No matter what your age, the pursuit of complexion perfection is universal. But the number of treatments that promise a flawless face can be confusing. We asked three leading dermatologists Tina Alster of Washington, D.C.; Joshua Wieder of Los Angeles; and Fredric Brandt of New York and Miami for the most up-to-date, effective options.
"My favorite treatment for lines includes injectable fillers like Juvéderm and Restylane," says Alster. "But topical products that infuse skin with moisture also temporarily plump wrinkles."
What the Derm Can Do
Hyaluronic-acid fillers like Juvéderm and Restylane continue to be popular wrinkle fixes. When hyaluronic acid is injected into lines, it binds to water, immediately plumping the skin. It's used on wrinkles around the mouth, crow's-feet, and forehead lines, and results last about six months. Both brands cost $600 to $1,000 per syringe, depending on the doctor. Juvéderm Ultra Plus is a more viscous hyaluronic-acid filler. "It can fill deeper wrinkles and replace more significant volume loss," notes Brandt. A bigger needle is used with thicker fillers, so patients may experience more pain during injection and more redness and swelling afterward. Juvéderm Ultra Plus is $600 to $1,000 per syringe, and results last six months or longer.
Another option is Fraxel, a laser that makes tiny microinjuries to deep layers of skin to trigger production of collagen, tightening skin and improving texture. A new version, Fraxel SR1500, penetrates up to 30 percent deeper, making it a more effective catalyst for collagen production. "While it can require more recovery time, this laser has greater wrinkle-smoothing capabilities," says Brandt. Sessions take 90 minutes, and mild redness, swelling, or peeling is common for a few days afterward. Three to five sessions at intervals of two to four weeks are recommended, at around $1,000 per session.
"Botox remains the gold standard for treating frown lines and crow's-feet," says Alster. The injections paralyze muscles beneath expression lines and cost $300 to $500 per area. Effects are visible within days and last up to four months.
On the horizon is Isolagen, currently in FDA trials. Isolagen is a process in which a skin biopsy from a patient is used to grow millions of collagen-producing fibroblast cells over the course of a few weeks. These cells are then injected back into the patient's wrinkles, lines, and scars. "After a few months," notes Brandt, who is one of the doctors conducting trials, "scars and wrinkles are diminished and skin looks rejuvenated." The process could be approved by the FDA in a year or two. "Theoretically, the new fibroblasts will continue to produce collagen for years," says Brandt. For more information, visit isolagen.com.
Best Skin-Care Options
"Products with retinols and alpha-hydroxy acids boost cell turnover to fight fine lines," says Wieder. Try Neutrogena Healthy Skin Anti-Wrinkle Intensive Face Lotion SPF 20 ($17.99) with retinol, or ask your doctor about prescription retinoids like Renova and Tazorac.
A new category of antiaging treatments is aimed at preventing sugar from damaging skin. When we consume sweets, excess sugar attaches to elastin fibers, causing them to harden. This process, called glycation, makes skin lose elasticity and wrinkle more easily. "Products containing anti-inflammatory alistin prevent glycation," says Brandt, who recently introduced Dr. Brandt Lineless Anti-Glycation Serum ($90).
"Temporarily plump wrinkles with Hyalogy products," says Alster. "They contain micronized hyaluronic-acid particles small enough to penetrate the skin and plump lines." Try Hyalogy P-effect Essence ($170).