Our skin is the body’s largest organ, and keeping it healthy requires commitment, particularly when it comes to our faces. The reflection we see daily in the mirror is often the first to show the telltale signs of aging, sun damage, environmental factors, and lifestyle choices. Fine lines deepen. Moisture, volume, and elasticity diminish. Dark spots and circles begin to appear. Before long, we’re purchasing an arsenal of products and possibly spending thousands more on professional treatments to be comfortable in our own skin.
With so many products and procedures on the market, it’s easy to be overwhelmed and over budget. But most dermatologists agree that the ideal skin care regimen involves a simple at-home routine—morning and night—coupled with a program individually tailored to your needs and supervised by a qualified skin care professional.
“The products you use should be dependent upon your skin type and your lifestyle,” points out board-certified dermatologist and Mohs surgeon Dr. Anand Haryani, who owns and operates Iconic Dermatology and Cosmetic Surgery with his wife, Dr. Divya Haryani, also a board-certified dermatologist and Mohs surgeon. “Do you have oily skin? Dry skin? Are you acne prone? How often are you in the sun? In general, basic cleansers work very well, but if you want to add exfoliation to remove dead skin, I’d recommend upgrading to an acid-based wash containing glycolic acid, rather than using a beaded wash,” says Dr. Anand Haryani.
“Serums and moisturizers should be part of your daily routine,” he adds. “I recommend either a hyaluronic acid serum or vitamin C serum, depending on skin type. Moisturizers help to maintain the skin barrier, reducing inflammatory skin conditions, and are beneficial to those who have combination or dry skin.”
“Sunscreens are a must for everyone,” Haryani emphasizes. “Mineral-based sunscreens are preferred over chemical sunscreens for almost every patient we see. UV rays damage our DNA, resulting in damaged-looking skin. Preventing that damage is the number one thing you can do to maintain healthy skin.”
“Your morning skin care regimen should include cleansing, applying a vitamin C and/or hyaluronic acid serum, and moisturizing with an SPF 30 or above to protect your skin from the sun,” agrees Dr. Monika Srivastava, a board-certified dermatologist, Mohs surgeon, and owner of Select Skin MD. “Vitamin C is a powerful antioxidant that repels free radicals— unstable molecules that are produced in our bodies because of exposure to UV rays from the sun or toxins in the environment,” she explains. “Free radicals are a leading cause of hyperpigmentation, fine lines, and wrinkles. Vitamin C not only helps counteract that damage, but it also helps stimulate the production of collagen—the protein that helps support your skin, bones, muscles, joints, and connective tissue.”
For nighttime, Srivastava recommends using an exfoliative cleanser with glycolic acid, patting the skin dry, and applying a pea-size amount of prescription Retin-A or over-the-counter retinol before smoothing on a thick night cream.
While both physicians agree that retinol is a phenomenal product for increasing the skin’s turn-over rate and slowing the breakdown of collagen, it can also take some getting used to.
“Originally developed to combat acne, retinol can cause flakiness or retinoid dermatitis in some people,” says Srivastava, “so it’s best to start using it one night a week and build up slowly before making it part of your nightly routine.” Be sure to use it only at bed-time, she cautions, because it can make your skin more sensitive to the sun.
Beyond your at-home routine, what else is worth adding to your skin maintenance program?
“Facials, which can be targeted to certain skin types, are a great way to get your skin the professional help it needs,” says Haryani, adding that the general recommendation is every four weeks.
“Skin cells turn over every 28 to 40 days,” points out Srivastava, “so if you’re getting a facial at more frequent intervals, you’re interfering with this natural process.”
What about Botox, fillers, and laser treatments? At what age should we begin to consider those? How often can they be safely and effectively repeated?
“These are all things that are not medically necessary and depend upon your goals,” observes Srivastava. “Wrinkles don’t bother everyone, so my advice is ‘do what makes you happy.’”
Neurotoxins such as Botox, Dysport, and Daxxify work by temporarily blocking the release of the neurotransmitter that causes muscle movement. “If your goal is to prevent facial lines from forming, you can start getting injections in your late 20s or early 30s. Once those lines are set, injectables will soften—but not eliminate—them,” says Srivastava. “Keeping those frown lines in check typically requires follow-up visits every three months.”
“Fillers are an effective tool for volume restoration,” says Haryani. “Some patients will use fillers to enhance features and create more symmetry, while others are looking to bring volume back to areas where we naturally lose it over the years due to the breakdown of collagen— areas such as the cheeks, lips, and midface. Depending upon the longevity of the product used, fillers can last from 6 to 12 months.”
The most popular fillers contain hyaluronic acid, a gooey substance that our bodies produce naturally to keep our joints and eyes lubricated and our skin hydrated and flexible. “Fillers can be used in many places, giving the skin a scaffold to bring back that youthful appearance,” says Srivastava. “They can address marionette lines and nasal labial folds. They can restore structure to lips, cheeks, and temples— where there is volume loss. They can even give a subtle lift to eyes when injected into eyelids.”
Lasers and peels are other minimally invasive strategies for maintaining healthy-looking skin. “One of the best things you can do for your skin is laser resurfacing treatments,” suggests Haryani. “You can do milder, non-ablative, treatments; more aggressive, ablative, treatments; and something in between. Resurfacing can reduce fine lines and wrinkles, treat irregularities such as brown spots, tighten skin and improve collagen production, and help blend scars from acne, trauma, or surgery. The Fotona erbium laser can deliver one or all of those benefits by allowing me to dial up or dial down both the depth of penetration and heat to optimize results.”
Chemical peels are another option that can be tailored to meet your individual skin care goals. Superficial peels are effective for gently exfoliating the skin’s outer layer and refreshing the skin’s appearance. Medium peels, which penetrate the outer and middle layers of skin, can reverse sun damage and improve the appearance of age spots, fine lines and wrinkles, freckles, and moderate skin discoloration. Although deep peels, which penetrate deeply into the middle layer of skin, produce dramatic results by removing lines, age spots, freckles, and shallow scars, most dermatologists recommend that they be performed only once.
While a basic skin care regimen and certain cosmetic treatments can help turn back the hands of time, dermatologists agree we shouldn’t overlook some simple lifestyle habits that can go a long way toward preventing signs of aging skin.
“Think about sun protection every single time you set your foot outside your door. From hats to UV-protective clothing and, of course, sunscreen,” reminds Haryani. “Like any organ, the skin responds to what you ingest. Your diet should be balanced and include antioxidants.
“Stay hydrated. This means both internally by drinking water and externally by using moisturizer. Most importantly, if something doesn’t look right to you on your body or you have a new growth, get it evaluated by a dermatologist. Skin cancer is more easily treated when caught early; and if caught late, can be life threatening.”
Sunscreen, nutrition, and hydration have always been priorities for 74-year-old Sharron O’Brien of Vero Beach, especially after living for many years in the Keys, where she and her husband spent considerable time outdoors, fishing and diving. “When I moved here two and a half years ago, I searched for a health care provider who could offer medical surveillance for skin cancer as well as cosmetic procedures,” she explains.
Now, O’Brien visits 2023 Iconic Dermatology annually for skin cancer screenings. She supplements her daily skin care regimen with Iconic facials, specially formulated for her skin, at five-to-six-week intervals; and she gets periodic Daxxify, filler, and laser treatments. “Dr. Haryani is excellent at guiding you to what is appropriate for your face. I really appreciate that he calmly studies your features with a true artist’s eye to determine how best to enhance them.”
When asked whether she’d consider a face-lift, O’Brien says, “As a retired nurse practitioner, I have no problem with surgery. But at my age, I’d prefer not to have general anesthesia.
If it requires more effort on my part to stick to my daily routine and maintenance, I’m willing to make that commitment and work with Dr. Haryani to ensure that I’m a good reflection of his procedures.
“Right now, I’m satisfied that there are less invasive procedures to achieve what I want to achieve. To each his own. For me, I’m going to have creases in my face because I’m going to smile. I’m going to have furrows because I’m going to make an expression. The line in the sand is different for everyone.”
As are the lines on our faces.
Lifestyle Tips for Healthy Skin
- Don’t smoke
- Limit alcohol, which dehydrates and, over time, damages skin
- Eat a well-balanced diet
- Get plenty of sleep
- Use sunscreen with SPF 30 or higher
- Step away from the tanning bed
- Get annual skin cancer screenings
- Drink plenty of water
- Exercise to improve circulation and boost your immune system
- Manage stress
- Use skin care products formulated for your skin type