The Holy Grail

April 6, 2019
The Holy Grail

“What kind of skin cream do you recommend for my face?”

“Are there any new products out there to help out with my skin? It looks so dull.”

“How can I stop my skin from looking old and worn out?”

Did I mention before is that my day job is a dermatology physician assistant? More often than not, these are the questions I hear at the end of the visit when I ask, “do you have any other questions?” Oh, and I get it, it’s a big challenge going into the Target or another drugstore and facing the skin care aisle. Once there, we are face with rows upon rows of products with their slick packaging and tag lines all promising the same or similar things.

2 weeks to even skin tone! Brighter, tighter skin! Smoother, clearer skin in 12 hours! Hydrating! Clarifying! Regenerating!

How does one deal with this barrage of marketing bs?

Ok, before I answer that question, it’s time for a quick primer on the largest organ in our body: our skin. The skin is made up of three main layers. The top layer is the epidermis – it the THE barrier between what is inside of you and what is out there. Check out all the things it does:

1. It is the gateway, a waterproof barrier that also keeps bacteria and other nasties out.

2. It has the pigmented cells that determine the lovely shade of color you where born with.

3. It helps with your body temperature – your skin and brain work together like a thermostat.

4. It protects against the sun’s harmful ultraviolet rays with your help. More on that in another post, no lectures today on suntanning.

Ok now file this fun fact away for later. At the bottom of this layer are a special type of skin cell that are alive and doing the the thing they were born to do. After about a month they travel upward to the surface and then fall off. This usually happens when the skin is rubbed or during washing.

The next layer is the dermis. It is the thickest layer because there is a lot going on in there. It provides the structure and cushioning that gives you those to-die-for high cheekbones or those luscious Angelina Jolie-esque lips. Here you can find hair follicles, oil glands, nerves and sweat glands. Oh yes….and running through it all is your very own surveillance system – your skin’s specialized immune cells.

For the curtain call, underneath that layer is the subcutis layer. Let’s just call it what it is – it is our fat layer. It helps insulate us and keep us warm. Sprinkled throughout this layer is elastin which makes our skin stretchy and springs back to its normal state.

Put this all together and you have to admit that your skin is a major player. Not only does it do all this but it can make us look good too!

Let’s revisit that fun fact I mentioned early about the top layer of skin – the epidermis. When we are in our teens and 20’s – our skin rubs off at a rate of about 30 days. This is called sloughing off. Now check this out and listen closely…as we hit our 40’s that rate kinda slows down to roughly 45 days. Which means that that dead skin layer gets a lot thicker before sloughing off. This usually makes the skin looks duller, crepe-y (it’s a word), dry and lackluster. You might notice some fine lines and wrinkles too. Smoking and suntanning will accelerate this ummm…less than savory effect too. Just putting that out there. .

So what do we do ladies? Well the holy grail to this little dilemma is….drum roll please…RETINOIDS. A retinoid is a medicated topical cream derived from vitamin A. It is the gold standard of skin creams because it can do what other cream only wish they can do. It actually will change the cells themselves and not just cover them up like with your fancy foundation. Retinoids also increase the rate of sloughing of the dead skin cells so that your skin looks brighter and more even. It can make the finer lines go away and stay away too.

The over the counter versions of retinoids are usually creams with RETINOL and can be found in many brands over the counter. It is found in serums by itself or mixed in with moisturizers and sunscreens. But mark my words – even the over the counter version is a powerhouse so use with caution. Don’t be like so many of my patients (and my mother). I will see their eyes light up when I tell them about a retinol product and immediately they start thinking that they will soak their faces in it. They think to themselves…”well if a little bit is good then a lot will get me there faster. No, no, no, no! Too much of a good thing and you will end up with a red, dry, irritated, peeling face. Be patient and use small amounts as directed on the packaging. With time and following up with a good moisturizer your skin will be be brighter, smoother and more even toned. Add in drinking lots of water, getting enough sleep and wearing your sunscreen regularly and you will have a perfect storm for glowing skin!

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Sharla May 12, 2018 - 11:21 am

I’m loving the info you’ve shared! Thanks!


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