INTERVIEW WITH DR. SOMMERVILLE ABOUT ANTIAGING SKIN CARE; WHAT’S HOT, WHAT’S NEW, WHAT’S PROVEN…

Q.  What is new in the area of antiaging skin care?

Dr. Sommerville:  All natural botanical ingredients are definitely in vogue.  Most of them provide antioxidant benefits.  Others such as kojic acid, licorice, and bearberry extract (arbutin), soy, or shitake mushroom extract lighten the dark spots associated with sun-damaged skin. There is an emphasis on prevention of aging of the skin especially in younger women.  This goes along with many patients in their late twenties or early thirties inquiring about procedures that may prevent wrinkle development.  Botox® Cosmetic, for instance, may prevent formation of dynamic (expression-related) wrinkles such as frown lines, crow’s feet, or forehead lines.  Most of my clients routinely use sunscreen on the face.

Q.  How do antioxidants protect us from aging?

Dr. Sommerville:  The benefits of antioxidants range from anti-aging, anti-inflammatory properties to conferring a degree of sun protection and possibly anti-cancer effects.  The challenge with topical antioxidants such as vitamin C or green tea extract is that they easily break down when exposed to light and air.  They must be stored in low-heat environment in airtight containers and they have short shelf life.

Q.  What antioxidants should we look for in our skincare product?

Dr. Sommerville:  One of the most extensively studied antioxidants is green tea.  It offers benefits with either oral or topical administration.  Although green tea is incorporated into numerous skin care products, it is not certain that its concentration is sufficient to achieve meaningful clinical efficacy.  Other antioxidants include lipoic acid, vitamin E, and ferulic acid.  Exposure to sunlight in even small amounts depletes vitamin C from the skin.  Vitamin C is necessary for collagen production.  Even high doses of oral supplements do not increase the skin concentration of vitamin C. 
Many skincare products incorporate vitamin C, but some of these products quickly break down and oxidize, turning brown when exposed to light and air.  To overcome this problem, researchers have stabilized vitamin C and vitamin E preparations with ferulic acid which itself is a potent antioxidant present in the cell walls of grains, fruits and vegetables.  Some other major antioxidants include coffee fruit extract, idebenone, and reservatrol.  

Q.  What are growth factors and peptides?

Dr. Sommerville:  These substances are short-chain sequences of amino acids.  Some of them increase collagen production and decrease breakdown of existing collagen.  Others, like neuropeptides, mimic the effects of botulinum toxin and decrease facial muscle contraction, therefore promising to reduce lines and wrinkles.  Carrier peptides deliver important trace elements such as copper necessary for wound healing and new blood vessel formation.  Other peptides are being studied for hyperpigmentation and dark spots.  We still need rigorous clinical trials to determine the clinical efficacy of peptides. 

Growth factors regulate cell communication and are essential in wound healing.  By repairing micro-wounds in sun-damaged skin, they are potentially effective in reducing photoaging.  Growth factors due to their large size have difficulty penetrating the skin.  As with peptides, further studies are needed to determine their clinical efficacy.

Q.  Are moisturizers necessary, and which ones are most effective?

Dr. Sommerville:  As long as we bathe every day and use shower gels that are in essence glorified detergents stripping away the moisturizing sebum from the skin, we will need to moisturize to restore the protective barrier in the skin and reduce transdermal water loss.  Dry skin can trigger or exacerbate such conditions as eczema or psoriasis, resulting in inflammation and itching.  Some moisturizers offer added benefits by including colloidal oatmeal and oat extracts.  Oatmeal was used for skin health and beauty as early as 2000 BC in Arabia and Egypt to soothe and protect dry, itchy, inflamed skin.

Q.  What is new in sun protection?  What is the best sunblock?

Dr. Sommerville:  There is no question in my mind that routine use of sunscreens has been shown to reduce skin cancers and slow the process of aging in the skin.  Unfortunately, most sunscreens in the past offered little or no UVA protection.  There is conclusive evidence that both UVA and UVB contribute to the development of skin cancer with UVA energy actually contributing more to aging of the skin because of deeper penetration.  This is why zinc oxide and titanium dioxide are the gold standards for sun protection since they are broad-spectrum UVA- and UVB- protective.  They are also photostable which means that they do not easily degrade upon ultraviolet exposure.  Zinc oxide and titanium dioxide work by reflecting UV radiation from the skin.  Due to recent technology of reducing the particle size of these products, such sunscreens are cosmetically-elegant, non-gritty, and leave no white residue.  There are other broad spectrum sunscreen ingredients on the market.  Some of them, when activated by UV radiation, may actually generate harmful free radicals which may be absorbed into the skin.  This is why it is important to apply such sunscreens in conjunction with an antioxidant serum.

Q.  What SPF should we choose?

Dr. Sommerville:  The American Academy of Dermatology generally recommends at least SPF 30.  One should keep in mind that the term SPF (Sun Protection Factor) refers only to the UVB protection so look for the term “wide spectrum” on the sunscreen label.  Many people do not realize that UVA penetrates car window glass.  This is why American drivers look older on the left side of their face while British drivers look older on the right side of their face.   

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