CBS HealthWatch

LOS ANGELES (CBS) ― Lisa Sigell sat down with Dermatologist Ava Shamban to learn what happens to skin as we age and what can be done to keep skin looking young.

Lisa: Eva, what happens to our skin as we age?

Ava Shamban, M.D.: We develop lines and wrinkles, brown spots, blood vessels where we don't want them, and just kind of a rough texture to the skin.

Lisa: Let's talk about specifics, changes that we will see in our 20's, in our 30's, in our 40's and in our 50's.

Ava Shamban, M.D.: In our 20's we may begin to see the first signs of age, little lines can form around our eyes, in the forehead, in the smile, they tend to go away when we rest, but they come back the next day.

Lisa: What changes will we see in our 20's in our 30's in our 40's even in our 50's?

Ava Shamban, M.D.: In our 20's we start to see little crow's feet or little fine lines that appear around the eyes, when we smile, but they go away when were not smiling; in our 30's we start to see the appearance of freckles or brown spots as well as fine lines that don't go away when were not smiling; in our 40's lines appear from the nose to the corner of the mouth, deeper lines, smile lines and people start to get a tired look; in our 50's it only gets worse, those brown spots that we used to call freckles are now age spots, those smile lines are now sad lines, and all of these things can be rectified.

Lisa: How much does the environment play when it comes to facial aging?

Ava Shamban, M.D.: The environment is the number one cause of pre-mature aging. Our exposure to the sun, to pollutants, to smoking, all of that can contribute to looking much older before your time.

Lisa: So what can anybody do to stay younger longer?

Ava Shamban, M.D.: Well the first thing is to protect your self in every possible way from the sun, so that includes not only sunscreen, but seeking out the shade, wearing a hat. The second thing is don't smoke, and the third thing is make sure your environment is a clean as it can possibly be from pollutants, eat well, sleep well, exercise every day, all of these things have been shown to retard aging.

Lisa: What is the different between Botox and injectible fillers?

Ava Shamban, M.D.: Botox is a protein that is injected into the muscle so it relaxes lines that are caused by motion, such as the lines that form between your eyebrows, where as fillers, restore volumes so the deep lines, the deep smile lines, that from your nose to the corner of your mouth or from the corner of the mouth down to the jaw, can be filled with a filler, you cant put Botox there, or you will look like you've had a stroke.

Lisa: Whats the different between botox something like that and a filler?

Ava Shamban, M.D.: Botox is a protein that is injected into the muscle that relaxes the muscle so that the lines that are formed by frowning, go away, fillers revolumize so the deep lines that from your nose to the corner of your mouth or from the corner of your mouth to the jaw line, can be plumped up and you can have a nice smooth youthful look.

Lisa: A lot of people wonder about dark circles under their eyes, what can you do about that?

Ava Shamban, M.D.: Dark circles are often an optical illusion, so if you have a canyon under your eye the light just sits there and doesn't reflect back out so actually you can revolumize under the eyes, so by changing the surface to be more round the light reflects out and you no longer have those dark circles and people stop asking you how much sleep you got last night.

Lisa: So what happens to our skin as we age?

Ava Shamban, M.D.: Well the first thing we notice is the appearance of brown spots and fine lines and wrinkles, and then later on we might even see blood vessels that can occur anywhere in on the face, but fine lines, wrinkles, brown spots, textural changes, our skin doesn't fill as smooth as it once did, it feels rough.

Lisa: What is Collagen?

Ava Shamban, M.D.: Collagen is the main protein present in the skin, and it's responsible for the volume of the skin, and as we age protein levels diminish and so the skin starts to get soft.

Lisa: What role does collagen play in our appearance as we age?

Ava Shamban, M.D.: Collagen is the main protein found in the skin. And it provides volume to the skin so as it goes down with age, we start to see wrinkles that may appear as fine lines or even as deep grews from the nose to the corner of the mouth or from the corner of the mouth to the jaw line.

Lisa: What are the main causes of aging? Both internal and external?

Ava Shamban, M.D.: Well the main cause of aging in the skin is exposure to the sun, the sun generates free radicals which damage the outside layer of the skin as well as the collagen which is deeper in the skin, the other cause of aging are out genes which determine, you can look at your grandmother and you can find out when your going to age, but our genetics determine how quickly we are going to age as well.

Lisa: Are there over the counter treatments that are available?

Ava Shamban, M.D.: Yes, in fact when you go to your drug store, there are many different lines that are very effective, from sunscreen to anti-oxidants to a good moisturizer that may have a retinal in it.

Lisa: You said that there's over the counter treatments available but what about at your doctor's office?

Ava Shamban, M.D.: When you visit your doctor's office, you'll find a surprising wide range of choices available now due to advances in technology, for example there are many different type lasers to treat fine lines and wrinkles, brown spots, irregular texture as well as injectables can reduce lines cause by motion and re-volumize or plump up the face where those line have gotten very deep.

Lisa: When should you consider surgery?

Ava Shamban, M.D.: I would consider surgery to be the last option, there are so many new procedures that are available that can tighten the skin that can re-volumize the skin, so that you can avoid surgery, and surgery often leaves you with a tight wind blown look, but surgery maybe necessary to treat the neck.

Lisa: In that case, what are the various surgeries available when it comes to the face?

Ava Shamban, M.D.: Well there's the so called traditional face lift, where you lift the lower face and the neck, sometimes the brow lift and sometimes the eyes, but all of these areas can really be addressed with tissue tightening devices such as radio frequency, thermage, as well as using volume to redrape the skin, to get this beautiful natural look.

Lisa: Which brings us to this, what can the average person do to protect their skin and hold off aging?

Ava Shamban, M.D.: The average person can do a lot to slow the process of aging down first and foremost is complete sun protection, so sun screen isn't good enough, you need to wear a hat, you need to seek out the shade, stay away from pollutants, don't pollute your body with smoking, extremely important. Third, eat well, sleep well, exercise, it seems so simple, but following these basics, really helps prevent pre mature aging and even helps slow down regular aging. And lastly, you can really find a lot of new ingredients, anti-oxidants, proteins, peptides, that can help stimulate your skin so that you can maintain a youthful appearance that you enjoyed when you were in your late teens and twenties.

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