Treating Aging Skin

Last Editorial Review: 1/31/2005
The Cleveland Clinic

New innovations in skin rejuvenation continue to develop, ranging from topically applied "cosmeceuticals" to new surgical techniques. A thorough understanding of how your skin changes as you age and how the sun affects your skin can help you decide with your doctor what treatment is best.

How Can I Maintain Healthy Skin?

The best way to keep skin healthy is to avoid sun exposure beginning early in life. Here are some other tips:

  • Do not sunbathe or visit tanning parlors and try to stay out of the sun between 10 a.m. and 3 p.m.
  • If you are in the sun between 10 a.m. and 3 p.m. always wear protective clothing?such as a hat, long-sleeved shirt, and sunglasses.
  • Put on sunscreen lotion before going out in the sun to help protect your skin from UV light. Remember to reapply the lotion as needed. Always use products that are SPF (sun protection factor) 15 or higher.
  • Check your skin often for signs of skin cancer. If there are changes that worry you, call the doctor right away. The American Academy of Dermatology suggests that older, fair-skinned people have a yearly skin check by a doctor as part of a regular physical check-up.
  • Relieve dry skin problems by using a humidifier at home, bathing with soap less often (use a moisturizing body wash instead), and using a moisturizing lotion. If this doesn't work, see your doctor.

What are the Treatment Options for Aging Skin?

The doctor's palette of resurfacing options continues to expand. In patients with early skin aging changes, nonsurgical treatment methods such as tretinoin, vitamin C, and alpha hydroxy acids may provide satisfactory improvement. Chemical peels, dermabrasion and laserabrasion may be used alone or in combination with other surgical procedures to treat moderate to severe degrees of facial photodamage.

Deeper facial lines may be treated with botulinum toxin or soft tissue enhancement, including collagen, autologous fat, and Goretex implants. Patients with more sagging, excess skin will benefit from additional procedures such as facelift, browlift, and blepharoplasty (surgical reconstruction of the eyelid). Treatment must be individualized accordingly to the patient's facial characteristics and cosmetic concerns.

Here is more detail about some of the more popular treatment options:

  • Chemical peels. Chemical peels are effective for removing fine lines and smoothing out the skin. Chemical peels remove the upper surface of the skin to expose newer, clearer skin. After the upper layers of the skin have been removed, a new layer of skin develops. Chemical peels can be used in areas, such as the eyelids and around the mouth, that are not improved by a facelift. Depending on the patient's skin type and degree of sun damage, a superficial, medium or deep chemical peel may be the appropriate treatment.
  • Dermabrasion. Dermabrasion removes lines and some scarring and can be used to treat moderate to severe photodamage (sun damage). In dermabrasion, the doctor sands away the top layer of skin, thus it has similar side effects and complications as medium to deep chemical peels. However, because of the bleeding associated with dermabrasion and variations in skill and technique, the control of wounding is not as accurate as with current laserabrasion technology. Dermabrasion is not done on the thin skin around the eyes. Care must also be taken when dermabrading the skin around the mouth.
  • Laser resurfacing. In the past few years, the development of high-energy carbon dioxide lasers has enhanced physicians' ability to improve photoaged skin, various types of scars and other dermatologic conditions. The precise depth control and ability to treat large areas in a relatively short amount of time makes these carbon dioxide lasers valuable tools. Before laser resurfacing is performed, your doctor will discuss with you other treatment options, what to expect during recovery, how to take care of your skin after the procedure, and possible side effects and complications. Camouflage makeup suggestions will also be discussed.

Reviewed by the doctors at The Cleveland Clinic, Department of Dermatology
Edited by Charlotte E. Grayson, MD, Sept. 2003.

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