In general, women with brown skin do not age as
quickly as women of European descent. Therefore, invasive anti-aging
procedures such as facelifts and laser resurfacing are usually not necessary.
However, brown skin may still benefit from several forms of rejuvenation.
One of these forms involves applying topical anti-aging creams. These
creams are popular among women with brown skin as a first line of defense
against the signs of aging skin. They are often used in conjunction
with other anti-aging treatments such as chemical peels, microdermabrasion,
filler substances and muscle relaxants such as Botox. The most popular
anti-aging creams are Avage, Renova and Prevage, the advantages of which
include the fact that they can be applied at home, require no healing
time, and are simple and easy to use. Avage and Renova are medications
that are both classified as retinoids, while Prevage is classified as
an anti-oxidant. Although these creams are generally well suited for
brown skin, it is important to discuss them with your dermatologist
to decide which cream will be most appropriate for your skin and will
give you the best results. Do not use a friend or family member’s
cream, as these medications should only be used under the supervision
of a licensed professional and as part of a skin care program in which
you avoid sunlight.
Retinoids have been used for many years to treat acne in teens and adults. Several years ago, these potent prescription medications were found to reverse some of the signs of aging such as fading dark marks, evening skin tone, reducing skin wrinkling and eliminating roughness. They are believed to work on all layers of the skin, including the epidermis where pigmentary changes occur and also on the deeper portions of the skin (the dermis) where wrinkling begins from the loss of collagen and elastin.
Retinoid based creams are easy to use. A small amount
of the retinoid cream is simply applied to the face once a day. However,
with the retinoid creams, more is not better; using too much will not
hasten results, and may actually cause the onset of dryness and skin
irritation. In brown skin, excessive dryness and irritation may lead
to dark marks or patches, termed postinflammatory hyperpigmentation,
so it is important to follow your doctor’s directions regarding
application. The following tips may help you avoid dryness and irritation
that may be associated with use of the retinoid creams.
- Use a moisturizing cleanser twice daily
- Wait 20-30 minutes after cleansing before applying the retinoid cream
- Apply a moisturizer before and/or after applying the retinoid cream
- Apply the retinoid every other night initially and slowly increase to nightly
- If you miss a dose of the retinoid, do not double up, simply resume your normal schedule
- Each morning apply an SPF 15 or greater to protect against sun sensitivity and sunburns
- Avoid using other products with drying effects such as alcohol based astringents or certain acne medications
- Avoid hair removal agents such as depilatories and waxes since these may further dry or irritate your skin
- See your dermatologist if dryness or irritation persists or is excessive
retinoid do’s and don’ts:
- Discontinue all retinoids 7-days before undergoing waxing to remove hair
- Discontinue all retinoids 7-days before undergoing chemical peel procedures
- Do not use a retinoids if you are currently experiencing an outbreak of eczema or any other skin rash
- Do not use a retinoids if you are pregnant, attempting to conceive or breast feeding
Avage is a prescription facial cream produced by Allergan, Inc. that
contains the compound tazarotene 0.1%. You may be familiar with the
prescription acne medication Tazorac, which is made of the same tazarotene
compound. Avage and Tazorac are both classified as retinoid compounds.
Avage differs from Tazorac, in that it contains emollients (heavy duty
moisturizers), which soften your skin and may help to prevent excessive
dryness. Even with the built in moisturizer, using another moisturizer
to avoid dryness is advisable.
Avage cream improves the appearance of the skin through
several mechanisms. It increases collagen (an essential building block
of the skin) and elastin in the dermal portion of the skin, which serves
to lessen wrinkling. In the epidermal layer of the skin, Avage cream
has two effects. It is felt to minimize skin discolorations and evens skin tone.
Additionally, it improves the rough texture of the skin, which commonly
occurs as we age.
Avage cream usually begins to show results within a
couple of weeks with maximal results after 4-6 months. Most side effects
are mild and are typically limited to the areas of skin where the cream
is applied (see tips above). You may at times experience itching of
the skin (pruritus), a stinging or burning sensation, dryness, or peeling.
Some patients, about 5%, in one study, had to stop treatment due to
skin irritation. If side effects become a problem, discontinue the cream
and contact your doctor immediately.
Renova is an anti-aging cream produced by Johnson & Johnson that
contains tretinoin or retinoic acid, a vitamin A metabolite. It contains
the same active ingredient as Retin A, which is used to treat acne.
Renova, however, comes in both a 0.2% or 0.5% concentration. Renova
shares most of the same application procedures, benefits and side effects
as Avage (see above) and other retinoid creams. Renova cream usually
take 3-4 months to notice a visible improvement, and you may need to
wait as long as six months before you notice definite beneficial effects.
Antioxidants are substances that protect the cells in our body from
damage caused by internal and external stresses. These stressors, which
may include things that you may not have considered, such as the digestion
of food, exercise, air pollution, smoking, and even sunlight, can cause
our cells to release free radicals. Free radicals are atoms or groups
of atoms with an odd (unpaired) number of electrons. Once these highly
reactive free radicals are formed, they can start a chain reaction in
your body, like dominoes. As free radicals build up in our bodies they
try to stabilize themselves by binding to the nearest normal cell. This
results in a chain reaction because once the free radical attaches to
a healthy cell it too becomes a free radical. Free radicals then damage
our body’s cells and they do this by reacting with important cellular
components such as DNA, or the cell’s membrane. In the skin, free
radicals specifically break down collagen and elastin tissues. This
causes our skin to age prematurely and wrinkles to develop. To prevent
free radical damage the body has a defense system of antioxidants. Antioxidants
are molecules that can safely interact with free radicals and terminate
the chain reaction or domino effect before vital molecules are damaged.
In our bodies, the principal antioxidants are vitamin E and vitamin
C. A complete listing of our body’s antioxidants are listed below.
- Vitamin A
- Vitamin B-6
- Vitamin B-12
- Vitamin C
- Vitamin E
- Folic acid
Our bodies cannot manufacture these antioxidants, so they must be supplied
in the diet and most recently in creams applied to the skin. Topically
applied antioxidants work by coating the skin and producing a protective
layer to neutralize free-radicals. It shields skin from outer environmental
damage and protects you by binding to free radicals and neutralizing
them before they cause damage.
Plants also contain antioxidants because they too need
protection from environmental stresses. Some of the plant antioxidants
have been formulated into creams for topical use. Some plant antioxidants
are listed below.
- Ferulic acid
- Soy isoflavones (Genistein)
- Green and black tea polyphenols
- Polypodium leucotomos
- Red Clover
- Grape seed extract
Prevage is a facial cream produced by Allergan, Inc. which contains
the antioxidant idebenone 1%. It is a synthetic version of ubiquinone,
an antioxidant, like vitamins C and E, which helps to protect skin cells
from environmental damage and the generation of free radicals. Prevage
is used to trap free radicals, reduce fine lines and wrinkles, smooth
skin roughness, reduce dryness and protect skin cells from deterioration.
Prevage is applied twice daily to the skin. A pea-size
amount is typically massage into the face and neck, after washing and
drying. Some dermatologists will recommend applying the cream once a
day for a period of about 2 weeks, but after that twice daily application,
in the morning and at night, to achieve maximal results is fine. Prevage
can usually be used with other topical agents, but you should discuss
this with your doctor. You should begin to notice improvements in your
skin 4-6 weeks after starting treatment. Because Prevage is an antioxidant,
it works differently than the retinoid creams, Avage and Renova, to
rejuvenate your skin. Therefore, women with brown skin can benefit from
using both an antioxidant and a retinoid, but they should be used at
different times of the day.
Generally, the studies indicate that Prevage is well
tolerated and is without serious side effects. However, a stinging or
burning sensation after application has been reported. In brown skin,
as with any other product, Prevage use can result in irritation which
can produce discoloration of the skin. Therefore, it is important to
note how your skin reacts to this product and consult your physician
if you notice any adverse effects. Although Prevage can protect your
skin from many environmental stressors, it does not work as a sunscreen.
An SPF 15 or higher sunscreen should be worn daily. Also, you do not
want to use Prevage if you are pregnant, attempting to conceive or nursing.
Tazarotene, Tretinoin, and Idebenone are all relatively
inexpensive and easy to use anti-aging treatments. There are generally
well tolerated in brown skin and can be used in conjunction with other
procedures. They must, however, be used with the guidance of your dermatologist.