As we get older, our skin undergoes a multitude of changes that result in sagging skin lined with wrinkles and dark and light spots. Preventing these changes has grown into a million dollar industry with so many different products out there that claim “anti-aging.” But what really works? To figure out what ingredients are actually effective, we need to dive down into the molecular changes in the skin.

There are two types of aging, one that happens naturally with age and one that is caused by the sun.

As we age, our skin loses collagen and thins. Gravity and repetitive movements of our facial muscles in our daily expressions start forming wrinkles as we lose elasticity, or the ability of the skin to snap back into its original shape. We also lose hyaluronic acid, a powerful humectant that allows us to retain moisture in the skin. The sun also plays a huge role in photoaging, causing discoloration in light and dark spots, wrinkles, rough leathery texture, and small superficial blood vessels.

One of the key strategies to combat skin aging is prevention. Now that we know that the sun causes skin changes, we can start protecting our skin from UV radiation at an early age. There is no “right time” to start using sunscreen; I wish I had started as a teen!I recommend using SPF 30 broad-spectrum (blocking UVA and UVB) sunscreen daily, whether it’s a sunny day or a cloudy day, because UV radiation penetrates through all the time.

Side note: myths about sunscreen

I’ve heard some patients say they are concerned about the safety of sunscreen ingredients; I’ve taken a critical look into the literature and found that many of these myths about sunscreen components are just that, myths, without scientific basis (more on that here). Once you are comfortable with the idea of daily sunscreen application, you have to choose a sunscreen that’s right for your skin type (more information on that here).

Skincare ingredients to look for

Practicing sun safety is not only great for anti-aging, but it also helps decrease your chances of getting skin cancer, which has far greater implications for your health. Aside from prevention, there are a few other key ingredients that I like to keep in my anti-aging regimen.

First off, there are retinoids, or Vitamin A. It has an important role in dermatology because of its comedolytic properties, meaning it breaks up comedones that you seen in acne. Aside from being a great acne medication, retinoids also help with anti-aging by increasing cell turnover, thereby reducing fine lines and dark spots. Dermatologists can prescribe you retinoids in gel or cream format, and these topical formulations can over the course of months help with new collagen formation, increased skin thickness, and improved texture.

The main side effects are sun sensitivity and irritation, and you must NOT use it if you are pregnant or trying to conceive, because it can potentially cause harm to the developing fetus.

Another helpful ingredient in antiaging is hyaluronic acid, a naturally occurring humectant in your skin that helps you retain an insane amount of water. One gram of HA can hold up to 6 LITERS of water! It doesn’t help us that we lose hyaluronic acid as we age, meaning our skin gets more dry and wrinkled faster. By choosing topical creams like serums or ampoules with HA, you can help replenish your supply. Older patients can also consider injections of filler made from HA, which deposits the HA deeper in the skin mimicking naturally occurring HA to get a more youthful appearance. This is only temporary though, as the body will break up the injected HA over time and carry it away in the bloodstream.

The power of antioxidants

Lastly, antioxidants can play a big role in helping to reduce and even reverse sun damage. UV radiation causes reactive oxidative species to be generated in the skin, causing damage to the deeper structures. Vitamin C helps to combat this damage, working to improve skin texture, help with production of collagen, and to reverse DNA damage from UV radiation. Vitamin E also acts to decrease inflammation and damage in the skin. These vitamins together can be very helpful in clearing your skin of sun-induced oxidative stress and damage.

All of these ingredients can be used at any age, and it is never too early to start investing in a good anti-aging regimen! What products do you use?

Joyce Park, MD is a dermatology resident at NYU Langone Medical Center with an interest in using the media for public health. Dr. Park tries to actively increase public awareness of skin safety through her much read health and beauty blog, TeaWithMD and its associated social media accounts.

Aptly named, Enclothed Cognition is the official Medelita blog for medical professionals interested in topics relevant to a discerning and inquisitive audience. Medelita was founded by a licensed clinician who felt strongly about the connection between focus, poise and appearance.