Science 101

How to Look Younger

You may have heard of myriad ways to look younger, but here’s the true science behind botox and trendy treatments.

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Wanting to look younger is an age-old pursuit. Cleopatra reportedly put a mixture of lizard guts and pigeon droppings on her hair and bathed in donkey’s milk to protect her skin from the ravages of aging. Chinese empress Wu Zeitan is said to have washed her face with an herbal “fairy powder” to keep her skin looking young.

As people have started to live longer, our obsession with looking youthful has only grown. In 2016 (the last year for which data is available), an estimated 131,000 U.S. patients had surgical and non-surgical hair restoration treatments, according to the International Society of Hair Restoration Surgery. And in 2018, Americans spent more than $16.5 billion on cosmetic surgery procedures to help them look younger, according to the American Society of Plastic Surgeons.

In the past few decades, a growing number of treatments have been developed to erase wrinkles, fill in fine lines, and reverse or protect against hair thinning and loss. Here’s what exists and how they work.


For Wrinkles and Lines

Botox

Botox (OnabotulinumtoxinA) is made from a neurotoxin called botulinum toxin. It’s injected into the muscle, where it blocks nerve transmission, effectively freezing the area for up to six months, says New York City plastic surgeon Brett Kotlus, MD.

Botox has become wildly popular because, unlike surgical procedures, it has no downtime and isn’t as invasive, notes Kotlus. In 2018, more than 1.8 million Botox injections were given in the U.S.; up six percent from 2014, according to the American Society for Aesthetic Plastic Surgery (ASAPS). Sixteen percent of these injections were among 18-34 year olds. While older people get Botox to soften etched lines that form when we use our faces to make expressions, younger people get the treatment to stop them from forming the lines in the first place, says Kotlus.

Although generally safe, in rare cases, the toxin can spread beyond the treatment area and cause botulism-type symptoms like breathing problems, trouble swallowing, muscle weakness and slurred speech. One study in animals found evidence that Botox may move between nerve cells, raising the possibility that the same kind of migration could be occurring in humans.

Fillers

Fillers are injectables, the most popular being hyaluronic acid, a gel-based sugar that can help erase undereye circles, plump up lips and cheeks, and fill in frown lines for up to two years, explains Kotlus. Other, more permanent fillers stimulate collagen production. In a handful of cases, hyaluronic acid fillers have been linked to blindness (because the filler was inadvertently injected into a blood vessel near the eye), which is why it’s important to get the treatment from a licensed professional.

Laser resurfacing

Dermatologists can use lasers to create injuries on or in the skin, says Kotlus. As the body heals, newer, brighter-looking skin replaces the areas damaged by the laser. These treatments can make your skin appear five years younger, says Kotlus, but they’re not without risks. Lasers can cause acne flares, redness, and herpes breakouts, if you’re prone.

Microneedling 

Instead of lasers, a device covered in tiny needles creates mini-injuries in the skin, prompting collagen production, which can minimize lines. The results aren’t as dramatic as with a laser, but the procedure is much cheaper, says Kotlus.  At-home microneedling devices are available, but they don’t pierce the skin as deeply, so the effect isn’t as great. And they may potentially cause infections and scarring, which is why the FDA is considering regulating at-home devices.

For Hair Thinning and Loss

Follicular Unit Extraction (FUE)

Hair transplant is based on the “donor dominance” theory. In a nutshell: Hair follicles from the back and sides of the scalp will keep growing hair if you transplant them to the top of the head where hair is thinning (or gone). That’s because these follicles are immune to the effects of dihydrotestosterone (DHT), the hormone that causes most male-pattern baldness, says Alan Bauman, M.D., a hair transplant surgeon in Boca Raton, Florida.

In the past, strips of scalp were transplanted, but with FUE, individual follicles are moved (by a surgeon or a robot), so there’s no scarring. The procedure is nuanced and precise measurements need to be taken, so getting this treatment requires a professional who is board certified in hair restoration, says Bauman.

Medications

Minoxidil (Rogaine) is a topical medication that encourages hair growth when you apply it to your crown twice a day. It was originally developed as a blood pressure medication before doctors realized what it could do for hair growth. Finasteride (Propecia) is an oral drug that blocks an enzyme that converts testosterone to DHT, or dihydrotestosterone, developed to treat thinning hair. Both can be used by people with thinning hair, though they won’t work for baldness because once a hair follicle is gone, it’s gone for good. And if you stop using these products, you’ll start losing hair again.

Laser Therapy

Uses red-light photons (a much lower level wavelength than is used for laser hair removal) to stimulate hair growth in the follicle. It won't rescue a receding hairline, says Bauman, but can help with thinning.

Platelet Rich Plasma (PRP) Therapy

PRP, which uses a person’s own blood platelets to enhance hair growth, is another option for those with thinning hair. The patient’s blood is removed and spun in a centrifuge to separate out the red blood cells from the plasma. The plasma, which is rich in platelets that contain growth factors, is injected into the scalp at the level of the hair follicles. PRP has been found to have high success rates in people with male-pattern hair loss, but again, the protocol for the procedure can be nuanced, which is why choosing a board-certified practitioner is important.


At Home

Research has also revealed that certain day-to-day habits have the potential to keep hair and skin looking younger. Among the most effective:

Wearing Sunscreen 

Photoaging (sun exposure) is the biggest contributor to aging skin, says Kotlus. Wear a broad-spectrum, mineralized sunscreen any time you’re going to be out in the sun (that includes during the winter) and reapply every two hours.

Apply Retinols 

Retinoids — the umbrella term for retinol products — are a class of medications that are derived from vitamin A which encourage collagen production and even pigmentation. Prescription strength ones are most potent, says Kotlus, but they can irritate and dry skin, so start with an OTC product to see how you tolerate it.

Treat From the Inside Out 

Research shows that nutritional deficiencies may impact hair growth, so eating a healthy diet could help your locks look younger, though no food can completely ward off balding or thinning hair. And diets high in fish, fruit and vegetables could protect against wrinkles, according to a recent study published in the Journal of the American Academy of Dermatology. ChoOse fish rich in omega-3 fatty acids like salmon. These compounds may improve skin barrier function and protect against inflammation from sun damage and hyperpigmentation, per another recent study.

Sleep Well 

Not getting enough sleep can make you look older, and getting fewer than five hours a night is linked to diminished functioning of the skin barrier— the outer layer that locks in moisture and protects against damaging (and aging) elements like UV rays and free radicals.

Exercise 

Researchers at McMaster University in Ontario found that people over the age of 40 that regularly exercised had skin composition that resembled people in their 20s and 30s. The study authors suspect exercise creates myokines, substances that help slow aging in skin.

Reduce stress. Stress contributes to some forms of hair loss (particularly in women), says Bauman. Research suggests neurotransmitters or hormones produced when you’re under stress could be to blame. And constantly furrowing your brow because you feel frazzled can contribute to lines on the face, says Kotlus. Try yoga: one study found the known stress-buster might also positively impact skin aging.

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