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The Grades of Aging

By: Sam Dhatt, MD
Posted: June 29, 2009, from the July 2009 issue of Skin Inc. magazine.
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Home care. Home care is the same as it is with Grade 0, but clients should use an antioxidant cleanser at night and a scrub one to two times weekly. The nighttime eye treatment should be upgraded to one containing anti-aging antioxidants and moisturizers.

Grade 2

Fine lines around the eyes, possibly in expression areas and on forehead; slight deepening of the nasolabial folds; minor loss of firmness and tone. Treatments must include repair to some degree, with more exfoliation stimulation and higher levels of moisturizers and maintenance.

Professional care. Professional care should be a step up from Grades 0 and 1, with the first treatment being an enzyme facial to remove dead cells and allow the penetration of home care products. After the first treatment and two to four weeks on a proper home care program, this client will have a three- to six-treatment series twice a year of light acid resurfacers (20–30% lactic acid at 3.0 pH). Antioxidant-rich and moisture-rich maintenance facials should be offered between the series with an occasional light microdermabrasion to help increase cell turnover.

Home care. Home care should also be stepped up with the client using an antioxidant-laden cleanser in the morning and evening, as well as an exfoliating cleanser every two to three nights, such as a 15% glycolic or lactic cleanser, or home care lotion. The moisturizer must be high in hyaluronic acid and should also include antioxidants. Eye area home care should be moisturizing, and rich in antioxidants and dermal-building peptides. Preventive products with ingredients such as copper will help stave off aging.

Grade 3

Fine lines are fully developed; a hint of actual wrinkles in expression areas; definite deepening of nasolabial folds; hyperkeratotic areas possible; some loss of firmness and elasticity on the neck, lower face, eye area and forehead. This client needs repair right from the start, as well as regular exfoliation. Home care should be a step up in percentages and assertiveness. The client must be observed closely to determine the need for higher-grade treatments and home care because this grade defines whether a little or a lot of later aging will occur. It must be addressed now and reversed, if possible.