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What Is the Skin Made of?

The skin is the largest organ in the body, comprising about 15% of the body weight. The total skin surface of an adult ranges from 12 to 20 square feet. In terms of chemical composition, the skin is about 70% water, 25% protein and 2% lipids. The remainder includes trace minerals, nucleic acids, glycosoaminoglycans, proteoglycans and numerous other chemicals.
The skin consists of three main layers: epidermis, dermis and subcaneous tissue.

The epidermis

The epidermis is the topmost layer of the skin. It is the first barrier between you and the outside world. The epidermis consists of three types of cells keratinocytes, melanocytes and Langerhans cells. Keratinocytes, the cells that make the protien keratin, are the predominant type of cells in the epidermis. The total thinkness of the epidermis is usually about 0.5 - 1 mm. At the lowermost portion of the epidermis are immature, rapidly dividing keratinocytes. As they mature, keratinocytes lose water, flatten out and move upward. Eventually, at the end of their life cylce, they reach the uppermost layer of the epidermis called stratum corneum. Stratum corneum consists mainly of dead keratinocytes, hardened proteins (keratins) and lipids, forming a protective crust. Dead cells from stratum corneum continuously slough off and are replaced by new ones coming from below. The skin completely renews itself every 3 - 5 weeks. Most mild peels work by partly removing the stratum corneum and thus speeding up skin renewal.
Another significant group of cell in the epidermis are melanocytes, the cells producing melanin, the pigment responsible for skin tone and color. Finally, Langerhans cells are essentially a forepost of the immune system in the epidermis. They prevent unwanted foreingn substances from penetrating the skin.
The condition of epdermis determines how "fresh" your skin looks and also how well your skin absorbs and holds moisture. Wrinkles, however, are formed in lower layers.

The dermis

The dermis is the middle layer of the skin located between the epidermis and subcutaneous tissue. It is the thickest of the skin layers and comprises a tight, sturdy mesh of collagen and elastrin fibers. Both collagen and elastin are critically important skin proteins: collagen is responsible for the structural support and elastin for the resilience of the skin. The key type of cells in the dermis is fibroblasts, which synthesize collagen, elastin and other structural molecules. The proper function of fibroblasts is highly important for overall skin health.
The dermis also contains capillaries (tiny blood vessels) and lymph nodes (depots of immune cells). The former are important for oxygenating and nourishing the skin, and the latter -- for protecting it from invading microorganisms.
Finally, the dermis contains sebacious glands, sweat glands, hair follicles as well as a relatively small number of nerve and muscle sells. Sebacious glands, located around hair follicles, are of particular importance for skin health as they produce sebum, an oily protective substance that lubricates and waterproofs the skin and hair. When sebacious gland produce too little sebum, as is common in older people, the skin becomes excessively dry and more prone to wrinkling. Conversely, overproduction or improper composition of sebum, as is common in adolescents, often leads to acne.
The dermis is the layer responsible for the skin's structural integrity, elasticity and resilience. Wrinkles arise and develop in the dermis. Therefore, an anti-wrinkle treatement has a chance to succeed only if it can reach as deep as the dermis. Typical collagen and elastin creams, for example, never reach the dermis because collagen and elastin molecules are too large to penetrate the epidermis. Hence, contrary to what some manufacturers of such creams might imply, these creams have little effect on skin wrinkles.

Subcutaneous tissue

Subcutanous tissue is the innermost layer of the skin located under the dermis and consisting mainly of fat. The predominant type of cells in the subcutaneous tissue is adipocytes or fat cells. Subcutaneous fat acts as a shock absorber and heat insulator, protecting underlying tissues from cold and mechanical trauma. Interestingly, most mammals lack subcutaneous tissue because their fur serves as a shock absorber and heat insulator. Sweat glands and minute muscles attached to hair follicles originate in subcutaneous tissue.
The loss of subcutaneous tissue, often occuring with age, leads to facial sag and accentuates wrinkles. A common procedure performed by dermatologists to counteract this process is to inject fat (collected elsewhere in the body) under the wrinkles on the face.

Important Skin Molecules

Health, resilience and youthful appearance of the skin depends, among other things, on several key classes of biological molecules, just like the quality of a house depends on the quality of bricks, beams and concrete. The most important skin molecules are collagen, elastin, glycosoaminoglycans and proteoglycans.
Collagen is a protein forming the structural grid that holds other skin structures. It plays a role somewhat similar to that of steel rods in a reinforced concrete block. It gives the skin its strength and durability. As any other protein, collagen is composed of amino acids. However, it is unusually rich in a few specific amino acids, proline, hydroxyproline, lysine and glycine. Some experts believe that foods or supplements rich in these amino acids may benefit the skin by stimulating collagen production. There is a number of other ways to stimulate collagen production, including topical vitamin C and copper peptides. Increasing collagen production is important because age-related decline in the collagen synthesis is partly responsible for the signs of skin aging such as thinning, wrinkles and sagging.
Elastin is also a protein. It is more stretchable than collagen and helps maintain skin resilience and elasticity. Elastin contains two special amino acids, desmosine and isodesmonsine. When both elastin and collagen and abundant and undamaged, the skin easily regains its shape after being stretched or folded. Just as collagen, elastin deteriorates with age, leading to wrinkles and facial sag.
Glycosoaminoglycans (GAGs) and proteoglycans are special biological polymers whose key role is to hold moisture in the skin. In essense, they are extremely effective natural moisturizers - far more effective that common cosmetic moisturizers. Hydrated GAGs and proteoglycans help the skin stay plump and fresh and provide mechanical support for skin cells. GAGs are composed of special units (mainly water-holding sugars) such as glucosamine hydrochloride, N-acetyl glucosamine, and glucosamine sulfate. These units combine to form various types of GAGs, such as hyaluronic acid, keratin sulfate, heparin, heparin sulfate, dermatin sulfate, and chondroitin sulfate. Proteoglycans are larger than GAGs and are formed when certain types of GAGs are attached to a protein backbone. Since GAGs and proteoglycans are composed largely of water-holding sugars, supplementing one's diet with these sugars may enhance the skins production of GAGs and proteoglycans. In particular, N-acetyl-D-glucosamine, D-glucosamine hydrochloride, and D-glucosamine sulfate are often used as supplemets to increase skin moisture.

Sebum, Sweat, Skin pH and Acid Mantle

Sebum is an oily secretion produced by sebacious glands, tiny ducts adjacent to hair follicles. Sebum is secreted into the follicle, from which it spreads over the hair and skin. The main role of sebum is to waterproof the skin and hair. Both excess and lack of sebum are undesirable. Excess sebum is associated with oily skin and acne. It is particularly common in adolescents as the increased levels of sex hormones stimulate sebum production. Lack of sebum, which is common in middle and older age, leads to skin dryness and accelerates wrinkle formation.
Sweat is a salty, watery solution produced by sweat glands, numerous microscopic channels opening onto the skin surface. As sebum and sweat mix up on the skin surface, they form a protective layer often referred to as the acid mantle . Acid mantle has a particular level of acidity characterized by pH from about 4 to 5.5. A pH of 7 is considered neutral, above 7 is alkaline, and below is acidic. The pH of acid in the human stomach, for example, is usually from 1 to 2, which is highly acidic. The skin, on the other hand, is mildly acidic. In addition to helping protect skin from "the elements" (such as wind or pollutants), acid mantle also inhibits the growth of harmful bacteria and fungi. If acid mantle is disrupted or loses its acidity, the skin becomes more prone to damage and infection. The loss of acid mantle is one of the side-effects of washing the skin with soaps or detergents of moderate or high strength.


Skin Rejuvenation Treatments

There are hundreds of skin rejuvenation treatments, techniques and procedures on the market. If all of them worked as advertised, anyone with some extra cash to spend, could have a skin of a fifteen year old. In reality, relatively few treatments are clinically proven to improve wrinkles and other signs of skin aging. For others, there is some evidence of possible effectiveness but not enough to be positive that they work. Numerous others aren't backed by any reliable science at all, and can even be harmful. (As you probably know, cosmetics, as opposed to drugs, is not regulated by the FDA, so skin care manufacturers do not have to prove their products' safety).

Clinically Proven Topical Treatments

Alpha-Hydroxy Acids
Tretinoin (a.k.a. retinoic acid, Retin A, Renova)
Estrogens
Possibly Effective Topical Treatments
Vitamin C
Vitamin C derivatives
Furfuryladenine (a.k.a. Kinetin, Kinerase)
Copper peptides
Palmitoyl pentapeptide
Alpha lipoic acid
Active retinol
Coenzyme Q10
Lycopene
DMAE
Popular but Unproven Topical Treatments
Collagen (cream)
Beta-hydroxy acids
Noninvasive and Minimally Invasive Procedures
N-lite laser therapy
Radiofrequency lift (a.k.a. Thermage, Thermacool)
Botox
Microdermabrasion
Do-it-yourself microdermabrasion
Collagen (injections)
Invasive Treatments/Procedures
Laser resurfacing
We are currently working on including more articles on various invasive skin rejuvenation treatments. In the meantime, if you are considering an invasive procedure, such as a face lift, please read the article on risks and benefits of plastic surgery


Alpha-Hydroxy Acids

Alpha hydroxy acids have been an ongoing craze of skincare industry for several years, although their cosmetic use has started several decades ago. They are a group of structurally related organic acids found in natural sources or synthesized in the laboratory.
Before we go any further, it should be noted that skincare products based on alpha hydroxy acids are often ridiculously overpriced. Alpha hydroxy acids are very simple, inexpensive chemicals. The cost of alpha hydroxy acids contained in a typical jar of alpha hydroxy acids-based cosmetics is a fraction of a dollar. The effectiveness of an alpha hydroxy acids skincare product depends mainly of the concentration of alpha hydroxy acids rather than accompanying inactive ingredients with scientific-sounding names. Provided alpha hydroxy acids concentrations are the same, an affordable department store brand would bring the same skin benefits as its overpriced counterparts.
There are two different ways in which alpha hydroxy acids are commonly used: (1) high strength alpha hydroxy acids are used by dermatologists in chemical peels. Several studies convincingly demonstrated that such peels can reverse some signs of skin aging. In a 1996 study at the University of Los Angeles, California, forty five volunteers were treated with 50 percent glycolic acid or vehicle alone. The treatment was applied to one side of the face, forearms and hands for 5 minutes once weekly for 4 weeks. The researchers concluded that "application of 50 percent glycolic acid peels improves mild photo aging [aging due to sun damage] of the skin." Another study conducted at Hahnemann University School of Medicine, Philadelphia, Pennsylvania, tested a lotion containing 25 percent of glycolic, lactic or citric acid against a placebo lotion. The treatment was continued for 6 month. Alpha hydroxy acids treatment lead to a 25 percent increase in skin thickness, improved quality of elastic fibers and increased density of collagen. The researches concluded that alpha hydroxy acids "produced a significant reversal of epidermal and dermal markers of photo aging."
Peels with high strength alpha hydroxy acids (over 15%) should not be done without the supervision of a dermatologist.
These days the most common use of alpha hydroxy acids is in OTC skincare products formulated for regular use. Most such products contain relatively low concentrations of alpha hydroxy acids, usually 5-15 percent. Benefits of these skincare products are less clear. Products with alpha hydroxy acids concentration below 8% appear to be of no benefit. Most studies of 8 - 15% alpha hydroxy acids report very modest improvements in wrinkles and skin smoothness. Concentrations at the high end of this range might be a little more effective but are more likely to cause irritation.

Reducing Skin Wrinkles with Retin A or Renova

Retin A and Renova are brands of tretinoin (a short for trans-retinoic acid), a substance related to but distinct from vitamin A. Retin A (Renova) produces multiple effects in the skin. In particular, it increases the responsiveness of skin cells to epidermal growth factor (EGF), the natural hormone that stimulates skin growth.
Topical Retin A (Renova) is one of very few substances whose anti-aging effects on the skin have been documented in many well-designed studies. Retin A (Renova) was found to reduce fine wrinkles and skin roughness, increase epidermal thickness and stimulate deposition of collagen. Typical strength of topical tretinoin (Retin A, Renova) creams is 0.025 - 0.1 percent. With tretinoin (Retin A, Renova), more is not necessarily better. One study has found that 0.025 percent Retin A may be as effective as 0.05 or 0.1 percent, but with lower incidence of skin irritation. For people with sensitive skin, 0.025% Retin A (Renova) may be the optimal strength. According to the studies, improvement on tretinoin (Retin A, Renova) may continue for up to a year of continued use.
The most common side-effect of topical tretinoin (Retin A, Renova) is skin irritation. If persistent, it may lead to skin damage and accelerated aging, i.e. the result opposite to the goal of the treatment. Fortunately, in most cases the irritation can be avoided or minimized with proper care. (See Skin Rejuvenation Infopack for recommendations how to avoid side effects of tretinoin.) At present topical tretinoin (Retin A, Renova) is sold by prescription.

Estrogens: The Skin Connection

It is often noticed that after the menopause women begin to age faster. Wrinkles spread rapidly, skin quickly loses elasticity and smoothness. To a large degree this seems to result from the decline in estrogen levels after the menopause. Of all hormones that decline with age, estrogens have the most dramatic effect on the skin. Estrogens are known to protect women from heart disease, and now it seems that they also slow down skin aging. Several studies indicate that postmenopausal women on estrogen replacement therapy develop less wrinkles and have better skin texture and elasticity than those not taking estrogens.
While going on estrogen replacement is a complex decision requiring the analysis of one's medical history, women after menopause can get the skin benefits of estrogen with topical preparations. Dr. Schmidt and colleagues, from the University of Vienna Medical School, Austria, studied the effects of topical estrogen treatment with 0.01% estradiol or 0.3% estriol in 59 postmenopausal women. After 6 month of treatment, a marked improvement in skin elasticity and firmness was noted; wrinkle depth and pore size decreased by over sixty percent in both estradiol and estriol groups. Skin moisture and collagen synthesis increased significantly.
Many experts believe that estrogen creams could also improve the signs of aging in premenopausal women and in men although further studies are needed to confirm‎ that. The recommendations regarding the use of estrogen creams to treat wrinkles and other signs of aging are detailed in the Skin Rejuvenation Infopack

Vitamin C for wrinkles and skin aging

In just a few recent years there has been an explosion in the number of skin rejuvenation / anti-wrinkle products with vitamin C. Do their claims have any substance? Do these products work? The situation is a little complicated. On one hand, vitamin C does possess definite merits for wrinkle reduction and skin rejuvenation. On the other hand, most vitamin C products don't work.
Potentially, vitamin C can benefit skin in two important ways. Firstly, vitamin C is essential for the synthesis of collagen, a key structural protein of the skin. Adding vitamin C to a culture of skin cells (fibroblasts) dramatically increases the synthesis of collagen. Secondly, vitamin C is an antioxidant and can help reduce skin damage caused by free radicals. So, when vitamin C is properly delivered into skin cells, there is a good chance to reduce wrinkles and improve skin texture.
There are, however, some complicating circumstances often disregarded by manufacturers. First, vitamin C is relatively unstable (unless it is in a dry form). In the presence of air or other oxidizing agents, vitamin C is easily converted to an oxidized form. The oxidized vitamin C is not only incapable of boosting collagen synthesis or scavenging free radicals but actually promotes free radical formation causing damage to vital molecules such as proteins and DNA. In poorly prepared or poorly stored skin care products, vitamin C may already be oxidized by the time you apply it to your skin. Second, only highly concentrated preparations (10% or more) deliver enough vitamin C to the cells to be topically effective.
A few skin care companies offer highly concentrated stabilized vitamin C products, which (at least in theory) are supposed to be consistently effective. However, these products are usually quite expensive. Furthermore, even stabilized vitamin C products may be excessively oxidized by the time you use them. Color or tint is a good indicator of vitamin C oxidative state. The oxidized vitamin C is yellowish-brown. A fresh vitamin C product should be either colorless or white whereas yellowish-brown tint usually indicates vitamin C degradation. Interestingly, some manufacturers add coloring to their vitamin C products, in which case it becomes hard to tell whether vitamin C is intact or oxidized. Whatever the motives for adding color may be, we recommend avoiding vitamin C products that aren't colorless or white.
If you are willing to invest a bit of extra time, you can easily make a vitamin C serum on your own. That way you ensure both freshness and potency - not to mention substantial cost savings. (For more information on making your own skincare preparations, including vitamin C serum, see our article Do-It-Yourself Anti-Aging Skin Care.)
Even when using an optimal formulation, not everyone will respond to vitamin C treatments. About 50% of people show noticeable benefits. The chances are improved when vitamin C is a part of a comprehensive regimen to rebuild collagen in your skin. (See our article on collagen.) Also, people who do not respond to vitamin C may respond to its derivatives, such as magnesium ascorbyl phosphate, ascorbyl palmitate and others. These vitamin C cousins not only boost collagen synthesis but also are more stable and less irritating. (See our article on vitamin C derivatives.)
Finally, keep in mind that taking large amounts of vitamin C (or its derivatives) orally is of little benefit for reducing wrinkles because you cannot obtain high enough concentration of vitamin C in the skin to increase collagen production.

Vitamin C derivatives: skin benefits of ascorbic acid without the downside

Vitamin C (L-ascorbic acid) is one of the relatively few topical agents whose effectiveness against wrinkles and fine lines is backed by a fair amount of reliable scientific evidence. (See our article on vitamin C.) Unfortunately, the practical use of vitamin C in skin care presents some difficulties due to its lack of stability. When exposed to air, vitamin C solution undergoes oxidation and becomes not only ineffective but also potentially harmful (oxidized vitamin C may increase the formation of free radicals).
Some skin care companies offer stabilized vitamin C products, which oxidize less rapidly. However, these products are usually very expensive (especially the ones concentrated enough to be effective) and may still be excessively oxidized by the time you use them.
Is it possible to get the skin benefits of vitamin C at lower cost and without the risk of using a degraded product? Yes -- and in more ways than one. For instance, you can relatively easily prepare a high potency vitamin C serum on your own. If you make fresh batches often and store them properly, you can ensure a reliable supply of effective topical vitamin C. (For more information on making your own skincare preparations, including vitamin C serum, see our article Do-It-Yourself Anti-Aging Skin Care.) If you do not wish to go the DIY route, or high potency vitamin C irritates your skin, you can use vitamin C derivatives.
To improve the practicability of vitamin C in skin care, scientists have been looking for its relatives with comparable or superior skin benefits. An ideal vitamin C derivative should be able to easily penetrate into skin cells and release L-ascorbic acid in amounts sufficient to boost collagen synthesis. Also, it should be more stable and less irritating than vitamin C. So far, two compounds have found their way into the broad skin care market: ascorbyl palmitate and magnesium ascorbyl phosphate. A few other highly promising derivatives are on the horizon.

Ascorbyl palmitate

Ascorbyl palmitate is the most widely used fat-soluble derivative of vitamin C in skin care. It is nonirritating and more stable than vitamin C. Furthermore, ascorbyl palmitate is a fat-soluble antioxidant and is at least as effective as vitamin E in protecting the skin from lipid peroxidation (a key type of free radical damage in the skin). Unfortunately, it appears that the concentrations of ascorbyl palmitate achievable in skin care formulas do not boost collagen synthesis as much as vitamin C.
Numerous skin care products containing ascorbyl palmitate are commercially available. When buying products with ascorbyl palmitate (or other vitamin C-derived skin care for that matter), it is best to choose colorless or white formulation. That way you can easily spot the oxidation of the active ingredient by the emergence of yellowish-brow tint.

Magnesuim ascorbyl phosphate

Magnesuim ascorbyl phosphate is a water-soluble derivative of vitamin C rapidly gaining popularity in skin care. It is nonirritating and more stable than vitamin C. Most importantly, magnesuim ascorbyl phosphate appears to have the same potential as vitamin C to boost skin collagen synthesis but is effective in significantly lower concentrations. Overall, magnesuim ascorbyl phosphate appears to be a better choice than vitamin C for people with sensitive skin and those wishing to avoid any concomitant exfoliating effects. (Most vitamin C formulas are highly acidic and therefore produce exfoliation.)
Skin care products with magnesuim ascorbyl phosphate are available and their number is growing. Be careful though. Many products contain less than effective concentration and fail to boost collagen synthesis. Also, even though magnesuim ascorbyl phosphate is several times more stable than vitamin C, it still gradually degrades when exposed to light and air. Hence freshness and proper storage are important.

Next generation of vitamin C derivatives

Most vitamin C derivatives on the market, including ascorbyl palmitate and magnesuim ascorbyl phosphate, consist of the ascorbic acid fragment (ascorbyl) and a fragment of another acid (e.g. palmitate or phosphate). Recent research indicates that a new vitamin C derivatives consisting of multiple chemical fragments bound to a single ascorbic acid fragment may work even better. These new derivatives are more stable compared to both vitamin C and older derivatives. Furthermore, some of these newcomers also appear to be more powerful boosters of collagen synthesis. Even though very few products on the market contain these new compounds, they are likely to become widely used in skin care as more evidence of their benefits accumulates.
Bottom line
While unmodified vitamin C remains an important skin care ingredient, its derivatives may do a better job in some situations. They tend to be more stable, more affordable and less irritating. Some of the newer derivatives may even be superior in boosting skin collagen synthesis. On the other hand, unmodified vitamin C may be a better choice if you want to stimulate collagen synthesis and exfoliate at the same time. (High potency vitamin C products are highly acidic and therefore have exfoliating effect.)
To learn about the practical use of vitamin C derivatives, including the promising new compounds, see Skin Rejuvenation Infopack. It covers optimal concentrations, proper application, storage and other issues that impact the effectiveness of these agents.

Furfuryladenine (Kinetin and Kinerase) for Skin Rejuvenation

Furfuryladenine is a plant-derived growth factor claimed to reduce wrinkles, fine lines and other signs of skin aging without causing skin irritation. In fact, furfuryladenine has been hailed as a non-irritating alternative to Retin A. Unfortunately, only a few studies of furfuryladenine's effectiveness have been conducted so far. These studies indicate that topical furfuryladenine at 0.1% concentration may be equivalent or superior in its effectiveness to Retin A while producing no or little side-effects in most people. At this point, furfuryladenine appears very promising but more studies are needed to confirm‎ its effectiveness (most importantly the studies not sponsored by furfuryladenine manufacturers). If the benefits of furfuryladenine are reliably proved it may indeed become a superior alternative to Retin A, particularly for wrinkles in sensitive areas such as under eyes.
Currently, furfuryladenine is sold under two brand names Kinetin and Kinerase. Based on current retail prices, Kinerase gives you more active ingredient per dollar spent.

Copper peptides: Can you 'repair' a wrinkle?

If aging, as some say, is a disease, then wrinkles can be viewed as small, improperly healed wounds. Indeed wrinkles are characterized by incorrect deposition of collagen and imperfect skin cell layering, which is also seen in healed wounds albeit on a much larger scale. If so, could the agents that modify the process of wound healing (by minimizing scar formation and improving skin remodeling) have a potential to prevent or even reduce wrinkles? Well, possibly. A good example of a wound-healing agent that appears to also have anti-wrinkle potential is the class of compounds called copper peptides.
What exactly are copper peptides and how can they boost skin rejuvenation? Generally speaking, peptides are small fragments of proteins. (And the proteins are the key building blocks of most living tissues.) Certain kinds of peptides have an avid affinity for copper, to which they bind very tightly. The resulting compound consisting of a peptide and a copper atom has become known as a copper peptide.
The benefits of copper peptides for tissue regeneration were discovered by Dr. Loren Pickart in the 1970s. He found and patented a number of specific copper peptides (in particular, GHK copper peptides or GHK-Cu) that were particularly effective in healing wounds and skin lesions as well as some gastrointestinal conditions. One of the end results of this research was Iamin gel approved by the FDA for the treatment of acute and chronic wounds and ulcers.
A lot of substances can have a positive effect on wound healing. A distinctive feature of GHK copper peptides is that they reduce scar tissue formation while stimulating normal skin remodeling. In other words, they help better restore the damaged area to its original look.
The mechanism of copper peptide action is relatively complex. GHK-Cu induces the degradation of "extra-large" collagen aggregates found in scars and promotes the synthesis of smaller more regular collagen found in normal skin. It also promotes the synthesis of elastin, proteoglycans, glycosaminoglycans and other components of skin matrix. Other important effects of GHK-Cu include the ability to regulate the growth rate and migration of different types of cells; significant anti-inflammatory action; and the ability to prevent the release of oxidation-promoting iron into the tissues. The net result is a faster, better and "cleaner" healing.
You might say it's nice to have cleanly healed wounds, but what about people who do not have any wounds or ulcerations to heal? Can copper peptides be useful for regular skin protection and rejuvenation? It appears that they can. However, while the wound healing effects of copper peptide have been investigated and documented in many studies, much less research has been done so far on their cosmetic and anti-aging use. The available evidence indicated the following potential skin benefits:
· Many existing skin care treatments are based on the concept of removing the outermost or even deeper layers of the skin. The resulting healing process stimulates skin remodeling leading to smoother, younger looking skin. Since copper peptides optimize healing and improve skin remodeling, then can augment the effect of treatments based on various forms of controlled skin injury. In particular, copper peptides can be useful after various forms of laser resurfacing, dermabrasion, and chemical peels. IMPORTANT: If you are considering using copper peptides after a particular procedure, make sure to discuss it with your physician.
· Copper peptides are effective against various forms of skin irritation, mainly due to their anti-inflammatory effects. Skin irritation, even in the absence of open lesions, dramatically accelerates skin aging by promoting the formation of free radicals and other toxic byproducts. Some common skin rejuvenation treatments, such as tretinoin (Retin A, Renova) and alpha hydroxy acids, can cause irritation. If during treatment you experience skin irritation for an extended period of time, your skin will likely end up in a worse shape than when you started. In many cases, copper peptides can reduce or eliminate the irritation and help maximize treatment benefits.
· It is always easier to prevent the damage than to fix it later. To a significant degree, skin aging is caused by the accumulation of minor day-to-day damage from sun, wind, detergents, acne, abrasions and so forth. As these minute lesions heal, they leave microscopic imperfections, which, eventually, accumulate to become visible signs of aging. While it remain to be further researched, it appears that copper peptide can help minimize the damage from daily wear and tear of the skin. For instance, one study demonstrated that copper peptides helped recover skin integrity after exposure to SLS, a common detergent found in many shampoos, cleansers, and dishwashing/laundry products.
· It remains unclear whether copper peptides can reverse wrinkles and other signs of aging in the intact skin. Theoretically, it is possible since copper peptides promote the degradation of abnormally large cross-linked collagen (the one found in scars and, to a lesser degree, in wrinkles). They also stimulate the production of "regular" collagen found in normal skin. In one small study, copper peptides stimulated collagen production in the intact skin. In fact, in that study copper peptides produced a stronger stimulation of collagen sysnthesis than tretinoin (Retin A, Renova) or ascorbate (vitamin C).
At present, several skin care companies offer a range of copper peptide products. However, to the best of my knowledge, all copper peptides in these products are based on Dr. Pickart's patents.
The bottom line
Copper peptides are a promising skin treatment with a good safety profile. Their ability to improve the healing of various types of skin lesions is well established. It is likely that copper peptides may slow down the development of the signs of skin aging by limiting the consequences of daily wear and tear. Also, copper peptides may augment the results of the skin rejuvenation treatments based on controlled skin injury, such as laser resurfacing, dermabrasion and peels. There are also indications that copper peptides have the potential to improve wrinkles and skin texture on their own. However, more extensive and prolonged studies are required to definitively prove it. Further practical details of optimally selecting and using copper peptides products are discussed in Skin Rejuvenation

Palmitoyl pentapeptide, a gentler wrinkle cure candidate.

Palmitoyl pentapeptide (a.k.a palmitoyl oligopeptide) is a new skin rejuvenation compound developed by the corporations Sederma SA and Proctor & Gamble. Lately, it has generated a lot of media buzz and has been included in a variety of pricey skin care formulas.
The proponents claim that palmitoyl pentapeptide is at least as effective against wrinkles as retinol but does not cause skin irritation, which is a common side-effect of retinoids.
So, is there any science under the hype? Chemically speaking, palmitoyl pentapeptide is a relatively small molecule (five amino acids linked together and attached to a fatty acid) structurally related to the precursor of collagen type I (a.k.a. procollagen type I). Researchers found that when added to the culture of fibroblasts (the key skin cells), palmitoyl pentapeptide stimulated the synthesis of the key constituents of the skin matrix: collagen, elastin and glucosamnoglycans. How exactly palmitoyl pentapeptide did that remains unclear, although a number of theories exist.
Unfortunately, the ability to improve the productivity of skin cells in the test tube, does not always translate into an effective anti aging treatment. Less than one in ten promising test tube discoveries ever becomes an established therapy. Clinical studies of palmitoyl pentapeptide do exist but all of them (to my knowledge as of the day of this writing) have been conducted or sponsored by the manufacturers (Sedema and Proctor & Gamble). This does not necessarily make the studies biased, but potential conflict of interests is always a red flag. Unfortunately, this situation is typical. Early studies of patented chemicals are almost always sponsored by manufacturers. It usually takes a long time before completely independent research is conducted.
So far, clinical data are encouraging. One study demonstrated that palmitoyl pentapeptide was as effective as retinol in repairing sun-damaged skin but was devoid of side-effects. Most other studies showed at least some improvement in various objective and subjective measures of wrinkles. No side effects have been reported.
Unfortunately, the clinical data is still too skimpy to view palmitoyl pentapeptide as a proven anti-wrinkle treatment at this time. So, should you wait? Or is palmitoyl pentapeptide worth a try today? There is no universal answer to this question. If your skin care budget is tight, you may not want to spend your hard earned cash on "perhaps-effective" products. On the other hand, if you have cash to burn and/or other alternatives didn't work, palmitoyl pentapeptide, with its good safety profile, may be worth a try. Palmitoyl pentapeptide may also be considered as a nonirritating fall back option for people who develop skin irritation in response to retinoids or alpha-hydroxy acids.
If you decide to try palmitoyl pentapeptide, keep in mind that its concentration in a product should be sufficiently high (e.g. matching the levels used in the clinical studies). There is a large price variation between different palmitoyl pentapeptide products, although none are dirt-cheap. However, the price does not always reflect the concentration of the active ingredient. It my reflect prestige of the brand, advertising overhead, sophistication of packaging and so forth. Be wise. Make sure you are paying a fair price per until of the pentapeptide. For recommended palmitoyl pentapeptide concentrations, clinical data and details see Skin Rejuvenation Infopack.


Alpha lipoic acid skin care: What is all the fuss about?

Many if not most skin care conscious people have heard about alpha lipoic acid (often called lipoic acid for short). These days the number of skin care products with lipoic acid is growing as rapidly as its media coverage. However, as many consumers know from personal experience, neither media coverage nor acceptance by skin care companies guarantees effectiveness or even safety. So, what do we really know about lipoic acid in general, and its purported skin care benefits in particular.
Lipoic acid is a well-known natural substance found in certain foods and also produced in the human body. It has an impressive array of potentially beneficial mechanisms of action:
· Lipoic acid is a potent and versatile antioxidant.
· It is a co-factor in a key biochemical pathway responsible for energy production in the cells (citric acid cycle).
· It inhibits cross-linking which is the formation of chemical bridges between proteins or other large molecules. Cross-linking contributed to the aging process by causing hardening of arteries, wrinkling of the skin and stiffening of joints.
· It has moderate anti-inflammatory effect.
· Finally, it has a capacity, albeit a modest one, to neutralize and remove from the body a variety of toxic metals.
Lipoic acid supplements have been repeatedly demonstrated to benefit a number of health conditions, including the neurological complications of diabetes, arterial sclerosis and others.
In theory, all of the above effects of lipoic acid may benefit skin cells and, therefore, improve skin texture and wrinkles. However, many substances that were deemed "theoretically" effective against wrinkles, proved to be of little or no value when actually tested. (Topical collagen, aloe vera, topical amino acids to name a few.) Furthermore, even if a substance has been demonstrated to protect skin cells or stimulate collagen production in a test tube, this is no guarantee of its effectiveness when applied to real human faces in a cream. The only reliable indicators are clinical studies, preferably performed by several independent teams of researchers.
How does topical lipoic acid fare in clinical studies department? Well, at this point it holds a junior position. In one small-scale study, high potency lipoic acid reduced mild-to-moderate wrinkles by up to 50 percent, whereas fine lines have almost disappeared. In another study, lipoic acid significantly improved the appearance of certain types of scars. In both studies the effectiveness varied among participants, from little effect to a marked improvement. However, this shouldn't disqualify lipoic acid as a "wrinkle cure" contender. Even well established wrinkle treatments tend to produce widely varied results in different people. If further studies corroborate skin benefits of lipoic acid, it may become one of the mainstays of today's anti-aging skin care. In fact, lipoic acid will be especially welcome in the family of proven wrinkle fighters because it is less irritating than tretinoin (Retin A, Renova) and hydroxy acids. (Therefore it can be used, albeit in lower concentrations, in delicate and wrinkle prone area around the eyes.)
But don't get too excited just yet. Unfortunately, most studies of topical lipoic acid have been performed by the same researcher, a Yale dermatologist Nickolas Perricone. Doctor Perricone has pioneered the use of lipoic acid for skin rejuvenation, and later on promoted it in his popular book "The Wrinkle Cure." As impressive as Dr. Perricone's credentials and studies may be, the research that comes largely from a single source cannot be fully relied upon until independently corroborated. Also, note that Dr. Perricone's studies employed a rather high concentration of lipoic acid, whereas most commercial preparations are less concentrated. Finally, lipoic acid is a cornerstone of Dr. Perricone's own skin care line. I do not think that he would intentionally exaggerate the benefits of lipoic acid just to boost sales. However, a potential conflict of interest is there. Serious scientific research is a complicated business. When there is a conflict of interest (e.g. income or prestige is affected by the outcome of the experiment), a researcher may misinterpret the data without even realizing it. This is known to have happened to some of the history's greatest scientific minds, not to mention rank and file scientists and physicians.
So, should you give lipoic acid a try or rather wait until more studies have been performed? On one hand, to wait for more research is always prudent. On the other hand, additional clinical studies may not materialize for another five or ten years. In the mean time you may be missing out on an effective wrinkle treatment with a good safety profile. (Although almost any treatment can produce negative effect in a some people, adverse reactions to lipoic acid are less common than to such agents as Retin A, vitamin C or glycolic acid.)
With that in mind, the dilemma for most people is whether it is worth spending money on a 2-3 month supply of lipoic acid cream to give it a fair try. Unfortunately, even though topical lipoic acid products are proliferating, they remain somewhat costly. The prices include what I call a "hype premium" because lipoic acid itself is an inexpensive, widely available chemical. If you like taking matters in your own hands, you can easily make a lipoic acid cream yourself. The benefits of this approach include very substantial cost-savings, freshness and the ability to optimize the concentration of lipoic acid to fit your needs. There is yet another important advantage of the do-it-yourself approach in this particular case. Most lipoic acid products contain a mixture of its two variants, so-called S and R forms. (For the scientifically inclined, these are two different optical isomers of lipoic acid.) While both S and R forms are potent antioxidants, only R-lipoic acid improves cellular energy production and reduces inflammation. Furthermore, the presence of the S form appears to reduce the effectiveness of the R-form. Other conditions being equal, R-form alone is more likely to bring results than the commonly used S & R mixture. Lipoic acid creams I've seen so far all use the mixture of the R and S forms. (Assume that the cream contains a mixture unless the label explicitly says "R-lipoic acid".) Pure R-form is available as a powder, however, and is suitable for making your own R-lipoic acid cream.
For more information on making your own skincare preparations, including an alpha lipoic acid cream, see the article Do-It-Yourself Anti-Aging Skin Care.

Active retinol

Elsewhere on this site we mention that most retinol-based cream have no effect on wrinkles and skin texture. And that's true. Yet recent evidence indicates that there may be a way to make retinol work for your skin.
First, let us explain the basics. Retinol is just a fancy name for vitamin A or, to be more accurate, retinol is one of several forms of vitamin A found in the body. Other forms of vitamin A include retinyl palmitate, retinal and retinoic acid. Among these related but different chemical compounds, only retinoic acid has direct effect on skin cells. If fact, retinoic acid is the active ingredient in Retin A and Renova - some of the best known anti-wrinkle creams (see Treatments section of this site). Other forms of vitamin A have to be converted to retinoic acid to be able to activate the metabolism of skin cells. The good news is that skin cells have the "equipment" (specialized enzymes) that converts other forms of vitamin A into retinoic acid. Indeed, if sufficient amounts of retinol, retinal or retinyl palmitate are added to the culture of skin cells, the amount of retinoic acid in the cells markedly increases.
Why then most retinol creams are virtually useless? The main reason is that they do not deliver enough retinol in skin cell. The rate of conversion of retinol into retinoic acid is low, so a relatively large amount of retinol needs to be delivered into a cell to produce significant effect. Most creams simply have too little retinol for that. Simply increasing the amount of retinol doesn't quite work for too reasons. Firstly, a cream with too high a concentration of retinol may be almost as irritating as retinoic acid. Secondly, retinol is relatively unstable, so most creams lose potency upon storage.
What can be done? One possibility is to prepare one's own retinol-based cream. If retinol concentration is made moderately high (but not too high) it may be enough to produce skin benefits but low enough to avoid skin irritation. Furthermore, if a creams is used up soon after is has been prepared, retinol does not have time to degrade. For more on making your own retinol-based cream see DIY Anti-Aging Skin Care Infopack
There are some new technologies to help to increase the amount of retinol in skin cells without causing skin irritation. Firstly, retinyl palmitate appears to be a better alternative than retinol because it is much less irritating and may be used at higher concentrations than retinol. (Just as retinol, retinyl palmitate is converted to retinoic acid inside skin cells.) Another enhancement is to make retinol or retinyl palmitate better soluble and thus better able to penetrate the skin. This can be done, for instance, by chemical modification or by encasing retinol (or retinyl palmitate) in special microglobules called lyposomes. Preliminary research studies of creams made using the above techniques indicate that these products are almost as effective as retinoic acid (Retin A, Renova) for reducing wrinkles but far less irritating. Hopefully, further research will confirm‎ these findings. For more information about pros, cons and practical use of "active retinol" products see See Skin Rejuvenation Infopack.

Can conenzyme Q10 help protect and repair your skin?

Coenzyme Q10 (Co Q10) is a relative newcomer to the skin care industry. Yet, its value for general health and nutrition is rather well known and well researched.
CoQ10 has at least two important roles in the body. First, it is one of the essential cogs in the biochemical machinery that produces biological energy (ATP) inside the cells. Second, CoQ10 is an antioxidant. It helps neutralize harmful free radicals, which are one of the causes of aging. Under perfect conditions, the body can produce as much CoQ10 as it needs. However, various factors, such as aging, stress and some medications, can lower the levels of CoQ10 in the body. As a result, the ability of cells to withstand stress and regenerate declines. Unfortunately, the levels of CoQ10 in the body almost inevitably decline with age. In fact, CoQ10 is regarded as one of the most accurate biomarkers of aging since its decline correlates so well with the aging process. In some studies, rodents treated with supplemental CoQ10 lived up to 30 percent longer than their untreated counterparts. The effects of CoQ10 supplements on human longevity remain unknown. On the other hand, it was proven useful in treating certain human diseases, including heart failure and hypertension.
What can CoQ10 do for your skin? Theoretically speaking, CoQ10 (in a skin cream, for example) can be helpful. In most people over thirty, levels of CoQ10 in the skin are below optimum, resulting in lesser ability to produce collagen, elastin and other important skin molecules. Besides, CoQ10-depleted skin may be more prone to the damage by free radicals, which are particularly abundant in the skin since it is exposed to the elements. Thus, CoQ10 may boost skin repair and regeneration and reduce free radical damage. Furthermore, CoQ10 is a small molecule that can relatively easily penetrate into skin cells.
Based on this rationale as well as the drive to put new products on the marker, some companies introduced skin care products with CoQ10. It is unclear whether these products are effective. Firstly, theoretical effectiveness does not always result into practical benefits. Second, very few real studies indicating possible practical skin benefits of CoQ10 have been conducted so far. Arguably, the most encouraging was a 1999 study by German researchers who reported that long-term use of CoQ10 reduced crows feet (wrinkles around the eye).
Even if CoQ10 can be effective in treating skin aging, it is unclear whether popular CoQ10 products contain sufficient concentration of active CoQ10. (Keep in mind that CoQ10, just like vitamin C, can be inactivated by oxygen from the air.). You can get around this problem, however, by preparing your own CoQ10 cream where you can ensure proper freshness and concentration. (See DIY Anti-Aging Skin Care Infopack for specific instructions).

Lycopene: antioxidant and sunscreen in one.

Lycopene, a relative newcomer to the world of skin care, belongs to a class of compounds called carotenes. Carotenes are plant pigments that share certain elements of chemical structure and usually have color somewhere in the orange-red-brown range. To one degree or another, different carotenes can scavenge free radicals and block visible and UV-light.
Lycopene may be the best free radical scavenger among carotens - it is at least twice as effective an antioxidant as beta carotene. In recent years, a number of studies indicated a variety of health benefits of lycopene, including reduced risk of cancer, heart diseases and other chronic conditions. In addition to protecting cells from free radical damage, lycopene may produce its beneficial effect by other means, such as improving the function of cell-to-cell junctions and some aspects of cell metabolism. Being fat soluble, lycopene appears to be particularly effective in the tissues with high fat and lipid content. For example, it significantly reduces the risk of cancer of the prostate, an organ very high in lipids. The skin, also a lipid-rich organ, is likely to benefit from high antioxidant activity of lycopene. Theoretically, lycopene's ability to regulate cell-to-cell junctions might provide an additional benefit of improving skin texture.
The ability of lycopene to block UV light is an additional benefit for the skin. However, lycopene has SPF of about 3, which is insufficient to protect from direct sun or any other harsh UV exposure. On the other hand, it is enough to reduce the effects of indirect sunlight or the sunlight that has passed through window glass. For people who do not wish to use sunblock at all times, an alternative strategy may be to wear a sunblock (SPF 15 or greater) outdoors, and use a lycopene lotion at other times.
What is the best way to get skin benefits of lycopene? As with most other non-invasive treatments, you can either put it on or ingest it. The best food source of lycopene is tomatoes. There is a catch though. In raw tomatoes, lycopene is tightly bound to indigestible fiber. Therefore eating raw tomatoes provides relatively small amounts of bioavailable lycopene. Cooked tomatoes, such as tomato paste or tomato sauce are a much better dietary source of lycopene. However, to get any appreciable health and skin benefit of lycopene you need to eat at least 100 grams (3.5 ounces) of tomato paste a day. An easier way may be to use lycopene supplements which are widely available in health food stores.
Dietary intake may not be sufficient to maximize skin benefits of lycopene. When ingested, lycopene is distributed throughout the entire body and only relatively small amount finds its way into the skin. Luckily, lycopene is well absorbed if applied topically (e.g. in a cream or lotion) because it is fat soluble and has relatively small molecules. The only possible downside of topical application is that lycopene may give your skin a bit of a tint (in the orange-red-bronze range). Some people enjoy this look as it resembles a light, fresh tan while others prefer to minimize it and therefore use lycopene lotions at night. The way lycopene looks on you may depend on your skin complexion as well as your choice of makeup. However, you will get the antioxidant, UV-protection and possibly other anti-aging benefits of lycopene regardless of your skin type or complexion.
How to get lycopene skin care products? We don't sell or promote and particular lycopene products since the mission of this site is to provide unbiased, well researched information. Commercial lycopene creams and lotions are available (just search the web). However, at the time of this writing, they are relatively few and quite expensive. Another problem with the products containing topical lycopene or other antioxidants is that once a jar has been opened (or if it is intact but poorly sealed), the contents starts to degrade due to exposure to oxygen in the air. A viable alternative is to make your own lycopene cream or lotion. It is surprisingly easy to do and allows you to have topical lycopene that is both fresh and costs many times less than most commercial alternatives. For more information on making your own skincare preparations, including a lycopene lotion, see our article Do-It-Yourself Anti-Aging Skin Care.

Will DMAE lift your face, or just your wallet?

Topical DMAE has recently been nominated, mostly by skin care ads and lay media, for the vacant position of the "facelift in a jar." To appreciate the scope of this claim, it is important to distinguish between topical agents that reduce the appearance of wrinkles and the ones that reduce facial sag. The former have been around for quite a while. For example, Retin A have been consistently shown to reduce the appearance of fine lines and wrinkles in some people. On the other hand, none of the well known topical agents have been proven to reverse facial sag. This is unfortunate because a sagging face is arguably a more prominent sign of aging than wrinkles. A common thinking goes that even young people may have wrinkles but only older people have sagging faces. True or not, firming is as important for facial rejuvenation as any other facet of skin care.
So what about DMAE? Can it help, or is it just another rub-on facelift scam? The reality is somewhere in between. DMAE won't accomplish anything approaching a well-performed surgical face lift, but it is not useless either. In fact, it may be the fist agent proven in a study to have at least some positive effect on facial sag.
What is DMAE and what does it do anyway? DMAE is a short for dimethylaminoethanol, a naturally occurring substance that facilitates the synthesis of a neurotransmitter acetylcholine. DMAE also may stimulate the synthesis of phosphatidylcholine, an important component of cell membranes. Interestingly, DMAE is far better known and researched as a "smart drug" than a skin firming agent. In a number of studies, DMAE has been shown to reduce age-related decline in cognitive ability and memory. It was also found to modestly increase life span of laboratory animals. An intriguing finding in some DMAE studies was that it reduced the accumulation of lipofuscin deposits inside cells. Lipofuscin is a cellular pigment consisting of aggregated chunks of molecular waste. It tends to occur in the cells of older people. It is likely that lipofuscin is not simply a byproduct of aging but also contributes to the aging process. Neurons, heart and skin of older people usually contain particularly large amounts of lipofiscin.
The DMAE-skin connection is less researched. It has been demonstrated that DMAE causes some degree of skin tightening. However, despite speculation it remains unclear how DMAE firms the skin ?whether by stabilizing the membranes, boosting acetylcholine, reducing lipofuscin deposits or none of the above. Whatever the mechanism, the effect of DMAE is often noticeable although seldom dramatic. Besides, even though DMAE can't fully reverse the existing facial sag, it may reduce its further progression. Some people report a cumulative effect with continued use of DMAE.
A number of skin care companies released DMAE creams, most costing upward of $20 for a small jar. The prices reflect the hype and relative lack of competition from "supermarket" brands. DMAE itself is a rather simple substance, no more costly than alpha hydroxy acids or aspirin. Besides, DMAE does not need special stabilization like vitamin C, and it is easy to disperse in a topical vehicle. Based on purely economic and manufacturing considerations, a DMAE cream shouldn't cost more than $5. Is there an alternative to paying a large "hype" premium for a DMAE cream? Yes there is. It is surprisingly easy and affordable to make your own DMAE cream. An additional advantage of this approach is that you can fine-tune DMAE concentration to fit your skin. For more information on making your own skincare preparations, including a DMAE cream, see our article Do-It-Yourself Anti-Aging Skin Care.

Collagen: a hope for a younger-looking skin or an advertising gimmick?

Most people interested in maintaining youthful skin and reducing wrinkles have heard about collagen. It's something "they put in expensive creams or inject into wrinkles." Well, there is much more to collagen than that. Collagen is a protein (a biological polymer consisting of amino acids) that serves as a key structural component of connective tissue such as skin, bones, ligaments, etc. Dermis, the inner layer of the skin, contains large amounts of collagen whose fibers form a supporting mesh responsible for skin's mechanical characteristics such as strength, texture and resilience.
As any material, collagen is subject to wear and tear: it slowly breaks down over time. Skin cells called fibroblasts are capable of producing collagen. When needed, fibroblasts replace broken collagen fibers with new ones. Unfortunately, as we age the skin's ability to replace damaged collagen diminishes and more gaps and irregularities develop in the collagen mesh. This process eventually leads to wrinkles. Thus, one important target of wrinkle prevention and elimination regimen is to reduce collagen breakdown and increase its supply. This task is achievable but you have to go about it in the right way.
Many factors contributing to accelerated collagen breakdown can be fully or partially neutralized. They include sun damage, free radicals, some age-related hormonal changes, and smoking. See other articles on this site and Skin Rejuvenation Infopack for further details.
Why creams with collagen are good only for covering wrinkles
To reduce rather than just cover wrinkles, new collagen must become a part of the skin's inner layer, the dermis. Unfortunately, collagen molecules are too large to penetrate into the dermis when applied to the surface of the skin. Thus, when simply applied onto the skin, collagen remains locked outside without affecting the skin structure, at best just temporarily covering wrinkles.
Collagen injections for wrinkles one step forward, two steps back
Another common approach to smoothing wrinkles is collagen injections. Collagen is injected in the skin under the wrinkles in such a way that it pushes the groove of a wrinkle up making it less visible. This procedure does have some noticeable cosmetic effect but has a number of serious drawbacks.
Collagen for injections usually comes from animals sources. Since it is a foreign protein for humans, injected collagen may be attacked by the immune system, which may lead to a serious allergic reaction. This is not common but it does happen. Furthermore, injections of animal collagen carry a small risk of triggering a long-lasting auto-immune disease. The wrinkle smoothing effect of injections is relatively brief. Although injected collagen cannot escape outside the skin, it still fails to structurally integrate into the skin's own collagen mesh. As a result, it breaks down relatively quickly, which causes wrinkles to reappear.
Better technologies for collagen delivery
New technologies to resupply wrinkled areas with collagen are emerging. One notable improvement is to inject human collagen produced via biotechnology. The approach eliminates the risk of allergic and auto-immune reactions almost completely. The results are still not very lasting but somewhat less transient than animal collagen.
Another ingenuous new technology is to extract a person's own collagen producing cells (skin fibroblasts), grow them in a laboratory and then reinject in areas with wrinkles. The cells begin producing collagen, filling the gaps and smoothing wrinkles. Collagen created by this method is much longer lasting because it is arranged properly in the skin.
Stimulating your skin to produce more collagen
As was mentioned, aging of the skin shifts the balance between collagen production and breakdown leading to wrinkles, facial sag and rough skin texture. Stimulating skin cells to produce collagen can partly reverse this process. Stimulating collagen synthesis in aged skin was shown to reduce wrinkles and improve skin texture. The benefit of stimulating your own collagen production is that collagen is deposited in an orderly, structured manner and that there is no risk of allergy, immune reaction or injection-induced infection. Furthermore, many ingredients useful in stimulating collagen synthesis are relatively inexpensive and safe.
Stimulation of collagen synthesis in aging skin is realistic and can substantially improve the appearance of fine lines and even deeper wrinkles when done correctly. However, it requires a comprehensive approach. Production of collagen is a complex process, not unlike the assembly of an automobile. Many parts and assembly tools must come together to efficiently create a product. Similarly, lots of things are needed to efficiently produce collagen:
Vitamin C: Vitamin C (ascorbic acid) is essential for efficient synthesis of collagen. Many of the symptoms of scurvy (vitamin C deficiency disease) such as bleeding gums, skin hemorrhages and poor wound healing a due to impaired collagen synthesis. On the other hand, supplying extra vitamin C can accelerate collagen synthesis especially when other key ingredients are also in abundance. While vitamin C is useful for rebuilding your skin's collagen and reducing wrinkles, it could be of no benefit or even harmful if used improperly. Click here for more about the use of vitamin C to treat wrinkles and rejuvenate skin.
Key amino acids: Like any other proteins, collagen consists of amino acids (a type of small organic molecules). Altogether there are 20 different kinds of amino acids in human cells. However, collagen is unusually rich in a few particular amino acids. Supplying these key amino acids in abundance helps stimulate collagen synthesis.
Copper peptides: Certain minerals are also essential for collagen production. One such mineral is copper. Indeed when the level of copper inside skin cells increases, collagen production goes up. However, copper is a potentially toxic metal. Supplements containing more than RDA for copper (2 mg) should not be taken. Simply applying inorganic copper to the skin would do more harm than good because inorganic copper promotes free radical formation. There is an promising new technology to circumvent these problems. When copper is converted to organic form by binding to peptides (small fragments of proteins) it can be safely applied to the skin. Such copper peptides were shown to promote collagen synthesis and thereby stimulate hair growth and wound healing. They also may prove effective in smoothing wrinkles.
Growth factors and hormones: To maximize collagen synthesis in the skin, it is not enough to simply supply cells with all necessary ingredients. Most cells in the body are responsive to a variety of external signals transmitted by signaling molecules such as growth factors and hormones. Some of those signals can switch skin cells into higher gear making them produce more collagen. In fact, one of the reasons why the skin of a child or a young adult produces more collagen than the skin of an older person is that the body's ability to manufacture signal molecules diminishes with age. The challenge is to supply these activators of collagen via topical application.
Comprehensive Collagen Rebuilding
When setting out to battle wrinkles by enhancing collagen production in one's skin, it is important to use a comprehensive approach outlined above, rather than a single active ingredients. (This doesn't have to be more time consuming though.) The difference in results may be a dramatic improvement versus slight, questionable change. Specific recommendations on Comprehensive Collagen Rebuilding are included in Skin Rejuvenation Infopack.

Beta-Hydroxy Acids
Just as alpha hydroxy acids, beta hydroxy acids are simple organic acids found in nature or synthesized in the laboratory. They are somewhat different from alpha hydroxy acids in structure and mode of action. Although beta hydroxy acids are now often portrayed as the latest skincare breakthrough, they have been around for quite a while. Salicylic acid, a common beta hydroxy acids, has been used for treating acne for decades. In fact, acne treatment remains the use of choice for beta hydroxy acids. There are no studies showing that beta hydroxy acids are superior or even equal to alpha hydroxy acids for skin exfoliation, reducing fine wrinkles, etc. For acne, however, beta hydroxy acids are clearly superior to alpha hydroxy acids. For persons without acne, adding beta hydroxy acids to alpha hydroxy acids regimen is a waste of money.

N-lite laser therapy, a new safer alternative to traditional laser resurfacing
Note: If you are insufficiently familiar with laser skin care, we recommend first reading the article on traditional laser resurfacing in Antiaging Treatments section of this site.
N-lite laser therapy is a new method recently approved by the FDA as effective for treatment of crow's feet. If this method is indeed effective for treating crow's feet, it is very likely to be effective for treating other areas of the face.
The unique feature of N-lite laser is that it uses yellow wavelength of visible light which easily penetrates the outermost skin layer (the epidermis) and is absorbed by deeper layers (the dermis) where it stumulates collagen production. As a result, there is usually no skin burn, no discoloration, minimal redness and no or little downtime for the patient. It is claimed that N-lite can reduce crow's feet by up to 50% within 3 month after the procedure. Further, N-lite laser therapy, though still expensive, costs between $1,000 - 2,000 for a full face treatement - significantly less that a typcial traditional laser.
Is there a downside to this "miracle" procedure? First, N-lite laser has been around for only a very short time, and it is too early to judge whether its effects are lasting and cosistent. Second, very few dermatologists and surgeons have enough experience with N-lite to ensure its optimal application. Thirdly, the results with N-lite, though impressive, seem to be less dramatic than with CO2 laser.
Bottom line
N-lite laser therapy appears to have an excellent cost/risk/benefit profile but is still in early stages of practical use. It would be prudent to wait until the benefits are better proven and there are more surgeons experienced in using N-lite. In the future, it may very well become a very popular skin rejuvenation option.

Microwaving skin sag off your face. Can you get burnt by Thermage?
It is a widely known fact of cosmetic life that effective methods of reversing facial sag are hard to come by. While sagging can be prevented or at least slowed down with proper care (such as topical DMAE, collagen synthesis activators, etc), once significant sag has occurred, the only consistently and markedly effective way to reverse it is a facelift. The problem is that facelift is costly, requires 2-4 weeks of downtime, and carries all the typical risks of surgery. In that context, it is not surprising that a new noninvasive method of skin tightening using a nonablative (nonstripping) radiofrequency device is generating both legitimate interest and excessive hype.
How it works
The method is based on the ability of radiowaves of certain frequency to penetrate and be absorbed by body tissues. The absorption of radiowaves causes tissue heating as well as some structural molecular changes. (An essentially similar effect is used in microwave ovens where high-frequency radiowaves heat and cook food.)
The skin is deep-treated with controlled doses of targeted radiowaves, while its surface layer (epidermis and upper dermis), is being cooled by a cryogenic spray to prevent open burns. The treatment produces localized heat injury of the dermis and subdermal layer as well as the collagen contraction leading to skin tightening. The subsequent healing of the microscopic dermal and subdermal lesions causes further skin tightening and also reduces the depth of wrinkles. Notably, since the skin surface is preserved, the downtime after the procedure is relatively short.
In theory, this approach makes good sense. First, most of the ideas behind it have been in practical use for years. Such well-established rejuvenation methods as laser skin resurfacing, dermabrasion and deep chemical peels, are partially based on skin remodeling following a controlled injury. Second, radiofrequency tissue tightening is being used with reasonable success in other areas of medicine. For instance, endoscopic radiofrequency devices are employed to tighten sphincters in the GI tract.
Studies
The first practical implemetation of radiofrequency skin tightening is a procedure called Thermage. It is performed with a patented radiofrequency device, ThermaCool, recently approved by the FDA. However, FDA approves medical devices based largely on safety (rather than both safety and effectiveness as for drugs). Therefore, we should not view the FDA approval of Thermage / ThermaCool as a guarantee that it does what it is purported to.
Unfortunately, relatively few clinical studies of Thermage have been performed so far. Most of them were sponsored by the manufacturer, which is not uncommon but does increase the potential for biased results. The studies were small or medium size and had only short-term follow-up. In one study, Drs Alster and Tanzi from Washington Institute of Dermatologic Laser Surgery at Georgetown University Medical Center treated 50 subjects with Thermage to improve cheek and neck laxity. The authors reported short-term effectiveness and relatively mild side effects:
"Significant improvement in cheek and neck skin laxity was observed in the majority of patients. Patient satisfaction scores paralleled the clinical improvements observed. Side effects were mild and limited to transient erythema (redness), edema (swelling), and rare dysesthesia (alteration of sensation). No scarring or pigmentary alteration was seen. ...
Although tightening continued to be evident 6 months after a single treatment, the longevity of clinical results has yet to be determined."
In a multicenter study, Dr Fitzpatrick et al investigated the effects of a single Thermage treatment in 86 subjects over the six months period. The results were analyzed using potentially inaccurate methods: photograph scoring and self-reports of the subjects. Fifty percent of the subjects reported being satisfied or very satisfied with wrinkle reduction in eye area. Photographic analysis showed that 61.5% of eyebrows were lifted by at least 0.5 mm. Typical side effects were redness and swelling, occurring in the minority of subjects; very rarely second degree burns (blisters) occurred. Three patients (4% of the subjects) had small areas of residual scarring at 6 months.
Based on these and other studies, it appears that only about 50-60% people experience clearly noticeable improvement with Thermage (at least with a single treatment). Even in responders the lifting effect is relatively modest: for example, brows are usually lifted by about 0.5-2 mm. This translates into a fresher, brighter look rather than dramatically younger appearance. However, since the healing response varies widely among people, there seems to be a minority, perhaps 10%, who experience substantial lifting and may look 10 years younger. On the other hand, up to a half of the people get no benefits at all.
Pros and cons
So, is Thermage worth having done? While there is no universal answer, here is a number of considerations to keep in mind.
Thermage is a midrange procedure -- between topical treatments on one end, and a facelift and ablative resurfacing on the other. Thermage reduces sag far less dramatically than a facelift and softens wrinkles less noticably than ablative laser. However, Thermage's risks, recovery time and side effect profile are significantly better.
Thermage costs about $1000-1500 for a single treatment and around $2000-$2,5000 for a set of two treatment, usually spaced 3-6 months apart. This is close to the cost of common laser treatments but about 5-10 times cheaper than a facelift.
Considering its relatively modest tightening effect, Thermage seems to best fit the people in their late thirties and forties who are only beginning to show facial sag.
Since Thermage is relatively new, many practitioners have limited experience. The lack of experience increases the risk of under- and overtreatment, leading to smaller improvements and greater side effects than reported in the clinical studies. If opting for Thermage, look for a practitioner who has been performing it on a daily or at least weekly basis for a minimum of 2 years, and has performed at least several dozen procedures.
The notion that Thermage requires no downtime is an exaggeration. While most people require a rather short downtime (from one to three days), some develop significant redness, swelling or even blisters and may need to stay out of public eye for a week or more. Also, the procedure itself may be rather painful. Some residual pain may linger for several days.
Many uncertainties remain. Do repeated Thermage treatments increase the positive and/or negative effects? Do benefits persist over the long term? Can radiofrequency injury, while tightening skin in the short term, reduce the skin's long-term viability and lead to faster aging down the road? How many people suffer long-term negative effects, such as worsening of skin texture, loss of subcutaneous fat, dryness, discoloration, or scarring? More studies are needed to address these questions. If history is any indicator, it will take another ten years or more before we know all that we need to know about this method.
In the meantime, the decisions to have Thermage will be based on limited knowledge, educated guesses and personal preferences. Search this site for user reviews of Thermage. You will find both positive and negative opinions. Keep in mind that user reviews are useful only as an adjunct to rigorous research and should never be the cornerstone of your decision to undergo a potentially harmful procedure.

Botox: Misunderstood Gem of Cosmetology.
Botox a.k.a. botulinum endotoxin A is arguably one of the more ingenious anti-wrinkle treatments on today's market. Success with Botox depends on whether it is appropriately used and correctly administered. When misused, Botox is at best a waste of money. When used properly, it can produce results as dramatic as laser resurfacing but with lower risk of side effects.
Botulinum A exotoxin, the active ingedient in Botox, is a neurotoxin produced by the bacterium Clostridium botulinum. This substance acts by causing a reversible paralysis of muscles. Large doses of botulinum toxin circulating in the bloodstream (like those occasionally seen in cases of botulism) are extremely dangerous and may cause death. On the other hand, small doses administered locally via a targeted injection are generally safe and have been used by ophthalmologists for many years to treat a condition known as "lazy eye." In the 90s, botulinum A exotoxin (marketed as Botox) has become a part of a cosmetic practitioner's arsenal.
In cosmetology, Botox is good for one thing only, the treatment of hyperkinetic wrinkles a.k.a. motion wrinkles. Motion wrinkles are the ones resulting from facial movements (e.g. frown lines, smile lines and crow뭩 feet). Botox does not reduce fine lines, sun damage or skin roughness, nor does it help with acne scars, uneven pigmentation or age spots. On the other hand, it often dramatically improves motion wrinkles. Sometimes Botox-treated motion wrinkles become virtually unnoticeable. In cases when wrinkle reduction by Botox alone is insufficient, additional injections of fat, collagen or other fillers under the wrinkle may be performed.
The rationale behind Botox treatments is the following. Motion wrinkles result from the contraction of facial muscles. If the cause is eliminated, i.e. the facial muscles responsible for the wrinkles stop contracting, the skin gradually reshapes itself making the wrinkles less noticeable. If motion wrinkles were shallow to begin with, they might virtually disappear. Botox helps eliminate wrinkle-causing contrations of facial muscles by producing reversible local paralysis.
Botox injections are a simple outpatient procedure. Basically, the physician injects small amounts of Botox under the skin in the affected area. As the muscles relax, the wrinkles improve over the next few weeks. The effectiveness depends on the skill of the physician, accurate dosage, individual variation and other factors. Typically, the effect lasts for 3 to 6 month, after which the treated muscles regain mobility and the wrinkles begin to "grow back." Hence, most patients undergo additional treatments. One treatment generally costs from $300 to $600. One study has reported that injecting Botox deep inside a facial muscle rather than under the skin increases the duration of the effect up to 10 months.
Generally, a patient receives multiple injections during one procedure. Depending on the technique, wrinkle severity and the muscle involved, doses per injection vary from 5 to 50 IU of Botox. Correct dose choice depends mainly on the physician's experience. Some unscrupulous practitioners use lower than optimal doses so that the effects aren뭪 as lasting as they can be. As a result, patients need to repeat the procedure more frequently (at $300-$600 a pop).
Compared to invasive cosmetic procedures like face lift, dermabrasion, laser or deep peels, Botox has a favorable safety profile. Side-effects are uncommon and generally benign. Temporary bruising infrequently occurs at the injection site. Droopy eyebrows or eyelids occur in about 1% of patients. The problem usually resolves by itself within a few weeks.
There is a theoretical possibility that facial inactivity caused by Botox may contribute to facial sag. It is claimed, although not proven, that facial exercises reduce facial sag by plumping up facial muscles. The opposite might also be true -- facial inactivity might thin out facial muscles and increase the sag. So far, however, there is no scientific evidence showing that Botox contributes to facial sag. Perhaps the muscles responsible for motion wrinkles are different from the ones associated with facial sag.
Bottom line
When used properly, Botox has one of the best risk-to-benefit profiles among today's cosmetic procedures. However, it addresses only one aspect of facial rejuvenation -- motion wrinkles. It is often used to in combination with other procedues, such as face lift or laser resurfacing. Botox dramatically reduces motion wrinkles in most cases but the results are temporary. For the effect to last, Botox injections need to be repeated every 3 to 6 month although some patients do well with less frequent treatments.

Microdermabrasion. Do you get what you pay for?
Microdermabrasion is a process of 'scraping' the skin using a controlled flow of microcrystals. In essence, it is a moderate peel performed using a stream of fine crystals.
It is important to distinguish between dermabrasion and microdermabrasion. Dermabrasion is a much more invasive procedure performed using special 'sanding' devices. Dermabrasion causes as much or more damage to the skin as laser resurfacing or deep chemical peels. The skin recovery after dermabrasion takes several weeks or more. Dermabrasion has been used in cosmetic surgery for decades. However, its use has been declining since the advent of laser resurfacing.
Microdermabrasion, on the other hand, is a relatively new, mildly invasive procedure. It causes virtually no downtime and the patients can usually return to their regular activities the same day. In fact, some call microdermabrasion a lunchtime peel. Convenience and minimal recovery period account for much of the popularity of microdermabrasion. Some people are also enticed by seemingly low cost of a microdermabrasion treatment (usually in the range of $150-$300 per session).
Is there a catch? Unfortunately, there is. First, the effect of microdermabrasion is generally small. Many people see no effect whatsoever. Others see a small effect, and only a small percentage of people report substantial benefits. Actually, this is understandable: a mild mechanical treatment like microdermabrasion is unlikely to cause significant skin restructuring required for a noticeable reduction in wrinkles. Repeated treatments may provide cumulative improvement in some cases, but just as often (or even more often) produce little or no benefit. (And the cost is cumulative whether you get cumulative benefits or not). On top of that, adequate clinical research documenting the benefits of microdermabrasion is lacking.
Bottom line
The benefits of microdermabrasion are not well proven and appear to be -- on average -- rather small. (Occasional exceptions happen though.) Most people would probably do as well or better using Retin A / Renova or other topical treatments. The cost of multiple microdermabrasion treatments allegedly required for optimum results is comparable to that of laser skin resurfacing. The latter may be somewhat more risky but is also significantly more effective.

Do-it-yourself microdermabrasion.
Unless you are well familiar with the method of microdermabrasion, we suggest that you first read the article about it in the Antiaging Treatments section of this site.
Basically, microdermabrasion is a process of 'scraping' the skin using microcrystals, typically aluminum oxide. This treatment produces exfoliation sometimes sufficient to improve the appearance of fine lines and minor scars. The effectiveness of microdermabrasion as wrinkle treatment is rather limited and some people see no effect whatsoever. Nonetheless, microdermabrasion is often viewed as a worthwhile alternative to chemical peels. The problem is that it usually takes several microdermabrasion treatments too see any results, each costing from $150 to $300. It really adds up over time.
Now it is possible to perform microdermabrasion at home. We are aware of at least two commercial do-it-yourself microdermabrasion system, but more are likely to exist. One is Dermanew Microdermabrasion System (by Dean Rhoades Beauty Systems, http://www.dermanew.com/), which sells for under $150 and can be used for multiple treatments. Using this system allegedly "requires no special skills or training and is actually as easy as counting." It is unclear whether Dermanew system produces the same results as standard microdermabrasion tools used by dermatologists.
Another DIY device is Dermapower Microdermabrasion System (by Exalt, Inc, http://www.dermapower.com/), which sells for around $200. The manufacturer claims that Dermapower is "designed to emulate the exact treatment preformed in the offices of leading cosmetic surgeons around the world."
NOTE: SmartSkinCare.com is in no way associated with the manufactrers or distributors of these systems, nor do we specifically endorse them. If you decide to give either of them a try, please let us know about the results.

The promise, dangers and reality of laser resurfacing
Laser resurfacing is a process where the upper layers of aged or damaged skin are vaporized by applying a controlled laser beam. The resulting healing and restructuring of the skin is believed to reduce the appearance of wrinkles.
Over the last two decades laser resurfacing (a.k.a. laser peel) has become one of the most popular procedures in cosmetic surgery. Claims of the benefits of laser resurfacing, depending on the source, range from remarkable to minimal. The dangers of laser skin resurfacing -- again, depending the source, -- range from relatively minor and infrequent to rather significant. The situation is very confusing to a person trying to decide whether to go ahead with laser resurfacing and, if yes, how to best proceed.
This article attempts to introduce some clarity into this complex situation by looking at possible benefits, risks, techniques and current research on laser resurfacing.
Benefits
Most research studies agree that properly performed laser resurfacing can visibly reduce the appearance of fine lines and, in some cases, deeper wrinkles. It is used either on the entire face, or, more commonly, in the areas around the eyes and mouth. Some surgeons combine laser resurfacing with a face lift or other procedures to produce maximal effect. The advantages of laser over other resurfacing methods (deeps chemical peels and dermabrasion) include greater precision, less bleeding and discomfort and, possibly, shorter recovery time.
The results of laser resurfacing are particularly noticeable after the initial healing and for about a year thereafter. According to different sources, the results generally last from one to five years. (The results of lower eyelid resurfacing tend to be less lasting - one to two years). Maintenance treatment with topical agents may prolong beneficial effects of laser resurfacing on the skin appearance. Generally, the wrinkles solely due to skin aging respond better than those due to facial movement, such as smiling, frowning or squinting. Even if successfully removed, movement wrinkles tend to recur relatively quickly.
It appears that the results of laser resurfacing vary greately, depending on the technique, skill of the surgeon and patients unique physiology. Some people experience results exceeding their expectations, while others see little benefit, or even have negative reactions.
Risk
Whether you call it a laser peel or resurfacing, it is still an invasive surgical procedure where top layers of your skin are vaporized by a laser-generated energy burst. In most cases the damage is well controlled and the recovery is smooth. Possible adverse reactions include excessive scarring, infection, loss of normal skin pigmentation, skin redness and dryness, and others. When the procedure is performed skillfully and the patient and technique are properly selected, side effects are relatively infrequent. If you opt to undergo a laser peel, it is critical to find a board-certified physician with extensive hands-on experience in this procedure.
Keep in mind that due to variations in individual physiology, adverse reactions can occur even if you are treated by a highly skilled professional. In particular, people with darker skin are more likely to develop uneven pigmentation whereas people who were on accutaine (a common acne treatment) or those with certain connective tissue disorders are more prone to scarring. Various inflammatory skin conditions also increase the risk of adverse reactions. Also, laser peels can activate herpes virus and possibly other dormant pathogens. In most cases, a patient is given an oral antiviral drug and sometimes antibiotics before and after the procedure.
It may be prudent to perform a test patch (a small test treatment), particularly in people with darker skin pigmentation to assess the risk of skin discoloration and other side effects.
Laser techniques
There is a considerable variety in the equipment and treatment techniques userd for laser resurfacing. The two most common lasers for wrinkle removal are carbon dioxide and erbium:YAG lasers. Carbon dioxide laser appears to be somewhat more effective for treating deep wrinkles but has longer recovery time and tends to cause greater adverse reactions. Some surgeons use both carbon dioxide and erbium:YAG lasers in the same procedure: erbium laser for fine lines and small wrinkles and carbon dioxide laser for deeper wrinkles. Such an approach may provide the best risk-to-benefit ratio.
Another important technical aspect is the number of passes the surgeon makes when treateing skin with a laser. Multiple passes, particularly with carbon dioxide laser, produce greater thermal injury and lead to greater side-effects and longer recovery. Some surgeons assume that more passes results in a greater wrinkle reduction. However, research indicates that the benefit from additional passes may be small whereas additional risk is substantial. Some surgeons use a combination protocal where problem areas (around eyes, mouth and on the foreehad) are first treated with one pass of carbon dioxide laser and then with one or more passes of less injurious erbium laser. The rest of the face may be treated with one pass of erbium laser.
Limitations
No mater what equipment or techniques is used, laser resurfacing rarely removes or markedly reduces deep wrinkles. Most surgeons agree that facelift remains the procedure of choice for the removal of particularly deep wrinkles. On the other hand, botox (botulinum toxin) injections are often surprisingly effective as a short-term treatment for facial movement-related deep wrinkles.

[미나리]

이글은 중요한것같아서 자원자 한분 찾습니다.해석해서 정리해서 올려주세요.내일까지 자원안하시면 시킵니다.어차피 교과서든 무엇이든 한번은 발표를 해야하는데 그분은 다음에 발표에서 빼드립니다 ㅎㅎㅎ본인의 실력을 위한것이니 결국은 본인을 위한것입니다.누가 하실래요???

[lure]

정말 좋은 내용인듯하군요....빨리 자원자가 나와야 할텐데....에스테틱 선생님들 잘 하세요.

[이스크라]

상당히 많네요..ㅎㅎ

[녹차]

제가 자원할께요. 시원스럽지요?ㅎㅎ

[태평세월]

저도 하고있는데.. ㅎㅎ

[미나리]

녹차님은 active retinol 이후부터 정리해주시고 김성한샘은 앞부분을 정리해주세요.물론 읽는것은 다 하시구요.

[녹차]

이럴수가... active retinol 이전까지 거의 끝났는데 이를 어찌하나요...

[미나리]

녹차님 대단하시네요 벌써 절반을 햇다구요??? 다 자신을 위한 공부이니 좋은것 아닌가요???

[태평세월]

아이구 감사합니다. 열심히 읽고 정리하는데 정말 좋은 자료같습니다. 이런 기회를 주셔서 감사하니다. 정리하는것도 참 힘드네요... ㅎㅎㅎ

[녹차]

그렇지요. 다 피가되고 살이 되지요. 힘내서 나머지 부분도 열심히 정리하고 있습니다아아...!

[희망]

고대하겠습니다. I hate English.. ^^ 미리 감사드립니다,녹차님 태평세월님..

[미나리]

희망님...영어를 미워할수록 더 정복하고 싶지않으세요??? ㅎㅎㅎ