Dan's Papers - June 29, 2007

Babies have great skin. It's soft, flexible, elastic, moist and smooth. This fact begs two questions - Why do we lose that luster, elasticity and smoothness as we age? And, how can we slow or prevent this upsetting process?

Let's start at the surface. The outermost layer of epidermis, the Stratum Corneum, consists of dead skin cells filled with a tough fibrous protein called Keratin. Dead skin cells are not pretty. They're flaky, rough and dry. Babies desquamate (lose and replace this layer) about every seven to ten days. At age 40 we hang on to dead skin cells for up to 60 days!

Not only do surface cells keep moisturizers and topical treatments from being absorbed, but they also block our pores and keep destructive oxidizing chemicals and bacterial waste trapped inside.

Therefore, step one of any logical skincare program is exfoliation. My pick is Vibradermabrasion(R) which uses vibrating paddles that gently lift away dead cells while stimulating collagen formation. Exfoliation performed by a licensed aesthetician every month will clear the pores and open the channels for moisturizers and cosmeceuticals to work their magic.

Beneath the epidermis is the backbone of skin structure, the Dermis, which is a matrix or "woven cloth" of collagen fibers and fibroblasts. Fibroblasts produce fresh collagen. Young skin is remarkable for its thick, luxurious collagen content. Old skin is thin and brittle, and the once tightly coiled, supple collagen has essentially collapsed. This is why step two of a skin care regimen should be designed to protect the Dermis.

Were your only exposure to the sun ten minutes a day twixt apartment and taxi, you'd be effectively "sunning" an hour a week - 52 hours a year...and the damage is cumulative. Every day should be an SPF 30 to 45 sunscreen day.

Pollution is unavoidable. Until we switch to electric cars, nuclear energy and start cleaning up toxic waste dating back to the Industrial Revolution, we must gently cleanse our skin twice a day and moisturize, moisturize, moisturize.

Finally, very few of us include adequate supplementary anti-oxidants, Omega Oils and fresh fruit and vegetables in our diet. Change your diet or age poorly...you decide.

Step three should consist of rebuilding the dermal layer, the work of trained physicians armed with the latest laser technology. Again, I hold a strong personal preference...I like Cutera(R) Lasers. A series of Genesis(TM) Laser Treatments stimulates the fibroblasts and thickens the dermis. It fills in shallow furrows such as smokers' lines, surface acne scars, large pores and the like. The effects border on amazing and, followed by occasional touch-ups, Genesis can keep your skin smooth and lustrous for years.

TITAN(TM) lasers, on the other hand, treat sagging skin on the face, tummy, thighs and buttocks. They heat the fibroblasts, fooling them into responding to non-existent damage. When fibroblasts are actually damaged, they produce loads of collagen to repair the defect and that excess collagen production is exactly what TITAN(TM) provokes. I call TITAN(TM) the anti-gravity laser.

Underlying the epidermis and dermis are our facial muscles, and they seem to be in constant motion... squinting, frowning, raising our brows, smiling and a plethora of other natural expressive responses.

The "woven cloth" of the dermis becomes more brittle as we age - as if cashmere were becoming burlap - and our facial muscles are actively wrinkling that fragile cloth over and over, thousands of times a day. Regrettably, the most susceptible areas are also the most active - between the brows, the forehead and crow's feet.

Step four is properly applied BOTOX(R) to weaken the facial muscles. That's right, weaken, not paralyze. The worst enemy of "good" is "better," less is more, etc. Over-application of BOTOX(R), paralyzing your face into an expressionless mask, is simply unattractive.

Weakening the muscles, however, while preserving the attractive and essential quality of facial expression is a terrific way to extend your youthful, smooth appearance and possibly completely avoid ever forming passive wrinkles and deep furrows.

For questions regarding this article or suggestions for future articles please contact Dr. Eric Berger at info@bergermedical.com.