Save face (and money) — let yourself age

Every time I look in the mirror, I see my mom.

It's our hair. Hers was prematurely white in her 30s, while mine's getting there in my 60s. It's eerie to see her staring back at me, four years after her death. I love the reminder and often say hi. One of my mom's best qualities was her common-sense approach to life, including getting older. Like most people of her generation, she took it in stride.

Most of it, anyway. Decades ago she told me she didn't like her "turkey neck" — folds of skin beneath her chin. She confided she was thinking about having surgery. I gasped in horror.

"Easy for you to criticize," she said, "since you're still young." Good point. She never had the surgery, and her face (but not her neck) remained amazingly wrinkle-free until she died at age 81.

My mom's common-sense generation is almost gone. Today, despite (or because of) a rapidly aging army of 77 million boomers, we're more beset with messages of beauty and youth than ever. The pressure's on to be forever young.

Hardest hit are women and men in high-profile positions, especially in the entertainment fields. The same drums beat for the rest of us by osmosis. Friends much younger than me color their hair to hide the gray; some have had eye "tweaks" or more radical "enhancements." Judge not, my mother would say: You're not there yet.

Well, I am. So I thought I'd look at this wrinkle business a little more closely.

I began with a basic question: What causes wrinkles?

People wrinkle to different degrees due to two factors, said Dr. Sam Most, medical director of the Cosmetic Surgery Center and chief of facial plastic surgery at the University of Washington School of Medicine in Seattle. (www.drmost.com). One is genetics — some folks never get many wrinkles. The second is environmental, the result of smoking or sun exposure.

For those who do wrinkle, there are two causes, he said, and each has its own reduction strategies. The first cause is muscle movement — the more you move your facial muscles (frowning is worse than smiling), the more folds appear in the skin. A common solution to stop the muscles from moving is an injection of Botox.

The second cause is thinning of the skin as we age, causing the collagen fibers in the skin to lose organization and elasticity. Collagen is one of the most abundant proteins in our body — it's in the joints, skin and other tissues. To eliminate these wrinkles, we can "fill in the folds" with materials, such as collagen, Restylane or other substances. Or we can use surgery to fool the skin into rejuvenating itself, creating a wound that produces a new layer of skin and thus newer collagen that's better organized. This is how chemical peels, laser peels and dermabrasion work, says Most.

But what everyone wants is to eliminate wrinkles with no down time — no swelling or bruising that makes them hide until they heal, says Most. However, that doesn't exist. As a result, thousands of devices and cosmetics now claim to do the job instantly, painlessly and more cheaply — but don't.

In a recent study, Most examined two popularly advertised facial stimulators that claimed to produce results similar to traditional face-lifts. "There are more than 50 of these types of devices being sold over the counter and on the Internet," he said. His findings — after four months in which 10 adults used the devices (one a handheld stimulator that passes over the face at specific points, the other a mask with built-in contact points that deliver electrical impulses) — showed that researchers found them to be useless.

"When you compare what the ads for these devices say — that stimulating muscles will make wrinkles go away — and compare it to what really causes wrinkles," says Most, "you know the ads have no validity. Buyers beware."

The same idea applies to over-the-counter cosmetics. Cosmetics have minimal effects on wrinkles, says Most. "The ingredients are typically not strong enough to cause more than a 10 percent improvement — but you need a 25 percent change to see a difference with the naked eye!"

One currently advertised product — claiming to be better than Botox — originally was designed to remove stretch marks (which are discolorations, not wrinkles). Touted as "the anti-wrinkle treatment of choice," the product was 13 percent effective on stretch marks in studies, says Most (which is almost imperceptible), but he knows of no evidence to show it works on wrinkles. Yet the company makes millions by selling it as a wrinkle remover.

"If something sounds too good to be true," says Most, "it probably is." Echoes Bob Schroeder of the Federal Trade Commission in Seattle, "Don't just accept advertising claims — check with your health-care provider before spending substantial amounts of money."

And don't believe everything you read. In my research, I found a Web site that promised "unbiased information on anti-aging cosmetics" — and lavished praise on the stretch-mark cream that now parades as "the anti-wrinkle treatment" I mentioned above. Buyer beware. Age with grace.

Liz Taylor's column runs Mondays in the Northwest Life section. A specialist in aging and long-term care for 30 years, she consults with families and their elders. E-mail her at growingolder@seattletimes.com or write to P.O. Box 11601, Bainbridge Island, WA 98110. You can see all of her columns at www.seattletimes.com/growingolder/.