"How Not to Look Old" is based on the idea of fast and easy fixes to make you look Y&H (young and hip), whether you are looking for high-, medium- or low-maintenance solutions. But I'm going to be honest with you: When it comes to making wrinkles disappear, the fastest fixes can be found at your dermatologist's office. There is no fast fix in a jar of cream at the drugstore (yet) that can make wrinkles disappear before your eyes. And anything done at the doctor's office - from a vast menu of injectable fillers and freezers to peels and lasers - will be expensive. But visiting a doctor is the only way we have right now to see real results short of plastic surgery (which is neither fast nor easy).
What do I mean by "real results"? I mean a difference you can clearly see when you look in the mirror. When cosmetic companies tout the results of their products, they're often talking about a change visible if you looked at your skin under a microscope. Who does that? A topical cream - even an expensive one - is not going to give you that "Wow, what a difference!" reaction when you check yourself out in the mirror. But getting an injection of Botox or a wrinkle filler will give you that result, if not right there on the spot, then a few days later.
First, though, let's talk about what the dermatologist can do for you. I'm a big fan of injectables, because I've seen the results on my own face. I think they're the best thing we have in our anti-aging arsenal. I've had Botox injections to smooth the furrows in my forehead and my crow's feet. I've had Restylane, CosmoPlast and CosmoDerm injections to fill smile and marionette lines, and I know they can work wonders.
I personally haven't done much with lasers. I had a couple of sessions with the Fraxel laser that did result in some improvements in my skin texture and tone, but I didn't have the patience to complete the six-session series. So for me, the jury is still out on whether laser treatments are worth the price and the pain.
Yes, pain. It hurts to be beautiful! You have to tell yourself things like that, because if you have a low threshold for pain, you will find that these injections and lasers kill. And the redness and inflammation that occur afterward are not to be minimized. Drug companies advertise these minimally invasive procedures as "lunchtime" treatments, but don't think for a second that they are easy, breezy no-big-deals. Let's just say that it's best not to make plans afterward. Better to schedule your appointment after work or on a day off so you can go home and recover. Even if you have just a few minor red spots and needle pricks, who wants to go back to the office looking like that? In her book "Beauty Junkies," Alex Kuczynski offers a cautionary tale of her own Restylane injections gone terribly wrong - at the hands of a topnotch doctor she trusted. You never know how your skin will react to a particular procedure, even if it's not the first time around.
So if you can deal with the pain and the expense, these nonsurgical solutions are your best option for getting rid of a shopping list of aging woes: wrinkles, brown spots, sagging skin and more. Smart shoppers should know that the list of options at the dermatologist's office keeps changing. New fillers are being approved by the Food and Drug Administration (FDA) every year, and new lasers and other skin-enhancing gizmos are relentlessly touted as the Next Big Thing. Just FYI, doctors tend to be partial to one solution over another. So one might suggest filling your marionette lines with one filler, another might suggest something different, a third might suggest a combination of the two (called layering), and a fourth might tell you that you need a filler plus a laser to see any significant improvement. That's why the cosmetic dermatological mountain is such a slippery slope for consumers to navigate - there is no clear path in sight. When I asked celebrity dermatologist Patricia Wexler about going in one direction versus another, she told me, "There are many ways to get downtown." (She admits that she's not the first doctor to use that expression!) If a doctor suggests the same laser as the answer to a variety of your problems, be wary. It may be the only laser in his office. "The worst thing you can do is to use inappropriate technology," warns Dr. Neil Sadick, whose Sadick Dermatology Center in New York is a showcase for state-of-the-art treatment. "When someone turns their laser on you for the wrong reason, that can lead to poor results," he says. Before undergoing any treatment, he suggests you do your homework, going as far as to check your doctor's credentials with respected groups such as the American Society of Laser Medicine Surgery (aslms.org) and the American Academy of Cosmetic Surgery (cosmeticsurgery.org). You can't be too careful; this is your face.
Because next-generation technologies are always in development, you're bound to encounter new options once you're in the doctor's office. "Every month there's something new," confirms my friend and dermatologist Gervaise Gerstner. Unless you have a subscription to the Journal of the American Academy of Dermatology, it's almost impossible to keep up on all this. But ultimately it's your call whether you allow something to be injected into your face. Don't hesitate to ask your doctor for more information so that you can do some research before you commit. I know that it's hard to say no once you're sitting in the office, but you have to have the guts to do just that if your doctor is suggesting something that makes you nervous. I'm reminded of the time I once went to interview a plastic surgeon who said, "I have half a syringe of Botox left over from another patient. Want some? It's free!" I know he was trying to be nice, but I wasn't prepared to have Botox yet - free or otherwise - so I said, "No, thanks." Remember, you can always exercise your option of getting up and walking out.
So if you can deal with the pain and the expense, these nonsurgical solutions are your best option for getting rid of a shopping list of aging woes: wrinkles, brown spots, sagging skin and more. Smart shoppers should know that the list of options at the dermatologist's office keeps changing. New fillers are being approved by the Food and Drug Administration (FDA) every year, and new lasers and other skin-enhancing gizmos are relentlessly touted as the Next Big Thing. Just FYI, doctors tend to be partial to one solution over another. So one might suggest filling your marionette lines with one filler, another might suggest something different, a third might suggest a combination of the two (called layering), and a fourth might tell you that you need a filler plus a laser to see any significant improvement. That's why the cosmetic dermatological mountain is such a slippery slope for consumers to navigate - there is no clear path in sight. When I asked celebrity dermatologist Patricia Wexler about going in one direction versus another, she told me, "There are many ways to get downtown." (She admits that she's not the first doctor to use that expression!) If a doctor suggests the same laser as the answer to a variety of your problems, be wary. It may be the only laser in his office. "The worst thing you can do is to use inappropriate technology," warns Dr. Neil Sadick, whose Sadick Dermatology Center in New York is a showcase for state-of-the-art treatment. "When someone turns their laser on you for the wrong reason, that can lead to poor results," he says. Before undergoing any treatment, he suggests you do your homework, going as far as to check your doctor's credentials with respected groups such as the American Society of Laser Medicine Surgery (aslms.org) and the American Academy of Cosmetic Surgery (cosmeticsurgery.org). You can't be too careful; this is your face.
Because next-generation technologies are always in development, you're bound to encounter new options once you're in the doctor's office. "Every month there's something new," confirms my friend and dermatologist Gervaise Gerstner. Unless you have a subscription to the Journal of the American Academy of Dermatology, it's almost impossible to keep up on all this. But ultimately it's your call whether you allow something to be injected into your face. Don't hesitate to ask your doctor for more information so that you can do some research before you commit. I know that it's hard to say no once you're sitting in the office, but you have to have the guts to do just that if your doctor is suggesting something that makes you nervous. I'm reminded of the time I once went to interview a plastic surgeon who said, "I have half a syringe of Botox left over from another patient. Want some? It's free!" I know he was trying to be nice, but I wasn't prepared to have Botox yet - free or otherwise - so I said, "No, thanks." Remember, you can always exercise your option of getting up and walking out.
Even Dr. Neil Sadick, who helps develop over-the-counter skin-care products for Dior, confirms that there are limits to the kind of dramatic results you can get with an over-the-counter cream or serum. "Are you talking about erasing deep wrinkles? Absolutely not," he says. "Are you talking about smoothing fine wrinkles and slowing down the wrinkling process? Absolutely yes. Hydrating the skin, stimulating new collagen and decreasing redness are realistic goals." Women spend an estimated $470 million a year on anti-aging products, but simply spending more isn't necessar-ily going to buy you any better ammunition for your battle against wrinkles. According to Consumer Reports' Shop Smart magazine, which tested nine wrinkle creams at various price points, some of the most effective (Olay) were drugstore brands, while some of the least effective (La Prairie) cost hundreds of dollars.
The role of at-home products is maintenance. Whether or not you choose to see a dermatolo-gist, getting religious about daily skin care is essential. "You need to have a program," advises Sadick, who thinks that you can keep it simple. "If you want to have healthy skin, protect it with a high-dose antioxidant and a sunblock every morning. At night, turn over your skin. I truly believe you can turn back the clock at least a decade on wrinkles at night." Here's a five-step program.
- CLEANSE Keeping your skin clean - free of dirt, bacteria and makeup - will go a long way toward keeping it looking fresh. Choose a gentle cleanser that won't strip your skin (your face shouldn't feel tight after you wash it). I like Patricia Wexler M.D. Universal Anti-Aging Cleanser. In fact, I love her entire skin-care line. My other Brilliant Buys include Clarins Cleansing Milk with Alpine Herbs, because it's so soft and creamy it almost makes you want to wash your face before you hit the pillow, and Philosophy Purity Made Simple, which removes eye makeup at the same time. Cetaphil Gentle Skin Cleanser is always a winner. Shown here: Philosophy Purity Made Simple face wash, $20 at Sephora
- EXFOLIATE As we get older, our skin cells don't turn over as rapidly as they once did, resulting in a rough, uneven or blotchy texture. To speed up cell turnover and help reveal fresher-looking skin, you need to give those cells a nudge. One of the first (and still best) at-home microdermabrasion kits is the L'Oreal Paris Advanced RevitaLift Micro-Dermabrasion Kit, which you can use a few times a week. If you prefer not to scrub, you can use Patricia Wexler M.D. Dermatology Exfoliating Glyco Peel System daily, unless your skin is super-sensitive. For a heated masklike treat, I like Olay Regenerist Thermal Skin Polisher. This unique product is a scrub with glycolic acid that warms up on your face and is gentle enough to use daily. Shown here: Estee Lauder Idealist Micro-D Deep Thermal Refinisher, $46 at Saks
- RESTORE A dizzying number of antioxidants seem to take turns on the hot list, each promising to reverse the damage already done and to perform other skin-saving miracles. Every morning, slap on a serum, a rich cocktail delivering potent doses of skin-fixing vitamins. You want an antioxidant-rich product, such as Elizabeth Arden Prevage Anti-Aging Treatment. Studies have shown that antioxidants can help boost skin's defenses against damaging free radicals. I am crazy about Patricia Wexler M.D. Dermatology MMPi Skin Regenerating Serum, which looks like pink Vaseline and feels like cashmere on your cheeks. At night, nothing has been proven to restore your skin like prescription Retin-A, aka Renova. It has withstood the test of time (as well as clinical testing) and consistently works to improve skin tone and texture and even helps build collagen. You can get drugstore products that contain retinol, but they aren't as potent as the prescription version. You can't use Retin-A every night (every other night is suggested), so switch off with a cream that will really make a difference in the morning. My favorites include Clinique Turnaround Concentrate Visible Skin Renewer, Elizabeth Arden Prevage Anti-Aging Treatment, Guerlain Orchidee Imperiale Cream, and Patricia Wexler M.D. Dermatology Intensive Night Reversal and Repair Cream. Shown here: Kiehl's Powerful-Strength Line-Reducing Concentrate, $55 at www.kiehls.com
- MOISTURIZE When skin is dry, even fine lines start to look like wrinkles etched deep into the skin - a very OL look for sure. By adding moisture to your skin, you can temporarily plump it up, making it look dewier and more youthful. Moisturizers that cost a mint, such as celebrity favorite La Mer Creme de la Mer, Shiseido Future Solution, and Guerlain Orchidee Imperiale Cream, are wonderfully luxurious, but you also can get good results from less pricey products. When-ever someone complains about the high price of skin care, I tell them to buy Olay Definity Deep Penetrating Foaming Moisturizer. I love its mousse-like texture. If you don't want to slap on yet another product, make sure your daily moisturizer multitasks as a sunscreen. At the drugstore, Dr. Gerstner recommends Olay Complete Defense Daily UV Moisturizer SPF 30. If you're near a Bath & Body Works, check out Patricia Wexler M.D. Dermatology Universal Anti-Aging Moisturizer or Skin Brightening Daily Moisturizer, both SPF 30. Shown here: Shiseido Bio-Performance Advanced Super Revitalizer Cream, $88 at Macy's
- PROTECT If your moisturizer doesn't include a sunscreen, add one more product to your routine. Sunscreen (at least SPF 15 every day) is essential not only for preventing skin cancer but also for defending against the UV damage that leads to signs of aging. If you're going on vacation and plan to play a lot of tennis, golf or water sports, splurge on La Roche-Posay Anthelios SX Daily Moisturizing Cream with Mexoryl SX SPF 15 (it goes up to SPF 60). What is Mexoryl? It provides peak efficacy, blocking short UVA rays as well as UVB rays. And if you decide to have a peel, microdermabrasion or laser resurfacing to get rid of brown spots, stay out of the sun or slather on even more sunscreen. Without protection, those dark patches you paid good money to eradicate are going to come right back. "Your skin is smart, and it remembers them," says Gerstner. "After 15 minutes in the sun without protection, those spots will reappear." Shown here: La Roche-Posay Anthelios SX Daily Moisturizing Cream with Mexoryl SX SPF 15, $29 at www.anthelios.com or CVS
From the book "How Not to Look Old: Fast and Effortless Ways to Look 10 Years Younger, 10 Pounds Lighter, 10 Times Better," by Charla Krupp. Copyright © 2008 by Charla Krupp and the Stonesong Press, LLC. Reprinted by permission of Grand Central Publishing, New York, NY. All rights reserved.