Dr. Novick: As I stress in my most recent book, You Can Look Younger At Any Age - A Leading Dermatologist's Guide, the four essentials of a healthy skin care regimen for people at any age include: 1) adequate sun protection; 2) appropriate moisturization; 3) proper cleansing; and 4) proactive lifestyle changes.
Ultraviolet light, both UVB and UVA, is responsible for 80 percent of the lifetime esthetic damage to our skin that we see as a roughened, leathery texture, warty-looking keratoses, loss of tone, mottled discolorations and "liver spots," sallowness of complexion, wrinkles and sagging and "broken" blood vessels. It's also responsible for 90 percent of the medical damage (pre-cancers and skin cancers, including potentially life-threatening malignant melanoma).
So, every healthy skin care regime MUST include measures to prevent the short and long-term effects of sun exposure. These involve the regular use of sunscreens with an SPF factor of at least 15 for everyday activities and greater than 30 for more extended outdoor activities, such as tennis, golf and swimming. Wearing protective clothing and broad-brimmed hats that cover the neck as well as the forehead are also important steps, along with limiting outdoor exposure between the hours of 10am and 2pm, when the sun is directly overhead and strongest. Finally, no one should seek out a tan and certainly not frequent tanning parlors. A tan isn't the sign of health; it's actually a reflection of underlying, largely permanent skin damage.
Appropriate moisturization is another essential for healthy and younger-looking skin. Since dryness can accentuate and make more apparent any wrinkles that are already present in the skin, every effort must be made to ensure that the skin is optimally lubricated at all times. For most people this simply means applying any all-purpose moisturizer on a regular basis, especially to damp skin immediately after washing, in order to lock in the moisture absorbed while cleansing.
Despite what advertisers promote, you don't need separate products for the face and body and a $12, 12 ounce bottle of moisturizer from the local supermarket is just as effective as its $125/ounce counterpart found in the so-called "finest department stores." Any general purpose one will do. I suggest avoiding fragranced products, since these are more prone to irritating the skin, especially for individuals with sensitive skin.
Proper cleansing is another crucial healthy skin care tip. We Americans, perhaps more than any other group, have truly taken the "cleanliness is next to Godliness" dictum to an extreme. When I ask patients what their daily cleansing routine entails, some often proudly proclaim that they wash three or four times a day. In fact, rather than good, this constitutes skin abuse. The skin's sebum, our own natural oil, and other substances known as natural moisturizing factors, which are essential for maintaining our skin's water content, are emulsified and rinsed away, leaving our skin tight, dry, flaky and more prone to irritation from environmental contaminants and cosmetics.
For this reason, I recommend using a sensitive skin cleanser that doesn't contain harsh preservatives or fragrances, washing gently no more than twice daily and avoiding the use of abrasive polyester scrub sponges and even wash cloths. It's best to lather up with the fingertips, rinse thoroughly and lightly pat dry. Lukewarm water is preferable to hot water, since the latter is much more degreasing. Finally, the best time to apply the moisturizer is immediately after patting dry while the skin is still moist to wet, rather than completely dry in order to lock in the moisture absorbed by the skin during washing.
Finally, the last essential for achieving healthy and younger-looking skin is a common sense step. Since the skin is such a magnificent mirror of what's going on inside us, anything that's good for our insides will be good for our skin's overall appearance. I call this Proactive Lifestyle Changes. Proper diet, regular exercise, avoidance of smoking and recreational drugs and limiting alcohol intake are all proven measures for maintaining optimal overall health, which translates into healthier and younger-looking skin at any age.
SCN: You've been involved in some incredible research projects. Please elaborate on what you've learned through your work.
Dr. Novick: In the nearly three decades I've been in practice, I am proud to have been at the forefront of dermatology in a number of major areas and have been the author and editor of several medical textbooks and chapters and dozens of peer-reviewed journal articles.
I'm currently investigating an in-office, minimally invasive surgical technique to stimulate hair regrowth in individuals suffering from male and female pattern hair loss (androgenetic alopecia). The implications of this research, as you can well imagine, may eventually prove of benefit to the millions who suffer from this cosmetically distressing condition.
In addition, although commercially available topical hair growing treatments are of varying and generally limited benefit, based upon recently published findings, I've successfully been able to compound a variety of topical formulations that has proven quite successful in maintaining hair density and promoting new hair growth.
For years I've been directly involved in creating techniques that expand the uses of current injectable dermal augmenting agents and volumizers beyond simply filling smile lines. In the course of my work, I've developed a variety of methods to treat sagging necklines ("turkey necks"), elevate droopy nasal tips, treat crinkling and bagginess under the eyes all without any cutting or surgery and all in the course of a "lunchtime beauty fix," a term I coined many years ago.
I was one of the first cosmetic physicians to use Botox for cosmetic purposes way back in 1991. Now few people in the world are unfamiliar with this amazing injectable that's capable of dramatically improving the aging face, neck and chest in so many ways. Injection discomfort has always been a problem, however. The application of ice, topical anesthetics and even nerve blocks has been tried in attempt to make the injections less uncomfortable. Unfortunately, each of these has its limitations and drawbacks.
In the past six months I've developed a protocol for reconstituting the Botox solution that hasn't only significantly reduced, and in the majority of cases eliminated entirely, the discomfort of Botox treatments, but speeds up the onset of action by several days and increases Botox efficacy by about 20 percent. A process patent is currently being sought for this technique, after which, in due course, the technique of preparation and administration will become widely available.
SCN: What is a common skin care myth?
Dr. Novick: One of the greatest myths in skin care, for which we must thank the ad men of Madison Avenue, is that soap is good for the skin. Let me make it perfectly clear: No soap or cleansing agent is good for the skin, no matter how much cold cream and moisturizer it contains, no matter how fragrance-free it is, and regardless of how much its ad copy asserts that it's good for dry and sensitive skin.
All cleansers must contain some emulsifying agent (grease dissolver) in order to be able to clean the skin of dirt, grease, grime, environmental pollutants and cosmetics. And so, by its very nature, every cleanser will also degrease the skin of its own sebum and natural moisturizing factors. I can't emphasize this point enough. Skin cleansers are the best we have for getting rid of things we don't want to accumulate on our skin, but that doesn't make them really good for you.
SCN: What is one main misconception people have regarding skin care?
Dr. Novick: Thinking back, I would have to say that one of the main and most consistent misconceptions has been that the use of moisturizers (especially the high-ended ones that are fancily packaged and heavily advertized) is anti-aging. Moisturizers are necessary to keep the skin supple, but they have no effect on preventing or treating the photo-aging process. Fortunately, we do have a wide range of cosmeceutical products that have proven effective in preventing and treating the manifestations of sun damaged skin.
SCN: What is a skin care related fact that would surprise our readers?
Dr. Novick: While most people nowadays know that we have fillers for treating wrinkles of the lower face and Botox for the scowl lines between the eyes, very few are aware of just how many new fillers and volumizers are really available and that these agents can treat not only the face, but the eyebrows, the nose, the jowls, the neck and even the décolleté of the chest.
SCN: If you were stranded on an island, what are three skin care products you couldn't (and others shouldn't!) live without?
Dr. Novick: Since the essentials of skin care include adequate sun protection, appropriate moisturization and proper cleansing, I think my answer should be pretty obvious: a high SPF sunscreen, a large bottle of all-purpose moisturizer and a cleanser labeled for "sensitive skin."
SCN: What are the latest treatments offered at your practice for common skin care concerns?
Dr. Novick: The field of dermatology, and in particular the field of cosmetic dermatology and cosmetic dermasurgery, has experienced a veritable explosion in the number of new treatments in the past half dozen years. Just 10 years ago, most dermatologists could offer only collagen injections and strong chemical peels to treat wrinkles and weather-beaten skin. Collagen didn't last long, didn't handle a lot of skin problems, and chemical peels entailed a lot of discomfort and healing time. Aggressive facelift surgery, expensive, painful and with long recuperative downtimes, was the measure of last resort for many people.
Today, this has all changed with the advent of a whole range of temporary, semi-permanent and even permanent fillers and volumizers that have come to market. In addition to the usual office treatments for smile lines on the sides of the nose, worry lines on the forehead, bunny lines around the nasal bridge and sad lines around the lower mouth, I can now offer my patients a large and varied menu of non-surgical cosmetic procedures that are relatively inexpensive, involve no cutting or surgery, can be done in the course of a lunch break and entail little or no downtime. Eyebrows can be lifted, noses straightened, nasal tips raised, under-eye sagging, bulging and crinkling dramatically improved, turkey necks softened, horizontal "necklace" lines eliminated, unsightly jowls eliminated from along the jawline and weather-beaten décolletés restored. Those of us who offer these advanced treatment techniques sometimes refer to them as "liquid facelifts." I never cease to be extremely gratified when a patient steps off the table, looks with absolute wonder at herself in the mirror and exclaims with a huge smile, "My God, it looks like you did a facelift!" Not surprisingly, in the past five years, the number of surgical facelifts performed in the U.S. has fallen by 20 percent. It's truly an exciting time to be a cosmetic dermatologist.
SCN: As a leading skin care expert, what do you really love about your work?
Dr. Novick: At the risk of sounding corny, I love everything about my work. I love going to work every day. My practice is unique among dermatologists in the nation in that I've structured my practice so that each and every patient is booked for at least an hour of time. My reception room (I can't call it a waiting room) is never used unless a family member or friend has come along and wishes to remain outside. Patients aren't stressed by long waits, nor do they have to feel rushed or pressured to ask their questions before the doctor is out the door. And I'm relaxed, because I have the time to give my patients the complete explanations and instructions they require in order for them to fully understand what they have, what they must do about it and how I can help them.