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SUMMER/FALL 2015
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WHY
YOUR
SKIN
CHANGES
01
As you enter your 40s, the thinning of your skin accelerates.
This isn’t a change you’ll see overnight—it’s likely to take
weeks, or even months, for the texture of your skin to
transform. Melbourne, FL, dermatologist Anita Saluja, MD,
says there are a few elements that cause skin to become
crepey. “The sun, a loss of collagen and elastin, and a decline
in moisture due to aging, can all cause changes in texture.”
Crepey skin becomes more pronounced when there’s a
significant amount of fat loss in the area (from aging or weight
loss). “Chronic use of medications like steroids can also be a
causative factor,” adds Dr. Saluja. A decrease in female
hormones, which leads to dry skin, contributes to crepiness
on the arms and thighs more so than the face. Hormonal
replacement therapies may help improve the look of the skin.
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CALL IT WHAT YOU WILL: ELEPHANT SKIN, PAPER-THIN SKIN OR GRANDMA SKIN—IT’S ALL THE SAME, AND IT’S ALL
SKIN
CREPEY. “CREPEY SKIN IS ONE OF THE MOST DIFFICULT SIGNS OF SKIN AGING TO PREVENT BECAUSE IT HAS SO
MANY DIFFERENT CAUSES AND CAN OCCUR ON SO MANY DIFFERENT PARTS OF THE BODY,” SAYS NEW YORK
DERMATOLOGIST MACRENE ALEXIADES, MD. BUT, JUST BECAUSE YOUR SKIN IS STARTING TO HAVE A MIND OF ITS
02
WHAT IT
LOOKS LIKE
DID YOU KNOW?
According to La Jolla,
CA, plastic surgeon
Robert Singer, MD,
while these treatments
may have benefits, they
are not a replacement
for surgery in patients
with anything other
than minimal concerns.
THE CAUSES OF CREPEY SKIN
OWN AND LACKS THE FIRMNESS IT USED TO HAVE, DOESN’T MEAN YOU HAVE TO LIVE WITH IT LIKE THAT.
Skin that has turned crepey is thin, loose
and flaccid with a certain degree of sagging.
Sacramento, CA, dermatologist Suzanne
Kilmer, MD, says that crepey skin doesn’t
look nearly as thick or plump as younger
skin does. Often compared to the thinness of
a piece of paper or a crêpe, it’s the thinning
of the dermis and epidermis that make skin
look like this. “Crepey skin differs from
other types of skin aging,” says Dr. Alexiades.
“It first appears as an increase in skin
markings, which look like little dots around
the hair follicle that start to merge into linear
or diamond-shaped marks and connect the
dots together.” Over time, the subtle creases
and pores in the skin slowly become
exaggerated as the breakdown of collagen
and elastin becomes more evident. From
there, skin folds accumulate and skin starts
to thin out. Whereas a stretch mark is the
cause of a dermal tear in the skin and a loss
of elastin, and a wrinkle forms from repeat
motions in one area, crepey skin is more so
the result of a lack of skin thickness.
03
WHO IT
AFFECTS
FAT LOSS +
COLLAGEN & ELASTIN DAMAGE
+ A LACK OF MOISTURE
= THIN, CREPEY SKIN
Everyone is susceptible to crepey skin, but
some skin tones and types are more likely to
experience it than others. Anyone who’s prone
to sun damage and has little melanin in their
skin—think fair- and lighter-toned types—and
those who bake in the sun or use tanning beds,
may see signs of it faster or more intensely.
Certain ethnicities, such as Latinas, African
Americans and Asians, inherently have thicker
skin than others, which may hinder the effects
of crepiness to some degree.
MORE >
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CRE PEY
SKIN
ON YOUR FACE
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THE SKIN ON YOUR FACE GETS
MORE SUN EXPOSURE THAN
OTHER PARTS OF YOUR BODY,
MAKING IT MORE SUSCEPTIBLE
TO CREPINESS. “IF YOU DON’T
USE A GOOD SPF DAILY, THEN
YOU’RE PUTTING YOUR SKIN AT
RISK FOR DAMAGE,” SAYS DR.
KILMER. “SUN DAMAGE AFFECTS
NEWBEAUTY
THE NUMBER OF
NONSURGICAL SKINTIGHTENING PROCEDURES
PERFORMED IN 2014.
SOURCE: ASAPS
ELASTIN AND COLLAGEN AND
CAN ACCELERATE FAT LOSS.
WHEN YOU LOSE FACIAL FAT,
YOU EXPERIENCE DEFLATION
LIKE HOW A BALLOON DEFLATES
WHEN IT LOSES AIR. UVA DAMAGE
ALSO TRIGGERS THE PRODUCTION
OF AN INTERLEUKIN (A GROUP
OF PROTEINS THAT REGULATE
WHITE BLOOD CELLS) THAT
CAUSES FAT TO BE LOST, TOO.”
+
THE
AFFECTED
AREAS
BEFORE
AFTER
Edina, MN, facial plastic surgeon Edward
Szachowicz, MD, used the Fraxel re:pair CO2
laser and Sculptra, a dermal filler, to address
this patient’s age-related skin changes.
160
298,223
WHAT ELSE TO DO:
Swiss line by Dermalab Cell
Shock Youth-Inducing Cream
is full of plant-derived stem
cells and collagen-promoting
peptides and claims to help
restructure skin’s underlying
architecture so that it’s tighter.
$270, shopswissline.com
THE FACE
The quality of the skin on the
face is affected by sun damage,
repeat muscle movement and
a breakdown of the integrity of
the skin. The eyes and neck are
most likely to show crepiness
first; over time, skin on the
cheeks can start to thin, too.
Plenty of women have crepey
skin on their faces that also
comes with sunspots—a dead
giveaway that sun exposure
has basically eaten away at the
collagen, leaving the skin with
little fullness or elasticity.
HOW TO FIX IT There’s more
than one way to alleviate crepey
skin on your face. “Peeling away
fine lines with hydroxy-acid
creams, lotions or chemical
peels may help. Stimulating
collagen with nightly retinoid
creams or retinol may improve
the look of your skin, too,” says
Dr. Saluja. An ablative fractional
laser can also amend your skin’s
texture. “It’s the best thing you
can do to minimize the crepiness,
but it has the most downtime
of the options,” says Dr. Kilmer.
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SKIN
THE CAUSES OF CREPEY SKIN
THE EYES
The skin around the eyes is superthin.
In fact, it’s the thinnest skin on the
face. Years of environmental damage
and squinting can wear away the
thickness of the skin, making the eyes
look worn out. “The skin here looks
like crêpe paper—very thin with fine
puckers. Patients with eczema often
have crepey skin around their eyes,
even if they are younger, due to the
chronic inflammation and dryness,”
says New York dermatologist Heidi
Waldorf, MD. While genetics do play
a role, once the skin around your
eyes begins to look crepey, it affects
your overall appearance.
HOW TO FIX IT The extent of how
thinned out your skin is will determine
what is best. Some dermatologists and
plastic surgeons prefer a one-two
punch method that consists of first
smoothing the skin with a series of
chemical peels around the eyes or
fractionated CO2 laser treatments on
the eyelids (you will be put under
anesthesia so you won’t feel anything,
but plan for a few days off to fully
recover at home), which stimulates
collagen to help thicken the skin. Then,
once the skin has begun to soften
and increase in thickness, Botox
and/or a hyaluronic acid filler can be
injected into the little lines around
your eyes to help minimize them.
WHAT ELSE TO DO:
Because the skin around
the eyes is thin, it’s best
to use an eye cream with
ingredients that are as
pure as possible (to reduce
the risk of irritation and
reaction). Blending science
with nature, Schaf Skincare
Nutritive Daily Eye Cream
is free of toxins, fragrance
and parabens and helps to
smooth and firm the eye
area with peptides, CoQ10
and hyaluronic acid. $40,
schafskincare.com
THE NECK
Crepiness on the neck
is different from crepey
skin elsewhere. The skin here
is naturally thin and thins out
even more once collagen and
elastin begin to break down.
Skin doesn’t just become
loose; it also becomes laden
with horizontal bands. Sun
damage and smoking speed
up the extent of the damage.
HOW TO FIX IT Most experts
agree that the best way to
tackle crepiness on the neck
is with a laser that stimulates
collagen production to thicken
the skin. “My go-to is the
Fraxel Dual laser, which
contains both erbium and
thulium wavelengths,” says
Dr. Waldorf. “It makes a
difference on thin areas of
skin with just one treatment.”
Because neckbands are a
contributor, too, those can’t
be glossed over, which is
why a neuromodulator like
Botox, Dysport or Xeomin is
necessary. “It helps where
muscle movement aggravates
the appearance of the neck,
making the crepey skin bunch
up,” Dr. Waldorf adds.
WHAT ELSE TO DO:
Loading skin with firming
ingredients like peptides and
niacin will help tighten it and
downplay its loose texture.
NIA 24 Neck Sculpting Cream
is the perfect adjunct to use
with in-office treatments
because it adds moisture
and gives a tightening effect
over time. $118, skinstore.com
FIND A BEAUTY
DOCTOR NOW!
The essential guide to
help you make the right
choices. Turn to page 193.
MORE >
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CREPEY SKIN ON THE BODY IS FORMED THE SAME WAY AS ON THE
FACE, BUT THE BIGGEST POINT OF DISTINCTION IS THE ROLE THAT
ON
CREPEY SKIN
YOUR BODY
WEIGHT LOSS PLAYS. YOU’VE ALREADY GOT THE SUN DAMAGE AND
162
NEWBEAUTY
COLLAGEN BREAKDOWN, AND WHEN YOU ADD WEIGHT LOSS INTO
THE MIX, YOU CAN BE LEFT WITH SKIN THAT’S THIN, STRETCHED
OUT AND ALMOST MUSHY. ANOTHER DIFFERENCE: “IT’S HARDER
TO TREAT SKIN ON THE BODY WITH ANTI-AGING ACTIVES ON A
THE HANDS
DAILY BASIS BECAUSE OF THE AMOUNT OF SKIN THAT NEEDS
TO BE COVERED WITH PRODUCT,” SAYS DR. ALEXIADES.
+
THE
AFFECTED
AREAS
Aged hands are a telltale sign
of how old you are. They’re
notorious for becoming wrinkly
over time and displaying signs
of crepiness, which results
from both sun damage and
fat loss. Overwashing your
hands can also zap your skin
of moisture, which needs to
be replaced often.
HOW TO FIX IT Long-lasting
collagen fillers are the go-to
for most doctors. “Fillers like
Radiesse and Sculptra can
improve the appearance of
your skin by revolumizing
the area,” says Dr. Saluja.
“Another option is Ultherapy
(a noninvasive ultrasound
treatment that tightens and
lifts skin), which is now being
used to treat crepey skin on
the hands, too.” Applying
Retin-A to the backs of your
hands nightly, and sealing it
in with a layer of moisturizer
that contains ingredients like
urea, shea butter, petrolatum,
mineral oil or hyaluronic
acid, will also help improve
skin texture so that it
begins to look thicker
and firmer over time.
THE KNEES
Years of basking in the sun,
plus weight fluctuation, can
cause skin around the knees
to become loose and crepey.
HOW TO FIX IT For this part
of the body, Dr. Alexiades says
she’s had success with the
Profound laser, a minimally
invasive injectable laser
treatment, which delivers
energy deep within the skin
via fine needles at a threshold
temperature. “Bypassing the
skin’s surface allows for more
energy to be delivered than
with a skin surface tightener.”
WHAT ELSE TO DO:
Firm and hydrate loose
skin with DermaQuest
Stem Cell 3D Body
Crème, a botanical-based
anti-aging body cream.
$70, dermaquestinc.com
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SKIN
WHAT ELSE TO DO:
THE CAUSES OF CREPEY SKIN
Rich in skin-softening
and retexturizing
glycolic acid, Glytone
Ultra Heel and Elbow
Cream helps transform
skin. $50, dermstore.com
THE ARMS
& ELBOWS
The undersides of the arms, the
elbows and the area where the
arms connect to the chest near
the armpits, are some of the
crepiest areas on the body.
“Women get it so bad here,”
says Dr. Kilmer. “Part of the
reason why it’s so apparent on
the undersides of the arms is
because of hormonal changes
due to menopause. As estrogen
levels drop in the body, collagen
is diminished, so there’s less
supportive collagen in the arms
and thinning skin becomes
more noticeable.” When you
lose weight in your arms, which
can be an area that fluctuates,
the skin becomes stretched out.
THE THIGHS
Skin on the inner thighs loses
firmness over time, becoming
loose and more stretched out.
Just like how skin on the rest
of the body becomes crepey,
the same thing happens to
the skin on the thighs, which
is naturally thinner than other
parts of the body.
HOW TO FIX IT The most
effective way to improve the
appearance of crepiness on
the thighs is with topicals.
“One of the best things to use
is retinol or Retin-A, or even
a DNA repairing cream that’s
designed for the face,” says
Dr. Alexiades. “When dealing
with the thighs and other
large areas of the body, it can
get expensive because you
have to use more product to
cover all of the skin. But, it’s
one of the best ways to limit
the effects of crepiness.”
THE CHEST
Crepey skin on the chest
becomes accentuated by sun
damage. A lack of moisture
in the area—the chest is often
exposed to the sun and other
environmental damagers—only
makes the crepiness (and any
wrinkles) more pronounced.
HOW TO FIX IT Treatments like
microdermabrasion can help
smooth out skin, but for more
of a transformation to the
skin’s surface, your doctor may
recommend anywhere from
one to five sessions of Fraxel.
“We’re also using Ultherapy to
treat crepiness on the décolleté
because it stimulates collagen
production in a deeper layer of
skin,” says Dr. Saluja. Microfat
grafts may also be a beneficial
solution for some patients.
WHAT ELSE TO DO:
Restorsea Repairing
Neck and Decollatage
Treatment improves
skin texture with a
patented natural
enzyme and vitamin C.
$150, restorsea.com
HOW TO FIX IT A skin-tightening
treatment, which helps firm skin
by inciting new collagen to be
made, may be needed. And,
because the arms are a hard
area to treat, a more accurate
microinvasive skin tightener,
such as ThermiTight, may
be your best option. It works
differently than more traditional
radio-frequency treatments in
that it “injects” energy deep into
the skin with tiny probes (the
areas are first injected with
anesthetic, so you won’t feel
much during the treatment). The
results take up to six months to
see and some doctors say they
are not yet certain if they are
long-term. You may be swollen
for a few days afterward, but the
brand claims you typically only
need one 60-minute treatment
for it to work.
MORE >
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IS KEY
PREVENTION
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+
WHAT ELSE TO DO:
OKU offers personal skin-care coaching
through your phone. The handheld device uses
light and sensor technology to assess changes
below your skin’s surface, up to 2 millimeters,
and then gives suggestions on how to prevent
and correct them. $299, getoku.com
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NEWBEAUTY
ESSENTIAL
INGREDIENTS
TO USE
If crepey skin is a problem,
these skin-care ingredients,
which are commonly found in
creams, lotions and serums,
can help improve the look
and feel of your skin.
01
MOISTURIZE
REGULARLY
Hydration is important for
maintaining healthy skin.
Properly moisturized skin
looks fuller, plumper and
more resilient and snaps
back into place. On the
flipside, a lack of moisture
will make crepey skin look
worse—drier, thinner and
unable to recoil. Dr. Waldorf
says that when crepiness
is a matter of lost hydration
(which is common in patients
with atopic dermatitis skin
conditions), applying a bland
barrier cream or occlusive,
like Vaseline, will help.
ALPHAHYDROXY ACIDS
HYALURONIC ACID
Besides brightening skin, AHAs
like glycolic acid help repair
collagen and bring new skin
cells to the surface.
This ingredient helps to lock
in moisture by attracting
water to the area and
plumping up the skin.
CERAMIDES
PEPTIDES
Naturally found in skin,
ceramides lock in water so
moisture doesn’t escape.
Peptides promote collagen
production, which leads
to stronger, firmer and
smoother skin.
GLYCERIN
With its slick feel, glycerin
draws on water in the air to lock
it into your skin, which is why
these work best on damp skin.
02
STIMULATE
COLLAGEN
In addition to keeping skin
moisturized, preserving
the integrity of your skin’s
collagen and elastin is key.
“The best way to do this is
through the regular and
consistent use of anti-aging
ingredients. Intermittently,
you should undergo laser or
energy-based treatments,
which can make bigger
contributions to the collagen,
elastin and hyaluronic acid
content in the deeper levels of
your skin,” says Dr. Alexiades.
Topical products that contain
growth factors, peptides,
alphahydroxy acids and
retinoids will help, too.
03
MAINTAIN A
STABLE WEIGHT
You want to try to keep
your weight fairly consistent
and not fluctuate too much.
The reason: “Fat loss will
increase the appearance of
lines and wrinkles and crepey
skin,” says Dr. Waldorf. With
less of a cushion of sorts to
support the skin, changes
in skin quality and texture
become much more evident.
“In some areas, patients with
crepey skin can improve its
appearance with very small
superficial injections of a
thinner hyaluronic acid
filler like Belotero, or one
that gives a skin-boosting
effect like Restylane Silk.”
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SKIN
SHEA BUTTER
Superthick—it’s in a lot of
moisturizers—petrolatum
keeps moisture in the skin
by creating a seal of sorts.
An intense moisturizer,
shea butter is loaded with
essential fatty acids that keep
skin hydrated and pliable.
RETINOL
UREA
Whether you use an
over-the-counter or
prescription-strength
version, this vitamin A
derivative thickens skin.
It works to thicken skin,
address changes in skin
texture and exfoliate, too.
THE CAUSES OF CREPEY SKIN
PETROLATUM
INSIDE
tip
When it comes to correcting
crepiness, Dr. Saluja says it’s
important to know that treating
crepey skin is one of the most
difficult tasks to accomplish in
aesthetic medicine. There’s
only so much improvement
that can be done due to the
biological components of
crepey skin. “It’s best to keep
your expectations realistic,”
she says. The crepier the skin,
the less healthy the collagen
and elastin is.
04
PROTECT YOUR
SKIN FROM
THE SUN
Because the sun is directly
responsible for degrading
healthy collagen and
elastin, which makes skin
look weathered, crepey
and loose, it is crucial to
use sunscreen daily on both
your face and areas of your
body that are exposed. NB
WHAT ELSE TO DO:
Vaseline Intensive Care
Healing Serum moisturizes
skin on the body and delivers
a dose of concentrated
ingredients to lock moisture
in and keep skin perfectly
hydrated. $8, target.com
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