By Avni Mahiji, PharmD

Aging is a result of a combination of intrinsic factors (uncontrollable things like genetics, gravity and normal hormonal changes) and extrinsic factors (controllable things like environment and lifestyle choices— smoking, for example). Scientists believe extrinsic factors may increase the rate at which the internal aging process proceeds. By understanding that process, we can prevent it or slow it down.

Slowing sun damage

UV rays account for a majority of the aging process, by damaging the DNA and decreasing the number and activation of dormant stem cells in the basal layer of the skin. To prevent this damage, use sunscreen with an SPF of 15 or higher daily, especially from 10 a.m. to 4 p.m. You need protection from both UVA and UVB rays, so look for a product with “broad spectrum” or “multispectrum” coverage. (Neutrogena Helioplex is my favorite.)

Also, look for fabrics with a high Ultraviolet Protection Factor: the higher the UPF, the better protection from UV rays. Bright- or dark-colored clothing reflects more UV radiation than do pastels and bleached cottons.

Sun protection is critical for slowing down the aging process. Reversing it is another matter.

Reversing aging

Thousands of creams and serums claim to reverse aging, but only one ingredient has been clinically shown to have anti-aging properties that work at the molecular level. Retin-A, a derivative of vitamin A, is available over the counter in cosmetic form (retinols). It’s also available in prescription strength (retinoids).

Here’s how retinols and retinoids work:

Our skin cells have retinoid receptors that help regulate skin cell function. While skin cell function normally decreases with age, regular use of retinoids helps maintain function and improve overall skin texture. Vitamin A derivatives improve the turnover of skin cells, which helps minimize clogged pores that lead to blackheads and whiteheads. It also help diminish wrinkles, brown spots and freckles and has antioxidant effects.

Retinoids’ most important effect, however, is to increase the number of fibroblasts that are responsible for collagen production, along with glycosaminoglycans, reticular and elastic fibers, and glycoproteins (the connective tissue that supports the matrix of skin structure).

Given their potency, retinoids can be very irritating to the skin. So if you try them, start with over-the-counter retinol—a peasized amount applied every other night (sunlight reduces their effect). Make sure to use moisturizer and sunscreen, as the product can dry out your skin and make it sensitive to the sun.

The key to using retinols and retinoids is consistency. Side effects can last up to 8 weeks, while dramatic improvements can seen by 24 weeks. Be patient—the best results are seen over time.

Stem cell skin care

The new hype in the skin-care world is plant stem cells. They don’t replace human stem cells; rather, they protect our cells so they live longer, and they stimulate our cells’ activation. In a sense, the plant stem cells “wake up” human skin stem cells. Many scientists have labeled them “the fountain of youth.”

Skin stem cells play an important role because they help regenerate damaged skin cells. They’re usually dormant in the basal layer of the skin, and when activated, they help repair wounds (such as acne scars, for example). As we get older, these cells are less easily activated and less efficient at repairing wounds. Our skin stem cell population also decreases as we age, so skin cell turnover decreases. That’s why exfoliating becomes a necessity as we get older, to increase cellular turnover and skin sloughing. That also explains why, as we get older, it takes longer for our skin to repair wounds.

In skin care, the topical use of stem cells stimulates the dormant basal skin cells to help repair fine lines and wrinkles; reduce the appearance of redness, age spots and sun damage; and restore and maintain firmness and elasticity by producing lipids (fatty acids), carbohydrates and protein.

Sunscreen, retinols, retinoids and stem cell skin care are my fountain of youth.

Dr. Avni Mahiji, PharmD, is a board-certified pharmacist and a graduate of prestigious school, Massachusetts College of Pharmacy and Health Sciences. Her goal is to bring awareness of the connection between medications and overall wellness by educating patients about the benefits and potential risks of pharmaceuticals and homeopathic products. Contact her at [email protected], and follow her on Instagram @Drmahiji.