Anti-Aging Techniques for Your Skin

WebMD Live Events Transcript

How can you reduce theagingeffects of summer fun in the sun? What are your options to treat the signs ofagingwithout surgery? Daniela Paunesky, MD, joined us on July 13, 2004, to answer your skin-care questions.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MODERATOR:
Welcome, Dr. Paunesky. Please tell us whatanti-agingmedicine is.

PAUNESKY:
Anti-aging medicine is basically preventative medicine. It's looking at aging as a degenerative process and replacing hormones and nutrients that become deficient with age.

MODERATOR:
What are some of those nutrients and hormones?

PAUNESKY:
The therapy is individualized for men and women. First, I do a comprehensive blood panel prior to the patient coming in to see me so I can learn which hormones they are deficient in. For example, in a female I'll check levels of:

• Estradiollevel
• Estrone
• Testosterone
• 脱氢表雄酮
• Progesterone
• Growth hormone
• Insulin

Nutrients I generally check are B12,folic acid, and ferritin, because these are most commonly associated withhair lossandfatigue, which are very common patient complaints. So the process is very simple. We go over every hormone, we replace the deficient hormones, and as far as the nutrients are concerned, I have compounded appropriate dosages ofvitamins, too.

We only replace bio-identical hormones, meaning the hormone is the exact replica of the hormone existing in your body. There may beover-the-counter productsstating they're a "natural hormone" because they come from a natural substance (such assoy), but they're still foreign to the body. Soy is a natural food product, but it's not a bio-identical hormone. Recent studies inJAMAreported that high levels of soy inmenopauseactually increase the risk ofAlzheimer's. The theory is that soy blocks estrogen receptors and doesn't allow the female's own estrogen to bind to those receptors.

MODERATOR:
When should people begin checking these hormone levels and doing something about deficiencies?

PAUNESKY:
I have men as young as 32 and as old as 98 that are hypogonadal, meaning severely deficient in testosterone. For women, hormones begin to decline aroundperimenopause, which usually begins at about 35.

"Thermage is still too new to decide whether it's truly effective; a recent statistic showed that 72.5% of patients who have had Thermage noticed no results."

MEMBER QUESTION:
Is there anything I can do to firm and tighten the skin on my face?

PAUNESKY:
There are several things:

• Very low-dose estriol
• Heat, in the form of a photo facial (on an IPL machine), or certain laser devices
• DMAE has been shown to be effective at diminishing wrinkling

DMAE is a supplement, but you can find it as a topical cream. A few studies have shown DMAEsupplementsare helpful, but topical creams show definite benefit. DMAE can also be injected sub-epidermal, which is called a meso lift, and is very popular in France.

Thermage is still too new to decide whether it's truly effective; a recent statistic showed that 72.5% of patients who have had Thermage noticed no results. To thicken skin, the proven topicals include:

• Vitamin C
• Estriol
• Retinoic acid
• 脱氢表雄酮gel

脱氢表雄酮gel is a hormone you can take orally to help thicken the skin, although it takes years to notice appreciable results; apply it topically and results are noticed in a few months. However, it may causeacneto the face, so I tend to use it on the hands and arms.

MEMBER QUESTION:
What is the best way to prevent sun damage to my sensitive skin?

PAUNESKY:
Avoid the sun with wide hats or visors. Or SkinMedica makes asunscreenfor sensitive skin that can be mixed with foundation and doesn't leave a greasy look.

MEMBER QUESTION:
I am a 44-year-old runner and though I use SPF30 sunscreen and a hat I'm getting brown spots. How can I minimize their appearance and prevent them?

PAUNESKY:
Estrogen stimulates melanocytes and heat from the sun or tanning beds can cause these melanocytes to overproducemelanin. The most effective treatment is a topical cream of hydroquinolone, the most popular prescription being Trilumina. This will reduce the appearance of the brown spots and prevent new ones. However, it's still important to avoid sun exposure at all costs with sunscreen and visors.

MEMBER QUESTION:
I've been searching for a nongreasy sunscreen or sunblock that can be used on oily/acne-prone skin but everything I've tried is greasy. Is there anything you could recommend? Also, do darker-skinned individuals have to wear sunscreen?

PAUNESKY:
First, SkinMedica makes a nongreasy sunscreen or sunblock (they're the same thing) for sensitive skin. Or try having one made from a compounding pharmacy (with a doctor's recommendation).

Second: light- and darker-skinned individuals are at risk forskin cancerand sun damage. Everyone should usesun protection.

MEMBER QUESTION:
I'm 14 and take good care of my skin. What would be best for my skin to keep its looks long term?

PAUNESKY:

• Eat right
• Takevitamins
• Don't smoke
• Wear sunscreen
• Avoid a stressful job

MEMBER QUESTION:
Are human growth hormones "the fountain of youth" or are the risks too great? Are anyclinical trialsusing them as a cure for aging?

PAUNESKY:
I love these questions! I have been using human growth hormone (HGH) in my practice for over three years. In my experience, injecting HGH is much more beneficial in individuals who have tested deficient. Otherwise, I'd recommendsupplements. The benefits of higher HGH are:

• Thickened skin
• Smoother skin
• Tighter skin
• A slight increase in lean muscle mass
• Increasedbone density

You must use HGH for six months or more before results are noticed. If using injectable HGH, fasting insulin levels must be monitored because it may raise fasting insulin, which will add weight around the midsection; supplements avoid this side effect. Water retention at the initial phase is another very prevalent side effect with injectable HGH, and again, not seen with supplements.

So, if an individual is truly deficient, human growth hormone can reverse age-related disorders such as:

• Osteoporosis
• Thin skin
• Hair loss
• Skin sagginess

If a person isn't deficient, the benefits are not as noticeable in my experience.

"There is overwhelming evidence that people who have tested significantly deficient in HGH (human growth hormone) do benefit from HGH replacement. "

MEMBER QUESTION:
我读的HGH研究只有六个月and had few study subjects. Can it be trusted?

PAUNESKY:
There have been a lot of studies, and a lot of controversy surrounding HGH replacement, because the studies are conflicting. We still need to learn more about long-term effects. Yet there is overwhelming evidence that people who have tested significantly deficient in HGH do benefit from HGH replacement. People have even reported improved quality of life, improvedsleepand libido, and improved muscle mass to fat ratio.

MEMBER QUESTION:
Where can you get a good HGH supplement?

PAUNESKY:
It's difficult to buy supplements over the counter because you don't know what you're really getting. To ensure the supplement is FDA-approved, question your physician and ask if they use pharmacy-grade supplements.

MODERATOR:
Dr. Paunesky, any final words for us?

PAUNESKY:
Remember to wear your sunscreen, hats, and visors!

MODERATOR:
Thanks to Daniela Paunesky, MD, for sharing her expertise with us. Dr. Paunesky is the director of medicine at the Renaissance Medical Center and co-director of research at the Atlanta Medical Research Institute.

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