Anti-Aging Techniques for Your Skin

WebMD Live Events Transcript

How can you reduce the aging effects of summer fun in the sun? What are your options to treat the signs of aging without surgery? Daniela Paunesky, MD, joined us on July 13, 2004, to answer your skin-care questions.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Welcome, Dr. Paunesky. Please tell us what anti-aging medicine is.

Anti-aging medicine is basically preventative medicine. It's looking at aging as a degenerative process and replacing hormones and nutrients that become deficient with age.

What are some of those nutrients and hormones?

The therapy is individualized for men and women. First, I do a comprehensive blood panel prior to the patient coming in to see me so I can learn which hormones they are deficient in. For example, in a female I'll check levels of:

Nutrients I generally check are B12, folic acid, and ferritin, because these are most commonly associated with hair loss and fatigue, which are very common patient complaints. So the process is very simple. We go over every hormone, we replace the deficient hormones, and as far as the nutrients are concerned, I have compounded appropriate dosages of vitamins, too.

We only replace bio-identical hormones, meaning the hormone is the exact replica of the hormone existing in your body. There may be over-the-counter products stating they're a "natural hormone" because they come from a natural substance (such as soy), but they're still foreign to the body. Soy is a natural food product, but it's not a bio-identical hormone. Recent studies in JAMA reported that high levels of soy in menopause actually increase the risk of Alzheimer's. The theory is that soy blocks estrogen receptors and doesn't allow the female's own estrogen to bind to those receptors.

When should people begin checking these hormone levels and doing something about deficiencies?

I have men as young as 32 and as old as 98 that are hypogonadal, meaning severely deficient in testosterone. For women, hormones begin to decline around perimenopause, which usually begins at about 35.

"Thermage is still too new to decide whether it's truly effective; a recent statistic showed that 72.5% of patients who have had Thermage noticed no results."

Is there anything I can do to firm and tighten the skin on my face?

There are several things:

  • Very low-dose estriol
  • Heat, in the form of a photo facial (on an IPL machine), or certain laser devices
  • DMAE has been shown to be effective at diminishing wrinkling

DMAE is a supplement, but you can find it as a topical cream. A few studies have shown DMAE supplements are helpful, but topical creams show definite benefit. DMAE can also be injected sub-epidermal, which is called a meso lift, and is very popular in France.

Thermage is still too new to decide whether it's truly effective; a recent statistic showed that 72.5% of patients who have had Thermage noticed no results. To thicken skin, the proven topicals include:

  • Vitamin C
  • Estriol
  • Retinoic acid
  • DHEA gel

DHEA gel is a hormone you can take orally to help thicken the skin, although it takes years to notice appreciable results; apply it topically and results are noticed in a few months. However, it may cause acne to the face, so I tend to use it on the hands and arms.

What is the best way to prevent sun damage to my sensitive skin?

Avoid the sun with wide hats or visors. Or SkinMedica makes a sunscreen for sensitive skin that can be mixed with foundation and doesn't leave a greasy look.

I am a 44-year-old runner and though I use SPF30 sunscreen and a hat I'm getting brown spots. How can I minimize their appearance and prevent them?

Estrogen stimulates melanocytes and heat from the sun or tanning beds can cause these melanocytes to overproduce melanin. The most effective treatment is a topical cream of hydroquinolone, the most popular prescription being Trilumina. This will reduce the appearance of the brown spots and prevent new ones. However, it's still important to avoid sun exposure at all costs with sunscreen and visors.

I've been searching for a nongreasy sunscreen or sunblock that can be used on oily/acne-prone skin but everything I've tried is greasy. Is there anything you could recommend? Also, do darker-skinned individuals have to wear sunscreen?

First, SkinMedica makes a nongreasy sunscreen or sunblock (they're the same thing) for sensitive skin. Or try having one made from a compounding pharmacy (with a doctor's recommendation).

Second: light- and darker-skinned individuals are at risk for skin cancer and sun damage. Everyone should use sun protection.

I'm 14 and take good care of my skin. What would be best for my skin to keep its looks long term?


  • Eat right
  • Take vitamins
  • Don't smoke
  • Wear sunscreen
  • Avoid a stressful job

Are human growth hormones "the fountain of youth" or are the risks too great? Are any clinical trials using them as a cure for aging?

I love these questions! I have been using human growth hormone (HGH) in my practice for over three years. In my experience, injecting HGH is much more beneficial in individuals who have tested deficient. Otherwise, I'd recommend supplements. The benefits of higher HGH are:

  • Thickened skin
  • Smoother skin
  • Tighter skin
  • A slight increase in lean muscle mass
  • Increased bone density

You must use HGH for six months or more before results are noticed. If using injectable HGH, fasting insulin levels must be monitored because it may raise fasting insulin, which will add weight around the midsection; supplements avoid this side effect. Water retention at the initial phase is another very prevalent side effect with injectable HGH, and again, not seen with supplements.

So, if an individual is truly deficient, human growth hormone can reverse age-related disorders such as:

If a person isn't deficient, the benefits are not as noticeable in my experience.

"There is overwhelming evidence that people who have tested significantly deficient in HGH (human growth hormone) do benefit from HGH replacement. "

I read that the HGH study was for only six months and had few study subjects. Can it be trusted?

There have been a lot of studies, and a lot of controversy surrounding HGH replacement, because the studies are conflicting. We still need to learn more about long-term effects. Yet there is overwhelming evidence that people who have tested significantly deficient in HGH do benefit from HGH replacement. People have even reported improved quality of life, improved sleep and libido, and improved muscle mass to fat ratio.

Where can you get a good HGH supplement?

It's difficult to buy supplements over the counter because you don't know what you're really getting. To ensure the supplement is FDA-approved, question your physician and ask if they use pharmacy-grade supplements.

Dr. Paunesky, any final words for us?

Remember to wear your sunscreen, hats, and visors!

Thanks to Daniela Paunesky, MD, for sharing her expertise with us. Dr. Paunesky is the director of medicine at the Renaissance Medical Center and co-director of research at the Atlanta Medical Research Institute. 

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