This is a guest post by Dr. Val Jones who works with our Doctors Online partners at eDocAmerica.

How can we combat skin that becomes dry, thin, and inelastic as we age? Dr. Val shares her final tips with us below. If you missed her previous post on what happens to aging skin, you can read here.

There are some products and procedures that can help to slow or reverse the aging process to some degree. 

1. Removing the dry, dead layer of outer skin

Our skin is constantly replacing itself, as dead skin cells slough off and fresh ones grow underneath. If you've noticed how beautiful baby skin is, that's because their cells turn over every three to five days. Compare that to turnover rates in teenage skin (about 14-21 days), middle aged skin (45-60 days) or older skin >50 years (60-90 days). No wonder our skin doesn't look baby-fresh as we age. In order to stimulate skin turnover, there are a few things we can do. Firstly, we need to remove the dry, dead layer of skin so that fresh cells can replace them. This can be achieved through mechanical (such as scrubs and rough textured surfaces - dermabrasion) or chemical means (such as acidic or enzymatic removal). 

There are hundreds of different products that can help to remove dead skin cells. Over-the-counter scrubs, mitts, pumice stones, Clarisonic brushes, acid washes, and enzymatic peels are readily available. Facial skin is thinner than other parts of the body, and it's important to be gentle with it so as not to damage the deeper layers while removing the dead cells on top. 

If you can afford it, I recommend seeing a skincare professional (a cosmetic dermatologist or his/her aesthetician) to optimize your anti-aging skincare regime. They can be very helpful in recommending products that have been scientifically tested, and contain prescription strength ingredients that will do the job they claim to do. Depending on your individual skin's properties (degree of oiliness or dryness, acne, wrinkles or discoloration), they can recommend a regimen that works best with your skin type. 

2. Increasing skin cell turnover  

Vitamin A products (including retinol, adapalene, and tretinoin) work by stimulating collagen synthesis in the deeper skin layers, reducing inflammation, and triggering skin turnover. They are helpful in reducing wrinkles, treating acne, and adding back some thickness and smoothness to aging skin. Over-the-counter products contain lower doses of vitamin A than their prescription counter parts, and take longer to show an effect. 

Some people are more sensitive to Vitamin A products than others, and experience some redness and flakiness when they first begin using it. Retinol and vitamin A-derivative creams break down in the bright light or in the presence of acid, so it's important to apply them at night and without other creams that have salicylic, hyaluronic, glycolic or other acids in them. Because Vitamin A thins the dry, outer layer of skin, sun-sensitivity is also common. It is important to use sunscreen, especially higher SPF types, if you use Vitamin A creams regularly. 

Dermatologists often say that if you only use one anti-aging product on your face, it should be a Vitamin A-derived cream. The results from retinol type creams are more pronounced than with most other interventions. 

3. Hydrating the healthy skin

As we age, our skin tends to lose its moisture content as well as cell metabolism slows, hormones change, and the outer skin layer fractures. Restoring the water content to our skin is helped by avoiding harsh soaps that dry the skin further, drinking sufficient water, and applying non-comedogenic (meaning, creams that don't block pores) products to the skin surface. Facial moisturizer creams that are generally recommended by dermatologists may contain urea, hyaluronic acid, lipids, sunscreens, and anti-oxidants (such as Vitamin C).

4. Stimulating collagen production

Retinol: Vitamin-A-derivative creams (such as retinol) have been clinically proven to increase the elastic collagen layer of the skin. Stronger concentrations of Vitamin A are more effective, but may have unwanted side effects of skin irritation and dryness.

Vitamin C: Vitamin C serums and vitamin supplements can be helpful in reducing the effects of photo-aging. Vitamin C is a powerful anti-oxidant that can reduce sun damage, as well as assist in collagen production.  Vitamin C is so important in skin health that a disease state, known as "scurvy" can result from lack of Vitamin C in the diet. 

Lasers: dermatologists recommend different kinds of laser treatments to rejuvenate aging skin. Various wavelengths of light perform different functions. Types of lasers include (from American Board of Cosmetic Surgery):

• CO2 Lasers are generally ablative lasers used to treat scars, warts, wrinkles and other deeper skin flaws.
• Erbium Lasers can be ablative or non-ablative. They promote collagen remodeling, making them popular options for treating fine lines, wrinkles, skin laxity, and age spots.
• Pulsed-Dye Lasers are typically non-ablative lasers that heat the skin and absorb pigments to reduce redness, hyperpigmentation, broken capillaries, and rosacea.
• Fractional Lasers break up the laser energy into thousands of tiny beams to treat only a fraction of the skin in the area, which reduces downtime. Fractional lasers can be ablative or non-ablative, and are used to treat a number of age-related blemishes.
• IPL (intense pulsed light) treatments technically are not lasers, but are often used to treat similar concerns as lasers, such as sun damage, acne, rosacea, and hyperpigmentation.

5. Reducing redness

In addition to laser treatments to reduce redness, there are some medications that are effective - especially in the treatment of rosacea or adult acne:

Brimonidine gel and oxymetazoline hydrochloride cream: These prescription medications can reduce the redness caused by rosacea. They work for up to 12 hours. Once the effects wear off, the redness returns. With daily use, you can have reduced facial redness for up to 12 hours a day.

Both medications have been approved by the U.S. Food and Drug Administration (FDA) to treat the facial redness of rosacea. In clinical trials, these medications safely and effectively treated the facial redness of rosacea when used daily.

Green-tinted makeup: This cannot reduce the redness, but it can hide it. Some companies make green-tinted makeup specifically for people with rosacea.

6. Reducing dark spots

Sometimes known as "bleaching cream," hydroquinone is a prescription topical cream that slows down the pigment-making processes in the skin. Doctors usually prescribe a 4% hydroquinone cream, and a 2% version is available over the counter.

Retin-A (tretinoin) and steroids may be prescribed in addition to or in place of hydroquinone, but they might not work as well.

7. Reducing wrinkles

Botox: botulinum toxin injections temporarily paralyze facial muscles so that they no longer gather upper layers of skin into wrinkles when they contract.

Exfoliation: chemical peels and dermabrasion procedures aim to "sand off" or peel away wrinkles.

Soft Tissue Fillers: (such as fat, collagen, and hyaluronic acid) can be injected into deep wrinkles in the face to fill them in.

Face lifts: involve removing excess skin and fat in the lower face and neck and tightening the underlying muscle and connective tissue. The results typically last five to 10 years.

The bottom line is that aging is inevitable, but reducing the obvious wear-and-tear on facial skin is possible with the treatments I described in the past 2 health tips. Cosmetic dermatologists specializing in anti-aging products and procedures can be helpful in rejuvenating facial skin. Unfortunately insurance companies don't pay for cosmetic treatments, and so looking your youngest may cost a pretty penny. Only you can decide if it's worth it!