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.
10 comments
Connie Reed
Good Morning Dr. Karam and Staff!! I am 77 years old and have always taken care of my body and my skin. I am healthy, but, like most, recognized I needed a skin care routine that was consistent. I would try every product that came along, hoping that the ads actually were true. Nothing can repair what age and product jumping can destroy. I followed Dr. Karam for a while, thinking a facelift was the way to go at 74. I wanted to see what the process was and the outcomes, so watched his videos. While following him, I learned about the skin care and thought that if he were a plastic surgeon of reknown, he surely wouldn’t be steering us wrong on the correct skin care.
I started using his products, for 4 years, stopping now and again when it seemed too expensive on a retiree income. Each time I stopped, I found that my skin was tight, shallow looking and not smooth anymore. Then I’d start using the products again.
Well I stopped the “on again, off again” routine and started using Dr. Karams products faithfully, and my skin is the winner! It feels wonderful, and when I look in the mirror, I feel I have a glow….I feel so good! Thank you Dr. Karam, it’s amazing what a faithful routine and good honest products can do for skin!!!
Barbara Boyer
I will be turning 80 this June , I was your patient around 2016 what do you suggest for a noninvasive pick me up ! Thanks
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KaramMD Skin replied:
Hi Barbara—Thank you for your comment! Happy early 80th birthday, and thank you for reaching out! For a noninvasive “pick me up,” Dr. Karam recommends focusing on healthy, radiant skin first. A consistent and effective skincare routine, red light therapy, and treatments that support collagen and skin quality can make a beautiful difference while still looking natural. Depending on your goals, options like gentle laser treatments may also be worth exploring.
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!
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