Ways to look younger without surgery

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It used to be that a face-lift was the only way to deal with skin that was wrinkled, sun-damaged, sagging or scarred. However, this is no longer true.

Today, while surgery is still required for serious problems, there are numerous safe, inexpensive nonsurgical techniques for rejuvenating your skin. Here’s a look at your options

Alpha hydroxy acids

Glycolic, lactic, citric and other alpha hydroxy acids (AHAs) are found in a growing number of cosmetics. Excellent moisturizers, they also seem to minimize wrinkling, sun damage and acne if used on a daily basis.

More effective: Prescription AHA products, which contain higher concentrations of the acid. These products are available from your dermatologist.

Sunscreens and moisturizers

Sunscreens don’t just prevent skin damage. They also help fade existing fine wrinkles. Moisturizers keep skin soft and supple and temporarily improve its appearance. But they neither prevent nor reverse wrinkles. In fact, wearing moisturizer without sunscreen can raise your skin’s vulnerability to sun damage.

Vitamin a derivative

Tretinoin (Retin-A) is a potent drug originally developed as a treatment for acne. Doctors may prescribe this vitamin A derivative to fade fine lines around the eyes and to get rid of stretch marks and liver spots.

It’s surprisingly effective when used on a regular basis, although it can take a year or more for the effects to become apparent. Tretinoin makes the skin appear smoother by thickening its outermost layer and “compact” the layer of dead skin cells.

Caution: Tretinoin can cause redness and dryness and can raise your susceptibility to sunburn. Because of the possible risk of birth defects, it’s inappropriate for pregnant women.

Another formulation of tretinoin, Renova, is the first drug developed specifically for wrinkle removal. It reduces fine facial lines, brown spots and surface roughness just as effectively as ordinary tretinoin and it’s less likely to irritate the skin.

Chemical peels

Chemical peels involve the application of concentrated AHAs (40% to 70% acid vs. 0.5% to 10% acid for over-the-counter AHA products). Peels are administered in a doctor’s office.

A series of light glycolic acid peels helps remove damaged skin and improves the appearance of crow’s feet and minor acne scars. The peel may cause stinging, as well as slight pinkness for a day.

Deeper peels, using trichloracetic acid (TCA) or phenol, are needed to obliterate wrinkles around the mouth, eyes and forehead, to correct irregular pigmentation and to eliminate liver spots.

The effects of a peel last for several years. However, peels may cause considerable pain, as well as persistent redness, skin tightness and scarring. Phenol peels are inappropriate for people with heart or kidney disease or with dark skin.

Warning: Recovery from a TCA or phenol peel isn’t pretty. Crust-like scabs that appear immediately after the peel can take up to two weeks to heal. During this period, it’s essential to avoid the sun.


This procedure involves use of a rotating wire brush to “sand” off the upper two layers of skin, smoothing its appearance. Results last for several years.

Dermabrasion is good for removing acne scars, pockmarks and small wrinkles around the lips. For severe blemishes, two procedures, six to 12 months apart, may be necessary.

Caution: Dermabrasion can cause infection, scarring, variations in skin tone and extreme sun sensitivity. As with peels, the skin crusts over. And be advised that full recovery can take up to several months. Also as with peels, dermabrasion works best for people with light complexions.

Laser peel

In this procedure a new alternative to dermabrasion and chemical peels the doctor uses a laser to “shear off’ the epidermis. Laser peels are less likely than chemical peels to cause scarring and over lightening. They are also more precise.

Although crusting and redness still occur with a laser peel, recovery is usually faster. Laser peels are particularly effective against wrinkles around the eyes, age spots, scars and facial discoloration.

Collagen injections

Doctors can inject you with a natural protein called collagen to plump up facial skin and help fill in severe (cystic) acne scars and deep wrinkles.

Effects are immediate and will last for four to eight months, until the collagen is resorbed. Then a new round of injections needs to be administered.

Infection and sun sensitivity at the injection site can occur following the injections. And allergies to collagen can cause excessive firmness and purple discoloration. This can last up to six weeks.

To make sure you’re not allergic:

Have two collagen allergy tests prior to receiving the injections. Do not have the injections if you have rheumatoid arthritis, Graves’ disease, lupus or another autoimmune disorder.

Instead of collagen, some doctors have begun injecting fat “harvested” from elsewhere in the body (buttocks, back, etc.). Because the injected material is part of the body, there’s no danger of allergic reaction. Unfortunately, it’s not clear just how long fat injections last.

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