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Adam G. Tattlebaum M.D.
Skin Care in Washington

Skin Care

Confused by Skin Care?

My patients, both men and women, want to do what they can to avoid surgery-it’s only natural. While your genetics plays a role there are simple things you can do, inexpensive things, to slow down the aging process of your skin. There are so many product on the market and so many claims that are unreal you really need to be careful. You don’t need to spend a lot to get good skin protection. Frankly, most of what you need is at the local drug store.

I think of basic Skin Care as four steps:


I placed them here in the order they should be used. The confusing step is the Rejuvenating part and this is where there are a million products that all sound different but use largely the same ingredients. I will try to give some clarity in that section.

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Step one: Cleanser:

Clean skin is healthier. Less dirt, less acne, less dead skin more fresh skin. I recommend patients experiment with the cleanser they like best. Avoid dyes, perfumes, astringents and alcohols as these are harsh on the skin. I have long been a fan of Neutrogena skin products which are Hypoallergenic. You want your skin to be clean but not oil free. Your skin’s natural oils are protective.


Step two:

Rejuvenation Step two is where every manufacturer of non prescriptive skin care selects form the same group of over the counter ingredients and makes their own “Special Formulation” that will defy aging. Here is my humble attempt to explain what things most manufacturers use into these formulas. I am only including the best studied ingredients.

1) Retinol and Retinyl Palmitate:
Think of this as a topical medication that exfoliates outer layers of skin, retinol is like a controlled irritant that improves mottled pigmentation, fine lines and wrinkles, skin texture, and skin tone and color. It’s stronger brother, Retin-A is a prescription drug.

2) Antioxidant -Vitamin C ascorbic acid (or another antioxidant)
When sun hits the skin, the suns energy can disrupt electrons in our cells creating free radicals. There is strong evidenced that free radicals damage our cells and promote aging. Sunblock blocks this process from outside the skin. Antioxidants like topical vitamin C block this process from the inside. Some people take oral antioxidants to protect other areas of the body as well. Vitamin C is a common additive because it is not only an antioxidant, but also a mild acid that helps exfoliate the skin and helps with fine lines and wrinkles. Alpha-lipoic acid is often added for the same reason.

3) Hyaluronic Acid:
This is a gelatinous substance that as made its name mainly as an injectable filler. It is normally found in the skin and other areas of the body. It is a lubricator for lack of a better word and is commonly added to products do diminish fine lines and wrinkles.

4) Copper Peptide:
There is laboratory evidence that this topical additive can increase the skin’s collagen production, improving lines and wrinkles and even boost the amount of hyaluronic acid and also act as an antioxidant. A kind of trifecta of desired goals if you will.

5) Hydroquinone:
Think of this as a skin bleach to help even out textures. Higher doses must be prescribed. Kojic acid is a similar product for bleaching skin.

6) Alpha and Beta Hydroxy acids:
These are the components of low grade chemical peels. They exfoliate the outer layers of skin but can sometimes be irritating. Some rejuvenation potions have low doses of these.

Summary: The above six ingredients are the big players in the topical skin care rejuvenation market. They are sometimes sold individually, but commonly combined into a “proprietary special formula” I am a fan of the formulas, doing each one individually would be confusing and take forever.

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Step three: Moisturizing

Gets simpler here again. There are many good moisturizers on the market. Choose the one that suits you best. I always recommend avoiding heavy perfumes and I favor hypoallergenic products.


Step four: Sunblock

I can’t stress this one enough!! Pick a sunblock with UVA and UVB protection SF15 or more. Anything more than 15 doesn’t make a big difference. Apply and reapply as directed liberally. The more you adhere to sunblock the less likely you will need all the products above. I wish I knew that when I was a teenager!

Key point : It is much easier to maintain younger looking skin than it is to make sun damaged skin look younger.

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