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Science-Backed Skincare That Actually Works

Here's an evidence-based skincare routine that I personally follow and recommend to my patients. There are fundamental steps that help support and protect skin from the inside out, followed by the topical applications, and lastly, the advanced methods that can bring about more noticeable changes and faster.

My aim here is to present you with a variety of options so that you can select the ones that best suit your budget, your schedule, and your level of comfort, while creating significant and lasting changes to the signs of skin aging.

Step 1: Understanding the causes of skin aging

Skin aging occurs as a result of two types of factors: intrinsic (from the inside) and extrinsic (from the outside).

Extrinsic factors occur from the outside and are primarily due to exposure to UV rays from the sun. Intrinsic factors occur from within. As we age, our skin undergoes a series of intrinsic changes that occur simultaneously:

  • Cells become slower
  • Fibroblasts produce less collagen and elastin
  • Epidermal thinning
  • Reduced capacity of the skin to retain moisture
  • Increased unevenness in texture and tone

These changes lead to the signs of skin aging that we all recognize: fine lines and wrinkles; dryness; sagging skin; reduced elasticity; and discoloration.

You cannot stop the process of aging, but you can significantly impact the rate of these changes.

The three inside-out foundations

Your skin begins internally. The three inside-out foundations are among the most critical factors that determine general health.

1. Diet

Diet affects the skin through multiple pathways:

  • Nutrient availability to the skin for structure and repair
  • Control of inflammation
  • Effects of gut microflora on the skin microflora balance

Research continually shows that there is a dietary pattern that resembles a number of other health-oriented diets:

  • Limit consumption of ultra-processed foods
  • Eat a large amount of fruits and vegetables
  • Include whole grains, nuts, seeds, and lean proteins
  • Avoid excessive consumption of refined sugars
  • Drink enough water

Mediterrean and DASH-type eating patterns are examples of the types of diets that match this pattern.

Key diet-related nutrients for skin health often include: vitamin A and carotenoids; vitamin C; and numerous types of plant polyphenols. This aligns with the general guidelines in healthy eating made simple.

Clinical evidence for skin markers exists for two supplements:

Collagen peptides

In a 2023 meta-analysis of 26 randomized controlled trials, researchers found that collagen peptides were associated with improvements in skin hydration and elasticity. Both of these characteristics decrease with age. More details can be reviewed in the article: what science really says about collagen peptides.

Hyaluronic acid

Hyaluronic acid maintains the skin's ability to retain moisture and helps maintain its smoothness and plumpness. Research indicates that supplementation with hyaluronic acid may improve wrinkling and hydration. Researchers in a recent trial noted a mean improvement in wrinkling of approximately 18.8% with hyaluronic acid treatment compared to very little improvement in the placebo group. Researchers in a larger 2023 study demonstrated comparable benefits in skin health with hyaluronic acid treatment.

Supplements can be beneficial, however, they are most effective when used on top of a solid diet plan, not as a replacement for a healthy diet.

2. Exercise

While exercise is commonly viewed as a means to improve the skin, the evidence base clearly demonstrates that regular physical activity can positively affect skin health.

Researchers recently conducted a study comparing 16 weeks of aerobic training versus resistance training in previously sedentary middle-aged women:

  • Both groups experienced improvements in skin elasticity and structural markers of the skin.
  • Resistance training resulted in an additional positive effect: increased skin thickness. Because the skin naturally thins with age, this is a key factor.
  • The study also identified genetic activation related to collagen, hyaluronic acid, and other functions of the skin. Although both aerobic and resistance training shared some overlap in terms of their impact on skin health, each type of training produced unique benefits.

Therefore, it is reasonable to assume that the combination of both types of training will be the most effective method. Additional information regarding the use of exercise to rejuvenate the skin can be found in can exercise rejuvenate skin.

3. Sleep

One of the least recognized ways to positively impact your skin is through quality sleep.

During sleep, the body is transitioning towards repair and regeneration. Numerous studies demonstrate that individuals who do not obtain sufficient sleep experience more pronounced visual signs of aging, as well as reduced recovery from stressors such as UV exposure.

Poor sleep was also associated with the following:

  • loss of moisture through the skin
  • delayed recovery from UV-induced damage
  • greater skin aging scores

Only a couple of nights of limited sleep can cause reductions in moisture and elasticity, as well as increases in oxidative stress.

Therefore, if you desire healthier skin, improving your sleep quality is crucial. For additional information regarding the importance of sleep for overall health, see how to optimize your sleep for better health.

The Outside: The Basic Topical Routine

After establishing a solid internal foundation, the effectiveness of topical strategy is greatly enhanced.

1. Sunscreen is the Most Important Product

The majority of visible facial aging is attributed to UV radiation, and it also increases skin cancer risk.

Daily application of sunscreen represents one of the most potent anti-aging tools available. A landmark study found that consistent sunscreen users did not develop any measurable new signs of skin aging over a number of years. Follow-up research also suggested that sunscreen can also reverse some signs of aging.

Safe Choice of Sunscreen

A problem with many chemical sunscreens is the issue of absorption. A study demonstrated that several common chemical sunscreen ingredients were detectable in the blood at levels exceeding established safety limits. That does not indicate harm; it merely raises concerns that have not yet been thoroughly addressed.

Mineral sunscreens employing zinc oxide and titanium dioxide are commonly regarded as the safest options since they are not absorbed through the skin to the same extent as chemical sunscreens.

There are also newer chemical filters being used in various countries that appear to offer broad-spectrum protection without appreciable skin penetration due to their larger molecular size. However, availability differs.

General Guidelines for Sunscreen Use:

  • Choose a sunscreen that protects against UVA and UVB
  • Select a sunscreen with an SPF of 50 or higher
  • Apply sufficient sunscreen and reapply as necessary

More detailed information is provided in the articles sunscreen vs. skin cancer: what's happening.

2. Ceramide Moisturizer

Moisturizers aid in maintaining skin hydration, and support skin barrier function.

Ceramides are particularly valuable as they perform the role of "mortar" between skin cells and assist in reducing moisture loss and increasing hydration. Studies have demonstrated statistically significant increases in skin water content within days in those with dry skin.

The simplest evidence-based routine that addresses the greatest gains would be as follows:

Morning:

  • Broad-spectrum SPF 50 sunscreen
  • Moisturizer (with ceramides)

Night:

  • A retinoid a couple of times per week initially and then gradually build up
  • Moisturizer as required

Foundational Steps:

  • Eat a diet based on whole foods, plants, and sufficient water
  • Engage in moderate amounts of exercise combining resistance and aerobic activities
  • Obtain consistent high-quality sleep

Conclusion

As stated earlier, skincare does not need to be complex. However, it does require planning.

If you focus on developing a solid internal foundation, applying sunscreen daily, and adding a scientifically-supported nighttime agent (such as a retinoid), you will address the majority of the essential elements. All additional options can be incorporated into your routine as desired, based upon your financial situation, time constraints, and personal tolerance.

If you want to achieve the maximum return on investment in terms of your skin, begin with prevention.

Research Sources

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