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Beat father time with a fresh, younger face

"Your Future Face," a new book by Dr. Dennis Gross, offers a plan to help you achieve more youthful, beautiful skin. Read an excerpt.

Last year, Americans spent more than $40 billion on antiaging products while nearly 9 million people underwent age-reversing plastic surgery. But is any of it really worth it, and what's the secret to the fountain of youth? New York dermatologist Dr. Dennis Gross is the author of a new book, "Your Future Face: The Customized Plan to Look Younger at Any Age," and he was invited to appear on “Today” to share some answers to these questions and more. Here’s an excerpt:

Taking Charge of Your Skin
We are now in what I call the Golden Age of Skin Care. There have never before been so many products and procedures that can literally erase years off our faces. In fact, skin care, plastic surgery, and antiaging techniques are now frequently the topic of newspaper and magazine articles, TV news programs, and reality shows. Everywhere you look, it seems, there are new miracle ingredients and procedures designed to make you look younger than ever no matter what your age.

When it comes to turning back the clock, we are truly fortunate. No prior generation has had such an in-depth knowledge of the aging process as well as the chemistry and biological makeup of the skin. This knowledge has resulted in a dizzying number of amazing technological breakthroughs and a cornucopia of products and procedures that make it easier than ever to get a gorgeous and glowing complexion at any age.

But as media coverage and antiaging options have increased, it has become clear to me that many of my patients are really confused about what they should do for their skin. Often my patients come in with a magazine article or an ad for a product and ask me to explain it and to advise them on whether it is right for them. As modern technology increases and more ingredients and therapies are discovered, the more perplexed my patients become.

I decided that now more than ever it is crucial to clarify what is out there to help stop this confusion so that you can take charge of your skin and make fully educated decisions rather than relying on the recommendations of friends, the media, and product advertisements. I’ve written this book based on my sixteen years in private practice, the extensive research I’ve conducted in the antiaging area, and on the published studies of other prominent scientists and physicians. Its purpose is to help you choose the products and procedures that are right for you so you can beat father time at his own game. But more than presenting you with skin-care regimens and high-tech treatments, I want to help you tap into a powerful age-fighting weapon that is innate — your ability to predict how and when you are going to age and which areas are most vulnerable to its visible signs.

Sure, aging can seem like an overnight phenomenon. We go to bed one night with smooth, taut, glowing skin and wake up the next day somehow looking older. We may ask ourselves “How did this suddenly happen?” But no matter how much it seems like a sneak attack (and can it ever!), the aging process is actually systematic and predictable. And this is a beautiful thing. We have the power to look into the future and know what we can expect in terms of how we will look as we get older. This knowledge provides us with the most effective way to make our skin look better than ever today and to keep it looking that way well into tomorrow.

The key predictors are:

  • Our genetics
  • How our face looks when we are expressionless versus when it is expressing an emotion
  • How we look when we are tired versus well rested
  • How our skin has been affected by the sun. Sun-damaged skin often gets crinkles, which will ultimately turn into wrinkles.

Paying attention to these signals helps us determine how we will look as we get older and what areas of vulnerability we may have that might require a little extra TLC. And here is the best part: Once we know our specific aging patterns, we can take a targeted, results-oriented and, hence, more effective approach to getting beautiful, healthy, and more radiant-looking skin. And if you already have any early signs of time etched into your face, predicting their future impact will help you prevent these imperfections from becoming further entrenched and even erase many of them.

These days, selecting the skin-care regimens and treatments that will work best for us is more complicated than it was back when there were only day versus night creams to choose from. In this new era of walk-in, antiaging clinics, myriad skin-care products and treatments available in doctors’ offices, spas, and stores, it is more important than ever to know what will help you get the right results for your face. Further complicating the matter is that it seems like a new wonder ingredient, product, or procedure is being introduced nearly every day. Some are actual miracle workers — proven by bona fide scientific research — to erase and prevent the signs of time. But some haven’t yet proven themselves. While this may not necessarily mean they won’t some day, I strongly believe in going with the tried and true versus the not yet confirmed. This book will present and explain the scope of therapies currently on the market to help you weed out the ones that will be the most effective for you. By honing in on your specific needs, you can make the best possible decisions about the products and treatments that will give you the best results. The truth is, to get the benefits you are looking for, it is crucial that you use the products and procedures that address your specific patterns of aging at the appropriate phase of your skin’s life cycle. Even if it is an ingredient or procedure with positive research behind it, not every antiaging remedy is appropriate for you now, and some may never be.

The next chapter features my “Skin Life Cycle Quiz” that will determine the phase of your skin’s development and your specific aging patterns. Then we will discuss the spectrum of treatments that will work best for you and help you develop your most effective regimen. In general, I have found that the vast majority of my patients get better results by starting out with milder but still efficacious products and treatments and gradually working their way up to stronger more aggressive ones if need be. Even if you are looking for a dramatic change, it’s important to begin with the basics, such as wearing sunscreen and adhering to a solid daily regimen with proven active ingredients to help your skin get into the best possible condition it can be and then to keep it that way. Invasive procedures like face-lifts may turn back the clock, but they don’t stop it from ticking. Time inevitably marches on. And while plastic surgery may tighten sagging skin, it won’t improve your overall complexion. Meaning if your skin is blotchy, sun-damaged, and lined before the surgery, it will still be that way afterward.

Think of it this way. If we want to get in shape, going to the gym for the first time in years and hoisting the heaviest weights possible and running as fast as we can on the treadmill for five miles will most likely cause us to become injured — not become more fit. Our bodies respond better if we gradually increase the duration and intensity of our exercise routines. It is the cumulative effects of these consistent workouts that will help us to achieve our goals — not one extreme sweat session. Skin care operates in much the same way. Shocking the skin with an overly aggressive product or procedure can result in an injury that may outweigh any of its potentially positive effects. Over the years, I’ve treated hundreds of patients who’ve made enormous gains from nonaggressive products and procedures.

The Facts on Aging Skin
To understand better how to combat the signs of aging, it’s a good idea to become familiar with the process itself. The rate at which our skin ages and how this aging will manifest itself are determined primarily by our genetics, the passage of time, and our lifestyles. All of these factors play a role in how we will look at any given moment and give us information to help predict how we will look in the future.

Our Family Trees
Our bodies have their own internal clocks that help determine how and when we will age. For some people, that clock ticks faster than others, and they look and/or feel older than their chronological years. For others, it ticks more slowly, and they look and/or feel younger. This clock is set by our ancestral DNA, which means there is a strong likelihood that our health and bodies, including our skin, will have the same strengths and weaknesses as those of our family members in much the same way as we inherit eye and hair color. Looking at the parent we most closely resemble and assessing how his or her skin aged can be a powerful predictor of how we will look in the future (see photo section, page 2). But lifestyle habits do play a role here. For example, if a parent smoked or worshiped the sun and you never did, your overall health and appearance will no doubt reap the benefits.

Knowing our inherent strengths and weaknesses lets us take the most targeted preventative and curative measures. For example, if sagging seems to be a family trait, there are lifestyle habits we can adopt, such as not losing a drastic amount of weight as we get older, to stave off the so-called inevitable. Our genetics also give us a good indication of which treatments and procedures will be the most effective for us. For example, if family members have been using an ingredient successfully without irritation, there is an excellent chance that it will have similar benefits for us.

As Time Goes By
As we age our body’s natural functions start to wind down, including the biochemical mechanisms that keep skin looking its best. Our skin has built-in natural defenses to protect it from damage, be it from a bad sunburn, drinking too much alcohol, not sleeping enough, and a host of other things. Skin also has amazing regenerative abilities that help it repair any damage it may have incurred. But our skin also has natural enzymes that break it down. As we age, our skin’s defensive and healing powers no longer outpace its natural degradation process. The net result is that our skin loses its ability to fend off and recover from internal and external stressors.

Here’s another fitness analogy. A young jogger can go out one day and pound the pavement. Her knees might be a bit sore afterward, but the next day she can get up and jog again without any major problems. An older jogger, whose knees have taken this type of stress for years, has less natural protection against this type of trauma and less than optimum regenerative abilities to help repair the damage her joints may have sustained during her afternoon run. She will most likely not be able to handle that kind of beating two days in a row without having aching knees. Our skin is no different. As we age, routine stresses, like the sun or lack of sleep, become more traumatic to our skin because we have fewer natural defenses to come to its aid. But here’s where modern science steps in, bringing with it a host of protective and reparative products that can take over where our own natural functions have left off.

Wear and Tear
When we buy a pair of new shoes, the leather is smooth, even in color, and blemish-free. But as we wear them, they start to develop creases. In the beginning, these creases are only visible when we are walking. But the more we walk in the shoes, the deeper the creases get until they are visible all the time. Our skin is kind of like that. The more we use it, the less “new” it appears. And we use our skin a lot. Our many years of making repetitive facial movements, for example, are a key cause of lines. If, let’s say, we have a tendency to furrow our brows, our faces may “freeze that way,” as our mothers might have said. Well, not exactly but close. What happens is that by constantly creasing our foreheads, we can tax the skin to the extent that its ability to bounce back becomes compromised. Gradually a wrinkle will form as a result, even when we are not furrowing (see photo section, page 3). But again, these creases don’t have to be permanent. There are proven ways to relax them back either to their former smooth state or very close to it. Plus, there are many lifestyle habits we can adopt that will prevent further wear and tear and even reverse some of the signs of it. The sun, wind, not sleeping enough, eating an unhealthy diet, and many other habits do show up on our faces. By making certain changes in our daily routines, we not only can improve our overall health but also the condition of our skin.

Genetics also comes into play here, though. Some people are more predisposed than others to particular stresses. Think of that annoying friend who lives on cheeseburgers and fries yet remains superthin and doesn’t develop high blood pressure. Once we factor in genetics with our skin’s natural aging process and our lifestyle habits, we can develop a precise and targeted strategy that will put us on the path (and keep us there) to amazing-looking skin.

Amazing-looking skin, however, can be a completely subjective term. How we feel about the way we look plays a significant role when we are trying to determine an appropriate course of action. In my experience, a person who is happy with their appearance is pleased with making slow and steady improvements, even if others might say she needs a more speedy and radical approach. On the other hand, a person who is very critical of their appearance is often tempted to take more extreme measures in the hopes of making a dramatic difference, whether or not the condition of their skin calls for it.

But no matter how you feel about your skin, it is important to remember that permanent procedures such as a face-lift aren’t reversible. And other invasive measures, such as laser resurfacing, which can be appropriate for some people, can leave lasting scars and skin discolorations.

Your first step to beautiful, younger-looking skin is to take all of these elements into account: your genetics, lifestyle, inherited patterns of aging, your skin’s present condition, and the way you feel about your appearance so that you can make educated decisions about which products and therapies will work for you. “Creating Your Personal Profile” will help us determine your skin’s level (phase of its life cycle) by factoring in all of the above. Your score will help you map out your personalized plan of products and perhaps procedures that will best work for you to give you the results that you want. Every level, however, does need to start out with the basic preventative measures and healthy skin-care habits outlined in chapter 3, “Level One: Essential Care and Prevention.” Each successive chapter level will provide progressively more intensive measures that will yield more dramatic results. The important thing to remember, however, is that you don’t have to get more aggressive and invasive if you are satisfied with the results you are getting and/or are just plain uncomfortable with the idea of elective cosmetic surgery or a procedure that requires substantial recovery time. It is your face, after all.

The last two chapters will focus on the lifestyle and nutritional habits that will make all the difference in the world to the way you look and feel — no matter what your level.

So with all this in mind, let’s get started and give you the knowledge and the tools that will give you your best skin ever.

Excerpted from, "Your Future Face: The Customized Plan to Look Younger at Any Age," by Dennis Gross, M.D. with Cara Kagan. Copyright 2004. All rights reserved. Reprinted by permission of Viking Books, a division of Penguin Putnam, Inc. For more information, visit