After thirty, the skin starts to lose elastin and collagen fibres, the two main fibres responsible for the skin’s structure. This results in the skin losing its elasticity and becoming thinner. Wrinkles form from aging and also from movement of facial muscles. As well as this, melanocytes, the cells responsible for the skin’s pigmentation, become unevenly distributed leading to the formation of pigmentation spots. In Australia, damage by the sun, or photo-aging, is also a major cause of facial lines and wrinkles, as well as skin cancers.
Dr Cope can recommend anti-aging treatments to prevent and reverse these changes through the use of medical grade skin care regimes.
Medical skin care ranges have a minimum of 5 times the concentration (and sometimes much more) of the active ingredients in comparison to the over the counter products.
Maintaining good skin
Dr Cope advises patients that the following lifestyle changes have been shown to be effective in producing better skin quality:
Drinking plenty of water
Eating plenty of fruits and vegetables
Eating less red meat
Ensuring you sleep well
Apart from improving these lifestyle factors you should also:
1) Avoid sun exposure
2) Wear protective clothing when outside
3) Use sunscreens or mineral makeup that protect against both UVA and UVB, such as Actinica.
4) Have a regular daily medical grade skin care program which contains
i) Skin exfoliants and stimulating agents, such as alpha hydroxy acids (AHAs) and Retinol (Vitamin A)
ii) Topical antioxidants which help your skin both protect and repair itself such as topical Vitamin C & Vitamin E (these help protect against the damage caused by the sun and other factors such as brown pigment spots)
iii) Growth factors such as SkinMedica TNS Essential Serum, Oprah’s ‘Magic Lotion’
5) Consider having Dermaroller treatments to increase the effectiveness of your skin care regime
*Medical grade skin care programs involving the above agents often take 3-6 months to achieve the final maximum effect possible, with Dr Cope prescribing the highest concentration of product that your skin will tolerate. The treatment needs to be continued for any improvement to be maintained, and it is essential to prevent further damage by changing lifestyle factors, especially sun avoidance.
Retinol is a compound related to Vitamin A, which reverses some of the effects of aging, and has been safely used now for 35 years. It significantly increases the amount of collagen in the skin, and improves fine wrinkles and helps to lighten brown spots.
It may be used in combination with alpha hydroxy acids, and the combination is usually well tolerated. It should also be used with a lightening agent (see below) for reduction of skin pigmentation (brown spots) if this is your main concern. If therapy is stopped then the skin will return to pre-treatment condition two months later, therefore continued use is required.
For those who are sensitive to taking Retinol, Dr Cope may substitute an Alphahydroxy acid.
Alphahydroxyl acids (AHAs) enhance exfoliation, increase cell turnover, smoothing the skin and helping to reduce pigmentation spots. A desirable pH for a therapeutic preparation is between 2.8 and 4.8 (pH about 3.0 produces the most effective epidermal renewal).
By law, the concentration of AHAs in cosmetics cannot exceed 10% and the pH of the cosmetic must be 3.5 or higher, so these products only offer mild improvement for photodamage. The formulations Doctor Cope can prescribe contain stronger concentrations that are more effective, as well as suited to your specific skin needs.
Please note that both Retinol (Vitamin A) and Alpha Hydroxy acids increase sun sensitivity, and therefore sun avoidance and the use of a broad spectrum sunscreen is essential.
Skin pigmentation is caused by melanin, and sun exposure stimulates the production of melanin by the skin, causing both a darkening in colour and the appearance of darker “age” spots. Dr Cope can provide a number of treatments which decrease the production of melanin by stopping the enzyme tyrosinase, which produces melanin, with the commonest being hydroquinone, kinerase, and azelaic acid.
Dr Cope recommends SkinMedica Lytera Skin Brightening Complex is a unique brightening formula that improves dark pigmentation spots caused by the sun. Lytera also contains highly effective antioxidants and improves uneven skin tone. Lytera has been shown to be more effective than hydroquinone and other compounds at treating pigmentation spots and melasma.
These antioxidants help to protect against the ultraviolet rays of the sun by fighting oxygen free radicals in the skin, which lead to collagen breakdown, aging, and the development of skin cancer. They also protect against damage from free radical formation from environmental pollutants, such as smoking and alcohol.
Vitamin C stimulates collagen production, and diminishes the appearance of fine lines and wrinkles, and has been used since the mid-90s. When applied on the skin Vitamin C is most effective as a 15-20% solution, which Dr Cope can prescribe. Most over the counter creams only contain 1%.
A lot of commercially available suncreens only give protection against UVB (ultraviolet B), which causes sunburn, but not against UVA (ultraviolet A), which causes many of the changes of photoaging and skin cancer. A sunscreen should contain protection against both UVA and UVB, and be a SPF (sun protection factor) of minimum 15 or greater. The SPF factor only tells the effectiveness of the sunscreen against UVB. There are some newer sunscreens containing micronised zinc oxide which are colourless, rather than the old fashioned opaque versions (5-7% zinc oxide is an effective broad spectrum suncreen protecting against both UVA and UVB). An alternative to using sunscreen everyday is Mineral makeup, which has an SPF of 20-26.
Dr Cope recommends Actinica, which is the first sunscreen shown to reduce non-melanoma skin cancers (actinic keratosis and SCCs) in high-risk patients, and is recommended for patients who have sundamage and skin cancers. It does not contain zinc or titanium oxide, but uses a special liposomal delivery system that delivers micro-particles that reflect, scatter and transfer UV energy to the upper corneal layer of the skin, maximising protection.
Actinica is SPF50+ with 4 hour water resistance.
SkinMedica Tissue Nutrient Solution is the first skin care product to contain a high concentration of natural growth factors to rejuvenate your skin. It contains a combination of human growth factors, soluble collagen, antioxidants, and matrix proteins to reduce the signs of aging, improving fine lines and wrinkles.
This product product increases collagen in your skin by 35% in just 2 months, and also protects against sunburn and sundamage.
Only about 0.3% of cosmeceutical products such as Vitamin A are absorbed through the surface of your skin. The Dermaroller increases the penetration by up to 200 times!
Dr Cope recommends using the Dermaroller to significantly increase the effectiveness of your normal skin care regime, giving additional benefit from products such as Vitamin A and antioxidants such as Vitamin C & Vitamin E.
Any new product should be tested by putting it on a small area of skin the size of a postage stamp overnight, and watching to see if any irritation occurs. When starting a combination of products, Dr Cope advises patients that only one should be introduced at a time. Many of medical grade skin care products are in a highly concentrated and refined form, which only need a small amount to be effective, such as pea-sized dab for the entire face and neck.
After starting Vitamin A, some redness or light peeling can occur within several days of initiating treatment, but the skin “hardens” and the reaction decreases with continued use, however this phase may last a few weeks. The hardening effect is lost when the application is stopped. Application should be 20-30 minutes after facial cleansing to avoid irritation. With Vitamin A, starting application slowly will minimise the chance of this reaction. We would recommend every third day for 10 days, then every second day for 10 day, then using every day. Topical Vitamin C produces a mild tingling effect when applied to the skin, which is normal.
*Note results may vary from person to person