On a recent trip to Los Angeles, I ran into Ariel, a former neighbor of mine who had relocated to California.

"Dr. Perricone this is perfect timing! I am considering undergoing some serious cosmetic procedures, and would welcome your guidance," Ariel confided. Although only in her early 40’s, Ariel showed many signs of aging on her face and neck. "I want to start with a laser resurfacing to see if I can even out my skin tone and erase some of these fine lines in my eye area," she continued. "After that I want to try Botox for the forehead frown lines."

Ariel has the peaches-and-cream complexion prevalent in many blondes and redheads. However, whatever her beauty routine was—or wasn’t—her complexion was red and irritated. Her skin appeared dry and lacked radiance. I suspected that Ariel was on a very low-fat, low-protein diet. She was not only extremely thin; her face had lost the youthful contours that only a healthy layer of subcutaneous fat can provide. In addition, the skin on her chin and around her mouth was taking on a very wrinkled, crepe-like appearance.

"Ariel," I explained, "I have helped many of my patients diminish fine lines, uneven skin tone and many other problems usually associated with aging." I suggested to Ariel that before taking these more drastic measures, she give my three-tiered approach a try for one month.

One of the great joys of practicing dermatology is seeing immediate visible effects when the right treatment is applied to a particular condition. This has been a great motivator for me during the past two decades. In fact, it inspires me to spend many hours in the laboratory looking for that next miracle ingredient that can truly deliver effective results.

For far too long, the beauty and skin care industry has focused on the look and feel of a product, its packaging and its perfume, as opposed to genuine efficacy. Since I first introduced topical formulations containing highly active ingredients such as alpha lipoic acid and DMAE, retailers have had a hard time keeping their shelves stocked with these products. A new generation of women and men are controlling the marketplace—a generation that not only wants, but demands products that work overtime to keep them as young-looking and as vital as possible.

In addition, there is an alarming trend to start serious (and very costly) surgical procedures at a younger and younger age. New fillers designed to plump up facial lines are being rushed to market. And the choice to inject Botox—a neurotoxin (nerve poison) that paralyzes muscles to smooth out wrinkles and expression lines—is rampant. These products offer the quick fix, but what is the long-term safety profile? We won’t have these answers for years to come.