What To Do In-Between Botox Appointments, According to a Board-Certified Dermatologist

Dr. Shari Marchbein

As a 42-year-old dermatologist and mother of six-year-old twin boys, I am keenly aware of the aging process and the fact that the days of simply washing my face and applying sunscreen are long gone.

We know that after age 25, our bodies start producing less collagen at a rate of about 1% less per year in the skin. By the time we’re 50, there is almost no new collagen being made, and the collagen that remains becomes broken down, fragmented, and weaker. This loss of collagen and elastin shows up on the skin as wrinkles, fine lines, and skin laxity.

It’s therefore really important to use high quality skin care products on a consistent basis. For me, the trifecta of an "anti-aging" routine that everyone should be on in some form is: a broad spectrum SPF 30+ every morning (ideally something tinted to protect from visible blue light as well as UV rays), as well as an antioxidant vitamin C serum to help even skin pigmentation and fight free radical damage. At night, opt for a retinoid — ideally prescription — which helps to build collagen, can minimize pores, and even tone and pigment. Peptides are also key to boosting production of collagen and elastin.

If you are open to more invasive treatments, dermatologists can inject neuromodulators, like botulinum toxin, also known as Botox, to relax particular facial muscles. This helps to soften existing wrinkles and stop the development of deeper, etched lines on the forehead, between the brows, and around the eyes, which can result in crows feet.

We also use it to sculpt the jawline and lift the neck — by injecting the thick muscular neck/platysma bands — as well as to reduce the appearance of a widened jawline and prominent masseter/chewing muscles.

This is by far the most popular cosmetic procedure I perform in my office. Treatments, such as botulinum toxin, fillers, and lasers help round out a balanced routine for aging skin and need to be maintained a few times a year. And they are best used when coupled with a great skincare routine.

Here's everything I suggest you do in-between your Botox appointments to keep your skin looking its best.

Wear Sunscreen Every Single Day

It is important to continue to wear sunscreen every day, even when indoors. UV light is the ultimate ager, and longer UVA rays (the rays that cause wrinkles, sunspots, and skin cancer) can travel through windows. So unless you have zero windows in your home, you are still susceptible to UV damage. It's also important to re-apply. During the day, you can use a mineral powder SPF over your makeup to make things easier.

In addition to UV light, blue light is also a real concern as we are staring at our computer and phone screens much more as we work from home. I recommend tinted sunscreens with iron oxide, as well as antioxidants in the morning to help protect the skin from these HEV blue light rays that we know can contribute to hyperpigmentation of the skin and may also cause collagen breakdown and contribute to wrinkles, although the evidence is less clear.

And Don't Forget About Retinoids

Whether you use an over-the-counter formula or prescription strength, retinoids are an essential part of any skin care routine, especially for those interested in anti-aging benefits. They work by increasing collagen production as well as increasing the rate of skin cell turnover. They also improve the texture of skin and give it a glow, along with minimizing fine lines and wrinkles, evening out skin tone, and decreasing pore size.

I recommend using them at night.

Ideally, apply a small pea sized amount to the entire face 30 minutes after washing your face. Start off only using it three times a week (Monday, Wednesday, and Friday) as dryness and peeling can be expected for four to six weeks. The prescription strengths retinoids (i.e. tretinoin, retin a micro, Tazorac) will be stronger and more effective, but over the counter options, such as Differin 0.1% gel, Cerave Skin Renewing Day Cream, and Neutrogena Rapid Wrinkle Repair are especially good for beginners or those with sensitive skin, since they are a lower strength than prescription versions.

Skinbetter Alpharet is one of my favorite cosmeceutical grade retinoids and contains so many antioxidant and anti-aging ingredients including retinol, glycolic acid, niacinamide, ubiquinone, squalane, ceramides, and hyaluronic acid.

VIDEO: Dermatologists Use This Anti-Aging Eye Cream in Their Own Routines

Add in Peptides

Peptides can help boost production of collagen and elastin, which improves the appearance of fine lines and wrinkles. My favorite is the No7 Laboratories Line Correcting Booster Serum. The key ingredient in this product is a proprietary blend of peptides, called Matrixyl 3000 Plus, which boosts skin's production of elastic fibrillin and is used specifically to soften the appearance of individual deeper lines.

Additionally, Skinbetter Interfuse Eye Cream has a combo of peptides, antioxidants, glycerin, niacinamide, and caffeine for the delicate eyelid skin to hydrate and reduce the appearance of fine lines, wrinkles as well as dark circles. Alastin Restorative Skin Complex with Trihex peptide technology is great for the whole face.

Use an Antioxidant Serum

An effective and high-quality antioxidant serum is a key morning step in every daily skincare routine. Vitamin C is a powerful antioxidant that helps protect from and repair free radical damage, can reduce the appearance of brown spots, and even out skin tone and hyperpigmentation.

Serums containing this ingredient protect the skin from oxidative free radical damage and therefore work best in the morning. Vitamin C also plays a critical role in the formation of collagen. Skinceuticals Phloretin, Skinbetter Alto Defense and ISDIN Flavo C ampules are some of my favorite medical-grade antioxidant vitamin C serums.

Ole Henriksen Truth Serum, Olay Tone Perfection Serum with vitamin C and B3, and L’Oreal Revitalift Vitamin C Serum are over the counter options to try for those who don’t want to make the immediate splurge. But keep in mind that these cosmeceuticals are not FDA regulated and I have no studies comparing the efficacy and clinical benefit of the over the counter options.

Stay in Touch with Your Dermatologist

As restrictions in certain states are lifted, elective procedures are being permitted with the proper guidelines and precautions. Check in with your dermatologist to see if they might have re-opening plans in the works, so you can try to get back on their calendar in the coming months.

At the very least, you might be able to set up a virtual consultation for them to answer any of your other immediate skincare questions.