Last Reviewed on March 22, 2021 by Alice Pien, MD & Asher Milgrom, PhD
DMAE… Skin Tightening Cream?
For all those who are looking for a “quick fix” for skin tightening, DMAE sounds like a dream come true. It is marketed under the clever moniker “facelift-in-a-jar”, which conjures up images of a 50 plus year old woman (or man) looking in the mirror, opening a jar of cream that she slathers on her face and viola!… a 35 year old face is looking back at her from the mirror.
What can I say…. Sign me up for a lifetime supply of that stuff… and put me on auto-ship!
Though the reality is far from anything resembling a real non-surgical face lift or even a “mini face lift”, let alone what I just described, DMAE does have some positive effects of tightening skin.
Before we get into the details, let’s start with some background about aging skin, wrinkles and sagging.
The Effects of Aging on the Skin
As skin ages, a number of different visual characteristics negatively affect its appearance. Wrinkles, sagging, pigmented discoloration (sun spots etc.), vascular discoloration (broken capillaries etc.) and changes in the contour of your face. Wrinkles and to a lesser degree sagging and loose skin are affected by DMAE, but none of the others are.
The good news is that for all of these conditions that DMAE does not help, there is hope!
After administering over 85,000 skin care treatments over the past 20 years, rest assured that treating these conditions is a well-developed science, and excellent results are almost assured for every patient. (The only exception are cases of unstable Melasma which can be extremely difficult to resolve – See my article on “What is Melasma”)
The best news about all the above conditions, is that the most effective treatments are also natural (including lasers), and work through your own physiology.
Simply stated, your skin has tremendous regenerative capacity, and if properly stimulated, your skin can return to a younger physiological and functional state, and actually repair and rebuild itself from the “inside out” as it did when you were younger.
I will discuss pigmented issues in another article.
Broken capillaries, spider veins, cherry angioma and rosacea, are all associated with aging, and are all caused by issues with the arteries and veins that nourish the skin. These vascular conditions will be discussed in another article.
Once again, rest assured that fabulous results are virtually a sure thing for almost every patient afflicted with these lesions.
Changes in Facial Contour
Changes in the contour of a person’s face are associated with aging, but are primarily not a skin issue. Let me explain…
The skin is comprised of two primary layers, the thin epidermis on top and the thicker dermis underneath. Under those two layers of skin is the subcutaneous fat, or the layer of “fat under the skin”. For most people this layer of fat is actually thicker that the skin itself and has a significant effect on the contours of a persons’ face. As most people approach 50 years old and beyond, they typically lose some of the fat from under the skin (Subcutaneous fat). Even if their skin is in perfect shape, the loss of fat changes the contours of their face to look “thinner”, “bonier”, and gaunt.
Treatment for Loss of Facial Contour
The aesthetic effects of this condition can be very effectively treated with dermal fillers and will be discussed in another article.
More recently, new procedures that utilize the patient’s own Platelets and Stem Cells have been developed, which are then administered with injections and /or Collagen Induction Therapy (CIT). The results can be stunning, and are completely natural and long lasting.
Wrinkles and Sagging
Wrinkles and sagging are definitely associated with aging, but sagging, especially “jowls” on the jaw line is a much more significant indicator of aging than wrinkles.
Younger people with wrinkles are not uncommon, especially for people who experience prolonged overexposure to the sun, such as life guards, surfers and golfers, especially those who refuse to use sun protection.
However, sagging is typically found only with aging even if wrinkling and sun damage is not present. Of course, sagging is typically exacerbated beyond the effects of a person’s age by the presence of sun damage and wrinkles.
Treatment for Wrinkles and Sagging
Don’t fret! Superficial fine lines and wrinkles can be fixed.
Regarding fine lines and superficial wrinkles, there are some topical skin tightening creams that have been proven to provide various degrees of improvement. These include Retin-A, Glycolic Acid, Hydroxy Acid and Alpha Lipoic Acid.
Regarding skin tightening of sagging loose skin, there are no topical skin tightening creams or formulations proven to improve sagging other than DMAE. Before anyone gets their hopes raised to high, be advised that the effects of DMAE are incremental at best, and don’t even begin to approach the visual improvement that can be reliably achieved with a non-surgical facelift or laser skin tightening or of course, a surgical facelift procedure.
What is DMAE (dimethylaminoethanol)?
DMAE is an acronym for dimethylaminoethanol which is involved in the synthesis of phosphatidylcholine, which is a very important substance that is found in every single cell of our bodies. Therefore, a conversation about DMAE often becomes a conversation about phosphatidylcholine and its many roles in our physiology. Among its many roles are critical 3 biochemical pathways relevant to this article:
1. Synthesis of Acetylcholine
Phosphatidylcholine is important in the synthesis (creation) of the neurotransmitter acetylcholine. Acetylcholine is the primary neurotransmitter that energizes the parasympathetic nervous system, which is constantly in a state of dynamic balance with the sympathetic nervous system whose primary neurotransmitter is epinephrine.
Knowledge Nugget – Dynamic Balance
In general, human physiology is based on its ability to finely tune the balance between opposing forces of stimulation verses suppression. Every system in the body has neurological and endocrine (hormone) input that stimulates that system and a different neurological and endocrine input that suppresses that system. For example, our digestive function is stimulated by the parasympathetic system and suppressed by the sympathetic system, where as our emergency “fight or flight” function is stimulated by the sympathetic system and suppressed by the parasympathetic system. Notice how the two functions are perfectly coordinated: After all, we wouldn’t want to be using any energy in our digestive functions at the same time as we are need to be at full throttle using every ounce of energy we have to escape a pack of hungry hyenas that are chasing us.
DMAE and Memory Loss
Given one of DMAE’s benefits is its association with the synthesis of acetylcholine, it stands to reason that it may have applications in the world of neurological medicines. As a matter of fact it does, as DMAE benefits have been shown to have a positive impact on age related problems of memory loss and reduced cognitive abilities, which earned DMAE the reputation of being a “smart drug”.
Knowledge Nugget – DMAE
To go even further than the therapeutic use of DMAE, many doctors use phosphatidylcholine as a treatment for many neurological conditions such as: memory loss, Alzheimer’s disease, anxiety, manic depressive disorders and others.
2. Breakdown Stored Fat
Phosphatidylcholine has been shown to cause the breakdown of stored fat, though the exact mechanism for how this happens is not known. Thus, as regarding skin, Phosphatidylcholine is mainly used for treating fat deposit lesions, such as fat bags under the eyes, or yellowish cholesterol deposits just under the surface of the skin called xanthelasmas, and bumps of accumulated fat under the skin called lipomas.
Not an Approved Treatment for Fat Burning
The use of phosphatidylcholine for “fat burning” treatments has not been adequately studied to the point of being an “approved” treatment. In some circles, it is considered controversial and in some jurisdictions it is not legal. If you are seeking such treatments be sure that the practitioner is very experienced in the use of phosphatidylcholine for the exact treatment you are seeking, and has data to back up his/her claims. Ultimately, clinical outcomes is what really counts…. Not theories.
3. Important Structural Component of Cells
Phosphatidylcholine, which is a critically important structural component of cell membranes, is a key building block of all tissues in our bodies, including skin.
DMAE – The Final Analysis
In the final analysis, it is probably this 3rd function of phosphatidylcholine, whose synthesis is supported by DMAE that contributes to skin tightening of loose skin.
The truth is however, that we do not understand exactly how DMAE benefits the firmness or tightening of skin. We do know that it can have a modest and incremental tightening of sagging skin. So once again I assert that clinical results are what really count in the final analysis… not theories or lack of theories.
We also know that since DMAE was introduced in the 1990’s, no reports of damage have surfaced, though some concern about its safety when used for a long time have been made.
Knowledge Nugget – About Lipofuscin and Aging Cells
Lipofuscin is a pigmented substance composed of accumulated metabolic waste that is found in aging cells. For some reason the cell is unable to dispose of the waste, which results in its accumulation within the cell. It is not clear why and how this happens, nor do we understand if it is a byproduct of a cell that is aging, or if it contributes to the aging of a cell. It is likely that both are true. We are also not clear on the effect that Lipofuscin has on the function of a cell, but it stands to reason that it would have a negative effect.
The cells that seem most susceptible to the accumulation of Lipofuscin are neurons, cardiac (heart) and skin cells of older people.
Interestingly, it has also been shown is some studies that DMAE reduces the accumulation of Lipofuscin deposits in cells.
About the Authors
Doctors Alice Pien, MD and Asher Milgrom, Phd are established pioneers in the fields of Regenerative Medicine and Skincare. Their expertise ranges from advanced laser systems to HCT/P – Stem Cell medicine. Their medical education and advanced certifications span from medical schools of NY State University, the University of Chicago, to Johns Hopkins, Harvard and UCLA. They approach medicine with the clinical expertise of over 85,000 successful treatments over the past 20 years and significant scientific research resulting in proprietary protocols that they customize for each individual patient.
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