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Prescription Skin Care

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AAFPRS Annual Fall Meeting.
Orlando, Florida, United States
Sep 18 – Sep 21,2014

European Academy of Facial Plastic Surgery
37th Congress
Palma de Mallorca, Spain
October 2-5 2014

California Academy of Cosmetic Surgery 16th Annual Scientific Meeting
Newport Beach, CA, United States
October 24 October 24, 2014

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Thursday November 13, 2014
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Prescription Topical Skin Care Products

Your daily skin care routine with effective prescription skin care products is your basic essential first step for maintaining beautiful blemish free skin and preventing and correcting environmental damage and facial aging. This is one of the most important aesthetician services I offer.

I am amazed when I hear a board certified skin specialist say “all you need is sun block and Dove Soap”-obviously this doctor has not bothered to investigate the results of modern prescription skin care products available today.

I am also amazed when I talk to patients who spend on non-prescription skin care products the see on TV or the internet, use them year after year and see no benefit. The most important thing you should know is that there are only two treatmentsthat have been approved by the FDA as effective for reversing facial aging changes– Retin A and laser resurfacing, the latter, of course is a surgical procedure.

In my practice you will undergo a professional skin evaluation and then a topical skin care regimen will be recommended based on your unique face and skin. I recommend that all of my patients utilize some form of topical therapy. Today’s prescription products work and if you are serious about keeping your skin healthy and preventing aging, then you need prescription skin care.

What Do Skin Care Products Do

Today’s prescription strength skin care products really work to achieve the following benefits:

  1. Protect your skin from sun and environmental damage which causes skin aging
  2. Exfoliate your skin to remove dry damaged skin cells and reveal healthy, plump, fresh cells for healthy looking skin
  3. Stimulate the formation of new collagen in your skin to replace collagen damaged by UV sun light and aging. This plumps the skin, helps fine lines and wrinkles, and improves skin texture
  4. Remove pigment and blood vessels, signs of sun damage and aging. Rosacea can also be improved
  5. Reverse pre cancerous changes in your skin caused by sun damage
  6. Moisturize your skin
  7. Control Acne and break outs

Which Skin Care Ingredients Really Work

Retin A

This chemical, also known astretinoin, is a by-product of Vitamin A synthesisand is a member of a key family of skin care medications. Retinoids regulate the growth of the epidermis, inhibit the formation of cancer, decrease inflammation and improve immune function. Retin A is a prescription drug. You cannot buy it at the beauty counter. Retin A, a drug in cream form, has been clinically proven to improve the epithelium, provide skin exfoliation, stimulate new collagen production, prevent collagen breakdown and lessen pigmentation (2). Why would you want to use anything else?

Retin Acan be mixed with Hydroquinone 4%, a bleaching cream to enhance the removal of pigment or brown spots which improves the anti-aging effectiveness of Retin A. In addition, when used in conjunction with microdermabrasion Retin A’s penetration and effectivenessis enhanced.

Retin Ais too irritating for many people, however. Also, you must wear sun block while using Retin A because the drugcan sensitize your skin to the sun. Thus, sun block and skin protection (such as a hat and large sunglasses) are essential. Newer, less-irritating compounds are Renova and Retin A Micro. Retin A comes in different strengths– 0.01%, 0.025%, 0.05%, and 0.1%. I typically start patients on 0.025% to see if they can tolerate the product well, and if they can, I gradually increase the strength. Tazorac and Avage, two other retinoids which have been very helpful medications for psoriasis and acne, are now being approved for anti-aging effects.

Retinols

Retinolsare available as over-the-counter products, no prescription necessary. Although their effectiveness is a matter of controversy among dermatologists, these compounds, once applied, are converted in your skin to retinoesters and small quantities of tretinoin or Retin A. Combining Retinol 0.3% with Hydroquinone 4%is effective in resolving fine lines, pigment and improving skin texture (3). Retinols are not as strong as Retin A and, therefore, can be used by many people who cannot tolerate the stronger products.

Alpha Hydroxy Acids (AHAs)

The AHAs– glycolic acid and lactic acid–are derived from fruit and milk sugars. The AHAmost commonly used is glycolic acid, whichis widely added to over-the-counter skin creams and by estheticians and doctors to perform skin peels to reverse skin aging damage and pigmentation.

AHAs produce exfoliation and stimulate the production of new collagen in the dermis, so they are a valuable component of most anti-aging skin care regimens. A recent study also showed that glycolic acid treatment of the skin increased the Hyaluronic acid (HA) content of both the epidermis and dermis, a very exciting finding since, as we know, the loss of HA is an important cause of dryness in aged skin (4).

Skin care products sold over-the-counter, which contain glycolic or lactic acid; contain, at most, only 10% AHAs. Trained cosmetologists may use products which contain 20-30% AHAs. Doctors may use products with as much as 50-70% AHAs, but at these concentrations, a deep chemical peel is produced.

I frequently use AHAs, both in prescription and non-prescription forms for patients who cannot tolerate Retin A. The Cosmetic Ingredient Review Panel (5) concludes that AHA’s, glycolic and lactic acid are safe for you the consumer when:

  • The AHA concentration is 10% or less
  • The pH is 3.5 or higher
  • The product contains sunscreen or the label clearly recommends that you use sunscreen.

Vitamin C - L Ascorbic Acid

Vitamin Cis an important antioxidant which, in the form of L ascorbic acid, can be applied topically to the skin. When Vitamin C ester is put in a lipophilic (fat loving) solution it may be possible to deliver it directly to the skin (6). As you remember, the skin cells have fat in their cell walls, and the Vitamin C ester must be in a solution which can penetrate this fatty barrier to get into the skin to have an effect.

Vitamin C esterhas multiple anti-aging effects. It’s a free radical scavenger, it promotes new collagenformation, and it actively protects skin from the aging effects of UV radiation in sunlight, above and beyond the benefit provided by sun block. This effect is enhanced by the addition of Vitamin E(7). I frequently use Vitamin C preparations on patients who cannot tolerate Retin A, and in patients with rosacea or other inflammatory skin conditions for whom Retin A is too irritating.

What Skin Care Products Do I Use In My Practice

Sun Block - There are many excellent sun blocks available in drug stores. In my practice I carry what I consider to be the best. One of our favorites is the Obagi Healthy Skin SPF 35, it has a 9% zinc and is a total block it is also recommended by the Skin Cancer Foundation. It is only sold in doctor’s offices.

The Obagi System - The Obagi Skin care line is one of the most effective anti-aging and pigment removal topical skin care programs I have used. It includes Retin A or Vitamin C as an exfoliant and consists of a 6-step, 3 morning and 3 evening products that exfoliate, remove pigment, stimulate collagen, moisturize and control acne. It is a prescription system only sold in doctors offices. The results that I have seen are very impressive.

IS-Innovative Skin Care - The IS line consists of modern, highly sophisticated, well manufactured products that are excellent. There are specific types of skin that are best treated with the IS line. In particular patients with sensitive skin, rosacea, and many acne patients are best treated with several of the IS products. One of my favorites is Pro Heal Serum and Vitamin C.

La Roche Posay/Biomedic - La Roche Posay/Biomedic, originally Biomedic was an innovator in topical skin care 10-12 years ago. Some of their lines have moved to the mass non prescription market which limits the strength and effectiveness of many of their products. There are still some excellent products only available in the doctors office that I use, especially for post laser skin care which are excellent. I also still carry products that many of my patients like and still prefer to use.

Jane Iredale - Jane Iredale mineral make ups are the best and are carried in my practice. They are excellent make ups for daily use and are particularly valuable for oily skin, acne prone, and post operative patients who need to camouflage bruising.

Your 6-Step Skin Evaluation

I prefer that you have a 6-step skin evaluation by our aesthetician before starting your topical skin care program. We will customize the appropriate plan for your unique face. We have specific programs for environmental damage, sensitive skin, acne prone, rosacea, and pigment control.

This professional evaluation and customized therapy is the greatest advantage you gain in my practice. Topical skin care managed by a physician and a medical aesthetician greatly increases the result you will achieve from topical skin care, the most important first step in facial rejuvenation and beautiful skin.

To learn more about skin care products read Save Your Face or contact me. Be sure to sign up for my email newsletter.

 

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Dr. Richard Gentile - Beeghly Medical Park Building A, Suite 103, 6505 Market Street, Youngstown, Ohio 44512 | 800.286.1844
© 2014 Dr. Richard Gentile. All rights reserved.
Dr. Richard Gentile is a face and body plastic surgeon specialist located in Youngstown, Akron, and Cleveland, Ohio. The Facial Plastic & Aesthetic Center is Ohio’s most technologically advanced Plastic Surgery practice.  Dr. Gentile is certified by the American Board of Facial Plastic and Reconstructive Surgery and by the American Board of Otolaryngology - Head and Neck Surgery.
Dr. Gentile is an Eyelid Surgery, Facelift and Rhinoplasty expert on RealSelf.com

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