Fully Exposed


Posted on: October 20, 2017

That little fold or crease in the outer corner of your eye, or on your forehead, or perhaps, falling from your nose towards the corners of your mouth. Interestingly enough, if you biopsy a wrinkle, and look at it under the microscope, the wrinkle is not evident. As a matter of fact, there is no anatomical structure associated with either a skin wrinkle or crease. And if you compare skin from a wrinkle with adjacent non-wrinkled skin, there is no histological difference seen in either a light microscope or an electron microscope.

So what is a wrinkle? Are wrinkles arbitrary? Are they a configurable change brought about by repeated muscular contractions? Are they influenced by environmental stressors like ultraviolet light or cigarette smoke?

The top layer of skin is called the epidermis. This layer gives the skin its waterproofing ability and protects the skin from environmental stressors like bacteria, viruses, allergens, and ultraviolet light. The second layer of skin is called the dermis. Within the dermis, specialized cells called fibroblasts produce the structural proteins, collagen and elastin, that give the skin its tensile strength and flexibility.

Under a light microscope, a breakdown in the elastic tissue within the dermis is seen in wrinkled skin. Deep wrinkles found in sun damaged skin show a disruption of the elastic tissue adjacent to the wrinkle in the lower levels of the dermis. These wrinkles seem permanent as one is unable to rid of them when stretching the skin. Wrinkles from sun protected skin, however, show a disruption of elastin in the superficial dermis. These wrinkles appear more temporary as one can 'erase' the wrinkles by stretching the skin.

Science has also shown that ultraviolet radiation from the sun, in particular UVB rays, can stimulate pro-inflammitory compounds. These compounds cause the collagen producing fibroblasts to express elastase, an enzyme that breaks down elastin yielding a loss of skin elasticity, and hence, wrinkle formation.

So what really causes wrinkles?

Many beauty and health magazines blame wrinkles on all sorts of things.

  1. Not washing your face.
  2. Not removing makeup before you go to sleep.
  3. Not sleeping on a silk pillowcase.
  4. Sleeping on your stomach instead of your back.
  5. Sitting too close to a computer screen.
  6. Resting your face in your hands.

There is very little, if any, science proving these allegations. 

Based on science, no one really knows for sure what causes wrinkles but the scientific evidence points to:

  1. The effects of time itself, the unpreventable aging process, causes a decrease in function of skin cells that produce structural proteins, collagen and elastin. This yields superficial wrinkling.
  2. Ultraviolet exposure from the sun, a preventable form of skin aging, causes deeper wrinkling and a more permanent skin wrinkling due to the stimulation of the enzymes that break down healthy structural proteins necessary for healthy looking skin.

Commentary on wrinkles: Wrinkles are inevitable because they are a part of aging, and aging is inevitable. But aging is a process, a process not everyone gets to experience. Image if you knew 20 years ago what you know today. Embrace those wrinkles. You've earned them!

The best advice for healthy skin: live a healthy livestyle. Eat a well-balanced nutritious diet, exercise regularly, get some zzz's, avoid direct sun exposure, especially midday, and wear a broad-spectrum sunscreen SPF 30+ daily!



Posted on: September 04, 2017

Anti-wrinkle creams ARE moisturizers. These products intend to increase the water content of the skin, temporarily improving the appearance of the skin. The consumer imagines water being pumped into a raisin, becoming a firmer grape. This theory may apply to very superficial fine lines, especially those found around the eyes where the skin is the thinnest, but in actuality, facial lines and wrinkles are due to a loss of connective tissue in the deeper layers of skin. In addition, dehydrated skin may exacerbate the appearance of facial imperfections. Although the application of an anti-wrinkle cream may leave the skin feeling more soft and supple to the consumer, and, as moisturizers, may increase the water content of skin thereby temporarily improving the appearance of the skin surface, more pronounced facial wrinkles and skin folds cannot be corrected by applying 'anti-wrinkle' creams.




Posted on: August 29, 2017

Like many ingredients touted as beneficial in skincare products, you can add activated charcoal to the list of "newest fads." 

Charcoal is the result of burning a carbon rich material (like wood) at a low heat without oxygen. It creates a non-porous (without spaces) carbon substance. Heat up this substance with steam (oxygen) in a pressurized environment and activated charcoal is the result. Unlike charcoal, activated charcoal is porous, filled with many tiny sponge-like spaces or pores. All these little spaces within activated charcoal create a large surface area that is particulary helpful for "soaking up substances."

Although there is little, if any, scientific evidence proving efficacy, manufacturers often claim that activated charcoal in skincare products can absorb oil from skin pores, draw out dirt that other cleansers cannot reach (which probably means you're using the wrong cleanser), and remove "toxins" (although manufacturers never identify exactly which "toxins" they're talking about.) Some manufacturers go so far as to claim that activated charcoal has anti-aging properties.

After review of the dermatologic literature, no clinically significant scientific evidence proving the claimed benefits of topically applied activated charcoal in skincare products could be found. Products containing activated charcoal are usually inexpensive, and due to their black color, pretty cool looking. So although no scientific evidence proving any benefits of topically applied activated charcoal could be found, there was no evidence finding it harmful, either.

The best skincare advice: Moisturize, apply daily sunscreen, live a healthy lifestyle (eat a healthy diet, get adequate sleep, exercise regularly), and if you have a little disposable income and wish to "have fun" with a trendy, neat looking skincare product that contains activated charcoal, go for it!


Posted on: July 27, 2017

Yes, vitamn C is good for you. As an essential vitamin, one that the human body cannot manufacture or store, it must be included in your daily diet, acquired from natural sources, like citrus fruits and green leafy vegetables, or taken as a supplement. Adequate vitamn C is necessary for the formation of connective tissue, for the absorption of iron, and important in wound healing. Too little vitamin C leads to bleeding gums and general muscle weakness. Too much vitamin C results in diarrhea, nausea, vomiting, even kidney stones. The absorption of vitamin C by the gut is limited despite high oral doses. Excess vitamin C is excreted in the urine. Research has yet to show that ingesting mega doses of vitamin C can pump up levels of the vitamin in the skin.

Vitamin C is an important molecule as it plays a vital role in collagen synthesis, the main structural protein found in skin and other connective tissue. It is commonly found in skincare products with the hopes of repairing sun damaged skin and increasing collagen formation. Although few research studies do indicate that vitamin C containing skincare products (especially those with a very low pH) may reduce the number of sunburn cells on the skin surface after exposure to ultraviolet light, the majority of "oxidative damage" and wrinkle formation occurs in the lower layers of skin, in the dermis. Unfortunately, the ability of vitamin C to penetrate into the lower layers of skin is limited by its water solubility and extremely unstable nature. Vitamin C is oxidized readily in the presence of oxygen, and once it is, it is no longer an active vitamin.

Many vitamin C containing 'anti-aging' creams, serums, and gels are available. Many of them do not contain the most active form of vitamin C, ascorbic acid, and those that do, are often not formulated at the appropriate low pH that maximizes the effects of vitamin C (because at such a low pH products often cause irritation and inflammation.) And none of them, once exposed to air and applied onto the skin, are able to prevent the vitamin C from oxidizing and turning into an inactive yellow compound called Dehydro Ascorbic Acid (DHAA).

Consumers read the front of a skincare product and are content when it contains vitamin C. They do not know the pH of the product, as manufacturers are not required to put that information on the label. It is not evident when the vitamin C is inactive because of the wrong pH or because the form of vitamin C in the product has minimal, if any, benefit. In addition, until the product turns brown or orange, which may be difficult to see as many vitamin C containing skincare products are packaged in dark bottles (in an attempt to minimize exposure to light and oxygen), they can't tell whether the vitamn C has already oxidized. The consumer is happy with the product because 'contains vitamin C' is written on the front label.

As cosmetics, vitamin C containing 'anti-aging' products cannot legally claim to change the structure of skin or they would be classified as drugs and need to acquire FDA premarket approval (see Cosmetic vs Drug.) In actuality, vitamin C containing skincare products are formulated as moisturizers. The anti-oxidant and stabilizing effects the vitamin C has on the formulation itself may be beneficial, but it is likely the mositurizing ability of these products that appeals to the consumer. 'Anti-aging' benefits of topical vitamin C products remains controversial. And none of them have been shown to be as effective as sunscreen.


Posted on: May 06, 2017

There is no doubt that the sun's ultraviolet (UV) rays are damaging to the skin. UV light is a major risk factor for cancer development, sunburn, and premature aging. Scientific evidence clearly supports the use of sunscreen as a safe and effective way to protect the skin from the damaging effects of the sun's UV radiation. 

The FDA (U.S. Food and Drug Administration) regulates sunscreen products as over-the-counter drugs. These products must prove safety and efficacy before being sold on skincare aisles. The benefits of using sunscreen have clearly been shown to outweigh any unproven human health hazards from sunscreen ingredients. The FDA has approved 17 sunscreen filters (ingredients.) Sunscreens contain one or more of these ingredients.

The American Academy of Dermatology recommends applying a water-resistant, broad-spectrum sunscreen with an SPF (Sun Protection Factor) of 30 or higher (see Sun Facts to learn more.)

Correct sunscreen application impacts sunscreen effectiveness. Sunscreen should be applied liberally and often. Sunscreen should be applied prior to going outdoors and allowed to dry on the skin. This may take 10-15 minutes. UV light damage is cummulative so sunscreen should be applied daily to all exposed surfaces, even on cold or cloudy days (as UV rays penetrate the clouds.) The average adult in a bathing suit should apply 1 ounce (a shot glass full) to cover all exposed skin surfaces. Sunscreen should be reapplied at least every 2 hours and immediately after swimming or excessively sweating for continued protection. Regardless of whether you select a sunscreen bottle, spray, or stick, applying an adequate amount of sunscreen is necessary to obtain the SPF protection shown on the sunscreen label.

The BEST sunscreen is the one you use, use liberally, and use often. 

Try the Product Selector to select a sunscreen that's right for you!


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Welcome to Fully Exposed

​Hello, and welcome to FryFace!

I've been a New York based dermatologist for over 25 years. I love music. I love triathlons. I love chemistry. (I love petroleum jelly.) I study skincare ingredients and product formulation. I listen to skincare "advice" from self-proclaimed ......Read More

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