Surgery not the only way to keep your face looking young

Dear Doctor K: I’m 65, and my face is starting to look old. Can you recommend nonsurgical treatments to take a few years off my face?

Many nonsurgical treatments can give your face a more youthful appearance. I was really dubious about this, but I’ve learned I was wrong. And I didn’t learn this just from my dermatologist colleagues — I learned it from my patients:

Sun protection. Protecting your face from the sun is the single best way to keep it looking youthful. Use broad-spectrum sunscreen that protects against both UVA and UVB light, and wear a wide-brimmed hat when you’re outside. My dermatologist colleagues say to do this “whenever you’re outside, even for a minute.” What I recommend, and what I do myself, is to use sunscreen and a hat whenever I know I’ll be outside for more than 10 minutes a day. (I’ll bet I get mail from dermatologists telling me that’s too lenient.)

Creams and lotions. Botulinum toxin (“Botox”) injections partially immobilize facial muscles to smooth out expression lines on the forehead and between the brows. They are safe, but you should find a doctor who has considerable experience doing them.

Dermal fillers treat lines created by lost collagen and fat. Prime treatment locations are the pair of lines that extend from the nose to the corners of the mouth, and another pair that extends from the corners of the mouth to the chin.

Laser treatments can home in on liver spots. They’re also used for wholesale facial resurfacing. The uppermost skin layers are stripped away, and with them, wrinkles from sun damage and acne scars. Smoother layers of tissue replace the old, damaged layers.

(This column originally appeared in October 2013.)