Read an Excerpt
Wrinkle Free Forever
The 5-Minute 5-Week Dermatologist's Program
By Howard Murad, Dianne Partie Lange
St. Martin's Press Copyright © 2003 Howard Murad, M.D.
All rights reserved.
The Next Generation in Skin Care
You know the feeling. You look in the mirror and are shocked to see that the laugh lines at the corners of your eyes linger seconds longer than your smile. For a fleeting moment you can actually see the crow's-feet in your future. Maybe you're frustrated that the fine lines on your cheeks never give way to the precious ounces of costly creams you use every night.
By the time you celebrate your fortieth birthday, you may notice that the frown lines of disappointment and worry on your brow and the corners of your mouth have become permanent furrows. You might have picked up the habit of widening your eyes when you look in the mirror, trying to "lift" your descending upper lids. Perhaps you've made some attempts to approximate what a face-lift might do for you, tugging up on the skin over your cheekbones to see if the creases and folds on your face disappear.
If you've done your time in the sun, your mottled skin tone and sagging jawline make putting on foundation downright depressing. And, noticing that those scattered lines above your lips have become a feathery filigree doesn't do much to lift your spirits or improve your self-image.
For some men and women, awareness of these changes comes as a sudden surprise. "Did that happen while I was sleeping?" you wonder at your reflection in the toaster one morning. Or perhaps it was the off-guard glance as you passed by a store window that got your attention. "For a second, I thought I saw my mother," you may have confided to a friend.
I know about these reactions to the visible signs of aging because as a dermatologist who has cared for more than forty thou-sand men and women over thirty years, I've heard your stories. And too often I've seen the unfortunate results of hasty desperate measures taken to turn back the clock. I've tried to erase the face-lift scars along the hairline of a woman embarassed by the red, ragged edges of the old incision that made her appear as if she were wearing a mask. I've seen how distraught a man can be when he learns that the pasty white skin tone that follows an overzealous peel cannot be reversed.
In skilled hands, most cosmetic surgery procedures either tighten or resurface skin without complications. But even when a quick fix is successful, a postoperative letdown isn't unusual. In fact, studies have shown that half of the people who have plastic surgery suffer from anxiety and depression afterward.
One reason for the letdown may be that while the person looks different, he or she doesn't necessarily appear any younger. The sagging may be gone, the fine wrinkles may be improved, but the skin still appears old and unhealthy. There's something about the new face that doesn't look normal. That's because no quick fix, no laser beam or surgeon's scalpel, changes the way the skin functions. Surgery to pull the skin tighter doesn't restore its youthfulness.
Reversing signs of aging and making skin more resilient and vital require treating it from the inside as well as the outside. This concept is the basis for the internal skin care that is an integral part of my program. Internal skin care repairs and rejuvenates. It repairs the supportive structures deep within the skin that give it support and elasticity And, it rejuvenates the cellular machinery that produces fresh, new skin cells.
Dermatologists are skilled in using the tools of the trade to correct surface imperfections — the lasers and scalpels, and injections of botulinum toxin (Botox) and wrinkle fillers. But when patients ask me for the latest anti-aging procedure they've seen on the news or read about in a magazine, I ask them first to give me five weeks. That's how long studies have shown it takes for the benefits of my skin care program to begin becoming visible. Sometimes, I ask the esthetician in my office to give the patient a topical vitamin C infusion treatment before he or she leaves the office. The smoothness and brightness that occurs after only one fifteen-minute treatment usually convinces the person to try the five-week program. More often than not, when my patients see how much their skin improves without costly procedures or down time missed from their work and social life, they make a lifelong commitment to the program.
TAKE CARE OF YOURSELF, INSIDE AND OUT
The rate at which your skin ages, what signs appear and when, depends largely on how you care for yourself inside and out. The same steps you can take right now to begin making over your skin will also improve the health of your body. I include taking care of the body as part of my program because the skin and the body can't be separated any more than the mind and body can. After all, the skin is the body's largest organ, and it's the only visible reflection of the body's health.
My program is not complicated. In fact, most people are amazed at how quick and easy it is.
"Not counting the time I'm in the shower, the morning regimen takes less than five minutes," says Linda, a thirty-one-year-old marketing executive who has put her career on hold until her children, who are now eight, six, and two, are older. Her schedule-juggling resembles her days a busy executive, and she says she's become an expert in multitasking. "I clean my face as I shower. As soon as I step out of the tub, I spray my face with toner, apply the antioxidant renewal serum, and towel-dry my body and brush my teeth while the serum seeps in. Then I moisturize. Swallow the supplements and, boom, I'm finished and out the door."
Linda keeps sunscreen in the car and applies it liberally, rain or shine, while the children are buckling up and settling in for the ride to school. (They've already learned to put on sunscreen after washing their faces.) "The morning steps have become a habit that I don't even think about," she says.
At night, Linda completes her evening regimen soon after dinner, so if she falls asleep while reading to her children, as she often does, there's no chance of missing the second part of the daily program.
Every month, Linda has a vitamin C infusion facial at my day spa to further nourish her skin with antioxidants. These salon treatments also give her an hour to herself. The relaxation of being pampered helps her skin, too. As I'll explain in chapter 14, I'm convinced that relaxation and being touched during a massage or a facial are essential antidotes to the cascading side effects of stress on the skin.
There is no single procedure, not even a deep face-lift or peel, or a single ingredient, not even my favorite antioxidant and sun protector, pomegranate, that will reverse all the aging changes etched on your face. What does work is a complete, holistic pro-gram that addresses all the causes of those changes. Also, by restoring the skin's internal environment, all of the skin's layers — from the deepest layer of fat to the topmost layer of skin cells — are fully hydrated and protected from further damage.
In nourishing, repairing, and protecting your skin, you will also be restoring health to your body. Think about it. The cells of your vital organs, like those of your skin, need a constant supply of oxygen, water, and nutrients. The cells of your heart, liver, brain, and skin have similar needs, which I don't believe can be provided by the food that most of us eat.
In repairing and rejuvenating the connective tissue that makes your skin resilient, for instance, this program also encourages the health of connective tissue in blood vessels, nerves, tendons, and joints. Curtailing inflammation in the skin also diminishes inflammation in the blood vessels that supply the heart and the brain. And every cell needs to be well hydrated in order to perform. That's why I think it's so important to take hydrating supplements such as fatty acids.
AN INCLUSIVE PROGRAM
The anti-aging program I've developed is an inclusive program. By inclusive I mean that the program includes
treating the surface signs of aging that bother you
enriching the body internally with the materials needed to maintain a healthy water balance, stimulate new cell growth, and repair vital skin structures
reducing the influences of negative emotions and stress on the skin and body
Clinical studies have shown that each step of my program has its unique, measurable benefits, and I'll be describing the results of that research in the following chapters. The daily regimens combine what you need to do in the morning and the evening in an easy-to-follow format. The products in the regimens are those that I prescribe to my patients, use in my spa, and distribute to estheticians throughout the country. Because I've designed these formulations and tested them, I'm certain that they will work for you. However, to give you choices, I've included alternative products that contain a similar recipe and are also widely available. In the appendix, you will find a list of the key ingredients in those products. Cosmetic companies do not share their product formulations, and while products may contain the same ingredients, they are not identical and the amounts can vary considerably. How the ingredients are combined is important, too. You may have to do some experimenting to find the substitution that works best for you.
I have also designed and patented supplements that contain the necessary nutrients in the amounts that I have found most effective and that are safe. However, if you prefer to assemble your own favorite brands of formulas, I have provided a breakdown of the ingredients in my formulas. Keep in mind, though, that supplements are not regulated as drugs are, so different brands may vary in quality. I suggest you stick with known brands. Also, if you have any health conditions or are on any medications, check with your personal physician before taking any supplement, since there may be interactions that could be harmful.
By following my program, you will turn back the clock in a natural way. One part of the program assists in repairing collagen. One boosts hydration. Another part focuses on sun protection. These steps also work synergistically, meaning the combination of steps in the program is more effective than each single step alone.
To achieve what I call an ageless face, a face that is youthful and natural yet has definition and character, all you have to do is follow a simple morning and evening regimen, eat a skin-healthy diet, and take some time out to relax. But as simple as my program is, some people may be tempted to take short cuts, especially when it comes to taking time out for a facial or to eat in a more healthful way. It's true that if you've relied on fast food and frozen prepared entrées, shopping and preparing fresh food takes time. In my experience most people get more efficient at it, and you'll look and feel so much better that the time investment will be worthwhile. If you're tempted to skip a step, think about this: Isn't it time you take care of yourself as well as you care for others?
HOW MY PROGRAM EVOLVED
Scientific breakthroughs are rarely sudden, and skin care discoveries are no exception. These advances come as a result of uncovering one piece of the aging skin puzzle and putting it together with another over many years. The new theory must be tested in the laboratory and then in humans. Researchers must then prove that the results are consistent and reproducible, and that the ingredient or product that helps treat the skin is safe for most people.
This painstaking process is not done by one person in one laboratory, but by scientists all over the world. We meet and share the results of our efforts and question each other's work frequently. We publish the results of our tests and talk about them at scientific meetings. A discovery by a researcher in Berlin may be the missing piece a physician in Los Angeles has been searching for. That's the way science works.
I'm telling you this because I think it's important to appreciate the years of study, experimentation, and testing by others and myself that have culminated in the program I'm going to share with you. The evolution of my inclusive skin care program mirrors the cutting edge of several important advances in skin physiology, nutrition, and psychology.
An example is the fairly recent awareness that stress directly affects skin. Throughout my years of medical practice, I've seen the impact of stress and the havoc that hormones released as a result can create. And I've seen how some people's skin improves when they add some form of emotional self-care to the treatments I prescribe.
Just last year, researchers at the University of Dresden in Ger-many made an important discovery that may help explain what other dermatologists and I have observed. The German scientists found that a particular stress hormone fits like a key into the lock of receptor in the skin and causes damaging inflammation, the kind that leads to wrinkles and hair loss. Another piece of the puzzle, linking stress and skin function, has been found.
I began devising my skin care program in 1972, as I was completing my residency at the University of California at Los Angeles. At that time, I was like most dermatologists in believing that my job was to treat skin disease. Yet soon after I started my private practice, it became clear to me that many of my patients were complaining of what medical professionals considered "cosmetic" problems. These men and women not only had psoriasis, they had wrinkles, too. Yes, they had acne, but melasma, or hyperpigmentation, that created dark blotches on their complexion, also troubled them. Rather than ignore the "cosmetic" problems that were causing my patients so much distress, I gave them my full attention. At the time, this was an enormous leap in medicine.
In 1984 I became one of the first dermatologists to invite an esthetician to join my practice. I shared with her my knowledge of how healthy skin functions and how it needs to be treated, and she shared with me her years of experience in deep cleansing, moisturizing, and massaging the skin. I began to realize that being touched and cared for, which is what happens in the hands of a good esthetician, relieves stress and helps people feel better about themselves. I saw that taking care of one's self is healing medicine, too.
I opened A Sense of Self skin care spa in 1987 in Brentwood, a Los Angeles community. It was one of the first day spas to integrate health and beauty into what I called an Optimal Health Care program. In addition to medically oriented skin care, clients could consult with a nutritionist, a fitness trainer, and have treatment facials by a trained esthetician.
Before I became a medical doctor, I was a pharmacist, and in the 1970s I began working with a cosmetic chemist to design unique treatments and products that met my patients' individual needs. In 1990, I made the now ubiquitous alpha hydroxy acids (AHAs) available to the public. Alpha hydroxy acids speed up the skin's natural shedding process. By removing the dead, dry cells from the surface of the skin, moisturizing products can be more easily absorbed, and the skin immediately becomes smoother. Alpha hydroxy acids remain an important part of my program for most skin types, and you'll be learning more about them later in this book.
Initially, the formulas I developed were only available to patients in my care. Then, my experience using AHAs in thou-sands of patients and spa clients and seeing how exfoliation improved their skin convinced me to formulate a line of AHA-based products. In 1990 I introduced AHAs to the professional skin care industry with home care products and the AHA Rapid Exfoliator Professional Treatment, both of which are now standard treatments. With AHAs, "feel good" facials became true treatment facials.
COSMETICS GET SERIOUS
Products with AHAs are included in a category of skin treatment products called cosmeceuticals, a term introduced twenty years ago by dermatologist Albert M. Kligman to describe agents applied to the skin that are more active than cosmetics but not so active that they have uncomfortable or harmful side effects, as drugs do. Cosmeceuticals have been medically defined as "product [s] with an activity that is intended to treat or prevent a (mild) skin (abnormality)." Although the Food and Drug Administration (FDA) has not officially recognized cosmeceuticals and doesn't regulate them, other countries have acknowledged that some cosmetic ingredients have a biological effect on skin. In Japan, for example, these active ingredients are called "quasidrugs" and must be proven mild and safe.
Several of the ingredients I'm going to suggest you look for are in cosmeceutical products. However, keep in mind that since the FDA does not regulate these products, the activity of the ingredients will vary. You'll need to pay close attention to how your skin reacts to them, and perhaps modify your regimen to suit your own skin.
FEEDING THE SKIN
Skin is a responsive, active organ. In a sense, it's a factory, because it continually maintains its own supporting structures and manufactures skin cells and the gel-like material that holds them together.
Whatever goes into the body affects how the organs function. So if you want healthy skin, you have to supply it with the necessary building blocks for cell membranes and connective tissue. These include proteins or amino acids; water-bonding elements such as phospholipids; fatty acids; lecithin, vitamins B and C; and trace minerals.
Excerpted from Wrinkle Free Forever by Howard Murad, Dianne Partie Lange. Copyright © 2003 Howard Murad, M.D.. Excerpted by permission of St. Martin's Press.
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