Dear Paula: Better Than Botox?

[SVZ]

Dear Paula,
I just read your very interesting report on products that claim to be "better than Botox." However, I never believed those claims in the first place. What I am interested in is this: Does any product out there show any promise AT ALL for getting rid of lines? What about expected results with long-term use? Perhaps that is impossible to know at this point. Forget being "better than" or "just like" Botox. I am in my late 20s. If there is a product that shows any antiwrinkle promise at all, I could start using it now and perhaps not want or need Botox until much later in life. Does this make sense? I can't be the only one thinking this way. You reviewed Hydroderm in your report, and said that it contains collagen, which never worked in the past. However, the company claims they have patented a collagen delivery system that now allows a full collagen molecule to penetrate the skin. True?

Jacqueline, via email

Dear Jacqueline,
Your question makes complete sense! But I think women often just don't want to hear the answer. Absolutely, there are products that can improve the appearance of skin and, yes, reduce the appearance of wrinkles. The answer that is hard for women to accept is that the ads and claims about products alleging they can prevent wrinkles from happening or repair the wrinkling you have are almost always overblown, misleading, or downright false.

Aging and wrinkling of the skin are complicated processes. Collagen depletion is not the only culprit. Cell damage from the sun and from free radicals (a destructive environmental molecular chain reaction), weakened elastin fibers, fat movement, muscle movement (which is what Botox impacts), loss of estrogen, and something called cell senescence (in which the skin cells are genetically programmed to stop regenerating) all add up to what we see as aging skin. There simply isn't one antiwrinkle product that can address all of these issues.

What can keep (or might have kept) Botox or other cosmetic medical procedures at bay? You're smart to be thinking about this while still in your 20s because there are absolutely things you can do. If we were all to be religious (from birth) about sun protection, never getting a tan or sunburn, reducing direct exposure to the sun as much as possible, not smoking, avoiding secondhand smoke, not growing older, and not going through menopause, our skin would wrinkle far less. In the meantime, the absolute best defense from wrinkles in the world of skin care is to be smart about protecting our skin from the sun, using moisturizers (or, if your skin is oily, serums or toners) that are loaded with antioxidants, cell-communicating ingredients, and ingredients that mimic the structure of skin, and supporting everything with a healthy diet.

Collagen as a skin-care ingredient isn't bad, and can have some significant impact on skin, but no more so than other ingredients found in skin such as ceramides, hyaluronic acid, lecithin, or cholesterol. However, collagen applied topically (no matter how refined) doesn't generate more collagen or combine with your own collagen to shore up supplies or stop deterioration. There just isn't any information or research showing this to be the case (Sources: Mutagenesis, July 2005, pages 305-310; Experimental Dermatology, April 2004, pages 36-40; Archives of Gerontology and Geriatrics, September-October 2001, pages 151-161; Plastic and Reconstructive Surgery, April 2005, pages 1156-1162; Biomaterials, May 2004, pages 1911-1917; and Journal of Health Psychology, July 2005, pages 585-595).