Trying to establish a skin care routine can be overwhelming – there are SO many products on the market that promise dramatic results and tout themselves as a must-have. There is certainly a role for a plethora of products, but for most patients, a simple routine of staple products is enough to make a marked difference in their skin health and appearance. 

We are inundated with information (and misinformation) about skin care – every product claims to be the next fountain of youth, the next age reversal, the next answer to our prayers. Ads for these products throw in fancy jargon to make them seem scientifically validated – let me say that “Leading choice of skin care professionals” means zip, and words like “complex amino acids” are meant to sound splashy and well-studied, when the true meaning is far simpler. Just because a product contains elements essential to the integrity of youthful skin, slathering it on your face does not mean that your skin will absorb it and make use of it. As physicians practicing both Emergency and Aesthetic Medicine, we like to rely on good science for explanation. For most people, four to five items are all they need. Below is a basic skin care plan that is a good starting off point for most. As always, consultations are free – and if you have specific concerns or questions, we would love to meet you in person to discuss further. 

1. SPF 

The number one factor in aging skin is not stress nor diet nor age itself, but cumulative sun exposure. UV rays are the culprit for those crinkly changes in your skin – whether they be from the sun or a (excuse my language) tanning bed. Sun exposure causes such changes as decreased elasticity, sallow colour (once those tans fade), as well as wrinkles, sun-spots, scaly plaques and dilated surface blood vessels. While bad burns seem to have the most impact on your cancer risk, it’s your cumulative sun exposure that’s responsible for making you wrinkle. Add this to the normal loss of subcutaneous fat as you age and the changes can be dramatic. The key here is prevention, and you are never too late. It isn’t realistic to avoid the sun entirely – but as the weather warms, you are likely to be spending more time outside. On top of wearing a hat, seeking shade, and covering up with clothing, we should be wearing broad spectrum SPF sunscreen every day. What does SPF even mean? Well, SPF stands for “Sun Protection Factor”, and refers to how much longer you would take to sunburn while wearing the product exactly as directed. So this means that if you were wearing SPF 50, it would take you fifty times longer to burn in the sun than if you weren’t. The reality is that life is not a lab – and how we wear our sunscreen is usually imperfect. When it comes to your face, perfect application would require a nickel sized dollop of product, 30 minutes before going in the sun, reapplied every two hours or immediately after swimming or sweating. This is recommended every day of the year – and chances are it’s not happening. Don’t be falsely reassured because you applied SPF 50 this morning under your make up – pack a powdered sunscreen to top yourself up throughout the day, or be sure to shield yourself from rays with hats and clothing. 

2. Cleanser 

The basic staple of all skin care rituals is washing your face at the end of the day. A gentle, pH balanced cleanser that is fragrance and irritant free is key, and also protects your skin’s acid-base balance – avoiding the need for toners. Your skin is naturally a pH of 4-6, which is slightly acidic. Most soaps and foaming washes are basic, and can lead to dryness (does your skin feel tight after washing?), irritation, and blemishes on certain skin types. If you are naturally very oily, you can use a higher pH cleanser to your advantage, but for most people there is little downside to something that is closer to their natural acidity. 

3. Moisturizer 

Selection of a moisturizer can be daunting, as there are so many options on the market. Often this takes some trial and error – so if you can get your hands on some samples, that is often a way to see if a product is a good fit. In general, moisturizers work in two ways: by protecting/sealing your skin’s lipid barrier, and by drawing water in to the upper layer of your skin. We recommend hypoallergenic, fragrance-free moisturizer for all, even if you don’t have sensitive or reactive skin. There is little point in introducing additional possible irritants to a functional product, when we are putting so many different products on our body in the form of cosmetics already. Oily skin usually benefits from lighter hydration in the form of gels and lotions, whereas dry and eczematous skin requires emollients to cover the skin with a protective film to trap in moisture. If you can find a moisturizer that meets the criteria to be an effective sunscreen as well, you’ve saved yourself a step in the morning. Simplify, simplify, simplify. 

4. Retinoid 

Retinoids deserve a whole series of posts of their own. These are Vitamin A derivatives that come in a number of forms and have a number of cosmetic applications. When used topically, they increase the production of collagen, which leads to a reduction in fine lines and wrinkles. They stimulate the production of blood vessels and give you a “glow”, unblock pores and impede the growth of bacteria. leading to a reduction in acne. They also help reduce the appearance of hyperpigmentation, such as melasma. Retinoids are not recommended in pregnancy or when trying to conceive, and I always recommend discussing their use with a physician before starting as they do have some side effects. such as irritation and sun-sensitivity. Stay tuned for more posts on this fantastic medication. 

5. Vitamin C 

An antioxidant, Vitamin C decreases the appearance of hyperpigmentation and stimulates collagen production, reducing fine lines and wrinkles. Look for a product that contains 10-20% L-ascorbic acid, the active version of this ingredient. Vitamin C is a bit finicky to store – if it appears brown or amber before application, it has oxidized, and is no longer effective. Tip: apply in the morning to avoid discolouration of your pillow cases! 

There is no one-size-fits-all skin care routine, but these keystone products are helpful for most people as part of a comprehensive skincare routine. Find a practitioner you trust to discuss what approach to positive aging is best for your needs.