With aging the fat in the face is lost resulting in skin sagging. The sun damages the skin elasticity creating static wrinkles. And the constant expressions create crow’s feet and frown lines around the eyes.

I tell my patients to imagine an old shirt of theirs…It is wrinkly...It is too big for them after they lost so much weight and it is worn out… They need new material to replace the worn out shirt (Medicated cosmetics or skin health restoration, chemical peels and CO2 laser resurfacing to renew the skin)…Ironing of the shirt to get the wrinkles out (Botox) and trimming to make the shirt fit (facelift) or must gain weight (fat transfer to the face).

As you see, the aging face has multiple problems each requiring a different solution. A facelift tightens sagginess but the quality of the worn out skin does not change unless you use Tretinoic Acids or chemical peels. A naso-labial fold – the fold between the nose and the cheeks - would benefit from fat transfer while dynamic wrinkles around the eyes due to a hyper active or expressive face are treated with Botox.

The dark side of the bright sun
How does it rip off your skin beauty?

We go to a great length of trouble and expense to treat our wrinkles, dark spots and acne. However, most treatments fail if we are not aware of the pervasive effect of sun exposure on our skin. We are not talking about sunbathing but about the insidious cumulative everyday accumulation of DNA radiation damage from five minutes here and five minutes there while driving, going to work, shopping or chauffeuring the kids.

In the 1930’s, a pale complexion used to be a sign of luxury and prosperity in contrast to the tanned farmers.

However, with the increased frequency of people flying to the beaches for their vacations, tanning became a sign of wealth, success and beauty.

Because of the increasing educational campaigns regarding the relationship of sun damage and skin cancer, tanning is fast becoming a sign of ignorance rather than a sign of wealth or beauty.

The new self tanning creams, while not perfect, create fewer streaks than the older formulations and are a good substitute to sun tanning.

The closer we are to the equator, the more perpendicular the ultraviolet lights are as they penetrate the atmosphere, hence very little is reflected away by the atmosphere. Fifteen minutes of sun exposure in countries close to the equator equals one hour of exposure in Europe.

Car pollution is depleting the ozone layer allowing for the harmful sun ray to penetrate instead of being deflected.

White skin wrinkles with chronic sun exposure, whereas melanin rich Asian skin becomes full of blotches and dark spots upon sun exposure. Melanin is the pigment that gives the skin its color and is the natural sunscreen that protects us from sun.

The skin also loses its elastin, the material that gives the skin its snap back ability. Thick skin ages by sagging of the face, neck, arms, breast, buttocks and thighs.

Sun exposure is responsible for 80% of the external factors causing skin aging with 10% resulting from smoking and the remaining 10% for all other factors combined such as lack of sleep, stress, poor nutrition and insufficient water intake.

Sun exposure also contributes to the appearance of the unsightly blue and red spider veins in the thighs and the legs.

Most sunscreens are chemicals that become much less effective when exposed to the heat in the shipping and storage environment of hot countries or handbag where they belong. The expiration date on the bottle may be misleading since it refers to the environment found in Europe or North America not in a car in Dubai.

The American Academy of Dermatology has therefore endorsed physical sunscreens that are heat resistant such as the transparent Zinc oxide (example is the Skinusa brand or other brands containing Zinc oxide and Titanium).

There is no need to use a sunscreen with a Sun Protection Factor (SPF) higher than 30 as you would be adding significant chemicals to achieve the higher SPF numbers with negligible additional protection. The most common problem is that people do not apply enough of the sunscreen on their skin.

Children’s skin is very sensitive to sun damage. The damage is a ticking bomb that will explode 20-30 year later.

I am not sure that it is safe to apply large amounts of chemicals (sunscreens) over children’s entire body as they can be absorbed. I recommend instead using sunscreen for the face and protecting the body with tightly knitted cotton cloth that should be changed when wet.

Since the best heat resistant sunscreen can only provide 80% protection from the sun, it is best to avoid sun exposure before five PM (wait until your shade is taller than you). Sun exposure and beautiful skin do not mix.