02 Oct Look forver 21: Anti-aging tips from the experts
Mason Pearson filling up a bit too quickly? You’re not alone. “I used to treat about three patients a month for hair loss, and now it’s roughly three per day,” says NYC-based dermatologist Macrene Alexiades-Armenakas, MD, who attributes the “astounding increase” of hair loss to stress-induced testosterone production, which causes hair follicles to slow down.
Double Up: To jump-start growth, Alexiades often suggests combining her “mainstay” treatment, Rogaine (minoxidil), with a topical prescription of testosterone-regulating spironolactone (like many prescription therapies, the combo is not for women trying to get pregnant, or who are pregnant or nursing). Miami- and New York–based dermatologist Fredric Brandt, MD, sends patients home with biotin supplements (which help the body metabolize amino acids and protein, the basic building blocks of hair), plus a prescription for a pharmacist-blended compound of eyelash-boosting Latisse (which many derms have found also stimulates hair growth on the scalp) and liquid Retin-A. “The retinoid opens up the follicles and increases the penetration of Latisse,” Brandt says. “It makes a huge difference in speeding up results.” With a three-milliliter bottle of Latisse costing roughly $150 (Dom Pérignon suddenly seems like a steal), risk-takers are ordering generic forms of key ingredient bimatoprost from Canada. But Brandt cautions against the money-saving strategy: “Unless it comes from a trusted pharmacy, it may be counterfeit.” Initial FDA trials for an allover scalp formulation of Latisse are in the works.
Fast Fixes: To camouflage a wide part (one of the signs of thinning hair), New York colorist Marie Robinson gives clients a base color that’s a similar shade to their scalp (making the part less noticeable). Next, Robinson weaves in highlights, which roughen up hair’s cuticles, creating fullness and visual depth so that strands appear thicker.
With new injectables making their way into derm offices, treating the face is becoming a highly bespoke science. “People have different lines and muscle functions,” NYC-based dermatologist Francesca Fusco, MD, says. “Having new options gives me a more individualized approach to each patient.”
Filler Frontier: Popular in Europe, Belotero (a hyaluronic acid filler awaiting FDA approval) will soon find its niche among injectables in the U.S. Thanks to its texture, it’s an ace at treating shallow nasal labial folds and undereye bags. “Fillers can cast blue discoloration under the skin if injected too close to the skin’s surface,” Brandt says, describing what is known as the Tyndall effect (aptly named after the nineteenth-century physicist who discovered why the sky is blue). Because Belotero’s consistency is thinner than that of other fillers, “it will be a good option for the most superficial injections,” Brandt says.
Freeze Frame: The FDA recently approved Xeomin, a third type of botulinum toxin, for treating frown lines. “Xeomin is just pure botulinum toxin,” Fusco says. “No additives means less chance of antibodies being formed. If someone develops a strong antibody response, the injection may not work.”
Whiteout: A recent study presented at the World Congress of Dermatology suggests a new use for hardworking eyelash serum Latisse: treating vitiligo (patches of depigmented skin) and UV-induced white sunspots (which are harder to banish than brown spots). “The main ingredient, bimatoprost, causes cells to produce more melanin,” Fusco says, which explains why eyelids may darken when treating lashes with the serum. Initial study results were promising: The 10 trial participants saw 100 percent repigmentation on the treated facial areas.
The neck and décolleté showcase some of our finest assets (sparkly Cartier necklaces, delicate Chloé blouses) but often are SPF-neglected, leading to wrinkly skin that can look a generation older than our faces.
Neck Deep: Alexiades uses two innovative treatments to keep saggy necks in check. For older patients looking to avoid the scalpel, Alexiades employs ePrime, a onetime firming treatment designed for the jawline and neck. Ten hair-thin needles deliver short bursts of heat to the skin’s deeper layers, stimulating both collagen and elastin production. “It usually takes a total of 150 injections to cover the lower face and neck,” Alexiades says. The results are impressive: A comparative analysis among five leading plastic surgeons and dermatologists calculated the treatment to be 37 percent as effective as a face-lift, with only two to three days of downtime while swelling subsides. To rid patients of “turkey neck,” Alexiades inserts Sciton laser fibers into a tiny incision under the chin. “The first fiber melts the fat, which is subsequently removed using a syringe,” she says. “Then I use another laser cannula to deliver laser energy to the undersurface of the skin, which tightens.” Patients wear a neck wrap for three days while healing from the lipo-lift.
Hope Chest: Injections also work anti-aging magic below the chin. “Lifting the neck with Botox is a home run,” says Brandt, who uses the neurotoxin to relax the muscle bands that often sag with age. He also fills décolletage creases with micro-injections of hyaluronic acid fillers, and then he finishes with a few sessions of the Excel-V KTP and Nd:YAG to remove redness and brown spots for an even skin tone.
If sun salutations and SoulCycle spin sessions haven’t whittled down trouble spots, in-office toning and fat-blasting procedures can pick up the slack.
Tighten Up: NYC dermatologist Neil Sadick, MD, opts for Venus Freeze, a body-contouring treatment that uses radio frequency to build new collagen and tighten skin on the arms, legs, and tummy. “It is easy, painless, and has no downtime,” says Sadick, who suggests up to five treatments to see results. For ultraprecise (and faster) contouring, both Fusco and Brandt recommend Exilis. The machine is equipped with an ultrasound guidance system, so the powerful radio waves can be delivered to exact locations in the dermis (up to two centimeters beneath the surface) for precise lifting and tightening. Fusco says a series of three or four treatments—each session a few weeks apart—is necessary to achieve desired toning.
Cold Play: To zap fat cells, Brandt loves Zeltiq, which he calls “the greatest thing ever.” During an hour-long treatment,
fat cells are frozen—a vacuum applicator, placed over a trouble spot, drops the tissue’s temperature. Only the fat cells feel the effect; the rest of the skin is unharmed. The damaged cells shrink and eventually die over several weeks, and then are excreted via the liver. While the loss is permanent, it’s no excuse to skip Vinyasa. A healthy weight will prevent the remaining fat cells from expanding, says Sadick. Alexiades echoes the praise. “Patients see a 25 percent reduction of fat in just one treatment.”
Rx Risk: Although early studies indicated that the controversial (yet effective) acne drug Accutane could help erase wrinkles from head to toe, one recent study found it to be no more effective than a combo of moisturizer and SPF. According to Alexiades, “the significant risk of side effects and complications—including birth defects and depression—does not make Accutane a safe anti-aging option.”