What’s on your face?

A guide to choosing the safest, best skin care products

High school chemistry is a distant memory when you begin to battle wrinkles. Skin-care product labels touting the age-reversing qualities of ascorbic acid and antioxidants may seem a mystery to you. At $50 or more for a tiny jar however, you want more than a promise and an ingredient list. Yet little has been done to test their effectiveness because they are cosmetics, not medicine.

“The most important part of any anti-aging regimen is the daily use of sunscreen to help prevent sun damage that can lead to skin cancers and aging skin,” says Dr. Kelly Bickle, a Lakeland dermatologist who prefers sunscreens with an SPF rating of 30 or higher. “Retinol has been shown to improve skin texture and clarity, and may help improve fine lines and wrinkles as well as dyspigmentation (brown spots). Other ingredients to look for in anti-aging creams are topical antioxidants including vitamin E, vitamin C, and green tea extracts.”

It is believed topical antioxidants prevent oxidative damage. “Products with glycolic acid or salicylic acid can also help improve overall skin texture and tone,” says Dr. Bickle, who practices at Watson Clinic’s Bella Vista Building.

With a doctor’s prescription, a cream can be used to treat fine lines, wrinkles and dyspigmentation. “The gold standard prescription cream for anti-aging is tretinoin (Retin-A or Renova are two commonly used brands),” she explains.

Products with the right ingredients can be helpful, but moisturizers using collagen may be misleading.  “[…] The claim that these products can replace the collagen that is lost as we age is unfounded,” Dr. Bickle states.  “The size of the collagen molecule is large – too large to penetrate through the skin in the form of a moisturizer. This is why collagen (and other fillers) must be injected into skin.”

Estrogen creams may be contraindicated because of oral hormone replacement therapy and estrogen-responsive cancers. Natural products, however, can be useful. “Cucumbers and teabags can temporarily reduce swelling and redness, especially under the eyes,” she explains. “Oatmeal is used quite often to treat dry irritated skin, including eczema.”

Meanwhile, one researcher at the University of Illinois at Chicago is studying cosmeceuticals, a blend of cosmetics and medicinal ingredients. “My research is looking at the true effectiveness of anti-wrinkle products,” says J. Regan Thomas, MD, head of Otolaryngology (the study of ear, nose and throat diseases), at UIC.

The ingredients he’s targeting in his ongoing experiments are forms of vitamin C, topical estrogen, soy cream, peptides and retoinic acid, and alpha hydroxy acids.

Dr. Thomas asks, “We’re looking at the effects [in mice] on a microscopic level. The ingredient could be sealing off the skin, but does it have a real effect on the cells of the skin?”

Until more research provides evidence-based answers however, it’s important to use caution when selecting creams for your daily skin care regimen. If you’re unsure about any product, consult your physician or a local dermatologist.


Dr. Bickle is a board-certified dermatologist at Watson Clinic’s Bella Vista Building in Lakeland and a Polk County Medical Association member. She is a MOHS micrographic surgeon, meaning she is able to precisely remove certain carcinomas in patients at high risk for reoccurrence. The procedure has a high cure rate and conserves a maximum amount of tissue. She also is an expert on cutaneous oncology, post-Mohs reconstruction, and cosmetic dermatology.

Dr. Bickle received her medical degree from the University of Texas Medical School in Houston. She completed her residency in dermatology at the University of South Florida and her fellowship in MOHS micrographic surgery at the Bennett Surgical Center in Santa Monica, CA.


story by BEV BENNETT

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