Can Your Skin Be Saved?

Anti-wrinkle creams: Most of these creams use glycolic or alpha-hydroxy acids to rid your face of old, scaly surface skin. Loofahs and shaving do the same thing by physically scraping off the cells. Neither approach actually changes your skin or the aging process. They simply reveal a fresh layer of skin a little sooner than normal. Most over-the-counter preparations will make your skin appear slightly firmer, but use them carefully. Applying an acid-laced cream too near your eyelids or other sensitive areas will cause irritation. Also, understand that two lotions that list the same acid content may affect you differently, depending on their composition. Test a new concoction on a small area for several days before coating your face with it.

The only creams that really kill wrinkles are those containing retinoic acid. Unlike "retinol," a compound found in many over-the-counter products, retinoic acid must be prescribed. Researchers have found it effective for reducing fine wrinkles and evening out skin color. And some studies suggest that after a year or more of use, it helps skin produce new and better collagen, the elastic material that gives young skin its cushiony texture. The downside: retinoic acid does little for deep wrinkles, causes irritation in many people and leaves you very sensitive to sunlight.

Chemical peels: Dig ever deeper and you'll find ever more pristine skin. That's the theory behind chemical peels, which are usually applied in a dermatologist's office and come in three strengths. A light peel involves getting swabbed with a glycolic-acid solution, waiting several minutes and then being mopped with a neutralizing agent. You can do it on your lunch hour and go back to work with a slightly red face. A medium-duty peel requires an application of trichloroacetic acid, which makes the skin turn white the first day. The next day your face turns red, and then the skin actually peels off. The effect is as strong as some laser treatments. The most powerful peels employ phenol acid. These are rarely used, because they have such serious side effects that they must be performed in a hospital setting with cardiac monitoring.

A peel, or a series of peels, will smooth out superficial irregularities and blotchy coloring, making your skin look younger. The technique is relatively inexpensive ($100 to $500 for a light peel, $500 to $1,000 for a trichloroacetic peel). But to avoid burns, inflammation and infection, you need a skilled practitioner. Dark-skinned women should be particularly cautious. Their skin sometimes responds to irritation by making more pigment, which means a peel could increase blotchiness. Because peels usually lighten the skin, the newly peeled need to be slavish about sun protection.

Laser treatments: Getting zapped is all the rage. Dermatologists say cosmetic laser use has exploded over the past five years as the devices have become safer and more precise. Lasers will remove hair and erase birthmarks, but age-conscious women use them most often to resurface their faces and shrink blood vessels on the nose, cheeks and chin. The first thing to know about these treatments is that every beauty objective requires a different laser--and every laser demands a different set of skills. Because any licensed doctor who can afford a laser can use it on patients, the only way to assess competence is to find out how much experience a practitioner has with the treatment you're considering. Pulse dye lasers are extremely safe for shriveling veins, and their effect can last a year or two. For resurfacing, there are two options. An erbium laser vaporizes the top layer of skin; a carbon laser goes a step further, heating the underlying tissue and possibly tightening the skin's collagen, says Dr. David Becker, director of dermatologic and laser surgery at New York Weill Cornell Medical Center.