Golden rules for youthful-looking skin

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Surgery is not the only way to keep your face looking youthful.

Proper skin care is more effective than you might imagine at keeping wrinkles at bay. The earlier you start taking care of your skin, the better the results.

Begin in your 20s, and your skin should keep its youthful appearance into your 50s and beyond.

Even if you’re over 60, you can undo much of the damage caused by the combined effects of time and environmental stress, such as extremes of temperature, dryness, pollution and sunlight. You can also slow the skin’s aging process.

That does not mean you should stock up on costly lotions. Cosmetic counters and drugstore shelves sag under the weight of products that claim to work miracles. None do.

But here are five products that really will have a noticeable effect on your skin

Alpha hydroxy acid

Creams containing alpha hydroxy acids (AHAs) are the first over-the-counter anti-aging preparations that really work.

Derived from natural sources including sugarcane, grapes and milk, AHAs act as exfoliants, encouraging new cell growth, fading discoloration and reducing or eliminating fine lines.

There are now dozens of AHA creams on the market, each with its own “special” acid (lactic, citric, glycolic, etc.). All work equally well. Just be sure the label specifies an AHA concentration of 10% or so. That’s the minimum strength capable of really smoothing the skin.

AHA creams yield noticeable results only after several months of daily use so you must be patient.

Caution: Since once-a-day application of AHA gets such good results, some people assume that they might as well slather it on morning and night.

Bad idea: Overuse of AHA cream can cause severe skin irritation.

For faster results: Ask a plastic surgeon or dermatologist about getting a light chemical peel. Such peels use a solution containing 30% to 70% AHA. They’re performed in the doctor’s office with no anesthesia.

In most cases the only side effect is a slight tingling and redness for an hour afterwards.

Sunscreen

Used properly, virtually any sunscreen on the market filters out ultraviolet A (UVA) and ultraviolet B (UVB) light. Those are the rays that cause premature aging.

Best: A sun protection factor (SPF) of at least 15. Do not assume that sunscreen with an SPF 30 allows you to stay in the sun twice as long as a sunscreen with an SPF 15.

Sunscreen gets sweated off quickly. I recommend reapplying it liberally at least once an hour. If you go into the water, reapply it as soon as you come out. I also recommend wearing a hat when venturing outdoors in sunlight.

Antioxidant vitamins

Vitamins C and E are the only vitamins proven to be beneficial to the skin. These antioxidant vitamins work by preventing the breakdown of collagen. That’s the structural protein that keeps skin strong, smooth and elastic.

There’s even some evidence that C and E help the body build more collagen. I recommend taking 1,000 milligrams (mg) of vitamin C and 800 international units (IU) of vitamin E daily.

Caution: Check with your doctor before you begin taking supplements.

These vitamins must be taken internally to have any effect. Though it’s a popular practice, there’s no evidence that rubbing vitamin E oil or lotion onto your skin does any good. The vitamin molecules are far too big to penetrate the skin.

Tretinoin

This vitamin A derivative (sold as Retin-A) smooth skin and erases fine wrinkles. It does so by speeding cellular turnover and stimulating the skin to produce collagen.

It’s effective, but Retin-A can cause red, scaly patches. Luckily, there’s a moisturizer-like formulation of tretinoin called Renova. It’s not quite as effective as Retin-A but is less likely to cause irritation.

For visible results, tretinoin must be used for at least four months. To minimize the risk of skin irritation, I tell my patients to stop treatment periodically to allow the skin to recover. When and for how long you use tretinoin should be discussed with your doctor.

Retin-A and Renova are available only by prescription. AHAs and tretinoin can be used at the same time.

Moisturizer

Moisturized skin isn’t any healthier than dry skin, but it certainly looks and feels as if it is.

Moisturizer hydrates dead cells on the skin’s surface, temporarily preventing them from flaking off.

Any water- or oil-based formula will do the job, as will Vaseline or even Crisco. There’s no medical reason to pay extra for fancy brands no matter what “special ingredients” they contain.

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