Aging Skin Doesn't Have to Be Wrinkled

One cream that really works: a good sunscreen.

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While birthday cakes may gain a candle every year, the appearance of dreaded crow's feet and creases, luckily, isn't so inexorable. To some extent, simple steps can prevent wrinkles from forming. And even when those time-wrought lines start to appear, it's in our power to contain the damage.

By far, the most fundamental component of wrinkle prevention is sun protection, since sun exposure, compounded by other environmental insults, accounts for the vast majority of wrinkles. The rest are caused by uncontrollable factors such as genes and years of repetitive muscle movements, says David J. Leffell, a professor of dermatology and surgery at the Yale School of Medicine and author of Total Skin.

While prevention of sun damage ideally begins in childhood, it's never too late to start safeguarding skin, to retard further harm, he says. With time, rays break down collagen and elastin tissue, which keep skin supple and pliant. While the body can replenish some of what's lost, its repair mechanisms do falter over time. "By the late teens, early 20s, if you aren't careful, you're going to have damage outstripping any repair that the body can do," says Leffell.

Sun care is simple: Use sunscreen or a sun-protective moisturizer year-round—even in winter, he says. A minimum of SPF 30 is ideal, as is a product that contains zinc oxide or Parsol 1789, which protect against UVA radiation. (SPF reflects only UVB protection.)

Other dermatologists also recommend topical antioxidants, like vitamins C and E, thought to neutralize damage to DNA triggered by the UVA rays. Studies of such skin products have won over Arielle Kauvar, a New York-based dermatologist, though she cautions that certain agents, like vitamin C, have to be formulated in a very specific way—i.e., sealed in a light-tight container—to work. Leffell, however, isn't convinced that the evidence supports antioxidant topicals.

Evidence does support another kind of topical—prescription creams containing retinoic acid, more commonly called tretinoin, which can actually rejuvenate skin, as University of Michigan researchers reported in the Archives of Dermatology last May. Retinoic acid works by gradually stimulating fresh collagen production, which helps stave off or reverse fine lines, says Leffell. "There's no point at which you lose a benefit from starting [its] application," says Kauvar, who frequently prescribes retinoic acid to patients in their 50s and 60s, just as she pre-emptively does for the younger set. Just one potential wrinkle: If used during pregnancy, it may cause birth defects.