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NO ONE KNOWS MORE ABOUT INNOVATIONS IN SKIN CARE THAN DERMATOLOGISTS. AND
MOST OF THEM CLEARLY PRACTICE WHAT THEY PREACH. (EVER SEEN A WRINKLY SKIN DOC? WE HAVEN'T EITHER.)
SO WE WENT TO THE FIVE MOST RADIANT, FINE-LINE-FREE FEMALE MDS WE KNOW AND SAID,"FESS UP." HAPPILY, THEY OBLIGED» BY MICHELE BENDER
1/They use a cleanserwith horsepower
We've all heard dermatologists endorse washing up with a mild, gentlecleanser. But in truth that's not what
they use at home. Most of the MDs wetalked to lather up with formulas filledwith glycolic or lactic acid (to accelerate exfoliation) and salicylic acid (tounclog pores and make them appearsmaller). "As an African-Americanwoman in my forties, I battle blotchiness. And for that, I find an exfoliating cleanser is best: It evens out the toneof my skin better than a basic, nofrills formula," says Jeanine Downie,MD, coauthor of Beautiful Skin ofColor. Some doctors do use a gentlercleanser but rotate in a more aggressive exfoliator (a scrub or at-home microdermabrasion kit) once a week toensure that no skin-dulling dead cellsare hanging around. Some favorites:Vivite Exfoliating Facial Cleanser ($39;viviteskincare.com) and the PatriciaWexler MD Microdermabrasion System Step 1:Resurfacing Cream ($35;bathandbodyworks.com).
They fight free radicals onthe outside-and in
According to the doctors we interviewed, the danger of free radicalsfrom such sources as air pollutionand the sun's rays-isn't marketing hype,it's real. "Damage from free radicalsis one of the primary causes of fine linesand uneven tone," Downie says. Soshe and the others minimize futurewrinkles and blotchiness with anti
oxidants, applying a serum or cream
that contains a free-radical fightersuch as vitamin C, phloretin, idebenone, green tea or coffeeberry everymorning, after cleansing and beforeputting on sunscreen (see number3, below). Downie loves Revale SkinIntense Recovery Treatment withCoffeeBerry ($130; revaleskin.com).Other antioxidant serums to try:Elizabeth Arden Prevage Face AntiAging Serum ($155; elizabetharden.com, available beginning in March)with idebenone plus green tea, andSkinCeuticals phloretin CF ($150; skinceuticals.com), which contains threeantioxidants: vitamin C, phloretin andferulic acid. But most docs don't relyon topical antioxidants alone. MaryLupo, MD, a clinical professor of
. dermatology at Tulane University, inNew Orleans, also downs smoothiesmade with yogurt and antioxidant-richfruit, such as blueberries or acai. "Ibelieve skin is a mirror of your overallhealth. So I treat the inside of me as
well as I do the outside," she says.
Protection is a priority
To skin doctors, applying sunscreenis like brushing teeth: It's unfathomable not to do it. Most apply a thinlayer as the last step of their morningskin care regimen to prevent UV exposure, the chief cause of prematurewrinkles and discoloration. Two for
mulas frequently cited: For dry skin,La Roche-Posay Anthelios Daily Moisturizer SPF 15 ($30; larocheposay.us)and, for oilier complexions, Neutrogena Ultra Sheer Dry Touch Sunblock SPF 55 ($11; drugstores). Then,to further boost their skin's sun
shield, our experts layer on sunscreenspiked makeup. Naila Malik, MD, acosmetic dermatologist in Southlake,Texas, sweeps on Neutrogena MineraI Sheers Powder Foundation SPF
20 ($13; drugstores). "It's light, safefor sensitive skin and doesn't make
me break out:' she says. Katie Rodan,MD, associate clinical professor of
dermatology at Stanford University,uses her own Rodan+Fields Mineral
Peptides SPF 20 ($29; rodanandfields.com), which absorbs excess oil.And Lupo applies L'Oreal VisibleLift Foundation SPF 17($15; drugstores), a moisturizing liquid formulawith retinol.
4/They rave about Retin-A
Dead cells are complexion enemynumber one, say our skin experts, because they clog pores and give skinan ashy appearance. So, after exfoliating in the evening, most docs slatheron a retinoid cream (a topical form ofvitamin A found in Rx options suchas Retin-A and Renova, and over-thecounter in retinol), which has beenshown to speed up the rate at whichthe body sheds dead skin. But retinoid benefits don't stop there. VitaminA also stimulates collagen production (making skin look plumper andfine lines smoother) and normalizescells exposed to UV rays, effectivelyundoing sun damage. But there's adownside: Retinoids, dermatologistssay, can be irritating if overused, somost advocate a flexible retinoid regimen. Lupo alternates daily betweenmoisturizing Renova and the more aggressive (and more drying) prescription Tazorac. Downie rotates Vivite
Vibrance Therapy, which has retinol($119; viviteskincare.com), with TriLuma Cream, an Rx-strength retinoidthat also contains spot-fading hydroquinone. And every night, Rodanapplies her own Rodan+Fields Anti-AgeNight Renewing Serum ($89; rodanandfields.com), an over-the-countertreatment with retinol. Then, once aweek, she applies Tazorac as a mask for15minutes: "Tazorac is the strongest
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retinoid, but it's too irritating for meto wear all night. Using it as a maskboosts the effects of my retinol serumwithout causing flaking." Some doctors also apply a moisturizer under theirretinoid to dilute the strength. Orthey cut back on how often they applyit (e.g., every third night rather thanseven days a week) if they see signs ofsensitivity. (For more on what to doif your skin is irritated, check out "Chch-changes: Your Skin Is SuddenlySo Sensitive;' on page 50.)
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They freeze and fillin moderation
Almost every dermatologist we spokewith says that when it comes to inoffice treatments, Botox (or Dysport,its brand-new competitor) gives youthe most bang for your buck. They inject their foreheads to relax frownlines; a few also target their eyes' outercorners to minimize crow's-feet. Patricia Wexler, MD, a cosmetic dermatologist in New York City, says oneof her favorite new spots is along thejawline, which gives her neck a liftedappearance. For areas where deeperwrinkles have formed, most doctorssay they turn to hyaluronic acid fillerslike Juvederm or Restylane to plumpup the crevices. The most frequentlytreated spot: the nasolabial folds(aka the marionette lines beside yourmouth). Rodan and Lupo both injectthis area once or twice a year. Docs, ofcourse, get these treatments at cost;even so, they avail themselves onlythree to four times a year, which theyconsider moderate usage. You can expect to pay $375 and up for one Botoxor Dysport treatment, and $600 andup for one filler treatment.
Maintaining skin bounceis essential
Yes, retinoids boost collagen and elastin production in the skin. But mostskin doctors don't feel that vitamin A
alone does quite enough plumping, soover this they layer a second topical containing either peptides or a growthfactor. Popular peptide picks: NeocutisBioRestorative Cream ($130; dermstore.com) and Olay Regenerist DailySerum ($19; drugstores). Best of thegrowth factor bunch: SkinMedica TNSEssential Serum ($250; skinmedica.com) and ReVive Moisturizing RenewalCream ($165; neimanmarcus.com).Note: Most peptide and growth factorcreams are hydrating, so you won'tneed an additional moisturizer. Like
you, these docs don't have time foran eight-step regimen. So at night theyjust cleanse, apply a retinoid cream,top it off with a collagen-boostingcream-and hit the sheets. And there
is a reason doctors typically save thebig-gun treatments like retinoids andpeptides for nighttime. "Your bodytemperature goes up while you sleep,and the heat helps products penetrate skin better;' Rodan explains.
They sleep on their backs
Fetal-position snoozers, take note: Asurprising number of doctors believethat smashing your face into a pillowleads to permanent creases-so theytry never to do it. "Sleeping on yourface not only etches wrinkles into theskin, but fluid pools on the side of theface that's pressed against the pillow,stretching out the skin," Lupo says.Rodan went so far as to buy herself aTherapeutica Sleeping pillow ($79to $110, depending on the size; therapeuticainc.com), which is contoured to
cradle your head and neck, making iteasier to lie on your back. "The connection between wrinkles and how yousleep is no joke. I can look at 80 percent of my patients and tell you whichside they sleep on;' Rodan says.
They exercise for better skin
Most female MDs cited improved circulation and reduced stress as workout
benefits that help their appearance."I get stress relief from working out,which I think keeps my worries off myface," says Downie, who runs, hits theStairMaster or kickboxes seven days aweek. Malik goes to the gym for 60 to90 minutes, six or seven days a weekbecause she believes it reduces her
level of the stress hormone epinephrine: "This hormone can cause con
striction of blood flow and make yourskin lose its glow." Wexler swears bythe long-term effect ofPilates on skintone; Rodan, a former runner, nowgoes Spinning. "Aplastic surgeon I trusttold me to stop high-impact workoutsonce I entered my forties;' she says. "Hesaid over time it causes tiny tears inthe microscopic attachments in the skin,which can ultimately lead to sagging."~
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