In this Special Report:
Fact: No skin-care products can work like Botox or dermal fillers because the ingredients cannot reach their targeted areas.
There is absolutely no research showing that any skin-care product can even remotely work in any manner like Botox or like dermal fillers (such as Restylane or Aretcoll) or like laser resurfacing. Regardless of the ingredients or the claims for skin-care products, it just isn't possible. Even Botox can't work like Botox if you apply it topically rather than injecting it into facial muscles. Nor can dermal fillers plump up wrinkles when applied topically rather than being injected. When administered by professionals, Botox and dermal injections almost immediately make wrinkles in the treated area disappear. Believing that skin-care products can do the same is a complete waste of money. There has never been a single skin-care product that has ever put a plastic surgeon or cosmetic dermatologist out of business!Read More Below
The ads in fashion magazines for these types of skin-care products often make claims about how dangerous Botox injections can be. There is nothing scary about Botox (other than the sound of the botulism toxin material used). In fact, the research about Botox's effectiveness and safety is overwhelmingly positive for every disorder they treat with it (and there are many, from cerebral palsy in children to headaches and eye tics). Dermal fillers are nothing to be frightened about, either, though that hasn't stopped many skin-care brands from playing on consumer's fear of the needle.
What about the idea that dermal fillers such as Radiesse and Restylane are completely safe and are the best filler options available? Also not true! First, there are more than 30 dermal fillers in use and new ones are in ongoing development. Many of these dermal fillers are even more beneficial and longer-lasting than Radiesse and Restylane.
Although dermal fillers do work beautifully to fill out depressed areas of the face, such as the nasal labial folds that extend from your nose to your mouth, deep lines between the eyebrows, and marionette lines along the sides of the mouth, they do pose risks. The advertising for these two products, and the repeated mentions of them in fashion magazines, has led consumers to believe that these work flawlessly. There are definitely problems (albeit infrequent) associated with these fillers, and with all of the more than 30 fillers currently being used. These problems and adverse events are primarily granulomas (a mass of inflamed tissue) and nodules, which are lumps or hard spheres that may occur at or near the injection site. Although these sometimes must be corrected with surgery, for the temporary fillers the adverse events do fade with time while the semi-permanent fillers can stay for far longer periods of time. The trade off is duration versus risk and the decision is yours.
Please don't take this information to mean you shouldn't consider using dermal fillers to successfully treat wrinkles (millions of successful treatments have been performed); it's just that you should be fully informed before you make any decision about any product or procedure you are considering. One more thing: There are absolutely no skin-care products that can work in any way, shape, or form like a dermal filler
(Sources: Journal of Neural Transmission, April 2008, pages 617-623; Laryngoscope, May 2008, pages 790-796; Expert Opinion on Pharmacotherapy, June 2007, pages 1059-1072; Journal of Headache and Pain, October 2007, pages 294-300; and Pediatrics, July 2007, pages 49-58; Clinical and Plastic Surgery, April 2005, pages 151-162; Plastic and Reconstructive Surgery, November 2007, pages 33S-40S; Dermatologic Therapy, May 2006, pages 141-150; Dermatologic Surgery, June 2008, Supplemental, pages S92-S99, and December 2007, Supplemental, pages S168-S175; Plastic and Reconstructive Surgery, November 2007, Supplemental, pages S17-S26; Journal of Cosmetic Laser Therapy, December 2005, pages171-176; Dermatology, April 2006, pages 300-304; Aesthetic and Plastic Surgery, January-February 2005, pages 34-48.)
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Fact: Many products on the market claim to be designed for a specific age group, especially for "mature" women; mature usually refers to women over 50.
(So we wonder, does that mean if you are under 50, you're immature?) Nonetheless, before you buy into any of these arbitrary age divisions, ask yourself why the over-50 group is always lumped together? According to this logic, someone who is 40 or 45 shouldn't be using the same products as someone who is 50 (only 5 or 10 years older), but someone who is 80 should be using the same products as someone who is 50...? What you need to know is that age is not a skin type and choosing products based on your age is not a wise way to shop.
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It can be confusing but the truth is not everyone in the same age group has the same skin type. Your skin-care routine depends on how dry, sun-damaged, oily, sensitive, thin, blemished, or normal your skin is, all of which have nothing to do with age. Then there are the issues of skin conditions such as rosacea, psoriasis, allergies, and other skin disorders, which again, have nothing to do with age. What everyone needs to do is protect the outer barrier of their skin in exactly the same way and avoid unnecessary direct sun exposure (sun protection!), don't smoke, don't irritate your skin, and be sure you use state-of-the-art skin-care products loaded with antioxidants and skin-repairing ingredients. Plenty of young women have dry skin, and plenty of older women have oily skin and breakouts (particularly women who are experiencing perimenopausal or menopausal hormone fluctuations).
There are some skin disorders, diseases, and functionality problems associated with older skin, but they depend on the woman and her particular skin; they are not universally true of older skin, because even these specific maladies can occur in younger people as well (such as ulcerated skin, wounds that don't heal, itchy skin, and thinning skin). In addition, none of these problems have anything to do with "normal," daily skin-care needs; a healthy skin-care routine for your skin type can do wonders.
Turning 50 does not mean a woman should assume her skin is drying up and, therefore, that she must begin using "mature" skin-care products, which almost always are just products that are designed for dry skin, which are no different from any of the other skin-care products for dry skin on the market. And for many women over 50 (including Paula), it definitely does not mean that the battle with blemishes is over. And let us reiterate: There are no products designed for older women that address any special needs other than dry skin!
(Sources: British Journal of Community Nursing, May 2007, pages 203-204; Journal of Investigative Dermatology, December 2005, pages 364-368; Journal of Vascular Surgery, October 1999, pages 734 -743; International Journal of Cosmetic Science, October 2007, pages 409-410; Cutaneous and Ocular Toxicology, April 2007, pages 343-357.)
Fact: "Hypoallergenic" is little more than a nonsense word. It is nothing more than an advertising contrivance meant to imply that a product is unlikely or less likely to cause allergic reactions and therefore is better for sensitive or problem skin.
To "imply" is never the same as "fact," and in this situation it is patently untrue that products labeled "hypoallergenic" are any better for sensitive skin! There are absolutely no accepted testing methods, ingredient restrictions, regulations, guidelines, rules, or procedures of any kind, anywhere in the world, for determining whether or not a product qualifies as being hypoallergenic. A company can label their product "hypoallergenic" because there is no regulation that says they can't, regardless of any proof, and what proof can they provide given there is no standard to measure against. That being said, it's no surprise that there are plenty of products labeled "hypoallergenic" that contain problematic ingredients and that could indeed trigger allergic reactions. Unfortunately, the word "hypoallergenic" gives you no better understanding of what you are or aren't putting on your skin.
The terms "dermatologist-tested" and "cosmeceutical" are also misleading. "Dermatologist tested" on a cosmetic label is not a good indication that the product is reliable and can live up to the claims. You absolutely should not rely on the "dermatologist tested" claim any more than you should rely on the appearance of a doctor's name on a product's label to indicate you are getting a superior (or "medical-grade") formulation. There are many aspects to the term "dermatologist-tested," as it's used on a cosmetics label, that are misleading and deceptive; however, the primary problem is that it does not tell you what dermatologist did the testing, what he or she tested, how he or she performed the testing, or what the results were. That is, they don't tell you what they found with their supposed testing; they just tell you that they tested it.
Without all of the testing information, there is no way to determine what it means. More often than not, it just means that a cosmetics company paid a doctor to say it is a good product (and there are lots of doctors on the payroll of lots of cosmetics companies). Or they could actually have performed a test, but only on six people, and that happens more often that you'd think. These are hardly provides results you can rely on! Dermatologist-tested is nothing more than a marketing gimmick because people like to believe that doctors have the consumer's best interest at heart. But, in the world of cosmetics, that is not always the case.
What about "cosmeceutical"? Do companies with this marketing angle really make better products than other cosmetics companies? Nope. The term "cosmeceutical" is, sad to say, a false advertising gimmick created by dermatologists to suggest that their "cosmeceutical" products are somehow better than other products in the cosmetics industry. What deceit! At the very least what you should expect from the medical world is scientific fact, not these fictitious sales-oriented buzzwords. When you hear the word "cosmeceutical," you're supposed to think a product is a blend of cosmetic ingredients and pharmaceutical-grade ingredients and, therefore, it must be better for your skin, right?
The fact is, "cosmeceutical" is just a trumped up word that has no legal or recognized meaning as to what constitutes content versus the content of any "non-cosmeceutical" cosmetic. A quick comparison of ingredient lists reveals that there is nothing any more unique or pharmaceutical about cosmeceuticals than any other cosmetic in the cosmetics industry. Plus, the FDA does not consider the term "cosmeceutical" to be a valid product class, so the term isn't regulated. So, you should view it merely as a marketing term, and nothing more. Anyone can use that term to represent their brand's identity (Source: www.fda.gov).
It's interesting to point out that organizations such as the American Academy of Dermatology (AAD, www.aad.org) has muddied the cosmeceutical water even further. Depending on who you talk to, cosmeceuticals can be viewed as products containing retinol (or other retinoids, which are part of the vitamin A molecule) or hydroquinone. But, these ingredients are available for use to all cosmetics companies. Another description tossed around is that a cosmeceutical contains an ingredient that performs some kind of special action on the skin. However, all of those ingredients can be used by any cosmetics company, regardless of the designation. It's not universally true that cosmeceutical companies use higher amounts of key ingredients, either.
According to the AAD, "the answer to whether or not cosmeceuticals really work lies in the ingredients and how they interact with the biological mechanisms that occur in aging skin." But again, that's true for any cosmetic. Even doctors can be seduced by their own hype so they can sell skin-care products and market them as different by using a coined, misleading term.
(Sources: www.fda.gov; Ostomy and Wound Management, March 2003, pages 20 -21)
Fact: First, the term "age spot" is really a misnomer. Brown, freckle-like skin discolorations are not a result of age; they are the result of years of unprotected sun exposure.
Sun spots can show up at any age, from the freckles sprinkled across a child's nose to smooth, flat brown discolorations you may see as early as your mid-20s. At any age, treating sun-induced brown discolorations doesn't necessarily requite a specialty product, but it does take proven ingredients (like hydroquinone, niacinamide, and forms of vitamin C) plus daily sun protection to make a noticeable, lasting difference.
It is frustrating that the number of skin-care products claiming they can make skin whiter or lighter more often than not contain no ingredient that can have any significant, or even a minor, impact on melanin production (melanin is the brown pigment in skin). In addition, even when the product does contain an ingredient that can have an effect, it usually contains such a small amount that it won't help at all. Finding products that stand a good chance of working isn't easy, but one thing we know for sure: sun protection is vital if you truly want to lighten these spots.
Because unprotected sun exposure is the primary trigger for most brown, freckle-like skin discolorations, the primary way to reduce, prevent, and possibly even eliminate skin discolorations is diligent, daily application of a well-formulated sunscreen. Be sure not to forget the back of your hands and your chest (and be sure to reapply every time you wash your hands, because sunscreen does wash off).
No other aspect of controlling or reducing brown skin discolorations is as important as being careful about not getting a tan and never exposing your skin to the sun without using a sunscreen rated SPF 15 or more (and more is better if the goal is avoiding discolorations). And make sure that the sunscreen includes the UVA-protecting ingredients of titanium dioxide, zinc oxide, avobenzone (which can also be on the label as butyl methoxydibenzoylmethane), Tinosorb, or Mexoryl SX (which can also be on the label as ecamsule) because UVA damage is part of what triggers brown spots.
Though we rarely express our personal, anecdotal experience (we prefer to rely on scientific studies rather than guess why a positive or negative result is taking place), in this case we will. We have found that using a sunscreen with only titanium dioxide and zinc oxide as the active ingredients has the most impressive results. The difference in our face, arms, and hands has been significant ever since we made that change several years ago. There is some research that supports this personal experience, but we wish there were more science to back it up. We suspect the coverage zinc oxide or titanium dioxide provides (more as a blanket over skin) "blocks" the sun rather then deflects the rays as synthetic sunscreen agents do is why you may get superior results. Keeping the sun from penetrating into skin is the best protection possible for skin.
After the use of sunscreen, hydroquinone has the highest efficacy for lightening skin, and a long history of safe use behind it, more so than any other skin-lightening ingredient. There are other alternatives that show promise for lightening skin, but they have been the subject of far less research and their effectiveness often pales in comparison to that of hydroquinone. It is interesting to note that some of these alternative ingredients when applied to the skin actually break down into small amounts of hydroquinone, which explains why they have an effect. These alternative ingredients include Mitracarpus scaber extract, Uva ursi (bearberry) extract, Morus bombycis (mulberry), Morus alba (white mulberry), and Broussonetia papyrifera (paper mulberry), all of which contain arbutin, which can inhibit melanin production. Technically these extracts contain hydroquinone-beta-D-glucoside.
Pure forms of arbutin, such as alpha-arbutin, beta-arbutin, and deoxy-arbutin, are considered more potent for skin lightening, but again, the research is at best limited. Other ingredients that have some amount of research on their potential skin-lightening abilities are licorice extract (specifically glabridin), azelaic acid, and stabilized vitamin C (L-ascorbic acid, ascorbic acid, and magnesium ascorbyl phosphate), aloesin, gentisic acid, flavonoids, hesperidin, niacinamide, and polyphenols. However, not much is known about how much of these ingredients is needed in a cosmetic lotion or cream to have an effect. Most of the research has been done in vitro, not on human skin.
To sum it up, there is a very specific game plan you can follow to get the most impressive results; it starts with avoiding sun exposure, daily use of a well-formulated sunscreen (365 days per year), and using a skin-care product that contains hydroquinone. In addition, an exfoliant (e.g., AHAs and BHA) can be helpful, and certain laser, intense pulsed light, and radio wave treatments from a dermatologist or plastic surgeon can be extremely helpful. But, and this is an important but: If you don't also use a sunscreen daily you will be wasting your time and money!
(Sources: Journal of Cosmetic Dermatology, September 2007, pages 195 -202; Dermatology Nursing, October 2004, pages 401 -413; Age and Ageing, March 2006, pages 110 -115; Journal of Cutaneous Medicine and Surgery, May-June 2008, pages 107 -113; Journal of Investigative Dermatology Symposium Proceedings, April 2008, pages 20 -24; Experimental Dermatology, August 2005, pages 601 -608; Bioscience, Biotechnology, and Biochemistry, December 2005, pages 2368 -2373; International Journal of Dermatology, August 2004, pages 604 -607; Journal of Drugs in Dermatology, July -August 2004, pages 377 -381; Facial and Plastic Surgery, February 2004, pages 3 -9; Dermatologic Surgery, March 2004, pages 385 -388; and Journal of Bioscience and Bioengineering, March 2005, pages 272 -276; The Lancet, August 2007, pages 528 -537; Skin Pharmacology and Physiology, June 2005, pages 253 -262; Journal of the American Academy of Dermatology, December 2006, pages 1048 -1065; http://www.aad.org/public/publications/pamphlets/common_melasma.html; http://www.emedicine.com/DERM/topic260.htm.)
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Fact: If only that were true, lots of people's skin-care struggles in life would have been very different. In fact, women in their 20s, 30s, 40s, and even 50s can have acne just like teenagers, and the treatment principles remain the same.
Not everyone who has acne as a teenager will grow out of it, and even if you had clear skin as a teenager, there's no guarantee that you won't get acne later in life, perhaps during menopause. You can blame this often-maddening inconsistency on hormones! What is true is that men can outgrow acne, because after puberty men's hormone levels level out, while women's hormone levels fluctuate throughout their lifetime, which is why many women experience breakouts around their menstrual cycle. What about the association between acne and food, stress, and over-cleaning your face?
There are actually lots of myths about acne; following are among the most common:
Myth: Acne is caused by eating the wrong foods.
Fact:This is both true and false. The traditional foods thought to cause acne, such as chocolate and greasy foods, have no effect on acne, and there is no research indicating otherwise.
However, there is the potential that individual dietary allergic reactions can trigger acne, such as eating foods that contain iodine, like shellfish, although there is an ongoing controversy about that. A bit more conclusive is new research showing that milk, especially skim milk, can increase the risk of acne. The same may be true for a diet high in carbohydrates; a high glycemic load can increase breakouts, while a low glycemic load can reduce their occurrence. (Glycemic load is a ranking system for the amount of carbohydrates in a food portion; too many refined carbs in your diet could trigger breakouts.) Experimenting for a few months to see which of these food groups either hurt or help your skin is worth the effort.
(Sources: Molecular Nutrition and Food Research, June 2008, pages 718-726; Dermatologic Therapy, March-April 2008, pages 86-95; Journal of the American Academy of Dermatology, May 2008, pages 787-793; Dermatology Online Journal, May 30, 2006.)
Myth: If you clean your face better you can clear up your acne.
Fact: Over-cleaning or scrubbing your face can actually make matters worse.
Acne is caused primarily by hormonal fluctuations that affect the oil gland, creating an environment where acne-causing bacteria (Propionibacterium acnes) can flourish. Don't confuse scrubbing or "deep cleaning" with helping acne, because it absolutely doesn't. Over-cleansing your face triggers inflammation that actually makes acne worse. What really helps breakouts is using a gentle cleanser so you don't damage your skin's outer barrier or create inflammation (both of which hinder your skin's ability to heal and fight bacteria) and using gentle exfoliation. An effective exfoliating product that contains salicylic acid or glycolic acid can make all the difference in reducing acne and the red marks it leaves behind.
(Sources: Journal of the European Academy of Dermatology Venereology, May 2008, pages 629 -631; Expert Opinion in Pharmacotherapy, April 2008, pages 955-971; Journal of Cosmetic Dermatology, March 2007, pages 59-65; Cutis, July 2006, Supplemental, pages 34-40; Skin Pharmacology and Physiology, June 2006, pages 296-302.)
Myth: Stress causes acne.
Fact: Generally, it is believed that stress can trigger acne, but no one is exactly sure how that works, and there is conflicting research.
While it never hurts to reduce angst and worry in your life, stress as a causative factor for acne is hard to pinpoint. Plus, the way to treat acne doesn't change because of the stressors in your life.
(Sources: European Journal of Dermatology, July-August, pages 412-415; International Journal of Cosmetic Science, June 2004, pages 129-138; Archives of Dermatologic Research, July 2008, pages 311-316; American Journal of Clinical Dermatology, May 2006, pages 281-290.)
Myth: Toothpaste works to prevent or quickly heal a pimple.
Fact: Absolutely not true!!! This would be funny if so many people didn't believe it.
None of the ingredients in toothpaste can have a positive effect on acne or change a blemish once you have it, and actually it can make matters worse. The bacteria in your mouth are not related to the bacteria in your pores that cause acne (P. acne). And although the fluoride or sodium monofluorophosphate in your toothpaste can help fight bacteria in your mouth, on your skin it actually can cause pimples and redness in the areas with which it comes in contact. This is known as perioral dermatitis. The other ingredients in toothpaste might offer minimal abrasive properties, but they provide nothing that a gentle rubbing with a washcloth doesn't provide far better. Another issue for skin is that the flavorings added to toothpaste present additional problems that you should avoid.
(Sources: Journal of the American Dental Association, September 2003, page 1165; Journal of the American Academy of Dermatology, June 1990, pages 1029 -1032; Archives of Dermatology, June 1975, page 793; Contact Dermatitis, October 2000, pages 216-222; International Journal of Cosmetic Science, June 2004, pages 129-138; American Journal of Clinical Dermatology, May 2006, pages 281-290; International Journal of Dermatology, November 2007, pages 1188-1191.)
Fact: Probably not. There is no research indicating that makeup or skin-care products cause acne, and there is no consensus on which ingredients are problematic.
In the late 1970s there was some research performed on rabbit skin using 100% concentrations of ingredients to determine whether or not they caused acne. Subsequently, it was determined that this study had nothing to do with the way women wear makeup or use skin-care products, and it was never repeated or considered useful in any way. Still, women do experience breakouts after using some skin-care products. Such breakouts can be the result of an irritant or an inflammatory response, a random skin reaction, or a result of problematic ingredients unique to a person's skin type. That means you have to experiment to see what might be causing your breakouts. There is no information from medical research or the cosmetic industry to help or point you in the right direction. And it is critical to know that terms such as "noncomedogenic" and "non-acnegenic" are meaningless. The cosmetics industry uses these terms to indicate that a product is less likely to cause breakouts, but there is no standard or regulation set to categorize this labeling. Any product can make this claim, even pure wax or vegetable shortening.
Fact: In the world of skin care, there is an entire business known as claim substantiation, and it definitely does not equate to legitimate scientific research at all.
Laboratories, including those at some respected universities and colleges, are expert at setting up a study so that the results support whatever the label or advertisements say that a product can do. One important thing that many consumers and physicians aren't aware of, and this includes lots of physicians who are involved in these dubious (often completely bogus) studies, is the question, "Under what conditions were the studies performed?" This is critical to know!
For example, in a skin-care study to establish whether or not a product gets rid of wrinkles, the subjects participating often begin by washing their face and then stripping it clear with alcohol. They then take the "before" photos and measurements (e.g., wrinkle depth, skin tone, and water loss, among other parameters). With that starting point, it's hardly surprising that the "before" situation is much worse than the "after" results. What would the results have been if the woman had started by using a gentle cleanser, a good moisturizer, and a sunscreen (e.g., effective ones different from those being tested)? Or, were the effects of any other products compared to those of the product being tested; perhaps dozens of other products could have performed as well or better.
During the more than 30 years we've been doing this, we have asked every cosmetics company whose product or products we've reviewed to show us their "study," and in all those years, we have received only 5 of these studies (and NONE, and we mean NONE, of those 5 studies proved the claims the companies were making). There are lots of ways to use pseudo-science to create proof for a claim that, in reality, has very little to do with science and everything to do with marketing. Insist on published, peer-reviewed research, not meaningless clinical studies (or perhaps the cosmetic companies will begin publishing these clinical studies so we can know the details rather than being asked to take their word for it)!
(Sources: Cosmetic Claims Substantiation, Cosmetic Science and Technology Series, vol. 18, ed. Louise Aust, New York: Marcel Dekker, 1998; Cosmetics and Toiletries, Article: The European Group on Efficacy Measurement of Cosmetics and Other Topical Products is considering new cosmetic legislation to regulate claims of efficacy, Pierard, G.E. Masson, Ph., Publisher Allured Publishing Corp, .2000)
Fact: Collagen and elastin in skin-care products can serve as good water-binding agents, but they cannot fuse with your skin's natural supply of these supportive elements.
In most cases, the collagen molecule is too large to penetrate into the skin. But even when it is made small enough to be absorbed it cannot bind with the collagen existing in skin, and there isn't a shred of research indicating otherwise. What does exist are myriad studies showing that collagen is a very good moisturizing ingredient, which is great for skin, but not unique or the only formulary option.
It is important to point out that even if you were to take the collagen that is used in medically administered dermal injections and rub it on your skin, it wouldn't be absorbed, and it wouldn't change wrinkles by bolstering the existing collagen. There is even less research showing that elastin has any benefit when applied topically. In fact, research has shown that once elastin fibers in our skin are damaged they are very difficult to repair (in adulthood, elastin doesn't regenerate or increase production as collagen can).
Keep in mind that even if collagen or elastin could be absorbed, and even if it could combine with your existing collagen or elastin, without controls you would just keep adding collagen and elastin to your skin, and eventually it would stick out in places you wouldn't want it to (after all a doctor can inject only so much collagen into your face before you end up with overblown lips and a face that doesn't move naturally). Protecting your skin from sun damage, daily exfoliation with a well-formulated AHA or BHA product, and treating your skin to a range of ingredients (antioxidants, cell-communicating ingredients, and skin-repairing ingredients) that it needs to look and feel younger will protect its natural collagen supply and allow it to build new collagen (something that healthy skin loves to do and does quite well under the right conditions).
Fact: There is no evidence, research, or documentation validating the claim that the eye area needs ingredients different from those you use on your face or neck area or décolletage.
Even if there were ingredients that were special for the eye area, that isn't evident in eye-area products; their formulations are random, with no consistency in the industry. All cosmetics companies put whatever ingredients they want to into their eye products (and usually give you half as much but charge you twice as much as the same product for your face). The ingredient label on these "specialty" products more than proves the point. Eye creams are a whim of the cosmetics industry designed to evoke the sale of two products when only one is needed.
One more point: Occasionally a physician, aesthetician, or someone selling skin-care products will defend their eye creams by telling me that the eye area doesn't need ingredients that cause irritation. Well, we agree wholeheartedly with that statement, but the same is absolutely true for the face, or anywhere else on your body. You shouldn't be applying formulations with needlessly irritating ingredients-period! That means that all your eye area needs is a well-formulated product, and that can certainly be the same product you use on your face.
If the skin around your eyes is drier than the rest of your face, that doesn't mean you need a special eye cream. Instead, you simply need to treat your eye area with a more emollient, fragrance-free facial moisturizer. A well-formulated serum is another great option to use around the eyes (it doesn't need to be labeled "eye cream"). The same is true for eye gels or serums.
Fact: Regrettably, there is no magic potion or combination of products in any price range that can make wrinkles truly disappear or prevent them. Daily use of a well-formulated sunscreen (and never getting a tan) are the two best things you can do, but there's more that helps, too!
The wrinkles you see and agonize over (not to be confused with fine lines caused by dryness, which are easily remedied with a good moisturizer) are the result of cumulative sun damage and the inevitable breakdown of your skin's natural support structure. Skin-care ingredients, no matter who is selling them or what claims they make for them, cannot replace what plastic surgeons and cosmetic dermatologists do. There are literally thousands of antiwrinkle products being sold and we buy more of these than almost any other beauty product. But despite this onslaught of products, plastic surgeons and dermatologists are not going out of business.
An interesting study in Skin Research and Technology (May 2007, pages 189 -194) compared the effects of an inexpensive moisturizing face cream with an expensive one in a luxurious jar. Eighty Swedish women ages 35-64 years were randomly divided into three groups: Group A treated their facial skin for 6 weeks with the expensive cream in its luxury jar, Group B used an inexpensive moisturizer presented in the same luxury jar, and Group C used the expensive cream contained in a neutral jar. The evaluations were made by the subjects, by a clinical trained observer, and by measuring the skin surface using optical profilometry (a method that measures the contours and roughness of surface skin). All the results showed no differences between the three groups related to the effects on wrinkles and smoothness, and there was no assessment of their skin feeling younger or more beautiful. Facial appearance was the same and profilometry showed reduced surface microrelief with all products.
Don't take this to mean that there aren't skin-care products that can help improve skin, because there absolutely are, including sunscreen, exfoliants (AHAs or BHA), moisturizers loaded with antioxidants and cell-communicating ingredients, retinoids (components of Vitamin A), and numerous others. But, most skin-care products don't perform according to the exaggerated claims on the label; if they worked as promised, then cosmetics companies wouldn't be launching new antiwrinkle products every few months, with ever-more miraculous-sounding claims.
Fact: The absolute truth is that there are good and bad products in all price categories. It's all about the formulation, not the price.
The amount of money you spend on skin-care products has nothing to do with the quality or uniqueness of the formula. An expensive soap by Erno Laszlo is no better for your skin than an inexpensive bar soap such as Dove (though we suggest that both are potentially too irritating and drying for all skin types). On the other hand, an irritant-free toner by Neutrogena can be just as good as, or maybe even better than, an irritant-free toner by Chanel or La Prairie (depending on the formulation), and any irritant-free toner is infinitely better than a toner that contains alcohol, peppermint, menthol, essential oils, eucalyptus, lemon, or other irritants, no matter how natural-sounding the ingredients are and regardless of the price or claim. We've seen lots of expensive products that are little more than water and wax, and inexpensive products that are beautifully formulated. Spending less doesn't hurt your skin, and spending more doesn't help it. Again, it's all about the formulation, not the price.
Fact: This recurring, foolish, misinformation about mineral oil and petrolatum is maddening because it isn't accurate.
Although mineral oil does originate from crude oil, this oil is as natural as any other earth-derived substance. Moreover, lots of ingredients are derived from awful-sounding sources, but are nevertheless benign and totally safe. Salt is a perfect example. Common table salt is sodium chloride, composed of sodium and chloride, but salt doesn't have the caustic properties of chloride (a form of chlorine) or the unstable explosiveness of pure sodium. Mineral oil is actually a great ingredient for dry skin!
Cosmetics-grade mineral oil and petrolatum are considered the safest, most nonirritating moisturizing ingredients ever found. Yes, they can reduce the amount of air that comes in contact with skin, and reduce its impact on skin, but that's what a good antioxidant is supposed to do; they don't suffocate skin! There are several studies showing that mineral oil can help heal and moisturize skin quite effectively. The confusion around mineral oil is also caused by some cosmetics companies and people who use the information about non-purified mineral oil as a scare tactic. The mineral oil used in skin-care products is certified as either USP (United States Pharmacopeia) or BP (British Pharmacopeia). This is the type that's used in skin-care products, and it's completely safe, soothing, and healthy for skin. It does not contain impurities that harm skin in any way, though the oily texture of mineral oil doesn't make it a favorite ingredient of those with oily or breakout-prone skin (though mineral oil is not known to clog pores because it remains on the surface of skin, protecting it from dryness).
(Sources: International Journal of Cosmetic Science, October 2007, pages 385-390; Journal of Dermatologic Science, May 2008, pages 135-142; Dermatitis, September 2004, pages 109-116;International Wound Journal, September 2006, pages 181-187.)
Fact: Whatever preconceived notion someone might have or media-induced fiction someone might believe about natural ingredients being better for the skin; it's not true. There is no factual basis or scientific legitimacy for that belief.
Not only is the definition of "natural" hazy, but the term is loosely regulated, so any cosmetics company can use it to mean whatever they want it to mean. Just because an ingredient grows out of the ground or is found in nature doesn't make it automatically good for skin; and the reverse is also true, just because it is synthetic doesn't make it bad.
"Consumers should not necessarily assume that an 'organic' or 'natural' ingredient or product would possess greater inherent safety than another chemically identical version of the same ingredient," Dr. Linda M. Katz, director of the Food and Drug Administration's Office of Cosmetics and Colors (New York Times, November 1, 2007). "In fact, 'natural' ingredients may be harder to preserve against microbial contamination and growth than synthetic raw materials."
"But people should not interpret even the USDA Organic seal or any organic seal of approval on cosmetics as proof of health benefits or of efficacy," said Joan Shaffer, USDA spokeswoman. The National Organic Program is a marketing program, not a safety program. Steak may be graded prime, but that has no bearing on whether it is safe or nutritious to eat.
Ideally, the skin-care products you choose should contain a mix of beneficial natural and synthetic ingredients. When properly formulated, these ingredients work in harmony to give your skin the best that natural and synthetic have to offer, and you'll see the difference.
Fact: This sensation is your skin telling you it is being irritated, not helped.
That familiar tingling sensation is actually just your skin responding to irritation, resulting in inflammation. Products that produce that sensation can actually damage your skin's healing process, make scarring worse, cause collagen and elastin to break down, and increase the growth of bacteria that cause pimples. Ingredients such as menthol, peppermint, camphor, and mint are counter-irritants. Counter-irritants are used to induce local inflammation in an effort to reduce inflammation in deeper or adjacent tissues. In other words, they substitute one kind of inflammation for another, which is never good for skin. Irritation or inflammation, no matter what causes it or how it happens, impairs the skin's immune and healing response. And although your skin may not show it or doesn't react in an irritated fashion, if you apply irritants to your skin the damage is still taking place and is ongoing, so it adds up over time.
(Sources: Skin Pharmacology and Applied Skin Physiology, November-December 2000, pages 358-371; Skin Research and Technology, November 2001, pages 227-237; Archives of Dermatologic Research, May 1996, pages 245-248; Code of Federal Regulations Title 21-Food and Drugs, revised April 1, 2001, CITE: 21CFR310.545, www.fda.gov; www.naturaldatabase.com.)
Fact: Blackheads may make skin look dirty, but they are unrelated to dirt.
Blackheads are formed when hormones cause too much sebum (oil) to be produced, dead skin cells get in the way, the pore is impaired or misshapen, and the path for the oil to exit through the pore is blocked, creating a clog. As this clog nears the surface of the skin, the mixture of oil and cellular debris oxidizes and turns, you guessed it, black. But you cannot scrub away blackheads, at least not completely. Using a topical scrub removes the top portion of the blackhead, but does nothing to address the underlying cause, so they're back again before too long. Instead of a scrub, try using a well-formulated BHA (salicylic acid) product. Salicylic acid exfoliates inside the pore lining, dissolving oil and dead skin cells that lead to constant blackheads. Paula's Choice offers a broad selection of BHA products to help eliminate blackheads and provide numerous other benefits.
Fact: Possibly, but right now this is mere conjecture, involving an extremely complicated and difficult-to-understand process.
Oil production is triggered primarily by androgens and estrogen (male and female hormones, respectively), and altering hormone production topically is not something available in the realm of cosmetics. However, the sebaceous gland itself also produces active androgens, which can increase sebum excretion. What can happen is that stress-sensing skin signals (think skin inflammation and irritation) can lead to the production and release of androgens and cause more oil production, which can clog pores. That makes topical irritation and inflammation bad for skin, but that still doesn't affect the production of hormones inside the body.
What you can do is use a retinoid (vitamin A or tretinoin) to improve the shape of the pore so that the oil can flow more evenly and prevent clogging. There is some research that niacinamide in skin-care products can help, but no one is quite sure why. You also can avoid making matters worse by not using products that contain oils or thick, emollient ingredients. You can absorb surface oil by using powders, mattifiers, or clay masks, although avoid masks that contain irritating ingredients. How often you should use a mask depends on your skin type; some people use one every day, others once a week. These types of mask may be used after cleansing, left on for 10-15 minutes, and then rinsed with tepid water.
(Sources: Clinical Dermatology, September-October 2004, pages 360-366; Experimental Dermatology, June 2008, pages 542-551)
Fact: Ironically, dry skin is not as simple as just a lack of moisture. And, surprisingly, drinking more water won't make dry skin look or feel better.
The studies that have compared the water content of dry skin to that of normal or oily skin show that there doesn't appear to be a statistically significant difference. And adding more moisture to the skin is not necessarily a good thing. If anything, too much moisture, like soaking in a bathtub, is bad for skin because it disrupts the skin's outer barrier (the intracellular matrix) by breaking down the substances that keep skin cells functioning normally and in good shape. So how does dry skin happen?
What is thought to be taking place when dry skin occurs is that the intracellular matrix (the substances between skin cells that keep them intact, smooth, and healthy) has become depleted or damaged, bringing about a rough, uneven, and flaky texture that allows water to be lost. But adding water won't keep that moisture in skin unless the outer barrier is maintained or repaired. To prevent dry skin, the primary goal is to avoid and reduce anything that damages the outer barrier, including sun damage, products that contain irritating ingredients, alcohol, drying cleansers, and smoking. All of the research about dry skin is related to the ingredients and treatments that reinforce the substances in skin that keep it functioning normally.
As for drinking lots of water each day, if all it took to get rid of dry skin was to drink more water, then no one would have dry skin and moisturizers would stop being sold. Keeping your liquid intake up is fine, but if you take in more water than your body needs, all you will be doing is running to the bathroom all day and night. The causes of and treatments for dry skin are far more complicated than water consumption.
(Sources: British Journal of Dermatology, July 2008, pages 23-34; Dermatologic Therapy, March 2004, Supplement 1, pages 43 -48; Journal of Cosmetic Dermatology, June 2007, pages 75-82; International Journal of Cosmetic Science, April 2003, pages 63 -95, October 2000, pages 37-383.)
Fact: The ONLY difference between a daytime and nighttime moisturizer is that the daytime version should offer sun protection of SPF 15 or greater.
What you often hear cosmetics salespeople say is that the skin needs different ingredients at night than during the day. They usually state that skin does more repair work at night, so needs more "nourishing" ingredients to assist this nightly renewal process. Well, let us tell you: If that's the case there isn't a shred of research or a list anywhere of what those ingredients should be. Skin is repairing itself and producing skin cells every nanosecond of the day, and night. Helping skin do that in as healthy a manner as possible doesn't change based on the time of day.
Skin needs a generous amount of antioxidants, cell-communicating ingredients, and skin-identical (repairing) ingredients all day and all night. For daytime wear, unless your foundation contains an effective sunscreen, it is essential that your moisturizer feature a well-formulated, broad-spectrum sunscreen rated SPF 15 or higher. Well-formulated means that it contains UVA-protecting ingredients, specifically titanium dioxide, zinc oxide, avobenzone (also called butyl methoxydibenzoylmethane or Parsol 1789), Tinosorb, or Mexoryl SX (ecamsule) and includes antioxidants. Regardless of the time of day, your skin needs all the current state-of-the-art ingredients it can get. Saving these ingredients only for nighttime use is cheating your skin of the benefits it could be gaining during daylight hours, too!
Fact: Skin doesn't adapt to skin-care products any more than your body adapts to a healthy diet.
If spinach and grapes are healthy for you they are always healthy, and they continue to be healthy, even if you eat them every day. The same is true for your skin, as long as you are applying what is healthy for skin (and avoiding negative external sources such as unprotected sun exposure) it remains healthy. You may see skin stop improving as much as it initially did, but that stands to reason: If you were using products with irritating or drying ingredients and then switch to brilliantly-formulated products, your initial improvement is going to be much more impressive than what you'll see months later, when skin is maintaining its new-found healthy, younger appearance.
Fact: Lots of people have problems with their skin because they often like what isn't good for skin.
For example, you may like getting a tan, but that can cause skin cancer and most certainly will cause wrinkles and skin discolorations. You may like smoking cigarettes, but that will cause collagen breakdown and will cause the growth of unhealthy, malformed skin cells. You may like that daytime moisturizer you are using, but if it doesn't contain sunscreen it leaves your skin wide open to sun damage. Or you may like that moisturizer that comes packaged in a jar, but most state-of-the-art ingredients, especially antioxidants, plant extracts, vitamins, and cell-communicating ingredients like retinol, deteriorate in the presence of air.
That means jar packaging will not keep these ingredients stable, and so you would be short-changing your skin soon after the product is opened (think about how long a head of lettuce lasts in your refrigerator). What it takes to help your skin be at its best and to function normally and really fight wrinkles or acne or any other skin problem is far more complex than just using what you "like." This doesn't mean that you shouldn't like what you use, but do take the time to select from among products that are truly healthy and beneficial for skin. That is, take the time to read the ingredient list, because you can't determine the benefits intuitively.
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Paula Begoun is the best-selling author of 20 books on skin care and makeup. She is known worldwide as the Cosmetics Cop and creator of Paula's Choice. Paula's expertise has led to hundreds of appearances on national and international TV including:
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