Adam’s Journal
Do anti-aging creams actually work? Or are they just expensive placebos?
Dr. Scofield Prescribes
Yes, some anti-aging creams really do work. However, only a small number of ingredients show strong clinical evidence. And rather than being transformative, their effects are modest and gradual – or preventive.
When it comes to protecting your skin against wrinkles, pigmentation and loss of elasticity, there’s one clear winner. It’s quite inexpensive, and you probably already have it in your bathroom cabinet.
The miracle product? Sunscreen.
Chronic exposure to ultraviolet A (UVA) rays is the primary cause of premature skin aging, known technically as photoaging. Be sure to use a sunscreen that blocks both UVA and UVB, which causes sunburn and also contributes to photoaging. If you choose one labeled as “broad spectrum,” you’ll be covered. For everyday use, look for one with an SPF of at least 30.
So, that’s your quick primer on sunscreen. Unfortunately, it only works on the prevention side of the ledger. Once damage has happened, sunscreen can’t reverse it.
For products that claim to turn back the effects of photoaging, researchers performed a comprehensive analysis of 23 randomized controlled trials. The results, published last year in the journal Nature Scientific Reports, found evidence that two compounds rose above the crowd.
For reducing wrinkles, tretinoin and retinol showed significant effects. Similarly, the pair again led the pack for moderating hyperpigmentation (what many of us might call “age spots”).
Both tretinoin and retinol are retinoids, which means they’re derived from vitamin A. Retinol is available over the counter, while tretinoin – sold commercially as Retin-A, but also available as a generic – requires a prescription.
If I had to recommend one cream with the best evidence for improving wrinkles, I’d probably say prescription tretinoin. It has decades of randomized clinical trials showing it can reduce wrinkles, improve pigmentation, stimulate collagen production, smooth skin texture and partially reverse signs of sun damage.
While these effects are real, they’re slow – and modest. Most people don’t notice meaningful improvement for three to six months, and benefits can continue to accrue through a year of use.
Still, tretinoin isn’t for everyone. It often causes side effects to the skin: redness, peeling, burning, dryness and sun sensitivity are all common. And dermatologists report increasing incidence of these adverse reactions as people age.
Over-the-counter retinol is less potent than tretinoin. The upside is that it’s usually better tolerated, meaning fewer side effects.
There are a host of other options out there, but the evidence supporting them is thinner. Topical vitamin C has shown some modest benefits. The research supporting peptides remains limited, although some newer studies appear promising. For other products – collagen creams, botanical extracts, growth-factor creams, luxury formulations and more – high-quality clinical evidence lags behind the marketing.
Finally, it’s worth noting that moisturizers can improve the skin’s appearance by increasing hydration, plumping the skin’s outer layer and smoothing wrinkles. However, they don’t rebuild collagen or reverse sun damage. That means their effects are only temporary, so you need to keep using them to maintain their benefits.
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Dr. Hal Scofield is a physician-scientist at the Oklahoma Medical Research Foundation, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. Adam Cohen is OMRF’s senior vice president and general counsel and needs to wear more sunscreen. Send your health questions to contact@omrf.org.
