Dead cells are complexion enemy number one, say our skin experts, because they clog pores and give skin an ashy appearance. So, after exfoliating in the evening, most docs slather on a retinoid cream (a topical form of vitamin A found in Rx options such as Retin-A and Renova, and over-the-counter in retinol), which has been shown to speed up the rate at which the body sheds dead skin. But reti-noid benefits don’t stop there. Vitamin A also stimulates collagen production (making skin look plumper and fine lines smoother) and normalizes cells exposed to UV rays, effectively undoing sun damage. But there’s a downside: Retinoids, dermatologists say, can be irritating if overused, so most advocate a flexible retinoid regimen. Lupo alternates daily between moisturizing Renova and the more aggressive (and more drying) prescription Tazorac. Downie rotates Vivité Vibrance Therapy, which has retinol ($119; viv-iteskincare.com), with Tri-Luma Cream, an Rx-strength retinoid that also contains spot-fading hydroquinone. And every night, Rodan applies her own Rodan+Fields Anti-Age Night Renewing Serum ($89; rodanandfields.com), an over-the-counter treatment with retinol. Then, once a week, she applies Tazorac as a mask for 15 minutes: “Tazorac is the strongest retinoid, but it’s too irritating for me to wear all night. Using it as a mask boosts the effects of my retinol serum without causing flaking.” Some doctors also apply a moisturizer under their retinoid to dilute the strength. Or they cut back on how often they apply it (e.g., every third night rather than seven days a week) if they see signs of sensitivity. (For more on what to do if your skin is irritated, check out “Ch-ch-changes: Your Skin Is Suddenly So Sensitive,” on page 50.)
They freeze and fill in moderation
Almost every dermatologist we spoke with says that when it comes to in-office treatments, Botox (or Dysport, its brand-new competitor) gives you the most bang for your buck. They inject their foreheads to relax frown lines; a few also target their eyes’ outer corners to minimize crow’s-feet. Patricia Wexler, MD, a cosmetic dermatologist in New York City, says one of her favorite new spots is along the jawline, which gives her neck a lifted appearance. For areas where deeper wrinkles have formed, most doctors say they turn to hyaluronic acid fillers like Juvederm or Restylane to plump up the crevices. The most frequently treated spot: the nasolabial folds (aka the marionette lines beside your mouth). Rodan and Lupo both inject this area once or twice a year. Docs, of course, get these treatments at cost; even so, they avail themselves only three to four times a year, which they consider moderate usage. You can expect to pay $375 and up for one Botox or Dysport treatment, and $600 and up for one filler treatment.
Maintaining skin bounce is essential
Yes, retinoids boost collagen and elastin production in the skin. But most skin doctors don’t feel that vitamin A alone does quite enough plumping, so over this they layer a second topical containing either peptides or a growth factor. Popular peptide picks: Neocutis BioRestorative Cream ($130; derm store.com) and Olay Regenerist Daily Serum ($19; drugstores). Best of the growth factor bunch: SkinMedica TNS Essential Serum ($250; skinmedica.com) and RéVive Moisturizing Renewal Cream ($165; neimanmarcus.com). Note: Most peptide and growth factor creams are hydrating, so you won’t need an additional moisturizer. Like you, these docs don’t have time for an eight-step regimen. So at night they just cleanse, apply a retinoid cream, top it off with a collagen-boosting cream—and hit the sheets. And there is a reason doctors typically save the big-gun treatments like retinoids and peptides for nighttime. “Your body temperature goes up while you sleep, and the heat helps products penetrate skin better,” Rodan explains.
They sleep on their backs