I am a 73-year-old woman. I would like to find out if all the fantastic claims in advertisements for facial creams and serums really can make mature skin look younger by removing wrinkles. Also, what is the professional opinion of dermatologists about using products that contain Retin-A or retinol? – E.T., Netanya.Veteran Jerusalem dermatologist Dr. Julian Schamroth replies:
Aging of the skin – which manifests itself as wrinkles, pigmentation, loss of elasticity and thinning of the skin – is due to many factors, including genetics, many years of sun exposure, the effects of gravity, and smoking.
Although there is often some overlap, cosmetic products generally fall into one of five distinct groups: cleansers, makeup, moisturizers, protection and "antiaging."
Here I will deal only with the last category – that of anti-aging products, which is probably the most lucrative area for cosmetic companies.
The cosmetics houses all produce sunblocking creams, which obviously play an important part in reducing skin damage.
However, over the last two decades, many of them have been making claims about the efficacy of new "anti-aging" chemicals. I can't deal with all these chemicals here, but some principles need to be stressed.
The skin is a very effective barrier and will not let large molecules pass through it. For example, many "anti-aging" creams contain substances such as collagen, elastin or hyaluronic acid. These chemicals do not penetrate the skin and clearly have no biological effect on the skin. These creams do nothing! Many dermatologists and plastic surgeons do use such chemicals, but they need to be injected into the skin for them to have any effect.
Another compound widely found in cosmetic products is the alpha-hydroxy acids. These chemicals are also unable to penetrate the skin, but act by peeling off the most superficial layers of skin, thereby causing a "fresher" look. They are of some benefit, but they are not true "antiaging" compounds.
Finally, there are some "anti-aging" chemicals that do actually penetrate the skin when applied in cream form. Retinol and tretinoin (the commercial name is Retin-A) are both derivatives of vitamin A, and – because of their similar sounding names – often lead to confusion. Retinol is basically vitamin A and is found in many cosmetic creams. It has some antioxidant properties, but very few antiaging properties, if any.
On the other hand, tretinoin is a potent agent that is available only by prescription and is primarily used to treat acne.
But it has been found that long-term use of tretinoin actually repairs degenerating elastic fibers in the skin and thus reverses the aging process. In addition, tretinoin tends to remove mild pigmentation, mild wrinkles and small superficial blood vessels.
The bottom line is that consumers should be aware of the wild and ridiculous claims (not to mention the outrageous prices) that many manufacturers use in marketing their "anti-aging" products.
Consumers would be better off simply applying a sunscreen and a moisturizer, if necessary. They should also discuss the long-term use of tretinoin with their dermatologists.
I am a longtime Israeli midwife. A US colleague told me something that shocked me – that in her country, there is a growing trend among women to eat their placentas after giving birth. I looked it up on the Internet and found that the general press, such as The Washington Post, has written about the phenomenon. It is called "placental encapsulation" and thought to be good for women's health, based on the fact that animals do it. Aside from the kashrut aspect, is there anything to this practice, which sounds quite disgusting?
– C.L., Jerusalem
Wendy Blumfield, veteran childbirth educator, lactation counselor and president of the Israel Childbirth Education Center, replies:
The eating of the placenta is called placentophagy. I have often heard of "placenta parties" given under the supervision of midwives at "alternative birth centers" in the US. We can learn a lot from animals. Cats, for example clean up the placenta, umbilical cord and every drop of blood while licking their kittens and stimulating their breathing and sucking reflexes. Anyone who lives with cats can observe that they don't suffer from postnatal depression unless they are separated from their kittens or a human interferes with the birthing process. The only cat I knew that did suffer from postnatal depression had a cesarean and did not have the opportunity to eat her placenta or enjoy the experience of the first physical contact with the kittens.
But we have to remember that animals live in a very different environment from humans and that their immune system works differently. One of the reasons for their scrupulous clearing up after birth, including eating the placenta, is to hide the remnants of birth from predators.
Until controlled studies are done on human mothers, at home births, birth centers and hospital labor wards, we cannot rule out the possible hazards or disadvantages such as infection or effect on the woman's digestive system.
In addition, although I often work with Orthodox women and couples, I have not been able to establish whether in fact the placenta is kosher.
Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or email it to jsiegel@jpost.com, giving your initials, age and place of residence.
