Anti-Aging Cream

In general, women with brown skin do not age as quickly as women of European descent. Therefore, invasive anti-aging procedures such as facelifts and laser resurfacing are usually not necessary. However, brown skin may still benefit from several forms of rejuvenation. One of these forms involves applying topical anti-aging creams. These creams are popular among women with brown skin as a first line of defense against the signs of aging skin. They are often used in conjunction with other anti-aging treatments such as chemical peels, microdermabrasion, filler substances and muscle relaxants such as Botox. The most popular anti-aging creams are Avage, Renova and Prevage, the advantages of which include the fact that they can be applied at home, require no healing time, and are simple and easy to use. Avage and Renova are medications that are both classified as retinoids, while Prevage is classified as an anti-oxidant. Although these creams are generally well suited for brown skin, it is important to discuss them with your dermatologist to decide which cream will be most appropriate for your skin and will give you the best results. Do not use a friend or family member’s cream, as these medications should only be used under the supervision of a licensed professional and as part of a skin care program in which you avoid sunlight.

Retinoids
Retinoids have been used for many years to treat acne in teens and adults. Several years ago, these potent prescription medications were found to reverse some of the signs of aging such as fading dark marks, evening skin tone, reducing skin wrinkling and eliminating roughness. They are believed to work on all layers of the skin, including the epidermis where pigmentary changes occur and also on the deeper portions of the skin (the dermis) where wrinkling begins from the loss of collagen and elastin.

Retinoid based creams are easy to use. A small amount of the retinoid cream is simply applied to the face once a day. However, with the retinoid creams, more is not better; using too much will not hasten results, and may actually cause the onset of dryness and skin irritation. In brown skin, excessive dryness and irritation may lead to dark marks or patches, termed postinflammatory hyperpigmentation, so it is important to follow your doctor’s directions regarding application. The following tips may help you avoid dryness and irritation that may be associated with use of the retinoid creams.

  • Use a moisturizing cleanser twice daily
  • Wait 20-30 minutes after cleansing before applying the retinoid cream
  • Apply a moisturizer before and/or after applying the retinoid cream
  • Apply the retinoid every other night initially and slowly increase to nightly
  • If you miss a dose of the retinoid, do not double up, simply resume your normal schedule
  • Each morning apply an SPF 15 or greater to protect against sun sensitivity and sunburns
  • Avoid using other products with drying effects such as alcohol based astringents or certain acne medications
  • Avoid hair removal agents such as depilatories and waxes since these may further dry or irritate your skin
  • See your dermatologist if dryness or irritation persists or is excessive

   Other retinoid do’s and don’ts:

  • Discontinue all retinoids 7-days before undergoing waxing to remove hair
  • Discontinue all retinoids 7-days before undergoing chemical peel procedures
  • Do not use a retinoids if you are currently experiencing an outbreak of eczema or any other skin rash
  • Do not use a retinoids if you are pregnant, attempting to conceive or breast feeding

Tazarotene
Avage is a prescription facial cream produced by Allergan, Inc. that contains the compound tazarotene 0.1%. You may be familiar with the prescription acne medication Tazorac, which is made of the same tazarotene compound. Avage and Tazorac are both classified as retinoid compounds. Avage differs from Tazorac, in that it contains emollients (heavy duty moisturizers), which soften your skin and may help to prevent excessive dryness. Even with the built in moisturizer, using another moisturizer to avoid dryness is advisable.

Avage cream improves the appearance of the skin through several mechanisms. It increases collagen (an essential building block of the skin) and elastin in the dermal portion of the skin, which serves to lessen wrinkling. In the epidermal layer of the skin, Avage cream has two effects. It is felt to minimize skin discolorations and evens skin tone. Additionally, it improves the rough texture of the skin, which commonly occurs as we age.

Avage cream usually begins to show results within a couple of weeks with maximal results after 4-6 months. Most side effects are mild and are typically limited to the areas of skin where the cream is applied (see tips above). You may at times experience itching of the skin (pruritus), a stinging or burning sensation, dryness, or peeling. Some patients, about 5%, in one study, had to stop treatment due to skin irritation. If side effects become a problem, discontinue the cream and contact your doctor immediately.

Tretinoin
Renova is an anti-aging cream produced by Johnson & Johnson that contains tretinoin or retinoic acid, a vitamin A metabolite. It contains the same active ingredient as Retin A, which is used to treat acne. Renova, however, comes in both a 0.2% or 0.5% concentration. Renova shares most of the same application procedures, benefits and side effects as Avage (see above) and other retinoid creams. Renova cream usually take 3-4 months to notice a visible improvement, and you may need to wait as long as six months before you notice definite beneficial effects.

Antioxidants
Antioxidants are substances that protect the cells in our body from damage caused by internal and external stresses. These stressors, which may include things that you may not have considered, such as the digestion of food, exercise, air pollution, smoking, and even sunlight, can cause our cells to release free radicals. Free radicals are atoms or groups of atoms with an odd (unpaired) number of electrons. Once these highly reactive free radicals are formed, they can start a chain reaction in your body, like dominoes. As free radicals build up in our bodies they try to stabilize themselves by binding to the nearest normal cell. This results in a chain reaction because once the free radical attaches to a healthy cell it too becomes a free radical. Free radicals then damage our body’s cells and they do this by reacting with important cellular components such as DNA, or the cell’s membrane. In the skin, free radicals specifically break down collagen and elastin tissues. This causes our skin to age prematurely and wrinkles to develop. To prevent free radical damage the body has a defense system of antioxidants. Antioxidants are molecules that can safely interact with free radicals and terminate the chain reaction or domino effect before vital molecules are damaged. In our bodies, the principal antioxidants are vitamin E and vitamin C. A complete listing of our body’s antioxidants are listed below.

  • Vitamin A
  • Vitamin B-6
  • Vitamin B-12
  • Vitamin C
  • Vitamin E
  • Beta-carotene
  • Folic acid
  • Glutathione
  • Selenium
  • Ubiquinone
  • Zinc

Our bodies cannot manufacture these antioxidants, so they must be supplied in the diet and most recently in creams applied to the skin. Topically applied antioxidants work by coating the skin and producing a protective layer to neutralize free-radicals. It shields skin from outer environmental damage and protects you by binding to free radicals and neutralizing them before they cause damage.

Plants also contain antioxidants because they too need protection from environmental stresses. Some of the plant antioxidants have been formulated into creams for topical use. Some plant antioxidants are listed below.

  • Ferulic acid
  • Silymarin
  • Feverfew
  • Tamarind
  • Soy isoflavones (Genistein)
  • Green and black tea polyphenols
  • Polypodium leucotomos
  • Red Clover
  • Grape seed extract

Idebenone
Prevage is a facial cream produced by Allergan, Inc. which contains the antioxidant idebenone 1%. It is a synthetic version of ubiquinone, an antioxidant, like vitamins C and E, which helps to protect skin cells from environmental damage and the generation of free radicals. Prevage is used to trap free radicals, reduce fine lines and wrinkles, smooth skin roughness, reduce dryness and protect skin cells from deterioration.

Prevage is applied twice daily to the skin. A pea-size amount is typically massage into the face and neck, after washing and drying. Some dermatologists will recommend applying the cream once a day for a period of about 2 weeks, but after that twice daily application, in the morning and at night, to achieve maximal results is fine. Prevage can usually be used with other topical agents, but you should discuss this with your doctor. You should begin to notice improvements in your skin 4-6 weeks after starting treatment. Because Prevage is an antioxidant, it works differently than the retinoid creams, Avage and Renova, to rejuvenate your skin. Therefore, women with brown skin can benefit from using both an antioxidant and a retinoid, but they should be used at different times of the day.

Generally, the studies indicate that Prevage is well tolerated and is without serious side effects. However, a stinging or burning sensation after application has been reported. In brown skin, as with any other product, Prevage use can result in irritation which can produce discoloration of the skin. Therefore, it is important to note how your skin reacts to this product and consult your physician if you notice any adverse effects. Although Prevage can protect your skin from many environmental stressors, it does not work as a sunscreen. An SPF 15 or higher sunscreen should be worn daily. Also, you do not want to use Prevage if you are pregnant, attempting to conceive or nursing.

Bottom Line
Tazarotene, Tretinoin, and Idebenone are all relatively inexpensive and easy to use anti-aging treatments. There are generally well tolerated in brown skin and can be used in conjunction with other procedures. They must, however, be used with the guidance of your dermatologist.

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