Clinical Skin Care

Is there true magic in the bottle? Dr. Sommerville believes that of all the antiaging topicals currently on the market, the two most studied and proven topical rejuvenation therapies are retinoids and hydroxy acids.

Retinoids are synthetic derivatives of Vitamin A shown to improve wrinkles, decrease skin roughness and hyperpigmentation. They include tretinoin, tazarotene and retinaldehyde. Tretinoin was approved by the US Food and Drug Administration (FDA) in 1971 for the treatment of acne. Soon thereafter it started being used off-label for photoaging (aging of the skin related to sun exposure). In 2003, an emollient-based retinoic acid cream was specifically approved for the treatment of sun damaged skin. Other formulations approved for this indication currently include tazarotene 0.1% cream, and tretinoin 0.02% emollient cream. The efficacy of these products is supported by the results of multiple, high quality studies. Therefore retinoids are the foundation of an aggressive antiaging topical skin care routine and the irritation that accompanies their use early in the treatment may be minimized or nearly eliminated with proper medical advice and the use of supporting products.

Hydroxy acids which naturally occur in fruit and dairy products, appear to help normalize disordered, hyperkeratinized, rough skin, producing exfoliation and reducing mottled hyperpigmentation. By promoting collagen synthesis they may also reduce sallowness and fine wrinkles. Their examples include glycolic acid, salicylic acid and lactic acid.

Antioxidants such as vitamin C, vitamin E, green tea, and ferulic acid compounded into the skin care products offer skin protection form ultraviolet rays. Vitamin C is also a promoter of collagen synthesis.  Vitamin C levels in the skin decrease with advancing age and with ultraviolet exposure. Achieving adequate levels with oral supplements is limited by active transport capacity to the skin. Vitamin C levels in the skin can be enhanced with well formulated topical preparations.

Another antioxidant, ferulic acid, common in the plant world, has also shown anticarcinogenic properties. Lipoic acid and coenzyme Q10 or idebenone have shown efficacy in reducing photodamage.

Niacinamide (vitamin B3) has demonstrated ability to improve fine lines, hyperpigmented areas, red blotchiness, and skin sallowness. Its sun protective effect is mediated by enhancing DNA repair.

Skin lightening agents include hydroquinone, arbutin, kojic acid, azelaic acid and glabridin.

The newest additions to the ever growing anti-aging skin care repertoire are growth factors and peptides. Growth factors regulate wound healing. We now know that repair of sun damaged skin requires tissue remodeling similar to that occurring in a chronic wound. Peptides are involved in production of new collagen and elastin.

Sun protection is at the core of any well thought out skin care regimen. Historically, the focus has been on the ultraviolet B (UVB) portion of the solar spectrum (the sunburn spectrum) and  sunscreens were originally developed to provide protection against the redness and inflammation which arise from UVB exposure. Growing body of evidence indicates that it is ultraviolet A (UVA) portion of the solar spectrum that is a primary factor in photoaging and major contributor to immunosuppression and sun related carcinogenesis. The difficulty is that UVA absorbers in sunscreens tend to be unstable. Fortunately, the newer compounds Meroxyl and Helioplex have overcome this obstacle.   

Dr. Sommerville offers in depth skin care consultations and carries only select group of carefully chosen products from some of the most reputable, innovative manufacturers. Her goal is not only to reverse many of the signs of aging but to keep you looking great!  Please call today to schedule your skin care consultation and benefit from her expertise.

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