Do I Look Older?

It might start with a line across the forehead that deepens into a wrinkle, or skin that suddenly appears dull looking. Whatever the signal, aging skin tends to hit women square in the face in their mid- to late 40s.

“Forty-six was a disaster,” recalled actress Linda Evans, now 56. “You look into the mirror one day and you see your mother.”

Other baby boomers may be experiencing such a rude awakening, but they also may be a lucky bunch. They are the first generation to have access to products that simply did not exist in their mothers’ time or were available only in doctors’ offices as recently as 10 years ago.

Pond’s Clean Solutions Combination Skin Moisturizer, Oil of Olay Daily Renewal Cream and some products sold in spas contain glycolic and beta-hydroxy acids that exfoliate and smooth the skin. Estee Lauder Diminish is one of many creams that contain Retinol, which reduces the appearance of fine lines.

Welcome to the world of “cosmeceuticals”--beauty aids that are hybrids of cosmetics and pharmaceuticals. These over-the-counter products contain ingredients approved by the Food and Drug Administration for sale without prescriptions. They are supposed to help protect the skin against the ravages of aging, sun exposure and smoking, and consumers in the millions are buying these products at department and drugstores.

“We’re at a time where things really work,” said Santa Monica dermatologist Karyn Grossman, who shares her office with a plastic and reconstructive surgeon, Steven Teitelbaum, and a staff of aestheticians trained to give facials.

“Most of the techniques for beauty 10 years ago were snake oil,” Teitelbaum said.

Consumers are spending a bundle on cosmeceuticals, which are far cheaper alternatives to a plastic surgeon or dermatologist. In 1998, Americans spent $548 million on over-the-counter anti-aging products, and industry analysts expect that to go as high as $835 million in 2003, according to the Freedonia Group, a Cleveland market research firm.

Freedonia expects cosmeceuticals, which it classifies as a range of products from whitening toothpaste to hair-growth Rogaine, to be a $34-billion wholesale business in the U.S. by 2003.

The breakthrough in using some pharmaceuticals in cosmetics started with Retin-A, first produced as a medical treatment for acne more than 25 years ago by drug giant Johnson & Johnson and is still available only by prescription. In the late ‘80s, some patients sought Retin-A from their doctors after having heard about its ability to reduce the appearance of wrinkles. By 1995, the FDA had approved Retin-A for anti-aging benefits. Today many nonprescription derivatives of it, including retinol, appear in some cosmeceuticals.

Then came improved moisturizers, from companies like Los Angeles-based Neutrogena Corp., with a simple skin-improvement solution. The new moisturizers do not settle into and clog pores.

Next came sunscreens with ingredients now called sun protection factors, or SPFs, to protect against harmful ultraviolet rays. At first, there was some resistance from consumers, even as late as the 1980s, said Dr. Yohini Appa, executive director of scientific affairs at Neutrogena.

Now sunscreen is included in almost every cosmetic product. Today, even lipsticks contain SPF 15.

Howard Murad, a Los Angeles dermatologist, helped popularize the use of relatively gentle, food-derived acids to remove dead skin cells and thus expose a layer of skin that retains moisture better and looks fresher. He was at the vanguard of experimenting with glycolic, lactic and other alpha- and beta-hydroxy acids in the last decade and has built a $60-million skin-care enterprise.

Today, many cosmetics companies, including Pond’s, Avon and Elizabeth Arden, are doing a lot of research in skin repair.

“I’m not saying that all companies are good. They are not. But some of them have made extraordinary contributions,” said Amy E. Newburger, a Scarsdale, N.Y., dermatologist who has just written “Looking Good at Any Age,” (Doubleday).

Cosmeceuticals may help for a time, but at some point the natural process of aging may not be held at bay with topical applications of cosmeceuticals.

Some significant skin changes, for example, are unavoidable because of genetically triggered biological changes within a person, Newburger explained.

Women, for example, undergo great hormonal changes during menopause, which begins usually in their mid- to late 40s and affects the skin. The results can be acne, increased rosacea, even increased blood-vessel dilations on the face.

Another big change is the decline in skin-cell growth, which results in dull-looking skin. The normal skin-cell renewal rate for a young person is four weeks.

But with all the interest in cosmeceuticals there are some caveats. These products are considered cosmetics, which are loosely regulated. The FDA, however, is concerned about liberal advertising claims, said Bill Martineau, a health care analyst for Freedonia.

While prescription drugs must go through a series of clinical tests before they can be approved by the FDA, cosmetics companies have to show only that they use safe ingredients, not that they specifically result in demonstrable changes in the skin.

At lot of these claims may not be printed, but even consumers as savvy as dermatologist Grossman hears outrageous claims. That means consumers are pretty much left on their own to assess highly subjective results.

“I think the only problem is that the consumer may be deluded into thinking that they’re getting more of a benefit than they are,” said Joshua Wieder, assistant clinical professor of dermatology at UCLA.

And for some like actress Evans, the solution to her rude awakening 10 years ago--before cosmeceuticals--was plastic surgery, a decision she regrets: “I looked better afterward, but I wish I had had another choice.”

Now she tries to prevent further aging with cosmeceuticals. She even has her own line--Rejuvinique, an at-home skin-care treatment that uses antioxidant creams to protect and a mask with electrical impulses to stimulate the skin.

Much of her aging could have been avoided if she had simply used sunscreen. Today, she lives happily in rainy Seattle.

Barbara Thomas can be reached at barbara.thomas@latimes.com.