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SKIN SIGNS OF AGING AND WHAT YOU CAN DO ABOUT THEM: Leading dermatologist Dr. Joshua Fox discusses symptoms & solutions.

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— Leading dermatologist Dr. Joshua Fox discusses symptoms & solutions

New York , NY , October 2007 – Getting older. None of us can avoid it, but most of us would love to keep our aging a little bit more secret. “If you are over 30 years old and enjoy an active lifestyle, your skin is probably showing signs of damage,” says Joshua Fox, MD, founder of Advanced Dermatology and a spokesman for the American Academy of Dermatology.

Luckily, dermatologists can counter many of the more common signs of aging. In fact, many conditions can be improved substantially in only one visit.

Here are the top 5 signs of aging -and what you can do about them.

This is the term given to the visible evidence of sun exposure. “The most common symptoms of photo damage are a coarsening of the skin’s texture, irregular pigmentation, and enlarged blood vessels and pores,” says Dr. Fox. “Picture a baby’s skin: smooth, plump, with perfectly even texture and color. That’s what you lose after spending years in the sun.”

The amount of photo aging you’ll develop depends on your skin color and your history of long-term or intense sun exposure. People with fair skin who have a history of sun exposure fare the worst. But even people who have never been beach babes can get into trouble. “Depending on your skin type, you might show evidence of serious sun damage, even if you never hung out at the pool or used a tanning bed,” Dr Fox says. Incidental exposure – the kind you get while driving your car or watching a baseball game -can expose you to a lot of UV rays over the course of your life.

Sun exposure can be blamed for freckles, spider veins, roughness, loose or “crepey” skin and blotchiness – changes are usually associated with chronologic aging and just make you look older than you are. When these changes start to appear on your face – as well as your neck and chest – you might want to do something about it.

The good news is that dermatologists now have several tools at their disposal to treat photo damaged skin and restore it close to its baby-like beauty.

“I’ve been very happy with the results we’ve had with our non ablative lasers ( e.g. Vbeam, Smooth Beam etc)” says Dr. Fox. Like other nonablative lasers, the PhotoGenica works by focusing a beam of light to a target in the skin, such as an enlarged blood vessel or patch of irregular pigmentation, removing it without damaging the skin. But unlike other lasers and anti- aging treatments, it can treat a wide variety of skin types. And it gently penetrates the skin without affecting the outer layers, meaning there’s a much shorter healing time or none at all.

We know that the sun causes 90 percent to 95 percent of the wrinkles, lines, and discolorations on our bodies, as per the American Academy of Dermatology. That’s why sun-exposed areas like the backs of the hands are most prone to these problems. And one of the biggest problems here: lentigines, also known as age spots, liver spots or sunspots.

To restore the even pigmentation of youthful hands, dermatologists can reach for a different type of laser, such as the Versapulse®, Con Bio ND-Yag which uses short pulses of energy to break up and eliminate pigmented areas usually in only one visit.

Another option: a treatment called “photo rejuvenation,” in which the skin is treated with pulses of broad-spectrum light, called IPL (or intense pulsed light). “This process is ideal for patients with active lifestyles because the procedure requires no downtime and produces few side effects but require more treatment,” says Dr. Fox. The results you’ll get from laser or IPL treatments are permanent – but neither treatment can prevent future aging or photo damage.

Your hands also give away your age in another way: by showing bulging, prominent veins. As people age, they often lose fat tissue in their hands, making the hands look skeletal and the veins more distinguishable, says Dr. Fox. Aging skin also gets thinner and loses its elasticity, making the problem even worse. In addition, most people take better care of the skin on their faces than on their hands, meaning the skin on you hands is probably drier – and thus looks older – than the skin on your face. “Veins that normally wouldn’t be visible become prominent,” he explains.

To eliminate veins, dermatologists can apply lasers, such as the Cool Touch CTEV or Lyra I, which are also used to treat varicose veins on the legs. They also can use sclerotherapy, a procedure in which the affected vein is injected with a solution that causes it to collapse and eventually disappear – forever (the doctor uses micro-needles, which generally cause very little pain). With the problematic veins gone, blood from those veins is redirected to veins deeper in the hands. Fat or filler such as Radiesse® can be injected to thicken the hands which also make the veins appear less promment.

Squinting, frowning, smiling – all of these expressions are part of life and make you who you are. But they’re also repetitive facial movements that lead to fine lines and wrinkles around your eyes. “Every time you use a facial muscle, a groove forms beneath the surface of the skin,” Dr. Fox explains. “As your skin ages and loses its elasticity, the skin stops springing back to its line-free state, and these grooves become permanently etched on your face.” You’ll see horizontal lines radiating out from the outer corners of your eyes – called crow’s feet – and one or more vertical lines between your eyebrows – known as glabellar lines. In addition there often forms a groove between your eye and nose on each side extending downward which gives the eye a baggy, tired, older look.

Dermatologists can use lasers to reduce or eliminate crow’s feet. And for glabellar lines, they’ll often reach for Botox with or without a filler substitute. Botox is a purified protein produced by the Clostridium botulinum bacterium, which reduces the activity of the muscles that cause those lines to form. “A Botox treatment is very simple,” says Dr. Fox. “You’ll get several tiny injections directly into the muscles.

No anesthesia is required – most patients compare the sensation to a pin prick – and you may resume your normal activities immediately.” Best of all, you’ll probably see a marked improvement in your lines within a couple of days. Results will last up to four months. To fix the under eye grove and bags you can either fill the sulcas with a filler like Restylane which can last 4 to 10 months or with fat which can last for many years. You might also consider having blepharplasty in which the fat is removed. Laser is also helpful sometimes.

Getting older also means developing lines and wrinkles around your mouth. These generally are worse on people who smoke – the puckering motion involved in puffing on cigarettes contributes to the problem, as does the many chemicals in cigarette smoke (research shows that cigarette smoking causes biochemical changes that accelerate aging) – although almost all of us will develop some wrinkles around our mouths as we age. According to the American Academy of Dermatology, the way your skin looks is directly related to the way your skin is supported. “As we age, the natural support layers in the skin break down, resulting in wrinkles,” adds Dr. Fox.

To treat those vertical lines above your mouth as well as the dreaded nasolabial folds (also known as “marionette” or “puppet” lines) that frame your lips like a pair of parentheses, dermatologists have a few options, says Dr. Fox. The best are injectable fillers; many are made with a purified form of hyaluronic acid (HLA), a naturally occurring sugar that’s found throughout the body, in the fluids surrounding cells and tissues. The best products with FDA approval yet don’t require skin tests are Restylane, Juvederm Ultra – 3-4 Months, Perlane, Juvederm Ultrafine 5-8 months and Radiesse 9 months – 2 years is how long they last.

The fillers are injected just under the skin’s surface to add volume lost during the aging process by temporarily smoothing out lines and wrinkles. The hyaluronic acid fills the space between collagen and elastin fibers, helping hydrate the skin by holding in water and acting as a cushioning agent.

The treatment is practically painless and the effect will be noticeable almost immediately, says Dr. Fox.

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