Anti - Aging - Dermatology NYC - Dr. Gary Rothfeld - (212) - 644 -9494



Anti-Aging

Obviously, the skin and the whole body will not indefinitely look and function the way they did at the age of 20. Skin aging appears to be the result of two types of aging, intrinsic and extrinsic aging. Intrinsic or chronological aging is a universal and mostly inevitable process defined by genetic disposition and internal factors such as hormone levels. Extrinsic aging results from certain environmental factors such as UV radiation (main factor!) and smoking, and becomes apparent mainly on the face and the hands. Therefore, aging is a complex multifactorial process, and no single drug or treatment can influence it globally. But certain measures can be taken to prevent extrinsic, premature aging.
Avoidance of the above-mentioned risk factors, especially smoking and excessive sun exposure and use of adequate sunscreens are the most important steps towards keeping a youthful appearance.
The following suggestions provide useful information for delaying the ageing process. We have deliberately focused on lifestyle factors and cosmetic ingredients and do not include invasive procedures or surgical methods.

Diet and weight

  • Obesity is one of the most serious pro-aging factors. Losing excess weight and keeping your weight down will result in an improved sense of well-being.
  • By adding a variety of fruit and vegetables to the daily meals, vitamins and nutrients are assimilated which can act as antioxidants, disarming damaging free radicals.
  • The hormone "Human Growth Hormone" appears to hold a key function in the process of aging. Its release from the pituitary gland takes place particularly at night, and it is inhibited by a high blood glucose level (e.g. after a substancial meal). So dinner cancelling (no intake of food or drinks besides water after 5 p.m.) is recommended by some physicians, although this recommandation is still controversial.
  • As it has been suggested in studies that sugar may play a part in advancing skin wrinkling, a low intake of sugar and refined carbohydrates may prove useful to the skin.

Moisturising
Aged skin often feels dry to the touch, its dryness worsening in cold climates. Moisturisers are recommended as a means to relieve feelings of dryness and itching. They should be applied on a daily basis to ensure maximum benefit. Successful treatment of dry skin with appropriate moisturisers leads to smoother, softer and firmer skin.

Cosmetic ingredients
A variety of ingredients (e.g. retinoic acid, vitamins, flavonoids) are incorporated into cosmetic products, promising to delay/ reverse premature aging. Some of these have a scientifically proven effect, others lack a scientifically confirmed efficacy. Some products are further limited in their efficacy by the fact that the incorporated active ingredients are either not contained in an adequate concentration, or not stable in the cream base, or do not penetrate through the stratum corneum.

  • The following active ingredients found in topical cosmetics are useful in prevention and treatment of premature aging:
Vitamin A (retinol): One of the few anti-ageing-pharmaceuticals with a scientifically proven efficacy. When applied topically, it is transformed to retinoic acid by human keratinocytes. Retinol stimulates collagen production in the skin, and its application can result in a reduction of wrinkles and skin pigmentation.

Vitamin C: It stimulates collagen production and has a photoprotective effect. Its wrinkle-improving effect has been proven in clinical studies. One problem is its instability in various topical products, as vitamin C is prone to oxidation, and may lose its efficacy this way. Furthermore, some topical products do not penetrate through the stratum corneum, and thus are not able to render the desired effects.

Alpha-lipoic acid: It has antioxidative effects and has been shown to significantly reduce symptoms of skin aging and skin roughness in a clinical study.

Flavonoids: Group of substances found in many foods, e.g. green-tea phenols. They have a photoprotective effect.

Copper: Copper peptides seem to have effects on skin ageing. Clinical studies showed wrinkle reduction und improvement of elasticity.
  • The following active ingredients in cosmetic products seem to have an impact on skin aging, but their efficacy must be confirmed in further studies:
Vitamin E: There are almost no data on the antioxidant effects of Vitamin E from clinical studies, although some studies indicate a reduced wrinkle depth and a decrease in skin roughness. Confirmation of this data is still lacking. Vitamin E is found in various cosmetic products, however, in some of these its concentration is so low that no effects on the skin can be expected.

Coenzyme Q10: A lipophilic antioxidant which is reduced in ageing humans. Only few scientific data is found regarding its clinical anti-aging effect. Further double-blind placebo-controlled studies are necessary to establish its efficacy.

Growth factors: A relatively new concept is the topical application of growth factos such as EGF (Epidermal Growth Factor) and TGF-beta (Transforming Growth Factor beta). EGF is supposed to accelerate the cell turn-over rate and thus increase the speed of skin regeneration. TGF-beta seems to be effective in reducing wrinkles due to photoaging. Further controlled studies are needed to establish their effects in the long run.

Phyto-estrogens: These are plant-derived substances with a hormone-like effect on the skin, such as isoflavones. They are found in soy products, grapes, and tropical fruits. A controlled study showed positive effects on skin tightness and wrinkle reduction after topical application of isoflavones in postmenopausal women.

DMAE: Dimethyl aminoethanol has supposedly a positive effect on periorbital oedema (swelling of the eyelids) and on skin tightness. Some studies show an anti-aging effect on the skin.

Emblica: This antioxidant is extracted from the plant Phyllantus emblica and is said to reduce free radicals.

Polypeptides: Studies have shown that topically applied polypeptides may induce an acceleration of collagen synthesis. A clinical study demonstrated a positive effect on skin thickness and skin density after the application of a product containing palmitoyl pentapeptide for three months.

It is important to realise that even if a cosmetic product contains an active ingredient with scientifically proven anti-aging effect on the skin, its concentration, stability and ability to penetrate through the stratum corneum are crucial for this product’s efficacy.