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Younger Looking Skin Without Surgery

Skin care products: What works, what doesn't

En español | "Most people don't realize how old I am," says Norma Sue Scher, of St. Louis. "When something comes up about being 73, they say, 'I thought you were in your 50s!' "

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Scher uses anti-aging lotions and cleansers every day, and she regularly gets chemical fillers and peels from her dermatologist. It's not that she wants to look 20, she says. But she wants to look her best, for her husband and for herself. Your reflection in the mirror "has to say, 'Hey you're OK,' " she says

Keeping your skin looking as young as possible requires Scher's multi-pronged approach, dermatologists say.

As we age, skin can become dull, large-pored and flaky, says Neal Schultz, coauthor of the book It's Not Just About Wrinkles. "Three-fourths of what you see in the mirror is really issues of color and texture," he says.

Darker skin is less prone to wrinkling, and more prone to color changes from too much pigment.

About 80 percent of the transition from smooth-as-a-grape to rough-as-a-corn-flake is due to sun damage, says Scher's doctor Lawrence Samuels, chief of dermatology at St. Luke's Hospital in St. Louis. (If you doubt him, take a look at the skin on your bottom.)

What can you do to get back at the sun — and old man time?

Next: Low-cost skin care tips. >>

No- or low-cost tips

Dermatologists have many products and procedures, but their cost can make a big wrinkle in your budget. So let's start with the less expensive options. First, use a good sunblock to protect your skin and help prevent wrinkles. (See box, below.) Then, watch how you sleep. You've heard of laugh lines, right? Well, sleeping with your face squished into the pillow also promotes lines, so try sleeping on your back. Eating a healthy diet and exercising help your skin as well, although dermatologists disagree over the value of vitamins in skin care products.

You don't need to spend a lot of money to get good cleansers or moisturizers, dermatologists say. Most people's skin gets drier with age, so use a moisturizing cleanser. Moisturizers don't prevent or stop wrinkles, but they do temporarily fill in lines. Dermatologists say a moisturizer is what's working in some of those before-and-after pictures that advertise anti-wrinkle creams.

If you have to wait longer than a minute or two for a skin care product to dry, you're using too much, Schultz says.

Next: Money doesn't buy better results for your skin. >>

"Go for a glycerin moisturizer," says Linda Rhein, a biochemist with Bayer HealthCare Pharmaceuticals and editor of the book Aging Skin: Current and Future Therapeutic Strategies.

"It really moisturizes very well, holds the moisture in the skin," she says. Since it seals in moisture, it's good to use right after a bath or shower.

It's unclear whether other additives to moisturizers — such as antioxidants, vitamin A (retinol), CoQ10 and vitamin C derivatives — reduce wrinkles or improve the look of skin, dermatologists say. Though studies show why they could help, there aren't long-term studies showing they do, says Rhein.

"Many cosmetic products are expensive and their price in the store has no relation to their content."

Take, for example, vitamin C: The molecule changes so much when added to lotions or creams it may not remain intact. Also, the body has to convert the vitamin C in some products to a form it can use, and whether the body does that is also unclear. The problem with the vitamin A derivatives in over-the-counter moisturizers is the low or unknown concentration. For those to work they need to be prescription strength.

Referring to her study last year that found evidence to support a potential role for vitamins A, C, E and B3 in skin care, dermatologist Jenny Kim, an associate professor at UCLA, said in a press release, "While it's evident that these vitamins can play a role in fighting sun damage, the question still remains whether these properties are effective when delivered in skin care products."

Money doesn't buy better results

Consumer Reports found that the serums and eye creams it tested had little to no effect, and that, as with all cosmetic products and procedures, results varied considerably among individuals. Also, higher prices don't necessarily mean better quality.

"Many cosmetic products are expensive and their price in the store has no relation to their content," Johann Wiechers, a cosmetic scientist and founder of JW Solutions, an independent cosmetic science consultancy, wrote in an article for an online industry magazine.

Next: Watch out for anti-aging skin products that don't work. >>

But if products don't work, they can't be sold, right? Wrong.

The U.S. Food and Drug Administration (FDA) doesn't approve cosmetics before they are sold. The agency is supposed to be policing product claims, says John Bailey, a biochemist and chief scientist at the industry-funded Personal Care Product Council. However, the products aren't a public health issue, and the "FDA will tolerate a certain amount of … puffery," says Bailey, a former head of the FDA's cosmetics office.

On the purely cosmetic level, regular makeup options, such as foundations and blushers, slightly fill wrinkles and reflect light in such a way as to make your skin look smoother.

But if products don't work, they can't be sold, right? Wrong.

Large pores may cause your makeup to appear uneven, but exfoliating can remove the dead surface cells that clog and thereby enlarge pores, Schultz explains on his website.

The skin's natural exfoliating process slows down with age, but there are many exfoliating peels, cleansers and scrubbing devices on the market. Products with alpha-hydroxy acid (AHA), such as glycolic AHA, can make your skin more sensitive to sunlight for up to a week after you stop using it, the FDA warns.

Whether a cream or lotion can help to reduce puffiness and dark circles under your eyes is an area of debate among dermatologists. But consumers have clear preferences.

Priscilla Gillett Parr, 57, of Seahurst, Wash., says the Olay Regenerist Anti-Aging Eye Roller is "absolutely wonderful for bags, sags and black circles."

For redness, try the anti-redness products that have a green tint, says Daihung Do, a dermatologist at Beth Israel Deaconess Medical Center. But if you have rosacea, see a dermatologist.

Tina Adler writes about health, science and the environment.

You may also like: Part 2 of AARP's Skin Care Guide: Dermatologists offer anti-aging skin care treatments. >>

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