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Q&A with the Pros

Q5 with Patricia Wexler, MD

July 22, 2010

Q5 with Patricia Wexler, MD

Much like Isabella Rossellini’s character in Death Becomes Her, Dr. Patricia Wexler’s allure lies in her infinite wisdom of all things anti-aging, youthful facade and lengthy list of (seemingly ageless) devotees.

Below, the good doctor dishes on everything from the secret to “eternal youth” to preventative fillers and age-specific s.

Q1: What skincare products and services should one splurge on? Save on?
SPLURGE: Our skin rebuilds and repairs itself as we sleep. Without environmental factors to ward off, skin is able to speed up its natural renewal process and absorb ingredients. This is why nighttime is the best time for active treatment. That’s why I highly recommend to splurge on an anti-aging night cream.

SAVE: Any SPF will do, just make sure to protect your skin. Women tend to not be vigilant about sunscreen during the times in which they are indirectly exposed to the sun. I demand that all my patients wear SPF 30 all year but it is especially important to be vigilant now by using a product with an SPF of 30 even on cloudy days.

Q2: Retinol is often hailed as the only proven treatment to fight both acne and aging. Do you agree?
The deepest wrinkles need an extra punch— that’s why I paired my patented MMPi-20 technology with pure Retinol. This “responsible retinol” treatment works in two ways: First, pure Retinol, coupled with MMPi-20 and vitamin C, works to exfoliate surface skin and optimize cell turnover, revealing fresher, younger looking skin while tired cells are reawakened to produce new collagen. Second, the antioxidant technology of Avantage and the moisture barrier properties of NIACYL work to protect skin from the traditional side effects of Retinol like drying, redness, and irritation, ensuring that skin looks its best even as you treat it.

Q3: What’s the one must-have (anti-aging) product/treatment for women in their 20s and 30s? 40s? 50s+?
20s: Skin in the 20s tends to be on the oilier side especially along the t-zone and hairline with open and closed comedomes. Sun exposure may have already caused freckling, pigmentation and fine lines most obviously around the eyes. A good skincare regimen including daily exfoliation and moisturizing with an SPF of 30. Use at least one anti-aging product to prevent further damage to collagen and elastic tissue.

30s: Etched lines become more exaggerated especially around the eyes, lips and forehead. Avoid smoking, wear large sunglasses with UVA and UVB protection to protect the eye area. Stress and hormone manipulation may require adult acne relief. Use anti-bacterial but not drying solutions. It is vital to incorporate your acne regimen into your anti-aging routine.

40s: Lines previously only seen with movement become visible at rest. Use products that contain peptides for immediate relaxation of lines while promoting long term collagen and elastic stimulation. In addition, line fillers containing dermaxyl and polysilicone will give immediate improvement in the appearance of lines and wrinkles.

50s: Now loss of volume in the face is occurring along with loss of elasticity and squaring of the jawline. Lost of estrogen and increased MMPs cause inflammation resulting in continued loss of collagen that causes more sinking and sagging. Use products that inhibit MMPs, increase firmness and promote elasticity. Remember daily exfoliation will help the penetration of active ingredients.

60s: With continued volume loss, we see hollows develop under the eyes which are associated with dark circles. Treating dark circles, bags and wrinkles requires the use of multiple peptides to boost collagen, decrease pigmentation, diminish bags and light diffusers to do the job.

Q4: Do you believe in the “preventative” use of fillers? How soon is too soon to start?
Botox is about a yin and yang of muscle movement. If you weaken a muscle that’s pulling something down, the muscle which is pulling up has nothing to oppose it. Unlike botox, which for about four months paralyzes muscles, fillers plump up the face from underneath the skin, actually filling in the wrinkles. For some who don’t have the money, time or desire for a face lift, these new injectable fillers offer a cheaper alternative. For the past 20 years, we have been using bovine collagen, which is collagen derived from beef. And this is an excellent filler. It lasts anywhere from three to six months. It’s several hundred dollars. And you have to be skin tested prior to the treatment because three to six percent of the population can be allergic to it.

As far as how soon is it to start, I think it’s more important as a doctor to tell a patient when they’re becoming obsessed, or when they have an unrealistic expectation. I think we see examples all the time of actors and actresses that have gone too far and certainly I don’t want patients like that in my waiting room, looking as if they’ve done too much and they look Draconian. So I think it’s up to the doctor to say you really have to accept the fact that we’re not going to turn the clock back to 20. We have to look the best we can for our age and look naturally and expressive. You know, when you talk about looking frozen, nobody should be abusing botox to the point where they do look frozen. We should keep our expressions. Botox is great for over expressive muscles, but then we use fillers for around the mouth. You don’t want to get rid of expressions around the mouth. I like to smile. Botox has been used for over 20 years for many medical uses. We actually use it for children with cerebral palsy muscle spasm. So it can be used very safely for non-cosmetic use in children. So I’m not worried about the safety of botox.

Q5: Finding an accomplished dermatologist, such as yourself, is often a daunting task. What questions can a patient ask to help ensure a success?
How much is enough sunscreen and what active ingredient should I look for?
What are the signs of skin cancer and how often should I have my moles checked?
How is my makeup affecting my skin?
What is the best way to treat visible sun damage?
What is the best facial cleansing routine for me?