Whether it's a wrinkle in time or a subtle smattering of discoloration that can emerge as early as our 20s, most of us have one thing we'd like to improve about our complexion. The good news is that now there are great ways to do just that -- at home or in a dermatologist's office. Learn how to treat the six most common concerns.
1. If You Want: Wide-awake eyes
The delicate eye area is the first call to action for many women. Under-eye circles and puffiness can appear because the skin there is thin and doesn't have as much padding as the rest of the face. Sometimes just a bad night's sleep is to blame, but more often than not, it’s your genetic destiny. "Most dark circles are caused by broken-down blood cells that deposit their pigment beneath the skin," says New York City dermatologist Amy Wechsler. Puffiness, on the other hand, occurs when the fat pad under the eye migrates down and out toward the surface of the skin. Allergies, along with alcohol and salt consumption, can magnify both problems.
At home: Because dark circles are often hereditary, they can be tricky to treat. Regular application of an under-eye cream containing vitamin K and light-reflecting pigments, like HydroPeptide Eye Authority ($74, hydropeptide.com) will help brighten the area. For under-eye bags, a massaging eye treatment with caffeine, such as Olay Eyes De-Puffing Eye Roller ($25, olay.com), can deflate and perk up tired-looking eyes. Also, keep these treatments in the refrigerator for an instant cooling effect.
At the doctor: Injecting a filler like Restylane or Juvéderm under the eyes can reduce sunkenness as well as darkness. Made from hyaluronic acid, a sugar found naturally in the body, these fillers (which start at $650 a syringe) typically last around six months, or longer with touch-ups, for which you'll pay only for the amount needed. To treat more pronounced under-eye bags, a lower-lid blepharoplasty, a surgical procedure, will remove the offending fat pad.
2. If you want: Smoother skin
Every expression -- from smiles to smirks -- causes temporary creases. But when skin's supply of collagen decreases as you age, those creases don't bounce back as quickly, and wrinkles gradually emerge. Sun exposure, cigarette smoking, and inflammation-causing free-radicals like pollution hasten that process.
At home: Start the day with a moisturizer that contains antioxidants, like licorice and rosemary, or peptides to ramp up skin's collagen production; then follow with a layer of SPF protection, says Santa Monica, California, dermatologist Karyn Grossman. At night, also apply a retinol, an over-the-counter vitamin A derivative, which will help increase cellular turnover and improve skin texture and tone. "Prescription retinoids like Retin A, Differin, and Tazorac are still the best wrinkle erasers," Grossman says, but their strength can cause irritation. For a milder at-home option, she suggests the retinol-and-hyaluronic-acid duo found in Neutrogena Rapid Wrinkle Repair Serum ($22, neutrogena.com).
At the doctor: Line-smoothing injectables such as Botox, Dysport, and Xeomin flatten crow's feet and forehead creases by blocking the signals nerves send to the muscles, causing them to (temporarily) stop contracting; these last three to six months and begin at $300. "For deeper lines, we also use a filler," says Grossman, who prefers hyaluronic-acid injectable fillers like Belotero and Restylane Silk, which last around six months and cost from $500 per syringe.
3. If you want: An even skin tone
We all have melanin; it's the pigment that colors our hair and skin. But sun exposure, genetics, hormones -- even picking a pimple or a bug bite -- can result in its overproduction, which shows up as brown splotches on the face and body.
At home: Both retinol (for skin-cell turnover) and hydroquinone can be effective on melanin when used "properly and judiciously," says Boston dermatologist Ranella Hirsch. The latter is a melanin-lightening topical in products like DCL AHA Lightening Gel ($100, dclskincare.com). "The one key mistake people make, even after successfully reducing brown spots, is not realizing that they will absolutely develop more pigment if they don't continue with sunscreen," Hirsch says.
At the doctor: "Hyperpigmentation is among the most difficult things dermatologists treat," says Hirsch. "There are multiple moving parts." Lasers are the go-to for most dermatologists, but care needs to be taken to ensure that they don't inadvertently create more pigment. A typical course of treatments includes intense pulsed light or fractionated laser, a mix of doctor-administered peels, at-home topical creams, and copious sun protection.
4. If you want: Supple skin
Your skin's supportive network of collagen and elastin weakens over time, and the areas around the cheeks, brow, eyes, lips, and neck start to droop. Couple that with sun damage, weight fluctuations, genetics, dehydration, and gravity, and the effects become even more apparent.
At home: Building collagen and maintaining elastin are key. Seek out salves with ingredients like ceramides that hold in moisture, such as Caudalie Resveratrol Lift Night Infusion Cream ($76, us.caudalie.com). "Also, use a retinol religiously," says David Colbert, a dermatologist and founder of the New York Dermatology Group. It will strengthen remaining elastin and help build new reserves.
At the doctor: There's no one-size-fits-all recipe for toning and adding volume to skin, but most dermatologists enlist laser or ultrasound therapies, like Fraxel and Ulthera, to stimulate collagen and tighten skin. For volume, hyaluronic-acid filler injections provide an immediate lift. There's artistry involved in achieving a natural effect, as the viscosity and longevity of each filler differ. For instance, Colbert prefers Radiesse to tone the jawline, Restylane to plump up lips, and Juvéderm or Restylane to raise cheekbones and minimize jowls and the nasolabial "brackets" that stretch from nose to mouth. Such fillers typically last six months or longer (depending on the area) and begin at $650.
5. If you want: A glowing complexion
Children's skin always looks bright because its cellular turnover is operating at peak efficiency. But skin's repair and renewal mechanisms slow down, leaving you with a dull, lackluster complexion in need of a pick-me-up.
At home: Look for this glow-inducing trio: retinol (to increase cell renewal and improve skin texture and thickness), vitamin C (an antioxidant and skin brightener that also helps build collagen), and alpha-hydroxy acids (to slough away dry cells for brighter skin). Find all three in L’Oréal Paris RevitaLift Bright Reveal Brightening Dual Overnight Moisturizer ($20, lorealparisusa.com).
At the doctor: "Peels are an excellent way to boost the outcome of at-home skin care," says Vivian Bucay, a dermatologist in San Antonio, Texas, who likes the PCA Sensi Peel with trichloroacetic acid (TCA) for its minimal down time and tolerance by highly sensitive skin. These professional-grade peels slough away dead skin so your treatments are more effective and healthier skin shines through.
6. If you want: Clearer skin
Got stress? Agita, genes, and hormones bear the blame for midlife acne breakouts. But unlike puberty-induced T-zone eruptions, these appear more inflamed and occur mostly around the mouth and jawline.
At home: The same ingredients that treat teen acne -- salicylic acid and benzoyl peroxide -- work on adults. Resist the urge, however, to reach for a 10 percent benzoyl-peroxide treatment, as adult skin becomes more sensitive than it once was. Try La Roche-Posay Effaclar Duo ($37, laroche-posay.us), with 5.5 percent benzoyl peroxide.
At the doctor: If you don't see an improvement after using over-the-counter acne treatments for a few weeks, see a dermatologist for oral antibiotics like doxycycline or Accutane, steroid injections, chemical peels, or lasers like Regenlite and Isolaz, all of which "work wonders" on acne, says Wechsler.
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