Known in the media as "America's Dermatologist™", Dr. Tony N. Nakhla is a Board Certified Dermatologist, Dermatologic Surgeon, Medical Director of OC Skin Institute, and author of The Skin Commandments: 10 Rules to Healthy, Beautiful Skin. Dr. Nakhla took some time to answer some questions about skin care, specifically anti-aging.
My readers have told time and time again that they just simply cannot and will not spend hundreds of dollars on a skin care regimen. It’s easy to assume that celebrities and the very rich are the only ones who can afford flawless skin. What do you say to the people who only buy drugstore skin care products? This is a consistent theme that I maintain both in my practice and in my book The Skin Commandments: 10 Rules to Healthy, Beautiful Skin, where I outline exactly how to choose a skin care product based on your skin type and the ingredients on the label. (read review of the book) These ingredients are difficult to make sense out of unless you have a PhD in biochemistry.
The good news is you don't have to import your skin care products from the Champes Elysee', 5th Avenue, or Beverly Hills, and you definitely don't have to spend a lot of money for great products. A number of excellent, inexpensive products can be found at the local drugstore.
Equally important as what's in your skin care product is what's NOT in your skin care product. Certain ingredients that are used in mass-production cause unnecessary damage. These ingredients are outlined in The Skin Commandments as well.
On the flip side, what product line/s would you recommend to those who really don’t blink an eye at the price, as long as the products are effective? I never recommend extraordinarily expensive products. There is no rationale for buying something ultra-expensive other than the fact that the companies who sell them have an incredibly high marketing budget, often having to honor big pay offs to A-list celebrities or other endorsements! Guess who pays for it? YOU- the consumer.
From an expert standpoint, there is no real reason to spend mucho bucks on high end products. The only product I suggest you spend a bit more for is your nightly retinoid which is inherently pricier because retinol is expensive to manufacture. Even with retinoid products, often one can get a prescription from their dermatologist and have the product covered by insurance if the suffer from acne, for example.
Other products that are usually a bit pricier, are products free of preservatives, dyes, fragrances, and other harmful allergens which I outline in The Skin Commandments. I also like plant-derived antioxidants which are usually pricier if they are organically sourced.
My advice to the average consumer is find a good sunscreen, moisturizer, cleanser, and nightly retinoid based on your skin type. Most of these ingredients can be fortified with highly potent antioxidants (read below). Otherwise, save your money for impactful dermatologic procedures and treatments that give you real results and the biggest bang for your buck.
When looking at a product ingredient list, what key age-fighting ingredients should we be looking for? And what about percentages of these ingredients? In my book, I outline specific ingredients that are "must haves". Retinol (and other retinoids in the same family), of course, is one of them and should be at a potency of at least 0.5%. Other important ingredients for anti-aging are high potency antioxidants like A,C, E, and green tea, coffeeberry, resveratrol and turmeric. (see more turmeric's skin benefiting properties)
A really exciting, emerging topical antioxidant is called Ergothionine, which is found in certain mushrooms, but has been difficult to extract and formulate into a topical product. Percentages for these ingredients are never indicated on topical products because, simply, the FDA does not require them.
On the horizon is an organically sourced, plant-derived, ultra-high powered antioxidant blend that I am developing that will include active ingredient percentages.
Let's talk about sun damage. I think the message is loud and clear today that the sun will age your skin, but unfortunately for many, the message came too late and the damage has already been done. Can people reverse their sun damage? What advice do you have for them? 90% of the visual signs of skin aging are due to damage from the sun. All anti-aging treatments are aimed at reversing those signs primarily by boosting collagen production, removing old layers of dead skin and getting down to fresher, newer skin. The most important of these is effective exfoliation.
Effective exfoliation reverses sun damaged skin by literally peeling away sun-induced pigment and fine lines, as well as boosting natural collagen production. A great, inexpensive exfoliation tip is to buy a 10% glycolic acid cleanser, lather it on your skin and allow it to dry for 10 to 15 minutes. Next, remove the cleanser as well as dead skin cells using warm water and a soft wash cloth with moderately aggressive strokes.
What should an age-fighting skin care regimen look like?
- AM: Cleanse and moisturize. Morning moisturizer must contain SPF and may also contain antioxidants.
- PM: Cleanse, exfoliate, apply retinoid and moisturize. PM moisturizer should contain antioxidants.
You’re in California, and maybe the stigma on visiting the dermatologist is different there, but where I am, in the Midwest, people assume you only visit the dermatologist if you have a funky mole or other skin condition. How can visiting a dermatologist help us in our quest for youthful skin?
Dermatologists should be your first and foremost expert for all of your anti-aging questions and concerns. The vast majority of anti-aging treatments such as botox, lasers, fillers and liposuction were invented by and continue to be refined by dermatologists. These doctors don't simply "dabble" in anti-aging, they are required to have continuing medical education, attend conferences, and stay on top of the latest and greatest treatments in order to stay certified.
My advice is to see a board certified dermatologist first if you have any question about an effective anti-aging program. Definitely do not trust your skin care to a medispa, dayspa, or nail salon where non-experts are performing unregulated procedures and treatment plans.
I love hearing what products Dermatologists use on their skin, so Dr. Nakhla, what product line do you personally use? I personally use a blend of organically sourced, plant derived, high powered antioxidants which I developed and have compounded for me by a local distributor. It is free of many commonly used fragrances, preservatives, dyes, and other inflammatory allergens.
It is unfortunately expensive because I order it in small quantities, although I am excited about bringing it to market in an affordable way as we would be able to order it in substantially larger quantities and bring down the cost.
Can you tell us a little bit about your book, The Skin Commandments: 10 Rules to Healthy, Beautiful Skin My book incorporates all I have learned from both the modern medical world and the osteopathic/holistic world, giving readers the best of the best of all disciplines.
It answers the most commonly asked skin care and anti-aging questions in a simple, easy to read format. Thru my book, I take pride in knowing that I am not only a dermatologist for the ultra-wealthy, A-list elite, but for men and women of all ages seeking to take control of their own skin health and beauty.
Actuarial tables and genetics aside, none of us knows how long we get to live. That is the perfect argument for living healthy, looking your best, and feeling great.