DuJour Navigation

In Search of Perfect Skin

Dermatologists are getting a bit closer to cracking the anti-aging code

It is a truth universally acknowledged that a woman in possession of good skin is in want of better skin. Nowadays, in our instant gratification society—of one-hour teeth whitening and spray-on tans—we expect to get it post-haste. But a rapid plan of attack isn’t always practical or realistic. “You don’t suddenly age overnight,” says New York City dermatologist Dr. Dennis Gross. “Radiation has a delayed effect on the skin. The sun that you got years ago is still with you, lurking beneath the surface, and will continue to manifest. As a result, skincare should be measured and ongoing.”

Switching mind-sets to slow and steady is, of course, easier said than done. “When [facial injectible] Sculptra came out and three months were needed to see results, it was difficult for patients to understand,” says New York City psychiatrist and dermatologist Dr. Amy Wechsler. “They were used to the quick fixes that Botox and fillers presented.”

While those fast-acting products have revolutionized skincare and improved countless people’s appearances, their main drawback is that the effects are temporary. The next generation of treatment, though—with results that may last—is focused on reinforcing and rebuilding collagen, a process that takes time to achieve. A naturally occurring protein in the body that connects and supports the tissues, collagen accounts for more than 70 percent of skin fibers. As we age, it slows down in production and declines in quality. “Anytime you use something that builds collagen, you’ll get a global improvement in skin—firmness and tightening,” says Gross. “I believe the key to true anti-aging could lie in targeting collagen: maintaining it, preventing its breakdown, or preventing the enzymes that trigger their degradation from working.”

Fibrocell, a lab in Pennsylvania, claims to have found a collagen solution with its product Laviv. Approved by the FDA last year, Laviv is the first “cell therapy” available on the market. It’s far from a get-young-quick remedy—it can take nine weeks or more to see effects from the injections. (The treatment consists of three injections in total, spaced three to six weeks apart.) “We take skin cells from behind a patient’s ear,” explains New York City and Miami dermatologist Dr. Fredric Brandt, who along with Wechsler is one of a small number of dermatologists offering Laviv. “These skin cells are sent to a lab to be cultured and to create thousands of fibroblast cells [which takes an average of three months]. After we get the new cells from the lab, we inject them into a person’s nasallabial folds, or smile lines.”

Fibroblast cells produce collagen, and when we get older, the number of fibroblasts diminishes and collagen breaks down, resulting in wrinkling and a duller skin tone. “Laviv is an injection, but what’s important to note is this isn’t about getting that full, puffy look,” says Brandt. “Those come from putting something foreign into your face. This is different because you’re boosting collagen production by producing your own cells.” Two clinical studies conducted by Fibrocell confirm its efficacy: By the third treatment, visible results were measured; six months later, significant improvement was observed in moderate-to-deep nasallabial folds. Brandt believes that dermatologists have just begun to see Laviv’s potential: “Acne scars, burns—anything can benefit from increased collagen.”

And if Laviv is the futuristic end of the skincare spectrum, at the other end a decidedly un-high-tech ingredient is having a renaissance. “It’s the return of the retinoid,” declares Brandt. A derivative of vitamin A, the compound has been a staple of dermatologists for decades due to its effectiveness in stimulating collagen production, evening skin tone, refining texture and boosting cell turnover.

“But using pure retinol isn’t the story any longer,” says Gross. “We think of it as a base ingredient and now we’re adding ingredients to boost or balance it.” New formulas—including those for sensitive skin and oil-based products like Ren’s Bio Retinoid Anti-Ageing Concentrate—and consumer awareness have also ensured that once-common side effects like full-face flaking and redness are often things of the past. “Women know not to use it every night,” notes Brandt. “For those who don’t think they can tolerate it, I actually have them begin their regimen by applying a small amount, leaving it on a few minutes, and then washing it off.”

Really, say Brandt, Gross and Wechsler, the most modern skincare is a mix of old and cutting-edge—and a balance between common sense and experimentation. “There’s always something new,” notes Gross. But too often people bypass tried-and-true practices in order to use the latest hyped treatment. He says, “A diet rich in antioxidants like lycopene, healthy oils and vitamins C and E gives the body tools to build collagen. And you can’t underestimate the importance of preventing damage by using a daily sunscreen. Anti-aging starts with knowing where you stand and where you can go from there.”