Taking Care of Aging Skin with Diane Young

Last Editorial Review: 10/23/2003

WebMD Live Events Transcript

Skincare and beauty consultant Diane Young will discuss how to take care and improve your skin.

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.

Moderator: Welcome to WebMD Live. Today we will be discussing "Taking Care of Aging Skin" with Diane Young.

Diane Young pioneered the concept of holistic beauty. In 1982, when she opened her skin care salon in New York City, she was the first salon in the country to combine beauty treatments and products with the services of a nutritionist, dermatologist, and plastic surgeon. She believed then, as she does now, that to improve skin it must be cared for on the inside, as well as the outside. She studied advanced skin care at the Bretlands Beauty Institute at Royal Turnbridge in Wells, England, attended the Christian Chauveau Makeup Institute in Paris, France, and completed the Elizabeth Jones Aromatherapy Program in Vienna, Austria. She has been named by Harper's Bazaar Magazine as one of the four top beauty experts in the world, and by a leading trade publication as a Living Legend in Skin Care. She has appeared on many top television shows, including the Oprah Winfrey Show.

Diane, welcome to WebMD Live.

What is the difference between normal aging of the skin and premature aging of the skin?

Dr. Young: The difference between them is light exposure. Photo-aging speeds up the hands of the aging clock. In terms of skin, you see sun damage, lines and wrinkles, uneven pigmentation and age spots. You see a dried out, leathery surface; these are the basic signs of aging. It's imperative, like brushing your teeth everyday, that you wear sun protection, minimum SPF 15. If you have sun damage, there are ways you can improve the way your skin looks and feels. Even in a blowing snow storm, you are receiving photo-damage to your skin. All light speeds up the biological aging of the skin.

What can we do if we've already experienced photo aging? Number one: moisturize every day and apply your sunscreen. You can use formulas that contain different vitamin combinations such as Vitamins A, C, and E. Various technologies have clinical studies that show the ability to make the skin appear younger. If you have uneven skin pigmentation, you need a product that contains at least 4% hydroquinone. It will help rid the brown spots and even-out the pigmentation. It's been around a long time, but only recently we've been using it to rid unwanted pigmentation. It's also important to exfoliate on a regular basis. You can use fruit acids, enzymes, vitamins.

There are also mechanical, old-fashioned ways; like beauty grains, but we really prefer these new technologies because they are less aggressive. Another example of a mechanical form is a loofah or body brush, appropriate for your body but not your face.

It's important because as you age, dead cells accumulate. Find a form of exfoliation that works for you and use it once a week.

Protective clothing is important; hats and long-sleeved shirts should also be part of your sun protection program. The best protection there is is to stay indoors, especially between 10:00 am and 2:00 pm.

Moderator: What is the role of oxygen in the aging process?

Dr. Young: Oxygen. There's two things; aging of the body and aging of the skin. Let's talk about skin. We have something called a free radical, an unattached oxygen molecule, that when it comes in contact with our skin, can cause problems. We need to neutralize it before it causes damage. We neutralize by using anti-oxidant ingredients.  For example, vitamin A, vitamin E and vitamin C are antioxidants that would neutralize this free radical before it had a chance to damage our skin. Internally, these free radicals are released many different ways to cause the same problem internally. Our body can deal with them, but when it is overwhelmed with them, it cannot keep up the job. It's important not to overwhelm our systems with free radicals, like smoking.

Moderator: What are some of the negative effects of free radicals on the skin?

Dr. Young: The major effect is that they cause irritation. The major free radical people experience is pollution. It causes the skin to look dull. In a lot of people who are sensitive, it irritates the skin.

Moderator: How do anti-oxidant skin cream treatments help fight free radicals?

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 http://www.sunandskin.com 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

Moderator: Doesn't botox freeze the forehead so that the woman loses facial expressions? What is the source of botox?

Dr. Young: It does, but it's temporary. Botox is not permanent.  It temporarily paralyzes that muscle so it cannot form the wrinkle or the furrow, but gradually that wears off and you have to have another injection; it's not permanent.

Moderator: What is the source of botox?

Dr. Young: Botox is a form of botulism, a toxin. In measured amounts it seems to work well for temporarily "paralyzing" the nerve that causes the muscle to move in a certain way.

Moderator: What are some new developments in anti-aging research in the next five years? Ten years?

Dr. Young: I think that we will have sun protectors that give us 100% protection. We don't have it now. I think that we'll have exfoliating and resurfacing procedures that can be done at home to keep skin soft and smooth, moisturizers and ingredients that work deeper than just the surface of the skin. But I think the real frontier in anti-aging will be internal.

Dr. Young: I think we'll take ingestibles that will be highly efficient in slowing down the aging process and maybe reversing it. We'll have ingestibles that go directly into our systems. We'll have information that will give us much more control over the aging process than we do now. We already have more information than we have had in the past. Small lifestyle changes help. I think it will be proven that drinking more pure water will add greatly to our health and information about food and supplements like vitamins and mineral supplements. We're just at the tip of the iceberg about what good nutrition can do for the overall aging process. 

Dr. Young: A lot of my clients in New York don't get enough sleep. The energy it takes to maintain our normal waking functions needs to be slowed down. Every night our body tries to catch up on the damage done during the day, but we short-change ourselves by not getting enough sleep or rest. I know it makes a difference in the way our skin functions.

Moderator: How much sleep do you recommend?

Dr. Young: Your body will tell you how much sleep you need. If you eat properly and practice a healthy lifestyle, you'll go into a deep and restful sleep. You'll wake up rested and refreshed, and eager to face the day. Most of us drag out of bed without enough rest.

Dr. Young: I think breathing is very important. When you are stressed you have shallow breathing, and oxygen is crucial to our health and function of our body. I think that breathing is going to be a huge anti-aging focus in the future.  Oxygen bars are a result of a lack of oxygen in our environments. What I'm talking about is adequate breathing for the regular functioning of your body. We know that skin is nourished by oxygen. Skin is the last delivery point of oxygen in our body. It is dropped off last in the skin. Just breathing well and increasing oxygen in your body makes an enormous difference in the appearance of your skin. One of the first treatments in a spa is a massage. It increases blood flow and thus oxygen to the skin.

Dr. Young: Our everyday living will impact our appearance immensely.

cpc99_WebMD After spending many years in the south with no regard for sun protection in my youth, is there a natural "reversal" of the negative effects of sun? Any tips?

Dr. Young: One way is to stay out of the sun. To wear everyday, sun protection minimum SPF 15. Exfoliation in various forms will help to reduce sun damage. Eating a diet high in natural anti-oxidants like fruits and vegetables, and exercising the whole body will show up in her face and keep her skin looking younger. Using anti-oxidants will help. Try health food stores or other distribution methods. 

I want to say this about skin care products; there is no such thing as a totally natural product. Products in jars, not made for one-time use need a preservative formula. Every time you stick your finger in, you introduce bacteria. While I agree that natural forms are important, there are good chemicals. The convenience of having a product ready in a jar is worth it.

Moderator: How are the oxygen levels in the skin scientifically measured?

Dr. Young: I don't know the exact answer, but I know that in skin care, there is a machine. It measures the results of hydration from products that contained hydrogen peroxide and anti-oxides. It's not widely available though. It was used in Europe and developed by a now-deceased man who worked on the original iron lung.

Moderator: Tell us about the advances in laser techniques.

Dr. Young: There are many forms of lasers now. They exfoliate on superficial layers of the skin, and deeper layers. There are lasers that work on broken capillaries and red pigmentation. There are lasers that work on dark-pigmented areas of the skin, and lasers that help remove hair from the skin. This whole laser technology is just really exploding; look for more to come.

Moderator: The skin is regarded as an organ. Why is this so?

Dr. Young: What confuses people about that is that they think of organs as internal, like your heart or lungs. They have some idea of the function of those organs. We take our skin for granted because it's an outside organ. It's function is to keep our insides "in" and outside things from getting in. Because we can see it and feel it everyday, we sort of take it for granted. It is not so involved with our survival as our inside organs are; it's crucial, but not in the same way as internal organs.

Dr. Young: People also forget that our skin is our air conditioning and heating regulation. It's a temperature regulator; through perspiration when our body temperature goes up. When we get cold and our temperature drops, our skin gives indicators that something is wrong; we shiver, we get goose bumps. It's main function is as a big envelope that's very difficult to penetrate, a wonderful armor. Once it becomes broken or cut, it becomes vulnerable to outside things getting inside our system

Moderator: Do you see a lot of botched cosmetic surgeries that you have to correct?

Dr. Young: Here's what I would say about cosmetic surgery: The most important thing is going to a doctor that is licensed and participates in medical accreditation. A doctor that is board-certified in their specialty. Problems arise when people go outside their area of expertise; getting to the right doctor is important.

Dr. Young: Next is the quality of the skin. We work with many plastic surgeons who tell us, other than the skill of the physician, the next most important thing is skin that is in good condition, protected from the sun, exfoliated. The quality of the skin is crucial to that result.

Dr. Young: Yes, first of all, most problems can be corrected. That's the good news.

Moderator: Can you help someone who's had a bad surgery?

Dr. Young: A salon can help cover discoloration from healing incisions, and if someone is unhappy with the results of a dermatological procedure, in most cases they just need to wait and let nature take its course.

Dr. Young: Most of the complaints we get is that women's expectations are unrealistic, and they don't wait to see the proper results of the surgery. It can take months and months to see the actual results.

sundown218_WebMD I'm pretty clear now on my daytime skin routine, but what do you recommend for make-up removal and bedtime?

Dr. Young: Cleaning, day or night. A product must be water-soluble, it must foam, and it should leave no film. After you towel dry your face, there should be no make-up residue on the towel. It should come clean.  If your face feels tight and drawn, you have used a product that is too strong and inappropriate for your skin type.

Dr. Young: What should you do at night? Night is a time when your body is slowing down, healing and repairing. You want to give your skin a "treatment". It can come in many forms. Maybe a serum, a concentrated booster-type product, or perhaps use a heavier product than for daytime. Heavier sometimes means more oil, or loaded with more reparative ingredients. It can be a product that is more treatment-oriented than just protective. I'm going to recommend a product of ours that's not available yet; it will be in about two months. It's called "Awaken Younger" and it contains an ingredient called centella asiatica. That's a Chinese herb that is actually combined with banana; the flower of the banana plant. These two have clinical studies that prove they decrease the appearance of lines and wrinkles and firm the skin.

Dr. Young: We have a very concentrated creme. It has something called "heavy water". It's found in greater concentrations at the bottom of saline lakes. It holds hydration on the skin better than anything else. It's concentrated water, so it holds itself and other ingredients on the skin longer and better.  Call 1-800-Stay Young or on the web, http://www.dianeyoung.com.  The product will be available at my salon.

sundown218_WebMD Are astringents too strong? They seem to "tingle" sometimes.

Dr. Young: I don't believe in toners. We used to need them when we used cold cream and cleansers that left an oily, greasy residue. We used to say that we needed toner or astringent to complete the process. We would wipe over the face in an effort to remove the residue of the product. We also needed them to restore the ph after cleansing, because many would over clean, and we had to sort of bring the acid back. That's not necessary today. With today's products, you can clean the skin without particularly harming the skin; cleansers and toners can be used to prepare the skin for moisturization.

Dr. Young: An example of this new category of "toners": If your skin is sensitive you can use a water-based toner that will have calming and soothing ingredients, like aloe vera that will calm your skin, and help hold in moisture.  It becomes a water phase on your skin and it has calming ingredients. The product should not contain alcohol, but there are all kinds of ingredients that will prevent breakouts.

Dr. Young: If your skin is dry, there are moisturizing ingredients that can be applied. This category is not an astringent, not a toner per se. No one should be using alcohol or astringents that tingle, it's detrimental to the skin. 

You have great control over the aging of your skin. Little things add up to big results. Inform yourself. There are many websites that give free information. Take action!

Moderator: Thank you for joining us, Diane. 

Dr. Young: Thank you, it was my pleasure!

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