Photoaging West Palm Beach Gardens Florida is the result of prolonged sun exposure. Sunspot, age spots, actinic keratosis, wrinkles, dilated pores, and hyperpigmentation are some of the signs of photoaging damage. There are three simple steps to treat photoaged skin: cleanse, treat, and protect.

Cleanse:

an effective cleanser removes dirt, oil, makeup, dead cells, and other debris. But it should be gentle enough to not strip the skin of its natural lipids. It is good to mention that most soaps in the market are not great cleansers as they have a high pH causing skin irritation and dryness. A good cleanser should have a pH of 4.5 to 6 that is close to the skin’s pH.

Using toners to cleanse the skin is good only for oily skin like people with acne. Otherwise, it can remove the skin’s own natural oils.

The best cleanser for photoaged skin is a cream-based surfactant that doesn’t foam. Foaming surfactants tend to dry the skin. This type of cleanser will help remove only surface oils in top of other dirt and debris without being too aggressive to remove the natural oils This kind of surfactant would leave your skin “squeaky clean”.

Treat:

The second step is the treatment which involves stimulating exfoliation and epidermal renewal, collagen and other dermal components synthesis, evening skin tone, and improving hydration. Some products to treat photoaged skin has multiple components to address many of the above without resorting to too many products.

Some of the good agents to treat photoaged skin are :

Growth Factors 

Fibroblast growth factor products stimulate the skin’s own fibroblast cells that are the main cells to produce the beneficial components of the skin as collagen, elastin, and other Extracellular matrices (ECM)material. Twice daily application for at least 3 months will start to show the benefits if FGF. It also helps with skin hydration and reduces roughness, hyperpigmentation, and wrinkles in photoaged skin.

Retinoids

Retinoids are Vitamin A derivatives that range from potent prescription products such as tretinoin to less active products as retinol and retinaldehyde.

Retinoids promote healthy epidermal turnover, enhance desquamation, inhibit melanogenesis, antioxidant functions, stimulating collagen production, and reducing keratinization within hair follicles thus preventing clogged pores from the formation.

Because of all the above, Retinoids are great for photoaged skin as well as hyperpigmentation and acne.

Prescription Retinoids have the most profound rejuvenating effects. Benefits are usually apparent in one month with improved texture. A drawback is that these retinoids can potentially cause erythema, sensitivity, and skin flaking. This usually resolves in most patients in 4 to 6 weeks. Prescription retinoids have to be stopped 1-2 weeks before some aesthetic procedures such as Laser to allow for intact epidermis at the time of treatment and are restarted 1-2 weeks after procedures. This can be challenging to time it for the patient and the clinician, It is because of this that prescription retinoids are often used as a stand-alone intervention for photoaged skin.

Cosmeceutical retinoids are less effective; however’ they rarely cause dermatitis or dry skin and are overall better tolerated by patients. Retinol is one of the most commonly used retinoids. The other commonly used ones are the retinaldehyde. All these products are inactive and they are converted into Retinoic acid in the skin which is the active form.

Good retinol concentration ranges between 0.5 to 1%. A prescription tretinoin’s concentration is 0.025-0.05%.

A good plan is to apply them every 3-4 days. Then you can increase frequency as tolerated.

Moisturizers:

They enhance epidermal barrier function and hydrate the epidermis and reduce the skin’s water loss. The skin becomes more supple and healthy. There are many different moisturizers with different qualities and indications. Some of these are mineral oil, waxes, silicones, shea butter, glycerin, Hyaluronic acid, and sorbitol to name but a few.

An appropriate moisturizer is selected based on the patient’s skin type.

For e.g. Ointments are the thickest moisturizers and contain nearly all oil. They are most useful for extremely dry or chaffed skin and are not meant for prolonged use as this may precipitate acne.

Exfoliants

they work by breaking the bonds between cells in the epidermis promoting desquamation. This stimulates epidermal renewal and evens out the distribution of melanin in photoaged skin. They are usually applied daily in the evening. Some of these exfoliants are irritating and they might need to be applied every other night for some time before switching to nightly. An e.g of exfoliants are

• Alpha acids as glycolic(sugar cane), malic(apples),tartaric(grapes),citric(citrus),mandelic(almonds),lactic(milk),and phytic(rice).

They also improve hydration and improve elastin fiber quality in the dermis and increase the deposition of collagen as well.

A lot of these acids are used as a chemical peel as well in higher concentrations.

• Beta hydroxy acids as salicylic acid. It readily penetrates and dissolves sebum making it a highly effective therapy for acne. It has an anti-inflammatory effect as well which helps with sensitive skin and rosacea.
• Niacinamide(Vitamin B3) is a gentle exfoliant for sensitive skin
• Urea exfoliates and hydrates skin

The final strategy in the treatment of photoaged skin is to

Protect

Here Antioxidenat and Sunscreens are the 2 main categories.

Antioxidants

UV light generates destructive free radicals in the skin which oxidizes nucleic acids, proteins, and lipids, leading to the development of skin cancers and signs of photoaging. Topical antioxidants protect the skin from free radical damage and provide added support to the body’s own antioxidant capabilities. Commonly used antioxidants are carotene, caffeine, glutathione, Kinetin, Vitamin C, melatonin, Vitamin B3, soy flavonoids, and Vitamin E.

Sunscreens

Sunscreens protect against UV-induced cutaneous damage by reducing exposure to UV radiation. Both UV lights are damaging.

UV-A is more damaging to collagen and elastin and is primarily responsible for fine lines and wrinkles. UVA remains strong throughout the day as well.

There are two main types of sunscreen ingredients each has a different mechanism of action. Chemical sunscreens absorb UV light and are not as effective. Physical sunscreen contains either Titanium dioxide or Zinc oxide. These inorganic compounds scatter both UV lights and are way more protective.

Results

Visible improvements in photoaged skin with the use of topical products are typically evident over 3-6 months. Improved texture and brightness may be apparent by 1 month, and reduction of fine lines and hyperpigmentation by 3 months. These changes can be seen more rapidly with prescription products than with cosmeceuticals products.