Anti-ageing creams: do they really work? How to harness the best results.

If you’re like me, you’ve stood in front of the beauty counter at a retail store wondering whether anti-wrinkle creams really work or whether they just cater to vanity.  We put the question to Cape Town-based dermatologist, Dr. Nomphelo Gantsho, and while she agrees that some creams do work, more often than not, these need to be part of a larger skincare regimen and generally take at least six months before showing results.

Here’s what you need to know:

In order to assess the efficacy of anti-wrinkle face creams, it is first important for us to identify signs of ageing because my concerns and your concerns, when it comes to ageing, are not the same.  Understanding the skin’s ageing process informs decisions about how to treat it.  There are three main manifestations of general skin ageing. Each one affects the look of the face in a different way.

In a country like South Africa that encompasses people of diverse origins, there are four main racial population groups: Black African (79.2%), Caucasian (8.9%), Coloured (8.9%) and Asian (3%).  The signs of ageing are age and race dependent and are also influenced by external causes such as smoking and too much sun exposure.

Fitzpatrick Phototype I – III skins include Caucasian skin in which fine lines appear first, with wrinkles, loss of volume and a loss of density in skin become noticeable over time.  Fitzpatrick Phototype IV – VI skins which include Coloured, Asians and African skin, ages differently.  The first signs of ageing these skin types experience include skin dullness, dryness, pigmentation and fine lines.

Age spots and pigmentation can be caused by chronic sun exposure, ultraviolet (UV) light exposure, chemical interactions, inflammation or distressed skin, hormonal fluctuations, and internal skin ageing.

Ageing skin produces less oil, so we need to help maintain the moisture balance in our skin, without stripping away the natural oils.  As the signs of ageing start to show, we need our skincare solutions to evolve with our skin’s changing needs.  One might say that in your 20’s your focus needs to be more about prevention, in your 30’s you start to see expression lines and pigmentation from the sun damage and in your 40’s the lines become more severe and prominent. In your 50’s there tends to be massive volume loss, which may explain why the moisturiser that worked so well in your 20’s and 30’s might not meet the same needs your skin has by the time you hit your 40’s and 50’s.

This means anti-ageing creams need to include products that strengthen and thicken the skin, provide moisture retention and barrier renewal, yet which are not too harsh or abrasive.

Anti-ageing agents

The normal ageing process and environmental stress depletes the skin of its endogenous protective antioxidants.

There are two main groups of agents that can be used as anti-ageing cosmetic components, antioxidants and cell regulators. Antioxidants, such as vitamins, reduce collagen degradation by reducing the concentration of free radicals (FR) in the tissues. The most well-known systemic antioxidants are vitamin C, vitamin E and carotenoids.  All easily penetrate the skin when applied topically because of their small molecular weight.  Cell regulators, such as retinoids have direct effects on collagen metabolism and influence collagen production.

Vitamin A (retinoids) and its derivatives (retinyl palmitate, retinaldehyde and tretinoin) are a group of agents that also have antioxidants effects.  Vitamin A contributes to the effacement of fine lines, it improves skin hydration and makes the epidermis thicker and decreases pigmentation due to photo-damage.

Topical vitamin C increases collagen synthesis in both young and old fibroblasts and therefore has a potential to reduce the appearance of wrinkles.

Vitamins C and E inhibit acute UV damage, demonstrated as a reduction in erythema, sunburn, and tanning as well as chronic UV photo-ageing and skin cancer.

In your 20’s the focus should be on protection and prevention, so use lots of sunscreen. During your 30’s while it is still about protection, it is also important to start repairing one’s skin with products that have retinol. In your 40’s and 50’s the focus is on more repair, using products that have antioxidants, retinol and alpha hydroxy acid and moisturizing ingredients to keep the skin’s barrier intact.

Vitamin B3 (niacinamide) improves uneven skin tone, fine lines and wrinkles. It also improves the skin’s barrier and helps the skin to repair signs of past damage that leads to older looking skin and dullness.

Thus, exogenous topical creams are capable of preventing the occurrence and reducing the severity of UV-induced skin damage and skin ageing.

Sunscreen

We can never talk about anti-ageing and leave out sun protection.

Sunscreen protects against UVB and UVA.  UVB causes sunburn whilst UVA has more long-term damaging effects on the skin such as premature ageing

Moisturising your skin

Anti-ageing creams are predominantly moisturiser-based cosmeceutical skin care products.

The daily routine of showering and scrubbing your body with soap can remove layers of dry, dead skin which is good, but it can also strip your skin of its protective oils. Moisturisers that contain ceramides can help to repair and protect the skin.

As we age, our cells become less robust in maintaining their role integrity and dry up and shrink. Applying a moisturiser to your skin can increase the moisture level of the stratum corneum, prevent skin from drying out. Regardless of age, everyone wants their skin to look glossy, radiant, and plump.

The main purpose of a moisturising is to hydrate the skin, and to reinforce the natural skin barrier.  Most moisturisers offer additional benefits, such as sun protection and anti-aging.  Using the right kind of moisturiser for your skin can help maintain its balance.  Glycerin locks in moisture within the cells and leads to reduced appearance of fine lines and wrinkles on the skin.

Moisturisers with Hyaluronic Acid (HA) secure moisture and creates fullness. HA keeps collagen synthesis up, contributing to the anti-aging benefits to the skin. Higher levels of collagen and Hyaluronic Acid are related to skin that is more supple and resistant to wrinkles and fine lines.

Tips to avoid premature ageing

Time is of essence when it comes to anti-ageing skincare.  Start anti-ageing care as early as your 20’s.  One’s skincare regime is determined by what one can afford and also depends on what signs are apparent that need to be corrected.  Skincare with an antioxidant (Vitamin C) in the day and a retinol cream at night both stimulate collagen and reduce the signs of ageing. Vitamin E reduces UV damage, nourishes and protects your skin. Niacinamide improve skin brightness, it helps renew and restore the surface of the skin. A moisturiser with Hyaluronic Acid, moisturizes the skin and assists in collagen synthesis.

You can mix up different brands depending on your preference and what has proven to give best results on the problem being treated. Using gentle products made from high-quality ingredients with less irritants, fragrances and additives is more important.

And remember, all skin types must always wear sunscreen every day throughout the year.

by Dr. Nomphelo Gantsho, Dermatologist, Cape Skin Doctor (www.capeskindoctor.com) 

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