H o w to Us e O r a l a n d

Top i c a l C o s m e c e u t i c a l s t o
Prevent and Treat Skin A ging
Leslie Baumann, MD

KEYWORDS

Skin care
Cosmeceutical
Baumann Skin Type
Antiaging
Photoaging
Supplement

Skin care
Improve outcome

KEY POINTS

Keratinocytes and fibroblasts play a role in skin aging.

DNA damage, free radicals, inflammation, and glycation cause skin aging.

Genes, growth factors, cytokines, and stem cells (LGR61) play a role in skin aging.

Diet, supplements, and topical cosmeceuticals can help prevent and treat skin aging.

Patient education and compliance are critical to improve outcomes and prevent skin aging.

INTRODUCTION keratinocytes and fibroblasts, intracellular and

Patients should adopt strategies to decrease their
risk of skin aging in their early 30s, if not sooner. It
is important to identify patients at an increased risk
of skin aging early enough to initiate countermea-
sures. The Baumann Skin Type Indicator question-
naire can be used to identify patients who are a
wrinkle-prone Baumann Skin Type,1 which is
defined as more than 30 years of age and/or
younger than 30 years of age with lifestyle factors
putting them at an increased risk for skin aging.2
Consistent daily use of efficacious technologies
targeted to patients’ Baumann Skin Type can pre-
vent and treat many of the signs of skin aging. Pa-
tient education is also critical for success because
compliance with treatment regimens is notoriously
low among patients.3
There are several causes of skin aging that can
be broken down into 2 broad categories, intrinsic
and extrinsic. Intrinsic aging results from cellular
processes that occur over time and is influenced
by genetics and includes decreased function of
extracellular accumulation of by-products,
decreased function of sirtuins, mitochondrial dam-
age, and loss of telomeres.
Extrinsic aging is incurred through environ-
mental causes of cell damage, including ultraviolet
(UV) light and infrared and radiation exposure. Air
pollution, smoking, tanning beds, sun exposure,
alcohol and drugs, stress, and poor diet play a
role. Extrinsic aging occurs from the interplay of
overlapping processes caused by free radicals,
DNA damage, glycation, inflammation, and other
actions by the immune system. In most cases,
these factors can be lessened through behavioral
change. As much as 80% of facial aging is thought
to be attributable to sun exposure.4 Several mech-
anisms by which sun exposure causes aging are
well understood. DNA damage results when UV
light induces covalent bonds between nucleic
acid base pairs and forms thymine dimers, which
can alter the function of the tumor suppressor
gene p53 increasing the risk of skin cancer
and skin aging.5 UV exposure also produces free
facialplastic.theclinics.com

Disclosure Statement: Patent owner of patent number US 20160128925 A1 Optimized Skincare Regimens for
Changing the Genetic Skin Type to the Ideal Skin Type–Oily, Resistant, Non-Pigmented and Tight Skin.
Division of Cosmetic Dermatology, University of Miami, 4500 Biscayne Boulevard Suite 101, Miami, FL
33137, USA
E-mail address: DrB@Derm.Net

Facial Plast Surg Clin N Am 26 (2018) 407–413

https://doi.org/10.1016/j.fsc.2018.06.002
1064-7406/18/Ó 2018 Elsevier Inc. All rights reserved.