By around 2006, because of both the science and what I was personally witnessing with Neda’s skin, I began integrating active topical anti-aging ingredients into my surgical practice aggressively.
From 2006 to 2016, every surgical patient underwent detailed skin analysis and planning. We organized patients onto comprehensive routines involving retinoids, antioxidants, vitamin C, pigment reducers, ceramides, moisturizers, cleansers, and multiple supporting products.
But there was one major problem.
Not everyone was Neda.
Most patients could not sustain complicated 8-to-10-step routines consistently. The regimens were too harsh, too expensive, too confusing, or simply too difficult to maintain long term.
Even highly motivated patients struggled.
And honestly, so did I.
The irony was that although I fully understood the biology, I personally could not consistently commit to these complicated routines either. If a routine was not fully comprehensive, I did not see the point. But fully comprehensive routines were simply too cumbersome for real life.
That frustration became one of the turning points in my career, because I knew something very important:
True skin rejuvenation is not episodic. It is behavioral.
Skin is constantly aging beginning in our mid-20s:
- collagen decreasess
- pigment production increases
- cell turnover slows
- skin becomes thinner
- duller
- rougher
- more discolored
The only meaningful way to influence that process is through consistent daily biologic signaling using active topical anti-aging ingredients.
And that consistency only works if people can realistically sustain it.
8 comments
Bo Palinic
This was such an informative article! I always learn so much about skin science from your articles and videos. Thanks, Dr. Karam!
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KaramMD Skin replied:
Hi Bo—Thank you for your comment! We’re so happy you enjoy Dr. Karam’s content. Thank you for being part of the community and following along!
Ruth Asper
What a great article – a testament to your care and knowledge and it seems that Neda’s a beautiful and thoughtful woman with super powers- who I can relate to. Thanks for sharing your story.
So glad KaramMD is in the world to advance woman’s health and aging!
Ruth Asper
What a great article – a testament to your care and knowledge and it seems that Neda’s a beautiful and thoughtful woman with super powers- who I can relate to. Thanks for sharing your story.
So glad KaramMD is in the world to advance woman’s health and aging!
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KaramMD Skin replied:
Hi Ruth— Thank you so much for your kind words. We’re so glad you enjoy Dr. Karam’s writings. Neda is indeed a force and we’re glad you can relate!
NATASHA FOX
I love all your messages and I’m going to contact you privately I’m 76 healthy and want surgery only with you . I’ve just ordered your products can’t wait to try them . Live in London but you’re the only one I trust because you’re so open and honest.
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KaramMD Skin replied:
Hi Natasha—Thank you for your comment. We’re so glad you’re enjoying the knowledge Dr. Karam shares. To get in touch about surgery, you can reach out to his practice here https://www.drkaram.com/contact/.
Monica Munoz
Im a 53 years old woman and I want to express my gratitude for sharing your wife’s journey. I understand that I will never be able to afford having surgery with you but I truly appreciate your efforts in educating us about aging.
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KaramMD Skin replied:
Hi Monica—Thank you for your comment and for reading the journal. We’re glad you enjoyed learning about Neda’s story. Even if surgery isn’t an option for you, there’s a lot you can do with your lifestyle and skincare routine to take care of yourself and feel your best and we hope Neda’s approach can inspire you to find a routine that works for you.
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