As our facial skin ages, it loses more and more of its ability to reflect light. Subtle (and sometimes not so subtle) pigmentations progressively accumulate in both the superficial and deeper layers of the facial skin making it actually look slightly darker. Years of sun damage and weathering also tends to give the facial skin a darker hue. Simultaneously, the sun and the elements add some wrinkles and lines that absorb more light than they reflect, unlike the smoother skin we had when we were younger. The collagen content of the face begins to diminish, and so does the subcutaneous fat content. The facial skin literally begins to thin and develops more surface irregularity as a result. An uneven skin surface with a rough texture does not reflect light and shine as well as smooth, soft skin does. All these factors combine and conspire to limit the brightness of the skin. The face begins to tend to have a dull, dark finish and then, unfortunately, we increasingly look more sullen, sallow, tired and old. Look that way long enough and you start to feel that way too.
Can we improve the brightness of the skin by whitening or lightening skin care techniques? Absolutely. These techniques are based on current methods used for excessive pigment situations known as “hyperpigmentation”. Taken to the extreme we can even effectuate a true “bleaching” of the skin. But bleaching is an unsophisticated, incomplete and possibly ill-advised approach to the quest of improving the radiance of the skin. Bleaching alone is merely addressing the pigment issues and not the other “neglected” qualitative aspects of the skin which are at least as significant and in need of equal attention if not more. And bleaching is supposed to do what exactly? What about looking natural, preserving ethnic identity or the potential color mismatches (of the face with the neck and body) with such treatments?
Better than bleaching (or simply whitening or lightening for that matter) are techniques which serve to improve the overall health of the skin and its reflective qualities. We don’t necessarily want “whiter” skin – what we really want is to improve the facial skin’s brightness, and brilliance. By focusing on reflecting more light, we strive to increase the luminosity and radiance of the skin. We do not seek a “whiter”, washed out, strange-looking, ethnic erasing, color mismatched or pale looking skin. We want a naturally younger, refreshed, more alive, beautiful, radiant look (and feel) to a restored, rejuvenated and healthier skin! We are all very familiar with the expression, “A beautiful, healthy glow”.
How do we accomplish all this? It must start where all good skin care starts – with a complete history and physical examination coupled with a thorough consultation by a qualified, trustworthy expert in cosmetic skin care. Then, the formulation of a cohesive, customized care plan and we can begin!
The overall basic principles for re-establishing more brilliant and radiant skin in general are:
- Even out the skin tone – A home skin care regimen as designed by your aesthetician should include methods which have this as one of the goals. Our aestheticians often recommend Neova Complex HQ Plus or Nia Skin Strengthening Complex be incorporated into the overall cosmetic skin care plan to help even out skin tone. Obagi-C Clarifying Serum is also another good choice for this.
- Minimize discolorations, blotchiness – Twice a day cleansing with a gentle, high quality product such as Nia Gentle Cleansing Cream or Revision Brightening Wash can make a big difference. Regular in-office facials and acne control (e.g. Obagi Therapeutic Lotion or Kinerase Clear Skin Blemish Dissolver) are also important mainstays. Areas of resistant and persistent reddish discolorations can sometimes be a sign of rosacea, darker areas may be hyperpigmentation. These conditions often require special treatments and, as do other conditions, must be properly diagnosed by your cosmetic skin care expert first so that a proper treatment plan can be developed.
- Smooth out and level the skin’s surface – In most cases, this will involve resurfacing the skin in some fashion. In principle, removing dead skin cells and debris on a regular basis helps to promote smoother, more evenly textured skin. Adding to the smoothing and leveling are techniques which are great for the deeper lines and folds such as Botox® and the wrinkle fillers, such as Restylane®.
- Increase the quality of the cells at the surface – The goal is plumper, more “alive” keratinocytes (skin cells), with more collagen. Peeling agents and techniques promote this. The overall best single technique for this is Retin-A®.
- Decrease surface irregularities, resurface the skin, eliminate dead skin cells/debris – There are several good home use peeling-style products available. We often recommend the Neova Smoothing Gel or Nia Rapid Exfoliating Serum. In-office treatments would include chemical peels (e.g. Obagi Blue Peel Radiance®), and in-office microdermabrasion. Most often combinations work better than any single treatment technique alone.
- Increase skin cell turnover – Methods which resurface the skin also tend to promote skin cell turnover. This serves to diminish pigmentation, lessen surface irregularity, “push” the dead skin cells off the surface, and rejuvenate the skin.
- Decrease surface (epidermal) dark, pigmentation spots – There are a variety of treatment strategies for hyperpigmentation and many articles can be found which address the most current approaches for this problem. One of my favorite products is the Obagi-C® Rx line which harnesses the double action lightening power of vitamin C combined with hydroquinone.
- Increase the reflectivity of light from the surface of the skin – Most of the lighteners and brighteners will do this to a certain degree. There is actually a rather long list of products and ingredients that can address this “hot topic”. Many currently available articles list these and one should check up on any product currently being used or any product up for consideration. One unique and novel approach is Revalskin Coffeeberry Illuminesse Brightening Complex. In addition to the nice effects of coffeeberry and the other ingredients which help to brighten the skin, it also contains light reflecting mica, and silica!
- Proper Nutrition and Hydration – Last but certainly not least, we all know that the skin is a rapid reflector of your general health and hydration state. There are a number of “skin friendly” foods that many currently available articles on this subject address in some detail. And a healthy diet with regular exercise defining what goes into the composition of your skin is probably more important for improving a radiant look than what you put on it. Hydration may play an even bigger role – dehydrated, dry skin versus well hydrated, moist skin – which sounds like it would look smoother and brighter?
Dr. Lyle Back is originally from New York City, receiving his medical and surgical training at Rutgers Medical School, Cooper Hospital – University Medical Center, and Ohio State. He is Board Certified in General Surgery (ABS) and Plastic Surgery (ABPS). He is a Fellow of the American College of Surgeons (ACS), the American Academy of Cosmetic Surgery (AACS), and a longstanding member of the premier American Society of Plastic Surgeons (ASPS). He served as a Professor of Plastic Surgery at Temple University and St. Christopher’s Hospital for Children and performed reconstructive surgery with “Operation Smile” in Vietnam. He specializes in the full range of the most modern and state of the art cosmetic surgery procedures and non-surgical cosmetic enhancement techniques available today. His aestheticians perform the most modern and specialized cosmetic skin care services using physician-grade skin care products.
