Featured Experts Dr. Shereene Idriss, a board-certified dermatologist in New York City and founder of skin-care line PillowtalkDerm Dr. Michele Green, a board-certified dermatologist in New York City Dr. Morgan Rabach, a board-certified dermatologist in New York City Dr. David Kim, a board-certified dermatologist in New York City
Since Botox received FDA approval for cosmetic use in 2002, it has been the premier choice for treating wrinkles. It operates by blocking nerve signals to the injected muscle, temporarily immobilizing it so it cannot contract, thereby smoothing existing lines and preventing new ones from emerging. Just like any medication, there are, naturally, risks and side effects, but Botox is widely regarded as highly safe when administered by a qualified injector.
Nevertheless, in spite of its effectiveness and safety, numerous people are reluctant to undergo neuromodulator treatments. For some, it's merely the cost; for others, it's a fear of needles or of having a frozen appearance. A common misunderstanding is that it's ideally suited for "elderly" individuals. (Quite the contrary, asserts board-certified New York City dermatologist Dr. Michele Green. "You ought to commence in your early 20s. By your mid-20s, your rate of cell renewal and collagen production begins to decline.")
But cosmetic procedures are an entirely personal choice – and if you're not inclined or prepared to get Botox, there are an abundance of other topical products and treatments available in the market that claim to reduce wrinkles. We solicited the opinions of top derms on what is effective and what is a waste of money.
1. Retinol
Studies demonstrate – and derms concur – that vitamin A is the most critical active skin-care component for combating signs of aging, and it functions even better in enhancing skin tone, smoothing fine lines, and facilitating collagen production, the earlier you start its usage. The most potent form, Retin-A (also known as tretinoin or retinoic acid), requires a prescription, but there are numerous effective over-the-counter retinols in the forms of retinyl acetate, retinyl palmitate, retinaldehyde, and hydroxypinacolone retinoate. "The strength and efficacy [depend] on the form of the vitamin A derivative and how the skin converts it to retinoic acid," remarks Dr. Green. Retin-A, she explains, is a pure form of vitamin A that the skin doesn't need to convert to retinoic acid, so you observe results more promptly, "but the advantages of using [retinols] are less irritation, redness, and peeling."
If you're someone who has not yet truly witnessed visible signs of aging and is deliberating whether to obtain preventive Botox, incorporating retinol into your routine will maintain your skin free of lines for a longer period and provide significant benefits in boosting collagen. If you already have visible lines and wrinkles, a retinol serum or cream can assist in softening them and slowing the formation of more, but it won't treat them nearly as rapidly and effectively as Botox. "I truly believe retinols are remarkable topical medications that can assist in keeping the skin youthful, but you have to apply them every night and for the remainder of your life," states Dr. Rabach.
Does retinol truly work? It's the most efficacious topical skin-care product (alongside sunscreen) for countering the signs of aging.
2. Bakuchiol
Bakuchiol, an extract derived from the babchi plant that has long been utilized in Eastern and Ayurvedic medicine to address hyperpigmentation, is being termed "nature's retinol." Despite lacking structural similarities to retinoids, Dr. Green says that studies have indicated that it does exert similar effects on the skin, without the irritation associated with retinol, potentially making it worth attempting for sensitive skin types. "It hasn't been studied as rigorously as retinols as a category, and the potency, overall, is not as strong as [that of] prescription-strength retinol – but it will aid in reducing some fine lines and wrinkles as part of a daily routine for life," says Dr. Rabach. One significant drawback of the ingredient? The babchi plant is rare and endangered, so it's crucial to ensure that the product you're purchasing is sustainably sourced.
Does bakuchiol truly work? This is a promising but not fully verified retinol alternative, with certain ethical sourcing concerns.
3. Argireline
