Navigating the world of cosmetic dermatology for the fist time is kind of like driving in a new city without a GPS: you’re likely lost, will take a few detours, and will hit a few bumps along the way.
As far as anti-aging treatments and ingredients go, new technology and formulations are developed at a dizzying rate. While getting older is a privilege, it’s also completely understandable if you’re curious about what ingredients and in-office treatments can help minimize visible signs of aging such as fine lines, wrinkles, loss of elasticity, and uneven texture.
Can collagen supplements improve skin? Should you get Botox or Juvaderm? Get all the answered about the buzziest anti-aging terms, ahead.
“Alpha hydroxy acids (AHA) are water-soluble acids derived from fruits and are used primarily to exfoliate, but they also promote blood flow, correct discoloration, brighten the complexion, prevent acne breakouts, and increase absorption of other products. They weaken the bonds between skin cells, which make them slough away more easily. As with most skincare products, continued use is necessary to maintain results since the skin cycle turns over every two to three weeks. Side effects are mild with AHAs, especially if glycolic or lactic acid are chosen since these two are among the more hydrating AHAs. Results can be maintained with regular application, but be careful, particularly if using an AHA in conjunction with a retinol. I recommend starting one at a time and staggering the introduction of the other since both products can cause mild peeling and irritation when first introduced.” – Dr. Corey L. Hartman, founder of Skin Wellness Dermatology in Birmingham, AL
“Botox is the most popular form of neuromodulator on the market. Neuromodulators work by decreasing the amplitude of muscle expression. This leads to an almost immediate improvement in fine lines and wrinkles, as well as a delay in the appearance of new fine lines and wrinkles. The immediate results of neurotoxin last for approximately three months in the average patient. But having the procedure done once a year still delays the appearance of fine lines and wrinkles, however there is cumulative benefit in having it performed routinely.” – Dr. Elyse Love, New York City-based board-certified dermatologist
“Radiesse [brand name] is considered a biostimulator because it stimulates your body’s own collagen production and is used on and off the face for deeper volume replacement as opposed to fine line reduction. It is made of material found in our bones called Calcium Hydroxyapatite, and has a firm consistency. It is best used for areas that need definition, lifting and volume such as the chin, jawline, checkbones, temples, and it was the first product FDA approved to be used for hand rejuvenation. It gives immediate results after being injected and lasts for 12-18 months. If there is a complication with Radiesse or the results are less than expected, sodium thiosulfate can be injected to reverse the effects of Radiesse (not all dermatology or plastic surgery offices routinely stock this, though).” – Dr. Shari Marchbein, New York City-based board-certified dermatologist
“A chemical peel uses chemical agents to resurface the skin by inducing a controlled wound and removing a specific layer of the skin, whether that’s superficial, medium or deep. As a result, the peel promotes growth of a healthy, fresh, new top layer of skin, helps the appearance of different types of pigmentary conditions, treats acne, and improves the appearance of pores, texture, fine lines, wrinkles and more. Depending on the the type of peel and the strength of your peel, peeling and ‘downtime’ can vary. Skin post-peel can also determine how much and how long your peeling lasts. Immediately after the peel, your skin will likely feel tight, it might be a little red, and any visible peeling will be fluffy or light, typically lasting around five days. Using a gentle cleanser, moisturizer, and sunscreen is going to enhance the healing process and the results as well as decrease the downtime.” – Dr. Melissa Kanchanapoomi Levin, board-certified dermatologist and founder of Entière Dermatology
“Collagen is the main structural protein that forms the connective tissue throughout our body, from skin to bones, muscles, tendons and ligaments. After age 25, our bodies start producing less collagen, at a rate of about 1% less per year in the skin. By the time we’re 50, there is almost no new collagen being made and the collagen that remains becomes broken down, fragmented, and weaker which, makes more fragile skin, wrinkles and sagging. Extrinsic aging, such as that resulting from smoking, diet, and sun exposure, can also lead to loss of collagen and elastin, uneven skin pigmentation, and in a worst case scenario, skin cancers.
“Although there are a few studies that support the idea that certain collagen supplements can increase skin elasticity, hydration, and dermal collagen density, there are many more studies that debunk these findings and have basically shown that the collagen we consume is broken down in the stomach and that the amino acids never makes it to the skin in high enough concentrations to have a clinical effect. That being said, there are peptide creams and serums that have very good evidence for stimulating collagen and elastin in the skin and improving skin firmness, tone and laxity, and retinoids topically help stimulate collagen. In office, there are multiple options, including laser resurfacing, fillers, microneedling and radiofrequency amongst others, and the best results often come from utilizing a combination of modalities.” – Dr. Shari Marchbein, New York City-based board-certified dermatologist
“Also known as CoolSculpting, this treatment freezes the fat and as the fat is frozen it causes the cells in the fat layer to die. Over several weeks, the fat cells die so you are losing your fat. Benefits are modest but the results are long lasting. Some patients can experience an increase in fat, which is quite common, and has been documented in medical literature as a side effect of CoolSculpting. The only way to remove this additional fat called paradoxical adipose hyperplasia (PAH) is with liposuction, which is surgical.” – Dr. Bruce Katz, founder of JUVA Skin and Laser Center in New York City
“Magnetic fields are used to cause the muscles to contract at rapid rates much faster that you can do while exercising – it’s about 20,000 repetitions in 30 minutes. Because the muscles are contracted so quickly, they need an energy source, so they break down the adjacent fat while also improving the muscle. This is one of the most effective non-invasive treatments at reducing fat and building muscle. [I typically recommend] two treatments a week for two weeks. Results will last over a year, and there are no side effects.” – Dr. Bruce Katz
“This treatment uses magnetic fields, however it also adds radio frequency, which helps muscles to be more efficient at contracting. It builds more muscle and removes more fat. It’s about 30% more fat removal and builds 25% more muscle compared to the original EmSculpt. It requires two weekly treatments and results last for a year or longer. There have never been any side effects.” – Dr. Bruce Katz
“Fractional lasers can be ablative or non-ablative. Non-ablative fractional laser includes Fraxel, while ablative fractional lasers include some CO2 lasers and erbium lasers. Halo laser combines both ablative and non-ablative fractional devices. Fractional lasers provide improvement in fine to medium wrinkles, sun spots, and skin texture. Ablative lasers provide improvement in deep wrinkles and scarring. Both should be used selectively and by experts in patients of color. The results are long-lasting, but most people will have one non-ablative fraxel performed a year. Ablative procedures are performed less often, in general, due to longer downtime.” – Dr. Elyse Love
“Hyaluronic acid fillers work by replacing lost volume to restore a more youthful appearance. This versatile ingredient is available on various products across brands to address central facial sagging, gauntness in the periphery of the face, fine lines and wrinkles, creases and folds and to provide an overall lift to overcome the forces of gravity and genetics. Deeper fillers like Juvederm Voluma, and Restylane Lyft provide the foundation for the lift, mimicking bone and giving structure. Juvederm Volbella shines for perioral rhytides and Restylane Kysse provides contour and volume restoration in the body of the lip. Restylane Defyne gives definition and balance to the chin, jawline and profile. HA fillers can be easily dissolved and removed with injection of an enzyme called hyaluronidase, so a patient is never truly married to the product if the results aren’t as expected.” – Dr. Corey L. Hartman
“IPL is a broad-based light device that targets redness – from rosacea or sun exposure – and sun spots of the skin. It can be used to treat the face and the body, but it should be used with high hesitancy in skin of color due to increased risk of burns and hyperpigmentation. It can also flare melasma, so I would avoid in that demographic. The results of IPL are long lasting, although most people will develop additional redness and/or sun spots with time.” – Dr. Elyse Love
“Kybella is on label for the treatment of submental chin fullness (double chin). It is an injectable treatment that works to permanently break down the fat in the area. After treatment, the fat is permanently destroyed.” – Dr. Elyse Love
“I pioneered laser lipolysis and was the first in the country to do it. The treatment requires local anesthesia and the laser fiber is inserted under skin to melt the fat and tighten the skin. The only side effect is bruising and swelling, and the results are permanent.” – Dr. Bruce Katz
“Microneedling is the creation of small micro-channels and injuries to the skin with acupuncture sized needles down to various depths depending on how deep the needles are set at. By creating these micro-injuries to the skin, the body will respond naturally by stimulating and producing collagen which can treat fine lines and wrinkles, enlarged pores, stretch marks, acne scars, and textural concerns. In-office microneedling procedures performed by dermatologists use sterile needles that puncture deep enough in order to cause bleeding in order to deliver consistent and effective results. Collagen stimulation and improvement of the skin texture occurs over one to three months. Microneedling is not for every skin type or concern. If you’re dealing with an inflammatory condition such as psoriasis or eczema, actively tanned, sun burned, have a skin infection such as cold sores, microneedling should not be performed.” – Dr. Melissa Kanchanapoomi Levin
“Niacinamide, also known as nicotinamide, is a form of vitamin B3, and like other B vitamins is water-soluble. It has multiple benefits for the skin including helping to support the skin barrier to prevent moisture loss, evening out skin tone, calming inflammation and providing antioxidant benefits. It is considered gentle on the skin and as such can be used in all skin types. While you may see some changes after several weeks, in general it can take up to eight to 12 weeks for the results to fully kick in, so make sure to be patient.” – Dr. Marisa Garshick, New York City-based board-certified dermatologist
“Sculptra, on the other hand, works differently than other filler options. Formulated with poly-l-lactic acid, Sculptra stimulates your body’s own natural collagen production. The result is a very natural and soft appearing increase in volume which develops over a period of months with repeated treatments. It is not immediate, so patients need to be aware that a foundation is being laid down which then increases collagen formation starting at around six weeks after the first treatment session and it is recommended to have a series of sessions over time. Sculptra needs to be reconstituted prior to injection and it is used for adding volume globally to the face, and off-label to areas such as the neck, chest and buttock. Sculptra lasts close to two years with a touch up recommended around one year. Sculptra can not be reversed.” – Dr. Shari Marchbein
“QWO is the first FDA-approved injectable for cellulite that removes moderate to severe cellulite in the buttocks of adult women. It is an in-office procedure; the injections work to dissolve the buildup of collagen in the fibrous bands, which are the bands underneath the skin that thicken and cause the ‘dimpled’ look of cellulite. To see results, patients need three sessions. After those sessions, results can be seen quickly, usually within three to six weeks. I was part of the clinical trials for QWO, and so far patients have seen results lasting two and a half years.” – Dr. Bruce Katz
“This treatment uses radio frequency to melt the fat. An electric current is applied to the skin and transmits an electrical current to fat level. It also tightens the skin. There is a modest benefit at best. Patients will see a little bit of fat removal, and there are no side effects.” – Dr. Bruce Katz
“Retinoids work by prompting surface skin cells to turn over and die rapidly, making way for new cell growth underneath. They hamper the breakdown of collagen, thicken the deeper layer of skin where wrinkles get their start, and stimulate production of collagen and elastin. Instead of permanent results, retinol resets the starting point with continual use affecting how quickly the [aging] process occurs. Retinols work best as prevention, so don’t wait until wrinkles and dark spots occur to start using it. Another misconception about retinols is that they thin the skin – this could not be farther from the truth. It actually thickens your skin by increasing production of glycosaminoglycans to keep the skin firm, taut, and smooth.” – Dr. Corey L. Hartman
This is the Glow Up, an examination of the most popular cosmetic procedures and products today, using survey data straight from readers like you.