Look Amazing in Your Own Skin

Skincare options for aging youthfully

Your face is marked with lines of life, put there by love and laughter, suffering and tears. It’s beautiful.

Lynsay Sands

Just like with everything else, anti-aging skincare and any rejuvenation treatments should focus primarily on health, with “looks” being the secondary purpose. Aging is a natural occurrence, and there is beauty in it. However, society can put pressure on us to pay extra attention to wrinkles and other imperfections that are normal as we age. Lucky for us, there is a plethora of over the counter and professional help to assist us in rejuvenating ourselves inside and out.

The Normal Aging Process

Once again, let’s ask: what are the normal effects of the aging process on our appearance? And, more importantly, what are the factors that contribute to skin health?

Skin is one of the largest organs of our body (accounting for 15% of our body weight and covering about 20 square feet!) and its health is affected by intrinsic and extrinsic factors. Intrinsic factors include DNA, buildup of damaging products of cellular metabolism, and increasing biological aging of the cells. Extrinsic factors are environmental and behavioral elements such as exposure to sun and UV radiation, hydration, nutrition, stress, lack of sleep, and exposure to toxins in tobacco and alcohol.

Normal aging effects are diminished skin elasticity (collagen loss) and hydration (loss of hyaluronic acid), thinning of the epidermis (surface layer of the skin), increased bruising potential and sagging (due to fatty tissue loss under the skin and thinning of the blood vessel walls), dry skin (less hyaluronic content and sebum production), and of course wrinkles.

How to Fight the Aging Process

In our previous article, The search for the Fountain of Youth begins at home, we discussed at-home care and daily habits to help us age well. But when should we start a skincare routine? According to specialists, a healthy routine should start as early as childhood. This doesn’t mean applying cosmetics or doing anything extreme, but simply building good habits that protect our skin from damage.

As we age, we can help our outer appearance look healthier through skincare products and daily routines; aesthetic medicine such as injectables (fillers; mesotherapy), laser treatment, chemical peels, or cryogenics (cool sculpting); plastic surgery; or osteoaesthetics (focused on improving the inner body function which translates outwardly on improved appearance). Let’s examine each option and hear from local Knoxville area experts on how they can help.


A good basic skincare routine is the best starting point. During childhood, the focus should be on hygiene, hydration, and damage protection—use a gentle cleanser, moisturizer, and sunscreen. As puberty hits, so do pimples, most likely. Adjust the cleanser and add spot treatments with salicylic acid. In our 20s we should up our regime to include anti-aging products such as antioxidant serums and creams. Start adding retinol and retinoid products into the skincare routine in our 30s and 40s, which along with antioxidants, will fight off fine lines and wrinkles. Be aware to use retinoid products carefully and as a part of your nightly routine, as they increase skin’s sensitivity to sunlight, thus making it more vulnerable for sun damage.

For mature skin, address the loss of collagen and hyaluronic acid, as well as skin damage. This is when we bring our A game. It’s important to understand what aging effect we want to target so we choose the right products and not get lost in the myriad of options touting miracle cures (spoiler alert: there are none).

Before choosing a skincare regimen, it’s important to understand your skin type and specific skin health issues you might have, so it’s wise to consult a dermatologist. Dr. Meredith T. Overholt, MD, FAAD, board-certified dermatologist and founding partner of The Skin Wellness Center cautioned against following self-made social media skincare experts, pointing out that, although well-meaning, the social media advisors usually don’t have the proper expertise.

“The biggest thing to keep in mind is that topical things work very well on the epidermis, the outer layer of the skin, on some disorders of pigmentation, and certain fine lines and wrinkles. The goal of topical therapy ought to be to address those things. When you see a topical product that’s claiming to help with deep lines and wrinkles, you’re probably going to end up disappointed,” Dr. Overholt concluded.

She pointed out that skincare is a very personal matter and should take into consideration specific factors which vary from person to person—there is not a “one-size-fits-all” solution. Dr. Overholt added: “Our practice has been looking at people’s skin for many years, addressing medical issues as well as cosmetic ones. Skincare is personal and customizable care. What we ultimately recommend is based on the level of involvement people want and a doctor’s opinion.”

Certain skin tones and genetics are more prone to certain skin conditions than others. In addition, many of the off-the-shelf skincare products are less potent than medical grade ones offered by dermatologists or skin care specialists. “You can go to the store and buy something that has retinol or hyaluronic acid but the problem with non-physician dispensed product lines is that they don’t have the same FDA scrutiny on consistency of ingredient percentages,” explained Dr. Gallaher, board-certified plastic surgeon and founder of Gallaher Plastic Surgery & Spa. “When you work with a specialist, it’s almost like having a personal trainer for working out: you get customized expert guidance.”

A good routine will include a hydrating cleanser, exfoliator (scrub), toner, serum, moisturizer, sunscreen, and face mask; it incorporates vitamin C (antioxidant), vitamin A/retinol (fights hyperpigmentation, dark spots, wrinkles, and increases collagen), antioxidants (help with hyperpigmentation and wrinkles), niacin (helps balance sebum production, improves water retention, and skin elasticity), hydroxy acids (increase cell turnover and stimulate new skin cell  growth), and hyaluronic acid (hydrates the skin and boosts hyaluronic acid production).

Aesthetic Medicine

Aesthetic Medicine refers to medical procedures aimed at improving physical appearance using non-invasive to minimally invasive cosmetic procedures. The most common cosmetic procedures for aging skin are: photorejuvenation, injections of Botulinum toxin (Botox), injection of dermal fillers, mesotherapy injections (injections of pharmaceutical preparations, enzymes, hormones, plant extracts, vitamins, and/or other ingredients such as hyaluronic acid), chemical peels, microdermabrasion, microneedling, laser treatments, and cool sculpting (cryolipolysis). Let’s talk briefly about each one.

Photorejuvenation uses Intense Pulsed Light (IPL) technology to reduce the appearance of common skin concerns, such as sunspots, age spots, melasma, broken capillaries, and wrinkles. This minimally invasive procedure requires little recovery time and has few side effects.

Injections vary in substance contained and effect duration. The most common derma fillers for injectables are: hyaluronic acid (HA), Calcium hydroxylapatite (CaHA), Poly-L-lactic acid, Polymethylmethacrylate (PMMA), and autologous fat injections. Except for PMMA, they are naturally occurring substances. HA injections plump and hydrate the skin for 6 to 18 months. CaHA injectables stimulate natural collage production, with effects lasting longer than HA (about 12 months), for deeper lines and wrinkles. Poly-L-lactic acid is as a collaged stimulator which can smooth deeper facial wrinkles for more than 2 years. A combination of collagen and a synthetic yet biocompatible substance, PMMA provides continuous skin support and firmness. Autologous fat injections put our own fat to good use: fat gets harvested via liposuction, purified, then injected in areas such as cheeks and lower lids to provide a more youthful look.

What are some things to consider before choosing any aesthetic medicine procedures? Do your research: know what is FDA-approved, understand the side effects, and find a qualified provider. “There is no right or wrong. When it comes to making a treatment decision, it depends not only on a person’s particular skin issues but also on their budget, pain tolerance, and downtime available for recovery,” said Dr. Overholt. She also noted that skin health should be the main reason for any procedure, which has been historically where dermatologists came in.

Plastic surgery

For me, any type of surgery is my last resort go-to. I asked Dr. Gallaher when one should consider plastic surgery as opposed to other aesthetic medicine solutions. His advice is to evaluate together with your healthcare specialist when noninvasive procedures do not meet your goals and don’t make a significant long-term impact. There are certain common aging effects that are best addressed with surgery, such as really saggy neck skin, hooded eyelids, significant puffiness of the lower eyelids, or heavy jowls. “We can tighten skin with other techniques but there really is no substitute for the traditional lift, which has been around for over 100 years with great success,” concluded Dr. Gallaher.

Bottom Line

“We live in a time where the ability and choices in aesthetic care are greater than they ever have been before,” shared Dr. Gallaher. “However, in my opinion, the individual seeking these treatments should be driven by their own goals and not by external factors or peer pressure. From sunscreen and moisturizers to advanced physician dispensed skincare, to neurotoxins and fillers to laser treatments to surgical procedures, the patient should be educated and given choices that allow them to be driven only by their desire to look and feel more youthful and heathier. In other words, these treatments are at their best when the patient has them as a gift to themselves,” concluded Dr. Gallaher.

Wrinkles mean you laughed, grey hair means you cared, and scars mean you lived.

Osteopathic esthetics

Osteoaesthetics combines principles of osteopathy and aesthetics, and is directed towards improving the inner body function, which as a result improves appearance.

Dr. Debra Durst, MD and owner of Revitalyze MD offers a comprehensive approach to aging and wellness, understanding that in order to be effective and sustainable, any procedure that impacts the outward appearance must have a solid backing at cellular and psychological level. “Regenerative aesthetics is the cornerstone of what we do and what sets us apart,” shared Dr. Durst. “We approach aging as a part of overall wellness and create cellular level support for sustained results.”

Dr. Durst highlighted several efficient anti-aging treatments:

Microneedling: A combination of procedures will generally yield the best results. For example, adding radiofrequency or PRP to microneedling: microneedling creates channels through the tissue, allowing radiofrequency or PRP to travel deeper into the tissue to produce collagen elastin and repair cells.

Biofillers: “You can have fillers like Botox injections, but they don’t stimulate collagen production.” Biofillers (Radiesse and Sculptra) provide short-term plumping effect while also stimulating the body’s production of collagen for longer-lasting fullness and lift.

Lasers: Lasers skin resurfacing is one of the most advanced skin rejuvenation techniques. It’s effective for skin pigmentation, facial contouring, baggy eye reduction, and even hair regrowth.

IV Therapy: “There are two key ingredients we use in our IVs: glutathione—a master antioxidant that helps with cellular detox, and NAD—a naturally occurring substance providing mitochondrial support to help with brain fog, energy levels, cravings, and youthfulness.” IV therapy is also a great way to introduce necessary nutrients directly into the body, bypassing the digestive system for better absorption.

PRP and PRF: “We draw your own blood to isolate growth cells and inject them back into the body to stimulate cellular healing.” PRP is a first-generation procedure, while PRF is a more advanced procedure. PRF gels can be injected to produce a clot which will keeps the platelets in place for up to three weeks to release the growth factor slowly for better results.

PDO threads: “This is a great non-surgical lifting procedure for areas around your cheeks, jaw, neck, and eyes.” The procedure uses dissolvable sutures which trigger cells called fibroblasts to produce more collagen, which rejuvenate and lift sagging skin.

Article first published in Cityview Magazine Sept/Oct 2023

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