Patient/physician teamwork produces best rejuvenation outcomes

Chicago - The trend toward non-invasive rejuvenation of the face is continually expanding with methods ranging from the simplest at-home therapies to aggressive, high-tech methods of removing as many signs of aging as possible.

During the American Academy of Dermatology Summer Meeting here, Marsha Gordon, M.D., vice-chairman of the dermatology department at The Mount Sinai School Of Medicine in New York City,outlined some of the steps physicians and their patients can take and some of the methods that are showing good results - ranging from patient responsibilities to the latest in the physician's armamentarium.

Cleansing important

Scrubs and toners

"I believe that exfoliating with a scrub or a toner is an excellent idea – but judiciously so that the top dead layer is exfoliated without irritation," she explains.

Dr. Gordon says exfoliation is an individual process. Some people can use a scrub twice a day while others can only use it once a week.

"My suggestion is always that less is more - especially at the beginning. I might suggest starting once or twice a week with a scrub and then increasing the routine gradually - as opposed to start by using the scrub every day, causing irritation and then needing to stop. That's not good. I'd rather start slowly and build up."

Sun protection

On the issue of sun-protection, Dr. Gordon stresses two important points.

Even small amounts of sun exposure - too small to cause tanning - can still cause aging damage to the skin.

A laboratory study in animals that shows very low levels of exposure – again, not enough to make the animals red - can cause wrinkles. Those wrinkles continue to worsen even after the sun exposure is discontinued.

"When patients say 'I use sunscreen all the time - but I didn't use it today because I wasn't out in the sun,' I ask them how they got to my office. They don't think the 10 minutes from the parking garage to my office counts, but it does. People need to use sunscreen every day without fail for complete protection."

Dr. Gordon says, "Patients shouldn't just look for a high SPF, which is primarily a measure of the UVB burning rays, but also look for a good UVA blocking agent to be listed in the active ingredients section - either a titanium-based ingredient, a zinc-based ingredient or avobenzone.

"An ingredient called Mexoryl seems to have an excellent UVA-protective capacity but it is not available in the United States. The FDA is still reviewing it, so we are hoping for its approval here," she says.

None of those ingredients eliminates the need for good sun avoidance techniques including a wide-brim hat, staying in the shade and avoiding the mid-day sun, according to Dr. Gordon. Both sunscreen and avoidance should be used.

Topical creams, lotions

Currently, the effectiveness of oligopeptides on collagen production has become a topic of speculation and study.

"The theoretical framework is found in wound healing studies, in which peptides have been shown to produce an increase in collagen production.