You may have heard me talk about the slow lane of skin care. There are plenty of quick fixes—like dermaplaning, lasers, chemical peels, and basic microneedling—that can jumpstart your progress, but if your daily skin care regimen is suboptimal, the results from those quick fixes will not last. Let’s review the basics that are essential for good skin maintenance.
The signs of photoaging are fine and coarse wrinkling, rough texture, uneven pigmentation, thinning skin, decreased collagen and increased laxity of skin, and precancerous cell formation.
The epidermis is the thinnest and outermost layer of skin, and it is responsible for protecting you from the outside world. It is composed of 5 layers. The outermost layer of epidermis is known as the stratum corneum, and it can be 5+ layers of dead cells. The dermis resides beneath this and houses collagen, an important component of skin providing strength and volume.
The number one essential skin care step for acne, tone, and texture is Retinoid, a prescription-strength vitamin A derivative. (Retinol refers to over-the-counter products, which can be gentler and less drying because they are less potent. These may be better tolerated but take longer to produce effects). The benefits of Retinoids include accelerated cell turnover, shedding of dead cells and making room for newer and healthier cells, increased collagen, smoothing of texture, evening tone, and reducing breakouts. My preferred Retinoid is Tazarotene (Tazorac, strengths 0.025%- 0.1%). The best time to apply retinoids is at night since the sunlight can break them down and make them less effective. The ideal effect is with daily use, but you will have to start slowly, once a week or every 3rd day depending on how you tolerate it, and work your way up to nightly, with a goal of 4-7 times a week. You will first notice sloughing of skin, the glorious skin peel that should signal excitement in your brain rather than annoyance, because these are the dead skin cells that are preventing you from your best skin. (This usually stops after 1-3 months of routine use and you can increase moisture and/or use a gentle morning glycolic/salicylic exfoliant to minimize this). You will start seeing results within 1 month but optimal results begin at 3-6 months of daily use. (If you have a rosacea tendency, we will have to walk through the initiation of retinoid slowly.)
The second essential skin care step is vitamin C/ascorbic acid, which promotes collagen production and provides antioxidant protection. It protects against damaging free radicals produced by UVA/UVB, infrared radiation, and ozone pollution, which can harm healthy skin cells and accelerate the aging process. It also is excellent for reducing hyperpigmentation.
You should be using a daily moisturizer containing squalene and niacinamide. In addition to providing a moisture barrier, squalene is an emollient and a detoxifier, and regular use can boost collagen production. Niacinamide serves as a lipid barrier, minimizes redness, regulates oil, and treats hyperpigmentation. You want to avoid moisturizers with alcohol, oils, or fruit or plant extracts to avoid acne and other inflammation.
Also use a daily SPF 40 or greater to protect against damaging free radicals. This should be reapplied every 2-4 hours. Bonus points if it contains hyaluronic acid and is non-comedogenic (i.e. non-acne forming). Extra bonus points if you stop your skin care routine at this layer and avoid foundation, which is heavy in chemicals and can clog pores and cause skin inflammation!
Your cleanser should remove oil, dirt, and makeup but should not disrupt your skin’s natural protective barrier. A foaming facial cleanser that contains ceramides, hyaluronic acid, and niacinamide can help maintain your skin’s moisture. Be gentle here. Avoid scrubs, which can disrupt your skin’s natural barrier and create a lot of trauma and inflammation.
If you can do these 5 things daily, every day, you will see your skin take on a fresh glow that no makeup could ever give you. If you make these a daily habit, we can move on to the next level of skin care, such as adding salicylic acid/glycolic acid exfoliating cleansers and microneedling with microinfusions of your own platelet-rich plasma.
