Retinoids such as Retin-A definitely help keep skin looking young.

Modern laser treatments apparently do too, and perhaps injections of dermal fillers such as Restylane.

Those were the key points that dermatologist Dr. John Voorhees (right), the grand master of skin-care research, made recently to a crowd of doctors at medical training sessions organized by the Department of Dermatology at UC-Irvine.

Voorhees described his personal anti-aging regimen and outlined scientifically researched techniques that can help keep the skin looking young.

In each case, he told the doctors, the key is collagen – the flexible strands of connective tissue that play a crucial role in giving the skin its texture.

If you let sunshine damage it, skin cells will lose shape and you’ll start to look old, he said.

Or collagen can be bolstered by some medical treatments – retinoid products such as Retin-A, some lasers, and perhaps injections of dermal fillers, he said.

“Aging is a problem that nobody can escape,” he admitted. In fact, from age 60 on, the body contains 30 percent higher levels of collagenase, an enzyme that destroys collagen.

“From that point on, you’re essentially self-digesting your own skin,” he said.

He’s worth listening to. As chairman of the University of Michigan department of dermatology for the past 34 years, Voorhees has racked up a much-admired record of research about how the skin works. He is the expert whose studies are most frequently cited by other dermatology researchers – a total of 4,706 citations in a 15-year period, according to a count by medical researchers from Harvard.

His advice could be helpful to anyone with aging skin, although he came to town to train UC Irvine doctors and medical students.

Collagen, he said, “is like a mattress underneath a sheet. It determines the skin’s form, function and strength.”

Voorhees detailed a particularly reliable treatment for rebuilding the skin:

Retinoids. This skin-saving technique has been around for decades and was originally formulated for acne fighting under the brand name Retin-A.

Retin-A’s active ingredient – retinoic acid, or tretinoin – can fill out small wrinkles and lines on the face by a still-unknown mechanism, Voorhees said. So can retinol, which the body converts into tretinoin.

It’s believed that they activate a collagen-producing pathway of biochemical reactions – the same pathway that UV in sunlight can block, Voorhees said.

He recommends, and uses, any of a variety of prescription creams containing 0.025 percent to 0.05 percent retinoic acid.

His rule of thumb for knowing how much to use is watching for a light peeling of skin, which means the ointment is causing production of new collagen. Larger concentrations can produce undesirable side effects, and none is suitable for pregnant women because of the possibility of birth defects.

Pharmacist Mark Fahim (right), pharmacy manager at Sav-on Drugs in Ladera Ranch, said the most popular retinoid is a generic version of Retin A that comes in strengths of 0.025 percent and 0.1 percent.

Other skin-care medications containing retinoic acid include Renova, a tretinoin cream, at 0.05 percent; and Retin A Micro, a slow-release form of tretinoin at 0.04 percent. Both are made by OrthoNeutragena Inc., a Johnson & Johnson subsidiary based in Skillman, N.J.

Two other anti-aging techniques that can work:

Laser procedures, especially the strong, old-style carbon-dioxide lasers that require weeks of recovery time while the skin of the face heals.

“This is the real thing,” Voorhees said. “It produces a big-time change.”

More modern devices that focus the laser beam on thousands of tiny spots, rather than on the whole skin’s surface, also can be effective, he said, but researchers are still working to find the best combination of intensity and location. That research will take three to four years, he predicted.

Typically these “fractional laser” treatments require several days to a week to recuperate at home as the skin grows new collagen and skin cells to replace what the laser destroys.

“As for a lunchtime laser, it looks like that’s not going to get the job done,” Voorhees said, because a procedure with such a short recovery time doesn’t damage enough cells to produce a significant change.

Injections of dermal fillers, which Voorhees called “promising.” In a study of the effects of the dermal filler Restylane, which is made by Medicis Pharmaceutical of Scottsdale, Ariz. Voorhees and his colleagues found that it produced rejuvenated areas within aging skin.

Similar effects might be caused by other fillers, such as Juvederm, made by Irvine-based Allergan, but the study focused only on Restylane because Medicis donated $8,000 worth of their product, he said.

The reason some fillers tend to last longer than predicted may be because they incite the skin to create new collagen before they are absorbed, Voorhees said.

Less promising anti-aging techniques:

Microdermabrasion. A coarse-tipped abrasion tool might work, Voorhees said, but fine and medium microdermabrasion tips are ineffective.

“A lot of stuff that we do doesn’t work, or at least the evidence that it works is slim,” he said.

Anti-oxidants. He pooh-poohed use of antioxidants for skin care. “There’s very little evidence that antioxidants work for anything.”

Related links:

• Researcher’s guide to retinoids for young-looking skin
• How the sun damages skin
• Seven ways to fix up your skin - - tips for dermatological comparison shopping
• New ‘fractional’ skin-treatment laser wins O.C. converts

For more on cosmetic medicine, see the links at the right side of this blog.

Photos above: Pharmacist Mark Fahim displays prescription retinoid skin care creams used to fight wrinkles and other signs of aging. (Anthony Castellano / The Orange County Register )

Posted in: OC • Skin treatments |

You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.