Camille: What are the main common causes of aging that you’ve seen over the years?

Dr. Schwartz: The quick answer is, of course, sun damage... but when you think about it further, the lack of a healthy lifestyle plays a large role in premature aging. An increasing number of scientific articles are being published showing how unhealthy food can make people look older, pointing out that nutritional deficiencies may increase wrinkles. As more and more studies like these are coming out, the more evident it becomes that eating well, having a relaxed lifestyle, and avoiding stress as much as possible could be the key to anti-aging. It helps to practice meditation, relaxation techniques, and to focus on contentment as much as possible in your life. How often do we see a friend that we haven’t seen for a while, and we either think:

“Wow, you look amazing, what are you doing? '' or you think to yourself, "Gosh, they've really aged".  Of course, you wonder why. My experience is that those who look amazing for their age are well-balanced, content, eat healthfully, and avoid sun exposure in general.

An individual's skin can be a good indication of the state of their internal health. When I examine a patient, I tell them "If we can make your skin look better with these lifestyle changes, if we could see them, just imagine how much better your internal organs will look, too." Even though they can't be seen, when you eat right, your internal organs are just as happy as your skin. We want you to look better, of course, but we also want to improve your overall health. With this kind of global approach, it can be accomplished. A patient’s appearance can be a highly motivating measure to get them on the right track.

Camille: I really like that, using your skin as an indicator of your overall health. It will not only help you counteract aging, but also heal you as a whole.

Dr. Schwartz:

All my patients coming to the office for cosmetic treatments get my “Diet and Nutraceutical Interventions for the Skin” handout where I summarize the recent science-based articles that show specific things in your diet, or vitamin deficiencies, that are associated with premature aging and wrinkles. These articles aren't just someone pontificating "eat this” or “don’t eat that." While we may intuitively understand some of these concepts, there is great science-based evidence that shows certain vitamins or supplements can actually help your skin, and affect whole-body health. The handout includes great references of scientific articles and books. Whenever I encounter a patient who is concerned about their appearance (concerned enough to come to me as a dermatologist, as well as motivated to pay for treatments), I say, "Look...we can do all of that, but don't miss out on the most important things, and they’re free." You'll improve everything in your body, not just your appearance.

Camille: I really like how encouraging that is. If someone went to a dermatologist and was told, "Hey, this is going to help everything," then I would also do anti-aging treatments, and it will really seal the deal. Why not - it's free? I think having my dermatologist say that would definitely give me that extra push. When I see my appearance as a motivating factor, I’d be so much more likely to stick to the routine too!

Dr. Schwartz: Right. How's that for motivation?  Then the treatments I do will last much longer, and they will not have to return as frequently to maintain their appearance. Why do filler treatments last longer for some and not for others?” I believe it has a lot to do with all the healthy habits we have at home. So I really like to get my patients motivated to start thinking about their body as a whole.

Camille: In your opinion, when should a person start using anti-aging products? Is there an age, or a certain indicator?

Sunblocks are great anti-aging products, and the earliest you can start is by protecting your children with both sunscreens and the right clothing. The other day I was at the beach and I saw two young children wearing hats and long sleeve shirts, so I went up to their parents to congratulate them. Interestingly, they were from Denmark, and I can't tell you how often I see people from other countries being very careful about their sun exposure. I wish it were more popular in the United States. Prevention is the key.

In regards to reducing the signs of aging, many people are starting to notice crow's feet and other small lines on their face in their mid-30s. It seems that’s the most common age at which I have patients asking, “How can I fix this? It’s starting to bother me”? That’s when I discuss neurotoxin injections like Botox, and topical treatments at home like Procell Therapies daily use serums so they can benefit from the growth factors. It’s easy- they can use it twice a day, morning and night, and it becomes their routine. If my patients wish to opt for a more drastic treatment, to make the skin as luminous as possible, I recommend ProCell microchanneling treatments to be used to start repairing and reversing fine lines by more aggressively stimulating new collagen formation. It’s a great way to supercharge and kick-start things to get going more quickly. I have patients in their early 20s that are in beauty pageants and want to do everything they can to optimize their skin, and I’ll treat them with ProCell serums and microchanneling.

Camille: So there’s no age per se, it’s just a personal choice and whatever your motivation might be?

Dr. Schwartz: Yes, it is absolutely a personal choice.

Camille: What can be done about age spots, sun spots, and hyperpigmentation?

For many years we’ve had effective “bleaching” treatments that are very effective at reversing excess pigmentation in the skin. Since hyperpigmentation is pretty much driven by the sun, that’s why we typically see it in sun-exposed areas. For many years hydroquinone has been effective in bleaching the skin and has been the gold standard for lightening age spots. Fortunately, over the years we have developed natural botanical agents that are very effective in skin lightening. We call them bleaching agents but they are not really bleaching the skin. They block various points in the biologic pathway in the production of melanin in the skin. Many of these plant-derived products block that melanin pathway in several locations. So we’re discovering if you combine a number of different natural ingredients we can get results that are comparable to hydroquinone. It is rewarding to see that now you can use chemical-free skin lightening products and get comparable results to hydroquinone.

You can then add microchanneling which many studies have shown increases product penetration into the skin by up to 300%. Combine it with a nice, naturally occurring skin -lightening product made specifically to be safely used with microchanneling, and it will enhance the effects up to three times greater. For my patients who have had difficult to treat cases of hyperpigmentation, I put them on a regimen of microchanneling with ProCell’s hyperpigmentation treatment serum, and the results are much more dramatic.

Camille: What are the most interesting anti-aging tools, and technology discoveries that are out there that make you really excited?

Stem cell technology is the newest piece of the anti-aging puzzle. Stem cells are amazing tools that seem to fix almost anything that needs to be repaired in the body. We now know which stem cells respond optimally to the areas that need to be repaired. We can isolate the best stem cells, which come from human bone marrow, and then stimulate them in the lab to secrete growth factors that orchestrate the body's response to damage. Technology like this is remarkable. When the skin is injured and needs repair, these stem cells leave the bone marrow and travel to the wound site, sending messages to begin the repair. Now we can produce these signals in the lab and create serums to put them on the skin. Combining that with microchanneling makes them even more effective. It’s fascinating to see where we have come from, and where we are headed, thanks to stem cell innovations.

Camille: What would you say are your top 3 Anti-Aging products? 

A few years ago, an article called "The Health and Beauty Pyramid" was published in the dermatology medical literature. Choosing an anti-aging product can be so challenging, especially when everyone is claiming to be the best. How can we tell if something is genuine or if companies are just making things up? It’s difficult. This article shows a 3-level pyramid which simplified so many things it’s now a poster in each of my exam rooms.

At the bottom of the health and beauty pyramid is the Protection layer. Sun protection is essential for your skin - easy enough. Sunscreens are one anti-aging product that we should all use.

The second level of the Health & Beauty pyramid is Correcting the skin. We all have sun damage that causes fine lines and wrinkles as we age. So how do we reverse this? With antioxidants and prescription-strength retinoids like tretinoin (Retin-A). Antioxidants are quite effective, and they're not as harsh as tretinoin, so I use them for those who have less severe sun damage. Antioxidants will also help protect the skin from the sun. Sunscreens don't block everything and some damaging rays slip through the cracks. Antioxidants can help fill in cracks, improving both protection and correction. 

The top of the Health & Beauty Pyramid is the Stimulation phase. Stimulation activates the collagen-producing cells which thicken the skin and make it appear more luminous. The top of the pyramid has appeared entirely because of the new human growth-factor serums. For the past 10 years in my practice, growth-factor serums have been the leading edge of anti-aging technology. It's where I want everyone to be once they've climbed to the top of the pyramid - using serums daily to stimulate the skin. That’s also the basis for ProCell Therapies’ growth-factor serums derived from human bone marrow stem cells to give you the best results stimulating new collagen. Those are the three aspects of the Health & Beauty Pyramid everyone should be using for anti-aging.

Dr. Schwartz founded and currently operates the largest cosmetic dermatology practice in the state of Vermont. He has contributed to many published clinical studies and has been helping his patients to look and feel their best for over 30 years. Through his consistent application of the latest technologies, Dr. Schwartz has earned a reputation as one of the best cosmetic dermatologists in the country. As a joint venture with his two sons, Daniel and Joseph, Dr. Schwartz founded ProCell Therapies where he continues to serve as the Chief Medical Officer.