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The question

I'm in my early 30s and starting to get wrinkles. Skin care tips please! Do the expensive creams really work?

The answer

Signs of aging such as fine lines and wrinkles usually appear in our 30s-early 40s. Sun exposure, smoking and genetics are all factors that influence how the skin ages. People with fair skin color are at higher risk of showing signs of aging earlier than those with darker complexions.

Before we get to treatment options, let's talk about prevention and some skin care tips:

1. Protect your skin from the sun: The sun gives off energy in the form of radiation known as UVA and UVB rays. Exposure to these rays from sunlight and tanning beds is the most significant contributing factor to age-related skin changes such as sun spots, wrinkles and discoloration. I cannot overemphasize the importance of skin protection with sunscreen (even in winter) and limiting sun exposure. These preventative actions are not only helpful to prevent wrinkles but also helps protect against skin cancer.

When choosing your sunscreen, pick one with an SPF (sun protective factor) of greater than 30 and one that is broad spectrum which covers for both UVA and UVB rays.

2. Reduce or quit smoking: Some studies cite an almost five-fold increased risk of wrinkles compared to those who don't smoke. Smoking ages the skin prematurely by increases carbon monoxide levels in the body which produces free radicals that can damage skin. It is also known that smoking depletes vitamin C in the body which is a known anti-oxidant that helps to synthesize collagen, an important building block of skin.

3. Nourish your skin from inside and out with a healthy diet and good hydration: Research has shown that people who eat more vegetables, fish and food rich in antioxidants and omega-3 have less wrinkles. Drink enough water as it helps to keep the skin appearing youthful, flushes out toxins and helps bring nutrients to skin cells.

There are an abundance of wrinkle creams available over-the-counter of varying prices that all promise to reduce wrinkles. While there have been no rigorous studies to prove their effectiveness, some cream formulations do seem to work.

In general, anti-wrinkle or anti-aging creams smooth the skin by removing dead cells, hydrating and plumping the skin. It may be tempting to purchase the most beautiful bottle with the best advertising, but more expensive does not always translate into a more effective product.

When choosing your cream, read the ingredients. The best studied anti-aging ingredients are retinoids, hydroxy or glycolic acids and anti-oxidants such as vitamin C and E. Retinol, a derivative of vitamin A, decreases breakdown of collagen and softens and adds volume to skin. 1% retinol is the highest concentration allowed by Health Canada for over-the counter products.

This product should be avoided in women who are pregnant or preparing for pregnancy as it can lead to birth defects. Hydroxy acids are also effective and work by exfoliating and removing dead skin which evens the skin tone. Creams can take several months to show improvement and it is important to note that once stopped, the wrinkles can return. When using cream, be aware of side effects such as rash and increased sensitivity to the sun so remember to continue to wear sunscreen even when using these products.

The challenge with choosing a proper cream is that despite containing quality ingredients, most skin care companies do not list the actual concentration of ingredients.

For this reason, it can be difficult to know which product will work best as the concentration can vary greatly. My suggestion would be to look for products where the concentration is listed, contains the ingredients mentioned above and start at a lower concentration and work your way up to decrease the risk of side effects. For stronger formulations or if you have sensitive skin, a visit to your family doctor or dermatologist may be helpful to understand what would be an appropriate treatment for you.

Everybody's skin type is different so finding the right fit is important as one product will not work for everyone. Remember, while these products may be helpful with continuous use, once stopped, the wrinkles and signs of aging can return.

Overall, the best way to maintain youthful appearance is sun protection, skin care products and a healthy lifestyle.

Send family doctor Sheila Wijayasinghe your questions at doctor@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

Read more Q&As from Dr. Wijayasinghe.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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