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What’s Important?

  1. Anti-aging therapies remain focused on inducing fibroblasts to produce collagen and ECM components and preventing the breakdown of these vital dermal constituents.

  2. No topical products can enhance elastin synthesis in the skin; increased elasticity claims are more likely due to greater moisturization than increased elastin.

  3. Retinoids, including retinol, are still the most proven topical anti-aging ingredients.

  4. Ascorbic acid also has significant efficacy data to show it increases collagen synthesis.

  5. Antioxidants help mitigate several aging processes such as mitochondrial damage, inflammation, DNA mutations, and glycation.

  6. Peptides have poor penetration and stability and are highly reactive with other ingredients.

  7. The efficacy and safety of growth factors depend on growth factor type.

What’s New?

  1. The abstracts of peptide anti-aging efficacy studies are misleading.

  2. Look closely at study design and statistical significance when evaluating anti-aging ingredient research.

  3. The growth factor TGF-β has the most data to support its use for skin rejuvenation.

  4. Stem cells in pre-packaged topical creams have no proven efficacy.

  5. Defensins activate the stem cell LGR6+ leading to new keratinocytes.

  6. Heparan sulfate improves cell-to-cell communication in aged fibroblasts.

What’s Coming?

  1. Safety data on the use of peptides, stem cells, and growth factors after microneedling.

  2. Improvements in peptide penetration may improve efficacy and possibly decrease safety.

  3. More information on growth factor safety in the presence of skin cancer.

Anti-aging skincare begins with sun avoidance but does not end there. In addition to the wise practice of avoiding prolonged direct sunlight between 10 AM and 4 PM, you should coach your patients to prevent photodamage with sunscreens, which limit the impact of ultraviolet (UV) radiation and reduce the formation of free radicals and inflammation. The aim of anti-aging skincare is to preserve the mitochondria and prevent the loss of collagen, elastin, and hyaluronic acid (HA) as well as promote the synthesis of collagen and HA. While sunscreens represent the optimal anti-aging skincare product category, there are several ingredients effective in lessening the signs of skin aging. Of course, the best anti-aging skincare products are sunscreens and the best skin-protective behavior, sun avoidance.

There are numerous anti-aging products on the market and it can be difficult to decide which ones to carry in your medical practice (see Chapter 33, Choosing Skincare Products). Many are expensive and the cost of carrying several products in an inventory, including various anti-aging stock keeping units (SKUs) can be cost prohibitive. It is best to choose one from each of these categories to sell in your practice: retinoids, antioxidants, an anti-aging product that excludes a retinoid and is gentle on sensitive skin such as a heparan sulfate, defensins, and growth factors or matrikine products. HA should be considered more of a moisturizer and an agent to increase penetration of other ingredients rather than an anti-aging product. This chapter will discuss various categories of anti-aging ingredients found in skincare products.



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