr. Young: I recommend them for appropriate situations. I actually left them out of that list of breakthroughs. We'll call them injections. Collagen started it, and in addition there's fat implementation, and botox. It's a paralyzation of nerves, but it depends on the face, condition of the skin, and what the objective is. Botox seems to work very well around the eye area for softening crow's feet and for working on these lines between the eyebrows. Collagen does not work well in the area in the thin skin around the eye because it's a heavier injectible, where botox is working to release that nerve. Collagen and fat work better around the lips

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