Do anti-aging remedies really work? Our columnists look at the best way to keep wrinkles at bay.

Oct.
18, 2005 - One day, you look in the mirror and a stranger is staring
back at you, a stranger with baggy pouches under her eyes and lines
that seem to echo laughing. Except you’re not laughing. You’re
wondering: who is that woman and how did she get in my mirror? Ah, the
sad fact is she’s you and you’re not 22--or even 32--any more.
Wrinkles, age spots and general sagging are common signs of facial
aging in women (and men, too). If we didn’t live in a youth-obsessed
culture, these reminders of time passing would be nothing to worry
about. But in the real world, we do worry that we may appear less
valuable at work or less desirable in the bedroom.

That’s why the cosmetics industry has spawned
a gigantic new category of products called cosmeceuticals that purport
to erase aging without a scalpel or a needle. This fall, the array
seems to have reached a critical mass, a bow to the buying power of
older baby boomers. You should know that cosmeceuticals fall into a
regulatory gray area: they’re neither drugs nor cosmetics and you have
no guarantee that they will do what they claim to do. You can purchase
cosmeceuticals in chic department stores, where they may cost a week’s
salary, or in your local drug store, where they’re a lot more
reasonable. Dermatologists say there’s no connection between
effectiveness and price so you’re better off going with cheaper
products from well-known manufacturers like Oil of Olay, Aveeno,
Neutrogena or Eucerin. But at any price, the real question is: do these
products work?

The
answer really depends on what you expect from them. Nothing you can buy
over the counter will give you the results you get from prescription
products or procedures only a doctor can perform. (In any case, if you
have concerns about a new dark spot on your skin or a rough patch, it’s
a good idea to see a dermatologist because these could be indications
of skin cancer.) Also, no cosmetic product can erase the damage caused
by the two biggest enemies of healthy skin: sun exposure and smoking.
Skin ages in two ways: intrinsically, which is controlled by our genes,
and extrinsically, which covers all our bad and good habits and the
effects of the environment. Which of these is more important really
depends on the life you’ve led. If you’ve been bad, you’re paying for
it now. “With sun damage, there’s irregular pigmentation and big dark
patches as well as freckling,” says Dr. D’Anne Kleinsmith of Bloomfield
Hills, Mich., a specialist in cosmetic dermatology and a spokesman for
the American Academy of Dermatology. “With intrinsic aging, wrinkling
is just fine lines. With sun damage, it can be thick, coarse wrinkling
like the farmers who have those cross-hatched lines on the back of
their neck.” Smoking, Kleinsmith says, makes skin look gray and also
exaggerates wrinkles. A smoker at 40 looks many years older than a
nonsmoker at the same age.

With those caveats, here are ingredients to look for if you’re trying to attack some specific problems:

General
dryness and loss of elasticity: Moisturize, moisturize, moisturize. In
a younger woman who is just starting to see wrinkles, the most
effective products are very aggressive hydrating creams or lotions,
says Dr. Mark G. Rubin, a dermatologist in Beverly Hills, Calif., and
assistant clinical professor of dermatology at the University of
California, San Diego. He suggests products containing ceramides,
triglycerides or cholesterol. “A lot of people have heard of those as
negatives in your blood stream, but on your skin they’re helpful,”
Rubin says. Products with retinol could stimulate cell growth, which
should help as well, says Rubin.

Age
spots: Also called sun spots or liver spots, these are flat areas of
brown skin on the face, neck, chest, top of the hands or forearms. If
you have a lot of them, you should check with a dermatologist because
they indicate that you’ve had considerable sun damage and may therefore
be more at risk for skin cancer. Nonprescription products that may help
contain the bleaching agent hydroquinone. Combining a bleaching agent
with an exfoliant, retinol creams or glycolic acid creams and lotions
can accelerate the fading you get from bleaching. But you need to use a
good sunscreen as well, otherwise any bleaching will be wiped away by a
few strong rays. If there’s no improvement in a few months, see a
physician, advises Dr. Ron Shelton, an assistant professor of
dermatology at Mount Sinai Medical Center in New York and director of
The New York Aesthetic Center. A dermatologist can prescribe more
powerful bleaching agents or administer peels and other treatments.

Fine
lines and puffiness around the eyes: Wrinkles anywhere look better if
the skin is moisturized, says Shelton. Again, the most expensive
moisturizer is not necessarily the most effective. Retinols and alpha
hydoxy acids like glycolic acid smooth skin, as well. Many products are
sold specifically as eye cream. Whether you really need them is
debatable. Doctors say that products for the face are generally mild
and you should try those first for lines around the eyes before you
invest in another tube or jar. Puffy eyes are harder to fix. If the
problem is allergies or lack of sleep, then you need to take
antihistamines or get more rest. Traditional cures, like cucumber
slices, tea bags or an astringent gel, can also help if the puffiness
is just temporary. But in many cases, the cause is herniated (or
protruding) fat pads above or beneath the eyes. Then, you really need
to see a doctor for surgery to remove the fat pads. Nothing sold in a
drug or department store--including hemorrhoid cream--an often-cited
cure, is likely to be of much help, says Kleinsmith.

Laugh
lines and lines around the lips:  Dermatologists aren’t very impressed
with anything sold over the counter. For laugh lines, Shelton
recommends injectable fillers. Botox injections will help those upper
lip lines that make lipstick bleed, he says.
Even if none of these
issues is facing you in the mirror now, you should pay more attention
to your skin-care regimen as you age. Dr. Robin Ashinoff, director of
Mohs surgery (a technique used to treat skin cancer) and cosmetic
dermatology at Hackensack University Medical Center in New Jersey,
sympathizes with patients who come in complaining that it’s hard to
pick the right products. A basic routine should always include
sunblock, she says, “winter, spring, summer and fall.” As for SPF, “30
is better than 15.” She also suggests sunblocks with micronized zinc or
titanium because they block all forms of light. Try a mild cleanser
like Cetaphil or Caress and some sort of abrasive like a mild buff puff
to increase skin turnover time, she says. A toner before applying
makeup is also good, especially if your skin tends to be oily. If you
have combination skin, you can use the toner just in the oilier T-zone
(forehead and nose). Apply moisturizer to any area that seems dry. And
though it may not seem to have much connection to your face, regular
exercise increases the blood supply to the skin, another thing that
worsens as we age.

The bottom line: Take care of your skin before that wrinkled stranger finds her way into your mirror.

"Her Body," is a new column focusing on women's health issues. It will run every two weeks.